Effective Strategies Urban Superintendents Utilize That Improve the Academic Achievement for African American Males

ERIC Educational Resources Information Center

Prioleau, Lushandra

2013-01-01

This study examined the effective strategies, resources, and programs urban superintendents utilize to improve the academic achievement for African-American males. This study employed a mixed-methods approach to answer the following research questions regarding urban superintendents and the academic achievement for African-American males: What…

Psychiatric nurses' beliefs, attitudes, and perceived barriers about medical emergency teams.

PubMed

Herisko, Camellia; Puskar, Kathryn; Mitchell, Ann M

2013-10-01

A literature review of nurses' attitudes, beliefs, and barriers regarding the medical emergency team (MET) process is limited to medical hospitals. How psychiatric nurses view the MET process and their prior experiences with METs are important because they are often the ones assessing the need for, and then calling, the MET. This article examines psychiatric nurses' attitudes, beliefs, and barriers toward the MET process in a 310-bed psychiatric hospital that is part of an urban academic medical center. Through the use of key informant interviews, nurses were asked for their feedback and input regarding the current MET practices. The results may be useful in improving the current operating system.

At-Risk Student Mobility in an Urban Elementary School: Effects on Academic Achievement

ERIC Educational Resources Information Center

Shoho, Alan R.; Oleszewski, Ashley

2010-01-01

The purpose of this study was to examine the impact of at-risk student mobility on academic achievement in an urban elementary school. Math and reading scores from the Texas Assessment of Academic Skills (TAAS) of 172 third, fourth, and fifth grade students from an urban school district in South Central Texas were examined to determine whether…

Urban Underrepresented Minority Students in Science, Technology, Engineering, and Math: An Analysis of the Differences between Developmental Assets and Academic Achievement

ERIC Educational Resources Information Center

Wells, Jovan Grant

2013-01-01

The purpose of this study is to determine the relationship between the developmental assets and academic achievement of urban underrepresented minority male and female students in a specialized science, technology, engineering, and math program, and the developmental assets and academic achievement of urban underrepresented minority male and…

Early Academic Skills and Childhood Experiences across the Urban-Rural Continuum

ERIC Educational Resources Information Center

Miller, Portia; Votruba-Drzal, Elizabeth

2013-01-01

The urban-rural continuum provides unique contexts for development. Differences in access to resources and childrearing norms and practices in urban, suburban, and rural areas may be linked to disparities in early achievement. Yet, few studies examine associations between urbanicity and children's early academic skills. Using nationally…

The Urban Nutrition Initiative: Bringing Academically-Based Community Service to the University of Pennsylvania's Department of Anthropology

ERIC Educational Resources Information Center

Johnston, Francis E.; Harkavy, Ira; Barg, Frances; Gerber, Danny; Rulf, Jennifer

2004-01-01

The Urban Nutrition Initiative (UNI) is a University of Pennsylvania/West Philadelphia schools academically-based community service program that integrates academics, research, and service through service-learning and participatory action research. UNI is based academically within Penn's Department of Anthropology and administratively within the…

Development of a medical academic degree system in China.

PubMed

Wu, Lijuan; Wang, Youxin; Peng, Xiaoxia; Song, Manshu; Guo, Xiuhua; Nelson, Hugh; Wang, Wei

2014-01-01

Context The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. Conclusion The future education reforms might include: 1) a domestic system of 'credits' that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International - a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord, setting up a system of easily comparable and well-understood medical degrees.

Development of a medical academic degree system in China.

PubMed

Wu, Lijuan; Wang, Youxin; Peng, Xiaoxia; Song, Manshu; Guo, Xiuhua; Nelson, Hugh; Wang, Wei

2014-01-01

The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. The future education reforms might include: 1) a domestic system of 'credits' that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International - a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord, setting up a system of easily comparable and well-understood medical degrees.

Development of a medical academic degree system in China

PubMed Central

Wu, Lijuan; Wang, Youxin; Peng, Xiaoxia; Song, Manshu; Guo, Xiuhua; Nelson, Hugh; Wang, Wei

2014-01-01

Context The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. Conclusion The future education reforms might include: 1) a domestic system of ‘credits’ that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International – a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord, setting up a system of easily comparable and well-understood medical degrees. PMID:24434025

General surgical services at an urban teaching hospital in Mozambique.

PubMed

Snyder, Elizabeth; Amado, Vanda; Jacobe, Mário; Sacks, Greg D; Bruzoni, Matias; Mapasse, Domingos; DeUgarte, Daniel A

2015-10-01

As surgery becomes incorporated into global health programs, it will be critical for clinicians to take into account already existing surgical care systems within low-income countries. To inform future efforts to expand the local system and systems in comparable regions of the developing world, we aimed to describe current patterns of surgical care at a major urban teaching hospital in Mozambique. We performed a retrospective review of all general surgery patients treated between August 2012 and August 2013 at the Hospital Central Maputo in Maputo, Mozambique. We reviewed emergency and elective surgical logbooks, inpatient discharge records, and death records to report case volume, disease etiology, and mortality. There were 1598 operations (910 emergency and 688 elective) and 2606 patient discharges during our study period. The most common emergent surgeries were for nontrauma laparotomy (22%) followed by all trauma procedures (18%), whereas the most common elective surgery was hernia repair (31%). The majority of lower extremity amputations were above knee (69%). The most common diagnostic categories for inpatients were infectious (31%), trauma (18%), hernia (12%), neoplasm (10%), and appendicitis (5%). The mortality rate was 5.6% (146 deaths), approximately half of which were related to sepsis. Our data demonstrate the general surgery caseload of a large, academic, urban training and referral center in Mozambique. We describe resource limitations that impact operative capacity, trauma care, and management of amputations and cancer. These findings highlight challenges that are applicable to a broad range of global surgery efforts. Copyright © 2015 Elsevier Inc. All rights reserved.

Robotic Telepresence in a Medical Intensive Care Unit—Clinicians' Perceptions

PubMed Central

Becevic, Mirna; Clarke, Martina A.; Alnijoumi, Mohammed M.; Sohal, Harjyot S.; Boren, Suzanne A.; Kim, Min S.; Mutrux, Rachel

2015-01-01

Background Robotic telepresence has been used for outsourcing of healthcare services for more than a decade; however, its use within an academic medical department is not yet widespread. Intensive care unit (ICU) robots can be used to increase access to off-site supervising physicians and other specialists, reducing possible wait time for difficult admissions and procedures. Objective To study the use of ICU robots through a pilot program in an academic hospital and examine provider attitudes toward the usability and effectiveness of an ICU robot. Materials and Methods The study was done as a postinterventional cross-sectional seven-question survey in a medical ICU in an urban academic hospital. Participants were attending physicians, fellows, residents, nurses, and respiratory therapists. Results Users of the ICU robot reported satisfaction with communication, and improved patient care. They also reported perceived improved quality of care with the use of the robot. Conclusions Findings show the importance of a whole-team approach to the installation and implementation of an ICU robot. The ICU robot is an effective tool when it is used to visualize and communicate with patients, bedside staff, and families. However, a number of providers are still not trained or have not been shown how to use the ICU robot, which affects the overall utilization rate. PMID:26396554

Robotic Telepresence in a Medical Intensive Care Unit--Clinicians' Perceptions.

PubMed

Becevic, Mirna; Clarke, Martina A; Alnijoumi, Mohammed M; Sohal, Harjyot S; Boren, Suzanne A; Kim, Min S; Mutrux, Rachel

2015-01-01

Robotic telepresence has been used for outsourcing of healthcare services for more than a decade; however, its use within an academic medical department is not yet widespread. Intensive care unit (ICU) robots can be used to increase access to off-site supervising physicians and other specialists, reducing possible wait time for difficult admissions and procedures. To study the use of ICU robots through a pilot program in an academic hospital and examine provider attitudes toward the usability and effectiveness of an ICU robot. The study was done as a postinterventional cross-sectional seven-question survey in a medical ICU in an urban academic hospital. Participants were attending physicians, fellows, residents, nurses, and respiratory therapists. Users of the ICU robot reported satisfaction with communication, and improved patient care. They also reported perceived improved quality of care with the use of the robot. Findings show the importance of a whole-team approach to the installation and implementation of an ICU robot. The ICU robot is an effective tool when it is used to visualize and communicate with patients, bedside staff, and families. However, a number of providers are still not trained or have not been shown how to use the ICU robot, which affects the overall utilization rate.

