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  1. Exploration of nursing doctoral admissions and performance outcomes.

    PubMed

    Megginson, Lucy

    2011-09-01

    This research aims to identify current admission criteria and academic performance outcomes in nursing PhD programs. A descriptive exploratory design was used to survey all American Association of Colleges of Nursing PhD programs (N = 110) via a Web-mediated standardized survey; the response rate was 51% (n = 56). Conclusions indicate six diverse yet complementary admission criteria: graduate grade point average (GPA), Graduate Record Examinations ® scores, writing samples, letters of recommendation, interviews, and research match with faculty. Findings also indicated that admission criteria largely lack predictive validity testing in regard to academic performance outcomes and are deficient in internal reliability. Academic performance outcomes included comprehensive examination, ongoing minimum graduate GPA of 3.0, formal dissertation, time to degree attainment, degree attainment, time to candidacy, type of employment after graduation, and publications and grants as a student and at 5 years postgraduation.

  2. Outcomes of Older Adults With Sepsis at Admission to an Intensive Care Unit

    PubMed Central

    Rowe, Theresa; Araujo, Katy L. B.; Van Ness, Peter H.; Pisani, Margaret A.; Juthani-Mehta, Manisha

    2016-01-01

    Background. Sepsis is a major cause of morbidity and mortality among older adults. The main goals of this study were to assess the association of sepsis at intensive care unit (ICU) admission with mortality and to identify predictors associated with increased mortality in older adults. Methods. We conducted a prospective cohort study of 309 participants ≥60 years admitted to an ICU. Sepsis was defined as 2 of 4 systemic inflammatory response syndrome criteria plus a documented infection within 2 calendar days before or after admission. The main outcome measure was time to death within 1 year of ICU admission. Sepsis was evaluated as a predictor for mortality in a Cox proportional hazards model. Results. Of 309 participants, 196 (63%) met the definition of sepsis. Among those admitted with and without sepsis, 75 (38%) vs 20 (18%) died within 1 month of ICU admission (P < .001) and 117 (60%) vs 48 (42%) died within 1 year (P < .001). When adjusting for baseline characteristics, sepsis had a significant impact on mortality (hazard ratio [HR] = 1.80; 95% confidence interval [CI], 1.28–2.52; P < .001); however, after adjusting for baseline characteristics and process covariates (antimicrobials and vasopressor use within 48 hours of admission), the impact of sepsis on mortality became nonsignificant (HR = 1.26; 95% CI, .87–1.84; P = .22). Conclusions. The diagnosis of sepsis in older adults upon ICU admission was associated with an increase in mortality compared with those admitted without sepsis. After controlling for early use of antimicrobials and vasopressors for treatment, the association of sepsis with mortality was reduced. PMID:26925430

  3. Is there a relationship between admission blood glucose level following acute poisoning and clinical outcome?

    PubMed Central

    Sabzghabaee, Ali Mohammad; Eizadi-Mood, Nastaran; Gheshlaghi, Farzad; Adib, Nooshin; Safaeian, Leila

    2011-01-01

    Introduction The aim of this study was to investigate the relationship between the admission blood glucose level following acute poisoning, severity of acute poisoning and clinical outcome. Material and methods This prospective study was conducted on 345 deliberate self-poisoning patients. Standard demographic and clinical information; admission blood glucose level; poisoning severity score and outcome were recorded. Patients with a history of diabetes mellitus, receipt of pre-sampling intravenous dextrose solution or glucocorticoids, and poisoning with toxic agents which produce hyper- or hypoglycaemia were excluded. Results Mean age of the patients was 27.5 ±8.6 years. Females outnumbered males (57.9%). Oral ingestion of more than one drug (46.7%) and opiates (14.2%) were the main causes of poisoning. Blood glucose values ranged from 50 mg/dl to 396 mg/dl. Hyper- and hypoglycaemia were observed in 23.8% and 13.91% respectively. A total of 24.41% and 22.92% of the patients in hyper- and hypoglycaemic groups had grade 3 and 4 severity score in comparison with 4.18% in the normoglycaemic group. Development of complications and death were 14.64% and 10.42% in patients with hyper- and hypoglycaemia versus 3.73% in patients with normoglycaemia. A significant difference between normoglycaemic and hyperglycaemic patients in the severity of poisoning and clinical outcome was observed (P < 0.001). Conclusions Admission blood glucose levels may have a relationship with the severity of poisoning and clinical outcome following acute poisoning. PMID:22291737

  4. Validity of the Medical College Admission Test for Predicting MD-PhD Student Outcomes

    ERIC Educational Resources Information Center

    Bills, James L.; VanHouten, Jacob; Grundy, Michelle M.; Chalkley, Roger; Dermody, Terence S.

    2016-01-01

    The Medical College Admission Test (MCAT) is a quantitative metric used by MD and MD-PhD programs to evaluate applicants for admission. This study assessed the validity of the MCAT in predicting training performance measures and career outcomes for MD-PhD students at a single institution. The study population consisted of 153 graduates of the…

  5. Admission Criteria, Program Outcomes, and NCLEX-RN(RTM) Success in Second Degree Students

    ERIC Educational Resources Information Center

    Rowland, Janet Wedge

    2013-01-01

    The purpose of this retrospective study was to examine the outcome performance of second degree students in an Accelerated BSN (ABSN) and an Entry Level MSN (ELMSN) program. In addition to student demographics (ethnicity/race, age, and gender), study variables included admission and end-of-program indicators. Admission criteria included the…

  6. Effect of Admission Hyperglycemia on 6-Month Functional Outcome in Patients with Spontaneous Cerebellar Hemorrhage

    PubMed Central

    Tao, Chuanyuan; Hu, Xin; Wang, Jiajing; You, Chao

    2017-01-01

    Background Cerebellar hemorrhage (CH) has a quite different treatment strategy and prognostic factors compared with supratentorial intracerebral hemorrhage (ICH). The prognostic role of hyperglycemia has been discussed mainly in cases of supratentorial hemorrhage; it remains to be elucidated following CH. We aimed to determine the association of hyperglycemia on admission with 6-month functional outcome in CH patients. Material/Methods We retrospectively analyzed 77 patients with acute CH between September 2010 and April 2015 in West China Hospital. Blood glucose level was measured when the patients were admitted. Primary outcome was 6-month functional outcome, which could comprehensively reflect the patient’s recovery of physical and social ability after stroke and was assessed by the modified Rankin scale (mRS). Association of hyperglycemia with functional outcome was identified in logistic regression models. Results There were 50 (64.9%) patients with poor functional outcomes. Patients with poor outcome were much older (P<0.001) and had a significantly higher glucose level on admission (P<0.001), a lower Glasgow Coma Scale score (P<0.001), a larger hematoma (P=0.003), and a higher incidence of intraventricular extension (P=0.002), brainstem compression (P=0.013), and hydrocephalus (P=0.023). Multivariate analysis showed that hyperglycemia (OR 1.50, 95% CI 1.07–2.08, P=0.017 when glucose level was analyzed as a continuous variable; OR 7.46, 95% CI 1.41–39.51, P=0.018 when glucose level was dichotomized by the critical threshold of 6.78 mmol/L) emerged as an independent predictor for adverse functional outcome at 6 months. Conclusions To the best of our knowledge, this is the first study focusing on the relationship between hyperglycemia and long-term functional outcome after CH. The study combined with previous pertinent reports definitely indicates the poor effect of hyperglycemia on both supra- and infratentorial ICH independent of hemorrhage site

  7. Effect of Admission Hyperglycemia on 6-Month Functional Outcome in Patients with Spontaneous Cerebellar Hemorrhage.

    PubMed

    Tao, Chuanyuan; Hu, Xin; Wang, Jiajing; You, Chao

    2017-03-08

    BACKGROUND Cerebellar hemorrhage (CH) has a quite different treatment strategy and prognostic factors compared with supratentorial intracerebral hemorrhage (ICH). The prognostic role of hyperglycemia has been discussed mainly in cases of supratentorial hemorrhage; it remains to be elucidated following CH. We aimed to determine the association of hyperglycemia on admission with 6-month functional outcome in CH patients. MATERIAL AND METHODS We retrospectively analyzed 77 patients with acute CH between September 2010 and April 2015 in West China Hospital. Blood glucose level was measured when the patients were admitted. Primary outcome was 6-month functional outcome, which could comprehensively reflect the patient's recovery of physical and social ability after stroke and was assessed by the modified Rankin scale (mRS). Association of hyperglycemia with functional outcome was identified in logistic regression models. RESULTS There were 50 (64.9%) patients with poor functional outcomes. Patients with poor outcome were much older (P<0.001) and had a significantly higher glucose level on admission (P<0.001), a lower Glasgow Coma Scale score (P<0.001), a larger hematoma (P=0.003), and a higher incidence of intraventricular extension (P=0.002), brainstem compression (P=0.013), and hydrocephalus (P=0.023). Multivariate analysis showed that hyperglycemia (OR 1.50, 95% CI 1.07-2.08, P=0.017 when glucose level was analyzed as a continuous variable; OR 7.46, 95% CI 1.41-39.51, P=0.018 when glucose level was dichotomized by the critical threshold of 6.78 mmol/L) emerged as an independent predictor for adverse functional outcome at 6 months. CONCLUSIONS To the best of our knowledge, this is the first study focusing on the relationship between hyperglycemia and long-term functional outcome after CH. The study combined with previous pertinent reports definitely indicates the poor effect of hyperglycemia on both supra- and infratentorial ICH independent of hemorrhage site

  8. Hazards of Hospitalization: Residence Prior to Admission Predicts Outcomes

    ERIC Educational Resources Information Center

    Friedman, Susan M.; Mendelson, Daniel A.; Bingham, Karilee W.; McCann, Robert M.

    2008-01-01

    Purpose: Previous studies investigating adverse outcomes of hospitalized elders have focused on community-dwelling patients. Given the rapid growth of populations living in other settings, such as assisted living facilities, it is important to understand whether these patients are at higher risk of experiencing specific adverse outcomes during…

  9. The impact of delays to admission from the emergency department on inpatient outcomes

    PubMed Central

    2010-01-01

    Background We sought to determine the impact of delays to admission from the Emergency Department (ED) on inpatient length of stay (LOS), and IP cost. Methods We conducted a retrospective analysis of 13,460 adult (≥ 18 yrs) ED visits between April 1 2006 and March 30 2007 at a tertiary care teaching hospital with two ED sites in which the mode of disposition was admission to ICU, surgery or inpatient wards. We defined ED Admission Delay as ED time to decision to admit > 12 hours. The primary outcomes were IP LOS, and total IP cost. Results Approximately 11.6% (n = 1558) of admitted patients experienced admission delay. In multivariate analysis we found that admission delay was associated with 12.4% longer IP LOS (95% CI 6.6% - 18.5%) and 11.0% greater total IP cost (6.0% - 16.4%). We estimated the cumulative impact of delay on all delayed patients as an additional 2,183 inpatient days and an increase in IP cost of $2,109,173 at the study institution. Conclusions Delays to admission from the ED are associated with increased IP LOS and IP cost. Improving patient flow through the ED may reduce hospital costs and improve quality of care. There may be a business case for investments to reduce emergency department admission delays. PMID:20618934

  10. Clinical outcomes and mortality associated with weekend admission to psychiatric hospital

    PubMed Central

    Patel, Rashmi; Chesney, Edward; Cullen, Alexis E.; Tulloch, Alex D.; Broadbent, Matthew; Stewart, Robert; McGuire, Philip

    2016-01-01

    Background Studies indicate that risk of mortality is higher for patients admitted to acute hospitals at the weekend. However, less is known about clinical outcomes among patients admitted to psychiatric hospitals. Aims To investigate whether weekend admission to a psychiatric hospital is associated with worse clinical outcomes. Method Data were obtained from 45 264 consecutive psychiatric hospital admissions. The association of weekend admission with in-patient mortality, duration of hospital admission and risk of readmission was investigated using multivariable regression analyses. Secondary analyses were performed to investigate the distribution of admissions, discharges, in-patient mortality, episodes of seclusion and violent incidents on different days of the week. Results There were 7303 weekend admissions (16.1%). Patients who were aged between 26 and 35 years, female or from a minority ethnic group were more likely to be admitted at the weekend. Patients admitted at the weekend were more likely to present via acute hospital services, other psychiatric hospitals and the criminal justice system than to be admitted directly from their own home. Weekend admission was associated with a shorter duration of admission (B coefficient −21.1 days, 95% CI −24.6 to −17.6, P<0.001) and an increased risk of readmission in the 12 months following index admission (incidence rate ratio 1.13, 95% CI 1.08 to 1.18, P<0.001), but in-patient mortality (odds ratio (OR) = 0.79, 95% CI 0.51 to 1.23, P = 0.30) was not greater than for weekday admission. Fewer episodes of seclusion occurred at the weekend but there was no significant variation in deaths during hospital admission or violent incidents on different days of the week. Conclusions Being admitted at the weekend was not associated with an increased risk of in-patient mortality. However, patients admitted at the weekend had shorter admissions and were more likely to be readmitted, suggesting that they may represent a

  11. Quality of Education Outcomes: The Role of the Graduate Management Admission Test

    ERIC Educational Resources Information Center

    Wamala, Robert; Buyinza, Mukadasi

    2013-01-01

    Although the Graduate Management Admission Test (GMAT) is considered by leading business institutions worldwide as a predictor of success in graduate programs, an issue of contention is whether the introduction of the examination enhances the quality of education outcomes. This study sought to obtain an understanding of this issue, focusing on…

  12. Relationships between Admission Variables and Outcome Variables in a Special Education Graduate Program

    ERIC Educational Resources Information Center

    LaFave, Matthew

    2012-01-01

    The need for well-prepared special education teachers has made it important to examine how to best select candidates for special education teacher education programs, or at least to determine which, if any, admission variables relate to program outcome measures. This study used archival data from 148 students to investigate the relationships among…

  13. Indications and outcome for obstetric patients' admission to intensive care unit: a 7-year review.

    PubMed

    Lataifeh, I; Amarin, Z; Zayed, F; Al-Mehaisen, L; Alchalabi, H; Khader, Y

    2010-05-01

    The objective of this retrospective study was to investigate the indications, interventions and clinical outcome of pregnant and newly delivered women admitted to the multidisciplinary intensive care unit at the King Abdullah University Hospital in Jordan over a 7-year period from January 2002 to December 2008. The collected data included demographic characteristics of the patients, mode of delivery, pre-existing medical conditions, reason for admission, specific intervention, length of stay and maternal outcome. A total of 43 women required admission to the intensive care unit (ICU), which represented 0.37% of all deliveries. The majority (95.3%) of patients were admitted to the ICU postpartum. The most common reasons for admissions were (pre)eclampsia (48.8%) and obstetric haemorrhage (37.2). The remainder included adult respiratory distress syndrome (6.9%), pulmonary embolism (2.3%) and neurological disorders (4.6%). Mechanical ventilation was required to support 18.6% of patients and transfusion of red blood cells was needed for 48.8% of patients. There were three maternal deaths (6.9%). A multidisciplinary team approach is essential to improve the management of hypertensive disorders and postpartum haemorrhage to achieve significant improvements in maternal outcome. A large, prospective study to know which women are at high risk of admission to the intensive care units and to prevent serious maternal morbidity and mortality is warranted.

  14. Predictors and outcome of obstetric admissions to intensive care unit: A comparative study.

    PubMed

    Jain, Shruti; Guleria, Kiran; Vaid, Neelam B; Suneja, Amita; Ahuja, Sharmila

    2016-01-01

    This descriptive observational study was carried out in Guru Teg Bahadur Hospital to identify predictors and outcome of obstetric admission to Intensive Care Unit (ICU). Ninety consecutive pregnant patients or those up to 42 days of termination of pregnancy admitted to ICU from October 2010 to December 2011 were enrolled as study subjects with selection of a suitable comparison group. Qualitative statistics of both groups were compared using Pearson's Chi-square test and Fisher's exact test. Odds ratio was calculated for significant factors. Low socioeconomic status, duration of complaints more than 12 h, delay at intermediary facility, and peripartum hysterectomy increased probability of admission to ICU. High incidence of obstetric admissions to ICU as compared to other countries stresses on need for separate obstetric ICU. Availability of high dependency unit can decrease preload to ICU by 5%. Patients with hemorrhagic disorders and those undergoing peripartum hysterectomy need more intensive care.

  15. Admission serum albumin is predicitve of outcome in critically ill trauma patients.

    PubMed

    Sung, Jin; Bochicchio, Grant V; Joshi, Manjari; Bochicchio, Kelly; Costas, Ainhoa; Tracy, Kate; Scalea, Thomas M

    2004-12-01

    There is a paucity of data evaluating serum albumin on admission as a predictor of outcome in adult trauma patients. Our objectives were to evaluate whether or not hypoalbuminemia on admission is a predictor of adverse outcome in trauma patients. Prospective data was collected daily on 1023 patients over a 2-year period. Patients were stratified by serum albumin level on admission, age, gender, injury severity, and comorbid conditions. Outcome was measured by ICU and hospital length of stay, ventilator days, incidence of infection, and mortality. Student t test, chi2, and multilinear regression analysis were used to determine level of significance. Blunt injuries accounted for the majority (78%) of the admissions. The mean age of the study population was 43+/-21 years with a mean Injury Severity Score (ISS) of 21.4+/-12. The majority of patients were male (74.5%). The mean albumin level on admission was 2.9+/-1.8. Five hundred ninety-three (58%) patients were admitted with a serum albumin level of > or =2.6 as compared to 430 patients (42%) with an admission albumin level of <2.6. Patients with a lower serum albumin level were found to have a significantly greater ICU (17.1 vs 14.2 days) and hospital length of stay (17.3 vs 20.1 days, P'< 0.05), ventilator days (11.1 vs 13.5 days, P < 0.05), and mortality (P = 0.008) when matched for age and injury severity. The relative risk of infection and mortality increased greater than 2.5-fold in patients with increased age and low serum albumin when analyzed by multilinear regression analysis, P < 0.001. An admission serum albumin level of <2.6 g/dL is a significant independent predictor of morbidity and mortality in trauma patients. The combination of increased age and low albumin level was most predictive of infection and mortality. Early nutrition should be considered in these high-risk patients.

  16. Outcome Prediction of Eating Disorders: Can Admission Data Forecast Outcome Needs at Discharge.

    DTIC Science & Technology

    1997-07-18

    admission Global Assessment of Functioning versus women with Anorexia Nervosa (AN); those with AN were positively linked to a family history of mood...trend. Although limited by available data, several significant findings were noted. Women diagnosed with Bulimia Nervosa (BN) had significantly higher

  17. Admission Laboratory Results to Enhance Prediction Models of Postdischarge Outcomes in Cardiac Care.

    PubMed

    Pine, Michael; Fry, Donald E; Hannan, Edward L; Naessens, James M; Whitman, Kay; Reband, Agnes; Qian, Feng; Schindler, Joseph; Sonneborn, Mark; Roland, Jaclyn; Hyde, Linda; Dennison, Barbara A

    Predictive modeling for postdischarge outcomes of inpatient care has been suboptimal. This study evaluated whether admission numerical laboratory data added to administrative models from New York and Minnesota hospitals would enhance the prediction accuracy for 90-day postdischarge deaths without readmission (PD-90) and 90-day readmissions (RA-90) following inpatient care for cardiac patients. Risk-adjustment models for the prediction of PD-90 and RA-90 were designed for acute myocardial infarction, percutaneous cardiac intervention, coronary artery bypass grafting, and congestive heart failure. Models were derived from hospital claims data and were then enhanced with admission laboratory predictive results. Case-level discrimination, goodness of fit, and calibration were used to compare administrative models (ADM) and laboratory predictive models (LAB). LAB models for the prediction of PD-90 were modestly enhanced over ADM, but negligible benefit was seen for RA-90. A consistent predictor of PD-90 and RA-90 was prolonged length of stay outliers from the index hospitalization.

  18. Validity of the Medical College Admission Test for predicting MD-PhD student outcomes.

    PubMed

    Bills, James L; VanHouten, Jacob; Grundy, Michelle M; Chalkley, Roger; Dermody, Terence S

    2016-03-01

    The Medical College Admission Test (MCAT) is a quantitative metric used by MD and MD-PhD programs to evaluate applicants for admission. This study assessed the validity of the MCAT in predicting training performance measures and career outcomes for MD-PhD students at a single institution. The study population consisted of 153 graduates of the Vanderbilt Medical Scientist Training Program (combined MD-PhD program) who matriculated between 1963 and 2003 and completed dual-degree training. This population was divided into three cohorts corresponding to the version of the MCAT taken at the time of application. Multivariable regression (logistic for binary outcomes and linear for continuous outcomes) was used to analyze factors associated with outcome measures. The MCAT score and undergraduate GPA (uGPA) were treated as independent variables; medical and graduate school grades, time-to-PhD defense, USMLE scores, publication number, and career outcome were dependent variables. For cohort 1 (1963-1977), MCAT score was not associated with any assessed outcome, although uGPA was associated with medical school preclinical GPA and graduate school GPA (gsGPA). For cohort 2 (1978-1991), MCAT score was associated with USMLE Step II score and inversely correlated with publication number, and uGPA was associated with preclinical GPA (mspGPA) and clinical GPA (mscGPA). For cohort 3 (1992-2003), the MCAT score was associated with mscGPA, and uGPA was associated with gsGPA. Overall, MCAT score and uGPA were inconsistent or weak predictors of training metrics and career outcomes for this population of MD-PhD students.

  19. Unplanned Intensive Care Unit Admission following Elective Surgical Adverse Events: Incidence, Patient Characteristics, Preventability, and Outcome

    PubMed Central

    Meziane, Mohammed; El Jaouhari, Sidi Driss; ElKoundi, Abdelghafour; Bensghir, Mustapha; Baba, Hicham; Ahtil, Redouane; Aboulaala, Khalil; Balkhi, Hicham; Haimeur, Charki

    2017-01-01

    Context: Adverse events (AEs) are a persistent and an important reason for Intensive Care Unit (ICU) admission. They lead to death, disability at the time of discharge, unplanned ICU admission (UIA), and prolonged hospital stay. They impose large financial costs on health-care systems. Aims: This study aimed to determine the incidence, patient characteristics, type, preventability, and outcome of UIA following elective surgical AE. Settings and Design: This is a single-center prospective study. Methods: Analysis of 15,372 elective surgical procedures was performed. We defined UIA as an ICU admission that was not anticipated preoperatively but was due to an AE occurring within 5 days after elective surgery. Statistical Analysis: Descriptive analysis using SPSS software version 18 was used for statistical analysis. Results: There were 75 UIA (0.48%) recorded during the 2-year study period. The average age of patients was 54.64 ± 18.02 years. There was no sex predominance, and the majority of our patients had an American Society of Anesthesiologist classes 1 and 2. Nearly 29% of the UIA occurred after abdominal surgery and 22% after a trauma surgery. Regarding the causes of UIA, we observed that 44 UIA (58.7%) were related to surgical AE, 24 (32%) to anesthetic AE, and 7 (9.3%) to postoperative AE caused by care defects. Twenty-three UIA were judged as potentially preventable (30.7%). UIA was associated with negative outcomes, including increased use of ICU-specific interventions and high mortality rate (20%). Conclusions: Our analysis of UIA is a quality control exercise that helps identify high-risk patient groups and patterns of anesthesia or surgical care requiring improvement.

  20. A Nationwide Analysis of Outcomes of Weekend Admissions for Intracerebral Hemorrhage Shows Disparities Based on Hospital Teaching Status

    PubMed Central

    Patel, Achint A.; Benjo, Alexandre; Pathak, Ambarish; Kar, Jitesh; Jani, Vishal B.; Annapureddy, Narender; Agarwal, Shiv Kumar; Sabharwal, Manpreet S.; Simoes, Priya K.; Konstantinidis, Ioannis; Yacoub, Rabi; Javed, Fahad; El Hayek, Georges; Menon, Madhav C.; Nadkarni, Girish N.

    2015-01-01

    Background and Purpose: With the “weekend effect” being well described, the Brain Attack Coalition released a set of “best practice” guidelines in 2005, with the goal to uniformly provide standard of care to patients with stroke. We attempted to define a “weekend effect” in outcomes among patients with intracranial hemorrhage (ICH) over the last decade, utilizing the Nationwide Inpatient Sample (NIS) data. We also attempted to analyze the trend of such an effect. Materials and Methods: We determined the association of ICH weekend admissions with hospital outcomes including mortality, adverse discharge, length of stay, and cost compared to weekday admissions using multivariable logistic regression. We extracted our study cohort from the NIS, the largest all-payer data set in the United States. Results: Of 485 329 ICH admissions from 2002 to 2011, 27.5% were weekend admissions. Overall, weekend admissions were associated with 11% higher odds of in-hospital mortality. When analyzed in 3-year groups, excess mortality of weekend admissions showed temporal decline. There was higher mortality with weekend admissions in nonteaching hospitals persisted (odds ratios 1.16, 1.13, and 1.09, respectively, for 3-year subgroups). Patients admitted during weekends were also 9% more likely to have an adverse discharge (odds ratio 1.09; 95% confidence interval: 1.07-1.11; P < .001) with no variation by hospital status. There was no effect of a weekend admission on either length of stay or cost of care. Conclusion: Nontraumatic ICH admissions on weekends have higher in-hospital mortality and adverse discharge. This demonstrates need for in-depth review for elucidating this discrepancy and stricter adherence to standard-of-care guidelines to ensure uniform care. PMID:27053981

  1. The Neutrophil to Lymphocyte Ratio on Admission and Short-Term Outcomes in Orthogeriatric Patients

    PubMed Central

    Fisher, Alexander; Srikusalanukul, Wichat; Fisher, Leon; Smith, Paul

    2016-01-01

    Aim: To investigate the association of the neutrophil to lymphocyte ratio (NLR) at admission with presence of fracture, comorbid conditions, and its prognostic value for short-term outcomes in orthogeriatric patients. Methods: On 415 consecutive patients (mean age 78.8 ±8.7[SD] years, 281 women, 255 with a non-vertebral bone fracture, including 167 with a hip fracture, HF) admitted to the Department of Orthopaedic Surgery at the Canberra hospital (2010 - 2011) data on clinical and laboratory characteristics were collected prospectively. The validation dataset included 294 consecutive patients (mean age 82.1 ± 8.0 years, 72.1% women) with HF. Results: Multivariate regression revealed four variables, presence of HF, hypoalbuminaemia (<33g/L), anaemia (<120g/L) and hyperparathyroidism (PTH>6.8 pmol/L), as independent determinants of admission NLR≥5.1. There was a dose-graded relationship between presence of fracture, especially HF, postoperative complications and levels of NLR categorized as tertiles. Compared to patients with NLR<5.1(first tertile), patients with NLR 5.1-8.5 (second tertile) had a 1.8-, 3.1-, 2.6-, and 2.5-fold higher risk for presence of any fracture, HF, developing postoperative myocardial injury (troponin I rise) and a high inflammatory response/infection (CRP>100mg/L after the 3rd postoperative day), respectively, while in subjects with NLR>8.5 (third tertile) these risks were 2.6-, 4.9-, 5.9- and 4.5-times higher, respectively; subjects with NLR>8.5 had a 9.7 times higher chance of dying in the hospital compared to patients with NLR 5.1-8.5; the NLR retained its significance on multivariate analyses. The NLR ≥5.1 predicted postoperative myocardial injury with an area under the curve (AUC) of 0.626, CRP>100mg/L with AUC of 0.631 and the NLR >8.5 predicted in-hospital mortality with an AUC of 0.793, showing moderately high sensitivity (86.7%, 80% and 90%, respectively) and negative predictive value (92.9%, 71.2%, 99.6%, respectively), but

  2. Effects of Admission and Treatment Strategies of DWI Courts on Offender Outcomes

    PubMed Central

    Sloan, Frank A.; Chepke, Lindsey M.; Davis, Dontrell V.; Acquah, Kofi; Zold-Kilbourne, Phyllis

    2013-01-01

    Purpose The purpose of this study is to classify DWI courts on the basis of the mix of difficult cases participating in the court (casemix severity) and the amount of involvement between the court and participant (service intensity). Using our classification typology, we assess how casemix severity and service intensity are associated with program outcomes. We expected that holding other factors constant, greater service intensity would improve program outcomes while a relatively severe casemix would result in worse program outcomes. Methods The study used data from 8 DWI courts, 7 from Michigan and 1 from North Carolina. Using a 2-way classification system based on court casemix severity and program intensity, we selected participants in 1 of the courts, and alternatively 2 courts as reference groups. Reference group courts had relatively severe casemixes and high service intensity. We used propensity score matching to match participants in the other courts to participants in the reference group court programs. Program outcome measures were the probabilities of participants’: failing to complete the court’s program; increasing educational attainment; participants improving employment from time of program enrollment; and re-arrest. Results For most outcomes, our main finding was that higher service intensity is associated with better outcomes for court participants, as anticipated, but a court’s casemix severity was unrelated to study outcomes. Conclusions Our results imply that devoting more resources to increasing duration of treatment is productive in terms of better outcomes, irrespective of the mix of participants in the court’s program PMID:23416679

  3. Use of Coercive Measures during Involuntary Psychiatric Admission and Treatment Outcomes: Data from a Prospective Study across 10 European Countries

    PubMed Central

    Giacco, Domenico; Priebe, Stefan

    2016-01-01

    To assess the association between different types of coercive measures (forced medication, seclusion, and restraint) used during involuntary psychiatric admission and two treatment outcomes: retrospective views of patients towards their admission and length of inpatient stay. A secondary analysis was conducted of data previously gathered by the EUNOMIA study (n = 2030 involuntarily detained inpatients across 10 European countries, of whom 770 were subject to one or more coercive measures). Associations between coercive measures and outcomes were tested through multivariable regression models adjusted for patients' socio-demographic and clinical characteristics. Use of forced medication was associated with patients being significantly less likely to justify their admission when interviewed after three months. All coercive measures were associated with patients staying longer in hospital. When the influence of other variables was considered in a multi-variate analysis, seclusion remained as a significant predictor of longer inpatient stay, adding about 25 days to the average admission. Of the three coercive measures, forced medication appears to be unique in its significant impact on patient disapproval of treatment. While all coercive measures are associated with patients staying longer in hospital, only use of seclusion is associated with longer inpatient stays independently of coerced patients’ having higher symptom scores at the time of admission. PMID:28033391

  4. Birth Outcomes of Latin Americans in Two Countries with Contrasting Immigration Admission Policies: Canada and Spain

    PubMed Central

    Urquia, Marcelo L.

    2015-01-01

    Background We delved into the selective migration hypothesis on health by comparing birth outcomes of Latin American immigrants giving birth in two receiving countries with dissimilar immigration admission policies: Canada and Spain. We hypothesized that a stronger immigrant selection in Canada will reflect more favourable outcomes among Latin Americans giving birth in Canada than among their counterparts giving birth in Spain. Materials and Methods We conducted a cross-sectional bi-national comparative study. We analyzed birth data of singleton infants born in Canada (2000–2005) (N = 31,767) and Spain (1998–2007) (N = 150,405) to mothers born in Spanish-speaking Latin American countries. We compared mean birthweight at 37–41 weeks gestation, and low birthweight and preterm birth rates between Latin American immigrants to Canada vs. Spain. Regression analysis for aggregate data was used to obtain Odds Ratios and Mean birthweight differences adjusted for infant sex, maternal age, parity, marital status, and father born in same source country. Results Latin American women in Canada had heavier newborns than their same-country counterparts giving birth in Spain, overall [adjusted mean birthweight difference: 101 grams; 95% confidence interval (CI): 98, 104], and within each maternal country of origin. Latin American women in Canada had fewer low birthweight and preterm infants than those giving birth in Spain [adjusted Odds Ratio: 0.88; 95% CI: 0.82, 0.94 for low birthweight, and 0.88; 95% CI: 0.84, 0.93 for preterm birth, respectively]. Conclusion Latin American immigrant women had better birth outcomes in Canada than in Spain, suggesting a more selective migration in Canada than in Spain. PMID:26308857

  5. Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance

    PubMed Central

    Price, Lori Lyn; Andoh-Duku, Augustine; LaCamera, Peter

    2017-01-01

    Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission). We assessed the impact of EDLOS on hospital mortality, compliance with sepsis protocol, and resuscitation. Statistical significance was determined by chi-square test. Results. Of the 287 septic ED patients, 137 (47%) were admitted to the ICU in <6 hours. There was no significant in-hospital mortality difference between early and delayed admissions (p = 0.68). Both groups have similar compliance with the 3-hour protocol (p = 0.77). There was no significant difference in achieving optimal resuscitation within 12 hours (p = 0.35). Conclusion. We found that clinical outcomes were not significantly different between early and delayed ICU admissions. Additionally, EDLOS did not impact compliance with the sepsis protocol with the exception of repeat lactate draw.

  6. Effects of time and day of admission on the outcome of critically ill patients admitted to ICU

    PubMed Central

    Orsini, Jose; Rajayer, Salil; Ahmad, Noeen; Din, Nanda; Morante, Joaquin; Malik, Ryan; Shim, Ahmed

    2016-01-01

    Background Studies have shown that patients admitted to hospitals on weekends and after-hours experience worse outcome than those admitted on weekdays and daytime hours. Although admissions of patients to intensive care units (ICUs) occur 24 hours a day, not all critical care units maintain the same level of staffing during nighttime, weekends, and holidays. This raises concerns in view of evidence showing that the organizational structure of an ICU influences the outcome of critically ill patients. The objective of this study is to evaluate the effects of day and time of admission to ICU on patients’ outcome. Methods A single-center, prospective, observational study was conducted among all consecutive admissions to ICU in a community teaching hospital during a 4-month period. Results A total of 282 patients were admitted during the study period. Their mean age was 59.5 years (median 59, range 17–96), and the majority were male (157, 55.7%). Mean Acute Physiology and Chronic Health Evaluation (APACHE)-II score was 18.9 (median 33, range 1–45), and mean ICU length of stay was 3.1 days (median 2, range 1–19). Of the patients, 104 patients (36.9%) were admitted during weekends and 178 (63.1%) during weekdays. A total of 122 patients (43.3%) were admitted after-hours, constituting 68.5% of all admissions during weekdays. Fifty-six patients (19.9%) were admitted during daytime hours, representing 31.5% of all weekday admissions. Forty-five patients (15.9%) died in ICU. Compared to patients admitted on weekends, those admitted on weekdays had increased ICU mortality (operating room (OR)=0.437; 95% confidence interval=0.2054–0.9196; p=0.0293). Conclusion Admissions to ICU during weekends were not independently associated with increased mortality. A linear relationship between weekdays and after-hours admissions to ICU with mortality was observed at our institution. PMID:27987290

  7. Relationship between blood alcohol concentration on admission and outcome in dimethoate organophosphorus self-poisoning

    PubMed Central

    Eddleston, Michael; Gunnell, David; von Meyer, Ludwig; Eyer, Peter

    2009-01-01

    AIMS Many patients acutely poisoned with organophosphorus insecticides have co-ingested alcohol. Although clinical experience suggests that this makes management more difficult, the relationship between plasma concentration of alcohol and insecticide is unknown. We aimed to determine whether acute intoxication results in ingestion of larger quantities of insecticide in dimethoate self-poisoning and a worse clinical outcome. METHODS We set up a prospective study of acute dimethoate self-poisoning in Sri Lankan district hospitals. An admission plasma sample was analysed to identify the ingested insecticide; in patients with detectable dimethoate, plasma alcohol was measured. RESULTS Plasma from 37 of 72 (51.4%) dimethoate-poisoned patients had detectable alcohol {median concentration 1.10 g l−1[110 mg dl−1][interquartile range (IQR) 0.78–1.65]} a median of 3 h post ingestion. The median plasma dimethoate concentration was higher in patients who had ingested alcohol [479 µmol l−1 (IQR 268–701) vs. 145 µmol l−1 (IQR 25–337); P < 0.001]. Plasma dimethoate concentration was positively correlated with plasma alcohol (Spearman's ρ= 0.34; P= 0.0032). The median alcohol concentration was higher in the 21 patients who died compared with survivors (0.94 vs. 0.0 g l−1, P= 0.018). Risk of death was greater amongst individuals who consumed alcohol [odds ratio (OR) 4.3, 95% confidence interval (CI) 1.2, 16.4]; this risk was abolished by controlling for dimethoate concentration (OR 0.3, 95% CI 0.0, 8.8), indicating that deaths were not due to the direct toxic effects of alcohol. CONCLUSIONS Alcohol co-ingestion is associated with higher plasma concentrations of dimethoate and increased risk of death. Larger studies are required to assess this finding's generalizability, since efforts to reduce deaths from self-poisoning may benefit from concurrent efforts to reduce alcohol consumption. PMID:20002086

  8. 2005 Admissions and Transfer Experiences of Students Continuing Their Studies in British Columbia: Findings from the BC College & Institute Student Outcomes Survey

    ERIC Educational Resources Information Center

    British Columbia Council on Admissions and Transfer, 2006

    2006-01-01

    This report presents the results of an analysis of admissions and transfer data from the 2005 British Columbia (BC) College and Institute Student Outcomes Survey. A number of issues related to the admissions and transfer experiences of former students from BC's college, university college, and institute sector are addressed from the student…

  9. Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients: A Nationwide Cross-Sectional Study.

    PubMed

    Huang, Chun-Che; Huang, Yu-Tung; Hsu, Nin-Chieh; Chen, Jin-Shing; Yu, Chong-Jen

    2016-02-01

    Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan.A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays.Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16-1.39; P < 0.001) and/or mechanical ventilation (OR, 1.25; 95% CI, 1.15-1.35; P < 0.001), cardio-pulmonary resuscitation (OR: 1.45; 95% CI: 1.05-2.01; P = 0.026), and be transferred to the intensive care unit (ICU) (OR: 1.16; 95% CI: 1.03-1.30; P = 0.015) compared with those admitted on weekdays. Weekend-admitted patients also had higher odds of in-hospital mortality (OR: 1.19; 95% CI: 1.09-1.30; P < 0.001) and hospital treatment cost (OR: 1.04; 95% CI: 1.01-1.06; P = 0.008) than weekday-admitted patients.General internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment.

  10. Is Admission Serum Sodium Concentration a Clinical Predictor for the Outcome of Therapy in Critically Ill Poisoned Patients?

    PubMed Central

    Eizadi-Mood, Nastaran; Sabzghabaee, Ali Mohammad; Hosseini, Hossein; Soltaninejad, Forough; Massoumi, Gholamreza; Farajzadegan, Ziba; Yaraghi, Ahmad

    2015-01-01

    Background: Disorders of serum sodium concentration are some of the most electrolyte abnormalities in the intensive care unit (ICU) patients. These disorders adversely affect the function of vital organs and are associated with increased hospital mortality. Purpose: In the present study we aimed to evaluate the effects of serum sodium concentration abnormalities at the time of hospital admission on the clinical outcome of therapy in a cohort of critically ill poisoned patients. Methods: In this cross-sectional study, 184 critically ill poisoned patients aged >18 years and in the first 8 hours of their poisoning, hospitalized in the ICU of a tertiary care university hospital (Isfahan, Iran) between 2010-2012, were evaluated at the admission time and 24 hours later for serum sodium concentration abnormalities and its relationship with age, gender, consciousness status, ingested drugs and clinical outcome of therapy. The clinical outcome was considered as recovery and mortality. Logistic Regression analysis was performed for predictive variables including serum sodium concentration abnormalities in patients’ clinical outcome. Findings: On admission, 152 patients (82.6%) were eunatremic, 21 patients (11.4%) were hyponatremic and 11 patients (6%) were hypernatremic. In the second day eunatremia, hyponatremia and hypernatremia was observed in 84.4%, 13% and 2.2% respectively. Age (OR=1.92; CI=1.18-3.12) and severity of toxicity (OR=1.32; CI=1.12-2.41) were predicting factors of mortality in ICU poisoning patients. Conclusions: Serum sodium concentration abnormalities are prevalent in critically ill poisoned patient but do not seem to have a predictive value for the clinical outcome of therapy. PMID:26543310

  11. Presentation, management, and outcomes of 25 748 acute coronary syndrome admissions in Kerala, India: results from the Kerala ACS Registry

    PubMed Central

    Mohanan, Padinhare Purayil; Mathew, Rony; Harikrishnan, Sadasivan; Krishnan, Mangalath Narayanan; Zachariah, Geevar; Joseph, Jhony; Eapen, Koshy; Abraham, Mathew; Menon, Jaideep; Thomas, Manoj; Jacob, Sonny; Huffman, Mark D.; Prabhakaran, Dorairaj

    2013-01-01

    Aims There are limited contemporary data on the presentation, management, and outcomes of acute coronary syndrome (ACS) admissions in India. We aimed to develop a prospective registry to address treatment and health systems gaps in the management of ACSs in Kerala, India. Methods and results We prospectively collected data on 25 748 consecutive ACS admissions from 2007 to 2009 in 125 hospitals in Kerala. We evaluated data on presentation, management, and in-hospital mortality and major adverse cardiovascular events (MACE). We created random-effects multivariate regression models to evaluate predictors of outcomes while accounting for confounders. Mean (SD) age at presentation was 60 (12) years and did not differ among ACS types [ST-segment myocardial infarction (STEMI) = 37%; non-STEMI = 31%; unstable angina = 32%]. In-hospital anti-platelet use was high (>90%). Thrombolytics were used in 41% of STEMI, 19% of non-STEMI, and 11% of unstable angina admissions. Percutaneous coronary intervention rates were marginally higher in STEMI admissions. Discharge medication rates were variable and generally suboptimal (<80%). In-hospital mortality and MACE rates were highest for STEMI (8.2 and 10.3%, respectively). After adjustment, STEMI diagnosis (vs. unstable angina) [odds ratio (OR) (95% confidence interval = 4.06 (2.36, 7.00)], symptom-to-door time >6 h [OR = 2.29 (1.73, 3.02)], and inappropriate use of thrombolysis [OR = 1.33 (0.92, 1.91)] were associated with higher risk of in-hospital mortality and door-to-needle time <30 min [OR = 0.44 (0.27, 0.72)] was associated with lower mortality. Similar trends were seen for risk of MACE. Conclusion These data represent the largest ACS registry in India and demonstrate opportunities for improving ACS care. PMID:22961945

  12. Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study

    PubMed Central

    Howard, R; Avery, A; Howard, P; Partridge, M

    2003-01-01

    Objective: To describe the drugs and types of medicine management problems most frequently associated with preventable drug related admissions to an acute medical admissions unit. Design: Observation study. Setting: Medical admissions unit in a teaching hospital in Nottingham, UK. Participants: 4093 patients seen by pharmacists on the medical admissions unit between 1 January and 30 June 2001. Main outcome measures: Proportion of admissions that were drug related and preventable, classification of the underlying causes of preventable drug related admissions, and identification of drugs most commonly associated with preventable drug related admissions. Results: Of the admissions seen by pharmacists, 265 (6.5%) were judged to be drug related and 178 (67%) of these were judged to be preventable. Preventable admissions were mainly due to problems with prescribing (63 cases (35%)), monitoring (46 cases (26%)), and adherence to medication (53 cases (30%)). The drugs most commonly implicated were NSAIDs, antiplatelets, antiepileptics, hypoglycaemics, diuretics, inhaled corticosteroids, cardiac glycosides, and beta-blockers. Conclusions: Potentially preventable drug related morbidity was associated with 4.3% of admissions to a medical admissions unit. In 91% of cases these admissions were related to problems with either prescribing, monitoring, or adherence. PMID:12897361

  13. Diabetes mellitus in Addis Ababa, Ethiopia: admissions, complications and outcomes in a large referral hospital.

    PubMed

    Gizaw, M; Harries, A D; Ade, S; Tayler-Smith, K; Ali, E; Firdu, N; Yifter, H

    2015-03-21

    Contexte : Hôpital de référence du Black Lion, Addis Ababa, Ethiopie.Objectif : Documenter les indications d’admission, les complications et le devenir des patients atteints de diabète (DM) admis à l’hôpital entre 2010 et 2013.Schéma : Etude descriptive rétrospective sur dossiers médicaux.Résultats : Sur 8048 admissions, 523 (6,5%) avaient un DM et parmi eux, 418 dossiers médicaux ont été retrouvés : 301 (72%) patients avaient un DM de type 2 et 104 (28%) avaient un DM de type 1 ; les hommes (62%) et les personnes âgées (âge médian 60 ans) étaient caractéristiques du type 2. Les diagnostics d’admission les plus fréquents du type 2 étaient l’ulcère diabétique du pied (39%) et les problèmes cardiovasculaires (21%), et celui du type 1, l’acidocétose diabétique (62%). L’hypertension, les neuropathies, les néphropathies, la rétinopathie et le pied diabétique représentaient 85% des 756 complications existantes. La mortalité totale des patients admis a été de 21%. Sur ces 89 décès, 77 patients étaient de type 2 avec comme indications principales d’admission l’ulcère diabétique du pied/la gangrène et les problèmes cardiovasculaires.Conclusion : Le DM, surtout de type 2, est une cause importante d’admission dans le plus grand hôpital de référence du pays. De nombreux patients avaient déjà développé des complications liées au DM lors de l’admission, et la mortalité a été élevée. Il est nécessaire d’améliorer la connaissance et les soins relatifs au DM en Ethiopie.

  14. Development and outcomes of an online-onsite hybrid dental admissions enhancement pilot program.

    PubMed

    Hanson, Carrie L; Van Ness, Chris; Gadbury-Amyot, Cynthia C; Crain, Geralyn

    2014-10-01

    The University of Missouri-Kansas City (UMKC) School of Dentistry has piloted two years of an Admissions Enhancement Program (AEP) with students from underrepresented minority groups and/or economically disadvantaged areas of Missouri interested in applying to dental school. The AEP utilizes an innovative online-onsite hybrid format to elevate students' foundational knowledge in biology, chemistry, organic chemistry, and quantitative reasoning. The online component includes interaction with UMKC instructors using tablet technology and Wimba virtual classroom sessions. The onsite component engages students in academic and professional development, enrichment activities targeting skills training, experience in dental labs and clinics, and mentoring in preparing the dental school application, essay writing, and interviewing. Results to date indicate overall program satisfaction among AEP participants and a dental school acceptance rate of 73.7 percent (14/19 students). Participants reported the mock interviews and essay-writing portions contributed to their becoming competitive candidates for the admission process, and the online material enhanced their preparation for the Dental Admission Test (DAT). Pre- and post-AEP data show participant DAT Academic Average scores increased by two points. The school will continue to monitor program participants in subsequent years.

  15. Same day admission for elective cardiac surgery: how to improve outcome with satisfaction and decrease expenses.

    PubMed

    Silvay, George; Goldberg, Andrew; Gutsche, Jacob T; T Augoustides, John G

    2016-06-01

    Admission on the day of surgery for elective cardiac and non-cardiac surgery has been established as a prevalent, critical practice. This approach realizes medical, logistical, psychological and fiscal benefits, and its success is predicated on an effective outpatient pre-operative evaluation. The establishment of a highly functional pre-operative clinic with a comprehensive set-up and efficient logistical pathways is invaluable. This notion has been expanded in recent years to include the entire peri-operative period and the concept of a 'peri-operative anesthesia/surgical home' is gaining popularity and support. Evaluating patients prior to admission for surgery, anesthesiologists can place themselves at the forefront of reducing unnecessary pre-operative hospital admissions, excess lab tests, unneeded consultations, and ultimately decrease the cancellations on the day of surgery. Furthermore, by taking a leadership role in the pre-operative clinic, anesthesiologists place themselves squarely at the forefront of the burgeoning movement for the peri-operative surgical home and continue to cement the indispensability of the anesthesiologist during the entire peri-operative course. The authors present this review as a follow-up describing the successful implementation of a pre-operative same-day cardiac surgery clinic and offer these experiences over the last 8 years as a guide to helping other anesthesiologists do the same.