Academic Self-Concept and Academic Achievement of African American Students Transitioning from Urban to Rural Schools

ERIC Educational Resources Information Center

Bacon, La Shawn Catrice

2011-01-01

The relationship between academic self-concept and academic achievement in African American students who have experienced geographic mobility was the focus of this study. Specifically, this study used quantitative methods to assess African American students from counties in Iowa to obtain information about the students' relocation from urban to…

Treatment Patterns and Differences in Survival of Non-Small Cell Lung Cancer Patients Between Academic and Non-Academic Hospitals in the Netherlands.

PubMed

van der Linden, Naomi; Bongers, Mathilda L; Coupé, Veerle M H; Smit, Egbert F; Groen, Harry J M; Welling, Alle; Schramel, Franz M N H; Uyl-de Groot, Carin A

2017-09-01

The aims of this study are to analyze differences in survival between academic and non-academic hospitals and to provide insight into treatment patterns for non-small cell lung cancer (NSCLC). Results show the state of NSCLC survival and care in the Netherlands. The Netherlands Cancer Registry provided data on NSCLC survival for all Dutch hospitals. We used the Kaplan-Meier estimate to calculate median survival time by hospital type and a Cox proportional hazards model to estimate the relative risk of mortality (expressed as hazard ratios) for patients diagnosed in academic versus non-academic hospitals, with adjustment for age, gender, and tumor histology, and stratifying for disease stage. Data on treatment patterns in Dutch hospitals was obtained from 4 hospitals (2 academic, 2 non-academic). A random sample of patients diagnosed with NSCLC from January 2009 until January 2011 was identified through hospital databases. Data was obtained on patient characteristics, tumor characteristics, and treatments. The Cox proportional hazards model shows a significantly decreased hazard ratio of mortality for patients diagnosed in academic hospitals, as opposed to patients diagnosed in non-academic hospitals. This is specifically true for primary radiotherapy patients and patients who receive systemic treatment for non-metastasized NSCLC. Patients diagnosed in academic hospitals have better median overall survival than patients diagnosed in non-academic hospitals, especially for patients treated with radiotherapy, systemic treatment, or combinations. This difference may be caused by residual confounding since the estimates were not adjusted for performance status. A wide variety of surgical, radiotherapeutic, and systemic treatments is prescribed. Copyright © 2015 Elsevier Inc. All rights reserved.

Maritime Tactile Education for Urban Secondary Education Students

ERIC Educational Resources Information Center

Sulzer, Arthur Henry, IV

2012-01-01

Urban high-school students' low average level of academic achievement is a national problem. A lack of academic progress is a factor that contributes to students failing to graduate. In response to these urban high school student problems, a growing number of urban charter high schools have opened as an alternative to the traditional public high…

Physical Education and Academic Performance in Urban African American Girls

ERIC Educational Resources Information Center

Shen, Bo

2017-01-01

This study was designed to examine urban African American girls' participation in physical education and its association with academic performance. One hundred eighty four participants completed questionnaires assessing moderate-to-vigorous physical activity and learning engagement in physical education while their academic performance was based…

Predictors of Payer Mix and Financial Performance Among Safety Net Hospitals Prior to the Affordable Care Act.

PubMed

Sommers, Benjamin D; Stone, Juliana; Kane, Nancy

2016-01-01

The objective of this study was to use audited hospital financial statements to identify predictors of payer mix and financial performance in safety net hospitals prior to the Affordable Care Act. We analyzed the 2010 financial statements of 98 large, urban safety net hospital systems in 34 states, supplemented with data on population demographics, hospital features, and state policies. We used multivariate regression to identify independent predictors of three outcomes: 1) Medicaid-reliant payer mix (hospitals for which at least 25% of hospital days are paid for by Medicaid); 2) safety net revenue-to-cost ratio (Medicaid and Medicare Disproportionate Share Hospital payments and local government transfers, divided by charity care costs and Medicaid payment shortfall); and 3) operating margin. Medicaid-reliant payer mix was positively associated with more inclusive state Medicaid eligibility criteria and more minority patients. More inclusive Medicaid eligibility and higher Medicaid reimbursement rates positively predicted safety net revenue-to-cost ratio. University governance was the strongest positive predictor of operating margin. Safety net hospital financial performance varied considerably. Academic hospitals had higher operating margins, while more generous Medicaid eligibility and reimbursement policies improved hospitals' ability to recoup costs. Institutional and state policies may outweigh patient demographics in the financial health of safety net hospitals. © The Author(s) 2015.

Community-Based Academic Level I Trauma Center Prepares for the 2016 Republican National Convention.

PubMed

Keefe, Judy; Cern, Kathy; Wiita, Sharon; Raubenolt, Amy; Atkins, Elizabeth

Disaster preparedness has come to the forefront for hospitals since the 9/11 attacks in 2001. Many improvements have been made in emergency management and planning for catastrophic events. Both urban and community hospitals have the same responsibilities and commitments to their patients and communities. When the announcement was made that the 2016 Republican National Convention was going to be held in Cleveland, OH, Cleveland Clinic Akron General (CCAG) had to be confident in its abilities to handle any situation that might arise not just as a community hospital but also as a Level I trauma center. Organizing and preparing for more than a year, CCAG developed a detailed and well-thought-out preparedness program, with senior leadership implementing a clear chain of command. Developing and maintaining a strong and steady defense through detailed preparation, communication, teamwork, and organization are the keys to success.

An analysis of reference laboratory (send out) testing: an 8-year experience in a large academic medical center.

PubMed

MacMillan, Donna; Lewandrowski, Elizabeth; Lewandrowski, Kent

2004-01-01

Utilization of outside reference laboratories for selected laboratory testing is common in the United States. However, relatively little data exist in the literature describing the scope and impact of these services. In this study, we reviewed use of reference laboratory testing at the Massachusetts General Hospital, a large urban academic medical center in Boston, Massachusetts. A retrospective review of hospital and laboratory administrative records over an 8-year period from fiscal years (FY) 1995-2002. Over the 8 years studied, reference laboratory expenses increased 4.2-fold and totaled 12.4% of the total laboratory budget in FY 2002. Total reference laboratory test volume increased 4-fold to 68,328 tests in FY 2002 but represented only 1.06% of the total test volume in the hospital. The menu of reference laboratory tests comprised 946 tests (65.7% of the hospital test menu) compared to 494 (34.3%) of tests performed in house. The average unit cost of reference laboratory tests was essentially unchanged but was approximately 13 times greater than the average unit cost in the hospital laboratory. Much of the growth in reference laboratory cost can be attributed to the addition of new molecular, genetic, and microbiological assays. Four of the top 10 tests with the highest total cost in 2002 were molecular diagnostic tests that were recently added to the test menu. Reference laboratory testing comprises a major component of hospital clinical laboratory services. Although send out tests represent a small percentage of the total test volume, these services account for the majority of the hospital laboratory test menu and a disproportionate percentage of laboratory costs.

Medicaid Expansion Affects Rural And Urban Hospitals Differently.

PubMed

Kaufman, Brystana G; Reiter, Kristin L; Pink, George H; Holmes, George M

2016-09-01

Rural hospitals differ from urban hospitals in many ways. For example, rural hospitals are more reliant on public payers and have lower operating margins. In addition, enrollment in the health insurance Marketplaces of the Affordable Care Act (ACA) has varied across rural and urban areas. This study employed a difference-in-differences approach to evaluate the average effect of Medicaid expansion in 2014 on payer mix and profitability for urban and rural hospitals, controlling for secular trends. For both types of hospitals, we found that Medicaid expansion was associated with increases in Medicaid-covered discharges. However, the increases in Medicaid revenue were greater among rural hospitals than urban hospitals, and the decrease in the proportion of costs for uncompensated care were greater among urban hospitals than rural hospitals. This preliminary analysis of the early effects of Medicaid expansion suggests that its financial impacts may be different for hospitals in urban and rural locations. Project HOPE—The People-to-People Health Foundation, Inc.

Cultivating the Academic Integrity of Urban Adolescents with Ethical Philosophy Programming

ERIC Educational Resources Information Center

Seider, Scott; Novick, Sarah; Gomez, Jessica

2013-01-01

This mixed-methods study considered the effects of ethical philosophy programming at a high-performing, high-poverty urban high school upon the academic integrity of participating adolescents ("n" = 279). Analyses of pre-post survey data revealed that participating adolescents reported significantly higher levels of academic integrity…

"I Have to Be Three Steps Ahead": Academically Gifted African American Male Students in an Urban High School on the Tension between an Ethnic and Academic Identity

ERIC Educational Resources Information Center

Graham, Anthony; Anderson, Kenneth A.

2008-01-01

This case study investigation of three Academically Gifted African American male high school seniors in a predominantly African American urban high school examines the interplay between their ethnic and academic identity. Using an embedded micro-ethnographic approach, we explore the extent to which these students value educational attainment, the…

The Generosity of an Urban Professoriate: Understanding Faculty as Donors and Academic Citizens

ERIC Educational Resources Information Center

Shaker, Genevieve G.

2013-01-01

Although faculties are often portrayed as institutionally uninvolved, evidence exists that many of them are actually academic citizens who contribute beyond requirements and expectations. Using a phenomenological approach to examine major giving by faculty and their academic citizenship at an urban university, this study of limited sample size…

Challenging Social Work Education's Urban Legends

ERIC Educational Resources Information Center

Colby, Ira

2014-01-01

Urban legends circulate throughout society, including higher education and social work education. Some academic mythologies take on the status of a tradition--no matter the evidence or lack thereof--and continue to thrive, to influence thinking, and to shape norms, which, in turn, direct behaviors. As with urban legends, academic myths are able to…

Perceived School and Neighborhood Safety, Neighborhood Violence and Academic Achievement in Urban School Children

ERIC Educational Resources Information Center

Milam, A. J.; Furr-Holden, C. D. M.; Leaf, P. J.

2010-01-01

Community and school violence continue to be a major public health problem, especially among urban children and adolescents. Little research has focused on the effect of school safety and neighborhood violence on academic performance. This study examines the effect of the school and neighborhood climate on academic achievement among a population…

Early Lessons for Planning and Implementing a Program to Prepare Urban Special Education Academic Leaders

ERIC Educational Resources Information Center

Barbetta, Patricia; Cramer, Elizabeth; Nevin, Ann; Moores-Abdool, Whitney

2006-01-01

The mission for Urban SEALS (Special Education Academic Leaders), a federally funded doctoral preparation program, is to prepare doctoral-level special educators, including those who are culturally and/or linguistically diverse (CLD) to assume leadership roles in the education of urban students with disabilities who are CLD. This paper provides…

Success in One High-Poverty, Urban Elementary School: A Case Study

ERIC Educational Resources Information Center

Holman, Shavonna Leigh

2011-01-01

The purpose of this qualitative study was to explore the efforts implemented in a high-poverty, urban elementary school in order to increase academic achievement. The central research question was: (1) How do teachers and administrators in a high-poverty, urban school describe the strategies they use to achieve academic success? The sub-questions…

Uninsured Hospitalizations: Rural and Urban Differences

ERIC Educational Resources Information Center

Zhang, Wanqing; Mueller, Keith J.; Chen, Li-Wu

2008-01-01

Context: Few studies have examined hospitalization patterns among the uninsured, especially from the perspective of rural and urban differences. Purpose: To examine whether the patterns of uninsured hospitalizations differ in rural and urban hospitals and to identify the most prevalent and costly diagnoses among uninsured hospitalizations.…

Financial Performance of Academic Health Center Hospitals, 1994-2000.

ERIC Educational Resources Information Center

Dobson, Allen; Koenig, Lane; Sen, Namrata; Ho, Silver; Gilani, Jawaria

This study examined how competitive market dynamics between 1994 and 2000 have affected the financial stability of Academic Health Center (AHC) hospitals and their ability to support their academic and social missions. It looked at the financial challenges facing AHC hospitals through a survey involving 1,138 teaching hospitals. Findings…

Attributable inpatient costs of recurrent Clostridium difficile infections.

PubMed

Dubberke, Erik R; Schaefer, Eric; Reske, Kimberly A; Zilberberg, Marya; Hollenbeak, Christopher S; Olsen, Margaret A

2014-11-01

To determine the attributable inpatient costs of recurrent Clostridium difficile infections (CDIs). Retrospective cohort study. Academic, urban, tertiary care hospital. A total of 3,958 patients aged 18 years or more who developed an initial CDI episode from 2003 through 2009. Data were collected electronically from hospital administrative databases and were supplemented with chart review. Patients with an index CDI episode during the study period were followed up for 180 days from the end of their index hospitalization or the end of their index CDI antibiotic treatment (whichever occurred later). Total hospital costs during the outcome period for patients with recurrent versus a single episode of CDI were analyzed using zero-inflated lognormal models. There were 421 persons with recurrent CDI (recurrence rate, 10.6%). Recurrent CDI case patients were significantly more likely than persons without recurrence to have any hospital costs during the outcome period (P < .001). The estimated attributable cost of recurrent CDI was $11,631 (95% confidence interval, $8,937-$14,588). The attributable costs of recurrent CDI are considerable. Patients with recurrent CDI are significantly more likely to have inpatient hospital costs than patients who do not develop recurrences. Better strategies to predict and prevent CDI recurrences are needed.

An Evaluation of Training for Lay Providers in the Use of Motivational Interviewing to Promote Academic Achievement among Urban Youth

ERIC Educational Resources Information Center

Simon, Patricia; Ward, Nadia L.

2014-01-01

This study examined training outcomes for lay service providers who participated in a motivational interviewing (MI) training program designed to help increase intrinsic motivation and academic achievement among urban, low-income minority youth. Seventeen lay academic advisors received 16 hours of workshop training in MI. Additionally, two 2-hour…

The Relationship between Bible Literacy and Behavioral and Academic Outcomes in Urban Areas: A Meta-Analysis

ERIC Educational Resources Information Center

Jeynes, William

2010-01-01

A meta-analysis is undertaken, including 11 studies, to determine whether there is a relationship between Bible knowledge on one hand and academic and behavioral outcomes on the other among those living in urban areas. The results indicate that increased Bible knowledge is associated with higher levels of student academic achievement and positive…

An Exploratory Study of Value-Added and Academic Optimism of Urban Reading Teachers

ERIC Educational Resources Information Center

Huff-Franklin, Clairie L.

2017-01-01

The purpose of this study is to explore the correlation between state-recorded value- added (VA) scores and academic optimism (AO) scores, which measure teacher self-efficacy, trust, and academic emphasis. The sample for this study is 87 third through eighth grade Reading teachers, from fifty-five schools, in an urban school district in Ohio who…

Rural vs urban hospital performance in a 'competitive' public health service.

PubMed

Garcia-Lacalle, Javier; Martin, Emilio

2010-09-01

In some western countries, market-driven reforms to improve efficiency and quality have harmed the performance of some hospitals, occasionally leading to their closure, mostly in rural areas. This paper seeks to explore whether these reforms affect urban and rural hospitals differently in a European health service. Rural and urban hospital performance is compared taking into account their efficiency and perceived quality. The study is focused on the Andalusian Health Service (SAS) in Spain, which has implemented a freedom of hospital choice policy and a reimbursement system based on hospital performance. Data Envelopment Analysis, the Mann-Whitney U test and Multidimensional Scaling techniques are conducted for two years, 2003 and 2006. The results show that rural and urban hospitals perform similarly in the efficiency dimension, whereas rural hospitals perform significantly better than urban hospitals in the patient satisfaction dimension. When the two dimensions are considered jointly, some rural hospitals are found to be the best performers. As such, market-driven reforms do not necessary result in a difference in the performance of rural and urban hospitals. Copyright 2010 Elsevier Ltd. All rights reserved.

Senge's Learning Organization and Teachers' Perceptions of Leadership at an Elementary School in Urban Ohio

ERIC Educational Resources Information Center

Moore, Robert J.