  16. Cohort analysis of outcomes in 69 490 emergency general surgical admissions across an international benchmarking collaborative

    PubMed Central

    Chana, Prem; Joy, Mark; Casey, Neil; Chang, David; Burns, Elaine M; Arora, Sonal; Darzi, Ara W; Faiz, Omar D; Peden, Carol J

    2017-01-01

    Objective This study aims to use the Dr Foster Global Comparators Network (GC) database to examine differences in outcomes following high-risk emergency general surgery (EGS) admissions in participating centres across 3 countries and to determine whether hospital infrastructure factors can be linked to the delivery of high-quality care. Design A retrospective cohort analysis of high-risk EGS admissions using GC's international administrative data set. Setting 23 large hospitals in Australia, England and the USA. Methods Discharge data for a cohort of high-risk EGS patients were collated. Multilevel hierarchical logistic regression analysis was performed to examine geographical and structural differences between GC hospitals. Results 69 490 patients, admitted to 23 centres across Australia, England and the USA from 2007 to 2012, were identified. For all patients within this cohort, outcomes defined as: 7-day and 30-day inhospital mortality, readmission and length of stay appeared to be superior in US centres. A subgroup of 19 082 patients (27%) underwent emergency abdominal surgery. No geographical differences in mortality were seen at 7 days in this subgroup. 30-day mortality (OR=1.47, p<0.01) readmission (OR=1.42, p<0.01) and length of stay (OR=1.98, p<0.01) were worse in English units. Patient factors (age, pathology, comorbidity) were significantly associated with worse outcome as were structural factors, including low intensive care unit bed ratios, high volume and interhospital transfers. Having dedicated EGS teams cleared of elective commitments with formalised handovers was associated with shorter length of stay. Conclusions Key factors that influence outcomes were identified. For patients who underwent surgery, outcomes were similar at 7 days but not at 30 days. This may be attributable to better infrastructure and resource allocation towards EGS in the US and Australian centres. PMID:28274969

  17. Symptomatic and functional outcomes of substance use disorder persistence 2 years after admission to a first-episode psychosis program.

    PubMed

    Abdel-Baki, Amal; Ouellet-Plamondon, Clairélaine; Salvat, Émilie; Grar, Kawthar; Potvin, Stéphane

    2017-01-01

    Substance use disorders (SUD) in first-episode psychosis (FEP) are highly prevalent and linked with poor outcomes. However, most longitudinal studies investigating their impacts in FEP have not reported proportions of patients who ceased SUD. Our aim was to examine the influence of SUD course on functional and symptomatic outcomes as well as service use in FEP. We performed a 2-year longitudinal study of 212 FEP patients, aged between 18 and 30 years, admitted to 2 early psychosis services in Montréal, Québec, Canada. We observed that cannabis was the first substance abused (42.9% at baseline), followed by alcohol (19.3%). The SUD rate decreased by approximately 30% during the first year. Patients with persistent SUD had worse functional outcomes (Quality of Life Scale, Social and Occupational Functioning Assessment Scale, employment), more symptoms (Positive and Negative Symptoms Scale) and heavier service use (emergency and hospitalization). SUD persistence was associated with illness severity, homelessness and cluster-B personality. Those living with their parents and financially supported by them were more likely to cease SUD. Our results indicate that SUD course was more significant than having SUD at admission; persistent SUD was associated with worse outcomes. SUD decreased during a general early psychosis intervention program (with no specialized SUD treatment). An integrated, specialized approach targeting FEP patients with predictive factors of SUD persistence during the first years of treatment might increase SUD cessation and possibly improve outcomes.

  18. Predicting economic and medical outcomes based on risk adjustment for congenital heart surgery classification of pediatric cardiovascular surgical admissions.

    PubMed

    Raucci, Frank J; Hoke, Tracey R; Gutgesell, Howard P

    2014-12-01

    The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification is an established method for predicting mortality for congenital heart disease surgery. It is unknown if this extends to the cost of hospitalization or if differences in economic and medical outcomes exist in certain subpopulations. Using data obtained from the University HealthSystem Consortium, we examined inpatient resource use by patients with International Classification of Diseases, Ninth Revision, procedure codes representative of RACHS-1 classifications 1 through 5 and 6 from 2006 to 2012. A total of 15,453 pediatric congenital heart disease surgical admissions were analyzed, with overall mortality of 4.5% (n = 689). As RACHS-1 classification increased, the total cost of hospitalization, hospital charges, total length of stay, length of intensive care unit stay, and mortality increased. Even when controlled for RACHS-1 classification, black patients (n = 2034) had higher total costs ($96,884 ± $3,392, p = 0.003), higher charges ($318,313 ± $12,018, p <0.001), and longer length of stay (20.4 ± 0.7 days, p <0.001) compared with white patients ($85,396 ± $1,382, $285,622 ± $5,090, and 18.0 ± 0.3 days, respectively). Hispanic patients had similarly disparate outcomes ($104,292 ± $2,759, $351,371 ± $10,627, and 23.0 ± 0.6 days, respectively) and also spent longer in the intensive care unit (14.9 ± 0.5 days, p <0.001). In conclusion, medical and economic measures increased predictably with increased procedure risk, and admissions for black and Hispanic patients were longer and more expensive than those of their white counterparts but without increased mortality.

  19. Comparison of admission random glucose, fasting glucose, and glycated hemoglobin in predicting the neurological outcome of acute ischemic stroke: a retrospective study

    PubMed Central

    Sung, Jia-Ying; Chen, Chin-I; Hsieh, Yi-Chen; Chen, Yih-Ru; Wu, Hsin-Chiao; Chan, Lung; Hu, Chaur-Jong; Hu, Han-Hwa; Chiou, Hung-Yi

    2017-01-01

    Background Hyperglycemia is a known predictor of negative outcomes in stroke. Several glycemic measures, including admission random glucose, fasting glucose, and glycated hemoglobin (HbA1c), have been associated with bad neurological outcomes in acute ischemic stroke, particularly in nondiabetic patients. However, the predictive power of these glycemic measures is yet to be investigated. Methods This retrospective study enrolled 484 patients with acute ischemic stroke from January 2009 to March 2013, and complete records of initial stroke severity, neurological outcomes at three months, and glycemic measures were evaluated. We examined the predictive power of admission random glucose, fasting glucose, and HbA1c for neurological outcomes in acute ischemic stroke. Furthermore, subgroup analyses of nondiabetic patients and patients with diabetes were performed separately. Results Receiver operating characteristic (ROC) analysis revealed that admission random glucose and fasting glucose were significant predictors of poor neurological outcomes, whereas HbA1c was not (areas under the ROC curve (AUCs): admission random glucose = 0.564, p = 0.026; fasting glucose = 0.598, p = 0.001; HbA1c = 0.510, p = 0.742). Subgroup analyses of nondiabetic patients and those with diabetes revealed that only fasting glucose predicts neurological outcomes in patients with diabetes, and the AUCs of these three glycemic measures did not differ between the two groups. A multivariate logistic regression analysis of the study patients indicated that only age, initial stroke severity, and fasting glucose were independent predictors of poor neurological outcomes, whereas admission random glucose and HbA1c were not (adjusted odds ratio: admission random glucose = 1.002, p = 0.228; fasting glucose = 1.005, p = 0.039; HbA1c = 1.160, p = 0.076). Furthermore, subgroup multivariate logistic regression analyses of nondiabetic patients and those with diabetes indicated that none of the three glycemic

  20. Serum Total Cholinesterase Activity on Admission Is Associated with Disease Severity and Outcome in Patients with Traumatic Brain Injury

    PubMed Central

    Zhang, Qing-Hong; Li, An-Min; He, Sai-Lin; Yao, Xu-Dong; Zhu, Jing; Zhang, Zhi-Wen; Sheng, Zhi-Yong; Yao, Yong-Ming

    2015-01-01

    Lowered ChE activity measured on admission appears to be associated with disease severity and outcome for TBI patients. PMID:26107885

  1. Graduate Management Admission Test Outcomes and the Academic Achievement: A Study on Masters of Business Administration Students at Makerere University, Uganda

    ERIC Educational Resources Information Center

    Wamala, Robert; Kizito, Saint Omala; Kakumba, Umar

    2012-01-01

    This study investigates whether the outcomes of the Graduate Management Admission Test (GMAT) can predict the academic achievement of enrollees in masters programs. The study is based on administrative data of 516 Masters of Business Administration (MBA) enrollees at the College of Business and Management Science, Makerere University in the 2011…

  2. National trends in inpatient admissions following stereotactic radiosurgery and the in-hospital patient outcomes in the United States from 1998 to 2011

    PubMed Central

    Ho, Allen L.; Li, Alexander Y.; Sussman, Eric S.; Pendharkar, Arjun V.; Iyer, Aditya; Thompson, Patricia A.; Tayag, Armine T.; Chang, Steven D.

    2016-01-01

    Purpose This study sought to examine trends in stereotactic radiosurgery (SRS) and in-hospital patient outcomes on a national level by utilizing national administrative data from the Nationwide Inpatient Sample (NIS) database. Methods and materials Using the NIS database, all discharges where patients underwent inpatient SRS were included in our study from 1998 – 2011 as designated by the ICD9-CM procedural codes. Trends in the utilization of primary and adjuvant SRS, in-hospital complications and mortality, and resource utilization were identified and analyzed. Results Our study included over 11,000 hospital discharges following admission for primary SRS or for adjuvant SRS following admission for surgery or other indication. The most popular indication for SRS continues to be treatment of intracranial metastatic disease (36.7%), but expansion to primary CNS lesions and other non-malignant pathology beyond trigeminal neuralgia has occurred over the past decade. Second, inpatient admissions for primary SRS have declined by 65.9% over this same period of time. Finally, as inpatient admissions for SRS become less frequent, the complexity and severity of illness seen in admitted patients has increased over time with an increase in the average comorbidity score from 1.25 in the year 2002 to 2.29 in 2011, and an increase in over-all in-hospital complication rate of 2.8 times over the entire study period. Conclusions As the practice of SRS continues to evolve, we have seen several trends in associated hospital admissions. Overall, the number of inpatient admissions for primary SRS has declined while adjuvant applications have remained stable. Over the same period, there has been associated increase in complication rate, length of stay, and mortality in inpatients. These associations may be explained by an increase in the comorbidity-load of admitted patients as more high-risk patients are selected for admission at inpatient centers while more stable patients are

  3. Wide Variability in Emergency Physician Admission Rates: A Target to Reduce Costs Without Compromising Quality

    PubMed Central

    Guterman, Jeffrey J.; Lundberg, Scott R.; Scheib, Geoffrey P.; Gross-Schulman, Sandra G.; Richman, Mark J.; Wang, Chien-Ju; Talan, David A.

    2016-01-01

    Introduction Attending physician judgment is the traditional standard of care for emergency department (ED) admission decisions. The extent to which variability in admission decisions affect cost and quality is not well understood. We sought to determine the impact of variability in admission decisions on cost and quality. Methods We performed a retrospective observational study of patients presenting to a university-affiliated, urban ED from October 1, 2007, through September 30, 2008. The main outcome measures were admission rate, fiscal indicators (Medicaid-denied payment days), and quality indicators (15- and 30-day ED returns; delayed hospital admissions). We asked each Attending to estimate their inpatient admission rate and correlated their personal assessment with actual admission rates. Results Admission rates, even after adjusting for known confounders, were highly variable (15.2%–32.0%) and correlated with Medicaid denied-payment day rates (p=0.038). There was no correlation with quality outcome measures (30-day ED return or delayed hospital admission). There was no significant correlation between actual and self-described admission rate; the range of mis-estimation was 0% to 117%. Conclusion Emergency medicine attending admission rates at this institution are highly variable, unexplained by known confounding variables, and unrelated to quality of care, as measured by 30-day ED return or delayed hospital admission. Admission optimization represents an important untapped potential for cost reduction through avoidable hospitalizations, with no apparent adverse effects on quality. PMID:27625720

  4. Impact of d-Dimer Levels on Admission on Inhospital and Long-Term Outcome in Patients With Type A Acute Aortic Dissection.

    PubMed

    Huang, Bi; Yang, Yanmin; Lu, Haisong; Zhao, Zhenhua; Zhang, Shu; Hui, Rutai; Fan, Xiaohan

    2015-06-01

    Limited studies with relatively small sample sizes have reported that elevated d-dimer levels on admission were associated with increased risk of short-term mortality in patients with type A acute aortic dissection (AAD). However, there were unavailable data regarding the impact of admission d-dimer levels on long-term outcomes. Our present study aimed to evaluate the association of admission d-dimer levels with both inhospital and long-term all-cause mortality in patients with type A AAD. A total of 212 consecutive patients with type A AAD were enrolled. d-Dimer levels were measured on admission, and patients were followed up prospectively. The primary end points were inhospital and long-term all-cause mortality. The median length of follow-up was 18.8 months (interquartile range 6.7 to 24.4 months). The inhospital and long-term all-cause mortality rates were 12.7% and 12.4%, respectively. Compared with the survivors, the nonsurvivors had significantly higher d-dimer levels (p <0.001). When divided into 4 groups according to admission d-dimer quartiles, patients in Q4 (>6.10 μg/ml) had the highest inhospital and long-term mortality among groups. After multivariate adjustment, the d-dimer level in Q4 (>6.10 μg/ml) was an independent risk factor for inhospital mortality (hazard ratio [HR] 6.12, 95% confidence interval 1.35 to 27.89, p = 0.019) in addition to surgical treatment; however, this was not an independent predictor for long-term mortality. In conclusion, our study with a relatively large sample size suggested that elevated admission d-dimer levels (>6.10 μg/ml) might be a predictor for increased risk of inhospital mortality, and urgent-emergent surgery might be needed in patients with elevated d-dimer levels on admission. However, d-dimer levels at admission failed to predict long-term mortality.

  5. Comparison of the clinical characteristics and treatment outcomes of patients requiring hospital admission to treat eosinophilic and neutrophilic exacerbations of COPD

    PubMed Central

    Kang, Hye Seon; Rhee, Chin Kook; Kim, Sung Kyoung; Kim, Jin Woo; Lee, Sang Haak; Yoon, Hyung Kyu; Ahn, Joong Hyun; Kim, Yong Hyun

    2016-01-01

    Purpose We compared the clinical characteristics and treatment outcomes of patients with eosinophilic and neutrophilic COPD exacerbations requiring hospital admission. Patients and methods This was a retrospective multicenter study performed between January 2010 and December 2014. In all, 1,688 COPD patients admitted via the outpatient clinics or emergency departments of six university hospitals were enrolled. The patients were grouped by complete blood counts: eosinophilic group, >2% peripheral blood eosinophils, and neutrophilic group, >65% peripheral blood neutrophils or >11,000 leukocytes/mL. The patients with radiographic evidence of pneumonia at the time of admission, those with lung cancer, those admitted for treatment of other medical problems, and those who chronically used steroids were excluded. Results A total of 605 patients hospitalized with COPD exacerbations (177 eosinophilic and 380 neutrophilic) were included. Pulmonary functions, including the forced expiratory volume in 1 second and forced vital capacity, were better in patients with eosinophilic exacerbations. Treatment outcomes, including the rate of admission to the intensive care unit and mortality, were poorer in patients with neutrophilic exacerbations (4.5% vs 12.4%, P=0.004; 1.1% vs 4.5%, P=0.043, respectively). Congestive heart failure (odds ratio [OR] =3.40, 95% confidence interval [CI]: 1.28–9.01) and neutrophilic exacerbation (OR = 2.81, 95% CI: 1.21–6.52) were independent risk factors for intensive care unit admission. Conclusion COPD patients with neutrophilic exacerbations experienced worse clinical outcomes than did those with eosinophilic exacerbations. The peripheral blood eosinophil count may be a useful predictor of clinical progress during hospitalization of COPD patients with acute exacerbations. PMID:27757029

  6. Impact of admission blood glucose on outcomes of nondiabetic patients with acute ST-elevation myocardial infarction (from the German Acute Coronary Syndromes [ACOS] Registry).

    PubMed

    Naber, Christoph K; Mehta, Rajendra H; Jünger, Claus; Zeymer, Uwe; Wienbergen, Harm; Sabin, Georg V; Erbel, Raimund; Senges, Jochen; Gitt, Anselm

    2009-03-01

    High blood glucose in patients with acute coronary syndromes have been associated with adverse short-term outcomes in patients without diabetes. However, the relation of admission glucose to long-term outcomes in these patients was less well established. Accordingly, consecutive patients with ST-elevation myocardial infarction (STEMI) without diabetes enrolled at 155 sites from July 2000 to November 2002 in the ACOS Registry were evaluated. Patients were categorized into tertiles based on admission blood glucose. Clinical end points of interest were 1-year mortality and composite of death, reinfarction, stroke, or rehospitalization (major adverse cardiac clinical events [MACCEs]) in the hospital and after discharge. Of 5,866 patients with STEMI, 36.9% had blood glucose <120 mg/dl; 33.1%, 120 to 150 mg/dl; and 30.0%, >150 mg/dl. Admission blood glucose was significantly related to increased risk of not only in-hospital events (death, glucose >150 vs <120 mg/dl, adjusted odds ratio [OR] 2.86, 95% confidence interval [CI] 2.13 to 3.82, p <0.0001; and MACCE, >150 vs <120 mg/dl, adjusted OR 1.88, 95% CI 1.52 to 2.33; p <0.0001), but this increased risk persisted beyond the acute phase during 1-year follow-up of a mean 380 days (median 387; death, glucose >150 vs <120 mg/dl, adjusted OR 1.46, 95% CI 1.04 to 2.03, p <0.0001; and MACCE, >150 vs <120 mg/dl, adjusted OR 1.31, 95% CI 1.00 to 1.71, p <0.0001). In conclusion, high blood glucose at admission to the hospital independently correlated with short- and midterm mortality in patients with STEMI.

  7. Patient outcomes following after-hours and weekend admissions for cardiovascular disease in a tertiary hospital in Calabar, Nigeria

    PubMed Central

    Ansa, Victor; Njideoffor, Uchenna; Nworah,, Charles; Odigwe, Clement; Otu, Akaninyene; Oku, Affiong

    2016-01-01

    Summary Background There are various reports of higher mortality rates occurring after admissions over the weekend and during after-hours. This study aimed to determine if there was a difference in mortality rates occurring during the weekend and after-hours among cardiovascular admissions in a tertiary hospital in Nigeria. Methods A review of cardiovascular admissions (including stroke) was carried out at the University of Calabar Teaching Hospital in Nigeria from January 2010 to December 2013. All admissions to the medical wards from the emergency department and medical out-patient department clinics during the study period were included. Results A total of 339 patients were studied and stroke was the commonest type of cardiovascular disease (CVD) admitted (187; 55.2%). Hypertension was the commonest cause of heart failure (70; 48.6%). Presentation to hospital during after-hours and length of stay of more than 14 days were significant predictors of death (OR: 3.37; 0.22). Conclusion An increase in CVD mortality rates occurred during after-hours, most likely a consequence of uneven staffing patterns and poor access to equipment. Healthcare providers in Nigeria need to consider remedies to this with a view to reducing excess mortality rates. PMID:27080145

  8. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome.

    PubMed

    Fairclough, Emily; Cairns, Eleanor; Hamilton, Jennifer; Kelly, Clive

    2009-02-01

    The modified early warning score (MEWS) was developed as a track and trigger tool for the prompt identification of seriously ill patients on an acute medical ward. This paper examines its value in the setting of an acute medical admissions unit (MAU) and compares it to biochemical markers of acute and chronic disease. Three hundred unselected acute admissions to the MAU of the Queen Elizabeth Hospital, Gateshead, were assessed. Correlations between MEWS score and C-reactive protein (CRP) and albumin separately were assessed, and then the relationship between MEWS and the CRP/albumin ratio across the age spectrum was examined. The findings demonstrated a strong correlation between the MEWS score and CRP/albumin ratio (r=0.88, p<0.001) across the whole age spectrum. Length of stay correlated poorly with MEWS (r=0.08) and CRP/albumin ratio (r=0.15). Overall mortality was 5% and was predicted by both tools, with a MEWS score of >4 (relative risk (RR)=7.8) outperforming a CRP/albumin of >2 (RR=2.6). MEWS remains the gold standard for assessing outcome in acute medical admissions, but does have limitations in the elderly (those aged over 70 years). A raised CRP/albumin ratio was less sensitive for overall mortality than MEWS. It did, however, appear to be of greater value in the elderly, especially in those with acute exacerbations of chronic disease. Neither test accurately predicted length of stay.

  9. 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…

  10. Manchester Triage System: main flowcharts, discriminators and outcomes of a pediatric emergency care 1

    PubMed Central

    Amthauer, Camila; da Cunha, Maria Luzia Chollopetz

    2016-01-01

    ABSTRACT Objetive: to characterize the care services performed through risk rating by the Manchester Triage System, identifying demographics (age, gender), main flowcharts, discriminators and outcomes in pediatric emergency Method: cross-sectional quantitative study. Data on risk classification were obtained through a search of computerized registration data from medical records of patients treated in the pediatric emergency within one year. Descriptive statistics with absolute and relative frequencies was used for the analysis. Results: 10,921 visits were conducted in the pediatric emergency, mostly male (54.4%), aged between 29 days and two years (44.5%). There was a prevalence of the urgent risk category (43.6%). The main flowchart used in the care was worried parents (22.4%) and the most prevalent discriminator was recent event (15.3%). The hospitalization outcome occurred in 10.4% of care performed in the pediatric emergency, however 61.8% of care needed to stay under observation and / or being under the health team care in the pediatric emergency. Conclusion: worried parents was the main flowchart used and recent events the most prevalent discriminator, comprising the hospitalization outcomes and permanency in observation in the pediatric emergency before discharge from the hospital. PMID:27579934

  11. Off-pump coronary artery bypass grafting in left main stem stenosis: outcomes, concerns and controversies

    PubMed Central

    Athanasopoulos, Leonidas V.

    2016-01-01

    Left main stem (LMS) disease is known to be a poor prognostic factor in terms of morbidity or mortality. Traditionally, it has been treated with constitution of bypass to provide required haemodynamic stability. We searched the literature for evidence on off-pump (OFP) surgery for treating this high-risk group of patients focusing in our review on postoperative outcomes, concerns and controversies. The majority of the studies identified showed favourable or equal outcomes of OFP when compared to conventional approach. All of the studies, apart from two, which showed lower incidence of postoperative deaths, demonstrated equal mortality rates. Stroke rates were found less in three studies. Less blood transfusions, inotropic use and length of study has been also demonstrated. The main concerns of OFP surgery are: haemodynamic instability and less complete revascularization. Main controversies are: same or favourable outcomes despite lower number of grafts with OFP surgery and less stroke rates despite manipulation of aorta with side-clamping. Despite these concerns and controversies OFP surgery has been proven to be feasible and safe as demonstrated by results from numerous studies. PMID:27942396

  12. The association between normal-range admission potassium levels in Israeli patients with acute coronary syndrome and early and late outcomes

    PubMed Central

    Shlomai, Gadi; Berkovitch, Anat; Pinchevski-Kadir, Shiran; Bornstein, Gil; Leibowitz, Avshalom; Goldenberg, Ilan; Grossman, Ehud

    2016-01-01

    Abstract Abnormal serum potassium levels are associated with an increased risk of ventricular arrhythmias and mortality in patients with acute myocardial infarction (AMI). The aim of the present study was to evaluate whether different levels of serum potassium, within the normal range, are associated with worse outcomes. The present study comprised 1277 patients with AMI and normal-range admission potassium levels (3.5–5.2 mEq/L), who were enrolled and prospectively followed up in the Acute Coronary Syndrome Israeli Survey between 2010 and 2013. Patients were divided into 4 quartiles based on admission potassium levels; “normal-low” (K ≥ 3.5 and K ≤ 3.9), “normal-moderate” (K > 3.9 and K ≤ 4.18), “normal-high” (K > 4.18 and K ≤ 4.45), and “normal-very high” (K > 4.45 and K ≤ 5.2). We analyzed the association between admission serum potassium levels and 7 days in-hospital complication rates, and 30-day and 1-year all-cause mortality rates. Patients with “normal-very high” potassium displayed increased frequency of baseline clinical risk factors and experienced a higher rate of acute kidney injury during hospitalization compared with the “normal-low” group (7.7% vs 2.4%; P = 0.002). However, the rate of in-hospital ventricular arrhythmias was similar across the range of admission potassium levels (overall P = 0.26), Multivariate analysis showed that compared with “low-normal” potassium values, patients with “normal-very high” potassium levels experienced increased risk for 30-days (adjusted hazard ratio 2.88, 95% confidence interval 1.05–7.87, P = 0.039) and 1-year all-cause mortality (adjusted hazard ratio 1.98, 95% confidence interval 1.05–3.75, P = 0.034). In patients admitted with AMI, admission serum potassium levels of 4.45 to 5.2 mEq/L are not associated with in-hospital ventricular arrhythmias, but are associated with increased short and long-term mortality. PMID:27281080

  13. Risk Assessment of Patients Undergoing Transfemoral Aortic Valve Implantation upon Admission for Post-Interventional Intensive Care and Surveillance: Implications on Short- and Midterm Outcomes

    PubMed Central

    Al-Rashid, Fadi; Kahlert, Philipp; Selge, Friederike; Hildebrandt, Heike; Patsalis, Polycarpos-Christos; Totzeck, Matthias; Mummel, Petra; Rassaf, Tienush; Jánosi, Rolf Alexander

    2016-01-01

    Background Several studies have found that standard risk scores inaccurately reflect risk in TAVI cohorts. The assessment of mortality risk upon post-interventional ICU admission is important to optimizing clinical management. This study sought to determine outcomes and factors affecting mortality in patients admitted to the intensive care unit (ICU) after transcatheter aortic valve implantation (TAVI), and to analyze and compare the predictive values of SAPS II and EuroSCORE. Methods and Findings 214 consecutive patients treated with transfemoral TAVI (2006–2012) admitted to the ICU in an academic tertiary-care university hospital, were included in this retrospective data analysis. The overall 30-day mortality rate was 7%. Non-survivors at 30-days and survivors showed differences in the rates of catecholamine therapy upon ICU admission (93 vs. 29%; p<0.001), stroke (20 vs. 1%;p<0.001), sepsis (27 vs. 2%;p<0.001), kidney injury (83 vs. 56%; log-rank p<0.001), catecholamine therapy (88 vs. 61%;log-rank p<0.001) and vascular complications (60 vs. 17%; p<0.001). Mean SAPS II score and predicted mortality were higher in non-survivors (38.1±7.0 vs. 29.9±6.2;p<0.001 and 23.1±11.7 vs. 10.5±8.2;p<0.001, retrospectively), whereas the logistic EuroSCORE could not discriminate between the groups (p = 0.555). Among the biochemical parameters, the maximum values of creatinine, procalcitonin, and troponin I during the first 48 h after ICU admission were significantly higher in non-survivors. Multivariate analysis of baseline characteristics and complications associated with two-year mortality showed no significant results. Conclusions The SAPS II is a good tool for estimating ICU mortality immediately after performing the TAVI procedure and provides valuable information for other known predictors of mortality. PMID:27880819

  14. Cerebrovascular Signal Complexity Six Hours after Intensive Care Unit Admission Correlates with Outcome after Severe Traumatic Brain Injury.

    PubMed

    Gao, Lei; Smielewski, Peter; Czosnyka, Marek; Ercole, Ari

    2016-11-15

    Disease states are associated with a breakdown in healthy interactions and are often characterized by reduced signal complexity. We applied approximate entropy (ApEn) analysis to investigate the correlation between the complexity of heart rate (ApEn-HR), mean arterial pressure (ApEn-MAP), intracranial pressure (ApEn-ICP), and a combined ApEn-product (product of the three individual ApEns) and outcome after traumatic brain injury. In 174 severe traumatic brain injured patients, we found significant differences across groups classified by the Glasgow Outcome Score in ApEn-HR (p = 0.007), ApEn-MAP (p = 0.02), ApEn-ICP (p = 0.01), ApEn-product (p = 0.001), and pressure reactivity index (PRx) (p = 0.004) in the first 6 h. This relationship strengthened in a 24 h and 72 h analysis (ApEn-MAP continued to correlate with death but was not correlated with favorable outcome). Outcome was dichotomized as survival versus death, and favorable versus unfavorable; the ApEn-product achieved the strongest statistical significance at 6 h (F = 11.0; p = 0.001 and F = 10.5; p = 0.001, respectively) and was a significant independent predictor of mortality and favorable outcome (p < 0.001). Patients in the lowest quartile for ApEn-product were over four times more likely to die (39.5% vs. 9.3%, p < 0.001) than those in the highest quartile. ApEn-ICP was inversely correlated with PRx (r = -0.39, p < 0.000001) indicating unique information related to impaired cerebral autoregulation. Our results demonstrate that as early as 6 h into monitoring, complexity measures from easily attainable vital signs, such as HR and MAP, in addition to ICP, can help triage those who require more intensive neurological management at an early stage.

  15. Outcome after admission to ITU following out-of-hospital cardiac arrest: are non-survivors suitable for non-heart-beating organ donation?

    PubMed

    Gratrix, Andrew P; Pittard, Alison J; Bodenham, Andrew R

    2007-05-01

    We have reviewed retrospective data from two large UK teaching hospitals regarding outcome following out-of-hospital cardiac arrest and the suitability of non-survivors for non-heart-beating organ donation. Patients were selected retrospectively from consecutive admissions from two intensive care units who had presented following out-of-hospital cardiac arrest, to a total of 50 patients in each centre. They had all been resuscitated to achieve a spontaneous cardiac output at the scene, in transit or after arrival in hospital, and required further intensive care support due to cardiovascular, respiratory, or neurological impairment. Eighty-six patients (86%) died in the Intensive Care Unit and only 14 (14%) survived to discharge from the Unit. A further nine (9%) patients died in hospital before discharge home. Four patients (4%) were alive after 6 months and three (3%) were alive after 1 year. Fifty-seven (57%) of patients had active withdrawal of treatment with only four (4%) being potentially suitable for organ procurement having not been excluded because of age, medical history or the length of time to die following withdrawal of treatment. Our results show that only a small increase in donor organs could be potentially achieved from this population. Further work is required to determine whether such patients should be considered as non-heart-beating donors.

  16. Admissions and Transfer Experiences of Students Continuing Their Studies in British Columbia: Findings from the BC College & Institute Student Outcomes Survey, 2002.

    ERIC Educational Resources Information Center

    Lawrance, Jill

    The British Columbia (B.C.) Council on Admissions and Transfer commissioned this report to investigate the admissions and transfer-related experiences of former students who had attended a B.C. college, institute, university college, or the Open Learning Agency. The analysis presented here is based on data collected through the 2002 B.C. College…

  17. Introduction: choosing the main outcome of an infertility trial is harder than you think.

    PubMed

    Legro, Richard S; Wu, Xiaoke

    2014-05-01

    Clinical trials in infertility choose from a variety of outcomes including change in some surrogate marker of gamete quality to healthy live birth. Incomplete reporting of outcomes makes it difficult to compare studies and to determine the clinical impact of infertility treatments. In this Views and Reviews, we explore the merits of collecting various outcomes of interest in infertility trials from the vantage point of infertility specialists, an obstetrician, and a pediatrician. These articles support more complete reporting of maternal, paternal, fetal, and infant outcomes from infertility trials to improve patient care and ultimately public health.

  18. The main factors influencing canine demodicosis treatment outcome and determination of optimal therapy.

    PubMed

    Arsenović, Milica; Pezo, Lato; Vasić, Nebojša; Ćirić, Rodoljub; Stefanović, Milan

    2015-07-01

    The main idea of this research was to evaluate the efficacy of canine demodicosis conventional treatments using mathematical analyses. All available papers published between 1980 and 2014 were used in this study. One hundred six clinical trials enrolling 3414 cases of generalized demodicosis in dogs are studied. Dogs entered in the analysis were only the ones in which the disease occurred naturally, excluding the studies in which transplantation of Demodex canis mites was done from other animals. In conventional acaricide treatments, sorted according to active substances (moxidectin, amitraz, doramectin, ivermectin, and milbemycin oxime), the way of application (spot-on, dips, orally, or subcutaneous), concentration, and interval of application were used as input parameters in mathematical modeling. Data of interest were the treatment outcome, the number of dogs that went into remission, the number of animals not responding to treatment microscopically, the average duration of therapy, the follow-up period, the number of patients with disease recurrence, the number of adverse effects, and the number of animals with side effects. Dogs lost to follow-up or when the treatment was discontinued, due to various reasons not in connection with the therapy protocol, were not considered. Statistical and mathematical analyses were applied for prediction of the drugs' effectiveness. Developed mathematical models showed satisfactorily r (2), higher than 0.87. Good evidence for recommending the use of milbemycin oxime PO (0.5 mg/kg, daily) and moxidectin spot-on (Advocate®, Bayer) weekly is found. A bit less effective therapies were based on ivermectin PO (0.5 mg/kg, daily), moxidectin PO (0.35 mg/kg, daily), and amitraz dips (0.05 % solution, weekly), respectively. It is important to keep in mind that Advocate® is recommended by the manufacturer for use in milder cases.

  19. Northern Territory Heart Failure Initiative–Clinical Audit (NTHFI–CA)–a prospective database on the quality of care and outcomes for acute decompensated heart failure admission in the Northern Territory: study design and rationale

    PubMed Central

    Iyngkaran, Pupalan; Tinsley, Jeff; Smith, David; Haste, Mark; Nadarajan, Kangaharan; Ilton, Marcus; Battersby, Malcolm; Stewart, Simon; Brown, Alex

    2014-01-01

    Introduction Congestive heart failure is a significant cause of morbidity and mortality in Australia. Accurate data for the Northern Territory and Indigenous Australians are not presently available. The economic burden of this chronic cardiovascular disease is felt by all funding bodies and it still remains unclear what impact current measures have on preventing the ongoing disease burden and how much of this filters down to more remote areas. Clear differentials also exist in rural areas including a larger Indigenous community, greater disease burden, differing aetiologies for heart failure as well as service and infrastructure discrepancies. It is becoming increasingly clear that urban solutions will not affect regional outcomes. To understand regional issues relevant to heart failure management, an understanding of the key performance indicators in that setting is critical. Methods and analysis The Northern Territory Heart Failure Initiative—Clinical Audit (NTHFI-CA) is a prospective registry of acute heart failure admissions over a 12-month period across the two main Northern Territory tertiary hospitals. The study collects information across six domains and five dimensions of healthcare. The study aims to set in place an evidenced and reproducible audit system for heart failure and inform the developing heart failure disease management programme. The findings, is believed, will assist the development of solutions to narrow the outcomes divide between remote and urban Australia and between Indigenous and Non-Indigenous Australians, in case they exist. A combination of descriptive statistics and mixed effects modelling will be used to analyse the data. Ethics and dissemination This study has been approved by respective ethics committees of both the admitting institutions. All participants will be provided a written informed consent which will be completed prior to enrolment in the study. The study results will be disseminated through local and international

  20. Weekend versus weekday hospital admission and outcomes during hospitalization for patients due to worsening heart failure: a report from Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD).

    PubMed

    Hamaguchi, Sanae; Kinugawa, Shintaro; Tsuchihashi-Makaya, Miyuki; Goto, Daisuke; Tsutsui, Hiroyuki

    2014-05-01

    The day of the week of admission may influence the length of stay and in-hospital death. However, the association between the admission day of the week and in-hospital outcomes has been inconsistent in heart failure (HF) patients among studies reported from Western countries. We thus analyzed this association in HF patients encountered in routine clinical practice in Japan. We studied the characteristics and in-hospital treatment in 1620 patients hospitalized with worsening HF by using the database of the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Patients were divided into two groups according to weekday (n = 1355; 83.6%) or weekend admission (n = 265; 16.4%). The mean age was 70.7 years and 59.4% were male. Etiology was ischemic in 34.0%, and mean left ventricular ejection fraction was 42.5%. Patients admitted on the weekend were significantly older and had more comorbidities, and more severe symptoms and signs of HF on admission. Length of stay was comparable between weekend and weekday admission (35.2 ± 47.0 days vs 33.6 ± 32.0 days, P = 0.591). Crude in-hospital mortality did not differ between patients admitted on the weekend and weekdays (7.5% vs 5.2%, P = 0.136). Even after adjustment for covariates in multivariable modeling with patients admitted on weekday as the reference, in-hospital death was comparable between patients admitted on the weekend and weekdays (adjusted odds ratio 1.125, 95% confidence interval 0.631-2.004, P = 0.691). Among patients hospitalized for worsening HF, admission day of the week did not affect in-hospital death and length of stay.

  1. Investigation of bias after data linkage of hospital admissions data to police road traffic crash reports

    PubMed Central

    Cryer, P; Westrup, S; Cook, A; Ashwell, V; Bridger, P; Clarke, C

    2001-01-01

    Research question—Does a database of hospital admission data linked to police road traffic accident (RTA) reports produce less biased information for the injury prevention policymaker, planner, and practitioner than police RTA reports alone? Design—Data linkage study. Study population—Non-fatal injury victims of road traffic crashes in southern England who were admitted to hospital. Data sources—Hospital admissions and police RTA reports. Main outcome measures—The estimated proportion of road traffic crashes admitted to hospital that were included on the linked database; distributions by age, sex, and road user groups: (A) for all RTA injury admissions and (B) for RTA serious injury admissions defined by length of stay or by nature of injury. Results—An estimated 50% of RTA injury admissions were included on the linked database. When assessing bias, admissions data were regarded as the "gold standard". The distributions of casualties by age, sex, and type of road user showed major differences between the admissions data and the police RTA injury data of comparable severity. The linked data showed smaller differences when compared with admissions data. For RTA serious injury admissions, the distributions by age and sex were approximately the same for the linked data compared with admissions data, and there were small but statistically significant differences between the distributions across road user group for the linked data compared with hospital admissions. Conclusion—These results suggest that investigators could be misinformed if they base their analysis solely on police RTA data, and that information derived from the linked database is less biased than that from police RTA data alone. A national linked dataset of road traffic crash data should be produced from hospital admissions and police RTA data for use by policymakers, planners and practitioners. PMID:11565992

  2. Admission Lipoprotein-Associated Phospholipase A2 Activity Is Not Associated with Long-Term Clinical Outcomes after ST-Segment Elevation Myocardial Infarction

    PubMed Central

    Woudstra, Pier; Damman, Peter; Kuijt, Wichert J.; Kikkert, Wouter J.; Grundeken, Maik J.; van Brussel, Peter M.; Stroobants, An K.; van Straalen, Jan P.; Fischer, Johan C.; Koch, Karel T.; Henriques, José P. S.; Piek, Jan J.; Tijssen, Jan G. P.; de Winter, Robbert J.

    2014-01-01

    Background Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity is a biomarker predicting cardiovascular diseases in a real-world. However, the prognostic value in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) on long-term clinical outcomes is unknown. Methods Lp-PLA2 activity was measured in samples obtained prior to pPCI from consecutive STEMI patients in a high-volume intervention center from 2005 until 2007. Five years all-cause mortality was estimated with the Kaplan-Meier method and compared among tertiles of Lp-PLA2 activity during complete follow-up and with a landmark at 30 days. In a subpopulation clinical endpoints were assessed at three years. The prognostic value of Lp-PLA2, in addition to the Thrombolysis In Myocardial Infarction or multimarker risk score, was assessed in multivariable Cox regression. Results The cohort (n = 987) was divided into tertiles (low <144, intermediate 144–179, and high >179 nmol/min/mL). Among the tertiles differences in baseline characteristics associated with long-term mortality were observed. However, no significant differences in five years mortality in association with Lp-PLA2 activity levels were found; intermediate versus low Lp-PLA2 (HR 0.97; CI 95% 0.68–1.40; p = 0.88) or high versus low Lp-PLA2 (HR 0.75; CI 95% 0.51–1.11; p = 0.15). Both in a landmark analysis and after adjustments for the established risk scores and selection of cases with biomarkers obtained, non-significant differences among the tertiles were observed. In the subpopulation no significant differences in clinical endpoints were observed among the tertiles. Conclusion Lp-PLA2 activity levels at admission prior to pPCI in STEMI patients are not associated with the incidence of short and/or long-term clinical endpoints. Lp-PLA2 as an independent and clinically useful biomarker in the risk stratification of STEMI patients still remains to be proven

  3. Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection

    PubMed Central

    Chen, Zhao-Ran; Huang, Bi; Lu, Hai-Song; Zhao, Zhen-Hua; Hui, Ru-Tai; Yang, Yan-Min; Fan, Xiao-Han

    2017-01-01

    Objectives Inflammation has been shown to be related with acute aortic dissection (AAD). The present study aimed to evaluate the association of white blood cell counts (WBCc) on admission with both in-hospital and long-term all-cause mortality in patients with uncomplicated Stanford type B AAD. Methods From 2008 to 2010, a total of 377 consecutive patients with uncomplicated type B AAD were enrolled and then followed up. Clinical data and WBCc on admission were collected. The primary end points were in-hospital death and long-term all-cause death. Results The in-hospital death rate was 4.2%, and the long-term all-cause mortality rate was 6.9% during a median follow-up of 18.9 months. WBCc on admission was identified as a risk factor for in-hospital death by univariate Cox regression analysis as both a continuous variable and a categorical variable using a cut off of 11.0 × 109 cell/L (all P < 0.05). After adjusting for age, sex and other risk factors, elevated admission WBCc was still a significant predictor for in-hospital death as both a continuous variable [hazard ratio (HR): 1.052, 95% CI: 1.024–1.336, P = 0.002] and a categorical variable using a cut off of 11.0 × 109 cell/L (HR: 2.056, 95% CI: 1.673–5.253, P = 0.034). No relationship was observed between WBCc on admission and long-term all-cause death. Conclusions Our results indicate that elevated WBCc upon admission might be used as a predictor for increased risk of in-hospital death in uncomplicated type B AAD. There might be no predictive value of WBCc for the long-term survival of type B AAD. PMID:28270842

  4. Association of Intensive Care Unit Admission With Mortality Among Older Patients With Pneumonia

    PubMed Central

    Valley, Thomas S.; Sjoding, Michael W.; Ryan, Andrew M.; Iwashyna, Theodore J.; Cooke, Colin R.

    2016-01-01

    IMPORTANCE Among patients whose need for intensive care is uncertain, the relationship of intensive care unit (ICU) admission with mortality and costs is unknown. OBJECTIVE To estimate the relationship between ICU admission and outcomes for elderly patients with pneumonia. DESIGN, SETTING, AND PATIENTS Retrospective cohort study of Medicare beneficiaries (aged >64 years) admitted to 2988 acute care hospitals in the United States with pneumonia from 2010 to 2012. EXPOSURES ICU admission vs general ward admission. MAIN OUTCOMES AND MEASURES Primary outcome was 30-day all-cause mortality. Secondary outcomes included Medicare spending and hospital costs. Patient and hospital characteristics were adjusted to account for differences between patients with and without ICU admission. To account for unmeasured confounding, an instrumental variable was used—the differential distance to a hospital with high ICU admission (defined as any hospital in the upper 2 quintiles of ICU use). RESULTS Among 1 112 394 Medicare beneficiaries with pneumonia, 328 404 (30%) were admitted to the ICU. In unadjusted analyses, patients admitted to the ICU had significantly higher 30-day mortality, Medicare spending, and hospital costs than patients admitted to a general hospital ward. Patients (n = 553 597) living closer than the median differential distance (<3.3 miles) to a hospital with high ICU admission were significantly more likely to be admitted to the ICU than patients living farther away (n = 558 797) (36%for patients living closer vs 23%for patients living farther, P < .001). In adjusted analyses, for the 13%of patients whose ICU admission decision appeared to be discretionary (dependent only on distance), ICU admission was associated with a significantly lower adjusted 30-day mortality (14.8%for ICU admission vs 20.5%for general ward admission, P = .02; absolute decrease, −5.7%[95%CI, −10.6%, −0.9%]), yet there were no significant differences in Medicare spending or hospital

  5. The IAEA international conference on fast reactors and related fuel cycles: highlights and main outcomes

    SciTech Connect

    Monti, S.; Toti, A.

    2013-07-01

    The 'International Conference on Fast Reactors and Related Fuel Cycles', which is regularly held every four years, represents the main international event dealing with fast reactors technology and related fuel cycles options. Main topics of the conference were new fast reactor concepts, design and simulation capabilities, safety of fast reactors, fast reactor fuels and innovative fuel cycles, analysis of past experience, fast reactor knowledge management. Particular emphasis was put on safety aspects, considering the current need of developing and harmonizing safety standards for fast reactors at the international level, taking also into account the lessons learned from the accident occurred at the Fukushima- Daiichi nuclear power plant in March 2011. Main advances in the several key areas of technological development were presented through 208 oral presentations during 41 technical sessions which shows the importance taken by fast reactors in the future of nuclear energy.

  6. Parents as Scholars: Education Works. Outcomes for Maine Families and Implications for TANF Reauthorization.

    ERIC Educational Resources Information Center

    Smith, Rebekah J.; Deprez, Luisa S.; Butler, Sandra S.

    Maine's Parents as Scholars (PaS) program provides parents who are eligible for Temporary Assistance for Needy Families (TANF) with cash assistance and support services while they attend a two-year or four-year postsecondary degree program. PaS participants receive the same cash benefits and access to support services as TANF recipients receive.…

  7. The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010

    PubMed Central

    Sarton, Cheryl; Lichter, Erika

    2016-01-01

    The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000–2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes. PMID:27747104

  8. Effectiveness of Using Incentives to Improve Parolee Admission and Attendance in Community Addiction Treatment

    PubMed Central

    Prendergast, Michael L.; Hall, Elizabeth A.; Grossman, Jason; Veliz, Robert; Gregorio, Liliana; Warda, Umme S.; Van Unen, Kory; Knight, Chloe

    2017-01-01

    This study is a randomized effectiveness trial of the use of incentives to improve treatment utilization among parolees in community treatment. In prison, Admission phase parolees were randomized to Admission Incentive (N=31) or Education (N=29). Attendance phase parolees entering community treatment were randomized to Attendance Incentive (N=104) or Education (N=98). There was no main effect for incentives in either study phase. Neither admission to community treatment (Incentive 60%, Education 64%; p =.74), nor intervention completion (Incentive 22%; Education 27%; p =.46) appeared to be impacted. Time-in-treatment was predicted by age, first arrest age, and type of parole status (Cox regression p<.05), but not by treatment group. Providing incentives did not increase the likelihood that parolees enrolled in or stayed in community treatment. In light of this finding, criminal justice practitioners who are considering incentives to increase admission or retention should be aware that they may not produce the desired outcomes.

  9. 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,…

  10. Determination of functional prognosis in hospitalized patients following an intensive care admission

    PubMed Central

    Ferreira, Natália A; Lopes, Agnaldo José; Ferreira, Arthur S; Ntoumenopoulos, George; Dias, Jerffesson; Guimaraes, Fernando S

    2016-01-01

    AIM To investigate the factors associated with the functional progress of hospitalized patients following an intensive care admission. METHODS Retrospective study including data from a cohort of 198 hospitalized patients following an intensive care admission and not requiring mechanical ventilation in a single tertiary referral hospital. A generalized linear model was used to identify the main effects of clinical and demographic variables on the outcomes of functionality (KATZ Index of Independence in Activities of Daily Living) and muscle strength (MRC Scale). The covariates identified as independent predictors were analysed using the receiver operating characteristic curves. The analysis differentiated the periods in the intensive care unit (ICU), in the Ward (WARD) and the total time of hospital stay (TOT). RESULTS Considering the functional outcome (ΔKATZ), the variables that significantly contributed to the model (P < 0.05) were the KATZ and MRC on admission, age, sepsis (no), and total length of stay (TLS). Regarding the muscle strength outcome model (ΔMRC), the predictors were MRC on admission, Simplified Acute Physiology Score III, previous stroke, TLS, and sex (female). The variable age (AUC = 0.664) discriminated the ΔKATZICU. The variables age (AUC = 0.712), KATZ in ICU (AUC = 0.590) and on ward admission (AUC = 0.746), and MRC on ward admission (AUC = 0.721) were discriminative for ΔKATZWARD. For ΔKATZTOT the variables KATZ on ICU admission (AUC = 0.621) and TLS (AUC = 0.617) were discriminative. For ΔMRCICU the variables SAPSIII (AUC = 0.661) and MRC on ICU admission (AUC = 0.653) were discriminative. MRC on ICU (AUC = 0.681) and ward admission (AUC = 0.553) were discriminative for ΔMRCWARD. TLS (AUC = 0.649) and MRC on ward admission (AUC = 0.696) discriminative for the ΔMRCTOT. CONCLUSION Specific functional, clinical and demographical variables at ICU admission are associated with the functional prognosis during the hospitalization period

  11. Fostering a culture of engagement: a pilot study of the outcomes of training mental health nurses working in two UK acute admission units in brief solution-focused therapy techniques.

    PubMed

    Hosany, Z; Wellman, N; Lowe, T

    2007-10-01

    It is widely acknowledged that there are major concerns about quality of care, ward atmosphere, the nature of nurse-patient interactions and patient outcomes in UK psychiatric acute admission units. Brief solution-focused therapy (SFT) is an approach which aims to shift the focus of interactions in professional care away from the traditional concentration on an individual's problems and weaknesses towards a more proactive identification of their strengths and positive coping mechanisms. This approach relies on a collaborative engagement with patients, in which the nurse or therapist using simple language aims to help the patient construct a plan to ensure their immediate safety while working to identify, focus on and reinforce their strengths and coping mechanisms in the achievement of identified future goals. This paper reports on a pilot study whose principal objective was to determine whether a short training in brief SFT for psychiatric nurses can produce measurable improvements in nurse-patient interactions in two psychiatric acute admission wards. In this study, 36 nurses undertook a 2-day training course in SFT and were followed up 3 months after training. Positive results were obtained on a number of measures indicating that nurses had acquired knowledge and skills and were applying SFT techniques in their clinical work.

  12. Observations and outcomes: a comment on "seasonal variation in AF-related admissions to a coronary care unit in a 'hot' climate: fact or fiction?".

    PubMed

    Deaton, Christi

    2004-01-01

    Observations about patients made by nurses and other healthcare professionals are important and may lead to new knowledge about patient outcomes and the development of interventions to improve outcomes. However, observations need careful study and validation before any conclusions can be drawn. The importance of the research process and building solid evidence is discussed, using an article from this issue of the Journal of Cardiovascular Nursing as an example.

  13. Risk factors for maternal deaths in unplanned obstetric admissions to the intensive care unit-lessons for sub-Saharan Africa.

    PubMed

    Okafor, Ugochukwu V; Efetie, Efenae R; Amucheazi, Adaobi

    2011-12-01

    This study was undertaken to determine the risk factors for maternal deaths in unplanned or unbooked obstetric admissions to the intensive care unit of a tertiary health centre. Hospital records of unbooked obstetric admissions to the intensive care unit of the hospital from January 1997 to December 2006 were retrospectively reviewed. Data collected included patients' demographics, diagnosis, duration of stay in the ICU and patient outcome. The intensive care unit records showed that there were 25 unbooked obstetric admissions. Major diagnoses for unplanned admissions to the ICU were preeclampsia/eclampsia (41.1%), obstetric haemorrhage (37.5%), and respiratory distress (12.5%). There were 12 deaths (48%). Organ dysfunction on admission, massive blood loss and late presentation were the risk factors for mortality. The high maternal mortality was mainly due to limited supply of blood products and inadequate prenatal care resulting in disease severity.

  14. Clinical outcomes of two main variants of progressive supranuclear palsy and multiple system atrophy: a prospective natural history study.

    PubMed

    Jecmenica-Lukic, Milica; Petrovic, Igor N; Pekmezovic, Tatjana; Kostic, Vladimir S

    2014-08-01

    Progressive supranuclear palsy (PSP) and parkinsonian subtype of multiple system atrophy (MSA-P) are, after Parkinson's disease (PD), the most common forms of neurodegenerative parkinsonism. Clinical heterogeneity of PSP includes two main variants, Richardson syndrome (PSP-RS) and PSP-parkinsonism (PSP-P). Clinical differentiation between them may be impossible at least during the first 2 years of the disease. Little is known about the differences in natural course of PSP-RS and PSP-P and, therefore, in this study we prospectively followed the clinical outcomes of consecutive, pathologically unconfirmed patients with the clinical diagnoses of PSP-RS (51 patients), PSP-P (21 patients) and MSA-P (49 patients). Estimated mean survival time was 11.2 years for PSP-P, 6.8 years for PSP-RS, and 7.9 years for MSA-P, where a 5-year survival probabilities were 90, 66 and 78 %, respectively. More disabling course of PSP-RS compared to PSP-P was also highlighted through the higher number of milestones reached in the first 3 years of the disease, as well as in the trend to reach all clinical milestones earlier. We found that PSP-P variant had a more favorable course with longer survival, not only when compared to PSP-RS, but also when compared to another form of atypical parkinsonism, MSA-P.

  15. What Admissions Officials Think

    ERIC Educational Resources Information Center

    Hoover, Eric

    2008-01-01

    Over the past two decades, college admissions has become a prime-time preoccupation. Most people know at least something about the process, especially if they have a teenager in high school and a college guide on their coffee table. Nonetheless, widespread public misconceptions persist about admissions requirements, the selection process, and the…

  16. The Administration of Admissions

    ERIC Educational Resources Information Center

    Campbell, Clifford C.

    1978-01-01

    Among all the tasks of the admissions officer in developing a successful marketing program, the hardest may be that of convincing other college administrators of the importance of admissions to the institution's survival. Discussed are long-range planning, budgeting, staff selection and training, and implementing a plan. (Author/LBH)

  17. 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…

  18. Bright Start: Description and main outcomes from a group-randomized obesity prevention trial in American Indian children.

    PubMed

    Story, Mary; Hannan, Peter J; Fulkerson, Jayne A; Rock, Bonnie Holy; Smyth, Mary; Arcan, Chrisa; Himes, John H

    2012-11-01

    The aim of the Bright Start study was to develop and test the effectiveness of a school environment intervention, supplemented with family involvement, to reduce excessive weight gain by increasing physical activity and healthy eating practices among kindergarten and first-grade American Indian children. Bright Start was a group-randomized, school-based trial involving 454 children attending 14 schools on the Pine Ridge Reservation in South Dakota. Children were followed from the beginning of their kindergarten year through the end of first grade. Main outcome variables were mean BMI, mean percent body fat, and prevalence of overweight/obese children. The goals of the intervention were to: increase physical activity at school to at least 60 min/day; modify school meals and snacks; and involve families in making behavioral and environmental changes at home. At baseline, 32% of boys and 25% of girls were overweight/obese. Although the intervention was not associated with statistically significant change in mean levels of BMI, BMI-Z, skinfolds or percentage body fat, the intervention was associated with a statistically significant net decrease of 10% in the prevalence of overweight. Intervention children experienced a 13.4% incidence of overweight, whereas the control children experienced a corresponding incidence of 24.8%; a difference of -11.4% (P = 0.033). The intervention significantly reduced parent-reported mean child intakes of sugar-sweetened beverages, whole milk, and chocolate milk. Changes in duration of school physical activity were not significant. Because obesity is the most daunting health challenge facing American Indian children today, more intervention research is needed to identify effective approaches.

  19. Student Admission and Attendance.

    ERIC Educational Resources Information Center

    Majestic, Ann L.

    1988-01-01

    Considers the North Carolina statutes that define the process for admitting students to public schools and ensuring their attendance. Examines cases relating to issues of school admission and compulsory attendance. (MLF)

  20. Hospice Admission Assessment.

    PubMed

    Moon, Paul J

    2017-04-01

    Hospice admission assessment is a pivotal encounter for patient/family and hospice representative. For patient/family, the admission is the threshold by which a particular level of care can commence and, symbolically, a certain marker in health status trajectory is reached. For hospice representative, the admission episode is an occasion to inaugurate an ambience that can serve to frame future hospice care experiences for the patient/family. Through a narrative lens, hospice admission assessment can be seen as experiential time and space, where patient's and family's stories are mindfully and deliberately witnessed and explored. Through the practice of narrative mining, the hospice representative can better understand others' offered stories of reality, which will better inform the plan of palliation and hospice care.

  1. A Revised Admissions Standard for One Community College Nursing Program

    ERIC Educational Resources Information Center

    Lown, Maris A.

    2010-01-01

    Predicting success on the NCLEX-RN is of paramount importance to nursing programs as they are held accountable for this outcome by accrediting agencies and by boards of nursing. This action research study examined the relationship between the NET admission test, anatomy and physiology grades, grade point average (GPA) on admission to the program…

  2. Variation in rates of hospital admission for appendicitis in Wales.

    PubMed Central

    West, R R; Carey, M J

    1978-01-01

    In a study designed to investigate the variations in rates of admission to hospital for appendicitis in Wales Hospital Activity Analysis listings were analysed according to the sex and age of the patients and the month and day of the week of admission. The incidence of hospitalisation was greatest among boys aged 10-14 and girls aged 15-19. The number of admissions was higher on weekdays than at weekends, but there were no seasonal variations. Durations of stay differed between the 17 health districts. We conclude that admission rates vary mainly because of differing hospital admission policies. Admission is not wholly governed by the sudden onset of abdominal pain; other factors include the threshold of consultation of each patient, the referral habits of general practitioners, the availability of hospital beds, and the degree to which doctors and patients expect admission. PMID:656866

  3. Main Trunk and Division Middle Cerebral Artery Occlusions: Differences in Recanalization Times, Number of Stent Retriever Passes and Clinical Outcomes: A Single-Center Experience

    PubMed Central

    Qureshi, Ihtesham A.; Maud, Alberto; Cruz-Flores, Salvador; Rodriguez, Gustavo J.

    2016-01-01

    Background and Purpose In this article, we present our experience with the recanalization of the middle cerebral artery (MCA), we hypothesize that there are higher rates of recanalization with fewer stent retriever passes and better clinical outcomes in patients with division MCA occlusions. A more complex anatomy at the bifurcation may prevent a faster recanalization in main trunk MCA occlusions. Methods We retrospectively identified consecutive patients admitted with MCA occlusions who underwent mechanical thrombectomy using stent retrievers. We categorized patients into division MCA and main trunk MCA occlusions based on angiography. Variables were compared between the groups. We further analyzed patients with trunk MCA occlusions to identify reasons for delays in recanalization. Results There were 32 MCA occlusions that underwent mechanical thrombectomy and eligible for the analysis during the study period. Of those, 11 were main trunk MCA occlusions. Univariate analysis disclosed a trend toward a lower GP-to-recanalization time (p = 0.05) and a lower number of passes required for recanalization in division MCA occlusions. However, there was a significantly better outcome in patients with division MCA occlusion after multivariate analysis. Analyzing main trunk MCA occlusion data, we found that the need for more than one pass to achieve recanalization led to a trend toward a longer GP-to-recanalization time and a worse outcome. When the stent was placed in the dominant division, the chances of recanalization were significantly higher. Conclusions Division MCA occlusions have higher recanalization rates with fewer stent retriever passes and better clinical outcomes than main trunk MCA occlusions, likely due to a more favorable anatomy. Measures like placing the stent retriever in the dominant division may decrease recanalization times and improve clinical outcomes in main trunk MCA occlusions. PMID:27051403

  4. Factors Associated with ICU Admission following Blunt Chest Trauma

    PubMed Central

    Etteri, Massimiliano; Cantaluppi, Francesca; Pina, Paolo; Guanziroli, Massimo; Bianchi, AnnaMaria; Casazza, Giovanni

    2016-01-01

    Background. Blunt chest wall trauma accounts for over 10% of all trauma patients presenting to emergency departments worldwide. When the injury is not as severe, deciding which blunt chest wall trauma patients require a higher level of clinical input can be difficult. We hypothesized that patient factors, injury patterns, analgesia, postural condition, and positive airway pressure influence outcomes. Methods. The study population consisted of patients hospitalized with at least 3 rib fractures (RF) and at least one pulmonary contusion and/or at least one pneumothorax lower than 2 cm. Results. A total of 140 patients were retrospectively analyzed. Ten patients (7.1%) were admitted to intensive care unit (ICU) within the first 72 hours, because of deterioration of the clinical conditions and gas exchange with worsening of chest X-ray/thoracic ultrasound/chest computed tomography. On univariable analysis and multivariable analysis, obliged orthopnea (p = 0.0018) and the severity of trauma score (p < 0.0002) were associated with admission to ICU. Conclusions. Obliged orthopnea was an independent predictor of ICU admission among patients incurring non-life-threatening blunt chest wall trauma. The main therapeutic approach associated with improved outcome is the prevention of pulmonary infections due to reduced tidal volume, namely, upright postural condition and positive airway pressure. PMID:28044070

  5. The Admissions Equity Struggle

    ERIC Educational Resources Information Center

    Freedman, Eric

    2012-01-01

    It has been a long, litigious road from Heman Sweatt, an African-American mail carrier who wanted to attend the prestigious, all-White law school at the University of Texas at Austin in 1946, to Abigail Fisher, a White high school student who failed to win undergraduate admission to the same university a half-century later. Depending on what the…

  6. Admissions Criteria in Teacher Education.

    ERIC Educational Resources Information Center

    Schwanke, Dean

    1981-01-01

    A review of the literature on the topic of admissions criteria in teacher education is presented. Bibliographic annotations review surveys, studies, models, and guidelines on various aspects of admissions criteria, as well as attracting and retaining quality students. (JN)

  7. Evidence for a persistent, major excess in all cause admissions to hospital in children with type-1 diabetes: results from a large Welsh national matched community cohort study

    PubMed Central

    Sayers, Adrian; Thayer, Daniel; Harvey, John N; Luzio, Stephen; Atkinson, Mark D; French, Robert; Warner, Justin T; Dayan, Colin M; Wong, Susan F; Gregory, John W

    2015-01-01

    Objectives To estimate the excess in admissions associated with type1 diabetes in childhood. Design Matched-cohort study using anonymously linked hospital admission data. Setting Brecon Group Register of new cases of childhood diabetes in Wales linked to hospital admissions data within the Secure Anonymised Information Linkage Databank. Population 1577 Welsh children (aged between 0 and 15 years) from the Brecon Group Register with newly-diagnosed type-1 diabetes between 1999–2009 and 7800 population controls matched on age, sex, county, and deprivation, randomly selected from the local population. Main outcome measures Difference in all-cause hospital admission rates, 30-days post-diagnosis until 31 May 2012, between participants and controls. Results Children with type-1 diabetes were followed up for a total of 12 102 person years and were at 480% (incidence rate ratios, IRR 5.789, (95% CI 5.34 to 6.723), p<0.0001) increased risk of hospital admission in comparison to matched controls. The highest absolute excess of admission was in the age group of 0–5 years, with a 15.4% (IRR 0.846, (95% CI 0.744 to 0.965), p=0.0061) reduction in hospital admissions for every 5-year increase in age at diagnosis. A trend of increasing admission rates in lower socioeconomic status groups was also observed, but there was no evidence of a differential rate of admissions between men and women when adjusted for background risk. Those receiving outpatient care at large centres had a 16.1% (IRR 0.839, (95% CI 0.709 to 0.990), p=0.0189) reduction in hospital admissions compared with those treated at small centres. Conclusions There is a large excess of hospital admissions in paediatric patients with type-1 diabetes. Rates are highest in the youngest children with low socioeconomic status. Factors influencing higher admission rates in smaller centres (eg, “out of hours resources”) need to be explored with the aim of targeting modifiable influences on admission rates. PMID

  8. 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

  9. Opening a Side-Gate: Engaging the Excluded in Chilean Higher Education through Test-Blind Admission

    ERIC Educational Resources Information Center

    Koljatic, Mladen; Silva, Monica

    2013-01-01

    The article describes a test-blind admission initiative in a Chilean research university aimed at expanding the inclusion of talented, albeit educationally and socially disadvantaged, students. The outcomes of the test-blind admission cohort were compared with those of students admitted via the regular admission procedure to the same academic…

  10. Referral patterns after a seizure admission in an English region: an opportunity for effective intervention? An observational study of routine hospital data

    PubMed Central

    Grainger, Ruth; Pearson, Michael; Dixon, Peter; Devonport, Elizabeth; Timoney, Michelle; Bodger, Keith; Kirkham, Jamie; Marson, Anthony

    2016-01-01

    Objectives To identify emergency seizure admissions to hospital and their subsequent access to specialist outpatient services. Design Algorithmic analysis of anonymised routine hospital data over 7 years using specialist follow-up by 3 months as the target outcome. Population All adults resident in Merseyside and Cheshire, England. Main Outcomes Whether, and when, access to the specialist advice that might prevent further admissions was offered. Results 1.4% of all emergency medical admissions are as a result of seizure. In the following 12 months 35% were readmitted and experienced a mean of 2.3 emergency department visits. Only 27% (48% of those already known to specialists and 13% of those not known) were offered appointments. Subsequent attendance at a specialist clinic is more likely if already known to a clinic, if aged <35 years, if female, or required a longer spell in hospital. Extrapolation from other work suggests 100 000 bed days per annum could be saved. Conclusions Most seizure admissions are not being referred for the help that could prevent future admissions. The majority of those that are referred are not seen within an appropriate time frame. Our service structures are not providing an optimum service for people with epilepsy. PMID:26792220

  11. Prevalence and risk factors for medication reconciliation errors during hospital admission in elderly patients.

    PubMed

    Rodríguez Vargas, Blanca; Delgado Silveira, Eva; Iglesias Peinado, Irene; Bermejo Vicedo, Teresa

    2016-10-01

    Background Care transitions are risk points for medication discrepancies, especially in the elderly. Objective This study was undertaken to assess prevalence and describe medication reconciliation errors during admission in elderly patients and to analyze associated risk factors. We also evaluate the effect of these errors on the length of hospital stay. Setting General surgery, orthopedics, internal medicines and infectious diseases departments of a 1070-bed Spanish teaching hospital. Method This is a prospective observational study. Patients >65 years and taking ≥5 medications were randomly selected from those admitted to hospital. The pharmacist obtained the best possible medication history based on medical records, medical notes from patients' previous admissions to hospital, "brown bag" review, community care prescriptions, and comprehensive patient interviews. It was compared to current inpatient prescription to detect unintentional discrepancies (discrepancy with no apparent clinical explanation), which were reported to the physician. When the physician accepted the discrepancy by changing the medication order, it was recorded as a medication reconciliation error and classified by type of error. Several variables were analyzed as possible risk/protective factors. Main outcome measure Is prevalence of medication reconciliation errors at admission. Results Reconciliation was performed on 206 patients. Medication reconciliation errors occurred in 49.5 % (102/206) of patients. 1996 medications were recorded, and 359 had unintentional discrepancies (56.0 % (201/359) medication reconciliation errors). The most common was omission (65.1 %). Identified risk factors were as follows: physician experience, number of pre-admission prescribed medications, and previous surgeries. Computerized order entry system was a protective factor. Conclusion Medication reconciliation errors occur in almost half of the elderly patients at admission, especially omissions. Risk

  12. 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)

  13. 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…

  14. [Cleaning and disinfection in nursing homes. Data on quality of structure, process and outcome in nursing homes in Frankfurt am Main, Germany, 2011].

    PubMed

    Heudorf, U; Gasteyer, S; Samoiski, Y; Voigt, K

    2012-08-01

    Due to the Infectious Disease Prevention Act, public health services in Germany are obliged to check the infection prevention in hospitals and other medical facilities as well as in nursing homes. In Frankfurt/Main, Germany, standardized control visits have been performed for many years. In 2011 focus was laid on cleaning and disinfection of surfaces. All 41 nursing homes were checked according to a standardized checklist covering quality of structure (i.e. staffing, hygiene concept), quality of process (observation of the cleaning processes in the homes) and quality of output, which was monitored by checking the cleaning of fluorescent marks which had been applied some days before and should have been removed via cleaning in the following days before the final check. In more than two thirds of the homes, cleaning personnel were salaried, in one third external personnel were hired. Of the homes 85% provided service clothing and all of them offered protective clothing. All homes had established hygiene and cleaning concepts, however, in 15% of the homes concepts for the handling of Norovirus and in 30% concepts for the handling of Clostridium difficile were missing. Regarding process quality only half of the processes observed, i.e. cleaning of hand contact surfaces, such as handrails, washing areas and bins, were correct. Only 44% of the cleaning controls were correct with enormous differences between the homes (0-100%). The correlation between quality of process and quality of output was significant. There was good quality of structure in the homes but regarding quality of process and outcome there was great need for improvement. This was especially due to faults in communication and coordination between cleaning personnel and nursing personnel. Quality outcome was neither associated with the number of the places for residents nor with staffing. Thus, not only quality of structure but also quality of process and outcome should be checked by the public health

  15. Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease

    PubMed Central

    Hyun, Dae Young; Jeong, Myung Ho; Sim, Doo Sun; Jeong, Yun Ah; Cho, Kyung Hoon; Kim, Min Chul; Kim, Hyun Kuk; Jeong, Hae Chang; Park, Keun Ho; Hong, Young Joon; Kim, Jun Han; Ahn, Youngkeun; Kang, Jung Chaee

    2016-01-01

    Background/Aims This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years). We evaluated clinical and angiographic characteristics and major adverse cardiac events (MACE) during 2-year clinical follow-up. Results Mean age of studied patients was 64 ± 10 years with 339 male patients. Average stent diameter was 3.6 ± 0.4 mm and stent length was 19.7 ± 6.3 mm. Stent implantation techniques and use of intravascular ultrasound guidance were not different between two groups. In-hospital mortality was 0% in group I and 7% in group II (p = 0.035). One-month mortality was 0% in group I and 7.7% in group II (p = 0.968). Two-year survival rate was 93% in the group I and 88.4% in the group II (p = 0.921). Predictive factors for 2-year MACE were hypertension, Killip class ≥ 3, and use of intra-aortic balloon pump by multivariate analysis. Conclusions Although in-hospital mortality rate was higher in ACS than in SAP, clinical outcomes during 2-year clinical follow-up were similar between SAP and ACS after PCI of ULMCA. PMID:27756119

  16. Predicting frequent hospital admission risk in Singapore: a retrospective cohort study to investigate the impact of comorbidities, acute illness burden and social determinants of health

    PubMed Central

    Liu, Nan; Wang, Sijia; Thumboo, Julian; Ong, Marcus Eng Hock; Lee, Kheng Hock

    2016-01-01

    Objectives To evaluate the impact of comorbidities, acute illness burden and social determinants of health on predicting the risk of frequent hospital admissions. Design Multivariable logistic regression was used to associate the predictive variables extracted from electronic health records and frequent hospital admission risk. The model's performance of our predictive model was evaluated using a 10-fold cross-validation. Setting A single tertiary hospital in Singapore. Participants All adult patients admitted to the hospital between 1 January 2013 and 31 May 2014 (n=25 244). Main outcome measure Frequent hospital admissions, defined as 3 or more inpatient admissions within 12 months of discharge. Area under the receiver operating characteristic curve (AUC) of the predictive model, and the sensitivity, specificity and positive predictive values for various cut-offs. Results 4322 patients (17.1%) met the primary outcome. 11 variables were observed as significant predictors and included in the final regression model. The strongest independent predictor was treatment with antidepressants in the past 1 year (adjusted OR 2.51, 95% CI 2.26 to 2.78). Other notable predictors include requiring dialysis and treatment with intravenous furosemide during the index admission. The predictive model achieved an AUC of 0.84 (95% CI 0.83 to 0.85) for predicting frequent hospital admission risk, with a sensitivity of 73.9% (95% CI 72.6% to 75.2%), specificity of 79.1% (78.5% to 79.6%) and positive predictive value of 42.2% (95% CI 41.1% to 43.3%) at the cut-off of 0.235. Conclusions We have identified several predictors for assessing the risk of frequent hospital admissions that achieved high discriminative model performance. Further research is necessary using an external validation cohort. PMID:27742630

  17. Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients: validation of PROMISSE study results

    PubMed Central

    Yelnik, Cecile M; Laskin, Carl A; Porter, T Flint; Branch, D Ware; Buyon, Jill P; Guerra, Marta M; Lockshin, Michael D; Petri, Michelle; Merrill, Joan T; Sammaritano, Lisa R; Kim, Mimi Y; Salmon, Jane E

    2016-01-01

    Objective We previously reported that lupus anticoagulant (LAC) is the main predictor of poor pregnancy outcome in antiphospholipid antibody (aPL)-positive patients. We sought to confirm this finding in an independent group of patients who were subsequently recruited into the PROMISSE study. Methods The PROMISSE study is a multicentre, prospective, observational study of pregnancy outcomes in women with aPL and/or systemic lupus erythematosus (SLE) that enrolled patients from 2003 to 2015. All consecutive, aPL-positive patients from the PROMISSE study who completed their pregnancy between April 2011 and January 2015 (after the previous PROMISSE report) are included in the current report. Patients were followed monthly until delivery, and aPL was tested at first, second and third trimesters of pregnancy and at 12 weeks post partum. Adverse pregnancy outcomes (APOs) were defined as fetal death after 12 weeks of gestation, neonatal death, delivery prior to 36 weeks of gestation due to pre-eclampsia or placental insufficiency or small-for-gestational age (birth weight <5th percentile). Results Forty-four aPL-positive patients are included in this paper. Thirteen patients had APOs, which occurred in 80% of cases during the second trimester of pregnancy. LAC was present in 69% of patients with APOs compared with 27% of patients without APOs (p=0.01). No association was found between anticardiolipin antibodies (aCL) or anti-β2 glycoprotein I antibodies (aβ2GPI) IgG or IgM positivity and APOs. Definite antiphospholipid syndrome (history of thrombosis and/or pregnancy morbidity and aPL) was found in 92% of patients with any APOs compared with 45% of patients without APOs (p=0.004). Conversely, the frequency of SLE was not statistically different between those with and without APOs (30% vs 39%). Conclusions Our findings, in an independent group of aPL-positive patients from the PROMISSE study, confirm that LAC, but not aCL and aβ2GPI, is predictive of poor pregnancy

  18. Impact of integrated health system changes, accelerated due to an earthquake, on emergency department attendances and acute admissions: a Bayesian change-point analysis

    PubMed Central

    Schluter, Philip J; Hamilton, Greg J; Deely, Joanne M; Ardagh, Michael W

    2016-01-01

    Objective To chart emergency department (ED) attendance and acute admission following a devastating earthquake in 2011 which lead to Canterbury's rapidly accelerated integrated health system transformations. Design Interrupted time series analysis, modelling using Bayesian change-point methods, of ED attendance and acute admission rates over the 2008–2014 period. Setting ED department within the Canterbury District Health Board; with comparison to two other district health boards unaffected by the earthquake within New Zealand. Participants Canterbury's health system services ∼500 000 people, with around 85 000 ED attendances and 37 000 acute admissions per annum. Main outcome measures De-seasoned standardised population ED attendance and acute admission rates overall, and stratified by age and sex, compared before and after the earthquake. Results Analyses revealed five global patterns: (1) postearthquake, there was a sudden and persisting decrease in the proportion of the population attending the ED; (2) the growth rate of ED attendances per head of population did not change between the pre-earthquake and postearthquake periods; (3) postearthquake, there was a sudden and persisting decrease in the proportion of the population admitted to hospital; (4) the growth rate of hospital admissions per head of the population declined between pre-earthquake and postearthquake periods and (5) the most dramatic reduction in hospital admissions growth after the earthquake occurred among those aged 65+ years. Extrapolating from the projected and fitted deseasoned rates for December 2014, ∼676 (16.8%) of 4035 projected hospital admissions were avoided. Conclusions While both necessarily and opportunistically accelerated, Canterbury's integrated health systems transformations have resulted in a dramatic and sustained reduction in ED attendances and acute hospital admissions. This natural intervention experiment, triggered by an earthquake, demonstrated that

  19. 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

  20. 28 CFR 549.42 - Involuntary admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... SERVICES Administrative Safeguards for Psychiatric Treatment and Medication § 549.42 Involuntary admission... voluntarily consent either to psychiatric admission or to medication, is subject to judicial...

  1. 32 CFR 242.5 - Admission procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... HEALTH SCIENCES § 242.5 Admission procedures. (a) Application—(1) Civilians. Civilians seeking admission to the School of Medicine shall make direct application following instructions published in...

  2. Trajectories of disability among older persons before and after a hospitalization leading to a skilled nursing facility admission

    PubMed Central

    Buurman, Bianca M.; Han, Ling; Murphy, Terrence E.; Gahbauer, Evelyne A.; Leo-Summers, Linda; Allore, Heather G.; Gill, Thomas M.

    2015-01-01

    Objectives To identify distinct sets of disability trajectories in the year before and after a Q-SNF admission, evaluate the associations between the pre- and post-Q-SNF disability trajectories, and determine short-term outcomes (readmission, mortality). Design, setting and participants Prospective cohort study including 754 community-dwelling older persons, 70+ years, and initially nondisabled in their basic activities of daily living. The analytic sample included 394 persons, with a first hospitalization followed by a Q-SNF admission between 1998–2012. Main outcomes and measures Disability in the year before and after a Q-SNF admission using 13 basic, instrumental and mobility activities. Secondary outcomes included 30-day readmission and 12-month mortality. Results The mean (SD) age of the sample was 84.9(5.5) years. We identified three disability trajectories in the year before a Q-SNF admission: minimal disability (37.3% of participants) mild disability (44.6%), and moderate disability (18.2%). In the year after a Q-SNF admission, all participants started with moderate to severe disability scores. Three disability trajectories were identified: substantial improvement (26.0% of participants), minimal improvement (36.5%), and no improvement (37.5%). Among participants with minimal disability pre-Q-SNF, 52% demonstrated substantial improvement; the other 48% demonstrated minimal improvement (32%) or no improvement (16%) and remained moderately to severely disabled in the year post-Q-SNF. Among participants with mild disability pre-Q-SNF, 5% showed substantial improvement, whereas 95% showed little to no improvement. Of participants with moderate disability pre-Q-SNF, 15% remained moderately disabled showing little improvement, whereas 85% showed no improvement. Participants who transitioned from minimal disability pre-Q-SNF to no improvement post-Q-SNF had the highest rates of 30-day readmission and 12-month mortality (rate/100 person days 1.3 [95% CI 0.6–2

  3. Standardizing admission and discharge processes to improve patient flow: A cross sectional study

    PubMed Central

    2012-01-01

    Background The aim of this study was to evaluate how hospital capacity was managed focusing on standardizing the admission and discharge processes. Methods This study was set in a 900-bed university affiliated hospital of the National Health Service, near Barcelona (Spain). This is a cross-sectional study of a set of interventions which were gradually implemented between April and December 2008. Mainly, they were focused on standardizing the admission and discharge processes to improve patient flow. Primary administrative data was obtained from the 2007 and 2009 Hospital Database. Main outcome measures were median length of stay, percentage of planned discharges, number of surgery cancellations and median number of delayed emergency admissions at 8:00 am. For statistical bivariate analysis, we used a Chi-squared for linear trend for qualitative variables and a Wilcoxon signed ranks test and a Mann–Whitney test for non-normal continuous variables. Results The median patients’ global length of stay was 8.56 days in 2007 and 7.93 days in 2009 (p < 0.051). The percentage of patients admitted the same day as surgery increased from 64.87% in 2007 to 86.01% in 2009 (p < 0.05). The number of cancelled interventions due to lack of beds was 216 patients in 2007 and 42 patients in 2009. The median number of planned discharges went from 43.05% in 2007 to 86.01% in 2009 (p < 0.01). The median number of emergency patients waiting for an in-hospital bed at 8:00 am was 5 patients in 2007 and 3 patients in 2009 (p < 0.01). Conclusions In conclusion, standardization of admission and discharge processes are largely in our control. There is a significant opportunity to create important benefits for increasing bed capacity and hospital throughput. PMID:22741542

  4. Admissions and Transfer Experiences of Students Continuing Their Studies in British Columbia.

    ERIC Educational Resources Information Center

    Lawrance, Jill

    This report presents the results of an analysis of admissions and transfer data from the 2000 British Columbia (BC) College and Institute Student Outcomes Survey. It addresses a number of issues related to the admissions and transfer experiences of former students from BC's college and institute system, from the students' perspective. Twenty-one…

  5. Florida initiative aims to slash unnecessary admissions due to 'catch-all' dehydration diagnosis.

    PubMed

    2001-05-01

    When the peer review organization in Florida sounded an alarm about unnecessary medical admissions with the diagnosis of dehydration, a Tampa hospital decided to make the issue a priority. Although St. Joseph's Hospital was performing better than average, it still found ways to reduce the number of inappropriate admissions and improve related outcome measures.

  6. Identifying Life-Threatening Admissions for Drug Dependence or Abuse (ILIADDA): Derivation and Validation of a Model.

    PubMed Central

    Nguyen, Tri-Long; Boudemaghe, Thierry; Leguelinel-Blache, Géraldine; Eiden, Céline; Kinowski, Jean-Marie; Le Manach, Yannick; Peyrière, Hélène; Landais, Paul

    2017-01-01

    Given that drug abuse and dependence are common reasons for hospitalization, we aimed to derive and validate a model allowing early identification of life-threatening hospital admissions for drug dependence or abuse. Using the French National Hospital Discharge Data Base, we extracted 66,101 acute inpatient stays for substance abuse, dependence, mental disorders or poisoning associated with medicines or illicit drugs intake, recorded between January 1st, 2009 and December 31st, 2014. We split our study cohort at the center level to create a derivation cohort and a validation cohort. We developed a multivariate logistic model including patient’s age, sex, entrance mode and diagnosis as predictors of a composite primary outcome of in-hospital death or ICU admission. A total of 2,747 (4.2%) patients died or were admitted to ICU. The risk of death or ICU admission was mainly associated with the consumption of opioids, followed by cocaine and other narcotics. Particularly, methadone poisoning was associated with a substantial risk (OR: 35.70, 95% CI [26.94–47.32], P < 0.001). In the validation cohort, our model achieved good predictive properties in terms of calibration and discrimination (c-statistic: 0.847). This allows an accurate identification of life-threatening admissions in drug users to support an early and appropriate management. PMID:28290530

  7. Characteristics of delayed admission to stroke unit.

    PubMed

    Silvestrelli, Giorgio; Parnetti, Lucilla; Tambasco, Nicola; Corea, Francesco; Capocchi, Giuseppe

    2006-01-01

    Early admission to stroke unit (SU) and factors that may cause admission delay represent relevant issues to obtain an optimal management of acute stroke. This study was aimed at recording timing from clinical onset to admission to our SU and to identify the reasons for delay. We prospectively examined acute stroke patients consecutively admitted to the Perugia SU. Baseline characteristics of stroke patients, stroke type and etiology, time from symptom onset to arrival in the SU were obtained from the Hospital-Based Perugia Stroke Registry. 60.8% of 2,213 consecutive stroke patients admitted to the SU arrived within 6 hrs and 39.2% after 6 hrs. Underestimation of symptoms was the cause of delay in 48.7% of cases. Younger age, especially for females, ischemic stroke, mild and/or unspecific symptoms and the underestimation of symptoms seem to be the main reasons for delayed arrival in the SU. To increase the proportion of stroke patients arriving in the SU within 3 hr of symptom onset, it is necessary to improve public and general practitioner awareness of stroke through educational programs.

  8. 22 CFR 229.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Admission. 229.300 Section 229.300 Foreign... and Recruitment Prohibited § 229.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to which §§...

  9. 22 CFR 229.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Admission. 229.300 Section 229.300 Foreign... and Recruitment Prohibited § 229.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to which §§...

  10. 22 CFR 146.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Admission. 146.300 Section 146.300 Foreign... Recruitment Prohibited § 146.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to which §§ 146.300...

  11. 10 CFR 1042.300 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Admission. 1042.300 Section 1042.300 Energy DEPARTMENT OF... Prohibited § 1042.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to which §§ 1042.300 through...

  12. 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...

  13. 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.…

  14. 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...

  15. What is the relationship between age and deprivation in influencing emergency hospital admissions? A model using data from a defined, comprehensive, all-age cohort in East Devon, UK

    PubMed Central

    Pereira Gray, Denis; Henley, William; Chenore, Todd; Sidaway-Lee, Kate; Evans, Philip

    2017-01-01

    Objectives To clarify the relationship between social deprivation and age as two factors associated with emergency admissions to hospital. Design Emergency admissions for 12 months were analysed for patients in the NHS NEW Devon CCG. Social deprivation was measured by the Index of Multiple Deprivation (IMD). Logistic regression models estimated the separate and combined effects of social deprivation and age on the risk of emergency admissions for people aged under and over 65. Setting East Devon, UK—area of the NEW Devon CCG. Population 765 861 patients in the CCG database. Main outcome measure Emergency admission to any English hospital. Results Age (p<0.001) and social deprivation (p<0.001) were significantly associated with emergency admission to hospital, but there was a significant interaction between age and social deprivation (p<0.001). From the third quintile of age upwards, age progressively overtakes deprivation and age has a dominant effect on emergency admissions over the age of 65. The effect of age was J-shaped in all deprivation groups, increasing exponentially after age 40. For patients under 65, age and social deprivation had similar risks for emergency admissions, the differences in risk between the top and bottom quintiles of IMD and age being ∼1.5 and 0.9 percentage points. In patients over 65, age had a much greater effect on the risk of admissions than social deprivation, the differences in risk between the top and bottom quintiles of IMD and age being ∼2.8 and 18.7 percentage points. Conclusions Risk curves for all social groups have similar shapes, implying a common biological pattern for ageing in any social group. Over age 65, the biological effects of ageing outweigh the social effects of deprivation. Our model enables CCGs to anticipate and plan for emergency admissions to hospital. These findings provide a new logic for allocating resources to different populations. PMID:28196950

  16. Seat Belt Usage in Injured Car Occupants: Injury Patterns, Severity and Outcome After Two Main Car Accident Mechanisms in Kashan, Iran, 2012

    PubMed Central

    Mohammadzadeh, Mahdi; Paravar, Mohammad; Mirzadeh, Azadeh Sadat; Mohammadzadeh, Javad; Mahdian, Soroush

    2015-01-01

    Background: Road traffic accidents (RTAs) are the main public health problems in Iran. The seat belts, which are vehicle safety devices, are imperative to reduce the risk of severe injuries and mortality. Objectives: The aim of the study was to evaluate injury patterns, severity and outcome among belted and unbelted car occupants who were injured in car accidents. Patients and Methods: This cross-sectional prospective study was performed on all car occupants injured in RTAs (n = 822) who were transported to hospital and hospitalized for more than 24 hours from March 2012 to March 2013. Demographic profile of the patients, including age, gender, position in the vehicle, the use of seat belts, type of car crashes, injured body regions, revised trauma score (RTS), Glasgow coma score (GCS), duration of hospital stay and mortality rate were analyzed by descriptive analysis, chi-square and independent t-test. P < 0.05 was considered significant. Results: A total of 560 patients used seat belts (68.1%). The unbelted occupants were younger (28 years vs. 38 years) and had more frequently sustained head, abdomen and multiple injuries (P = 0.01, P = 0.01 and P = 0.009, respectively). Also, these patients had significantly lower GCS and elongated hospitalization and higher death rate (P = 0.001, P = 0.001 and P = 0.05, respectively). Tendency of severe head trauma and low RTS and death were increased in unbelted occupants in car rollover accident mechanisms (P = 0.001, P = 0.01 and P = 0.008, respectively). Conclusions: During car crashes, especially car rollover, unbelted occupants are more likely to sustain multiple severe injuries and death. Law enforcement of the seat belt usage for all occupants (front and rear seat) is obligatory to reduce severe injuries sustained as a result of car accidents, especially in vehicles with low safety. PMID:26064867

  17. Association of cannabis use with hospital admission and antipsychotic treatment failure in first episode psychosis: an observational study

    PubMed Central

    Wilson, Robin; Jackson, Richard; Ball, Michael; Shetty, Hitesh; Broadbent, Matthew; Stewart, Robert; McGuire, Philip; Bhattacharyya, Sagnik

    2016-01-01

    Objective To investigate whether cannabis use is associated with increased risk of relapse, as indexed by number of hospital admissions, and whether antipsychotic treatment failure, as indexed by number of unique antipsychotics prescribed, may mediate this effect in a large data set of patients with first episode psychosis (FEP). Design Observational study with exploratory mediation analysis. Setting Anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust. Participants 2026 people presenting to early intervention services with FEP. Exposure Cannabis use at presentation, identified using natural language processing. Main outcome measures admission to psychiatric hospital and clozapine prescription up to 5 years following presentation. Mediator Number of unique antipsychotics prescribed. Results Cannabis use was present in 46.3% of the sample at first presentation and was particularly common in patients who were 16–25, male and single. It was associated with increased frequency of hospital admission (incidence rate ratio 1.50, 95% CI 1.25 to 1.80), increased likelihood of compulsory admission (OR 1.55, 1.16 to 2.08) and greater number of days spent in hospital (β coefficient 35.1 days, 12.1 to 58.1). The number of unique antipsychotics prescribed, mediated increased frequency of hospital admission (natural indirect effect 1.09, 95% CI 1.01 to 1.18; total effect 1.50, 1.21 to 1.87), increased likelihood of compulsory admission (natural indirect effect (NIE) 1.27, 1.03 to 1.58; total effect (TE) 1.76, 0.81 to 3.84) and greater number of days spent in hospital (NIE 17.9, 2.4 to 33.4; TE 34.8, 11.6 to 58.1). Conclusions Cannabis use in patients with FEP was associated with an increased likelihood of hospital admission. This was linked to the prescription of several different antipsychotic drugs, indicating clinical judgement of antipsychotic treatment failure. Together, this suggests that cannabis use might be

  18. The impact of primary care organization on avoidable hospital admissions for diabetes in 23 countries

    PubMed Central

    Van Loenen, Tessa; Faber, Marjan J.; Westert, Gert P.; Van den Berg, Michael J.

    2016-01-01

    Objective Diabetes is a so-called ambulatory care sensitive condition. It is assumed that by appropriate and timely primary care, hospital admissions for complications of such conditions can be avoided. This study examines whether differences between countries in diabetes-related hospitalization rates can be attributed to differences in the organization of primary care in these countries. Design Data on characteristics of primary care systems were obtained from the QUALICOPC study that includes surveys held among general practitioners and their patients in 34 countries. Data on avoidable hospitalizations were obtained from the OECD Health Care Quality Indicator project. Negative binomial regressions were carried out to investigate the association between characteristics of primary care and diabetes-related hospitalizations. Setting A total of 23 countries. Subjects General practitioners and patients. Main outcome measures Diabetes-related avoidable hospitalizations. Results Continuity of care was associated with lower rates of diabetes-related hospitalization. Broader task profiles for general practitioners and more medical equipment in general practice were associated with higher rates of admissions for uncontrolled diabetes. Countries where patients perceive better access to care had higher rates of hospital admissions for long-term diabetes complications. There was no association between disease management programmes and rates of diabetes-related hospitalization. Hospital bed supply was strongly associated with admission rates for uncontrolled diabetes and long-term complications. Conclusions Countries with elements of strong primary care do not necessarily have lower rates of diabetes-related hospitalizations. Hospital bed supply appeared to be a very important factor in this relationship. Apparently, it takes more than strong primary care to avoid hospitalizations. Key pointsCountries with elements of strong primary care do not necessarily have lower rates of

  19. Wāhine hauora: linking local hospital and national health information datasets to explore maternal risk factors and obstetric outcomes of New Zealand Māori and non-Māori women in relation to infant respiratory admissions and timely immunisations

    PubMed Central

    2013-01-01

    Background Significant health inequities exist around maternal and infant health for Māori, the indigenous people of New Zealand. The infants of Māori are more likely to die in their first year of life and also have higher rates of hospital admission for respiratory illnesses, with the greatest burden of morbidity being due to bronchiolitis in those under one year of age. Timely immunisations can prevent some respiratory related hospitalisations, although for Māori, the proportion of infants with age appropriate immunisations are lower than for non-Māori. This paper describes the protocol for a retrospective cohort study that linked local hospital and national health information datasets to explore maternal risk factors and obstetric outcomes in relation to respiratory admissions and timely immunisations for infants of Māori and non-Māori women. Methods/Design The study population included pregnant women who gave birth in hospital in one region of New Zealand between 1995 and 2009. Routinely collected local hospital data were linked via a unique identifier (National Health Index number) to national health information databases to assess rates of post-natal admissions and access to health services for Māori and non-Māori mothers and infants. The two primary outcomes for the study are: 1. The rates of respiratory hospitalisations of infants (≤ 1 yr of age) calculated for infants of both Māori and non-Māori women (for mothers under 20 years of age, and overall) accounting for relationship to parity, maternal age, socioeconomic deprivation index, maternal smoking status. 2. The proportion of infants with age appropriate immunisations at six and 12 months, calculated for both infants born to Māori women and infants born to non-Māori women, accounting for relationship to parity, maternal age, socioeconomic deprivation index, smoking status, and other risk factors. Discussion Analysis of a wide range of routinely collected health information in which

  20. 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.

  1. Pediatric Type 1 Diabetes: Reducing Admission Rates for Diabetes Ketoacidosis

    PubMed Central

    Choi, Steven; Rinke, Michael L.; Vandervoot, Kathy; Heptulla, Rubina A.

    2016-01-01

    Background: Diabetes ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM). Reducing DKA admissions in children with T1DM requires a coordinated, comprehensive management plan. We aimed to decrease DKA admissions, 30-day readmissions, and length of stay (LOS) for DKA admissions. Methods: A multipronged intervention was designed in 2011 to reach all patients: (1) increase insulin pump use and basal-bolus regimen versus sliding scales, (2) transform educational program, (3) increased access to medical providers, and (4) support for patients and families. A before-after study was conducted comparing performance outcomes in years 2007-2010 (preintervention) to 2012-2014 (postintervention) using administrative data and Wilcoxon rank sum and Fischer exact tests. Results: DKA admissions decreased by 44% postintervention (16.7 vs 9.3 per 100 followed patient-years; P = .006), unique patient 30-day readmissions decreased from 20% to 5% postintervention (P = .001), and median LOS significantly decreased postintervention (P < .0001). Although not an original goal of the study, median hemoglobin A1C of a subset of the population transitioned from sliding scale decreased, 10.3% to 8.9% (P < .02). Conclusions: When clinical and widespread program interventions were used, significant reductions in DKA hospitalizations, 30-day readmissions, and LOS occurred for pediatric T1DM. Continuous performance improvement efforts are needed for improving DKA outcomes. PMID:27749721

  2. 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... conditionally select candidates to fill available class spaces. Those conditionally selected shall be the...

  3. An Exploration of Maine Community College's Admission Process: A Recommendation to Maine's Department of Education

    ERIC Educational Resources Information Center

    Woodbury, Amanda L.

    2012-01-01

    It is no secret that the United States is falling way behind in world educational rankings. In 1995, the United States ranked 1st in the world for college graduates however, its ranking dramatically fell in 2005, earning 15th place (Woodruff, 2008). According to the U.S. Chamber of Commerce, most states earn a grade of C, D, or F when it comes to…

  4. The Admission Industrial Complex: Examining the Entrepreneurial Impact on College Access

    ERIC Educational Resources Information Center

    Liu, Amy

    2011-01-01

    The entrepreneurial admission sector is comprised of commercial enterprises aimed at helping students increase their odds of admission, as well as providing general college information to the masses. As for-profit entities, a goal of companies in this sector is to maximize revenue and profit. Existing research identifies four main activities as…

  5. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Admission. 1317.300 Section 1317.300 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY NONDISCRIMINATION ON... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  6. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Admission. 1317.300 Section 1317.300 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY NONDISCRIMINATION ON... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  7. 38 CFR 23.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Admission. 23.300 Section 23.300 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 23.300 Admission. (a) General....

  8. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Admission. 1317.300 Section 1317.300 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY NONDISCRIMINATION ON... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  9. 36 CFR 1211.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Admission. 1211.300 Section 1211.300 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1211.300 Admission. (a) General....

  10. An Economic Model for Selective Admissions

    ERIC Educational Resources Information Center

    Haglund, Alma

    1978-01-01

    The author presents an economic model for selective admissions to postsecondary nursing programs. Primary determinants of the admissions model are employment needs, availability of educational resources, and personal resources (ability and learning potential). As there are more applicants than resources, selective admission practices are…

  11. 17 CFR 12.33 - Admissions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... REPARATIONS Discovery § 12.33 Admissions. (a) Request for admissions. Any party may, within the time permitted... truth of any matters set forth in the request that relate to statements or opinions of fact or of the...) Reply. Each matter of which an admission is requested shall be separately set forth. The matter...

  12. 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…

  13. The Journal of College Admission Ethics Series.

    ERIC Educational Resources Information Center

    Loveland, Elaina C., Ed.; Raynor, Joyce, Ed.

    This book is the first significant body of literature on ethics in college admission published by the National Association for College Admission Counseling. The series is a select compilation of articles on ethics published in the Journal of College Admission in 1998 and 1999. The book is a source of information for the beginning and experienced…

  14. Reducing admissions for people with diabetes.

    PubMed

    Allan, Belinda

    Reversing the rise in emergency hospital admissions is an NHS priority. These admissions impact on elective capacity and waiting times and are unsustainable. The risk of hospitalisation for people with diabetes is almost twice that for others. Commissioners need to address admissions associated with diabetes and new guidance offers best-practice solutions.

  15. 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…

  16. Merit and Competition in Selective College Admissions

    ERIC Educational Resources Information Center

    Killgore, Leslie

    2009-01-01

    Using interview data from 34 admissions officers at 17 elite colleges, this paper compares two perspectives shaping admissions policy. Admissions officers apply a "merit" perspective that relies on indicators of student academic and nonacademic achievement. They also employ a "competition" perspective that evaluates student characteristics…

  17. Toward a Sociology of Law School Admissions.

    ERIC Educational Resources Information Center

    Erlanger, Howard S.

    1984-01-01

    The law school admission process plays a major role in determining the social class origins and ethnic composition of the bar, and perhaps also the nonlegal skills lawyers will have. Research is incomplete; consideration of admission criteria, the composition and processes of admissions committees, and applicant self-selection is advisable. (MSE)

  18. 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...