2010-01-01

Urban public schools in the United States face the problem of failure to reach academic goals of performance mandated by the No Child Left Behind Act. It was hypothesized that use of Senge's leadership model might result in academic performance in one urban elementary school. Based on Senge's shared vision leadership model as the theoretical…

Biometeorology for cities.

PubMed

Hondula, David M; Balling, Robert C; Andrade, Riley; Scott Krayenhoff, E; Middel, Ariane; Urban, Aleš; Georgescu, Matei; Sailor, David J

2017-09-01

Improvements in global sustainability, health, and equity will largely be determined by the extent to which cities are able to become more efficient, hospitable, and productive places. The development and evolution of urban areas has a significant impact on local and regional weather and climate, which subsequently affect people and other organisms that live in and near cities. Biometeorologists, researchers who study the impact of weather and climate on living creatures, are well positioned to help evaluate and anticipate the consequences of urbanization on the biosphere. Motivated by the 60th anniversary of the International Society of Biometeorology, we reviewed articles published in the Society's International Journal of Biometeorology over the period 1974-2017 to understand if and how biometeorologists have directed attention to urban areas. We found that interest in urban areas has rapidly accelerated; urban-oriented articles accounted for more than 20% of all articles published in the journal in the most recent decade. Urban-focused articles in the journal span five themes: measuring urban climate, theoretical foundations and models, human thermal comfort, human morbidity and mortality, and ecosystem impacts. Within these themes, articles published in the journal represent a sizeable share of the total academic literature. More explicit attention from urban biometeorologists publishing in the journal to low- and middle-income countries, indoor environments, animals, and the impacts of climate change on human health would help ensure that the distinctive perspectives of biometeorology reach the places, people, and processes that are the foci of global sustainability, health, and equity goals.

Web 2.0 Tools and Academic Literacy Development in a US Urban School: A Case Study of a Second-Grade English Language Learner

ERIC Educational Resources Information Center

Shin, Dong-shin

2014-01-01

This study explores a second-grade English language learner's literacy development and ability to use blogging for social and academic purposes, in the context of learning academic writing genres in a US urban school. Grounded in sociocultural theories, it conceptualizes learning as appropriation, and language as a dynamic and functional system of…

Clinical microsystems, Part 3. Transformation of two hospitals using microsystem, mesosystem, and macrosystem strategies.

PubMed

Godfrey, Marjorie M; Melin, Craig N; Muething, Stephen E; Batalden, Paul B; Nelson, Eugene C

2008-10-01

Two hospitals-a large, urban academic medical center and a rural, community hospital-have each chosen a similar microsystem-based approach to improvement, customizing the engagement of the micro-, meso-, and macrosystems and the improvement targets on the basis of an understanding of the local context. CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER (CCHMC): Since 2004, strategic changes have been developed to support microsystems and their leaders through (1) ongoing improvement training for all macro-, meso-, and microsystem leaders; (2) financial support for physicians who are serving as co-leaders of clinical microsystems; (3) increased emphasis on aligning academic pursuits with improvement work at the clinical front lines; (4) microsystem leaders' continuous access to unit-level data through the organization's intranet; and (5) encouragement of unit leaders to share outcomes data with families. CDH has moved from near closure to a survival-turnaround focus, significant engagement in quality and finally, a complete reframing of a quality focus in 2004. Since then, it has deployed the clinical microsystems approach in one pilot care unit (West 2, a medical surgery unit), broadened it to two, then six more, and is now spreading it organizationwide. In "2+2 Charters," interdisciplinary teams address two strategic goals set by senior leadership and two goals set by frontline microsystem leaders and staff CCHMC and CDH have had a clear focus on developing alignment, capability, and accountability to fuse together the work at all levels of the hospital, unifying the macrosystem with the mesosystem and microsystem. Their improvement experience suggests tips and actions at all levels of the organization that could be adapted with specific context knowledge by others.

Emergency Childcare for Hospital Workers During Disasters.

PubMed

Charney, Rachel L; Rebmann, Terri; Flood, Robert G

2015-12-01

The objectives were to determine the impact of emergency childcare (EC) needs on health care workers' ability and likelihood to work during a pandemic versus an earthquake as well as to determine the anticipated need and expected use of an on-site, hospital-provided EC program. An online survey was distributed to all employees of an academic, urban pediatric hospital. Two disaster scenarios were presented (pandemic influenza and earthquake). Ability to work based on childcare needs, planned use of proposed hospital-provided EC, and demographics of children being brought in were obtained. A total of 685 employees participated (96.6% female, 79.6% white), with a 40% response rate. Those with children (n = 307) reported that childcare needs would affect their work decisions during a pandemic more than an earthquake (61.1% vs 56.0%; t = 3.7; P < 0.001). Only 28.0% (n = 80) of those who would need childcare (n = 257) report an EC plan. The scenario did not impact EC need or planned use; during scheduled versus unscheduled shifts, 40.7% versus 63.0% reported need for EC, and 50.8% versus 63.2% reported anticipated using EC. Hospital workers have a high anticipated use of hospital-provided EC. Provisions for EC should be an integral part of hospital disaster planning.

Infection prevention needs assessment in Colorado hospitals: rural and urban settings.

PubMed

Reese, Sara M; Gilmartin, Heather; Rich, Karen L; Price, Connie S

2014-06-01

The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training. Surveys were received from 62 hospitals (77.5% response); 33 rural (75.0% response) and 29 urban (80.6% response). Fifty-two percent of rural ICPs reported multiple job responsibilities compared with 17.2% of urban ICPs. Median length of experience for rural ICPs was 4.0 years compared with 11.5 years for urban ICPs (P = .008). Fifty-one percent of rural ICPs reported no access to infectious disease physicians (0.0% urban) and 81.8% of rural hospitals reported no antimicrobial stewardship programs (31.0% urban). Through the interviews it was revealed that priorities for rural ICPs were training and communication. Our study revealed numerous differences between infection prevention programs in rural versus urban hospitals. An infection prevention outreach program established in Colorado could potentially address the challenges faced by rural hospital infection prevention departments. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Paediatric case mix in a rural clinical school is relevant to future practice.

PubMed

Wright, Helen M; Maley, Moira A L; Playford, Denese E; Nicol, Pam; Evans, Sharon F

2017-11-29

Exposure to a representative case mix is essential for clinical learning, with logbooks established as a way of demonstrating patient contacts. Few studies have reported the paediatric case mix available to geographically distributed students within the same medical school. Given international interest in expanding medical teaching locations to rural contexts, equitable case exposure in rural relative to urban settings is topical. The Rural Clinical School of Western Australia locates students up to 3500 km from the urban university for an academic year. There is particular need to examine paediatric case mix as a study reported Australian graduates felt unprepared for paediatric rotations. We asked: Does a rural clinical school provide a paediatric case mix relevant to future practice? How does the paediatric case mix as logged by rural students compare with that by urban students? The 3745 logs of 76 urban and 76 rural consenting medical students were categorised by presenting symptoms and compared to the Australian Institute of Health and Welfare (AIHW) database Major Diagnostic Categories (MDCs). Rural and urban students logged core paediatric cases, in similar order, despite the striking difference in geographic locations. The pattern of overall presenting problems closely corresponded to Australian paediatric hospital admissions. Rural students logged 91% of cases in secondary healthcare settings; urban students logged 90% of cases in tertiary settings. The top four presenting problems were ENT/respiratory, gastrointestinal/urogenital, neurodevelopmental and musculoskeletal; these made up 60% of all cases. Rural and urban students logged similar proportions of infants, children and adolescents, with a variety of case morbidity. Rural clinical school students logged a mix of core paediatric cases relevant to illnesses of Australian children admitted to public hospitals, with similar order and pattern by age group to urban students, despite major differences in clinical settings. Logged cases met the curriculum learning outcomes of graduates. Minor variations were readily addressed via recommendations about logging. This paper provides evidence of the legitimacy of student logs as useful tools in affirming appropriate paediatric case mix. It validates the rural clinical school context as appropriate for medical students to prepare for future clinical paediatric practice.