  19. 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,...

  20. 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,...

  1. 29 CFR 36.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 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...

  2. 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...

  3. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 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...

  4. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 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...

  5. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 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...

  6. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 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...

  7. 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...

  8. The Evolution of College Admission Requirements

    ERIC Educational Resources Information Center

    Beale, Andrew V.

    2012-01-01

    The development of college admissions requirements during the seventeenth and eighteenth centuries was basically the story of the admission policies and practices at Harvard College. Candidates for admission were examined on their ability to read and translate Latin and Greek, and a careful check was made of their character and background. With…

  9. Supply of in-patient medical services for elderly people and geographical variation in medical admissions in a health district in England.

    PubMed

    Maheswaran, R

    1997-11-01

    Geographical variation in the utilisation of in-patient medical services for elderly people in a health district in England was examined in relation to supply of in-patient geriatric medical care and indicators of need. An ecological study design based on electoral wards was used. The health district had a resident population of 67,919 aged 65 y or more and was divided into three localities, each with a different supply of in-patient medical services for elderly people. Locality A had a traditional model of geriatric medical care, Locality B an integrated model and Locality C an age-related model. Localities A and C also had a high provision of general practice hospital beds. The main outcome measure was the age and sex standardised hospital admission ratio for people aged 65 y or more admitted under geriatric medicine, general medicine or general practice in April 1991-March 1992. There were 8829 admissions in 1991/2, 48% in general medicine, 40% in geriatric medicine and 12% in general practice, giving an overall unadjusted admission rate of 130 per 1000 population aged 65 y or more for the three specialties combined. Locality A had the highest, and Locality B the lowest, unadjusted admission rate for the three specialties combined. This rate remained highest in Locality A if second and subsequent admissions in the same period were excluded. Lengths of stay in geriatrics were longest in this locality but lengths of stay for the three specialties combined were similar in the three localities. Multiple regression was used to examine the effect of three indicators of need, the Jarman score, standardised mortality ratio and prevalence of limiting long-term illness, on standardised admission ratios at the electoral ward level. Jarman score had a significant independent association with the standardised admission ratio but adjustment for this factor did not alter the ranking of the three localities, with the standardised admission ratio remaining highest in Locality A

  10. 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.

  11. Investigation of the degree of organisational influence on patient experience scores in acute medical admission units in all acute hospitals in England using multilevel hierarchical regression modelling

    PubMed Central

    Sullivan, Paul

    2017-01-01

    Objectives Previous studies found that hospital and specialty have limited influence on patient experience scores, and patient level factors are more important. This could be due to heterogeneity of experience delivery across subunits within organisations. We aimed to determine whether organisation level factors have greater impact if scores for the same subspecialty microsystem are analysed in each hospital. Setting Acute medical admission units in all NHS Acute Trusts in England. Participants We analysed patient experience data from the English Adult Inpatient Survey which is administered to 850 patients annually in each acute NHS Trusts in England. We selected all 8753 patients who returned the survey and who were emergency medical admissions and stayed in their admission unit for 1–2 nights, so as to isolate the experience delivered during the acute admission process. Primary and secondary outcome measures We used multilevel logistic regression to determine the apportioned influence of host organisation and of organisation level factors (size and teaching status), and patient level factors (demographics, presence of long-term conditions and disabilities). We selected ‘being treated with respect and dignity’ and ‘pain control’ as primary outcome parameters. Other Picker Domain question scores were analysed as secondary parameters. Results The proportion of overall variance attributable at organisational level was small; 0.5% (NS) for respect and dignity, 0.4% (NS) for pain control. Long-standing conditions and consequent disabilities were associated with low scores. Other item scores also showed that most influence was from patient level factors. Conclusions When a single microsystem, the acute medical admission process, is isolated, variance in experience scores is mainly explainable by patient level factors with limited organisational level influence. This has implications for the use of generic patient experience surveys for comparison between

  12. 2011 Admissions and Transfer Experiences of Students Continuing the Studies in British Columbia

    ERIC Educational Resources Information Center

    British Columbia Council on Admissions and Transfer, 2012

    2012-01-01

    This report presents the results of an analysis of admissions and transfer data from the 2011 BC Diploma, Associate Degree, and Certificate Student Outcomes (DACSO) Survey (formerly the BC College and Institute Student Outcomes Survey). This province-wide survey contacted former students 9 to 20 months after they completed all, or a significant…

  13. Association between air pollution and hospital admission: Case study at three monitoring stations in Malaysia

    NASA Astrophysics Data System (ADS)

    Zahari, Marina; Zin@Ibrahim, Wan Zawiah Wan; Ismail, Noriszura; Ni, Tan Hui

    2014-06-01

    The relationships between the exposure of pollutants towards hospitalized admission and mortality have been identified in several studies on Asian cities such as Taipei, Bangkok and Tokyo. In Malaysia, evidence on the health risks associated with exposure to pollutants is limited. In this study, daily time-series data were analysed to estimate risks of cardiovascular and respiratory hospitalized admissions associated with particulate matter ≤ 10 μm (PM10), carbon monoxide (CO), nitrogen dioxide, sulphur dioxide, and ozone concentrations in Klang Valley during 2004-2009. Daily counts of hospital admissions for cardiovascular and respiratory outcomes were obtained from eleven hospitals while pollutants data were taken from several air quality monitoring stations located nearest to the hospitals. These data were fitted with Generalised Additive Poisson regression models. Additionally, temperature, humidity, and time data were also included to allow for potential effect of weather and time-varying influences on hospital admissions. CO showed the most significant (P < 0.05) relationship to cardiovascular admissions. An increment of 1 ppm in CO predicted an increase of 4% to 20% in cardiovascular admissions. Respiratory admissions were associated with PM10, which had about 1% increase in risk of admission per 10 ug/m3 increment in PM10. Exposure to CO and PM10 increases the risk of hospitalization for cardiovascular and respiratory illnesses in Klang Valley, Malaysia.

  14. Predicting Appropriate Admission of Bronchiolitis Patients in the Emergency Department: Rationale and Methods

    PubMed Central

    Stone, Bryan L; Johnson, Michael D; Nkoy, Flory L

    2016-01-01

    Background In young children, bronchiolitis is the most common illness resulting in hospitalization. For children less than age 2, bronchiolitis incurs an annual total inpatient cost of $1.73 billion. Each year in the United States, 287,000 emergency department (ED) visits occur because of bronchiolitis, with a hospital admission rate of 32%-40%. Due to a lack of evidence and objective criteria for managing bronchiolitis, ED disposition decisions (hospital admission or discharge to home) are often made subjectively, resulting in significant practice variation. Studies reviewing admission need suggest that up to 29% of admissions from the ED are unnecessary. About 6% of ED discharges for bronchiolitis result in ED returns with admission. These inappropriate dispositions waste limited health care resources, increase patient and parental distress, expose patients to iatrogenic risks, and worsen outcomes. Existing clinical guidelines for bronchiolitis offer limited improvement in patient outcomes. Methodological shortcomings include that the guidelines provide no specific thresholds for ED decisions to admit or to discharge, have an insufficient level of detail, and do not account for differences in patient and illness characteristics including co-morbidities. Predictive models are frequently used to complement clinical guidelines, reduce practice variation, and improve clinicians’ decision making. Used in real time, predictive models can present objective criteria supported by historical data for an individualized disease management plan and guide admission decisions. However, existing predictive models for ED patients with bronchiolitis have limitations, including low accuracy and the assumption that the actual ED disposition decision was appropriate. To date, no operational definition of appropriate admission exists. No model has been built based on appropriate admissions, which include both actual admissions that were necessary and actual ED discharges that were

  15. Short- and long-term outcomes of AL amyloidosis patients admitted into intensive care units.

    PubMed

    Guinault, Damien; Canet, Emmanuel; Huart, Antoine; Jaccard, Arnaud; Ribes, David; Lavayssiere, Laurence; Venot, Marion; Cointault, Olivier; Roussel, Murielle; Nogier, Marie-Béatrice; Pichereau, Claire; Lemiale, Virginie; Arnulf, Bertrand; Attal, Michel; Chauveau, Dominique; Azoulay, Elie; Faguer, Stanislas

    2016-09-01

    Amyloidosis is a rare and threatening condition that may require intensive care because of amyloid deposit-related organ dysfunction or therapy-related adverse events. Although new multiple myeloma drugs have dramatically improved outcomes in AL amyloidosis, the outcomes of AL patients admitted into intensive care units (ICUs) remain largely unknown. Admission has been often restricted to patients with low Mayo Clinic staging and/or with a complete or very good immunological response at admission. In a retrospective multicentre cohort of 66 adult AL (n = 52) or AA (n = 14) amyloidosis patients, with similar causes of admission to an ICU, the 28-d and 6-month survival rates of AA patients were significantly higher compared to AL patients (93% vs. 60%, P = 0·03; 71% vs. 45%, P = 0·02, respectively). In AL patients, the simplified Index of Gravity Score (IGS2) was the only independent predictive factor for death by day 28, whereas the Mayo-Clinic classification stage had no influence. In Cox's multivariate regression model, only cardiac arrest and on-going chemotherapy at ICU admission significantly predicted death at 6 months. Short-term outcomes of AL patients admitted into an ICU were mainly related to the severity of the acute medical condition, whereas on-going chemotherapy for active amyloidosis impacted on long-term outcomes.

  16. Sample Size Requirements and Study Duration for Testing Main Effects and Interactions in Completely Randomized Factorial Designs When Time to Event is the Outcome

    PubMed Central

    Moser, Barry Kurt; Halabi, Susan

    2013-01-01

    In this paper we develop the methodology for designing clinical trials with any factorial arrangement when the primary outcome is time to event. We provide a matrix formulation for calculating the sample size and study duration necessary to test any effect with a pre-specified type I error rate and power. Assuming that a time to event follows an exponential distribution, we describe the relationships between the effect size, the power, and the sample size. We present examples for illustration purposes. We provide a simulation study to verify the numerical calculations of the expected number of events and the duration of the trial. The change in the power produced by a reduced number of observations or by accruing no patients to certain factorial combinations is also described. PMID:25530661

  17. Heatwaves and Hospital Admissions for Mental Disorders in Northern Vietnam

    PubMed Central

    Trang, Phan Minh; Rocklöv, Joacim; Giang, Kim Bao; Kullgren, Gunnar; Nilsson, Maria

    2016-01-01

    Studies in high-income countries have shown an association between heatwaves and hospital admissions for mental disorders. It is unknown whether such associations exist in subtropical nations like Vietnam. The study aim was to investigate whether hospital admissions for mental disorders may be triggered, or exacerbated, by heat exposure and heatwaves, in a low- and middle-income country, Vietnam. For this, we used data from the Hanoi Mental Hospital over five years (2008–2012) to estimate the effect of heatwaves on admissions for mental disorders. A zero-inflated negative binomial regression model accounting for seasonality, time trend, days of week, and mean humidity was used to analyse the relationship. Heatwave events were mainly studied as periods of three or seven consecutive days above the threshold of 35°C daily maximum temperature (90th percentile). The study result showed heatwaves increased the risk for admission in the whole group of mental disorders (F00-79) for more persistent heatwaves of at least 3 days when compared with non-heatwave periods. The relative risks were estimated at 1.04 (0.95–1.13), 1.15 (1.005–1.31), and 1.36 (1–1.90) for a one-, three- and seven-day heatwave, respectively. Admissions for mental disorders increased among men, residents in rural communities, and the elderly population during heatwaves. The groups of organic mental disorders, including symptomatic illnesses (F0-9) and mental retardation (F70-79), had increased admissions during heatwaves. The findings are novel in their focus on heatwave impact on mental diseases in a population habituating in a subtropical low- and middle-income country characterized by rapid epidemiological transitions and environmental changes. PMID:27195473

  18. 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.

  19. 45 CFR 2555.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Admission. 2555.300 Section 2555.300 Public... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 2555.300 Admission. (a) General. No..., by any recipient to which §§ 2555.300 through 2555.310 apply, except as provided in §§ 2555.225...

  20. 6 CFR 17.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 6 Domestic Security 1 2012-01-01 2012-01-01 false Admission. 17.300 Section 17.300 Domestic... in Admission and Recruitment Prohibited § 17.300 Admission. (a) General. No person shall, on the... which §§ 17.300 through 17.310 apply, except as provided in §§ 17.225 and 17.230. (b)...

  1. 40 CFR 5.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Admission. 5.300 Section 5.300... in Admission and Recruitment Prohibited § 5.300 Admission. (a) General. No person shall, on the basis... which §§ 5.300 through §§ 5.310 apply, except as provided in §§ 5.225 and 5.230. (b)...

  2. 15 CFR 8a.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Admission. 8a.300 Section 8a.300... in Admission and Recruitment Prohibited § 8a.300 Admission. (a) General. No person shall, on the... which §§ 8a.300 through §§ 8a.310 apply, except as provided in §§ 8a.225 and §§ 8a.230. (b)...

  3. 45 CFR 2555.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Admission. 2555.300 Section 2555.300 Public... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 2555.300 Admission. (a) General. No..., by any recipient to which §§ 2555.300 through 2555.310 apply, except as provided in §§ 2555.225...

  4. 14 CFR 1253.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Admission. 1253.300 Section 1253.300... in Admission and Recruitment Prohibited § 1253.300 Admission. (a) General. No person shall, on the... which §§ 1253.300 through §§ 1253.310 apply, except as provided in §§ 1253.225 and §§ 1253.230....

  5. Trends in Severity of Illness on ICU Admission and Mortality among the Elderly

    PubMed Central

    Fuchs, Lior; Novack, Victor; McLennan, Stuart; Celi, Leo Anthony; Baumfeld, Yael; Park, Shinhyuk; Howell, Michael D.; Talmor, Daniel S.

    2014-01-01

    Background There is an increase in admission rate for elderly patients to the ICU. Mortality rates are lower when more liberal ICU admission threshold are compared to more restrictive threshold. We sought to describe the temporal trends in elderly admissions and outcomes in a tertiary hospital before and after the addition of an 8-bed medical ICU. Methods We conducted a retrospective analysis of a comprehensive longitudinal ICU database, from a large tertiary medical center, examining trends in patients’ characteristics, severity of illness, intensity of care and mortality rates over the years 2001–2008. The study population consisted of elderly patients and the primary endpoints were 28 day and one year mortality from ICU admission. Results Between the years 2001 and 2008, 7,265 elderly patients had 8,916 admissions to ICU. The rate of admission to the ICU increased by 5.6% per year. After an eight bed MICU was added, the severity of disease on ICU admission dropped significantly and crude mortality rates decreased thereafter. Adjusting for severity of disease on presentation, there was a decreased mortality at 28- days but no improvement in one- year survival rates for elderly patient admitted to the ICU over the years of observation. Hospital mortality rates have been unchanged from 2001 through 2008. Conclusion In a high capacity ICU bed hospital, there was a temporal decrease in severity of disease on ICU admission, more so after the addition of additional medical ICU beds. While crude mortality rates decreased over the study period, adjusted one-year survival in ICU survivors did not change with the addition of ICU beds. These findings suggest that outcome in critically ill elderly patients may not be influenced by ICU admission. Adding additional ICU beds to deal with the increasing age of the population may therefore not be effective. PMID:24699251

  6. Retrospective observational study of emergency admission, readmission and the ‘weekend effect’

    PubMed Central

    Shiue, Ivy; McMeekin, Peter; Price, Christopher

    2017-01-01

    Objectives Excess mortality following weekend hospital admission has been observed but not explained. As readmissions have greater age, comorbidity and social deprivation, outcomes following emergency index admission and readmission were examined for temporal and demographic associations to confirm whether weekend readmissions contribute towards excess mortality. Design A retrospective observational study. Individual patient Hospital Episode Statistics were linked and 2 categories created: index admissions (not within 60 days of discharge from an emergency hospitalisation) and readmissions (within 60 days of discharge from an emergency hospitalisation). Logistic regression examined associations between admission category, weekend and weekday mortality, age, gender, season, comorbidity and social deprivation. Setting A single acute National Health Service (NHS) trust serving a population of 550 000 via 3 emergency departments. Participants Emergency admissions between 1 January 2010 and 31 March 2015. Outcome measure All-cause 30-day mortality. Results Over 5 years there were 128 966 index admissions (74.7% weekday/25.3% weekend) and 20 030 readmissions (74.9% weekday/25.1% weekend). Adjusted 30-day death rates for weekday/weekend admissions were 6.93%/7.04% for index cases and 12.26%/13.27% for readmissions. Weekend readmissions had a higher mortality risk relative to weekday readmissions (OR 1.10 (95% CI 1.01 to 1.20)) without differences in comorbidity or deprivation. Weekend index admissions did not have a significantly increased mortality risk (OR 1.04 (95% CI 0.98 to 1.11)) but deaths which did occur were associated with lower deprivation (OR 1.24 (95% CI 1.11 to 1.38)) and an absence of comorbidities (OR 1.17 (1.02 to 1.34)). Conclusions Associations with emergency hospitalisation were not identical for index admissions and readmissions. Further research is needed to confirm what factors are responsible for the ‘weekend effect’. PMID:28255092

  7. Re-audit of physical examination on admission.

    PubMed

    Drury, Andrew; Eriksson, Erik; Marriott, Rebecca; Symeon, Christopher; Chan, Jeni

    2011-09-01

    Re-audit of the physical examination of older adults admitted to one of two inpatient Older Adult wards at the Maudsley Hospital found that on admission, only 58% of patients had a brief physical examination and 43% had a full physical examination, and after 72 hours only 65% had a full physical examination. This is a slight improvement on the previous audit but still falls short of the target of 90% of patients having a full physical examination within 72 hours of admission. Recommendations include education of junior and senior doctors of the need for physical examination via presentation of audit and distribution of results, consideration of the use of a proforma to gather information on physical examination which may have been done in an acute hospital and a further re-audit to see if outcomes have improved.

  8. Temporal variation in major trauma admissions

    PubMed Central

    Kieffer, WKM; Michalik, DV; Gallagher, K; McFadyen, I; Bernard, J; Rogers, BA

    2016-01-01

    Introduction Trauma is a significant cause of morbidity and mortality in the UK. Since the inception of the trauma networks, little is known of the temporal pattern of trauma admissions. Methods Trauma Audit and Research Network data for 1 April 2011 to 31 March 2013 were collated from two large major trauma centres (MTCs) in the South East of England: Brighton and Sussex University Hospitals NHS Trust (BSUH) and St George's University Hospitals NHS Foundation Trust (SGU). The number of admissions and the injury severity score by time of admission, by weekdays versus weekend and by month/season were analysed. Results There were 1,223 admissions at BSUH and 1,241 at SGU. There was significant variation by time of admission; there were more admissions in the afternoons (BSUH p<0.001) and evenings (SGU p<0.001). There were proportionally more admissions at the weekends than on weekdays (BSUH p<0.001, SGU p=0.028). There was significant seasonal variation in admissions at BSUH (p<0.001) with more admissions in summer and autumn. No significant seasonal variation was observed at SGU (p=0.543). Conclusions The temporal patterns observed were different for each MTC with important implications for resource planning of trauma care. This study identified differing needs for different MTCs and resource planning should be individualised to the network. PMID:26741676

  9. A Variant in COX-2 Gene Is Associated with Left Main Coronary Artery Disease and Clinical Outcomes of Coronary Artery Bypass Grafting

    PubMed Central

    Liu, Hanning; Sun, Cheng

    2017-01-01

    As a particular severe phenotype of coronary artery disease (CAD), left main coronary artery disease (LMCAD) is heritable. Genetic variants related to prostaglandin metabolism are associated with LMCAD. Cyclooxygenase-2 (COX-2), a key synthase in prostaglandin pathways, displays high density in atherosclerotic lesions and promotes early atherosclerosis in CAD progression. We hypothesized that genetic variants in COX-2 gene contribute to LMCAD phenotype susceptibility compared to more peripheral coronary artery disease (MPCAD). In this study, we genotyped COX-2 rs5275, rs5277, and rs689466 of 1544 CAD patients undergoing coronary artery bypass grafting (CABG) and found that rs5277 C allele carriage was associated with LMCAD (adjusted OR: 1.590; 95% CI: 1.103~2.291; p = 0.013). Furtherly, long-term follow-up data suggested that rs5277 C allele carriage increased risk of major adverse cardiac and cerebrovascular events (MACCE) in the whole cohort (adjusted HR: 1.561; 95% CI: 1.025~2.377; p = 0.038) and LMCAD subgroup (adjusted HR: 2.014; 95% CI: 1.036~3.913; p = 0.039) but not in MPCAD subgroup (adjusted HR: 1.375; 95% CI: 0.791~2.392; p = 0.259). In conclusion, we demonstrate that COX-2 rs5277 C allele increases the risk of left main coronary artery lesion and is also correlated with poor prognosis of LMCAD patients with CABG therapy. PMID:28194409

  10. Daughters and Mothers Against Breast Cancer (DAMES): Main outcomes of a randomized controlled trial of weight loss in overweight mothers with breast cancer and their overweight daughters

    PubMed Central

    Demark-Wahnefried, Wendy; Jones, Lee W; Snyder, Denise C; Sloane, Richard J; Kimmick, Gretchen G; Hughes, Daniel C; Badr, Hoda J; Miller, Paige E; Burke, Lora E; Lipkus, Isaac M

    2014-01-01

    BACKGROUND Few studies to date have used the cancer diagnosis as a teachable moment to promote healthy behavior changes in survivors of cancer and their family members. Given the role of obesity in the primary and tertiary prevention of breast cancer, the authors explored the feasibility of a mother-daughter weight loss intervention. METHODS A randomized controlled trial of a mailed weight loss intervention was undertaken among 68 mother-daughter dyads (n = 136), each comprised of a survivor of breast cancer (AJCC stage 0-III) and her adult biological daughter. All women had body mass indices ≥ 25 kg/m2 and underwent in-person assessments at baseline, 6 months, and 12 months, with accelerometry and exercise capacity performed on a subset of individuals. All women received a personalized workbook and 6 newsletters over a 1-year period that promoted weight loss; exercise; and a nutrient-rich, low-energy density diet. A total of 25 dyads received individually tailored instruction (INDIVIDUAL), 25 dyads received team-tailored instruction (TEAM), and 18 dyads received standardized brochures (CONTROL). RESULTS The trial met its accrual target, experienced 90% retention, and caused no serious adverse events. Significant differences in baseline to 12-month changes were observed between INDIVIDUAL versus CONTROL mothers for body mass index, weight, and waist circumference (WC); significant differences also were observed in the WC of corresponding daughters (P < .05). Significant differences were found between INDIVIDUAL versus CONTROL and TEAM versus CONTROL dyads for WC (P = .0002 and .018, respectively), minutes per week of physical activity (P = .031 and .036, respectively), and exercise capacity (P = .047 for both). CONCLUSIONS Significant improvements in lifestyle behaviors and health outcomes are possible with tailored print interventions directed toward survivors of cancer and their family members. For greater impact, more research is needed

  11. Legacy Status as a Signal in College Admissions

    DTIC Science & Technology

    2006-01-01

    empirical support for any claims about legacy admits in the literature. The main assertion in favor of legacy admits is financial .1 William R...Fitzsimmons, dean of admissions and financial aid at Harvard, defends the school’s legacy policy because it helps raise funds that...and logit are inconsequential for this data set. Probit is used for computational simplicity because Stata automatically computes marginal effects. An

  12. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial

    PubMed Central

    Hanley, Janet; McCloughan, Lucy; Todd, Allison; Krishan, Ashma; Lewis, Stephanie; Stoddart, Andrew; van der Pol, Marjon; MacNee, William; Sheikh, Aziz; Pagliari, Claudia; McKinstry, Brian

    2013-01-01

    Objective To test the effectiveness of telemonitoring integrated into existing clinical services such that intervention and control groups have access to the same clinical care. Design Researcher blind, multicentre, randomised controlled trial. Setting UK primary care (Lothian, Scotland). Participants Adults with at least one admission for chronic obstructive pulmonary disease (COPD) in the year before randomisation. We excluded people who had other significant lung disease, who were unable to provide informed consent or complete the study, or who had other significant social or clinical problems. Interventions Participants were recruited between 21 May 2009 and 28 March 2011, and centrally randomised to receive telemonitoring or conventional self monitoring. Using a touch screen, telemonitoring participants recorded a daily questionnaire about symptoms and treatment use, and monitored oxygen saturation using linked instruments. Algorithms, based on the symptom score, generated alerts if readings were omitted or breached thresholds. Both groups received similar care from existing clinical services. Main outcome measures The primary outcome was time to hospital admission due to COPD exacerbation up to one year after randomisation. Other outcomes included number and duration of admissions, and validated questionnaire assessments of health related quality of life (using St George’s respiratory questionnaire (SGRQ)), anxiety or depression (or both), self efficacy, knowledge, and adherence to treatment. Analysis was intention to treat. Results Of 256 patients completing the study, 128 patients were randomised to telemonitoring and 128 to usual care; baseline characteristics of each group were similar. The number of days to admission did not differ significantly between groups (adjusted hazard ratio 0.98, 95% confidence interval 0.66 to 1.44). Over one year, the mean number of COPD admissions was similar in both groups (telemonitoring 1.2 admissions per person

  13. [Comprehensive Assessment of Psychiatric Residents: An Addition to the Program Admission Process].

    PubMed

    Luis, E Jaramillo G; Elena, Martín C

    2012-01-01

    The training of medical specialists is a long and complex process. Its purpose is to guarantee the society that they are the right professionals to meet the health needs of the population. The first step to ensure this objective is the admission process. In psychiatry this process, monitoring resident students and the criteria for each one are different in each country. Admission in Colombia is a heterogeneous process, not standardized, which varies greatly from one university to another, even between private and public universities. At the National University of Colombia, the admissions process is handled by the Admissions Office and includes: a written test for which you must obtain a minimum score, a resume rating and an interview. The Teaching Committee and the Department of Psychiatry considered the admission procedure in general to be good, but in need of refinement. Due to the experience of some teachers and given the current rules, a "comprehensive assessment" for master and doctoral students was required and in 1996 it was decided that this method of assessment for admission to a specialization in Psychiatry would serve to complement the admission process. The article describes the experience of the process and its outcomes, strengths and weaknesses.

  14. Pathways to Care for Critically Ill or Injured Children: A Cohort Study from First Presentation to Healthcare Services through to Admission to Intensive Care or Death

    PubMed Central

    Hodkinson, Peter; Argent, Andrew; Wallis, Lee; Reid, Steve; Perera, Rafael; Harrison, Sian; Thompson, Matthew; English, Mike; Maconochie, Ian; Ward, Alison

    2016-01-01

    Purpose Critically ill or injured children require prompt identification, rapid referral and quality emergency management. We undertook a study to evaluate the care pathway of critically ill or injured children to identify preventable failures in the care provided. Methods A year-long cohort study of critically ill and injured children was performed in Cape Town, South Africa, from first presentation to healthcare services until paediatric intensive care unit (PICU) admission or emergency department death, using expert panel review of medical records and caregiver interview. Main outcomes were expert assessment of overall quality of care; avoidability of severity of illness and PICU admission or death and the identification of modifiable factors. Results The study enrolled 282 children, 252 emergency PICU admissions, and 30 deaths. Global quality of care was graded good in 10% of cases, with half having at least one major impact modifiable factor. Key modifiable factors related to access to care and identification of the critically ill, assessment of severity, inadequate resuscitation, and delays in decision making and referral. Children were transferred with median time from first presentation to PICU admission of 12.3 hours. There was potentially avoidable severity of illness in 185 (74%) of children, and death prior to PICU admission was avoidable in 17/30 (56.7%) of children. Conclusions The study presents a novel methodology, examining quality of care across an entire system, and highlighting the complexity of the pathway and the modifiable events amenable to interventions, that could reduce mortality and morbidity, and optimize utilization of scarce critical care resources; as well as demonstrating the importance of continuity and quality of care. PMID:26731245

  15. 28 CFR 54.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  16. 14 CFR 1253.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION 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...

  17. 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…

  18. 7 CFR 15a.21 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 1 2014-01-01 2014-01-01 false Admission. 15a.21 Section 15a.21 Agriculture Office of the Secretary of Agriculture EDUCATION PROGRAMS OR ACTIVITIES RECEIVING OR BENEFITTING FROM FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited §...

  19. 7 CFR 15a.21 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Admission. 15a.21 Section 15a.21 Agriculture Office of the Secretary of Agriculture EDUCATION PROGRAMS OR ACTIVITIES RECEIVING OR BENEFITTING FROM FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited §...

  20. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on... shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by...

  1. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on... shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by...

  2. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on... shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by...

  3. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations 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,...

  4. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations 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,...

  5. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations 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,...

  6. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations 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,...

  7. Unethical Admissions: Academic Integrity in Question.

    PubMed

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

    2016-11-28

    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.

  8. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations 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,...

  9. Profile in Action: Linking Admission and Retention

    ERIC Educational Resources Information Center

    Cortes, Carla M.

    2013-01-01

    A profile-oriented retention strategy embraces the admission process as a powerful lever in improving retention and completion rates and recognizes that the student profile can be shaped by changes in admission policies or priorities--even within the current market position of the institution. In addition, the student body can be oriented toward…

  10. 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…

  11. Strategies and Trends in Admissions Research

    ERIC Educational Resources Information Center

    Fincher, Cameron

    1975-01-01

    Noting that the technical service rendered by the national testing agencies may be an undesirable tradeoff for the active involvement of admissions workers in admissions research, the author suggests that the use of decision theory, quasi-actuarial assessment, quasi-experimental design, and program evaluation strategies would place admissions…

  12. Alphabetical Order Effects in School Admissions

    ERIC Educational Resources Information Center

    Jurajda, Štepán; Münich, Daniel

    2016-01-01

    If school admission committees use alphabetically sorted lists of applicants in their evaluations, one's position in the alphabet according to last name initial may be important in determining access to selective schools. Jurajda and Münich (2010) "Admission to Selective Schools, Alphabetically". "Economics of Education…

  13. Why Do We Stay in Admissions?

    ERIC Educational Resources Information Center

    Piersol, Marion Kandel; And Others

    1993-01-01

    Admission counselors (n=200) completed surveys about employment, title, on-the-job training, travel, and availability and satisfaction with certain responsibilities. Most satisfying admission responsibilities were program organization and implementation, applicant review and decision, and formal presentations. Least satisfying were telemarketing,…

  14. 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…

  15. College Admission Professionals: Who Are We Now?

    ERIC Educational Resources Information Center

    Rapelye, Janet Lavin

    1999-01-01

    Reflects on roles that admission professionals hold within the academic community. Explains that admission professionals are educators and business managers; bring in revenue; and serve as advisors to the president, as spokespeople to alumni/ae, and if fortunate, as counselors to students. Suggests that counselors focus on students because they…

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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…

  4. Main Report

    PubMed Central

    2006-01-01

    Background: States vary widely in their use of newborn screening tests, with some mandating screening for as few as three conditions and others mandating as many as 43 conditions, including varying numbers of the 40+ conditions that can be detected by tandem mass spectrometry (MS/MS). There has been no national guidance on the best candidate conditions for newborn screening since the National Academy of Sciences report of 19751 and the United States Congress Office of Technology Assessment report of 1988,2 despite rapid developments since then in genetics, in screening technologies, and in some treatments. Objectives: In 2002, the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA) of the United States Department of Health and Human Services (DHHS) commissioned the American College of Medical Genetics (ACMG) to: Conduct an analysis of the scientific literature on the effectiveness of newborn screening.Gather expert opinion to delineate the best evidence for screening for specified conditions and develop recommendations focused on newborn screening, including but not limited to the development of a uniform condition panel.Consider other components of the newborn screening system that are critical to achieving the expected outcomes in those screened. Methods: A group of experts in various areas of subspecialty medicine and primary care, health policy, law, public health, and consumers worked with a steering committee and several expert work groups, using a two-tiered approach to assess and rank conditions. A first step was developing a set of principles to guide the analysis. This was followed by developing criteria by which conditions could be evaluated, and then identifying the conditions to be evaluated. A large and broadly representative group of experts was asked to provide their opinions on the extent to which particular conditions met the selected criteria, relying on supporting evidence and references from the

  5. A Fatal Outcome of Rhino-orbito-cerebral Mucormycosis Following Tooth Extraction: A Case Report

    PubMed Central

    Motaleb, Hesham Y Abdel; Mohamed, Mostafa S; Mobarak, Fahmy A

    2015-01-01

    Rhino-orbito-cerebral mucormycosis is an uncommon aggressive life-threatening opportunistic fungal infection that affects mainly the immunocompromised population with mortality rate up to 50%. Due to its aggressive nature, early detection and prompt management are of great importance for a good prognosis. Our report describes a fatal outcome of a case of rhino-orbito-cerebral mucormycosis following tooth extraction in an uncontrolled non-insulin-dependent diabetes mellitus patient after 14 days of admission. PMID:26225109

  6. A Fatal Outcome of Rhino-orbito-cerebral Mucormycosis Following Tooth Extraction: A Case Report.

    PubMed

    Motaleb, Hesham Y Abdel; Mohamed, Mostafa S; Mobarak, Fahmy A

    2015-01-01

    Rhino-orbito-cerebral mucormycosis is an uncommon aggressive life-threatening opportunistic fungal infection that affects mainly the immunocompromised population with mortality rate up to 50%. Due to its aggressive nature, early detection and prompt management are of great importance for a good prognosis. Our report describes a fatal outcome of a case of rhino-orbito-cerebral mucormycosis following tooth extraction in an uncontrolled non-insulin-dependent diabetes mellitus patient after 14 days of admission.

  7. Antibiotic prescribing and admissions with major suppurative complications of respiratory tract infections: a data linkage study.

    PubMed Central

    Little, Paul; Watson, Louise; Morgan, Stephen; Williamson, Ian

    2002-01-01

    BACKGROUND: Systematic reviews of antibiotic treatment of common acute respiratory tract infections (RTIs) suggest modest symptomatic benefit, but provide limited evidence that prescribing prevents complications. AIM: To assess the relationship between penicillin prescribing (the most commonly used group of antibiotics for RTIs) and hospital admission with complications. DESIGN OF STUDY: Data linkage study. SETTING: Ninety-six health authorities of England for the year 1997-1998. METHOD: Hospital admissions related to RTIs were linked with prescribing analysis and cost (PACT) data. RESULTS: There was close correlation between items of penicillin use and total antibiotic use (r = 0.96). After controlling for SMR, age, sex, and Townsend score, a one-unit increase in penicillin use (items dispensed per capita) was associated with a reduction in annual incidence per 10,000 of admissions for quinsy (-3.55 admissions, 95% confidence interval [CI] = -6.85 to -0.26), and mastoiditis (square root of incidence of admissions = -1.05, 95% CI = -1.82 to -0.27). This does not represent lower referral thresholds among higher prescribers as higher prescribing was associated with more admissions for tonsillectomy and overall admissions. Increasing prescribing by 2000 items of penicillin for a practice of 10,000 patients could possibly prevent one admission for either mastoiditis or quinsy. CONCLUSION: Higher antibiotic prescribing is associated with significantly fewer admissions with major complications. However, the overall size of the effect is modest and it is difficult to advocate an overall increase in prescribing to prevent complications. Future research should concentrate on finding better methods of targeting antibiotics to individuals at risk of poor outcome. PMID:12030660

  8. Early Admission Call-Up: A Strategy and Marketing Perk for Attracting Better Students to a College in Lebanon

    ERIC Educational Resources Information Center

    Naimy, Viviane; Nasser, Ramzi

    2009-01-01

    The purpose of this study was to determine whether an early call-up strategy helps in attracting better students to a private university in Lebanon. Early admission call-up was administered to the top 25 percentile-ranked students of main feeder schools at a private university in Lebanon. Admission data was accrued for students who applied for…

  9. Lunar phases and psychiatric hospital admissions.

    PubMed

    Gorvin, J J; Roberts, M S

    1994-12-01

    To assess the lunar hypothesis as predictive of mental health emergencies and antisocial behavior, the relation of the lunar hypothesis and the occurrence of psychiatric hospital admissions of developmentally disabled adults was examined. The full moon phase of the lunar cycle did not explain a higher rate of hospital admission and accounted for only .007% of the variance. A critique of the methodology in prior research led to the suggestion that more immediate stressors and environmental factors are more plausible contributing factors to hospital admission.

  10. The influence of the full moon on the number of admissions related to gastrointestinal bleeding.

    PubMed

    Román, Eva María; Soriano, Germán; Fuentes, Mercedes; Gálvez, María Luz; Fernández, Clotilde

    2004-12-01

    The objective of this study was to analyse whether the number of admissions for gastrointestinal bleeding to our bleeding unit increases during the full moon. In a prospective study, we included 447 consecutive patients with gastrointestinal haemorrhage admitted to our bleeding unit during a period of two years. The number of admissions was allocated to the corresponding day of the lunar cycle, and full moon and non-full moon days were compared. A wide variation in the number of admissions throughout the lunar cycle was observed. There were 26 admissions on the 25 days of full moon and 421 admissions in the remaining 713 days of non-full moon. This difference was mainly related to a higher incidence of haemorrhage in men and variceal haemorrhage at full moon. The results of this study suggest an increase in the number of admissions related to gastrointestinal haemorrhage in our bleeding unit during the full moon, especially in men and in patients experiencing variceal haemorrhage. However, the wide variation in the number of admissions throughout the lunar cycle could limit interpretation of the results. Therefore, further studies are needed to clarify the possible influence of the moon on gastrointestinal haemorrhage.

  11. 43 CFR 4.1141 - Admissions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... directed serves on the requesting party— (1) A sworn statement denying specifically the relevant matters of which an admission is requested; (2) A sworn statement setting forth in detail the reasons why he...

  12. 43 CFR 4.1141 - Admissions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... directed serves on the requesting party— (1) A sworn statement denying specifically the relevant matters of which an admission is requested; (2) A sworn statement setting forth in detail the reasons why he...

  13. 43 CFR 4.1141 - Admissions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... directed serves on the requesting party— (1) A sworn statement denying specifically the relevant matters of which an admission is requested; (2) A sworn statement setting forth in detail the reasons why he...

  14. Marketing in Admissions: The Information System Approach.

    ERIC Educational Resources Information Center

    Wofford, O. Douglas; Timmerman, Ed

    1982-01-01

    A marketing information system approach for college admissions is outlined that includes objectives, information needs and sources, a data collection format, and information evaluation. Coordination with other institutional information systems is recommended. (MSE)

  15. The Parent Role in College Admission.

    ERIC Educational Resources Information Center

    Krugman, Mary K.

    1990-01-01

    Discusses techniques secondary school counselors can use to help parents understand and negotiate the college admissions process, including encouraging parental self-assessment; assisting parents to assess student; giving parents special tips; and maintaining open and ethical communication. (ABL)

  16. 28 CFR 549.42 - Involuntary admission.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... SERVICES Administrative Safeguards for Psychiatric Treatment and Medication § 549.42 Involuntary admission. A court determination is necessary for involuntary hospitalization for psychiatric treatment. A sentenced inmate, not currently committed for psychiatric treatment, who is not able or willing...

  17. The Model Does Matter II: Admissions and Training in APA-Accredited Counseling Psychology Programs

    ERIC Educational Resources Information Center

    Norcross, John C.; Evans, Krystle L.; Ellis, Jeannette L.

    2010-01-01

    This study collected information on the acceptance rates, admission standards, financial assistance, student characteristics, theoretical orientations, and select outcomes of American Psychological Association-accredited counseling psychology programs (99% response rate). Results are presented collectively for all 66 counseling programs as well as…

  18. At Wake Forest U., Admissions Has Become "More Art than Science"

    ERIC Educational Resources Information Center

    Hoover, Eric

    2009-01-01

    The admissions process is awash in numbers. Students accumulate grade-point averages and test scores. Colleges use statistical models to predict enrollment outcomes, and they tout their place in commercial rankings. In many ways, numbers simplify this complex enterprise. However, they have come to carry undue weight, says Martha Blevins Allman,…

  19. Do College Rankings Matter? Examining the Influence of "America's Best Black Colleges" on HBCU Undergraduate Admissions

    ERIC Educational Resources Information Center

    Jones, Willis A.

    2016-01-01

    College rankings have become a ubiquitous part of American higher education. As the popularity of rankings has increased, so have the number of research studies attempting to better understand the impact rankings have on college/university admissions outcomes. In the past, these studies have focused almost exclusively on elite national…

  20. Parenteral penicillin for children with meningococcal disease before hospital admission: case-control study

    PubMed Central

    Harnden, Anthony; Ninis, Nelly; Thompson, Matthew; Perera, Rafael; Levin, Michael; Mant, David; Mayon-White, Richard

    2006-01-01

    Objective To explore the impact on mortality and morbidity of parenteral penicillin given to children before admission to hospital with suspected meningococcal disease. Design Retrospective comparison of fatal and non-fatal cases. Setting England, Wales, and Northern Ireland; December 1997 to February 1999. Participants 158 children aged 0-16 years (26 died, 132 survived) in whom a general practitioner had made the diagnosis of meningococcal disease before hospital admission. Results Administration of parenteral penicillin by general practitioners was associated with increased odds ratios for death (7.4, 95% confidence interval 1.5 to 37.7) and complications in survivors (5.0, 1.7 to 15.0). Children who received penicillin had more severe disease on admission (median Glasgow meningococcal septicaemia prognostic score (GMSPS) 6.5 v 4.0, P = 0.002). Severity on admission did not differ significantly with time taken to reach hospital. Conclusions Children who were given parenteral penicillin by a general practitioner had more severe disease on reaching hospital than those who were not given penicillin before admission. The association with poor outcome may be because children who are more severely ill are being given penicillin before admission. PMID:16554335

  1. Immigration, moving house and psychiatric admissions.

    PubMed

    Johansson, L M; Sundquist, J; Johansson, S E; Bergman, B

    1998-08-01

    This study was designed to elucidate psychiatric admission rates for native Swedes and foreign-born individuals during the period 1991-1994, when Sweden had a great influx of refugees. During the same period, and even earlier, psychiatric in-patient care had been reduced. Tests of differences between Swedes and foreign-born individuals in first psychiatric admission rates were performed using Poisson regressions, and the risk of a readmission was assessed using a proportional hazard model. Foreign-born individuals and native Swedes, both males and females, showed a similar admission pattern with regard to the number of admissions. Foreign-born males under 55 years of age and foreign-born females under 35 years of age had significantly higher admission rates than native Swedes. In total, native Swedes, both males and females, were hospitalized for a significantly longer period than the foreign-born subjects. About 43% of the patients were readmitted. The risk of a readmission was significantly increased among those with a high rate of internal migration. The high admission rates for young foreign-born individuals might be explained by a high incidence of mental illness owing to the trauma of being violently forced to migrate, acculturation difficulties, or unsatisfactory social circumstances such as high unemployment. The shorter hospitalization time could be due to undertreatment or less serious mental illness.

  2. Reductions in hospital admissions and mortality rates observed after integrating emergency care: a natural experiment

    PubMed Central

    Ahmed, Vazeer; Palmer, Christopher R; Bennett, Tom J H; Robinson, Susan M

    2012-01-01

    Objectives Reducing emergency admissions is a priority for the NHS. A single hospital's emergency care system was reorganised with the principles of front-loaded investigations, integration of specialties, reduced duplication, earlier decision making by senior clinicians and a combined emergency assessment area. The authors relocated our Medical Assessment Unit into our emergency department in 2006. The authors evaluated changes in admissions and mortality before and after 2006, compared with other similar hospitals. Design Quasi-experimental before and after study using routinely collected data. Setting and participants 1 acute hospital in England, the intervention site, was compared with 23 other English hospitals between 2001 and 2009. Outcome measures Our outcome measures were hospital standardised mortality ratios (HSMRs) for non-elective admissions and standardised admission ratios (SARs). Results The authors observed a statistically and clinically significant decrease in HSMR and SAR. The intervention hospital had the lowest HSMR and SAR of all the hospitals in our sample. This was statistically significant, p=0.0149 and p=0.0002, respectively. Conclusion Integrating emergency care in one location is associated with a meaningful reduction in mortality and emergency admissions to hospital. PMID:22858459

  3. An Integrative Literature Review of Organisational Factors Associated with Admission and Discharge Delays in Critical Care

    PubMed Central

    Peltonen, Laura-Maria; McCallum, Louise; Siirala, Eriikka; Haataja, Marjaana; Lundgrén-Laine, Heljä; Salanterä, Sanna; Lin, Frances

    2015-01-01

    The literature shows that delayed admission to the intensive care unit (ICU) and discharge delays from the ICU are associated with increased adverse events and higher costs. Identifying factors related to delays will provide information to practice improvements, which contribute to better patient outcomes. The aim of this integrative review was to explore the incidence of patients' admission and discharge delays in critical care and to identify organisational factors associated with these delays. Seven studies were included. The major findings are as follows: (1) explanatory research about discharge delays is scarce and one study on admission delays was found, (2) delays are a common problem mostly due to organisational factors, occurring in 38% of admissions and 22–67% of discharges, and (3) redesigning care processes by improving information management and coordination between units and interdisciplinary teams could reduce discharge delays. In conclusion, patient outcomes can be improved through efficient and safe care processes. More exploratory research is needed to identify factors that contribute to admission and discharge delays to provide evidence for clinical practice improvements. Shortening delays requires an interdisciplinary and multifaceted approach to the whole patient flow process. Conclusions should be made with caution due to the limited number of articles included in this review. PMID:26558286

  4. Do health checks for adults with intellectual disability reduce emergency hospital admissions? Evaluation of a natural experiment

    PubMed Central

    Hosking, Fay J; Harris, Tess; DeWilde, Stephen; Beighton, Carole; Shah, Sunil M; Cook, Derek G

    2017-01-01

    Background Annual health checks for adults with intellectual disability (ID) have been incentivised by National Health Service (NHS) England since 2009, but it is unclear what impact they have had on important health outcomes such as emergency hospitalisation. Methods An evaluation of a ‘natural experiment’, incorporating practice and individual-level designs, to assess the effectiveness of health checks for adults with ID in reducing emergency hospital admissions using a large English primary care database. For practices, changes in admission rates for adults with ID between 2009–2010 and 2011–2012 were compared in 126 fully participating versus 68 non-participating practices. For individuals, changes in admission rates before and after the first health check for 7487 adults with ID were compared with 46 408 age-sex-practice matched controls. Incident rate ratios (IRRs) comparing changes in admission rates are presented for: all emergency, preventable emergency (for ambulatory care sensitive conditions (ACSCs)) and elective emergency. Results Practices with high health check participation showed no change in emergency admission rate among patients with ID over time compared with non-participating practices (IRR=0.97, 95% CI 0.78 to 1.19), but emergency admissions for ACSCs did fall (IRR=0.74, 0.58 to 0.95). Among individuals with ID, health checks had no effect on overall emergency admissions compared with controls (IRR=0.96, 0.87 to 1.07), although there was a relative reduction in emergency admissions for ACSCs (IRR=0.82, 0.69 to 0.99). Elective admissions showed no change with health checks in either analysis. Conclusions Annual health checks in primary care for adults with ID did not alter overall emergency admissions, but they appeared influential in reducing preventable emergency admissions. PMID:27312249

  5. [Survey on the cost of the admission process of nursing technicians in a teaching hospital].

    PubMed

    Okano, Helena Isuku Horibe; Castilho, Valeria

    2007-09-01

    This study was aimed at contributing to the cost management of the admission process of nursing technicians by mapping and measuring the direct cost of the main activities in this process. The exploratory, retrospective, documental study on the modality of case study was carried out at the Educational Support Service of the University of São Paulo's Hospital Universitário. The admission process was divided into five sub-processes: planning, recruiting, selection, hiring and admission training. Results showed that the direct total cost of the admission process was R$ 6359.90, and that, within the sub-processes, selection was the one that consumed most resources--R$ 3416.40, amounting to 53.72% of the total. Each hired candidate cost R$ 635.99.

  6. Should the MCAT exam be used for medical school admissions in Canada?

    PubMed

    Eskander, Antoine; Shandling, Maureen; Hanson, Mark D

    2013-05-01

    In light of the structural and content changes to the Medical College Admission Test (MCAT) to be implemented in 2015 and the recent diversity- and social-accountability-based recommendations of the Future of Medical Education in Canada (FMEC) project, the authors review and reexamine the use of the MCAT exam in Canadian medical school admissions decisions.This Perspective article uses a point-counterpoint format to discuss three main advantages and disadvantages of using the MCAT exam in the medical school admissions process, from a Canadian perspective. The authors examine three questions regarding the FMEC recommendations and the revised MCAT exam: (1) Is the MCAT exam equal and useful in Canadian admissions? (2) Does the MCAT exam affect matriculant diversity? and (3) Is the MCAT exam a strong predictor of future performance? They present the most recent arguments and evidence for and against use of the MCAT exam, with the purpose of summarizing these different perspectives for readers.

  7. Association between antipsychotic/antidepressant drug treatments and hospital admissions in schizophrenia assessed using a mental health case register

    PubMed Central

    Cardinal, Rudolf N; Savulich, George; Mann, Louisa M; Fernández-Egea, Emilio

    2015-01-01

    Background: The impact of psychotropic drug choice upon admissions for schizophrenia is not well understood. Aims: To examine the association between antipsychotic/antidepressant use and time in hospital for patients with schizophrenia. Methods: We conducted an observational study, using 8 years’ admission records and electronically generated drug histories from an institution providing secondary mental health care in Cambridgeshire, UK, covering the period 2005–2012 inclusive. Patients with a coded ICD-10 diagnosis of schizophrenia were selected. The primary outcome measure was the time spent as an inpatient in a psychiatric unit. Antipsychotic and antidepressant drugs used by at least 5% of patients overall were examined for associations with admissions. Periods before and after drug commencement were compared for patients having pre-drug admissions, in mirror-image analyses correcting for overall admission rates. Drug use in one 6-month calendar period was used to predict admissions in the next period, across all patients, in a regression analysis accounting for the effects of all other drugs studied and for time. Results: In mirror-image analyses, sulpiride, aripiprazole, clozapine, and olanzapine were associated with fewer subsequent admission days. In regression analyses, sulpiride, mirtazapine, venlafaxine, and clozapine–aripiprazole and clozapine–amisulpride combinations were associated with fewer subsequent admission days. Conclusions: Use of these drugs was associated with fewer days in hospital. Causation is not implied and these findings require confirmation by randomized controlled trials. PMID:27336041

  8. Epidemiology, aetiology and outcome of acute and chronic pancreatitis: An update.

    PubMed

    Spanier, B W M; Dijkgraaf, M G W; Bruno, M J

    2008-01-01

    Over the past decades several epidemiological studies have been published reporting on incidence trends, hospital admissions, etiological factors and outcome of both acute and chronic pancreatitis. Over time, the incidence of acute pancreatitis has increased in the Western countries. Also, the number of hospital admissions for both acute and chronic pancreatitis have increased. These upward time trends possibly reflect a change in the prevalence of main etiological factors (e.g. gallstones and alcohol consumption) and cofactors such as obesity and genetic susceptibility. Acute and chronic pancreatitis are associated with significant morbidity and mortality and a substantial use of health care resources. Although the case-fatality rate of acute pancreatitis decreased over time, the overall population mortality did not change for both acute and chronic pancreatitis. This chapter will focus on recent developments in the epidemiology, aetiology, natural course and outcome of both acute and chronic pancreatitis.

  9. Residential exposure to aircraft noise and hospital admissions for cardiovascular diseases: multi-airport retrospective study

    PubMed Central

    Correia, Andrew W; Peters, Junenette L; Levy, Jonathan I; Melly, Steven

    2013-01-01

    Objective To investigate whether exposure to aircraft noise increases the risk of hospitalization for cardiovascular diseases in older people (≥65 years) residing near airports. Design Multi-airport retrospective study of approximately 6 million older people residing near airports in the United States. We superimposed contours of aircraft noise levels (in decibels, dB) for 89 airports for 2009 provided by the US Federal Aviation Administration on census block resolution population data to construct two exposure metrics applicable to zip code resolution health insurance data: population weighted noise within each zip code, and 90th centile of noise among populated census blocks within each zip code. Setting 2218 zip codes surrounding 89 airports in the contiguous states. Participants 6 027 363 people eligible to participate in the national medical insurance (Medicare) program (aged ≥65 years) residing near airports in 2009. Main outcome measures Percentage increase in the hospitalization admission rate for cardiovascular disease associated with a 10 dB increase in aircraft noise, for each airport and on average across airports adjusted by individual level characteristics (age, sex, race), zip code level socioeconomic status and demographics, zip code level air pollution (fine particulate matter and ozone), and roadway density. Results Averaged across all airports and using the 90th centile noise exposure metric, a zip code with 10 dB higher noise exposure had a 3.5% higher (95% confidence interval 0.2% to 7.0%) cardiovascular hospital admission rate, after controlling for covariates. Conclusions Despite limitations related to potential misclassification of exposure, we found a statistically significant association between exposure to aircraft noise and risk of hospitalization for cardiovascular diseases among older people living near airports. PMID:24103538

  10. The "Admissions" Side of BCCAT: An Update. Special Report

    ERIC Educational Resources Information Center

    British Columbia Council on Admissions and Transfer, 2008

    2008-01-01

    To spearhead increased emphasis on admissions, the British Columbia Council on Admissions and Transfer (BCCAT) formed an Admissions Committee in Fall 2003. The committee recognized the importance of institutional autonomy in determining admissions policies and processes at each institution. Following initiation of the Student Transitions Project…

  11. Selection Methods for Undergraduate Admissions in Australia. Does the Australian Predominate Entry Scheme the Australian Tertiary Admissions Rank (ATAR) Have a Future?

    ERIC Educational Resources Information Center

    Blyth, Kathryn

    2014-01-01

    This article considers the Australian entry score system, the Australian Tertiary Admissions Rank (ATAR), and its usage as a selection mechanism for undergraduate places in Australian higher education institutions and asks whether its role as the main selection criterion will continue with the introduction of demand driven funding in 2012.…

  12. 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…

  13. Major Research Efforts of the Law School Admission Council. Law School Admission Research.

    ERIC Educational Resources Information Center

    Hart, Frederick M.; Evans, Franklin R.

    Research conducted by the Law School Admission Council since the development of the Law School Admission Test (LSAT) in 1948 is described. An overview of the research topics is provided, and relevant published reports are cited in 61 footnotes. The following topics of study are discussed: (1) use and validity of traditional predictors of law…

  14. Multiple hospital admissions in a calendar year.

    PubMed

    Newton, J; Goldacre, M

    1993-09-01

    Hospital in-patient workload is routinely measured as episodes of care. We report on the extent to which counts of episodes of care differ from counts of patients treated in different specialties and in different age groups. Linked records of hospital care in a population of 1.9 million people, collected over an 11-year period (1976-1986), were analysed. The all-ages multiple admission ratio (the number of admissions per 100 people admitted in the same specialty and year) varied between specialties from 102 to 171. Medical specialties tended to have higher ratios than surgical ones. The influence of age on multiple admission ratios varied between specialties, although in general the ratios increased with increasing age. There were progressive but small increases in multiple admission ratios over the period studied in a number of specialties but, by and large, stability over time was more striking than any change. The information presented could be used to estimate person-based admission rates from available episode-based data where the former are not available. This should be helpful both in managing hospital resources and in purchasing care on behalf of resident populations. Purchasers in particular should be aware of numbers of people being treated as well as the numbers of episodes of care provided.

  15. International variation in the definition of 'main condition' in ICD-coded health data.

    PubMed

    Quan, H; Moskal, L; Forster, A J; Brien, S; Walker, R; Romano, P S; Sundararajan, V; Burnand, B; Henriksson, G; Steinum, O; Droesler, S; Pincus, H A; Ghali, W A

    2014-10-01

    Hospital-based medical records are abstracted to create International Classification of Disease (ICD) coded discharge health data in many countries. The 'main condition' is not defined in a consistent manner internationally. Some countries employ a 'reason for admission' rule as the basis for the main condition, while other countries employ a 'resource use' rule. A few countries have recently transitioned from one of these approaches to the other. The definition of 'main condition' in such ICD data matters when it is used to define a disease cohort to assign diagnosis-related groups and to perform risk adjustment. We propose a method of harmonizing the international definition to enable researchers and international organizations using ICD-coded health data to aggregate or compare hospital care and outcomes across countries in a consistent manner. Inter-observer reliability of alternative harmonization approaches should be evaluated before finalizing the definition and adopting it worldwide.

  16. [Medical examination prior to trade school admission].

    PubMed

    Hursidić-Radulović, Azra; Decković-Vukres, Vlasta

    2005-01-01

    Regulation on medical examination prior to apprenticeship is built in the Act on Trades and Crafts. Medical examinations of the students before admission to secondary craft schools have been done regularly since 1993. Between 11,000 and 14,000 students are admitted to secondary craft schools in the Republic of Croatia annually. According to statistics, about 10% of students have obvious health problems, about 5% of students have healt problems which vitally limit their capacity in particular crafts. This statistic refers to about 3% of the examined students. Medical examinations of students prior to admission to craft schools represent a particular sort of health capacity examinations. The paper includes applications for the most freqent trades and crafts, and findings of the craft school admission examinations.

  17. [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.

  18. Maternal mortality and morbidity: epidemiology of intensive care admissions in pregnancy.

    PubMed

    Senanayake, H; Dias, T; Jayawardena, A

    2013-12-01

    Maternal mortality reviews are used globally to assess the quality of health-care services. With the decline in the number of maternal deaths, it has become difficult to derive meaningful conclusions that could have an impact on quality of care using maternal mortality data. The emphasis has recently shifted to severe acute maternal morbidity (SAMM), as an adjunct to maternal mortality reviews. Due to its heterogeneity, there are difficulties in recognising SAMM. The problem of identifying SAMM accurately is the main issue in investigating them. However, admission to an intensive care unit (ICU) provides an unambiguous, management-based inclusion criterion for a SAMM. ICU data are available across health-care settings prospectively and retrospectively, making them a tool that could be studied readily. However, admission to the ICU depends on many factors, such as accessibility and the availability of high-dependency units, which will reduce the need for ICU admission. Thresholds for admission vary widely and are generally higher in facilities that handle a heavier workload. In addition, not all women with SAMM receive intensive care. However, women at the severe end of the spectrum of severe morbidity will almost invariably receive intensive care. Notwithstanding these limitations, the epidemiology of intensive care admissions in pregnancy will provide valuable data about women with severe morbidity. The overall rate of obstetric ICU admission varies from 0.04% to 4.54%.

  19. Paediatric admissions to the British military hospital at Camp Bastion, Afghanistan

    PubMed Central

    Arul, GS; Reynolds, J; DiRusso, S; Scott, A; Bree, S; Templeton, P; Midwinter, MJ

    2012-01-01

    INTRODUCTION International humanitarian law requires emergency medical support for both military personnel and civilians, including children. Here we present a detailed review of paediatric admissions with the pattern of injury and the resources they consume. METHODS All paediatric admissions to the hospital at Camp Bastion between 1 January and 29 April 2011 were analysed prospectively. Data collected included time and date of admission, patient age and weight, mechanism of injury, extent of wounding, treatment, length of hospital stay and discharge destination. RESULTS Eighty-five children (65 boys and 17 girls, median age: 8 years, median weight: 20kg) were admitted. In 63% of cases the indication for admission was battle related trauma and in 31% non-battle trauma. Of the blast injuries, 51% were due to improvised explosive devices. Non-battle emergencies were mainly due to domestic burns (46%) and road traffic accidents (29%). The most affected anatomical area was the extremities (44% of injuries). Over 30% of patients had critical injuries. Operative intervention was required in 74% of cases. The median time to theatre for all patients was 52 minutes; 3 patients with critical injuries went straight to theatre in a median of 7 minutes. A blood transfusion was required in 27 patients; 6 patients needed a massive transfusion. Computed tomography was performed on 62% of all trauma admissions and 40% of patients went to the intensive care unit. The mean length of stay was 2 days (range: 1–26 days) and there were 7 deaths. CONCLUSIONS Paediatric admissions make up a small but significant part of admissions to the hospital at Camp Bastion. The proportion of serious injuries is very high in comparison with admissions to a UK paediatric emergency department. The concentration of major injuries means that lessons learnt in terms of teamwork, the speed of transfer to theatre and massive transfusion protocols could be applied to UK paediatric practice. PMID:22524930

  20. Malnutrition in Joint Arthroplasty: Prospective Study Indicates Risk of Unplanned ICU Admission

    PubMed Central

    Kamath, Atul F.; McAuliffe, Caitlin L.; Kosseim, Laura M.; Pio, Finnah; Hume, Eric

    2016-01-01

    Background: Malnutrition has been linked to poor outcomes after elective joint arthroplasty, but the risk of unplanned postoperative intensive care unit (ICU) admission in malnourished arthroplasty patients is unknown. Methods: 1098 patients were followed as part of a prospective risk stratification program at a tertiary, high-volume arthroplasty center. Chronic malnutrition was defined as preoperative albumin <3.5 g/dL. Results: The overall incidence of malnutrition was 16.9% (primary and revision arthroplasty patients). Average BMI was highest for patients in albumin category 3.0-3.5 (BMI 35.7). Preoperative albumin <3.0 and <3.5 g/dL translated to 15.4% and 3.8% rates of unplanned ICU admission, respectively, indicating nutritional status to be a factor in postoperative ICU admission. Conclusion: Patients with poor nutritional status must be counseled on the risks of adverse medical complications. PMID:27200389

  1. An Admission-to-Discharge BNP Increase Is a Predictor of Six-Month All-Cause Death in ADHF Patients: Inferences from Multivariate Analysis Including Admission BNP and Various Clinical Measures of Congestion

    PubMed Central

    De Vecchis, Renato; Ariano, Carmelina; Baldi, Cesare

    2016-01-01

    Background: According to some authors, a single isolated measurement of serum B-type natriuretic peptide (BNP) executed on hospital admission would not be a sufficiently accurate method to predict the outcome of patients with acute decompensated heart failure (ADHF). Aims: To verify this assumption, a retrospective study was conducted on patients hospitalized for ADHF. Our main objective was to ascertain whether there was any difference in midterm mortality among patients with increasing BNP at discharge as compared with those with decreasing BNP at discharge. Methods: Medical records were examined so as to make a partition of the ADHF patient population into two groups, the former characterized by a rise in BNP during hospitalization, and the latter exhibiting a decrease in BNP in the measurement taken at hospital discharge. Results: 177 patients were enrolled in a retrospective study. Among them, 53 patients (30%) had increased BNP at the time of discharge, whereas 124 (70%) showed decreases in serum BNP during their hospital stay. The group with patients who exhibited BNP increases at the time of discharge had a higher degree of congestion evident in the higher frequency of persistent jugular venous distention and persistent orthopnea at discharge. Moreover, patients with increased BNP at the time of discharge had a lower reduction in inferior vena cava maximum diameter (1.58 ± 2.2 mm vs. 6.32 ± 1.82 mm; p (one-way ANOVA) = 0.001). In contrast, there was no significant difference in weight loss when patients with increased BNP at discharge were compared with those with no such increase. A total of 14 patients (7.9%) died during the six-month follow-up period. Multivariable Cox proportional-hazards regression analysis revealed that a BNP increase at the time of discharge was an independent predictor of six-month all-cause mortality after adjustment for persistent jugular venous distention, persistent orthopnea, reduction in inferior vena cava maximum diameter

  2. Acute and Chronic Effects of Particles on Hospital Admissions in New-England

    PubMed Central

    Kloog, Itai; Coull, Brent A.; Zanobetti, Antonella; Koutrakis, Petros; Schwartz, Joel D.

    2012-01-01

    Background Many studies have reported significant associations between exposure to PM2.5 and hospital admissions, but all have focused on the effects of short-term exposure. In addition all these studies have relied on a limited number of PM2.5 monitors in their study regions, which introduces exposure error, and excludes rural and suburban populations from locations in which monitors are not available, reducing generalizability and potentially creating selection bias. Methods Using our novel prediction models for exposure combining land use regression with physical measurements (satellite aerosol optical depth) we investigated both the long and short term effects of PM2.5 exposures on hospital admissions across New-England for all residents aged 65 and older. We performed separate Poisson regression analysis for each admission type: all respiratory, cardiovascular disease (CVD), stroke and diabetes. Daily admission counts in each zip code were regressed against long and short-term PM2.5 exposure, temperature, socio-economic data and a spline of time to control for seasonal trends in baseline risk. Results We observed associations between both short-term and long-term exposure to PM2.5 and hospitalization for all of the outcomes examined. In example, for respiratory diseases, for every10-µg/m3 increase in short-term PM2.5 exposure there is a 0.70 percent increase in admissions (CI = 0.35 to 0.52) while concurrently for every10-µg/m3 increase in long-term PM2.5 exposure there is a 4.22 percent increase in admissions (CI = 1.06 to 4.75). Conclusions As with mortality studies, chronic exposure to particles is associated with substantially larger increases in hospital admissions than acute exposure and both can be detected simultaneously using our exposure models. PMID:22529923

  3. Air pollution and emergency hospital admissions for cardiovascular diseases in Valencia, Spain

    PubMed Central

    Ballester, F; Tenias, J; Perez-Hoyos, S

    2001-01-01

    STUDY OBJECTIVE—To estimate the short-term association between air pollution levels and emergency hospital admissions for cardiovascular diseases in Valencia, within 1994-1996 period.
DESIGN—Daily levels of air pollution and emergency admissions for cardiovascular diseases were related to using an ecological time series design. The number of admissions was obtained from the hospital records database. Selected groups of causes were all cardiovascular diseases, heart admissions, and admissions for cerebrovascular diseases. The number of admissions for digestive diseases was used as control. Pollutants were black smoke, sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3). Magnitude of association was estimated by Poisson autoregresive regression. Estimations were calculated according the hottest (May to October) and the coldest (November to April) periods.
SETTING—City of Valencia, Spain, about 750 000 inhabitants.
PARTICIPANTS—People being admitted to the two major hospitals in the city, with a catchment area of nearly 400 000 inhabitants.
MAIN RESULTS—For the whole period, a significant association for SO2-24 h was found so a rise in its levels of 10 µg/m3 was associated with an increment of 3% (95%CI 0.4 to 5.7%) in the expected number of cardiovascular admissions. A significant association for black smoke, SO2-24 h, SO2-1 h, and CO-1 h was found in the hottest semester. All these associations were verified with a lag of two days. The estimates of the associations for particles, SO2, and CO were affected by the inclusion of the other pollutants in their models. NO2 was independently associated with cerebrovascular admissions. There were no significant associations between air pollution and admissions for digestive diseases.
CONCLUSIONS—Current levels of air pollution and emergency cardiovascular admissions are significantly related in Valencia.


Keywords: air pollution; cardiovascular disease

  4. Medication reconciliation at patient admission: a randomized controlled trial

    PubMed Central

    Mendes, Antonio E.; Lombardi, Natália F.; Andrzejevski, Vânia S.; Frandoloso, Gibran; Correr, Cassyano J.; Carvalho, Mauricio

    2015-01-01

    Objective: To measure length of hospital stay (LHS) in patients receiving medication reconciliation. Secondary characteristics included analysis of number of preadmission medications, medications prescribed at admission, number of discrepancies, and pharmacists interventions done and accepted by the attending physician. Methods: A 6 month, randomized, controlled trial conducted at a public teaching hospital in southern Brazil. Patients admitted to general wards were randomized to receive usual care or medication reconciliation, performed within the first 72 hours of hospital admission. Results: The randomization process assigned 68 patients to UC and 65 to MR. LHS was 10±15 days in usual care and 9±16 days in medication reconciliation (p=0.620). The total number of discrepancies was 327 in the medication reconciliation group, comprising 52.6% of unintentional discrepancies. Physicians accepted approximately 75.0% of the interventions. Conclusion: These results highlight weakness at patient transition care levels in a public teaching hospital. LHS, the primary outcome, should be further investigated in larger studies. Medication reconciliation was well accepted by physicians and it is a useful tool to find and correct discrepancies, minimizing the risk of adverse drug events and improving patient safety. PMID:27011775

  5. Does emotional intelligence influence success during medical school admissions and program matriculation?: a systematic review

    PubMed Central

    2016-01-01

    Purpose It aimed at determining whether emotional intelligence is a predictor for success in a medical school program and whether the emotional intelligence construct correlated with other markers for admission into medical school. Methods Three databases (PubMed, CINAHL, and ERIC) were searched up to and including July 2016, using relevant terms. Studies written in English were selected if they included emotional intelligence as a predictor for success in medical school, markers of success such as examination scores and grade point average and association with success defined through traditional medical school admission criteria and failures, and details about the sample. Data extraction included the study authors and year, population description, emotional intelligence I tool, outcome variables, and results. Associations between emotional intelligence scores and reported data were extracted and recorded. Results Six manuscripts were included. Overall, study quality was high. Four of the manuscripts examined emotional intelligence as a predictor for success while in medical school. Three of these four studies supported a weak positive relationship between emotional intelligence scores and success during matriculation. Two of manuscripts examined the relationship of emotional intelligence to medical school admissions. There were no significant relevant correlations between emotional intelligence and medical school admission selection. Conclusion Emotional intelligence was correlated with some, but not all, measures of success during medical school matriculation and none of the measures associated with medical school admissions. Variability in success measures across studies likely explains the variable findings. PMID:27838916

  6. Effectiveness of a Surgery Admission Unit for patients undergoing major elective surgery in a tertiary university hospital

    PubMed Central

    2010-01-01

    Background The increasing demand on hospitalisation, either due to elective activity from the waiting lists or due to emergency admissions coming from the Emergency Department (ED), requires looking for strategies that lead to effective bed management. The aim of this study was to evaluate the effectiveness of a surgery admission unit for major elective surgery patients who were admitted for same-day surgery. Methods We included all patients admitted for elective surgery in a university tertiary hospital between the 1st of September and the 31st of December 2006, as well as those admitted during the same period of 2008, after the introduction of the Surgery Admission Unit. The main outcome parameters were global length of stay, pre-surgery length of stay, proportion of patients admitted the same day of the surgery and number of cancellations. Differences between the two periods were evaluated by the T-test and Chi-square test. Significance at P < 0.05 was assumed throughout. Results We included 6,053 patients, 3,003 during 2006 and 3,050 patients during 2008. Global length of stay was 6.2 days (IC 95%:6.4-6) in 2006 and 5.5 days (IC 95%:5.8-5.2) in 2008 (p < 0.005). Pre-surgery length of stay was reduced from 0.46 days (IC 95%:0.44-0.48) in 2006 to 0.29 days (IC 95%:0.27-0.31) in 2008 (p < 0.005). The proportion of patients admitted for same-day surgery was 67% (IC 95%:69%-65%) in 2006 and 76% (IC 95%:78%-74%) in 2008 (p < 0.005). The number of cancelled interventions due to insufficient preparation was 31 patients in 2006 and 7 patients in 2008. Conclusions The implementation of a Surgery Admission Unit for patients undergoing major elective surgery has proved to be an effective strategy for improving bed management. It has enabled an improvement in the proportion of patients admitted on the same day as surgery and a shorter length of stay. PMID:20096114

  7. 40 CFR 89.604 - Conditional admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., the importer must store the nonroad engine at a location where the Administrator has reasonable access...) CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES Importation of Nonconforming Nonroad Engines § 89.604 Conditional admission. (a) A nonroad engine offered for importation under §...

  8. The National Center Test for University Admissions

    ERIC Educational Resources Information Center

    Watanabe, Yoshinori

    2013-01-01

    This article describes the National Center Test for University Admissions, a unified national test in Japan, which is taken by 500,000 students every year. It states that implementation of the Center Test began in 1990, with the English component consisting only of the written section until 2005, when the listening section was first implemented…

  9. 34 CFR 106.15 - Admissions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... higher education, and public institutions of undergraduate higher education. (e) Public institutions of undergraduate higher education. Subpart C does not apply to any public institution of undergraduate higher... 34 Education 1 2014-07-01 2014-07-01 false Admissions. 106.15 Section 106.15 Education...

  10. 34 CFR 106.15 - Admissions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... higher education, and public institutions of undergraduate higher education. (e) Public institutions of undergraduate higher education. Subpart C does not apply to any public institution of undergraduate higher... 34 Education 1 2011-07-01 2011-07-01 false Admissions. 106.15 Section 106.15 Education...

  11. 34 CFR 106.15 - Admissions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... higher education, and public institutions of undergraduate higher education. (e) Public institutions of undergraduate higher education. Subpart C does not apply to any public institution of undergraduate higher... 34 Education 1 2012-07-01 2012-07-01 false Admissions. 106.15 Section 106.15 Education...

  12. 34 CFR 106.15 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... higher education, and public institutions of undergraduate higher education. (e) Public institutions of undergraduate higher education. Subpart C does not apply to any public institution of undergraduate higher... 34 Education 1 2010-07-01 2010-07-01 false Admissions. 106.15 Section 106.15 Education...

  13. 34 CFR 106.15 - Admissions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... higher education, and public institutions of undergraduate higher education. (e) Public institutions of undergraduate higher education. Subpart C does not apply to any public institution of undergraduate higher... 34 Education 1 2013-07-01 2013-07-01 false Admissions. 106.15 Section 106.15 Education...

  14. PREP: Outreach to Online Learners through Admissions

    ERIC Educational Resources Information Center

    Gupton, Preeti

    2016-01-01

    Librarians have collaborated with academic departments within their institutions for decades now, working with professors and administrators to bring information literacy skills to students. The librarians at National American University decided to extend this collaboration to a non-academic unit, the admissions department of the university. The…

  15. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Admissions. 1317.220 Section 1317.220 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE...

  16. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Admissions. 1317.220 Section 1317.220 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE...

  17. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Admissions. 1317.220 Section 1317.220 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE...

  18. Open Admissions: The Pros and Cons.

    ERIC Educational Resources Information Center

    Barzun, Jacques; And Others

    The Council for Basic Education sponsored an all-day symposium on open admissions in 1971. This booklet contains the full text of the addresses given on that occasion, as well as the major part of the discussion among the panelists and answers to questions from the audience. The aim of the symposium was not only to provide information about…

  19. Foreign Language, the Classics, and College Admissions.

    ERIC Educational Resources Information Center

    LaFleur, Richard A.

    1993-01-01

    This article reports the results of a survey, funded by the American Classical League (ACL) and conducted during 1990-91, that assessed attitudes toward high school foreign-language study, in particular the study of Latin and Greek, in the college admissions process. (21 references) (VWL)

  20. Beyond Admission: The Challenge for Access.

    ERIC Educational Resources Information Center

    Roger, Angela; Sutherland, Margaret

    1992-01-01

    The Scottish Wider Access Programme (SWAP) aims to increase adults' access to higher education. Interviews with SWAP students and educators revealed that SWAP had been invaluable in preparing nontraditional students for admission to higher education. Issues include improving teaching methods geared toward mature students, providing support…

  1. The Admissions Criteria of Secondary Free Schools

    ERIC Educational Resources Information Center

    Morris, Rebecca

    2014-01-01

    This paper presents the results of an analysis of the admissions criteria used by the first two waves of secondary Free Schools in England. The type of criteria and their ranked order is explored and their potential impact on the school composition is considered. The findings demonstrate the diversity of criteria being used by this new type of…

  2. 15 CFR 8a.220 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Admissions. 8a.220 Section 8a.220 Commerce and Foreign Trade Office of the Secretary of Commerce NONDISCRIMINATION ON THE BASIS OF SEX IN... institution. (c) Application of §§ 8a.300 through .310. Except as provided in paragraphs (d) and (e) of...

  3. Reporting Subscores from College Admission Tests

    ERIC Educational Resources Information Center

    Lyren, Per-Erik

    2009-01-01

    The added value of reporting subscores on a college admission test (SweSAT) was examined in this study. Using a CTT-derived objective method for determining the value of reporting subscores, it was concluded that there is added value in reporting section scores (Verbal/Quantitative) as well as subtest scores. These results differ from a study of…

  4. 40 CFR 5.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Admission. 5.300 Section 5.300 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...

  5. 40 CFR 5.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Admission. 5.300 Section 5.300 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...

  6. "Stealth Applicants" Are Changing the Admissions Equation

    ERIC Educational Resources Information Center

    Hoover, Eric

    2008-01-01

    Jeff Rickey is a numbers guy. But three years ago, a colleague asked him about something he'd never counted: applicants who came out of nowhere. The question intrigued Mr. Rickey, dean of admissions and financial aid at Earlham College in Indiana. He found that 17 percent of the college's applicants that year had not called, taken a tour, or…

  7. 10 CFR 2.708 - Admissions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Admissions. 2.708 Section 2.708 Energy NUCLEAR REGULATORY COMMISSION RULES OF PRACTICE FOR DOMESTIC LICENSING PROCEEDINGS AND ISSUANCE OF ORDERS Rules for Formal... the request is directed serves on the requesting party either: (i) A sworn statement...

  8. EARLY SCHOOL ADMISSIONS PROJECT, PROMISING PRACTICES.

    ERIC Educational Resources Information Center

    Baltimore City Public Schools, MD.

    THE EXPERIMENTAL PROJECT ATTEMPTS TO DETERMINE WHETHER EARLY ADMISSION TO SCHOOL CAN OVERCOME BARRIERS TO LEARNING WHICH ENVIRONMENTAL FACTORS SEEM TO IMPOSE. A DEPRIVED CHILD OFTEN DOES NOT RECEIVE ATTENTION, AFFECTION, OR GUIDANCE WITHIN HIS HOME. THE YOUNG CHILD SHOULD BE HELPED TO DEVELOP A WHOLESOME SELF-CONCEPT, TO ACQUIRE THE DRIVE TO…

  9. Predicting Academic Success Using Admission Profiles

    ERIC Educational Resources Information Center

    Davidovitch, Nitza; Soen, Dan

    2015-01-01

    This study, conducted at a tertiary education institution in Israel, following two previous studies, was designed to deal again with a question that is a topic of debate in Israel and worldwide: Is there justification for the approach that considers restrictive university admission policies an efficient tool for predicting students' success at the…

  10. Hospital admissions before and after shipyard closure.

    PubMed Central

    Iversen, L.; Sabroe, S.; Damsgaard, M. T.

    1989-01-01

    To determine the effect of job loss on health an investigation was made of admissions to hospitals in 887 men five years before and three years after the closure of a Danish shipyard. The control group comprised 441 men from another shipyard. The information on hospital admissions was obtained from the Danish national register of patients. The relative risk of admission in the control group dropped significantly in terms of the number of men admitted from the study group from 1.29 four to five years before closure to 0.74 in the three years after closure. This was especially true of admissions due to accidents (1.33 to 0.46) and diseases of the digestive system (4.53 to 1.03). For diseases of the circulatory system, particularly cardiovascular diseases, the relative risk increased from 0.8 to 1.60, and from 1.0 to 2.6 respectively. These changes in risk of illness after redundancy are probably a consequence of a change from the effects of a high risk work environment to the effects of psychosocial stresses such as job insecurity and unemployment. PMID:2511968

  11. University Admissions. Policy Note. Number 3

    ERIC Educational Resources Information Center

    Group of Eight (NJ1), 2012

    2012-01-01

    University admissions, like many other aspects of the higher education sector, are going through a time of significant change. From 2012, universities will receive full funding under the Commonwealth Grants Scheme (CGS) for as many places as they offer. Previously, the Government limited the number of funded places, with a tolerance band for…

  12. Differential Prediction Generalization in College Admissions Testing

    ERIC Educational Resources Information Center

    Aguinis, Herman; Culpepper, Steven A.; Pierce, Charles A.

    2016-01-01

    We introduce the concept of "differential prediction generalization" in the context of college admissions testing. Specifically, we assess the extent to which predicted first-year college grade point average (GPA) based on high-school grade point average (HSGPA) and SAT scores depends on a student's ethnicity and gender and whether this…

  13. Obstetric patients in a surgical intensive care unit: prognostic factors and outcome.

    PubMed

    Mjahed, K; Hamoudi, D; Salmi, S; Barrou, L

    2006-07-01

    The objective of this study was to assess the incidence, prognostic factors and the outcome of obstetric patients admitted in a surgical intensive care unit (SICU) during the ante-partum or postpartum period (within 6 weeks of delivery). Between 1995 and 2002, the patients transferred from the department of obstetrics were retrospectively included into the study. Demographics included: obstetric data, medical and surgical histories, diagnosis, simplified acute physiology score (SAPS II), acute physiology and chronic health evaluation system APACHE II score; and the occurrence of organ failure, therapeutic interventions, length of stay in the SICU and outcome were recorded. During the study period, 364 obstetric patients were admitted to the SICU. Obstetric admissions to the SICU represented 0.6% of all deliveries and the SICU utilisation rate was 14.96%. The main indications for admission were eclampsia (70.6%) and postpartum haemorrhage (16.2%). The overall mortality rate was 16.7% (n = 61). In a logistic regression model, risk factors for death included organ system failure (odds ratio (OR) = 3.95 confidence interval (CI) [1.84 - 8.48], bilirubin >12 mg/l (OR = 1.017 CI [1.00 - 1.03]), and prolonged prothrombin time (OR = 0.97 CI [0.95 - 0.99]). Median length of stay was longer in non- survivors (6.5 +/- 7.3 vs 5.5 +/- 4.6 days). Maternal condition on admission and associated complications are the major determinant of maternal outcome.

  14. 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

  15. Correlation between catecholamine levels and outcome in patients with severe head trauma.

    PubMed

    Salehpoor, F; Bazzazi, A M; Estakhri, R; Zaheri, M; Asghari, B

    2010-08-01

    Some studies have shown that catecholamines and the changes in their levels during and after head trauma can be useful in predicting the outcome in head trauma patients. The goal of this study is to search for a probable relation between urine levels of catecholamines and prognosis in patients with severe head trauma. Fifty four patients with severe head trauma Glasgow Coma Scale (GCS < or = 8) on admission time were recruited in Imam Reza Hospital within one. These patients were included when having no major accompanying trauma in other organs. Twenty four hour urine was collected after admission and levels of metanephrine and nor-metanephrine were measured. The relation between urine levels of these metabolites with final outcome and also with GCS at admission, 24, 48 h and 1 week after admission and discharge time and Glasgow Outcome Scale (GOS) were studied. Fifty two patients, 48 males and 4 females with a mean age of 32.3 +/- 14.7 (3-72) years were included. The main underlying etiologies were motorcycle (46.2%) and car accidents (25%). Diffuse axonal injury, brain contusion and subdural hematoma were three main diagnoses (28.8, 17.3 and 15.4% of the cases, respectively). 19 (36.5%) of the patients expired within the study period. The mean level of metanephrine and normetanephrine in urine were 207.9 +/- 200.5 and 330.2 +/- 218.4 microg in 24 h, respectively. There was no meaningful relation between urine levels of these metabolites and any of GCS and GOS. There was also no meaningful relation between these parameters and final prognosis in patients.

  16. Performance-based Outcomes of Inpatient Rehabilitation Facilities Treating Hip Fracture Patients in the United States

    PubMed Central

    Baernholdt, Marianne; Anderson, Ruth A.; Merwin, Elizabeth I.

    2015-01-01

    Objective To examine the influence of facility and aggregate patient characteristics of inpatient rehabilitation facilities (IRFs) on performance-based rehabilitation outcomes in a national sample of IRFs treating Medicare beneficiaries with hip fracture. Design Secondary data analysis. Setting U.S. Medicare-certified IRFs (N=983). Participants 983 US Medicare-certified IRFs. Data included 34,364 patient records of Medicare beneficiaries admitted in 2009 for rehabilitation after hip fracture. Main Outcome Measures Performance-based outcomes included mean motor function on discharge, mean motor change (mean motor score on discharge minus mean motor score on admission) and percentage discharged to the community. Results Higher mean motor function on discharge was explained by aggregate characteristics of hip fracture patients (lower age [p=0.009], lower percentage of Blacks [p<0.001] and Hispanics [p<0.001], higher percentage of females [p<0.030], higher motor function on admission [p<0.001], longer length of stay [p<0.001]) and facility characteristics (freestanding [p<0.001], rural [p<0.001], for-profit [p=0.048], and smaller IRFs [p=0.041]). The findings were similar for motor change, but motor change was also associated with lower mean cognitive function on admission (0.008). Higher percentage discharged to the community was associated with aggregate patient characteristics (lower age [p<0.001], lower percentage of Hispanics [p=0.009], higher percentage of patients living with others [p<0.001], and higher motor function on admission [p<0.001]). No facility characteristics were associated with percentage discharged to the community. Conclusion Performance-based measurement offers health policymakers, administrators, clinicians, and consumers a major opportunity for securing health system improvement by benchmarking or comparing their outcomes to other similar facilities. These results might serve as the basis for benchmarking and quality-based reimbursement to

  17. Prognostic value of on admission arterial PCO2 in hospitalized patients with community-acquired pneumonia

    PubMed Central

    Yassin, Zeynab; Saadat, Mohammad; Abtahi, Hamidreza; Rahimi Foroushani, Abbas

    2016-01-01

    Background There is little data about the correlation between the outcome of community acquired pneumonia (CAP) and the hypercapnic type respiratory failure. In this study we prospectively investigated the prognostic significance of first arterial CO2 tension in patients hospitalized with CAP. Methods In this prospective study patients with CAP, admitted to a general hospital were included. PaCO2 was measured for each subject in an arterial blood sample drawn in the first 2 hours and its correlations with three major outcomes were evaluated: intensive care unit (ICU) admission, duration of admission and mortality in 30 days. Results A total of 114 patients (mean age: 60.9±18.3; male: 51.8%) diagnosed with CAP were included. Significant relationship was not found between PaCO2 and mortality (P=0.544) or ICU admission (P=0.863). However advanced age, associated CHF, high BUN levels, high CURB-65 scores, associated pleural effusion in chest X-ray and being admitted to the ICU (P=0.012, 0.004, 0.003, <0.001, 0.045 and <0.001 respectively) were all significant prognostic factors of higher mortality risks. Prognostic factors for ICU admission were a history of malignancy (P=0.004), higher CURB-65 (P<0.001) scores and concomitant pleural effusion (P=0.028) in chest X-ray. Hypercapnic patients hospitalized for longer duration compared with normocapnic subjects. Furthermore, patients with lower pH (P=0.041) and pleural effusions (P=0.002) were hospitalized longer than the others. Conclusions There was less prominent prognostic value regarding on-admission PaCO2 in comparison to other factors such as CURB-65. Considering the inconsistent results of surveys conducted on prognostic value of PaCO2 for CAP outcomes, further investigations are required to reach a consensus on this matter. PMID:27867552

  18. Outcomes of coronary artery bypass grafting versus percutaneous coronary intervention with second-generation drug-eluting stents for patients with multivessel and unprotected left main coronary artery disease

    PubMed Central

    Papadopoulos, Kyriacos; Lekakis, Ioannis; Nicolaides, Evagoras

    2017-01-01

    Objectives: To compare the efficacy and safety of percutaneous coronary intervention using second-generation drug-eluting stents with those of coronary artery bypass grafting among patients with multivessel disease and/or unprotected left main coronary artery disease in terms of mortality, myocardial infarction, repeat revascularization, and angina. Background: Although coronary artery disease is a leading cause of death in the Western world and in many developing countries, its optimal treatment is still a matter of controversy. Several studies have examined the clinical safety and efficacy of percutaneous coronary intervention using first-generation drug-eluting stents over coronary artery bypass grafting in patients with multivessel disease and/or unprotected left main coronary artery disease. However, this study compared the efficacy of percutaneous coronary intervention using second-generation drug-eluting stents to that of coronary artery bypass grafting for multivessel disease and/or unprotected left main coronary artery disease. Methods: This was a prospective single-center cohort study conducted from September 2012 to November 2014 at the Nicosia General Hospital. In total, 140 patients (94% men and 6% women) with chronic coronary artery disease undergoing revascularization with either percutaneous coronary intervention using second-generation drug-eluting stents or coronary artery bypass grafting were evaluated. We examined the differences in clinical outcomes between coronary artery bypass grafting and percutaneous coronary intervention at 1-year follow-up. Results: Percutaneous coronary intervention with second-generation drug-eluting stents as opposed to coronary artery bypass grafting resulted in similar rates of mortality (5.7% vs 11.4%, respectively; p = 0.135), myocardial infarction (0% vs 4.3%, respectively), repeat revascularization (4.3% vs 8.6%, respectively; p = 0.115) and angina (10% vs 18.6%, respectively; p = 0.153). Conclusion

  19. Guideposts of an Effective Admissions Program for the Private School.

    ERIC Educational Resources Information Center

    Johnson, Raymond E.

    1980-01-01

    Describes fundamental guideposts for an effective private school admissions program. Included are a clear statement of purpose, informative literature, clearly stated admission requirements, standardized testing, a cooperative faculty, image positioning and a recruiting plan. (RC)

  20. A mathematical model for the admission process in intensive care units

    NASA Astrophysics Data System (ADS)

    Rokni Lamooki, Gholam Reza; Maleki, Farzaneh; Hajihosseini, Amirhossein

    2014-01-01

    A mathematical model is given for the admission process in Intensive Care Units (ICUs). It is shown that the model exhibits bistability for certain values of its parameters. In particular, it is observed that in a two-dimensional parameter space, two saddle-node bifurcation curves terminate at a single point of the cusp bifurcation, creating an enclosed region in which the model has one unstable and two stable states. It is shown that in the presence of bistability, variations in the value of parameters may lead to undesired outcomes in the admission process as the value of state variables abruptly changes. Using numerical simulations, it is also discussed how such outcomes can be avoided by appropriately adjusting the parameter values.

  1. "In the beginning...": tools for talking about resuscitation and goals of care early in the admission.

    PubMed

    White, Jocelyn; Fromme, Erik K

    2013-11-01

    Quality standards no longer allow physicians to delay discussing goals of care and resuscitation. We propose 2 novel strategies for discussing goals and resuscitation on admission. The first, SPAM (determine Surrogate decision maker, determine resuscitation Preferences, Assume full care, and advise them to expect More discussion especially with clinical changes), helps clinicians discover patient preferences and decision maker during routine admissions. The second, UFO-UFO (Understand what they know, Fill in knowledge gaps, ask about desired Outcomes, Understand their reasoning, discuss the spectrum Feasible Outcomes), helps patients with poor or uncertain prognosis or family-team conflict. Using a challenging case example, this article illustrates how SPAM and UFO-UFO can help clinicians have patient-centered resuscitation and goals of care discussions at the beginning of care.

  2. 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)

  3. Female and Male Admission to Graduate School: An Illustrative Inquiry

    ERIC Educational Resources Information Center

    Maxwell, Scott E.; Jones, Lyle V.

    1976-01-01

    Female and male admission rates to four graduate programs at a university were compared over a two year time period to assess possible sex bias in admission procedures. The overall results showed that sex played only a modest role in admission decisions. (Author/DEP)

  4. Behind the Scenes, Admissions Offices Conquer Mounds of Mail

    ERIC Educational Resources Information Center

    Farrell, Elizabeth F.

    2008-01-01

    If coming back to work after winter break seems daunting, consider the plight of college-admissions officials. While most high-school students are breathing a sigh of relief after finally submitting their applications, those on the receiving end are rolling up their sleeves. January is crunch time for many admissions offices. Admissions officers…

  5. 45 CFR 618.305 - Preference in admission.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Preference in admission. 618.305 Section 618.305 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.305 Preference in admission....

  6. 45 CFR 618.305 - Preference in admission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Preference in admission. 618.305 Section 618.305 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.305 Preference in admission....

  7. 45 CFR 618.305 - Preference in admission.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Preference in admission. 618.305 Section 618.305 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.305 Preference in admission....

  8. 45 CFR 618.305 - Preference in admission.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 3 2012-10-01 2012-10-01 false Preference in admission. 618.305 Section 618.305 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.305 Preference in admission....

  9. The Roles of Testing and Diversity in College Admissions.

    ERIC Educational Resources Information Center

    Clarke, Marguerite; Shore, Arnold

    In order to understand the roles of test scores and diversity characteristics (including race and ethnicity) in the admission process, National Board researchers interviewed admissions directors who worked at selective public and private institutions are well as admissions consultants in the summer and fall of 1999. This report presents an…

  10. Equity of Access. New Approaches to Minority Admissions

    ERIC Educational Resources Information Center

    Bingham, Rebecca Saady

    1978-01-01

    One new approach to the admission of minorities to medical schools is that of the Simulated Minority Admission Exercises (SMAE). It sensitizes admission committee members to the different backgrounds of minority applicants and teaches them to evaluate them more effectively. (Author/AM)

  11. 49 CFR 511.34 - Requests for admission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for the admission, for the purposes of the pending proceeding only, of the truth of any matters within... served upon any party after filing of the answer. Each matter as to which an admission is requested shall be separately set forth. (b) Procedure for response. The matter as to which an admission is...

  12. 6 CFR 17.305 - Preference in admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Preference in admission. 17.305 Section 17.305... OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 17.305 Preference in admission. A...

  13. 18 CFR 1317.305 - Preference in admission.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Preference in admission... 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 § 1317.305 Preference in admission....

  14. 49 CFR 1114.3 - Admissibility of business records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 8 2013-10-01 2013-10-01 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...

  15. 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...

  16. 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...

  17. 42 CFR 456.122 - Evaluation criteria for admission review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Evaluation criteria for admission review. 456.122...: Review of Need for Admission 1 § 456.122 Evaluation criteria for admission review. The UR plan must provide that— (a) The committee develops written medical care criteria to assess the need for...

  18. 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…

  19. The Role of Obesity in Sepsis Outcome among Critically Ill Patients: A Retrospective Cohort Analysis.

    PubMed

    Papadimitriou-Olivgeris, Matthaios; Aretha, Diamanto; Zotou, Anastasia; Koutsileou, Kyriaki; Zbouki, Aikaterini; Lefkaditi, Aikaterini; Sklavou, Christina; Marangos, Markos; Fligou, Fotini

    2016-01-01

    Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P  0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P  0.005) were significantly associated with obesity, while nonobese patients suffered more frequently from spontaneous intracranial hemorrhage (P  0.038). Total ICU mortality was 22.5%. Increased mortality among obese ICU patients was observed. Sepsis was the main condition of admission for which obese patients had statistically lower survival than normal weight subjects (76.3% versus 43.7%; P  0.001). Mortality of septic patients upon admission was independently associated with SOFA score upon ICU admission (P  0.003), obesity (P  0.014), pneumonia (P  0.038), and development of septic shock (P  0.015). Conclusions. Our study revealed that sepsis upon ICU admission is adversely influenced by obesity but further studies are needed in order to assess the role of obesity in sepsis outcome.

  20. The Role of Obesity in Sepsis Outcome among Critically Ill Patients: A Retrospective Cohort Analysis

    PubMed Central

    Papadimitriou-Olivgeris, Matthaios; Zotou, Anastasia; Koutsileou, Kyriaki; Zbouki, Aikaterini; Lefkaditi, Aikaterini; Sklavou, Christina; Marangos, Markos; Fligou, Fotini

    2016-01-01

    Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P  0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P  0.005) were significantly associated with obesity, while nonobese patients suffered more frequently from spontaneous intracranial hemorrhage (P  0.038). Total ICU mortality was 22.5%. Increased mortality among obese ICU patients was observed. Sepsis was the main condition of admission for which obese patients had statistically lower survival than normal weight subjects (76.3% versus 43.7%; P  0.001). Mortality of septic patients upon admission was independently associated with SOFA score upon ICU admission (P  0.003), obesity (P  0.014), pneumonia (P  0.038), and development of septic shock (P  0.015). Conclusions. Our study revealed that sepsis upon ICU admission is adversely influenced by obesity but further studies are needed in order to assess the role of obesity in sepsis outcome. PMID:27777948

  1. Assisted living nursing practice: admission assessment.

    PubMed

    Mitty, Ethel; Flores, Sandi

    2007-01-01

    Admission assessment, generally conducted by a registered nurse, is autonomous, without opportunity for dialogue with colleagues and other health care professionals and bounded by the nurse's knowledge and skills, state regulations, facility practices, and marketing. The fact that some states permit admission and retention of nursing home level-of-care residents and provision of end-of-life care means that the assessment has to be able to predict the resident's likely trajectory of well-being as well as chronic illness exacerbation. The nurse must have a clear perspective on staff competencies and judge whether additional education or training will be necessary. This article reviews assessment standards of practice as put forth by the American Assisted Living Nurses Association as part of its application for recognition of assisted living nursing as specialty nursing practice by the American Nurses Association. The role of the Licensed Practical Nurse/Licensed Vocational Nurse in resident assessment is also discussed.