The Impact of Trauma Exposure and Post-Traumatic Stress Disorder on Healthcare Utilization Among Primary Care Patients

PubMed Central

Kartha, Anand; Brower, Victoria; Saitz, Richard; Samet, Jeffrey H.; Keane, Terence M.; Liebschutz, Jane

2009-01-01

Background Trauma exposure and post-traumatic stress disorder (PTSD) increase healthcare utilization in veterans, but their impact on utilization in other populations is uncertain. Objectives To examine the association of trauma exposure and PTSD with healthcare utilization, in civilian primary care patients. Research Design Cross-sectional study. Subjects English speaking patients at an academic, urban primary care clinic. Measures Trauma exposure and current PTSD diagnoses were obtained from the Composite International Diagnostic Interview. Outcomes were nonmental health outpatient and emergency department visits, hospitalizations, and mental health outpatient visits in the prior year from an electronic medical record. Analyses included bivariate unadjusted and multivariable Poisson regressions adjusted for age, gender, income, substance dependence, depression, and comorbidities. Results Among 592 subjects, 80% had ≥1 trauma exposure and 22% had current PTSD. In adjusted regressions, subjects with trauma exposure had more mental health visits [incidence rate ratio (IRR), 3.9; 95% confidence interval (CI), 1.1–14.1] but no other increased utilization. After adjusting for PTSD, this effect of trauma exposure was attenuated (IRR, 3.2; 95% CI, 0.9–11.7). Subjects with PTSD had more hospitalizations (IRR, 2.2; 95% CI, 1.4–3.7), more hospital nights (IRR, 2.6; 95% CI, 1.4–5.0), and more mental health visits (IRR, 2.2; 95% CI, 1.1–4.1) but no increase in outpatient and emergency department visits. Conclusions PTSD is associated with more hospitalizations, longer hospitalizations, and greater mental healthcare utilization in urban primary care patients. Although trauma exposure is independently associated with greater mental healthcare utilization, PTSD mediates a portion of this association. PMID:18362818

An Examination of the Influence of Self Efficacy, Locus of Control, and Perceptions of Parent Involvement on Academic Achievement of Urban High School Students

ERIC Educational Resources Information Center

Myree, Claudia

2011-01-01

Current research indicates that there is an on-going concern for the graduation rate of African American students in urban settings. This particular study sought to investigate the impact of students' self-efficacy, locus of control, and parental involvement on academic achievement via a targeted sample of urban African American high school…

Impact of case type, length of stay, institution type, and comorbidities on Medicare diagnosis-related group reimbursement for adult spinal deformity surgery.

PubMed

Nunley, Pierce D; Mundis, Gregory M; Fessler, Richard G; Park, Paul; Zavatsky, Joseph M; Uribe, Juan S; Eastlack, Robert K; Chou, Dean; Wang, Michael Y; Anand, Neel; Frank, Kelly A; Stone, Marcus B; Kanter, Adam S; Shaffrey, Christopher I; Mummaneni, Praveen V

2017-12-01

OBJECTIVE The aim of this study was to educate medical professionals about potential financial impacts of improper diagnosis-related group (DRG) coding in adult spinal deformity (ASD) surgery. METHODS Medicare's Inpatient Prospective Payment System PC Pricer database was used to collect 2015 reimbursement data for ASD procedures from 12 hospitals. Case type, hospital type/location, number of operative levels, proper coding, length of stay, and complications/comorbidities (CCs) were analyzed for effects on reimbursement. DRGs were used to categorize cases into 3 types: 1) anterior or posterior only fusion, 2) anterior fusion with posterior percutaneous fixation with no dorsal fusion, and 3) combined anterior and posterior fixation and fusion. RESULTS Pooling institutions, cases were reimbursed the same for single-level and multilevel ASD surgery. Longer stay, from 3 to 8 days, resulted in an additional $1400 per stay. Posterior fusion was an additional $6588, while CCs increased reimbursement by approximately $13,000. Academic institutions received higher reimbursement than private institutions, i.e., approximately $14,000 (Case Types 1 and 2) and approximately $16,000 (Case Type 3). Urban institutions received higher reimbursement than suburban institutions, i.e., approximately $3000 (Case Types 1 and 2) and approximately $3500 (Case Type 3). Longer stay, from 3 to 8 days, increased reimbursement between $208 and $494 for private institutions and between $1397 and $1879 for academic institutions per stay. CONCLUSIONS Reimbursement is based on many factors not controlled by surgeons or hospitals, but proper DRG coding can significantly impact the financial health of hospitals and availability of quality patient care.

Economic viability of geriatric hip fracture centers.

PubMed

Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

2013-12-01

Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers.

Academic Hospitality

ERIC Educational Resources Information Center

Phipps, Alison; Barnett, Ronald

2007-01-01

Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

Environmental market factors associated with electronic health record adoption among cancer hospitals.

PubMed

Tarver, Will L; Menachemi, Nir

2017-02-22

Although recent literature has explored the relationship between various environmental market characteristics and the adoption of electronic health records (EHRs) among general, acute care hospitals, no such research currently exists for specialty hospitals, including those providing cancer care. The aim of the study was to examine the relationship between market characteristics and the adoption of EHRs among Commission on Cancer (CoC)-accredited hospitals. Secondary data on EHR adoption combined with hospital and environmental market characteristics were analyzed using logistic regression. Using the resource dependence theory, we examined how measures of munificence, complexity, and dynamism are related to the adoption of EHRs among CoC-accredited hospitals and, separately, hospitals not CoC-accredited. In a sample of 2,670 hospitals, 141 (0.05%) were academic-based CoC-accredited hospitals and 562 (21%) were community-based CoC-accredited hospitals. Measures of munificence such as cancer incidence rates (OR = 0.99, CI [0.99, 1.00], p = .020) and percentage population aged 65+ (OR = 0.99, CI [0.99, 1.00], p = .001) were negatively associated with basic EHR adoption, whereas urban location was positively associated with comprehensive EHR adoption (OR = 3.07, CI [0.89, 10.61], p = .076) for community-based CoC-accredited hospitals. Measures of complexity such as hospitals in areas with less competition were less likely to adopt a basic EHR (OR = 0.33, CI [0.19, 0.96], p = .005), whereas Medicare Managed Care penetration was positively associated with comprehensive EHR adoption (OR = 1.02, CI [1.00, 1.05], p = .070) among community-based CoC-accredited hospitals. Lastly, dynamism, measured as population change, was negatively associated with the adoption of comprehensive EHRs (OR = 0.99, CI [0.99, 1.00], p = .070) among academic-based CoC-accredited hospitals. A greater understanding of the environment's relationship to health information technology adoption in cancer hospitals will help stakeholders in these institutions make informed strategic decisions about information technology investments guided by their facilities' respective environmental factors. The results of this study may also be useful to hospital chief information officers and chief executive officers seeking to either improve their quality of care or achieve and maintain accreditation in providing cancer care.

Insular pathways to health care in the city: a multilevel analysis of access to hospital care in urban Kerala, India.

PubMed

Levesque, Jean-Frédéric; Haddad, Slim; Narayana, Delampady; Fournier, Pierre

2007-07-01

To identify individual and urban unit characteristics associated with access to inpatient care in public and private sectors in urban Kerala, and to discuss policy implications of inequalities in access. We analysed the NSSO survey (1995-1996) for urban Kerala with regard to source and trajectories of hospitalization. Multinomial multilevel regression models were built for 695 cases nested in 24 urban units. Private sector accounts for 62% of hospitalizations. Only 31% of hospitalizations are in free wards and 20% of public hospitalizations involve payment. Hospitalization pathways suggest a segmentation of public and private health markets. Members of poor and casual worker households have lower propensity of hospitalization in paying public wards or private hospitals. There were important variations between cities, with higher odds of private hospitalization in towns with fewer hospital beds overall and in districts with high private-public bed ratios. Cities from districts with better economic indicators and dominance of private services have higher proportion of private hospitalizations. The private sector is the predominant source of inpatient care in urban Kerala. The public sector has an important role in providing access to care for the poor. Investing in the quality of public services is essential to ensure equity in access.

A case study of the counterpart technical support policy to improve rural health services in Beijing.

PubMed

Jian, Weiyan; Chan, Kit Yee; Tang, Shunv; Reidpath, Daniel D

2012-12-29

There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural-urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Significant reductions in rural-urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural-urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural-urban gap in hospital efficiency. The strategy for reducing urban-rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated.