  2. Lasers, the Price of Admission in 2045

    DTIC Science & Technology

    2015-04-01

    altitude. Water vapor, pollutants , and other particles in the air , which are more prevalent at lower altitudes, cause absorption and scattering. These...AU/ACSC/DAYTON, J/AY15 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY LASERS, THE PRICE OF ADMISSION IN 2045 by John G. Dayton, Maj, USAF...the Degree of MASTER OF OPERATIONAL ARTS AND SCIENCE Advisors: Lt Col Paul P. Clemans, Maj Thomas E. Kiesling Maxwell Air Force Base, Alabama

  3. Impact of PharmaNet-Based Admission Medication Reconciliation on Best Possible Medication Histories for Warfarin

    PubMed Central

    Au, Debbie; Wu, Hilary; San, Cindy; Chua, Doson; Su, Victoria; Kirkwood, Allison

    2016-01-01

    Background Inaccurate documentation of medication histories may lead to medication discrepancies during hospital admissions. Obtaining a best possible medication history (BPMH) for warfarin can be challenging because of frequent dosage changes and nonspecific directions of use (e.g., “take as directed”). On February 27, 2012, the study hospital implemented an admission medication reconciliation (MedRec) process using a form that compiled the most recent 6 months of outpatient prescription dispensing history from a provincial electronic database called PharmaNet. It was unclear whether admission MedRec had improved the process of obtaining warfarin BPMHs and the quality of their documentation. Objective To compare the rates of complete warfarin BPMH documentation before and after implementation of PharmaNet-based admission MedRec. Methods A single-centre, retrospective chart review was conducted using the health records of patients receiving warfarin who were admitted to the hospital’s Internal Medicine service before and after implementation of admission MedRec. The study periods were October 1, 2009, to February 26, 2012, and February 27, 2012, to July 31, 2014, respectively. The primary outcome was the rate of complete warfarin BPMH documentation during each period. Results Data were recorded for 100 patients in the pre-implementation phase and 100 patients in the post-implementation phase. The rates of complete warfarin BPMH documentation were 65% and 84% in these 2 phases, respectively (p = 0.002). Conclusion Implementation of PharmaNet-based admission MedRec was associated with a statistically significant increase in the rate of complete warfarin BPMH documentation. PMID:27826152

  4. Utility of serum concentration of protein S100 at admission to the medical intensive care unit in prediction of permanent neurological injury

    PubMed Central

    Knapik, Małgorzata; Partyka, Robert; Broll, Iwona; Cieśla, Daniel; Wawrzyńczyk, Maciej; Kokocińska, Danuta; Jałowiecki, Przemysław

    2016-01-01

    Introduction Admission to the intensive care unit (ICU) may be preceded by dramatic events leading to permanent neurological injury. Plasma S100 protein levels are proved to be clinically useful in predicting neurological outcome following cardiac arrest. It is unclear, however, whether this may be extrapolated to a broader population of ICU patients. Aim To assess the utility of plasma S100 protein in predicting death, permanent neurological damage, or unfavourable outcome at admission to the intensive care unit. Material and methods The concentration of plasma S100 protein was established in 102 patients on admission to the ICU, regardless of their neurological status and the reason for admission. The majority of patients were admitted with various cardiac diseases, excluding trauma patients. The patients were classified into three groups with the following binary outcomes: permanent neurological deficit or restoration of consciousness; unfavourable outcome (death or survival with permanent neurological deficit) or favourable outcome; and death or survival. Results Plasma S100 protein levels at admission facilitated the identification of patients who later developed a permanent neurological deficit or regained consciousness (p < 0.0001). All patients with plasma S100 protein over 0.532 μg/l at ICU admission either developed a permanent neurological deficit or had an unfavourable outcome (death or survival with permanent neurological deficit). However, sensitivity for this cut-off value was only 48% and 40%, respectively. Conclusions Plasma S100 protein levels over 0.532 μg/l are specific but not sensitive for both permanent neurological deficit and unfavourable outcome when assessed in a heterogeneous population at admission to the ICU. PMID:28096833

  5. Bipolar disorder and its outcomes: two cohorts, 1875-1924 and 1994-2007, compared.

    PubMed

    Atigari, Onome V; Harris, Margaret; Le Noury, Joanna; Healy, David

    2016-03-01

    We compared admission rates and outcomes for bipolar disorder patients using the medical records of patients with a first hospital admission in 1875-1924 retrospectively diagnosed based on International Classification of Diseases (ICD)-10 criteria, and patients with a first admission in 1994-2007. The incidences of first admissions in the historical and contemporary periods are comparable: 1.2 and 1.3 per hundred thousand per year, respectively. Manic episodes constituted a greater proportion of admissions historically, while depressive episodes made up more in the contemporary sample. There is no evidence for a reduction in the mean inter-admission intervals with duration of illness. This study suggests that modern treatments may have decreased lengths of stay in hospital, but at a cost of contributing to more admissions. It also points to a shift in the threshold for admissions.

  6. 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…

  7. 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.…

  8. Effects of the Economy on the Admission Process: 2008-09. National Association for College Admission Counseling, September 2009

    ERIC Educational Resources Information Center

    National Association for College Admission Counseling, 2009

    2009-01-01

    The 2008-09 college admission cycle took place during a period of heightened economic uncertainty. When added to the annual uncertainty of the admission process--for both students seeking college admission offers and colleges seeking to predict their annual enrollment yield--the economic environment caused great concern among colleges and students…

  9. A nested case–control study to determine the incidence and factors associated with unanticipated admissions following day care surgery

    PubMed Central

    Singh, Madhurita; Ponniah, Manickam; Jacob, KS

    2016-01-01

    Background and Aims: Day care surgery offers respite from hospitalisation for specific surgical procedures and has many advantages. However, occasionally patients who undergo such surgery require hospitalisation for unanticipated complications. We aimed to determine their incidence and to identify factors associated with unanticipated admissions in a tertiary care hospital in South India. Methods: During the 3-month study, 63 cases requiring admission and 126 randomly selected controls were taken from the 776 procedures that were performed were compared. The variables studied were patients’ demographic characteristics, pre-operative medical illness, personal habits, American Society of Anesthesiologists status, the diagnosis and surgical procedures, time since last meal, duration of anaesthesia and surgery, experience of the surgeon and anaesthetist, and intraoperative management (techniques, drugs, monitoring, etc.). Univariate and bivariate statistics were used to determine factors associated with unanticipated admissions. Results: The incidence of unanticipated admissions following day care surgery was 8.11%. The reasons for admission were anaesthetic (33.33%), surgical (15.87%), medical (6.34%) and social (44.44%). The factors significantly associated with unanticipated admissions included duration of anaesthesia more than 50 min (odds ratio [OR]: 3.179; 95% confidence interval [CI]: 1.503–6.722), and starting the last case after 3 pm (OR: 10.095; 95% CI: 2.418–42.148). Conclusion: Unanticipated admissions following day care surgery occur mainly due to anaesthetic, surgical, medical and social reasons. PMID:27942057

  10. Quality Markers in Cardiology. Main Markers to Measure Quality of Results (Outcomes) and Quality Measures Related to Better Results in Clinical Practice (Performance Metrics). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): A SEC/SECTCV Consensus Position Paper.

    PubMed

    López-Sendón, José; González-Juanatey, José Ramón; Pinto, Fausto; Cuenca Castillo, José; Badimón, Lina; Dalmau, Regina; González Torrecilla, Esteban; López-Mínguez, José Ramón; Maceira, Alicia M; Pascual-Figal, Domingo; Pomar Moya-Prats, José Luis; Sionis, Alessandro; Zamorano, José Luis

    2015-11-01

    Cardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in other countries.

  11. Cause-Specific Risk of Hospital Admission Related to Extreme Heat in Older Adults

    PubMed Central

    Bobb, Jennifer F.; Obermeyer, Ziad; Wang, Yun; Dominici, Francesca

    2015-01-01

    IMPORTANCE Heat exposure is known to have a complex set of physiological effects on multiple organ systems, but current understanding of the health effects is mostly based on studies investigating a small number of prespecified health outcomes such as cardiovascular and respiratory diseases. OBJECTIVES To identify possible causes of hospital admissions during extreme heat events and to estimate their risks using historical data. DESIGN, SETTING, AND POPULATION Matched analysis of time series data describing daily hospital admissions of Medicare enrollees (23.7 million fee-for-service beneficiaries [aged ≥65 years] per year; 85% of all Medicare enrollees) for the period 1999 to 2010 in 1943 counties in the United States with at least 5 summers of near-complete (>95%) daily temperature data. EXPOSURES Heat wave periods, defined as 2 or more consecutive days with temperatures exceeding the 99th percentile of county-specific daily temperatures, matched to non–heat wave periods by county and week. MAIN OUTCOMES AND MEASURES Daily cause-specific hospitalization rates by principal discharge diagnosis codes, grouped into 283 disease categories using a validated approach. RESULTS Risks of hospitalization for fluid and electrolyte disorders, renal failure, urinary tract infection, septicemia, and heat stroke were statistically significantly higher on heat wave days relative to matched non–heat wave days, but risk of hospitalization for congestive heart failure was lower (P < .05). Relative risks for these disease groups were 1.18 (95% CI, 1.12–1.25) for fluid and electrolyte disorders, 1.14 (95% CI, 1.06–1.23) for renal failure, 1.10 (95% CI, 1.04–1.16) for urinary tract infections, 1.06 (95% CI, 1.00–1.11) for septicemia, and 2.54 (95% CI, 2.14–3.01) for heat stroke. Absolute risk differences were 0.34 (95% CI, 0.22–0.46) excess admissions per 100 000 individuals at risk for fluid and electrolyte disorders, 0.25 (95% CI, 0.12–0.39) for renal failure, 0

  12. Race-Sensitive Admissions in Higher Education: Commentary on How the Supreme Court Is Likely To Rule.

    ERIC Educational Resources Information Center

    Bell, Derrick; Kehlenberg, Richard D.; Dorf, Michael C.; Tushnet, Mark V.; Delgado, Richard; Stefancic, Jean

    1999-01-01

    Six legal scholars suggest possible outcomes of a future Supreme Court ruling on affirmative action in student admissions to higher education. The scholars examine other Supreme Court decisions and look at the impact that different justices and different presidents would have on an affirmative action ruling. (SM)

  13. Children's Post-Traumatic Stress and the Role of Memory Following Admission to Intensive Care: A Review

    ERIC Educational Resources Information Center

    Dow, Belinda; Kenardy, Justin; Long, Deborah; Le Brocque, Robyne

    2012-01-01

    Although our understanding of children's psychological outcomes following intensive care lags significantly behind advances in medicine, there is a growing awareness that intensive care admission impacts children beyond the boundaries of physical well-being. Intensive care presents a variety of disease-related, treatment-related, and…

  14. Severe infective keratitis leading to hospital admission in New Zealand

    PubMed Central

    Wong, T; Ormonde, S; Gamble, G; McGhee, C N J

    2003-01-01

    Aim: To identify key risk factors and the management and outcome of severe infective keratitis leading to public hospital admission in New Zealand. Methods: Over a 2 year period, all admissions of presumed infective keratitis to Auckland Hospital were identified. The clinical records of all 103 cases were retrospectively reviewed with respect to clinical features, risk factors, management, and outcomes. Results: The mean time from first symptoms or signs and presentation to hospital was 8.9 (SD 15.5) days. The majority of subjects, 88%, had at least one of the risk factors commonly associated with infective keratitis including previous ocular surgery (30%), contact lens wear (26%), topical corticosteroid use (25%), and ocular trauma (24%). Corneal scraping was performed in 92% and of a total of 105 scrapes, 71% were positive. Bacteria were isolated in all these cases, the majority being Gram positive organisms (72%). The most common isolates identified were coagulase negative Staphylococcus (16%), Propionibacterium acnes (14%), Staphylococcus epidermidis (11%), and Streptococcus pneumoniae (9%). In addition, yeasts were isolated in 5%, fungi in 4%, virus in 2%, and chlamydia in 1%. Importantly, polymicrobial infection accounted for 33% of culture positive cases. Antimicrobial treatment was changed on the basis of culture results in 17 cases (16.5%). Median initial visual and final best corrected visual acuity was 6/36–6/48 (logMAR 0.86) (IQR 0.39–2.00) and 6/12–6/15 (logMAR 0.360) (IQR 0.15–1.70), respectively. Previous ocular surgery and topical corticosteroid use were significantly associated with poorer visual acuity. The mean hospital stay was 5.8 days and the median 4.0 (IQR 2.0–8.0) days. Longer duration of stay was associated with the presence of hypopyon, larger ulcers, previous ocular surgery, and poor visual acuity. Conclusions: Infectious keratitis is an important cause of ocular morbidity. A significant proportion of cases have potentially

  15. Is Walk Score associated with hospital admissions from chronic diseases? Evidence from a cross-sectional study in a high socioeconomic status Australian city-state

    PubMed Central

    Mazumdar, Soumya; Learnihan, Vincent; Cochrane, Thomas; Phung, Hai; O'Connor, Bridget; Davey, Rachel

    2016-01-01

    Objectives To explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs. Design A cross-sectional analysis of public hospital episode data (2007–2013). Setting Hospitalisations from the ACT, Australia at very small geographic areas. Participants Secondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013. No restrictions on age, sex or ethnicity. Main exposure measures Geographic Information System derived or compatible measures of general practitioner access, neighbourhood socioeconomic status, alcohol access, exposure to traffic and Walk Score walkability. Main outcome measures Hospitalisations of circulatory diseases, specific endocrine, nutritional and metabolic diseases, respiratory diseases and specific cancers. Results Geographic clusters with significant high and low risks of NCDs were found that displayed an overall geographic pattern of high risk in the outlying suburbs of the territory. Significant relationships between neighbourhood walkability as measured by Walk Score and the likelihood of hospitalisation with a primary diagnosis of myocardial infarction (heart attack) were found. A possible relationship was also found with the likelihood of being hospitalised with 4 major lifestyle-related cancers. Conclusions Our research augments the growing literature underscoring the relationships between the built environment and health outcomes. In addition, it supports the importance of walkable neighbourhoods, as measured by Walk Score, for improved health. PMID:27932340

  16. Forecasting asthma-related hospital admissions in London using negative binomial models.

    PubMed

    Soyiri, Ireneous N; Reidpath, Daniel D; Sarran, Christophe

    2013-05-01

    Health forecasting can improve health service provision and individual patient outcomes. Environmental factors are known to impact chronic respiratory conditions such as asthma, but little is known about the extent to which these factors can be used for forecasting. Using weather, air quality and hospital asthma admissions, in London (2005-2006), two related negative binomial models were developed and compared with a naive seasonal model. In the first approach, predictive forecasting models were fitted with 7-day averages of each potential predictor, and then a subsequent multivariable model is constructed. In the second strategy, an exhaustive search of the best fitting models between possible combinations of lags (0-14 days) of all the environmental effects on asthma admission was conducted. Three models were considered: a base model (seasonal effects), contrasted with a 7-day average model and a selected lags model (weather and air quality effects). Season is the best predictor of asthma admissions. The 7-day average and seasonal models were trivial to implement. The selected lags model was computationally intensive, but of no real value over much more easily implemented models. Seasonal factors can predict daily hospital asthma admissions in London, and there is a little evidence that additional weather and air quality information would add to forecast accuracy.

  17. Pattern of Otorhinolaryngological Admissions via Emergency Unit in a Suburban Tertiary Center

    PubMed Central

    Adedeji, Taiwo O.; Sogebi, Olusola A.; Tobih, James E.

    2015-01-01

    Background: Patients with ORL lesions sometimes present to the general emergency room. This study reviews the common ENT admissions via emergency room in a sub-urban town in Nigeria Methods: A retrospective study spanning five years from January 2009 to December 2013 Results: A total of 211 cases consisting of 131 (62.1%) males with male: female ratio 1.6: 1 and a mean age of 32.8 ± 22.4 years. About a quarter of the patients were children, the peak age was 21-40 years (in 37%). The common indications for emergency otorhinolaryngological admissions were Epistaxis (16.1%), Nasal/facial trauma (14.7%), pharyngo-esophageal foreign bodies (13.3%) and upper airway obstruction (8.1%). Majority 16 (57.1%) of the Pharyngo-esophageal FBs occurred in children. Most of the airway obstructions in children were due to juvenile recurrent respiratory papillomatosis while laryngeal cancer was the major cause among the adult. Sixty percent had surgical procedures, 86.7% had satisfactory outcome and mortalities were recorded in 1.4%. Conclusion: Majority of causes for ORL admissions via emergency unit are of pharyngo-esophageal origin. There is apparent reversal of the otological origin trend in ENT admissions via A&E unit. PMID:26508908

  18. 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

  19. An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years

    PubMed Central

    2010-01-01

    Background Most of the global neonatal deaths occur in developing nations, mostly in rural homes. Many of the newborns who receive formal medical care are treated in rural district hospitals and other peripheral health centres. However there are no published studies demonstrating trends in neonatal admissions and outcome in rural health care facilities in resource poor regions. Such information is critical in planning public health interventions. In this study we therefore aimed at describing the pattern of neonatal admissions to a Kenyan rural district hospital and their outcome over a 19 year period, examining clinical indicators of inpatient neonatal mortality and also trends in utilization of a rural hospital for deliveries. Methods Prospectively collected data on neonates is compared to non-neonatal paediatric (≤ 5 years old) admissions and deliveries' in the maternity unit at Kilifi District Hospital from January 1st 1990 up to December 31st 2008, to document the pattern of neonatal admissions, deliveries and changes in inpatient deaths. Trends were examined using time series models with likelihood ratios utilised to identify indicators of inpatient neonatal death. Results The proportion of neonatal admissions of the total paediatric ≤ 5 years admissions significantly increased from 11% in 1990 to 20% by 2008 (trend 0.83 (95% confidence interval 0.45 -1.21). Most of the increase in burden was from neonates born in hospital and very young neonates aged < 7days. Hospital deliveries also increased significantly. Clinical diagnoses of neonatal sepsis, prematurity, neonatal jaundice, neonatal encephalopathy, tetanus and neonatal meningitis accounted for over 75% of the inpatient neonatal admissions. Inpatient case fatality for all ≤ 5 years declined significantly over the 19 years. However, neonatal deaths comprised 33% of all inpatient death among children aged ≤ 5 years in 1990, this increased to 55% by 2008. Tetanus 256/390 (67%), prematurity 554

  20. Does Admission to Medicine or Orthopaedics Impact a Geriatric Hip Patient’s Hospital Length of Stay?

    PubMed Central

    Greenberg, Sarah E.; VanHouten, Jacob P.; Lakomkin, Nikita; Ehrenfeld, Jesse; Jahangir, Amir Alex; Boyce, Robert H.; Obremksey, William T.; Sethi, Manish K.

    2016-01-01

    Objectives The aim of our study was to determine the association between admitting service, medicine or orthopaedics, and length of stay (LOS) for a geriatric hip fracture patient. Design Retrospective. Setting Urban level 1 trauma center. Patients/Participants Six hundred fourteen geriatric hip fracture patients from 2000 to 2009. Interventions Orthopaedic surgery for geriatric hip fracture. Main Outcome Measurements Patient demographics, medical comorbidities, hospitalization length, and admitting service. Negative binomial regression used to determine association between LOS and admitting service. Results Six hundred fourteen geriatric hip fracture patients were included in the analysis, of whom 49.2% of patients (n = 302) were admitted to the orthopaedic service and 50.8% (3 = 312) to the medicine service. The median LOS for patients admitted to orthopaedics was 4.5 days compared with 7 days for patients admitted to medicine (P < 0.0001). Readmission was also significantly higher for patients admitted to medicine (n = 92, 29.8%) than for those admitted to orthopaedics (n = 70, 23.1%). After controlling for important patient factors, it was determined that medicine patients are expected to stay about 1.5 times (incidence rate ratio: 1.48, P < 0.0001) longer in the hospital than orthopaedic patients. Conclusions This is the largest study to demonstrate that admission to the medicine service compared with the orthopaedic service increases a geriatric hip fractures patient’s expected LOS. Since LOS is a major driver of cost as well as a measure of quality care, it is important to understand the factors that lead to a longer hospital stay to better allocate hospital resources. Based on the results from our institution, orthopaedic surgeons should be aware that admission to medicine might increase a patient’s expected LOS. PMID:26371621

  1. Wavelet frames and admissibility in higher dimensions

    NASA Astrophysics Data System (ADS)

    Führ, Hartmut

    1996-12-01

    This paper is concerned with the relations between discrete and continuous wavelet transforms on k-dimensional Euclidean space. We start with the construction of continuous wavelet transforms with the help of square-integrable representations of certain semidirect products, thereby generalizing results of Bernier and Taylor. We then turn to frames of L2(Rk) and to the question, when the functions occurring in a given frame are admissible for a given continuous wavelet transform. For certain frames we give a characterization which generalizes a result of Daubechies to higher dimensions.

  2. Adverse inpatient outcomes during the transition to a new electronic health record system: observational study

    PubMed Central

    Barnett, Michael L; Mehrotra, Ateev

    2016-01-01

    Objective To assess the short term association of inpatient implementation of electronic health records (EHRs) with patient outcomes of mortality, readmissions, and adverse safety events. Design Observational study with difference-in-differences analysis. Setting Medicare, 2011-12. Participants Patients admitted to 17 study hospitals with a verifiable “go live” date for implementation of inpatient EHRs during 2011-12, and 399 control hospitals in the same hospital referral region. Main outcome measures All cause readmission within 30 days of discharge, all cause mortality within 30 days of admission, and adverse safety events as defined by the patient safety for selected indicators (PSI)-90 composite measure among Medicare beneficiaries admitted to one of these hospitals 90 days before and 90 days after implementation of the EHRs (n=28 235 and 26 453 admissions), compared with the control group of all contemporaneous admissions to hospitals in the same hospital referral region (n=284 632 and 276 513 admissions). Analyses were adjusted for beneficiaries’ sociodemographic and clinical characteristics. Results Before and after implementation, characteristics of admissions were similar in both study and control hospitals. Among study hospitals, unadjusted 30 day mortality (6.74% to 7.15%, P=0.06) and adverse safety event rates (10.5 to 11.4 events per 1000 admissions, P=0.34) did not significantly change after implementation of EHRs. There was an unadjusted decrease in 30 day readmission rates, from 19.9% to 19.0% post-implementation (P=0.02). In difference-in-differences analysis, however, there was no significant change in any outcome between pre-implementation and post-implementation periods (all P≥0.13). Conclusions Despite concerns that implementation of EHRs might adversely impact patient care during the acute transition period, we found no overall negative association of such implementation on short term inpatient mortality, adverse safety

  3. Stable admission rate for acute asthma in Danish children since 1977.

    PubMed

    Sevelsted, Astrid; Pipper, Christian Bressen; Bisgaard, Hans

    2016-03-01

    Childhood asthma is consistently reported to have increased in recent decades in most westernized countries, but it is unknown if this increase is similar across severities. We aimed to study the time-trend of acute hospital admission and readmission for asthma of school-aged children in the recent 35 years in Denmark. We analyzed time-trends in the national incidence rate of hospitalization for acute severe asthma in children aged 5-15 in Denmark during the 35-year period 1977-2012 in the Danish national registry. Only in-patient admissions with a principal diagnosis of asthma (ICD-8: 493** or ICD-10: J45** or J46**) were included. Among children with asthma hospitalizations, we investigated the risk of readmission beyond 1 month of first admission. Admissions were summarized as rates per thousand person years at risk. The overall time-trend is stable with a rate of one admission per year per thousand children at risk and a per-year incidence rate ratio 0.999 [95 % CI 0.997-1.001]. The rate of any readmission decreased from approximately 20 per thousand children in the eighties to less than 10 in the early nineties before stabilizing at around 10 per thousand children from mid-nineties and onwards. During 35 years of nation-wide follow-up, we find a highly stable incidence rate of first hospital admission for acute severe asthma in children. Moreover, rates of readmission halved during the seventies and stabilized in the last twenty years. In conclusion, our data suggest that the reported increase in childhood asthma is mainly due to less severe cases.

  4. Development of a Maximum Admissions Index for Freshman Admissions to the University of Washington.

    ERIC Educational Resources Information Center

    Lunneborg, Clifford E.

    A new technique has been developed for admitting new freshman students at the University of Washington. Previously, an Admissions Index (AI) was used, in which the high school grade point average (HSGPA) was assigned twice the weight of the composite verbal and quantitative scores from the Washington Pre-College Test Battery (WPC). To offset the…

  5. An Evaluation of the Pharmacy College Admissions Test as a Tool for Pharmacy College Admissions Committees.

    ERIC Educational Resources Information Center

    Kelley, Katherine A.; Secnik, Kristina; Boye, Mark E.

    2001-01-01

    Investigated the capacity of the Pharmacy College Admissions Test (PCAT) to predict success in pharmacy school. Found demographic differences in PCAT scores, and that the PCAT used in combination with pre-pharmacy grade point average is meaningful in assessing applicants to pharmacy school; applicants with PCAT composite percentile scores below 40…

  6. Challenges in College Admissions. A Report of a Survey of Undergraduate Admissions Policies, Practices, and Procedures.

    ERIC Educational Resources Information Center

    Breland, Hunter M.; And Others

    The report summarizes undergraduate admissions policies, practices, and procedures at two- and four-year colleges and universities as of 1992. Information was drawn from a national survey, the third of a series conducted since 1979. A total of 2,024 institutions responded to the survey. An introductory chapter describes the surveys, their…

  7. Students Selection for University Course Admission at the Joint Admissions Board (Kenya) Using Trained Neural Networks

    ERIC Educational Resources Information Center

    Wabwoba, Franklin; Mwakondo, Fullgence M.

    2011-01-01

    Every year, the Joint Admission Board (JAB) is tasked to determine those students who are expected to join various Kenyan public universities under the government sponsorship scheme. This exercise is usually extensive because of the large number of qualified students compared to the very limited number of slots at various institutions and the…

  8. Psychological implications of admission to critical care.

    PubMed

    Pattison, Natalie

    Admission to critical care can have far-reaching psychological effects because of the distinct environment. Critical care services are being re-shaped to address long-term sequelae, including post-traumatic stress disorder, anxiety and depression. The long-term consequences of critical illness not only cost the individual, but also have implications for society, such as diminished areas of health-related quality-of-life in sleep, reduced ability to return to work and enjoy recreational activities (Audit Commission, 1999; Hayes et al, 2000). The debate around the phenomenon of intensive care unit (ICU) syndrome is discussed with reference to current thinking. After critical care, patients may experience amnesia, continued hallucinations or flashbacks, anxiety, depression, and dreams and nightmares. Nursing care for patients while in the critical care environment can have a positive effect on psychological well-being. Facilitating communication, explaining care and rationalizing interventions, ensuring patients are oriented as to time and place, reassuring patients about transfer, providing patients,where possible, with information about critical care before admission and considering anxiolytic use, are all practices that have a beneficial effect on patient care. Follow-up services can help patients come to terms with their experiences of critical illness and provide the opportunity for them to access further intervention if desired. Working towards providing optimal psychological care will have a positive effect on patients' psychological recovery and may also help physical recuperation after critical care.

  9. The effectiveness of post-detoxication referrals: effects on later detoxication admissions, drunkenness and criminality.

    PubMed

    Smart, R G; Finley, J; Funston, R

    1977-05-01

    This study concerned the effectiveness of post-detoxication referrals to a variety of treatment facilities. The purpose was to discover (i) the proportion of men accepting referrals who actually arrived, (ii) the differences in outcome for patients attending an out-patient clinic, a halfway house, and a long-stay farm, (iii) the differences in outcomes for patients treated in one of the above facilities compared with those for similar patients not receiving treatment. In all, 114 male detoxication admissions were included. However, only 60% arrived, even when firm referrals were made. Those arriving and not arriving did not differ in social or demographic characteristics, nor did those who were referred to the various treatment facilities. However, the referral group had more detoxication admissions in the post-detoxication period. There were no post-treatment overall differences between all treated and untreated patients in detoxication admissions, arrests for drunkenness or criminal convictions. Refusals were more often successes than the treated or untreated groups but this was due to their better prognosis at intake. In general, the data provide little cause for optimism about the value of post-detoxication referrals.

  10. Traumatic Brain Injury Practice-Based Evidence Study: Design and Patients, Centers, Treatments, and Outcomes

    PubMed Central

    Horn, Susan D.; Corrigan, John D.; Bogner, Jennifer; Hammond, Flora M.; Seel, Ronald T.; Smout, Randall J.; Barrett, Ryan S.; Dijkers, Marcel P.; Whiteneck, Gale G.

    2015-01-01

    Objective To describe study design, patients, centers, treatments, and outcomes of a traumatic brain injury (TBI) practice-based evidence (PBE) study and to evaluate the generalizability of the findings to the US TBI inpatient rehabilitation population. Design Prospective, longitudinal observational study Setting 10 inpatient rehabilitation centers (9 US, 1 Canada) Participants Patients (n=2130) enrolled between October 2008 and Sept 2011, and admitted for inpatient rehabilitation after an index TBI injury Interventions Not applicable Main Outcome Measures Return to acute care during rehabilitation, rehabilitation length of stay, Functional Independence Measure (FIM) at discharge, residence at discharge, and 9 months post-discharge rehospitalization, FIM, participation, and subjective wellbeing. Results Level of admission FIM Cognitive score was found to create relatively homogeneous subgroups for subsequent analysis of best treatment combinations. There were significant differences in patient and injury characteristics, treatments, rehabilitation course, and outcomes by admission FIM Cognitive subgroups. TBI-PBE study patients overall were similar to US national TBI inpatient rehabilitation populations. Conclusions This TBI-PBE study succeeded in capturing naturally occurring variation within patients and treatments, offering opportunities to study best treatments for specific patient deficits. Subsequent papers in this issue report differences between patients and treatments and associations with outcomes in greater detail. PMID:26212396

  11. Loneliness and nursing home admission among rural older adults.

    PubMed

    Russell, D W; Cutrona, C E; de la Mora, A; Wallace, R B

    1997-12-01

    In this study, the authors tested the relation between loneliness and subsequent admission to a nursing home over a 4-year time period in a sample of approximately 3,000 rural older Iowans. Higher levels of loneliness were found to increase the likelihood of nursing home admission and to decrease the time until nursing home admission. The influence of extremely high loneliness on nursing home admission remained statistically significant after controlling for other variables, such as age, education, income, mental status, physical health, morale, and social contact, that were also predictive of nursing home admission. Several mechanisms are proposed to explain the link between extreme loneliness and nursing home admission. These include loneliness as a precipitant of declines in mental and physical health and nursing home placement as a strategy to gain social contact with others. Implications for preventative interventions are discussed.

  12. Prevalence and characteristics of adverse drug reactions at admission to hospital: a prospective observational study

    PubMed Central

    Chan, Sze Ling; Ang, Xiaohui; Sani, Levana L.; Ng, Hong Yen; Winther, Michael D.; Liu, Jian Jun; Brunham, Liam R.

    2016-01-01

    Aims Adverse drug reactions (ADRs) contribute to poorer patient outcomes and additional burden to the healthcare system. However, data on the true burden, relevant types and drugs causing ADRs are lacking. The aim of this study was to determine the prevalence of ADR‐related hospitalization in the general adult population in Singapore and to investigate their characteristics. Methods We prospectively recruited 1000 adult patients with unplanned admission to a large tertiary‐care hospital. Two independent reviewers evaluated all suspected ADRs for causality, type, severity and avoidability. The prevalence of ADR‐related hospitalization was calculated based on ‘definite’ and ‘probable’ ADRs. Logistic regression was used to evaluate predictors for having an ADR at admission. Results The prevalence of all ADRs at admission was 12.4% (95% CI: 10.5–14.6%) and ADRs causing admission was 8.1% (95% CI: 6.5–10.0%). The most common ADRs were gastrointestinal‐related. The most common drug category causing ADRs were cardiovascular drugs. Patients with ADRs had a longer length of stay than those who did not (median 4 vs. 3 days, P = 1.70 × 10−3). About 30% of ADRs at admission were caused by at least one drug with a clinical annotation in the Pharmacogenomics KnowledgeBase (PharmGKB), suggesting that some of these ADRs may have been predicted by pharmacogenetic testing. Conclusions We have quantified the burden and characteristics of clinically impactful ADRs in the Singaporean general adult population. Our results will provide vital information for efforts in reducing ADRs through targeted vigilance, patient education and pharmacogenomics in Singapore. PMID:27640819

  13. Underrepresented Minorities in Medical School Admissions: A Qualitative Study.

    PubMed

    Hadinger, Margaret A

    2017-01-01

    Phenomenon: This study explored Black/African American and Hispanic/Latino medical students' perceptions of the medical school admissions process. Previous research has explored other elements of the medical education continuum. However, little is known regarding minorities' perceptions of navigating the medical school admissions process. To address this gap in the literature, this exploratory study suggests a conceptual model describing why minorities apply to medical school and the influences affecting their admissions experience.

  14. Accuracy of caregivers’ recall of hospital admissions: implications for research

    PubMed Central

    Burakevych, Nataliia; McKinlay, Christopher Joel Dorman; Alsweiler, Jane Marie; Harding, Jane Elizabeth

    2015-01-01

    Aim To determine the accuracy of caregivers’ recall of hospital admissions in early childhood. Methods Prospective cohort study of babies born at risk of neonatal hypoglycaemia at Waikato Hospital, New Zealand, a regional public hospital and sole provider of acute inpatient care to over 100,000 children. Caregivers’ recall of children’s hospital admissions up to 4.5 years were compared with medical records. Accuracy of recall was related to neonatal and socio-demographic characteristics. Results Out of 267 children, 179 (67%) visited hospital and 106 (40%) were admitted at least once. The most frequent reasons for admission were for respiratory (29%) and gastrointestinal (18%) problems. Of 106 children admitted to hospital, 27 (25%) caregivers did not recall the admission and only 37 (35%) accurately recalled the number of admissions. The accuracy of recall was lower for gastrointestinal (38%) and surgical (40%) problems, while recall of respiratory (64%) and ear, nose and throat (60%) admissions was more accurate. Low socio-economic status and multiple admissions were associated with less accurate recall of number of admissions. Conclusion Caregivers do not accurately report hospital admissions. Questionnaire data about use of hospital facilities should be interpreted cautiously, and may not be sufficiently accurate for use in research studies. PMID:26355393

  15. The admission patterns of octogenerians nonagenerians and centenarians to the Department of Otoloaryngology.

    PubMed

    Sagiv, Doron; Migirov, Lela; Lipschitz, Noga; Dagan, Elad; Glikson, Eran; Wolf, Michael; Alon, Eran E

    2016-12-01

    Life expectancy in Israel has risen by almost 6 years during the last 25 years, and the proportion of people 65 years of age or older is expected to reach 12 % of the total population by 2020. A substantial increase in the workload for Otolaryngologists and Head and Neck surgeons is anticipated. Our goal was to characterize the admissions of patients 80 years of age and older to the Department of Otolaryngology, Head and Neck Surgery in a tertiary medical center. The study group included all patients 80 years of age and older who were admitted to the Department of OTOHNS in our institute between 2009 and 2013. There were two control groups for comparison divided by age; one group 40-59 years old and the other group 60-79 years old. There were 385 admissions of 317 patients aged 80-103 years (4.2 % of overall admissions). Over the study period, admissions of patients over 80 years increased on average by 3 % per annum (p = 0.4), and those patients over 90 years old by 52 % per annum (p < 0.001). The most common indication was HN malignancy (28.8 %) followed by otologic disorders (22.0 %). Of the overall 158 operations conducted, 131 patients (82.9 %) underwent elective procedures (mainly oncology) and 27 patients (17.1 %) underwent emergent procedures. The distribution of the reasons for admission of the patients older than 80 years is surprisingly different from that of the "younger" patients. With life expectancy rising, our study predicts a workload increase mainly in the HN oncologic and otologic services.

  16. Prognostic Value of Admission Blood Glucose in Diabetic and Non-diabetic Patients with Intracerebral Hemorrhage

    PubMed Central

    Sun, Shichao; Pan, Yuesong; Zhao, Xingquan; Liu, Liping; Li, Hao; He, Yan; Wang, Yilong; Wang, Yongjun; Guo, Li

    2016-01-01

    We aimed to validate prognostic value of elevated admission blood glucose (ABG) for clinical outcomes in diabetic and non-diabetic patients with intracerebral hemorrhage (ICH) in a representative large cohort. Data of ICH patients with onset time ≤24 h were derived from the China National Stroke Registry. Clinical outcomes included 3-month poor outcome (death or dependency) and death. Logistic regression was performed for the association between ABG and clinical outcomes, both in the entire cohort and in patients with and without diabetes mellitus. 2951 ICH patients were enrolled, including 267 (9.0%) diabetics. In the entire cohort, there was a trend to increased risk of poor outcome with increasing ABG levels (adjusted OR 1.09; 95% CI, 1.04–1.15; P < 0.001). The risk of poor outcome was significantly greatest for the highest quartile (≥7.53 mmol/L) of ABG (adjusted OR 1.54; 95% CI, 1.17–2.03; p = 0.002, P for trend 0.004). We got similar association in non-diabetics but not in diabetics. Elevated ABG confers a higher risk of poor outcome in non-diabetics than diabetics with similar glucose level. Elevated ABG is an independent predictor of 3-month poor outcome in ICH patients, the prognostic value of which is greater in non-diabetics than diabetics with similar glucose level. PMID:27562114

  17. Hospital admissions among male drivers in Denmark

    PubMed Central

    Hannerz, H; Tuchsen, F

    2001-01-01

    OBJECTIVES—To facilitate decisions about interventions and to establish baseline values for future evaluation of preventive efforts, the aim of the present study was to elucidate the disease pattern among male professional drivers in Denmark. The study differentiated between drivers of goods vehicles and drivers of passenger transport.
METHODS—Cohorts of all 20-59 year old Danish male professional drivers in the years 1981, 1986, 1991, and 1994 were formed, to calculate age standardised hospital admission ratios (SHRs) and time trends (1981-97) for many diagnostic aggregations.
RESULTS—SHRs for diseases in practically all systems and organs of the body were higher among professional drivers than they were in the male working population at large. Also drivers of passenger transport, compared with drivers of goods vehicles, had significantly high SHRs due to infectious and parasitic diseases, diseases of the circulatory system, and diseases of the respiratory system, and significantly lower rates of injury. For both driver groups, the SHRs for acute myocardial infarction increased with time whereas the SHR for acute gastritis decreased, and for drivers of passenger transport an increasing SHR for chronic obstructive pulmonary disease, was found over time.
CONCLUSION—Drivers of passenger transport and drivers of goods vehicles differ in their disease patterns. The results support the hypothesis that preventive efforts are needed in both groups, but underline that different strategies are required for different categories of drivers.


Keywords: professional drivers; hospital admissions; surveillance system PMID:11245742

  18. The effect of solar-geomagnetic activity during and after admission on survival in patients with acute coronary syndromes.

    PubMed

    Vencloviene, Jone; Babarskiene, Ruta; Milvidaite, Irena; Kubilius, Raimondas; Stasionyte, Jolanta

    2014-08-01

    A number of studies have established the effects of solar-geomagnetic activity on the human cardio-vascular system. It is plausible that the heliophysical conditions existing during and after hospital admission may affect survival in patients with acute coronary syndromes (ACS). We analyzed data from 1,413 ACS patients who were admitted to the Hospital of Kaunas University of Medicine, Lithuania, and who survived for more than 4 days. We evaluated the associations between active-stormy geomagnetic activity (GMA), solar proton events (SPE), and solar flares (SF) that occurred 0-3 days before and after admission, and 2-year survival, based on Cox's proportional-hazards model, controlling for clinical data. After adjustment for clinical variables, active-stormy GMA on the 2nd day after admission was associated with an increased (by 1.58 times) hazard ratio (HR) of cardiovascular death (HR=1.58, 95 % CI 1.07-2.32). For women, geomagnetic storm (GS) 2 days after SPE occurred 1 day after admission increased the HR by 3.91 times (HR=3.91, 95 % CI 1.31-11.7); active-stormy GMA during the 2nd-3rd day after admission increased the HR by over 2.5 times (HR=2.66, 95 % CI 1.40-5.03). In patients aged over 70 years, GS occurring 1 day before or 2 days after admission, increased the HR by 2.5 times, compared to quiet days; GS in conjunction with SF on the previous day, nearly tripled the HR (HR=3.08, 95 % CI 1.32-7.20). These findings suggest that the heliophysical conditions before or after the admission affect the hazard ratio of lethal outcome; adjusting for clinical variables, these effects were stronger for women and older patients.

  19. The effect of solar-geomagnetic activity during and after admission on survival in patients with acute coronary syndromes

    NASA Astrophysics Data System (ADS)

    Vencloviene, Jone; Babarskiene, Ruta; Milvidaite, Irena; Kubilius, Raimondas; Stasionyte, Jolanta

    2014-08-01

    A number of studies have established the effects of solar-geomagnetic activity on the human cardio-vascular system. It is plausible that the heliophysical conditions existing during and after hospital admission may affect survival in patients with acute coronary syndromes (ACS). We analyzed data from 1,413 ACS patients who were admitted to the Hospital of Kaunas University of Medicine, Lithuania, and who survived for more than 4 days. We evaluated the associations between active-stormy geomagnetic activity (GMA), solar proton events (SPE), and solar flares (SF) that occurred 0-3 days before and after admission, and 2-year survival, based on Cox's proportional-hazards model, controlling for clinical data. After adjustment for clinical variables, active-stormy GMA on the 2nd day after admission was associated with an increased (by 1.58 times) hazard ratio (HR) of cardiovascular death (HR = 1.58, 95 % CI 1.07-2.32). For women, geomagnetic storm (GS) 2 days after SPE occurred 1 day after admission increased the HR by 3.91 times (HR = 3.91, 95 % CI 1.31-11.7); active-stormy GMA during the 2nd-3rd day after admission increased the HR by over 2.5 times (HR = 2.66, 95 % CI 1.40-5.03). In patients aged over 70 years, GS occurring 1 day before or 2 days after admission, increased the HR by 2.5 times, compared to quiet days; GS in conjunction with SF on the previous day, nearly tripled the HR (HR = 3.08, 95 % CI 1.32-7.20). These findings suggest that the heliophysical conditions before or after the admission affect the hazard ratio of lethal outcome; adjusting for clinical variables, these effects were stronger for women and older patients.

  20. Impact of delayed admission to intensive care units on mortality of critically ill patients: a cohort study

    PubMed Central

    2011-01-01

    Introduction When the number of patients who require intensive care is greater than the number of beds available, intensive care unit (ICU) entry flow is obstructed. This phenomenon has been associated with higher mortality rates in patients that are not admitted despite their need, and in patients that are admitted but are waiting for a bed. The purpose of this study is to evaluate if a delay in ICU admission affects mortality for critically ill patients. Methods A prospective cohort of adult patients admitted to the ICU of our institution between January and December 2005 were analyzed. Patients for whom a bed was available were immediately admitted; when no bed was available, patients waited for ICU admission. ICU admission was classified as either delayed or immediate. Confounding variables examined were: age, sex, originating hospital ward, ICU diagnosis, co-morbidity, Acute Physiology and Chronic Health Evaluation (APACHE) II score, therapeutic intervention, and Sequential Organ Failure Assessment (SOFA) score. All patients were followed until hospital discharge. Results A total of 401 patients were evaluated; 125 (31.2%) patients were immediately admitted and 276 (68.8%) patients had delayed admission. There was a significant increase in ICU mortality rates with a delay in ICU admission (P = 0.002). The fraction of mortality risk attributable to ICU delay was 30% (95% confidence interval (CI): 11.2% to 44.8%). Each hour of waiting was independently associated with a 1.5% increased risk of ICU death (hazard ratio (HR): 1.015; 95% CI 1.006 to 1.023; P = 0.001). Conclusions There is a significant association between time to admission and survival rates. Early admission to the ICU is more likely to produce positive outcomes. PMID:21244671

  1. Effectiveness of rotavirus vaccination in prevention of hospital admissions for rotavirus gastroenteritis among young children in Belgium: case-control study

    PubMed Central

    Braeckman, Tessa; Van Herck, Koen; Meyer, Nadia; Pirçon, Jean-Yves; Soriano-Gabarró, Montse; Heylen, Elisabeth; Zeller, Mark; Azou, Myriam; Capiau, Heidi; De Koster, Jan; Maernoudt, Anne-Sophie; Raes, Marc; Verdonck, Lutgard; Verghote, Marc; Vergison, Anne; Matthijnssens, Jelle; Van Ranst, Marc

    2012-01-01

    Objective To evaluate the effectiveness of rotavirus vaccination among young children in Belgium. Design Prospective case-control study. Setting Random sample of 39 Belgian hospitals, February 2008 to June 2010. Participants 215 children admitted to hospital with rotavirus gastroenteritis confirmed by polymerase chain reaction and 276 age and hospital matched controls. All children were of an eligible age to have received rotavirus vaccination (that is, born after 1 October 2006 and aged ≥14 weeks). Main outcome measure Vaccination status of children admitted to hospital with rotavirus gastroenteritis and matched controls. Results 99 children (48%) admitted with rotavirus gastroenteritis and 244 (91%) controls had received at least one dose of any rotavirus vaccine (P<0.001). The monovalent rotavirus vaccine accounted for 92% (n=594) of all rotavirus vaccine doses. With hospital admission as the outcome, the unadjusted effectiveness of two doses of the monovalent rotavirus vaccine was 90% (95% confidence interval 81% to 95%) overall, 91% (75% to 97%) in children aged 3-11 months, and 90% (76% to 96%) in those aged ≥12 months. The G2P[4] genotype accounted for 52% of cases confirmed by polymerase chain reaction with eligible matched controls. Vaccine effectiveness was 85% (64% to 94%) against G2P[4] and 95% (78% to 99%) against G1P[8]. In 25% of cases confirmed by polymerase chain reaction with eligible matched controls, there was reported co-infection with adenovirus, astrovirus and/or norovirus. Vaccine effectiveness against co-infected cases was 86% (52% to 96%). Effectiveness of at least one dose of any rotavirus vaccine (intention to vaccinate analysis) was 91% (82% to 95%). Conclusions Rotavirus vaccination is effective for the prevention of admission to hospital for rotavirus gastroenteritis among young children in Belgium, despite the high prevalence of G2P[4] and viral co-infection. PMID:22875947

  2. Anthropogenic Factors Are the Major Cause of Hospital Admission of a Threatened Species, the Grey-Headed Flying Fox (Pteropus poliocephalus), in Victoria, Australia

    PubMed Central

    Scheelings, Titus Franciscus; Frith, Sarah Elizabeth

    2015-01-01

    To determine the reasons for presentation and outcomes of hospitalised grey-headed flying foxes (Pteropus poliocephalus) in Victoria, Australia, a retrospective analysis was performed on 532 records from two wildlife hospitals. Cases were categorised based on presenting signs and outcomes determined. Anthropogenic factors (63.7%) were a major cause of flying fox admissions with entanglement in fruit netting the most significant risk for bats (36.8%). Overall the mortality rate for flying fox admissions was 59.3%. This study highlights the effects of urbanisation on wild animal populations and a need for continued public education in order to reduce morbidity and mortality of wildlife, especially threatened species. PMID:26207984

  3. Anthropogenic Factors Are the Major Cause of Hospital Admission of a Threatened Species, the Grey-Headed Flying Fox (Pteropus poliocephalus), in Victoria, Australia.

    PubMed

    Scheelings, Titus Franciscus; Frith, Sarah Elizabeth

    2015-01-01

    To determine the reasons for presentation and outcomes of hospitalised grey-headed flying foxes (Pteropus poliocephalus) in Victoria, Australia, a retrospective analysis was performed on 532 records from two wildlife hospitals. Cases were categorised based on presenting signs and outcomes determined. Anthropogenic factors (63.7%) were a major cause of flying fox admissions with entanglement in fruit netting the most significant risk for bats (36.8%). Overall the mortality rate for flying fox admissions was 59.3%. This study highlights the effects of urbanisation on wild animal populations and a need for continued public education in order to reduce morbidity and mortality of wildlife, especially threatened species.

  4. 28 CFR 54.305 - Preference in admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  5. 14 CFR 1253.305 - Preference in admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1253.305 Preference in admission. A... students only or predominantly members of one sex, if the giving of such preference has the effect...

  6. The Confidence Game in Honors Admissions and Retention

    ERIC Educational Resources Information Center

    Guzy, Annmarie

    2013-01-01

    Annmarie Guzy, an expert with almost three decades of experience in post-secondary honors education, responds to Jerry Herron's essay, "Notes toward an Excellent Marxist-Elitist Honors Admissions Policy," which argues that "a well-conceived admissions policy tells us much more than whom to recruit; it becomes the basis for a…

  7. Evaluating the Predictive Validity of Graduate Management Admission Test Scores

    ERIC Educational Resources Information Center

    Sireci, Stephen G.; Talento-Miller, Eileen

    2006-01-01

    Admissions data and first-year grade point average (GPA) data from 11 graduate management schools were analyzed to evaluate the predictive validity of Graduate Management Admission Test[R] (GMAT[R]) scores and the extent to which predictive validity held across sex and race/ethnicity. The results indicated GMAT verbal and quantitative scores had…

  8. 6 CFR 17.305 - Preference in admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 17.305 Preference in admission. A recipient... only or predominantly members of one sex, if the giving of such preference has the effect...

  9. 14 CFR 1253.305 - Preference in admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1253.305 Preference in admission. A... students only or predominantly members of one sex, if the giving of such preference has the effect...

  10. 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…

  11. Failure as a Criterion for Medical School Admission.

    ERIC Educational Resources Information Center

    Greer, David S.; Aronson, Stanley M.

    1980-01-01

    Admissions committees, it is suggested, should regard a failure experience as an opportunity to examine characteristics of candidates which may otherwise be inapparent. Current admissions criteria do not adequately address the social responsibilities and humanitarian goals of medical education. (Author/MLW)

  12. 14 CFR 125.315 - Admission to flight deck.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...,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 Aeronautics and Space 3 2011-01-01 2011-01-01 false Admission to flight deck. 125.315...

  13. 14 CFR 125.315 - Admission to flight deck.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...,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 Aeronautics and Space 3 2013-01-01 2013-01-01 false Admission to flight deck. 125.315...

  14. 14 CFR 125.315 - Admission to flight deck.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...,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 Aeronautics and Space 3 2014-01-01 2014-01-01 false Admission to flight deck. 125.315...

  15. 14 CFR 125.315 - Admission to flight deck.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...,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 Aeronautics and Space 3 2010-01-01 2010-01-01 false Admission to flight deck. 125.315...

  16. 14 CFR 125.315 - Admission to flight deck.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...,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 Aeronautics and Space 3 2012-01-01 2012-01-01 false Admission to flight deck. 125.315...

  17. 28 CFR 541.47 - Admission to control unit.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Admission to control unit. 541.47 Section... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.47 Admission to control unit. Staff shall provide an inmate admitted to a control unit with: (a) Notice of the projected duration...

  18. WICS: A Model for College and University Admissions

    ERIC Educational Resources Information Center

    Sternberg, Robert J.; Bonney, Christina R.; Gabora, Liane; Merrifield, Maegan

    2012-01-01

    This article outlines shortcomings of currently used university admissions tests and discusses ways in which they could potentially be improved, summarizing two projects designed to enhance college and university admissions. The projects were inspired by the augmented theory of successful intelligence, according to which successful intelligence…

  19. The Admission and Induction of Refugee Children into School.

    ERIC Educational Resources Information Center

    Spafford, Tim; Bolloten, Bill

    1995-01-01

    Examines induction and admission practice for refugee school children into Britain's public schools, highlights the educational issues and concerns of newly-arrived refugee families, and discusses what schools can do to make their entry into the school system less problematic. The author explains how good admission and induction practices can…

  20. 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…

  1. 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…

  2. Strategic Enrollment Management's Ambassadors: The Changing Role of Admissions Counselors

    ERIC Educational Resources Information Center

    Mathis, Daniel

    2010-01-01

    Road runner. File jockey. Advisor. Public speaker. Recruiter. At any given time, an admissions counselor fits one, some, or all of these descriptors. While all of these descriptors indicate an important function within a college or university, none reflects the increasingly complex nature of the role of an admissions counselor in strategic…

  3. Disciplinary Logics in Doctoral Admissions: Understanding Patterns of Faculty Evaluation

    ERIC Educational Resources Information Center

    Posselt, Julie R.

    2015-01-01

    Ph.D. attainment rates by race and gender vary widely across the disciplines, and previous research has found disciplinary variation in graduate admissions criteria and practices. To better understand how disciplines shape admissions preferences and practices, which in turn may shape student access to graduate education, this article uncovers…

  4. 7 CFR 15a.22 - Preference in admission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 1 2014-01-01 2014-01-01 false Preference in admission. 15a.22 Section 15a.22 Agriculture Office of the Secretary of Agriculture EDUCATION PROGRAMS OR ACTIVITIES RECEIVING OR BENEFITTING FROM FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and...

  5. 7 CFR 15a.22 - Preference in admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Preference in admission. 15a.22 Section 15a.22 Agriculture Office of the Secretary of Agriculture EDUCATION PROGRAMS OR ACTIVITIES RECEIVING OR BENEFITTING FROM FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and...

  6. 28 CFR 541.47 - Admission to control unit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Admission to control unit. 541.47 Section 541.47 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.47 Admission to control...

  7. 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...

  8. 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...

  9. Assessing Academic Potential for University Admission: The Biographical Questionnaire

    ERIC Educational Resources Information Center

    Enslin, P. A.; Button, A.; Chakane, M.; de Groot, M.; Dison, L.

    2006-01-01

    A Biographical Questionnaire (BQ) has been used in the Faculty of Humanities at the University of the Witwatersrand since the mid-80s, to identify potential to succeed at university among applicants who have not met the requirements for automatic admission. As the key instrument in a special admissions process, the BQ's history and assumptions are…

  10. 20 CFR 410.696 - Evidence admissible on review.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evidence admissible on review. 410.696 Section 410.696 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT..., Administrative Review, Finality of Decisions, and Representation of Parties § 410.696 Evidence admissible...

  11. 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...

  12. Virginia Western Community College's Health Technology Admissions Evaluation System.

    ERIC Educational Resources Information Center

    Houston, Charles A.; Sellers, Harry

    Due to factors such as high enrollment demands, limited institutional space, and high program costs, certain admissions requirements in the guidance/selection of students for health technology programs at Virginia Western Community College (VWCC) have become necessary. A Health Technology Admissions Evaluation System was created to develop and…

  13. 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…

  14. 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…

  15. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Admission to facilities or grounds. 3.41 Section 3... AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds § 3.41 Admission to facilities or grounds. The enclave is officially open to the public during normal working...

  16. 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…

  17. 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…

  18. 24 CFR 1720.425 - Presentation and admission of evidence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Presentation and admission of evidence. 1720.425 Section 1720.425 Housing and Urban Development Regulations Relating to Housing and Urban... PRACTICE Adjudicatory Proceedings Discovery and Evidence § 1720.425 Presentation and admission of...

  19. 34 CFR 106.22 - Preference in admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Preference in admission. 106.22 Section 106.22... EDUCATION 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 §...

  20. 10 CFR 5.305 - Preference in admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Preference in admission. 5.305 Section 5.305 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and...

  1. 8 CFR 1235.4 - Withdrawal of application for admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... 1235.4 Section 1235.4 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS INSPECTION OF PERSONS APPLYING FOR ADMISSION § 1235.4 Withdrawal of... construed as to give an alien the right to withdraw his or her application for admission. Permission...

  2. 8 CFR 1235.4 - Withdrawal of application for admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... 1235.4 Section 1235.4 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS INSPECTION OF PERSONS APPLYING FOR ADMISSION § 1235.4 Withdrawal of... construed as to give an alien the right to withdraw his or her application for admission. Permission...

  3. 8 CFR 235.4 - Withdrawal of application for admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Withdrawal of application for admission. 235.4 Section 235.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS... right to withdraw his or her application for admission. Permission to withdraw an application...

  4. 8 CFR 1235.4 - Withdrawal of application for admission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... 1235.4 Section 1235.4 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS INSPECTION OF PERSONS APPLYING FOR ADMISSION § 1235.4 Withdrawal of... construed as to give an alien the right to withdraw his or her application for admission. Permission...

  5. 33 CFR 5.15 - Admission to membership.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Admission to membership. 5.15... GUARD AUXILIARY § 5.15 Admission to membership. An applicant who is accepted for membership shall be enrolled in the Auxiliary and shall be issued a membership certificate and identification card....

  6. 33 CFR 5.15 - Admission to membership.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Admission to membership. 5.15... GUARD AUXILIARY § 5.15 Admission to membership. An applicant who is accepted for membership shall be enrolled in the Auxiliary and shall be issued a membership certificate and identification card....

  7. 33 CFR 5.15 - Admission to membership.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Admission to membership. 5.15... GUARD AUXILIARY § 5.15 Admission to membership. An applicant who is accepted for membership shall be enrolled in the Auxiliary and shall be issued a membership certificate and identification card....

  8. 33 CFR 5.15 - Admission to membership.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Admission to membership. 5.15... GUARD AUXILIARY § 5.15 Admission to membership. An applicant who is accepted for membership shall be enrolled in the Auxiliary and shall be issued a membership certificate and identification card....

  9. 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.…

  10. 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)...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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…

  18. 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... admission of up to 70,000 refugees to the United States during fiscal year (FY) 2014 is justified...

  19. The Use of Criminal History Information in College Admissions Decisions

    ERIC Educational Resources Information Center

    Pierce, Matthew W.; Runyan, Carol W.; Bangdiwala, Shrikant I.

    2014-01-01

    To understand the potential public health and social justice implications of criminal background screening on college admissions, we examined postsecondary institutions' reasons for collecting or not collecting applicants' criminal justice information. We invited heads of admissions from 300 randomly sampled postsecondary institutions to complete…

  20. 4 CFR 25.3 - Admission to the GAO building.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Admission to the GAO building. 25.3 Section 25.3 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES CONDUCT IN THE GOVERNMENT ACCOUNTABILITY OFFICE BUILDING AND ON ITS GROUNDS § 25.3 Admission to the GAO building. A person may be admitted to the GAO...

  1. 4 CFR 25.3 - Admission to the GAO building.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 4 Accounts 1 2011-01-01 2011-01-01 false Admission to the GAO building. 25.3 Section 25.3 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES CONDUCT IN THE GOVERNMENT ACCOUNTABILITY OFFICE BUILDING AND ON ITS GROUNDS § 25.3 Admission to the GAO building. A person may be admitted to the GAO...

  2. 42 CFR 418.25 - Admission to hospice care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 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...

  3. 42 CFR 418.25 - Admission to hospice care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Admission to hospice care. 418.25 Section 418.25... (CONTINUED) MEDICARE PROGRAM (CONTINUED) 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...

  4. 42 CFR 418.25 - Admission to hospice care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Admission to hospice care. 418.25 Section 418.25... (CONTINUED) MEDICARE PROGRAM (CONTINUED) 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...

  5. 42 CFR 418.25 - Admission to hospice care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Admission to hospice care. 418.25 Section 418.25... (CONTINUED) MEDICARE PROGRAM (CONTINUED) 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...

  6. 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…

  7. 29 CFR 458.71 - Procedure upon admission of facts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 2 2011-07-01 2011-07-01 false Procedure upon admission of facts. 458.71 Section 458.71... facts. The admission of all the material allegations of fact in the complaint shall constitute a waiver... his recommended decision and order in which he shall adopt as his proposed findings of fact...

  8. 29 CFR 102.40 - Stipulations of fact admissible.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Stipulations of fact admissible. 102.40 Section 102.40 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8... § 102.40 Stipulations of fact admissible. In any such proceeding stipulations of fact may be...

  9. 29 CFR 102.40 - Stipulations of fact admissible.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 2 2011-07-01 2011-07-01 false Stipulations of fact admissible. 102.40 Section 102.40 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8... § 102.40 Stipulations of fact admissible. In any such proceeding stipulations of fact may be...

  10. 29 CFR 458.71 - Procedure upon admission of facts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Procedure upon admission of facts. 458.71 Section 458.71... facts. The admission of all the material allegations of fact in the complaint shall constitute a waiver... his recommended decision and order in which he shall adopt as his proposed findings of fact...

  11. 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…

  12. 40 CFR 5.305 - Preference in admission.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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...

  13. Primary and Secondary Selection Tools in an Optometry Admission Process.

    ERIC Educational Resources Information Center

    Spafford, Marlee M.

    2000-01-01

    A five-year evaluation of the admissions decision process at the University of Waterloo (Ontario) School of Optometry found that when primary tools (i.e., university grades, Optometry Admission Test scores) did not differentiate candidates, there was an increased emphasis on secondary tools (i.e., interview, autobiographic sketch, prerequisite…

  14. 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…

  15. Development of a validation algorithm for 'present on admission' flagging

    PubMed Central

    2009-01-01

    Background The use of routine hospital data for understanding patterns of adverse outcomes has been limited in the past by the fact that pre-existing and post-admission conditions have been indistinguishable. The use of a 'Present on Admission' (or POA) indicator to distinguish pre-existing or co-morbid conditions from those arising during the episode of care has been advocated in the US for many years as a tool to support quality assurance activities and improve the accuracy of risk adjustment methodologies. The USA, Australia and Canada now all assign a flag to indicate the timing of onset of diagnoses. For quality improvement purposes, it is the 'not-POA' diagnoses (that is, those acquired in hospital) that are of interest. Methods Our objective was to develop an algorithm for assessing the validity of assignment of 'not-POA' flags. We undertook expert review of the International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM) to identify conditions that could not be plausibly hospital-acquired. The resulting computer algorithm was tested against all diagnoses flagged as complications in the Victorian (Australia) Admitted Episodes Dataset, 2005/06. Measures reported include rates of appropriate assignment of the new Australian 'Condition Onset' flag by ICD chapter, and patterns of invalid flagging. Results Of 18,418 diagnosis codes reviewed, 93.4% (n = 17,195) reflected agreement on status for flagging by at least 2 of 3 reviewers (including 64.4% unanimous agreement; Fleiss' Kappa: 0.61). In tests of the new algorithm, 96.14% of all hospital-acquired diagnosis codes flagged were found to be valid in the Victorian records analysed. A lower proportion of individual codes was judged to be acceptably flagged (76.2%), but this reflected a high proportion of codes used <5 times in the data set (789/1035 invalid codes). Conclusion An indicator variable about the timing of occurrence of diagnoses can greatly expand the use of routinely

  16. The Bromhead Care Home Service: the impact of a service for care home residents with dementia on hospital admission and dying in preferred place of care.

    PubMed

    Garden, Gill; Green, Suzanne; Pieniak, Susan; Gladman, John

    2016-04-01

    People with dementia have worse outcomes associated with hospital admission, are more likely to have interventions and are less likely to be offered palliative care than people without dementia. Advance care planning for care home residents has been shown to reduce hospital admissions without increasing mortality. Studies have shown that staff confidence in managing delirium, a common reason for admission, improves with training. A service combining education for care home staff and advance care planning for care home residents with dementia was introduced to care homes in Boston, UK. There were improvements in staff confidence in recognition, prevention, management and knowledge of factors associated with delirium and dysphagia. 92% of carers rated the service >9/10. Admissions fell by 37% from baseline in the first year and 55% in the second and third years. All but one resident died in the preferred place of care.

  17. Effectiveness of a Multimodal Therapy for Patients with Chronic Low Back Pain Regarding Pre-Admission Healthcare Utilization

    PubMed Central

    Borys, Constanze; Lutz, Johannes; Strauss, Bernhard; Altmann, Uwe

    2015-01-01

    Objective The aim of the study was to examine the effectiveness of an intensive inpatient three-week multimodal therapy. We focused especially on the impact on the multimodal therapy outcome of the pre-admission number of treatment types patients had received and of medical specialist groups patients had consulted. Methods 155 patients with chronic low back pain and indication for multimodal therapy were evaluated with respect to pain intensity, depression, anxiety, well-being, and pre-admission health care utilization. In our controlled clinical trial we compared N = 66 patients on the waiting list with N = 89 patients who received immediate treatment. The waiting list patients likewise attended multimodal therapy after the waiting period. Longitudinal post-treatment data for both were collected at three- and twelve-month follow-ups. The impact of pre-admission health care utilization on multimodal therapy outcome (post) was analysed by structural equation model. Results Compared to the control group, multimodal therapy patients’ pain intensity and psychological variables were significantly reduced. Longitudinal effects with respect to pre-measures were significant at three-month follow-up for pain intensity (ES = -0.48), well-being (ES = 0.78), anxiety (ES = -0.33), and depression (ES = -0.30). Effect sizes at twelve-month follow-up were small for anxiety (ES = -0.22), and moderate for general well-being (ES = 0.61). Structural equation model revealed that a higher number of pre-admission treatment types was associated with poorer post-treatment outcomes in pain intensity, well-being, and depression. Conclusion Multimodal therapy proved to be effective with regard to improvements in pain intensity, depression, anxiety, and well-being. The association between treatment effect and number of pre-admission pain treatment types suggests that patients would benefit more from attending multimodal therapy in an earlier stage of health care. PMID:26599232

  18. Incidence of hospital admissions due to adverse drug reactions in France: the EMIR study.

    PubMed

    Bénard-Laribière, Anne; Miremont-Salamé, Ghada; Pérault-Pochat, Marie-Christine; Noize, Pernelle; Haramburu, Françoise

    2015-02-01

    To assess the incidence of hospital admissions related to adverse drug reactions (ADRs) in France and the frequency of preventable ADRs in France, a prospective study was conducted among a representative randomly selected sample of medical wards in public hospitals between December 2006 and June 2007; all patients admitted during a 2-week period were included. An ADR-related hospitalization case was defined as a hospital admission because of an ADR, and an independent committee reviewed and validated all potential cases. Preventability was assessed using the French ADR preventability scale. Data were extrapolated to the population of France. Among 2692 admissions, 97 were related to an ADR (incidence 3.6%, 95% confidence interval, CI [2.8-4.4]). Patients admitted for an ADR were significantly older than those admitted for other reasons (P < 0.001). A third (32.0%) of ADR-related hospitalizations were 'preventable', 16.5% 'potentially preventable'. Drug interactions accounted for 29.9% of ADR-related hospitalizations. The most frequent causes of ADR-related hospitalizations were vascular disorders (20.6%), mainly bleeding complications, central nervous system disorders (11.3%), gastrointestinal disorders, and general disorders (9.3%). Antithrombotic and antineoplastic agents were the most frequently involved (12.6% each), followed by diuretics and analgesics (9.0% each). Vitamin-K-antagonists (VKAs) were the most common drugs associated with admission. The estimated annual number of ADR-related hospitalizations in France was 143 915 (95% CI [112 063-175 766]). ADRs were a significant cause of hospital admission in 2006-2007, in particular those due to VKAs. As new oral anticoagulants (NOACs) have been marketed, more attention needs to be paid to ensure a safe use of antithrombotic agents.

  19. 30. Engine controls and valve gear, looking aft on main ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. Engine controls and valve gear, looking aft on main (promenade) deck level. Threaded admission valve lift rods (two at immediate left of chronometer) permit adjustment of valve timing in lower and upper admission valves of cylinder (left rod controls lower valve, right rod upper valve). Valve rods are lifted by jaw-like "wipers" during operation. Exhaust valve lift rods and wipers are located to right of chronometer. Crank at extreme right drives valve wiper shaft when engaged to end of eccentric rod, shown under "Crank Indicator" dial. Pair of handles to immediate left of admission valve rods control condenser water valves; handles to right of exhaust valve rods control feedwater flow to boilers from pumps. Gauges indicate boiler pressure (left) and condenser vacuum (right); "Crank Indicator" on wall aids engineer in keeping engine crank off "dead-center" at stop so that engine may be easily restarted. - Ferry TICONDEROGA, Route 7, Shelburne, Chittenden County, VT

  20. 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…

  1. Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study

    PubMed Central

    Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M

    2016-01-01

    Objectives Multimorbidity, defined as the presence of 2 or more chronic medical conditions in an individual, is associated with poorer health outcomes. Several multimorbidity measures exist, and the challenge is to decide which to use preferentially in predicting health outcomes. The study objective was to compare the performance of 5 count-based multimorbidity measures in predicting emergency hospital admission and functional decline in older community-dwelling adults attending primary care. Setting 15 general practices (GPs) in Ireland. Participants n=862, ≥70 years, community-dwellers followed-up for 2 years (2010–2012). Exposure at baseline: Five multimorbidity measures (disease counts, selected conditions counts, Charlson comorbidity index, RxRisk-V, medication counts) calculated using GP medical record and linked national pharmacy claims data. Primary outcomes (1) Emergency admission and ambulatory care sensitive (ACS) admission (GP medical record) and (2) functional decline (postal questionnaire). Statistical analysis Descriptive statistics and measure discrimination (c-statistic, 95% CIs), adjusted for confounders. Results Median age was 77 years and 53% were women. Prevalent rates ranged from 37% to 91% depending on which measure was used to define multimorbidity. All measures demonstrated poor discrimination for the outcome of emergency admission (c-statistic range: 0.62, 0.65), ACS admission (c-statistic range: 0.63, 0.68) and functional decline (c-statistic range: 0.55, 0.61). Medication-based measures were equivalent to diagnosis-based measures. Conclusions The choice of measure may have a significant impact on prevalent rates. Five multimorbidity measures demonstrated poor discrimination in predicting emergency admission and functional decline, with medication-based measures equivalent to diagnosis-based measures. Consideration of multimorbidity in isolation is insufficient for predicting these outcomes in community settings. PMID:27650770

  2. Thinking About Clinical Outcomes in Medicaid

    PubMed Central

    Weimar, Dawn; Gray, Jeffrey; Davies, Bud

    2016-01-01

    As Medicaid expands in scope and influence, it is evolving toward being a “purchaser” of quality health care. This commentary discusses measurement and incentivization of clinical outcomes in Medicaid. Advantages and disadvantages of outcome versus process measures are discussed. Distinctions are drawn between the roles of Medicare and Medicaid, including the implications of the growth in Medicaid managed care. Medicaid's influence is particularly notable for obstetric, pediatric, newborn, and long-term care. We provide data on 3 Medicaid outcomes: potentially preventable hospital admissions, readmissions, and complications. The commentary concludes with suggestions for choosing and implementing outcome-oriented value-based purchasing initiatives in Medicaid. PMID:26945295

  3. Disaggregating Activities of Daily Living Limitations for Predicting Nursing Home Admission

    PubMed Central

    Fong, Joelle H; Mitchell, Olivia S; Koh, Benedict S K

    2015-01-01

    Objective To examine whether disaggregated activities of daily living (ADL) limitations better predict the risk of nursing home admission compared to conventionally used ADL disability counts. Data Sources We used panel data from the Health and Retirement Study (HRS) for years 1998–2010. The HRS is a nationally representative survey of adults older than 50 years (n = 18,801). Study Design We fitted Cox regressions in a continuous time survival model with age at first nursing home admission as the outcome. Time-varying ADL disability types were the key explanatory variables. Principal Findings Of the six ADL limitations, bathing difficulty emerged as the strongest predictor of subsequent nursing home placement across cohorts. Eating and dressing limitations were also influential in driving admissions among more recent cohorts. Using simple ADL counts for analysis yielded similar adjusted R2s; however, the amount of explained variance doubled when we allowed the ADL disability measures to time-vary rather than remain static. Conclusions Looking beyond simple ADL counts can provide health professionals insights into which specific disability types trigger long-term nursing home use. Functional disabilities measured closer in time carry more prognostic power than static measures. PMID:25256014

  4. Maine Technical College System Annual Report, 1996.

    ERIC Educational Resources Information Center

    Fitzsimmons, John

    Focusing on the 1995-96 academic year, this report discusses programs and outcomes for the seven colleges in the Maine Technical College System (MTCS). Following a message from the System President, general outcomes for the MTCS are described. This section indicates that systemwide enrollment in fall 1995 was 4,475, representing a 24% increase…

  5. A reappraisal of ICU and long-term outcome of allogeneic hematopoietic stem cell transplantation patients and reassessment of prognosis factors: results of a 5-year cohort study (2009-2013).

    PubMed

    Platon, L; Amigues, L; Ceballos, P; Fegueux, N; Daubin, D; Besnard, N; Larcher, R; Landreau, L; Agostini, C; Machado, S; Jonquet, O; Klouche, K

    2016-02-01

    Epidemiology and prognosis of complications related to allogeneic hematopoietic stem cell transplant (HSCT) recipients requiring admission to intensive care unit (ICU) have not been reassessed precisely in the past few years. We performed a retrospective single-center study on 318 consecutive HSCT patients (2009-2013), analyzing outcome and factors prognostic of ICU admission. Among these patients, 73 were admitted to the ICU. In all, 32 patients (40.3%) died in ICU, 46 at hospital discharge (63%) and 61 (83.6%) 1 year later. Survivors had a significantly lower sequential organ failure assessment (SOFA) score, serum lactate and bilirubin upon ICU admission. Catecholamine support, mechanical ventilation (MV) and/or renal replacement therapy during ICU stay, a delayed organ support and an active graft versus host disease (GvHD) significantly worsen the outcome. By multivariate analysis, the worsening of SOFA score from days 1 to 3, the need for MV and the occurrence of an active GvHD were predictive of mortality. In conclusion, the incidence of HSCT-related complications requiring an admission to an ICU was at 22%, with an ICU mortality rate of 44%, and 84% 1 year later. A degradation of SOFA score at day 3 of ICU, need of MV and occurrence of an active GvHD are main predictive factors of mortality.

  6. The Brief Symptom Inventory and the Outcome Questionnaire-45 in the Assessment of the Outcome Quality of Mental Health Interventions

    PubMed Central

    Schuetz, Christopher; Andreae, Andreas; Koemeda, Margit; Schulthess, Peter; Tschuschke, Volker; von Wyl, Agnes

    2016-01-01

    Self-report questionnaires are economical instruments for routine outcome assessment. In this study, the performance of the German version of the Outcome Questionnaire-45 (OQ-45) and the Brief Symptom Inventory (BSI) was evaluated when applied in analysis of the outcome quality of psychiatric and psychotherapeutic interventions. Pre-post data from two inpatient samples (N = 5711) and one outpatient sample (N = 239) were analyzed. Critical differences (reliable change index) and cut-off points between functional and dysfunctional populations were calculated using the Jacobson and Truax method of calculating clinical significance. Overall, the results indicated that the BSI was more accurate than the OQ-45 in correctly classifying patients as clinical subjects. Nonetheless, even with the BSI, about 25% of inpatients with schizophrenia attained a score at admission below the clinical cut-off. Both questionnaires exhibited the highest sensitivity to psychopathology with patients with personality disorders. When considering the differences in the prescores, both questionnaires showed the same sensitivity to change. The advantage of using these self-report measures is observed primarily in assessing outpatient psychotherapy outcome. In an inpatient setting two main problems—namely, the low response rate and the scarce sensitivity to psychopathology with severely ill patients—limit the usability of self-report questionnaires. PMID:27699166

  7. Body pushing, prescription drugs and hospital admission.

    PubMed

    Byard, Roger W; Kenneally, Michaela

    2017-03-15

    A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police. This case demonstrates that body pushing may not always involve illicit drugs or attempted concealment from police or customs officials. It appears that the drugs had been hidden to ensure an additional supply during the time of residence in hospital. The extent to which body pushing is currently being used by patients to smuggle drugs into secure medical facilities is yet to be determined.

  8. Short Term Effects of Particle Exposure on Hospital Admissions in the Mid-Atlantic States: A Population Estimate

    PubMed Central

    Kloog, Itai; Nordio, Francesco; Zanobetti, Antonella; Coull, Brent A.; Koutrakis, Petros; Schwartz, Joel D.

    2014-01-01

    Background Many studies report significant associations between PM2.5 (particulate matter <2.5 micrometers) and hospital admissions. These studies mostly rely on a limited number of monitors which introduces exposure error, and excludes rural and suburban populations from locations where monitors are not available, reducing generalizability and potentially creating selection bias. Methods Using prediction models developed by our group, daily PM2.5 exposure was estimated across the Mid-Atlantic (Washington D.C., and the states of Delaware, Maryland, New Jersey, Pennsylvania, Virginia, New York and West Virginia). We then investigated the short-term effects of PM2.5 exposures on emergency hospital admissions of the elderly in the Mid-Atlantic region.We performed case-crossover analysis for each admission type, matching on day of the week, month and year and defined the hazard period as lag01 (a moving average of day of admission exposure and previous day exposure). Results We observed associations between short-term exposure to PM2.5 and hospitalization for all outcomes examined. For example, for every 10-µg/m3 increase in short-term PM 2.5 there was a 2.2% increase in respiratory diseases admissions (95% CI = 1.9 to 2.6), and a 0.78% increase in cardiovascular disease (CVD) admission rate (95% CI = 0.5 to 1.0). We found differences in risk for CVD admissions between people living in rural and urban areas. For every10-µg/m3 increase in PM 2.5 exposure in the ‘rural’ group there was a 1.0% increase (95% CI = 0.6 to 1.5), while for the ‘urban’ group the increase was 0.7% (95% CI = 0.4 to 1.0). Conclusions Our findings showed that PM2.5 exposure was associated with hospital admissions for all respiratory, cardio vascular disease, stroke, ischemic heart disease and chronic obstructive pulmonary disease admissions. In addition, we demonstrate that our AOD (Aerosol Optical Depth) based exposure models can be successfully applied to epidemiological

  9. Similarity of Outcome Predictors across Opiate, Cocaine, and Alcohol Treatments: Role of Treatment Services.

    ERIC Educational Resources Information Center

    McLellan, A. Thomas; And Others

    1994-01-01

    Outcomes were predicted by similar factors, regardless of drug problem or type of treatment. Greater substance use at follow-up was predicted by greater severity of use at admission, not number of services during treatment. Social adjustment was negatively predicted by more severe psychiatric problems at admission and positively predicted by more…

  10. Impact of psychiatrists' qualifications on the rate of compulsory admissions.

    PubMed

    Eytan, Ariel; Chatton, Anne; Safran, Edith; Khazaal, Yasser

    2013-03-01

    Despite efforts to reduce coercion in psychiatry, involuntary hospitalizations remain frequent, representing more than half of all admissions in some European regions. Since October 2006, only certified psychiatrists are authorized to require a compulsory admission to our facility, while before all physicians were, including residents. The aim of the present study is to assess the impact of this change of procedure on the proportion compulsory admissions. All medical records of patients admitted respectively 4 months before and 4 month after the implementation of the procedure were retrospectively analyzed. This search retrieved a total of 2,227 hospitalizations for 1,584 patients. The overall proportions of compulsory and voluntary admissions were 63.9 % and 36.1 % respectively. The average length of stay was 32 days (SD ± 64.4). During the study period, 25 % of patients experienced two hospitalizations or more. The most frequent patients' diagnoses were affective disorders (30 %), psychotic disorders (18.4 %) and substance abuse disorders (15.7 %). Compared with the period before October 2006, patients hospitalized from October 2006 up were less likely to be hospitalized on a compulsory basis (OR = 0.745, 95 % CI: 0.596-0.930). Factors associated with involuntary admission were young age (20 years or less), female gender, a diagnosis of psychotic disorder and being hospitalized for the first time. Our results strongly suggest that limiting the right to require compulsory admissions to fully certified psychiatrists can reduce the rate of compulsory versus voluntary admissions.

  11. Daily weather variables and affective disorder admissions to psychiatric hospitals.

    PubMed

    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.

  12. 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.

  13. Air pollution from biomass burning and asthma hospital admissions in a sugar cane plantation area in Brazil

    PubMed Central

    Arbex, Marcos Abdo; Martins, Lourdes Conceição; de Oliveira, Regiani Carvalho; Pereira, Luiz Alberto Amador; Arbex, Flávio Ferlin; Cançado, José Eduardo Delfini; Saldiva, Paulo Hilário Nascimento; Braga, Alfésio Luís Ferreira

    2007-01-01

    Objective To evaluate the association between the total suspended particles (TSPs) generated from preharvest sugar cane burning and hospital admission due to asthma (asthma hospital admissions) in the city of Araraquara. Design An ecological time‐series study. Total daily records of asthma hospital admissions (ICD 10th J15) were obtained from one of the main hospitals in Araraquara, São Paulo State, Brazil, from 23 March 2003 to 27 July 2004. The daily concentration of TSP (μg/m3) was obtained using Handi‐vol equipment (Energética, Brazil) placed in downtown Araraquara. The local airport provided the daily mean figures of temperature and humidity. The daily number of asthma hospital admissions was considered as the dependent variable in Poisson's regression models and the daily concentration of TSP was considered the independent variable. The generalised linear model with natural cubic spline was adopted to control for long‐time trend. Linear terms were used for weather variables. Results TSP had an acute effect on asthma admissions, starting 1 day after TSP concentrations increased and remaining almost unchanged for the next four days. A 10 μg/m3 increase in the 5‐day moving average (lag1–5) of TSP concentrations was associated with an increase of 11.6% (95% CI 5.4 to 17.7) in asthma hospital admissions. Conclusion Increases in TSP concentrations were definitely associated with asthma hospital admissions in Araraquara and, despite using sugar cane alcohol to reduce air pollution from automotive sources in large Brazilian urban centres, the cities where sugar cane is harvested pay a high toll in terms of public health. PMID:17435205

  14. The effect of July admission on inpatient morbidity and mortality after adult spinal deformity surgery

    PubMed Central

    De la Garza-Ramos, Rafael; Passias, Peter G.; Schwab, Frank J.; Lafage, Virginie

    2016-01-01

    Background Some studies have suggested patients who undergo surgery in July have worse outcomes compared to patients treated during other months. The purpose of this study is to compare inpatient morbidity and mortality among patients who underwent adult spinal deformity (ASD) surgery in July with those who underwent surgery in other months. Methods Admission data for patients who underwent ASD surgery were extracted from the Nationwide Inpatient Sample for the years 2002 to 2011. Only adult patients (over 21 years of age) and elective admissions to teaching hospitals were included. A multivariable regression analysis was performed to examine the independent effect of July admissions on overall complications, major complications, and inpatient mortality. Results A total of 27,794 patients were identified, with 2,023 (7.8%) admitted in July and 25,771 (92.2%) in other months. Overall complication rates in July (43.1%) were not different from rates in other months (44.9%, p=0.468). Similarly, major complication rates were similar; 12.9% in July and 12.4% in other months (p=0.764). Mortality was not different between groups (p=0.807). After multivariable analysis, July admissions were not found to increase the odds of developing any complication (OR 0.94; 95% CI, 0.77 - 1.12; p=0.403), major complications (OR 1.04; 95% CI, 0.76 - 1.41; p=0.788) or inpatient mortality (OR 1.35; 95% CI, 0.31 - 5.84; p=0.684). Conclusion In this study of a nationwide database, patients who underwent ASD surgery in July did not have increased odds of developing a complication or inpatient mortality compared to patients admitted in other months. PMID:26913223

  15. Predictors of Recurrent Hospital Admission for Patients Presenting With Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

    PubMed Central

    Bradford, Annabel L.; Crider, Courtney Champagne; Xu, Xizheng; Naqvi, Syed Hasan

    2017-01-01

    Background Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are two serious, preventable complications of diabetes mellitus. Analysis of variables associated with recurrent DKA and HHS admission has the potential to improve patient outcomes by identifying possible areas for intervention. The aim of this study was to evaluate potential predictors of recurrent DKA or HHS admission. Methods This was a retrospective case-control study of 367 patients presenting during a 5-year period with DKA or HHS at a US tertiary academic medical center. Six potential readmission risk factors identified via literature review were coded as “1” if present and “0” if absent. Readmission odds ratios (ORs) for each risk factor and for the combined score of significant risk factors were calculated by logistic regression. Results Readmission odds were significantly increased for patients with age < 35, history of depression or substance/alcohol abuse, and self-pay/publicly funded insurance. HbA1C > 10.6% on admission and ethnic minority status did not significantly increase readmission odds, with inadequate study power for these variables. A total “ABCD” score, based on Age (< 35 years), Behavioral health (depression), insurance Coverage (self-pay/publicly funded insurance), and Drug/alcohol abuse, also had a significant effect on readmission odds. Conclusions Consideration of individual risk factors and the use of a scoring system based on objective predictors of recurrent DKA and HHS admission could be of value in helping identify patients with high readmission risk, allowing interventions to be targeted most effectively to reduce readmission rates, associated morbidity, and mortality. PMID:27924173

  16. 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.

  17. Home management of hematological patients requiring hospital admission.

    PubMed

    Isaia, Gianluca; Tibaldi, Vittoria; Astengo, Marco; Ladetto, Marco; Marinello, Renata; Bo, Mario; Michelis, Giuliana; Ruatta, Fiorella; Ricauda, Nicoletta Aimonino

    2010-01-01

    The hospital-at-home service (HHS) could be considered as an alternative to the traditional ward for elderly patients. We aimed at evaluating the home management of elderly people requiring transfusions. The ever-increasing demand on acute hospital services requires alternative methods of delivering all aspects of health care. HHS demonstrated to be as efficacious as a traditional ward for elderly and functionally compromised patients. The method was a retrospective descriptive study enrolling patients needing an hospital admission from 1st January 2007 to 31st December 2007 and reporting an hematological discharge's diagnosis as primary or secondary diagnosis. A total of 54 patients were evaluated in this study. Of them, 34 (62.9%) needed a hemocomponent transfusion for a total volume of 112 blood units and 49 platelet pools. Patients requiring at least one blood or platelet transfusion were more functionally compromised and presented a higher level of acute physiology and chronic health evaluation, compared to the non-transfused ones. The conclusion was that hematological subjects mainly the frail ones and functionally highly compromised with acute illnesses could be treated at home as an alternative of the traditional medical ward. This could be the starting point for future studies that will be able to increase the power of hospital-at-home service for this type of patients.

  18. Preparing Students for College Admissions Tests

    ERIC Educational Resources Information Center

    Appelrouth, Jed I.; Zabrucky, Karen M.; Moore, DeWayne

    2017-01-01

    Attaining successful outcomes on the SAT can have profound educational and financial consequences for college-bound students. Using archival data from a private tutoring centre, we investigated variables we hypothesised to contribute to SAT score increases. Our analyses revealed significant effects of time on task and rate of SAT homework…

  19. How Effective Are Military Academy Admission Standards

    DTIC Science & Technology

    2016-07-22

    Academy (USMA), and the U.S. Naval Academy (USNA) provide undergraduate education and training for stu- dents who will become commissioned officers...Reserve Officers Training Corps (ROTC) program (in the case of promotion outcomes). Unlike with USAFA, researchers did not find that a different

  20. Trend study on the association between hospital admissions and the health of Dutch older adults (1995–2009)

    PubMed Central

    Galenkamp, Henrike; Deeg, Dorly J H; de Jongh, Renate T; Kardaun, Jan W P F; Huisman, Martijn

    2016-01-01

    Objectives An increase in hospital admission rates in older people may reflect improved access to healthcare, but also declining health trends in the older population. Owing to a lack of individual-level data, the latter possibility has received little attention. The current study examines associations between health status and hospitalisation rates of older adults in the Netherlands. Design Observational individual-level data linked to hospital register data. Setting Data from 1995 to 2009 from the nationally representative Longitudinal Aging Study Amsterdam were linked to the Dutch Hospital Discharge Register. Participants A total of 5681 observations of 2520 respondents across 4 measurement points (each with a follow-up of 36 months; ages 65–88 years). Outcome measures The contribution of health, demographic, psychosocial and lifestyle characteristics to time trends in hospitalisation was assessed in multivariate models. Results Between 1995 and 2009, the percentage with 1 or more overnight admissions (planned or acute) increased slightly from 38.1% to 39.7%. This was due to an increase in acute admission only (22.2–27.0%). Increased prevalences of chronic diseases, functional limitations and polypharmacy accounted for part of the observed increase in acute admissions. In addition, a more than doubled prevalence of day admissions over time was observed (12.3–28.3%), a trend that was unrelated to changes in individual characteristics. Conclusions This trend study showed a contribution of declines in population health to increases in acute hospital admissions. Since these declines did not provide a full explanation, healthcare reforms and increases in treatment possibilities in this period are likely to have contributed as well. PMID:27531734

  1. Impacts of hot and cold temperature extremes on hospital admissions for cardiovascular diseases

    NASA Astrophysics Data System (ADS)

    Davídkovová, H.; Kyselý, J.; Kříž, B.

    2010-09-01

    Elevated mortality associated with high ambient temperatures in summer represents one of the main impacts of weather extremes on human society. Increases in mortality during heat waves were examined in many European countries; much less is known about the effects of heat waves on morbidity, measured for example by the number of hospital admissions. Relatively less understood is also cold-related mortality and morbidity in winter, when the relationships between weather and human health are more complex, less direct, and confounded by other factors such as epidemics of influenza/acute respiratory infections. The present study examines links between hot and cold temperature extremes and daily hospital admissions for cardiovascular diseases in the population of the Czech Republic over 1994-2007. We make use of a recently completed database of all admissions for cardiovascular diseases to hospitals in the area of the Czech Republic since 1994, with a detailed classification of diseases and detailed information concerning each patient (in total 1,467,675 hospital admissions over 1994-2007). The main goals of the study are (i) to identify excess/deficit morbidity during and after periods of heat waves in summer and cold spells in winter, (ii) to compare the links for individual diseases (e.g. acute myocardial infarction, I21; angina pectoris, I20; cerebral infarction, I63; brain ischemia, I64) and to identify those diagnoses that are most closely linked to weather, (iii) to identify population groups most vulnerable to temperature extremes, and (iv) to compare the links to temperature extremes for morbidity and mortality. Periods when morbidity data were affected by epidemics of influenza and acute respiratory infections in winter were excluded from the analysis.

  2. Perceived humiliation during admission to a psychiatric emergency service and its relation to socio-demography and psychopathology

    PubMed Central

    2013-01-01

    Background There is a lack of empirical studies of patients’ level of humiliation during the hospital admission process and its implications for the clinical setting. We wanted to explore associations between self-rated humiliation and socio-demography and psychopathology in relation to admission to a psychiatric emergency unit. Methods Consecutively admitted patients (N = 186) were interviewed with several validated instruments. The patients self-rated humiliation by The Cantril Ladder, and 35% of the sample was defined as the high humiliation group. Results Final multivariate analysis found significant associations between compulsory admission, not being in paid work, high scores on hostility, and on entitlement, and high levels of humiliation. No significant interactions were observed between these variables, and the narcissism score was not a confounder concerning humiliation. Conclusions High level of humiliation during the admission process was mainly related to patient factors, but also to compulsory admission which should be avoided as much as possible protecting the self-esteem of the patients. PMID:23988222

  3. Pattern of Investigation Reflects Risk Profile in Emergency Medical Admissions

    PubMed Central

    Cournane, Seán; Byrne, Declan; O’Riordan, Deirdre; Sheehy, Niall; Silke, Bernard

    2015-01-01

    Demand for hospital resources may increase over time; we have examined all emergency admissions (51,136 episodes) from 2005 to 2013 for underlying trends and whether resource utilization and clinical risk are correlated. We used logistic regression of the resource indicator against 30-day in-hospital mortality and adjusted this risk estimate for other outcome predictors. Generally, resource indicators predicted an increased risk of a 30-day in-hospital death. For CT Brain the Odds Ratio (OR) was 1.37 (95% CI: 1.27, 1.50), CT Abdomen 3.48 (95% CI: 3.02, 4.02) and CT Chest, Thorax, Abdomen and Pelvis 2.50 (95% CI: 2.10, 2.97). Services allied to medicine including Physiotherapy 2.57 (95% CI: 2.35, 2.81), Dietetics 2.53 (95% CI: 2.27, 2.82), Speech and Language 5.29 (95% CI: 4.57, 6.05), Occupational Therapy 2.65 (95% CI: 2.38, 2.94) and Social Work 1.65 (95% CI: 1.48, 1.83) all predicted an increased risk. The in-hospital 30-day mortality increased with resource utilization, from 4.7% (none) to 27.0% (five resources). In acute medical illness, the use of radiological investigations and allied professionals increased over time. Resource utilization was calibrated from case complexity/30-day in-hospital mortality suggesting that complexity determined the need for and validated the use of these resources. PMID:26239468

  4. Student Admission Criteria as Predictors of Research Potential.

    ERIC Educational Resources Information Center

    Cotton, Gary L.; And Others

    1986-01-01

    A study at one university found that traditional admission criteria for a graduate microbiology program, undergraduate grade point average, and Graduate Record Examination scores, were not good predictors of student potential as a researcher, as measured by faculty ratings. (MSE)

  5. 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

  6. 8 CFR 289.2 - Lawful admission for permanent residence.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AMERICAN INDIANS BORN IN CANADA § 289.2 Lawful admission for permanent residence. Any American Indian born in Canada who at the time of entry was entitled to the exemption provided for such person by the...

  7. Exploring Ethnic Inequalities in Admission to Russell Group Universities.

    PubMed

    Boliver, Vikki

    2016-04-01

    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.

  8. 8 CFR 289.2 - Lawful admission for permanent residence.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AMERICAN INDIANS BORN IN CANADA § 289.2 Lawful admission for permanent residence. Any American Indian born.... A person who does not possess 50 per centum of the blood of the American Indian race, but...

  9. 32. 48' MILL STEAM ENGINE ADMISSION BOX (?), STEAM VALVE, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    32. 48' MILL STEAM ENGINE ADMISSION BOX (?), STEAM VALVE, AND REVERSING MECHANISM LIFTING CYLINDER. - U.S. Steel Homestead Works, 48" Plate Mill, Along Monongahela River, Homestead, Allegheny County, PA

  10. Peritraumatic reactions and posttraumatic stress disorder symptoms after psychiatric admission.

    PubMed

    Ladois-Do Pilar Rei, Agnès; Bui, Eric; Bousquet, Benjamin; Simon, Naomi M; Rieu, Julie; Schmitt, Laurent; Billard, Julien; Rodgers, Rachel; Birmes, Philippe

    2012-01-01

    The present study aimed to explore exposure to stressful events during a psychiatric admission and the predictive power of peritraumatic distress and dissociation in the development of posttraumatic stress disorder (PTSD) symptoms after exposure to such events. Psychiatric inpatients (N = 239) were asked to report exposure to stressful events during their admission within 48 hours of being admitted. Individuals reporting at least one stressful event during admission (n = 70, 29%) were assessed for peritraumatic dissociation and distress in relation to this event and, 5 weeks later, were reassessed for PTSD symptoms. Eight participants (12.3%) scored above the cutoff for probable PTSD. Multiple regression analyses revealed that peritraumatic distress was a significant predictor of 5-week PTSD symptoms. Our findings suggest that individuals experiencing increased peritraumatic distress in relation to a stressful event experienced during a psychiatric admission might be at risk of PTSD symptoms and might benefit from increased attention.

  11. From Both Sides of the Fence: Admissions Counseling.

    ERIC Educational Resources Information Center

    McEvoy, Constance T.

    1984-01-01

    Discusses the role of secondary school counselors and college admissions officers in counseling college bound students. Stresses the importance of diplomacy and cooperation in working for the best interests of the student while addressing parent and institutional concerns. (JAC)

  12. Inpatient Dermatology: Characteristics of Patients and Admissions in a Tertiary Level Hospital in Eastern India

    PubMed Central

    Sen, Arpita; Chowdhury, Satyendranath; Poddar, Indrasish; Bandyopadhyay, Debabrata

    2016-01-01

    Introduction: Dermatology is primarily a non-acute, outpatient-centered clinical specialty, but substantial number of patients need indoor admission for adequate management. Over the years, the need for inpatient facilities in Dermatology has grown manifold; however, these facilities are available only in some tertiary centers. Aims and Objectives: To analyze the characteristics of the diseases and outcomes of patients admitted in the dermatology inpatient Department of a tertiary care facility in eastern India. Materials and Methods: We undertook a retrospective analysis of the admission and discharge records of all patients, collected from the medical records department, admitted to our indoor facility from 2011 to 2014. The data thus obtained was statistically analyzed with special emphasis on the patient's demographic profile, clinical diagnosis, final outcome, and duration of stay. Results and Analysis: A total of 375 patients were admitted to our indoor facility during the period. Males outnumbered females, with the median age in the 5th decade. Immunobullous disorders (91 patients, 24.27%) were the most frequent reason for admissions, followed by various causes of erythroderma (80 patients, 21.33%) and infective disorders (73 patients, 19.47%). Other notable causes included cutaneous adverse drug reactions, psoriasis, vasculitis, and connective tissue diseases. The mean duration of hospital stay was 22.2±15.7 days; ranging from 1 to 164 days. Majority of patients (312, 83.2%) improved after hospitalization; while 29 (7.73%) patients died from their illness. About 133 patients (35.64%) required referral services during their stay, while 8 patients (2.13%) were transferred to other departments for suitable management. Conclusion: Many dermatoses require inpatient care for their optimum management. Dermatology inpatient services should be expanded in India to cater for the large number of cases with potentially highly severe dermatoses. PMID:27688450

  13. Clinical Audit of COPD Patients Requiring Hospital Admissions in Spain: AUDIPOC Study

    PubMed Central

    Pozo-Rodríguez, Francisco; López-Campos, Jose Luis; Álvarez-Martínez, Carlos J.; Castro-Acosta, Ady; Agüero, Ramón; Hueto, Javier; Hernández-Hernández, Jesús; Barrón, Manuel; Abraira, Victor; Forte, Anabel; Sanchez Nieto, Juan Miguel; Lopez-Gabaldón, Encarnación; Cosío, Borja G.; Agustí, Alvar

    2012-01-01

    Backgrounds AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients’ characteristics, and adherence to guidelines. Methodology/Principal Findings An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0–35%). Among discharged patients, 37% required readmission (0–62%) and 6.5% died (0–35%). The overall mortality rate was 11.6% (0–50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles. Conclusions/Significance The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement. PMID:22911875

  14. A Retrospective Chart Review of Dietary Diversity and Feeding Behavior of Children with Autism Spectrum Disorder before and after Admission to a Day-Treatment Program

    ERIC Educational Resources Information Center

    Sharp, William G.; Jaquess, David L.; Morton, Jane F.; Miles, Aida G.