I Know Who I Am, Do You?: Identity and Academic Achievement of Successful African American Male Adolescents in an Urban Pilot High School in the United States

ERIC Educational Resources Information Center

Wright, Brian L.

2011-01-01

This study explores racial-ethnic identity and academic achievement of five young African American men in 11th and 12th grade in an urban pilot high school. Data gathered through individual and group interviews and a questionnaire were analyzed to understand how academically successful African American male adolescents interpret their social and…

Self-Concept Development in Rural and Urban Students.

ERIC Educational Resources Information Center

Velasco-Barraza, Carlos; Muller, Douglas

1982-01-01

Using the Self-Descriptive Inventory, compares development of self-concept, self-esteem, self-ideal in physical maturity, peer relations, academic success, school adaptiveness in 50 rural children (Hatch, New Mexico) and 50 urban children (Las Cruces New Mexico). Finds negative patterns in academic success and school adaptiveness more pronounced…

Virtual Urbanism.

ERIC Educational Resources Information Center

Sirc, Geoffrey

2001-01-01

Considers how visual literacy implies a poetics of technology, one rooted in basic human passion. Notes that most academic forms sanctioned for students to inhabit are as monumentally dull as the urban forms in which they pass an extra-academic portion of their lives. Concludes that technology is most useful when it allows the poetic spirit to…

The Relationship between Black Racial Identity and Academic Achievement in Urban Settings

ERIC Educational Resources Information Center

Harper, Brian E.

2007-01-01

This article examines the relationship between Black racial identity and academic achievement in urban settings. Using Mary Shelley's Frankenstein (1918) as a comparative framework, the author describes current practices and suggests practical applications of empirical findings for practicing classroom teachers of African American students.…

The Seven Secrets of Successful Urban School Students: The Evidence Continues to Grow

ERIC Educational Resources Information Center

Hampton, Frederick M.

2016-01-01

This article identifies seven specific attitudes, behaviors, and skills among academically successful urban Black students and explores the relationship to their achievement. This study examines the academic achievement of 157 Black students and finds that when specific "Successful Learner Characteristics" are present, above-average…

A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

PubMed

Symonds, Erin L; Simpson, Kalindra; Coats, Michelle; Chaplin, Angela; Saxty, Karen; Sandford, Jayne; Young Am, Graeme P; Cock, Charles; Fraser, Robert; Bampton, Peter A

2018-06-18

To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

Project RED Impacts Patient Experience.

PubMed

Cancino, Ramon S; Manasseh, Chris; Kwong, Lana; Mitchell, Suzanne E; Martin, Jessica; Jack, Brian W

2017-12-01

Hospitalized patients are frequently unprepared to care for themselves after discharge often leading to unplanned hospital readmission. One strategy to reduce readmission rates is improving the quality of patient education and preparation before hospital discharge. The ReEngineered Discharge (RED) is a standardized hospital-based program designed to provide patients and caregivers the information they need to continue care at home. We sought to study the impact of the RED intervention on posthospitalization adult patient experience scores in an urban academic safety-net hospital. We conducted a descriptive study of a pilot program that compared posthospitalization survey responses to the Press Ganey survey item "Instructions were given about how to care for yourself at home." We compared the survey results for 3 groups of adult patients: those receiving the RED program, those receiving a standard discharge on the same hospital unit, and those receiving a standard discharge on other hospital units. A greater percentage of adult patients who received the RED discharge program rated the quality of their discharge as "very good" as compared to those receiving a standard discharge on the same hospital unit and those receiving a standard discharge on other hospital units (61%, 35%, and 41%, respectively, P = .0001). Delivery of a standardized hospital discharge program resulted in a larger proportion of top-box "very good" responses on a Press Ganey posthospitalization survey. Future research should examine whether hospital-based transition programs can sustain improvement in patient experience measures and whether these improvements can be observed in other patient populations.

A comparison of future recruitment needs in urban and rural hospitals: the rural imperative.

PubMed

Williams, Thomas E; Satiani, Bhagwan; Ellison, E Christopher

2011-10-01

The potential impact of shortages of the surgical workforce on both urban and rural hospitals is undefined. There is a predicted shortage of 30,000 surgeons by 2030 and the need to train and hire more than 100,000 surgeons. The aim of this study is to estimate the average recruitment needs in our nation's hospitals for 7 surgical specialties to ensure adequate access to surgical care as the U.S. population grows to 364 million by 2030. We used the census figure of 309 million in 2010 for U.S. population. Currently there are estimated to be 3,012 urban hospitals and 1,998 rural hospitals in the U.S. (American Hospital Association's Trend Watch report, 2009). At 253 million people (82 % of the population of 309 million in 2010) receive healthcare in urban hospitals; 56 million people receive healthcare in rural hospitals (18%). We assumed a work force model based on our previous publications, equal population growth in all geographic areas, recruitment by rural hospitals limited to Ob-Gyn, General Surgery, and Orthopedics, and that the percentage of the population receiving care at urban and rural hospitals will stay constant. Rural hospitals will have to recruit an average of 3.4 OBGYN's, and an average of 1.6 Orthos, and 2.0 GS for a total of 7 full-time equivalents in the period from 2011 to 2030. Urban hospitals which have to recruit surgical specialists will have to recruit ten Ob-Gyns, about 5 Orthos, 6 GS's, 5 ear, nose, and throat surgeons (ENT's), an average of 2.5 urologists, a neurosurgeon, and a thoracic surgeon to meet the recruiting goals for the surgical services for their hospitals. Rural hospitals will be in competition with urban hospitals for hiring from a limited pool of surgeons. As urban hospitals have a socioeconomic advantage in hiring, surgical care in rural areas may be at risk. It is imperative that each rural hospital analyze local future healthcare needs and devise strategies that will enhance hiring and retention to optimize access to surgical care. Copyright © 2011 Mosby, Inc. All rights reserved.

Blood Product Utilization Among Trauma and Nontrauma Massive Transfusion Protocols at an Urban Academic Medical Center.

PubMed

Patel, Eshan U; Ness, Paul M; Marshall, Christi E; Gniadek, Thomas; Efron, David T; Miller, Peter M; Zeitouni, Joseph A; King, Karen E; Bloch, Evan M; Tobian, Aaron A R

2017-09-01

Hospital-wide massive transfusion protocols (MTPs) primarily designed for trauma patients may lead to excess blood products being prepared for nontrauma patients. This study characterized blood product utilization among distinct trauma and nontrauma MTPs at a large, urban academic medical center. A retrospective study of blood product utilization was conducted in patients who required an MTP activation between January 2011 and December 2015 at an urban academic medical center. Trauma MTP containers included 6 red blood cell (RBC) units, 5 plasma units, and 1 unit of apheresis platelets. Nontrauma MTP containers included 6 RBC and 3 plasma units. There were 334 trauma MTP activations, 233 nontrauma MTP activations, and 77 nontrauma MTP activations that subsequently switched to a trauma MTP ("switched activations"). All nontrauma MTP activations were among bleeding patients who did not have a traumatic injury (100% [233/233]). Few patients with a nontrauma activation required ad hoc transfusion of RBC units (1.3% [95% confidence interval {CI}, 0.3%-3.7%]) or plasma (3.4% [95% CI, 1.5%-6.7%]), and only 45.5% (95% CI, 39.0%-52.1%) required ad hoc transfusion of apheresis platelets. Compared to trauma and switched activations, nontrauma activations transfused a lower median number of RBC, plasma, and apheresis platelet units (P < .001 for all comparisons). There was also a lower median number of prepared but unused plasma units for nontrauma activations (3; [interquartile range {IQR}, 3-5]) compared to trauma (7; [IQR, 5-10]; P < .001) and switched activations (8; [IQR, 5-11]; P < .001). The median number of unused apheresis platelet units was 1 (IQR, 1-2) for trauma activations and 0 (IQR, 0-1) for switched activations. There was a high proportion of trauma and switched activations in which all of the prepared apheresis platelet units were unused (28.1% [95% CI, 23.4%-33.3%] and 9.1% [95% CI, 3.7%-17.8%], respectively). The majority of initial nontrauma MTP activations did not require a switch to a trauma MTP. Patients remaining under a nontrauma MTP activation were associated with a lower number of transfused and unused plasma and apheresis platelet units. Future studies evaluating the use of hospital-wide nontrauma MTPs are warranted since an MTP designed for nontrauma patient populations may yield a key strategy to optimize blood product utilization in comparison to a universal MTP for both trauma and nontrauma patients.