    2011-01-01

    The nutritional status and mealtime performance among a group of children with autism spectrum disorders (ASD) were examined before and after admission to an intensive feeding day-treatment program. Treatment involved escape extinction, reinforcement, and stimulus fading procedures. Outcomes focused on dietary diversity and mealtime performance,…

  15. Probabilistic Tracklet Characterization and Prioritization Using Admissible Regions

    DTIC Science & Technology

    2014-09-01

    association and track initiation tasks. Well before their use in data association for asteroids and SOs, admissible regions have been used in stochastic...logic resource management.14 Milani et al.15 first proposed using ARs to assist in the optical detection and discrimination of asteroids . This work is...object in question. 3 To illustrate this last point, consider an optical observation of an asteroid . Given the measurements made, an admissible

  16. SAT Wars: The Case for Test-Optional College Admissions

    ERIC Educational Resources Information Center

    Soares, Joseph A., Ed.

    2011-01-01

    What can a college admissions officer safely predict about the future of a 17-year-old? Are the best and the brightest students the ones who can check off the most correct boxes on a multiple-choice exam? Or are there better ways of measuring ability and promise? In this penetrating and revealing look at high-stakes standardized admissions tests,…

  17. 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

  18. Towards an understanding of graduate admissions practices in physics

    NASA Astrophysics Data System (ADS)

    Potvin, Geoff; Chari, Deepa

    2017-01-01

    The APS bridge program works to improve the participation of students from traditionally under-represented groups in graduate physics. Related to this, we have undertaken research to improve our understanding of graduate admissions practices from the point of view of both students and faculty. Previously, we collected data on admission practices from over 75% of PhD-granting physics departments in the U.S., which highlighted the role of various criteria (including the GRE) in the admissions decisions faculty make, and identified the efforts (or lack thereof) made to recruit students from traditionally under-represented backgrounds. Currently, we are conducting a parallel study of upper division undergraduate physics majors to investigate their post-graduation career intentions, their perceptions of graduate admissions and perceived barriers to admissions, and to understand how undergraduate experiences influence students' career interests. Lastly, we are also studying, in depth, students who have been connected to physics bridge programs, to understand post-admission experiences and the enculturation process in physics departments. In this talk, we report on the collective results of these research efforts to date. NSF Award # 1143070.

  19. Associations between environmental factors and hospital admissions for sickle cell disease.

    PubMed

    Piel, Frédéric B; Tewari, Sanjay; Brousse, Valentine; Analitis, Antonis; Font, Anna; Menzel, Stephan; Chakravorty, Subarna; Thein, Swee Lay; Inusa, Baba; Telfer, Paul; de Montalembert, Mariane; Fuller, Gary W; Katsouyanni, Klea; Rees, David C

    2017-04-01

    Sickle cell disease is an increasing global health burden. This inherited disease is characterized by a remarkable phenotypic heterogeneity, which can only partly be explained by genetic factors. Environmental factors are likely to play an important role but studies of their impact on disease severity are limited and their results are often inconsistent. This study investigated associations between a range of environmental factors and hospital admissions of young patients with sickle cell disease in London and in Paris between 2008 and 2012. Specific analyses were conducted for subgroups of patients with different genotypes and for the main reasons for admissions. Generalized additive models and distributed lag non-linear models were used to assess the magnitude of the associations and to calculate relative risks. Some environmental factors significantly influence the numbers of hospital admissions of children with sickle cell disease, although the associations identified are complicated. Our study suggests that meteorological factors are more likely to be associated with hospital admissions for sickle cell disease than air pollutants. It confirms previous reports of risks associated with wind speed (risk ratio: 1.06/standard deviation; 95% confidence interval: 1.00-1.12) and also with rainfall (1.06/standard deviation; 95% confidence interval: 1.01-1.12). Maximum atmospheric pressure was found to be a protective factor (0.93/standard deviation; 95% confidence interval: 0.88-0.99). Weak or no associations were found with temperature. Divergent associations were identified for different genotypes or reasons for admissions, which could partly explain the lack of consistency in earlier studies. Advice to patients with sickle cell disease usually includes avoiding a range of environmental conditions that are believed to trigger acute complications, including extreme temperatures and high altitudes. Scientific evidence to support such advice is limited and sometimes

  20. Mortality Associated with Night and Weekend Admissions to ICU with On-Site Intensivist Coverage: Results of a Nine-Year Cohort Study (2006-2014)

    PubMed Central

    Brunot, Vincent; Landreau, Liliane; Corne, Philippe; Platon, Laura; Besnard, Noémie; Buzançais, Aurèle; Daubin, Delphine; Serre, Jean Emmanuel; Molinari, Nicolas; Klouche, Kada

    2016-01-01

    Background The association between mortality and time of admission to ICU has been extensively studied but remains controversial. We revaluate the impact of time of admission on ICU mortality by retrospectively investigating a recent (2006–2014) and large ICU cohort with on-site intensivist coverage. Patients and Methods All adults (≥ 18 years) admitted to a tertiary care medical ICU were included in the study. Patients' characteristics, medical management, and mortality were prospectively collected. Patients were classified according to their admission time: week working days on- and off-hours, and weekends. ICU mortality was the primary outcome and adjusted Hazard-ratios (HR) of death were analysed by multivariate Cox model. Results 2,428 patients were included: age 62±18 years; male: 1,515 (62%); and median SAPSII score: 38 (27–52). Overall ICU mortality rate was 13.7%. Admissions to ICU occurred during open-hours in 680 cases (28%), during night-time working days in 1,099 cases (45%) and during weekends in 649 cases (27%). Baseline characteristics of patients were similar between groups except that patients admitted during the second part of night (00:00 to 07:59) have a significantly higher SAPS II score than others. ICU mortality was comparable between patients admitted during different time periods but was significantly higher for those admitted during the second part of the night. Multivariate analysis showed however that admission during weeknights and weekends was not associated with an increased ICU mortality as compared with open-hours admissions. Conclusion Time of admission, especially weeknight and weekend (off-hour admissions), did not influence the prognosis of ICU patients. The higher illness severity of patients admitted during the second part of the night (00:00–07:59) may explain the observed increased mortality. PMID:28033395

  1. The Fermilab Main Injector

    SciTech Connect

    Mishra, C.S.

    1992-11-01

    The Fermilab Main Injector is a new 150 GeV proton synchrotron, designed to replace the Main Ring and improve the high energy physics potential of Fermilab. The status of the Fermilab accelerator complex upgrade will be discussed.

  2. Long term mental health outcomes of Finnish children evacuated to Swedish families during the second world war and their non-evacuated siblings: cohort study

    PubMed Central

    Betancourt, Theresa S; Gilman, Stephen E

    2015-01-01

    Objectives To compare the risks of admission to hospital for any type of psychiatric disorder and for four specific psychiatric disorders among adults who as children were evacuated to Swedish foster families during the second world war and their non-evacuated siblings, and to evaluate whether these risks differ between the sexes. Design Cohort study. Setting National child evacuation scheme in Finland during the second world war. Participants Children born in Finland between 1933 and 1944 who were later included in a 10% sample of the 1950 Finnish census ascertained in 1997 (n=45 463; women: n=22 021; men: n=23 442). Evacuees in the sample were identified from war time government records. Main outcome measure Adults admitted to hospital for psychiatric disorders recorded between 1971 and 2011 in the Finnish hospital discharge register. Methods We used Cox proportional hazards models to estimate the association between evacuation to temporary foster care in Sweden during the second world war and admission to hospital for a psychiatric disorder between ages 38 and 78 years. Fixed effects methods were employed to control for all unobserved social and genetic characteristics shared among siblings. Results Among men and women combined, the risk of admission to hospital for a psychiatric disorder did not differ between Finnish adults evacuated to Swedish foster families and their non-evacuated siblings (hazard ratio 0.89, 95% confidence interval 0.64 to 1.26). Evidence suggested a lower risk of admission for any mental disorder (0.67, 0.44 to 1.03) among evacuated men, whereas for women there was no association between evacuation and the overall risk of admission for a psychiatric disorder (1.21, 0.80 to 1.83). When admissions for individual psychiatric disorders were analyzed, evacuated girls were significantly more likely than their non-evacuated sisters to be admitted to hospital for a mood disorder as an adult (2.19, 1.10 to 4.33). Conclusions The Finnish

  3. Elite US college admissions: could the quest for admission increase overuse injury risk?

    PubMed Central

    Schwebel, David C.; Yang, Jingzhen

    2016-01-01

    Abstract: This commentary addresses the intriguing correspondence of two trends. First, we describe the increasing selectivity for undergraduate admission to elite colleges and universities in the United States and an apparent preference for “angular” applicants who have demonstrated tremendous accomplishment in a single non-academic pursuit such as music, athletics, or the arts. Second, we describe an apparent increase in overuse injuries among American children and adolescents, a trend that many experts attribute to specialization within a single athletic, musical or artistic pursuit among youth who in previous generations were more “generalist” in their extracurricular activities. It is premature to demonstrate causality and suggest increasing college selectivity has led to increasing rates of overuse injuries, but we speculate there may be a causal relation present and encourage scholarly research on the topic. PMID:27130516

  4. Contrasting patterns of hospital admissions and mortality during heat waves: are deaths from circulatory disease a real excess or an artifact?

    PubMed

    Mastrangelo, Giuseppe; Hajat, Shakoor; Fadda, Emanuela; Buja, Alessandra; Fedeli, Ugo; Spolaore, Paolo

    2006-01-01

    In old subjects exposed to extreme high temperature during a heat wave, studies have consistently reported an excess of death from cardio- or cerebro-vascular disease. By contrast, dehydration, heat stroke, acute renal insufficiency, and respiratory disease were the main causes of hospital admission in the two studies carried out in elderly during short spells of hot weather. The excess of circulatory disease reported by mortality studies, but not by morbidity studies, could be explained by the hypothesis that deaths from circulatory disease occur rapidly in isolated people before they reach a hospital. Since the contrasting patterns of hospital admission and mortality during heat waves could also be due to chance (random variation over time and space in the spectrum of diseases induced by extreme heat), and bias (poor quality of diagnosis on death certificate and other artifacts), it should be confirmed by a concurrent study of mortality and morbidity. Many heat-related diseases may be preventable with adequate warning and an appropriate response to heat emergencies, but preventive efforts are complicated by the short time interval that may elapse between high temperatures and death. Therefore, prevention programs must be based around rapid identification of high-risk conditions and persons. The effectiveness of the intervention measures must be formally evaluated. If cardio- and cerebro-vascular diseases are rapidly fatal health outcomes with a short time interval between exposure to high temperature and death, deaths from circulatory disease might be an useful indicator in evaluating the effectiveness of a heat watch/warning system.

  5. Implementation and outcomes of a rapid response team.

    PubMed

    McFarlan, Susan J; Hensley, Sara

    2007-01-01

    Adverse events in hospitalized patients are preceded by clinical signs of decline. Thus, early recognition and intervention should improve patient outcomes. At the University of Kentucky Hospital, the impetus to start a rapid response team (RRT) was to decrease unplanned admissions to ICU, adverse events, and mortality overall. On the basis of the outcomes at our hospital, we conclude that there is benefit to having an RRT. The following article outlines processes for RRT implementation and our outcomes to date.

  6. 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…

  7. Hospital admissions for lower respiratory tract infections among infants in the Canadian Arctic: a cohort study

    PubMed Central

    Banerji, Anna; Panzov, Val; Young, Michael; Robinson, Joan; Lee, Bonita; Moraes, Theo; Mamdani, Muhammad; Giles, B. Louise; Jiang, Depeng; Bisson, Danny; Dennis, Marguerite; Morel, Johanne; Hall, Judith; Hui, Charles; Paes, Bosco; Mahony, James B.

    2016-01-01

    Background: It is unknown whether this burden of disease of lower respiratory tract infections is comparable across the Canadian Arctic. The objectives of this surveillance study were to compare the rates of hospital admission for lower respiratory tract infection and the severity of infection across Arctic Canada, and to describe the responsible viruses. Methods: We performed a prospective multicentre surveillance study of infants less than 1 year of age admitted in 2009 with lower respiratory tract infection to all hospitals (5 regional, 4 tertiary) in the Northwest Territories, Nunavut and Nunavik to assess for regional differences. Nasopharyngeal aspirates were processed by means of a polymerase chain reaction respiratory viral panel, testing for 20 respiratory viruses and influenza A (H1N1). The role of coinfection was assessed by means of regression analysis for length of stay (short: < 7 d; long: > 14 d). Outcomes compared included rates of lower respiratory tract infection, respiratory syncytial virus infection, transfer to tertiary hospital and severe lower respiratory tract infection (respiratory failure, intubation and mechanical ventilation, and/or cardiopulmonary resuscitation). Results: There were 348 admissions for lower respiratory tract infection in the population of interest in 2009. Rates of admission per 1000 live births varied significantly, from 39 in the Northwest Territories to 456 in Nunavik (p < 0.001). The rates of tertiary admissions and severe lower respiratory tract infection per 1000 live births in the Northwest Territories were 5.6 and 1.4, respectively, compared to 55.9 and 17.1, respectively, in Nunavut and 52.0 and 20.0, respectively, in Nunavik (p ≤ 0.001). Respiratory syncytial virus was the most common virus identified (124 cases [41.6% of those tested]), and coinfection was detected in 51 cases (41.1%) of infection with this virus. Longer length of stay was associated with coinfection (odds ratio [OR] 2.64) and underlying

  8. Liver transplantation for progressive familial intrahepatic cholestasis: clinical and histopathological findings, outcome and impact on growth.

    PubMed

    Aydogdu, Sema; Cakir, Murat; Arikan, C; Tumgor, Gokhan; Yuksekkaya, Hasan Ali; Yilmaz, Funda; Kilic, Murat

    2007-09-01

    In this study, we analyze the demographic features, clinical and histopathological findings in patients who underwent liver transplantation for progressive familial intrahepatic cholestasis. We also analyze outcome and impact of liver transplantation on growth and bone mineral content. Most of the patients were presented with jaundice mainly beginning within the first six months. At the time of initial admission; eight patients had short stature (height SD score<2), and four patients had weight SD score<2. Liver transplantation were performed at the age of 43.2+/-27 months (range 9 to 96 months), 6.5+/-3.5 months later after the first admission. Infection, surgical complications and osmotic diarrhea associated with severe metabolic acidosis were noted in 41.4%, 16.6% and 33.3%, respectively. One patient developed posttransplant lymphoproliferative disorder. Overall; 1 year graft and patient survival was 69.2% and 75%, respectively. At the end of the 1st year only 2 patients had height SD score<2. Linear regression of height gain against increase in total body BMD measured at the time of transplantation and 1 year after liver transplantation gave a coefficient r=0.588 (p=0.074). No correlation was found between the height gain and age and PELD score at time of transplantation, and no difference was noted between the sexes and donor type. Liver transplantation is effective treatment modality with good outcome and little morbidity, and increases the growth acceleration in patients with PFIC associated with cirrhosis.

  9. Outcome of patients with autoimmune diseases in the intensive care unit: a mixed cluster analysis

    PubMed Central

    Bernal-Macías, Santiago; Reyes-Beltrán, Benjamín; Molano-González, Nicolás; Augusto Vega, Daniel; Bichernall, Claudia; Díaz, Luis Aurelio; Rojas-Villarraga, Adriana; Anaya, Juan-Manuel

    2015-01-01

    Objectives The interest on autoimmune diseases (ADs) and their outcome at the intensive care unit (ICU) has increased due to the clinical challenge for diagnosis and management as well as for prognosis. The current work presents a-year experience on these topics in a tertiary hospital. Methods The mixed-cluster methodology based on multivariate descriptive methods such as principal component analysis and multiple correspondence analyses was performed to summarize sets of related variables with strong associations and common clinical context. Results Fifty adult patients with ADs with a mean age of 46.7±17.55 years were assessed. The two most common diagnoses were systemic lupus erythematosus and systemic sclerosis, registered in 45% and 20% of patients, respectively. The main causes of admission to ICU were infection and AD flare up, observed in 36% and 24%, respectively. Mortality during ICU stay was 24%. The length of hospital stay before ICU admission, shock, vasopressors, mechanical ventilation, abdominal sepsis, Glasgow score and plasmapheresis were all factors associated with mortality. Two new clinical clusters variables (NCVs) were defined: Time ICU and ICU Support Profile, which were associated with survivor and no survivor variables. Conclusions Identification of single factors and groups of factors from NCVs will allow implementation of early and aggressive therapies in patients with ADs at the ICU in order to avoid fatal outcomes PMID:26688741

  10. Tuberculosis in hospitalized patients: clinical characteristics of patients receiving treatment within the first 24 h after admission*

    PubMed Central

    Silva, Denise Rossato; da Silva, Larissa Pozzebon; Dalcin, Paulo de Tarso Roth

    2014-01-01

    Objective: To evaluate clinical characteristics and outcomes in patients hospitalized for tuberculosis, comparing those in whom tuberculosis treatment was started within the first 24 h after admission with those who did not. Methods: This was a retrospective cohort study involving new tuberculosis cases in patients aged ≥ 18 years who were hospitalized after seeking treatment in the emergency room. Results: We included 305 hospitalized patients, of whom 67 (22.0%) received tuberculosis treatment within the first 24 h after admission ( ≤24h group) and 238 (88.0%) did not (>24h group). Initiation of tuberculosis treatment within the first 24 h after admission was associated with being female (OR = 1.99; 95% CI: 1.06-3.74; p = 0.032) and with an AFB-positive spontaneous sputum smear (OR = 4.19; 95% CI: 1.94-9.00; p < 0.001). In the ≤24h and >24h groups, respectively, the ICU admission rate was 22.4% and 15.5% (p = 0.258); mechanical ventilation was used in 22.4% and 13.9% (p = 0.133); in-hospital mortality was 22.4% and 14.7% (p = 0.189); and a cure was achieved in 44.8% and 52.5% (p = 0.326). Conclusions: Although tuberculosis treatment was initiated promptly in a considerable proportion of the inpatients evaluated, the rates of in-hospital mortality, ICU admission, and mechanical ventilation use remained high. Strategies for the control of tuberculosis in primary care should consider that patients who seek medical attention at hospitals arrive too late and with advanced disease. It is therefore necessary to implement active surveillance measures in the community for earlier diagnosis and treatment. PMID:25029651

  11. Nontraumatic spinal cord injury at the neurological intensive care unit: spectrum, causes of admission and predictors of mortality

    PubMed Central

    Grassner, Lukas; Marschallinger, Julia; Dünser, Martin W.; Novak, Helmut F.; Zerbs, Alexander; Aigner, Ludwig; Trinka, Eugen; Sellner, Johann

    2015-01-01

    Objective: Nontraumatic spinal cord injuries (NTSCIs) form a heterogeneous group of diseases, which may evolve into a life-threatening condition. We sought to characterize spectrum, causes of admission and predictors of death in patients with NTSCI treated at the neurological intensive care unit (NICU). Methods: We performed a retrospective observational analysis of NTSCI cases treated at a tertiary care center between 2001 and 2013. Among the 3937 NICU admissions were 93 patients with NTSCI (2.4%). Using multivariate logistic regression analysis, we examined predictors of mortality including demographics, etiology, reasons for admission and GCS/SAPS (Glasgow Coma Scale/Simplified Acute Physiology Score) scores. Results: Infectious and inflammatory/autoimmune causes made up 50% of the NTSCI cases. The most common reasons for NICU admission were rapidly progressing paresis (49.5%) and abundance of respiratory insufficiency (26.9%). The mortality rate was 22.6% and 2.5-fold higher than in the cohort of all other patients treated at the NICU. Respiratory insufficiency as the reason for NICU admission [odds ratio (OR) 4.97, 95% confidence interval (CI) 1.38–17.9; p < 0.01], high initial SAPS scores (OR 1.04; 95% CI 1.003–1.08; p = 0.04), and the development of acute kidney injury throughout the stay (OR 7.25, 1.9–27.5; p = 0.004) were independent risk factors for NICU death. Conclusions: Patients with NTSCI account for a subset of patients admitted to the NICU and are at risk for adverse outcome. A better understanding of predisposing conditions and further knowledge of management of critically ill patients with NTSCI is mandatory. PMID:27006696

  12. The Maine Event

    ERIC Educational Resources Information Center

    McHale, Tom

    2007-01-01

    In this article, the author describes the successful laptop program employed at Mt. Abram High School in Strong, Maine. Through the Maine Learning Technology Initiative, the school has issued laptops to all 36,000 teachers and students in grades 7-8. This program has helped level the playing field for a student population that is 50 percent to 55…

  13. Teaching Main Idea Comprehension.

    ERIC Educational Resources Information Center

    Baumann, James F., Ed.

    Intended to help classroom teachers, curriculum developers, and researchers, this book provides current information on theoretical and instructional aspects of main idea comprehension. Titles and authors are as follows: "The Confused World of Main Idea" (James W. Cunningham and David W. Moore); "The Comprehension of Important…

  14. Maine's Employability Skills Program

    ERIC Educational Resources Information Center

    McMahon, John M.; Wolffe, Karen E.; Wolfe, Judy; Brooker, Carrie

    2013-01-01

    This Practice Report describes the development and implementation of the "Maine Employability Skills Program," a model employment program developed by the Maine Division for the Blind and Visually Impaired (DBVI). The program was designed to support the efforts of the chronically unemployed or underemployed. These consumers were either…

  15. Perspective: Medical school admissions and noncognitive testing: some open questions.

    PubMed

    Bardes, Charles L; Best, Peggy Carey; Kremer, Sara J; Dienstag, Jules L

    2009-10-01

    Medical schools use a variety of criteria in selecting applicants for admission, attempting to assess both the academic preparation and the personal characteristics suitable for a career in medicine. While assessing academic preparation is fairly straightforward, assessing applicants' personal characteristics is difficult and controversial. The possibility of implementing standardized testing of personal characteristics, so-called "noncognitive testing," has been proposed as part of the admissions process. Such a proposal, however, raises numerous questions about the validity, fairness, and cost of such testing and the impact of commercial test-preparation services on test performance and reliability. Therefore, before noncognitive testing is adopted for screening applicants to medical school, open discussion among all stakeholders in the admissions process is critically important.

  16. The ED-inpatient dashboard: Uniting emergency and inpatient clinicians to improve the efficiency and quality of care for patients requiring emergency admission to hospital.

    PubMed

    Staib, Andrew; Sullivan, Clair; Jones, Matt; Griffin, Bronwyn; Bell, Anthony; Scott, Ian

    2016-09-04

    Patients who require emergency admission to hospital require complex care that can be fragmented, occurring in the ED, across the ED-inpatient interface (EDii) and subsequently, in their destination inpatient ward. Our hospital had poor process efficiency with slow transit times for patients requiring emergency care. ED clinicians alone were able to improve the processes and length of stay for the patients discharged directly from the ED. However, improving the efficiency of care for patients requiring emergency admission to true inpatient wards required collaboration with reluctant inpatient clinicians. The inpatient teams were uninterested in improving time-based measures of care in isolation, but they were motivated by improving patient outcomes. We developed a dashboard showing process measures such as 4 h rule compliance rate coupled with clinically important outcome measures such as inpatient mortality. The EDii dashboard helped unite both ED and inpatient teams in clinical redesign to improve both efficiencies of care and patient outcomes.

  17. Increased Endothelial Progenitor Cell Levels are Associated with Good Outcome in Intracerebral Hemorrhage

    PubMed Central

    Pías-Peleteiro, Juan; Pérez-Mato, María; López-Arias, Esteban; Rodríguez-Yáñez, Manuel; Blanco, Miguel; Campos, Francisco; Castillo, José; Sobrino, Tomás

    2016-01-01

    Circulating endothelial progenitor cells (EPCs) play a role in the regeneration of damaged brain tissue. However, the relationship between circulating EPC levels and functional recovery in intracerebral hemorrhage (ICH) has not yet been tested. Therefore, our aim was to study the influence of circulating EPCs on the outcome of ICH. Forty-six patients with primary ICH (males, 71.7%; age, 72.7 ± 10.8 years) were prospectively included in the study within 12 hours of symptom onset. The main outcome variable was good functional outcome at 12 months (modified Rankin scale ≤2), considering residual volume at 6 months as a secondary variable. Circulating EPC (CD34+/CD133+/KDR+) levels were measured by flow cytometry from blood samples obtained at admission, 72 hours and day 7. Our results indicate that patients with good outcome show higher EPC numbers at 72 hours and day 7 (all p < 0.001). However, only EPC levels at day 7 were independently associated with good functional outcome at 12 months (OR, 1.15; CI95%, 1.01–1.35) after adjustment by age, baseline stroke severity and ICH volume. Moreover, EPC levels at day 7 were negatively correlated to residual volume (r = −0.525; p = 0.005). In conclusion, these findings suggest that EPCs may play a role in the functional recovery of ICH patients. PMID:27346699

  18. Can the US minimum data set be used for predicting admissions to acute care facilities?

    PubMed

    Abbott, P A; Quirolgico, S; Candidate, D; Manchand, R; Canfield, K; Adya, M

    1998-01-01

    This paper is intended to give an overview of Knowledge Discovery in Large Datasets (KDD) and data mining applications in healthcare particularly as related to the Minimum Data Set, a resident assessment tool which is used in US long-term care facilities. The US Health Care Finance Administration, which mandates the use of this tool, has accumulated massive warehouses of MDS data. The pressure in healthcare to increase efficiency and effectiveness while improving patient outcomes requires that we find new ways to harness these vast resources. The intent of this preliminary study design paper is to discuss the development of an approach which utilizes the MDS, in conjunction with KDD and classification algorithms, in an attempt to predict admission from a long-term care facility to an acute care facility. The use of acute care services by long term care residents is a negative outcome, potentially avoidable, and expensive. The value of the MDS warehouse can be realized by the use of the stored data in ways that can improve patient outcomes and avoid the use of expensive acute care services. This study, when completed, will test whether the MDS warehouse can be used to describe patient outcomes and possibly be of predictive value.

  19. The impact of heat, cold, and heat waves on hospital admissions in eight cities in Korea.

    PubMed

    Son, Ji-Young; Bell, Michelle L; Lee, Jong-Tae

    2014-11-01

    Although the impact of temperature on mortality is well documented, relatively fewer studies have evaluated the associations of temperature with morbidity outcomes such as hospital admissions, and most studies were conducted in North America or Europe. We evaluated weather and hospital admissions including specific causes (allergic disease, asthma, selected respiratory disease, and cardiovascular disease) in eight major cities in Korea from 2003 to 2008. We also explored potential effect modification by individual characteristics such as sex and age. We used hierarchical modeling to first estimate city-specific associations between heat, cold, or heat waves and hospitalizations, and then estimated overall effects. Stratified analyses were performed by cause of hospitalization, sex, and age (0-14, 15-64, 65-74, and ≥75 years). Cardiovascular hospitalizations were significantly associated with high temperature, whereas hospitalizations for allergic disease, asthma, and selected respiratory disease were significantly associated with low temperature. The overall heat effect for cardiovascular hospitalization was a 4.5% (95% confidence interval 0.7, 8.5%) increase in risk comparing hospitalizations at 25 to 15 °C. For cold effect, the overall increase in risk of hospitalizations comparing 2 with 15 °C was 50.5 (13.7, 99.2%), 43.6 (8.9, 89.5%), and 53.6% (9.8, 114.9%) for allergic disease, asthma, and selected respiratory disease, respectively. We did not find statistically significant effects of heat waves compared with nonheat wave days. Our results suggest susceptible populations such as women and younger persons. Our findings provide suggestive evidence that both high and low ambient temperatures are associated with the risk of hospital admissions, particularly in women or younger person, in Korea.

  20. Seasonality of hospital admissions for mental disorders in Hanoi, Vietnam

    PubMed Central

    Trang, Phan Minh; Rocklöv, Joacim; Giang, Kim Bao; Nilsson, Maria

    2016-01-01

    Background Some studies have shown a relationship between seasonality in weather patterns and depressive and behavioural disorders, especially in temperate climate regions. However, there is a lack of studies describing the seasonal patterns of hospital admissions for a variety of mental disorders in tropical and subtropical nations. The aim of this study has been to examine the relationship between seasons and daily hospital admissions for mental disorders in Hanoi, Vietnam. Designs A 5-year database (2008–2012) compiled by Hanoi Mental Hospital covering mental disorder admissions diagnosed by the International Classification of Diseases 10 was analysed. A negative binominal regression model was applied to estimate the associations between seasonality and daily hospital admissions for mental disorders, for all causes and for specific diagnoses. Results The summer season indicated the highest relative risk (RR=1.24, confidence interval (CI)=1.1–1.39) of hospital admission for mental disorders, with a peak in these cases in June (RR=1.46, CI=1.19–1.7). Compared to other demographic groups, males and the elderly (aged over 60 years) were more sensitive to seasonal risk changes. In the summer season, the RR of hospital visits among men increased by 26% (RR=1.26, CI=1.12–1.41) and among the elderly by 23% (RR=1.23, CI=1.03–1.48). Furthermore, when temperatures including minimum, mean, and maximum increased 1°C, the number of cases for mental disorders increased by 1.7%, 2%, and 2.1%, respectively. Conclusion The study results showed a correlation between hospital admission for mental disorders and season. PMID:27566716

  1. Transformation of admission interview to documentation for nursing practice.

    PubMed

    Højskov, Ida E; Glasdam, Stinne

    2014-09-01

    The admission interview is usually the first structured meeting between patient and nurse. The interview serves as the basis for personalised nursing and care planning and is the starting point for the clinic's documentation of the patient and his course of treatment. In this way, admission interviews constitute a basis for reporting by each nurse on the patient to nursing colleagues. This study examined how, by means of the admission interview, nurses constructed written documentation of the patient and his course of treatment for use by fellow nurses. A qualitative case study inspired by Ricoeur was conducted and consisted of five taped admission interviews, along with the written patient documentation subsequently worked out by the nurse. The findings were presented in four constructed themes: Admission interviews are the nurse's room rather than the patient's; Information on a surgical object; The insignificant but necessary contact; and Abnormalities must be medicated. It is shown how the nurse's documentation was based on the admission interview, the medical record details on the patient (facts that are essential to know in relation to disease and treatment), as well as the nurse's preconception of how to live a good life, with or without disease. Often, the patient tended to become an object in the nurse's report. It is concluded that in practice, the applied documentation system, VIPS, comes to act as the framework for what is important to the nurse to document rather than a tool that enables her to document what is important to the individual patient and his special circumstances and encounter with the health system.

  2. Applying Memories of Reinforcement Outcomes Mainly to Pavlovian Conditioning

    ERIC Educational Resources Information Center

    Capaldi, E. J.; Martins, Ana P. G.

    2010-01-01

    A theory devised initially on the basis of instrumental reward schedule data, such as the PREE, was extended to deal with various Pavlovian findings. These Pavlovian findings include blocking, unblocking, relative validity, positive and negative patterning, renewal, reinstatement, reacquisition, and inhibition. In addition, the sequential model…

  3. Epicardial fat: definition, measurements and systematic review of main outcomes.

    PubMed

    Bertaso, Angela Gallina; Bertol, Daniela; Duncan, Bruce Bartholow; Foppa, Murilo

    2013-07-01

    Epicardial fat (EF) is a visceral fat deposit, located between the heart and the pericardium, which shares many of the pathophysiological properties of other visceral fat deposits, It also potentially causes local inflammation and likely has direct effects on coronary atherosclerosis. Echocardiography, computed tomography and magnetic resonance imaging have been used to evaluate EF, but variations between methodologies limit the comparability between these modalities. We performed a systematic review of the literature finding associations of EF with metabolic syndrome and coronary artery disease. The summarization of these associations is limited by the heterogeneity of the methods used and the populations studied, where most of the subjects were at high cardiovascular disease risk. EF is also associated with other known factors, such as obesity, diabetes mellitus, age and hypertension, which makes the interpretation of its role as an independent risk marker intricate. Based on these data, we conclude that EF is a visceral fat deposit with potential implications in coronary artery disease. We describe the reference values of EF for the different imaging modalities, even though these have not yet been validated for clinical use. It is still necessary to better define normal reference values and the risk associated with EF to further evaluate its role in cardiovascular and metabolic risk assessment in relation to other criteria currently used.

  4. Epicardial Fat: Definition, Measurements and Systematic Review of Main Outcomes

    PubMed Central

    Bertaso, Angela Gallina; Bertol, Daniela; Duncan, Bruce Bartholow; Foppa, Murilo

    2013-01-01

    Epicardial fat (EF) is a visceral fat deposit, located between the heart and the pericardium, which shares many of the pathophysiological properties of other visceral fat deposits, It also potentially causes local inflammation and likely has direct effects on coronary atherosclerosis. Echocardiography, computed tomography and magnetic resonance imaging have been used to evaluate EF, but variations between methodologies limit the comparability between these modalities. We performed a systematic review of the literature finding associations of EF with metabolic syndrome and coronary artery disease. The summarization of these associations is limited by the heterogeneity of the methods used and the populations studied, where most of the subjects were at high cardiovascular disease risk. EF is also associated with other known factors, such as obesity, diabetes mellitus, age and hypertension, which makes the interpretation of its role as an independent risk marker intricate. Based on these data, we conclude that EF is a visceral fat deposit with potential implications in coronary artery disease. We describe the reference values of EF for the different imaging modalities, even though these have not yet been validated for clinical use. It is still necessary to better define normal reference values and the risk associated with EF to further evaluate its role in cardiovascular and metabolic risk assessment in relation to other criteria currently used. PMID:23917514

  5. Admissions and Readmissions Related to Adverse Events, 2007-2014

    DTIC Science & Technology

    2015-12-01

    1.0 Pregnancy, childbirth and puerperium 1,071 2.3 107 0.5 4,172 7.5 5 0.4 816 1.9 5,525 4.3 Respiratory system 3,609 7.8 638 2.8 3,110 5.6 200 14.3...This study assessed adverse events as they relate to readmissions in the Military Health System (MHS). Among 142,579 admissions with an adverse event...The following study retrospectively assessed admissions and readmissions for adverse events in the Military Health System (MHS) by quantifying

  6. Self-organized call admission control for optical communication networks

    NASA Astrophysics Data System (ADS)

    Zuo, Bing; Liu, Lei; Wu, Jian; Lin, Jintong

    2008-11-01

    Call Admission Control (CAC) is widely used in optical communication networks to reduce network congestion. However, the conventional CAC scheme recommended by International Telecommunication Union -Telecommunication Standardization Sector (ITU-T) has a serious deficiency under high traffic load. In this paper, the disadvantage of conventional CAC scheme is analyzed in detail, and a Self-organized Call Admission Control (SCAC) scheme is proposed to solve this disadvantage. This scheme is accord with the principle of self-organization system, so it can be easily implemented in practice. Numerical results show that the proposed scheme can improve the network performance to a great extent.

  7. Admissible consensus for heterogeneous descriptor multi-agent systems

    NASA Astrophysics Data System (ADS)

    Yang, Xin-Rong; Liu, Guo-Ping

    2016-09-01

    This paper focuses on the admissible consensus problem for heterogeneous descriptor multi-agent systems. Based on algebra, graph and descriptor system theory, the necessary and sufficient conditions are proposed for heterogeneous descriptor multi-agent systems achieving admissible consensus. The provided conditions depend on not only the structure properties of each agent dynamics but also the topologies within the descriptor multi-agent systems. Moreover, an algorithm is given to design the novel consensus protocol. A numerical example demonstrates the effectiveness of the proposed design approach.

  8. A lexicographic approach to constrained MDP admission control

    NASA Astrophysics Data System (ADS)

    Panfili, Martina; Pietrabissa, Antonio; Oddi, Guido; Suraci, Vincenzo

    2016-02-01

    This paper proposes a reinforcement learning-based lexicographic approach to the call admission control problem in communication networks. The admission control problem is modelled as a multi-constrained Markov decision process. To overcome the problems of the standard approaches to the solution of constrained Markov decision processes, based on the linear programming formulation or on a Lagrangian approach, a multi-constraint lexicographic approach is defined, and an online implementation based on reinforcement learning techniques is proposed. Simulations validate the proposed approach.

  9. Chloride alterations in hospitalized patients: Prevalence and outcome significance

    PubMed Central

    Thongprayoon, Charat; Cheungpasitporn, Wisit; Cheng, Zhen

    2017-01-01

    Serum Cl (sCl) alterations in hospitalized patients have not been comprehensively studied in recent years. The aim of this study is to investigate the prevalence and outcome significance of (1) sCl alterations on hospital admission, and (2) sCl evolution within the first 48 hr of hospital admission. We conducted a retrospective study of all hospital admissions in the years 2011–2013 at Mayo Clinic Rochester, a 2000-bed tertiary medical center. Outcome measures included hospital mortality, length of hospital stay and discharge disposition. 76,719 unique admissions (≥18 years old) were studied. Based on hospital mortality, sCl in the range of 105–108 mmol/L was found to be optimal. sCl <100 (n = 13,611) and >108 (n = 11,395) mmol/L independently predicted a higher risk of hospital mortality, longer hospital stay and being discharged to a care facility. 13,089 patients (17.1%) had serum anion gap >12 mmol/L; their hospital mortality, when compared to 63,630 patients (82.9%) with anion gap ≤12 mmol/L, was worse. Notably, patients with elevated anion gap displayed a progressively worsening mortality with rising sCl. sCl elevation within 48 hr of admission was associated with a higher proportion of 0.9% saline administration and was an independent predictor for hospital mortality. Moreover, the magnitude of sCl rise was inversely correlated to the days of patient survival. In conclusion, serum Cl alterations on admission predict poor clinical outcomes. Post-admission sCl increase, due to Cl-rich fluid infusion, independently predicts hospital mortality. These results raise a critical question of whether iatrogenic cause of hyperchloremia should be avoided, a question to be addressed by future prospective studies. PMID:28328963

  10. Previous hospital admissions and disease severity predict the use of antipsychotic combination treatment in patients with schizophrenia

    PubMed Central

    2011-01-01

    Background Although not recommended in treatment guidelines, previous studies have shown a frequent use of more than one antipsychotic agent among patients with schizophrenia. The main aims of the present study were to explore the antipsychotic treatment regimen among patients with schizophrenia in a catchment area-based sample and to investigate clinical characteristics associated with antipsychotic combination treatment. Methods The study included 329 patients diagnosed with schizophrenia using antipsychotic medication. Patients were recruited from all psychiatric hospitals in Oslo. Diagnoses were obtained by use of the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Additionally, Global Assessment of Functioning (GAF), Positive and Negative Syndrome Scale (PANSS) and number of hospitalisations and pharmacological treatment were assessed. Results Multiple hospital admissions, low GAF scores and high PANSS scores, were significantly associated with the prescription of combination treatment with two or more antipsychotics. The use of combination treatment increased significantly from the second hospital admission. Combination therapy was not significantly associated with age or gender. Regression models confirmed that an increasing number of hospital admission was the strongest predictor of the use of two or more antipsychotics. Conclusions Previous hospital admissions and disease severity measured by high PANSS scores and low GAF scores, predict the use of antipsychotic combination treatment in patients with schizophrenia. Future studies should further explore the use of antipsychotic drug treatment in clinical practice and partly based on such data establish more robust treatment guidelines for patients with persistently high symptom load. PMID:21812996

  11. Short-term associations of fine particulate matter components and emergency hospital admissions among a privately insured population in Greater Houston

    NASA Astrophysics Data System (ADS)

    Liu, Suyang; Ganduglia, Cecilia M.; Li, Xiao; Delclos, George L.; Franzini, Luisa; Zhang, Kai

    2016-12-01

    A number of time-series studies have associated PM2.5 (particulate matter with aerodynamic diameter less than 2.5 μm) mass and components with various health outcomes. No studies have yet examined the associations between PM2.5 components and hospital admissions among a privately insured population. We estimated the short-term associations between exposure to PM2.5 mass and components and emergency hospital admissions for all-cause and cause-specific diseases in Greater Houston, Texas, during 2008-2013 using Blue Cross Blue Shield Texas claims data. A total of 90,085 emergency hospital admissions were included in this study, with an average of 34 ± 10 admissions per day. We selected 20 PM2.5 components from the U.S. Environmental Protection Agency's Chemical Speciation Network site located in Houston, and then applied Poisson regression models to assess the short-term effects of PM2.5 mass and species on emergency hospital admissions. Effects were estimated without adjustment for other airborne pollutants. PM2.5 mass was not statistically significantly associated with increased all-cause emergency hospital admissions and selected cause-specific admissions. For selected PM2.5 species, we found interquartile range increases in arsenic (0.001 μg/m3) and copper (0.017 μg/m3) were significantly (P < 0.05) associated with increased admissions for stroke, (5.98% [95% confidence interval (CI): 0.73, 11.50%]) and pneumonia (4.07% [95% CI: 0.37, 7.90%]), respectively. Seasonal analysis showed weak variation among PM2.5 mass and components, except that nickel significantly increased all-cause emergency hospital admissions (2.16% [95% CI: 0.21, 4.14%]) during the warm season. Our findings suggest that hospital admissions in the privately insured population are slightly affected by ambient fine particulate matter air pollution.

  12. Health conditions in a cohort of New Zealand Vietnam veterans: hospital admissions between 1988 and 2009

    PubMed Central

    Cox, Brian; Broughton, John; Tong, Darryl

    2015-01-01

    Objectives To inform the provision of support to veterans by analysing hospital discharge data, thereby identifying which conditions show an excess risk, require specific management strategies and deserve further investigation. Setting Tertiary level care, including all public and private New Zealand hospitals. Participants All New Zealand Vietnam veterans with service between 1964 and 1972. Primary outcome measures Standardised hospitalisation ratios (SHRs) were calculated based on the number of first observed hospital admissions for a condition, those expected being based on New Zealand national hospitalisation rates. Results The SHR for all causes of hospitalisation was 1.18, 95% CI 1.15 to 1.21, with modest increases for the major common causes, cardio and cerebrovascular disease. Admission rates for chronic renal failure and chronic obstructive pulmonary disease were highest in the 2006–2009 time period. The highest statistically significant hospitalisation risk was for alcohol-related mental disorder, SHR 1.91, 99% CI 1.39 to 2.43. Conclusions Chronic renal failure has limited attribution to veteran service but along with chronic obstructive pulmonary disease has the potential to have high costs both to the individual and the health system. We suggest that routine surveillance of veterans by way of a ‘flag’ in national and primary care databases would facilitate the recognition of service-related conditions and the appropriate provision of healthcare. PMID:26656012

  13. Is Poor Premorbid Functioning a Risk Factor for Suicide Attempts in First-Admission Psychosis?

    PubMed Central

    Bakst, Shelly; Rabinowitz, Jonathan; Bromet, Evelyn J.

    2009-01-01

    Background While poor premorbid functioning is associated with poorer outcomes in psychotic illnesses, little is known about whether it is also a risk factor for suicide attempts. Objective The current study examined the association of premorbid functioning and suicide attempts in a county-wide cohort of first admission inpatients. Method Data were derived from participants of the Suffolk County Mental Health Project (n=444) over the course of 48 month follow-up. Premorbid functioning was estimated and categorized (good vs. poor/declining) using the Premorbid Adjustment Scale (PAS). Results Poorer premorbid functioning was significantly associated with increased likelihood of a suicide attempt prior to first psychiatric hospital admission. Specifically, 33.0% of participants with poor/declining premorbid functioning had a history of suicide attempts compared to 23.5% with good premorbid functioning. Among participants with a prior attempt (n=126), poor premorbid functioning was significantly associated with an increased likelihood of additional attempts during the four years after first hospitalization. Conclusion Identifying those with poor premorbid functioning and prior histories of attempts could help clinicians target high-risk patients. Thus, greater attention to persons with both risk factors may form the basis for early interventions aimed towards reducing the risk for subsequent suicide attempts. PMID:19954930

  14. Should We Pay Attention to the Delay Before Admission to a Pediatric Intensive Care Unit for Children With Cancer? Impact on 1-Month Mortality. A Report From the French Children's Oncology Study Group, GOCE.

    PubMed

    Fausser, Jeanne-L; Tavenard, Aude; Rialland, Fanny; Le Moine, Philippe; Minckes, Odile; Jourdain, Anne; Tirel, Olivier; Pellier, Isabelle; Gandemer, Virginie

    2017-03-06

    Acute complications requiring admission to pediatric intensive care unit (PICU) are frequent for children with cancer. Our objective was to determine early prognostic factors of mortality in a cohort of children with cancer hospitalized in PICU for acute complications and particularly to assess whether the delay before admission to a PICU is an early predictor of mortality. We conduct a retrospective multicenter analysis. All patients transferred in PICU for acute complications between January 2002 and December 2012 were included. One-month mortality of the 224 patients analyzed was 24.5%. Delay before PICU admission was a significant prognostic factor of 1-month mortality with nonsurvivors experiencing a longer median delay than survivors (24 vs. 12 h, respectively, P<0.05). Time from diagnosis to PICU admission (P<0.001), hematopoietic stem cell transplant (P<0.05), the duration of neutropenia (P<0.01), infection type (P<0.001), number of organ dysfunctions (P<0.001), and reaching any grade 4 toxicity before PICU admission (P<0.001) also affected mortality rate at 1-month post-PICU discharge. In the multivariate analysis, only reaching any grade 4 toxicity before PICU admission influenced 1-month mortality (odds ratio, 2.30; 95% confidence interval, 1.07-4.96; P<0.05). These results suggest that PICU admission before severe impairment leads to a better outcome for children with cancer.

  15. Numerical simulation and analysis of the internal flow in a Francis turbine with air admission

    NASA Astrophysics Data System (ADS)

    Yu, A.; Luo, X. W.; Ji, B.

    2015-01-01

    In case of hydro turbines operated at part-load condition, vortex ropes usually occur in the draft tube, and consequently generate violent pressure fluctuation. This unsteady flow phenomenon is believed harmful to hydropower stations. This paper mainly treats the internal flow simulation in the draft tube of a Francis turbine. In order to alleviate the pressure fluctuation induced by the vortex rope, air admission from the main shaft center is applied, and the water-air two phase flow in the entire flow passage of a model turbine is simulated based on a homogeneous flow assumption and SST k-ω turbulence model. It is noted that the numerical simulation reasonably predicts the pressure fluctuations in the draft tube, which agrees fairly well with experimental data. The analysis based on the vorticity transport equation shows that the vortex dilation plays a major role in the vortex evolution with air admission in the turbine draft tube, and there is large value of vortex dilation along the vortex rope. The results show that the aeration with suitable air volume fraction can depress the vortical flow, and alleviate the pressure fluctuation in the draft tube.

  16. Airborne particulates and asthma: a Maine case study.

    PubMed

    Langley-Turnbaugh, Samantha J; Gordon, Nancy R; Lambert, Thomas

    2005-05-01

    Maine currently has the second fastest growing asthma rate in the nation 9.4% of the adult population has asthma and one out of eight children is affected. The factors behind this increase are poorly understood, but previous reports suggest that biologically soluble metal ions from particulate matter (PM10) may play a role in asthma episodes. In an effort to study this issue, we first identified geographic and temporal trends in Maine asthma hospitalizations. Clinical data show a strong fall peak in asthma admissions with weaker peaks in January and May, and a summer low in asthma admissions. Asthma admissions are also higher in the cities than in the rural areas in Maine. We then analysed PM10 collected by the Maine Department of Environmental Protection in three different Maine locations in the years 2000 and 2001, at times when clinical asthma data showed peaks and during the summer low period. We also collected soil samples in the same locations. The PM10 and soils were analysed for 10 metals by acid extraction to determine total metal content and then with cell culture medium, DMEM/F12+CCS growth medium, to determine metal biosolubility. Our results showed that Mn, Cu, Pb, As, V, Ni and Al were present in the Maine PM samples. V, Ni and Pb showed seasonal variation, while the others were relatively constant throughout the year. Pb and Al did not appear to be soluble in the biological medium. There was also variation from location to location with the urban area showing the highest concentrations for most metals. Aluminium was present in the highest concentration in soil samples, followed by Mn and V. Only Cu was biologically available in soils. We determined from M/Al ratios that most of the PM10 did not originate from local crustal material.

  17. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds §...

  18. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds §...

  19. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds §...

  20. 45 CFR 3.41 - Admission to facilities or grounds.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Admission to facilities or grounds. 3.41 Section 3.41 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Facilities and Grounds §...