A case study of the counterpart technical support policy to improve rural health services in Beijing

PubMed Central

2012-01-01

Background There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Methods Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural–urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Results Significant reductions in rural–urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural–urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural–urban gap in hospital efficiency. Conclusions The strategy for reducing urban–rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated. PMID:23272703

Hospitalizations for heat-stress illness varies between rural and urban areas: an analysis of Illinois data, 1987-2014.

PubMed

Jagai, Jyotsna S; Grossman, Elena; Navon, Livia; Sambanis, Apostolis; Dorevitch, Samuel

2017-04-07

The disease burden due to heat-stress illness (HSI), which can result in significant morbidity and mortality, is expected to increase as the climate continues to warm. In the United States (U.S.) much of what is known about HSI epidemiology is from analyses of urban heat waves. There is limited research addressing whether HSI hospitalization risk varies between urban and rural areas, nor is much known about additional diagnoses of patients hospitalized for HSI. Hospitalizations in Illinois for HSI (ICD-9-CM codes 992.x or E900) in the months of May through September from 1987 to 2014 (n = 8667) were examined. Age-adjusted mean monthly hospitalization rates were calculated for each county using U.S. Census population data. Counties were categorized into five urban-rural strata using Rural Urban Continuum Codes (RUCC) (RUCC1, most urbanized to RUCC5, thinly populated). Average maximum monthly temperature (°C) was calculated for each county using daily data. Multi-level linear regression models were used, with county as the fixed effect and temperature as random effect, to model monthly hospitalization rates, adjusting for the percent of county population below the poverty line, percent of population that is Non-Hispanic Black, and percent of the population that is Hispanic. All analyses were stratified by county RUCC. Additional diagnoses of patients hospitalized for HSI and charges for hospitalization were summarized. Highest rates of HSI hospitalizations were seen in the most rural, thinly populated stratum (mean annual summer hospitalization rate of 1.16 hospitalizations per 100,000 population in the thinly populated strata vs. 0.45 per 100,000 in the metropolitan urban strata). A one-degree Celsius increase in maximum monthly average temperature was associated with a 0.34 increase in HSI hospitalization rate per 100,000 population in the thinly populated counties compared with 0.02 per 100,000 in highly urbanized counties. The most common additional diagnoses of patients hospitalized with HSI were dehydration, electrolyte abnormalities, and acute renal disorders. Total and mean hospital charges for HSI cases were $167.7 million and $20,500 (in 2014 US dollars). Elevated temperatures appear to have different impacts on HSI hospitalization rates as function of urbanization. The most rural and the most urbanized counties of Illinois had the largest increases in monthly hospitalization rates for HSI per unit increase in the average monthly maximum temperature. This suggests that vulnerability of communities to heat is complex and strategies to reduce HSI may need to be tailored to the degree of urbanization of a county.

Classroom Management, School Staff Relations, School Climate, and Academic Achievement: Testing A Model with Urban High Schools

ERIC Educational Resources Information Center

Back, Lindsey T.; Polk, Elizabeth; Keys, Christopher B.; McMahon, Susan D.

2016-01-01

Urban learning environments pose distinct instructional challenges for teachers and administrators, and can lead to lower achievement compared to suburban or rural schools. Today's educational climate increasingly emphasises a need for positive academic outcomes, often measured by standardised tests, on which student educational opportunities,…

Factors Influencing the Academic Achievement of the Turkish Urban Poor

ERIC Educational Resources Information Center

Engin-Demir, Cennet

2009-01-01

This study estimates the individual and combined effects of selected family, student and school characteristics on the academic achievement of poor, urban primary-school students in the Turkish context. Participants of the study consisted of 719 sixth, seventh, and eighth grade primary-school students from 23 schools in inner and outer city…

Classroom Practices and Academic Outcomes in Urban Afterschool Programs: Alleviating Social-Behavioral Risk

ERIC Educational Resources Information Center

Cappella, Elise; Hwang, Sophia H. J.; Kieffer, Michael J.; Yates, Miranda

2018-01-01

Given the potential of afterschool programs to support youth in urban, low-income communities, we examined the role of afterschool classroom ecology in the academic outcomes of Latino and African American youth with and without social-behavioral risk. Using multireporter methods and multilevel analysis, we find that positive classroom ecology…

Family Disruption and Academic Functioning in Urban, Black Youth

ERIC Educational Resources Information Center

Somers, Cheryl L.; Chiodo, Lisa M.; Yoon, Jina; Ratner, Hilary; Barton, Elizabeth; Delaney-Black, Virginia

2011-01-01

The purpose of this study was to examine from an ecological perspective the relationships between multiple levels of family disruption and children's academic functioning in a sample of 390 urban, Black adolescents at age 14. Subjects in this cohort have been followed longitudinally since before their birth. Data from previous assessments at birth…

Nurses in Action: A Response to Cultural Care Challenges in a Pediatric Acute Care Setting.

PubMed

Mixer, Sandra J; Carson, Emily; McArthur, Polly M; Abraham, Cynthia; Silva, Krystle; Davidson, Rebecca; Sharp, Debra; Chadwick, Jessica

2015-01-01

Culturally congruent care is satisfying, meaningful, fits with people's daily lives, and promotes their health and wellbeing. A group of staff nurses identified specific clinical challenges they faced in providing such care for Hispanic and underserved Caucasian children and families in the pediatric medical-surgical unit of an urban regional children's hospital in the southeastern U.S. To address these challenges, an academic-practice partnership was formed between a group of nurse managers and staff nurses at the children's hospital and nursing faculty and graduate students at a local, research-intensive public university. Using the culture care theory, the partners collaborated on a research study to discover knowledge that would help the nursing staff resolve the identified clinical challenges. Twelve families and 12 healthcare providers participated. Data analysis revealed five care factors that participants identified as most valuable: family, faith, communication, care integration, and meeting basic needs. These themes were used to formulate nursing actions that, when applied in daily practice, could facilitate the provision of culturally congruent care for these children and their families. The knowledge generated by this study also has implications for healthcare organizations, nursing educators, and academic-practice partnerships that seek to ensure the delivery of equitable care for all patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Challenges of using Hospital Information Systems by nurses: comparing academic and non-academic hospitals.

PubMed

Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel

2017-06-01

Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (p<0.05). The results of the ANOVA test also revealed that the educational degree and work experience in the healthcare environment (years) in the academic hospitals have a significant relationship with the mean score related to the hardware challenges, as well, experience with HIS has a significant relationship, with the mean score related to the human challenges (p<0.05). The most important challenges in using the information systems are the factors related to the human environment and the human factors. The results of this study can bring a good perspective to the policy makers and the managers regarding obstacles of using HISs from the nurses' perspective, so that they can solve their problems and can successfully implement these systems.

National disparities in laparoscopic colorectal procedures for colon cancer.

PubMed

Alnasser, Monirah; Schneider, Eric B; Gearhart, Susan L; Wick, Elizabeth C; Fang, Sandy H; Haider, Adil H; Efron, Jonathan E

2014-01-01

Racial disparity in the treatment of colorectal cancer (CRC) has been cited as a potential cause for differences in mortality. This study compares the rates of laparoscopy according to race, insurance status, geographic location, and hospital size. The 2009 Healthcare Cost and Utilization Project: Nationwide Inpatient Sample (HCUP-NIS) database was queried to identify patients with the diagnosis of CRC by the International Classification of Diseases, Ninth Revision (ICD-9) codes. Multivariate logistic regression was performed to look at age, gender, insurance coverage, academic versus nonacademic affiliated institutions, rural versus urban settings, location, and proportional differences in laparoscopic procedures according to race. A total of 14,502 patients were identified; 4,691 (32.35 %) underwent laparoscopic colorectal procedures and 9,811 (67.65 %) underwent open procedures. The proportion of laparoscopic procedures did not differ significantly by race: Caucasian 32.4 %, African-American 30.04 %, Hispanic 33.99 %, and Asian-Pacific Islander 35.12 (P = 0.08). Among Caucasian and African-American patients, those covered by private insurers were more likely to undergo laparoscopic procedures compared to other insurance types (P ≤ 0.001). The odds of receiving laparoscopic procedure at teaching hospitals was 1.39 times greater than in nonteaching hospitals (95 % confidence interval [CI] 1.29-1.48) and did not differ across race groups. Patients in urban hospitals demonstrated higher odds of laparoscopic surgery (2.24, 95 % CI 1.96-2.56) than in rural hospitals; this relationship was consistent within races. The odds of undergoing laparoscopic surgeries was lowest in the Midwest region (0.89, 95 % CI 0.81-0.97) but higher in the Southern region (1.14, 95 % CI 1.06-1.22) compared with the other regions. Nearly one-third of all CRC surgeries are laparoscopic. Race does not appear to play a significant role in the selection of a laparoscopic CRC operation. However, there are significant differences in the selection of laparoscopy for CRC patients based on insurance status, geographic location, and hospital type.

The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.

PubMed

Baernholdt, Marianne; Mark, Barbara A

2009-12-01

The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.

Early primary care follow-up after ED and hospital discharge - does it affect readmissions?

PubMed

Sinha, Sanjai; Seirup, Joanna; Carmel, Amanda

2017-04-01

After hospitalization, timely discharge follow-up has been linked to reduced readmissions in the heart failure population, but data from general inpatients has been mixed. The objective of this study was to determine if there was an association between completed follow-up appointments within 14 days of hospital discharge and 30-day readmission amongst primary care patients at an urban academic medical center. Index discharges included both inpatient and emergency room settings. A secondary objective was to identify patient factors associated with completed follow-up appointments within 14 days. We conducted a retrospective review of primary care patients at an urban academic medical center who were discharged from either the emergency department (ED) or inpatient services at the Weill Cornell Medical Center/New York Presbyterian Hospital from 1 January 2014-31 December 2014. Cox proportional hazard models were used to identify the relationship between follow-up in primary care within 14 days and readmission within 30 days. Logistic regression was used to evaluate the association of patient factors with 14-day follow-up. Among 9,662 inpatient and ED discharges, multivariable analysis (adjusting for age, gender, race/ethnicity, insurance, number of diagnoses on problem list, length of stay, and discharge service) showed that follow-up with primary care within 14 days was not associated with a lower hazard of readmission within 30 days (HR = 0.78; 95% CI 0.56-1.09). A higher number of diagnoses on the problem list was associated with greater odds of follow-up for both inpatient and emergency department discharges (inpatient: HR = 1.03, 95% CI 1.02-1.04; ED: HR = 1.02, 95% CI 1.00-1.04). For inpatient discharges, each additional day in length of stay was associated with 3% lower odds of follow-up (HR = 0.97, 95% CI 0.96-0.99). Early follow-up within 14 days after discharge from general inpatient services was associated with a trend toward lower hazard of 30-day readmission though this finding was not significant. Future studies should focus on identifying additional cohorts of patients in which readmission is reduced by early follow-up, so that access to primary care appointments is not compromised.

Hospitality, culture and regeneration: urban decay, entrepreneurship and the "ruin" bars of Budapest.

PubMed

Lugosi, Peter; Bell, David; Lugosi, Krisztina

2010-01-01

This paper considers the relationships between hospitality, culture and urban regeneration through an examination of rom (ruin) venues, which operate in dilapidated buildings in Budapest, Hungary. The paper reviews previous work on culture and urban regeneration in order to locate the role of hospitality within emerging debates. It subsequently interrogates the evolution of the rom phenomenon and demonstrates how, in this context, hospitality thrives because of social and physical decay in urban locations, how operators and entrepreneurs exploit conflicts among various actors involved in regeneration and how hospitality may be mobilised purposefully in the regeneration process. The paper demonstrates how networked entrepreneurship maintains these operations and how various forms of cultural production are entangled and mobilised in the venues' hospitality propositions.

The contributions of library and information services to hospitals and academic health sciences centers: a preliminary taxonomy

PubMed Central

Abels, Eileen G.; Cogdill, Keith W.; Zach, Lisl

2002-01-01

Objectives: This article presents a taxonomy of the contributions of library and information services (LIS) in hospitals and academic health sciences centers. The taxonomy emerges from a study with three objectives: to articulate the value of LIS for hospitals and academic health sciences centers in terms of contributions to organizational missions and goals, to identify measures and measurable surrogates associated with each LIS contribution, and to document best practices for communicating the value of LIS to institutional administrators. Methods: The preliminary taxonomy of LIS contributions in hospitals and academic health sciences centers is based on a review of the literature, twelve semi-structured interviews with LIS directors and institutional administrators, and a focus group of administrators from five academic, teaching, and nonteaching hospitals. Results: Derived from the balanced scorecard approach, the taxonomy of LIS contributions is organized on the basis of five mission-level concepts and fifteen organizational goals. LIS contributions are included only if they have measurable surrogates. Conclusions: The taxonomy of LIS contributions offers a framework for the collection of both quantitative and qualitative data in support of communicating the value of LIS in hospitals and academic health sciences centers. PMID:12113510

Reason for hospital admission: a pilot study comparing patient statements with chart reports.

PubMed

Berger, Zackary; Dembitzer, Anne; Beach, Mary Catherine

2013-01-01

Providers and patients bring different understandings of health and disease to their encounters in the hospital setting. The literature to date only infrequently addresses patient and provider concordance on the reported reason for hospitalization, that is, whether they express this reason in similar ways. An agreement or common ground between such understandings can serve as a basis for future communication regarding an illness and its treatment. We interviewed a convenience sample of patients on the medical wards of an urban academic medical center. We asked subjects to state the reason why their doctors admitted them to the hospital, and then compared their statement with the reason in the medical record. We defined concordance on reported reason for hospitalization as agreement between the patient's report and the reason abstracted from the chart. We interviewed and abstracted chart data from a total of 46 subjects. Concordance on reported reason for hospitalization was present in 24 (52%) and discordance in 17 (37%); 5 patients (11%) could not give any reason for their hospitalization. Among the 17 patients whose report was discordant with their chart, 12 (71%) reported a different organ system than was recorded in the chart. A significant proportion of medical inpatients could not state their physicians' reason for admission. In addition, patients who identify a different reason for hospitalization than the chart often give a different organ system altogether. Providers should explore patient understanding of the reason for their hospitalization to facilitate communication and shared decision making.

Using social-emotional and character development to improve academic outcomes: a matched-pair, cluster-randomized controlled trial in low-income, urban schools

PubMed Central

Lewis, Kendra M.; DuBois, David L.; Acock, Alan; Vuchinich, Samuel; Silverthorn, Naida; Snyder, Frank J.; Day, Joseph; Ji, Peter; Flay, Brian R.

2013-01-01

BACKGROUND School-based social-emotional and character development (SECD) programs can influence not only SECD, but also academic-related outcomes. This study evaluated the impact of one SECD program, Positive Action (PA), on educational outcomes among low-income, urban youth. METHODS The longitudinal study used a matched-pair, cluster-randomized controlled design. Student-reported disaffection with learning and academic grades, and teacher ratings of academic ability and motivation were assessed for a cohort followed from grades 3 to 8. Aggregate school records were used to assess standardized test performance (for entire school, cohort, and demographic subgroups) and absenteeism (entire school). Multilevel growth-curve analyses tested program effects. RESULTS PA significantly improved growth in academic motivation and mitigated disaffection with learning. There was a positive impact of PA on absenteeism and marginally significant impact on math performance of all students. There were favorable program effects on reading for African American boys and cohort students transitioning between grades 7 and 8, and on math for girls and low-income students. CONCLUSIONS A school-based SECD program was found to influence academic outcomes among students living in low-income, urban communities. Future research should examine mechanisms by which changes in SECD influence changes in academic outcomes. PMID:24138347

Using social-emotional and character development to improve academic outcomes: a matched-pair, cluster-randomized controlled trial in low-income, urban schools.

PubMed

Bavarian, Niloofar; Lewis, Kendra M; Dubois, David L; Acock, Alan; Vuchinich, Samuel; Silverthorn, Naida; Snyder, Frank J; Day, Joseph; Ji, Peter; Flay, Brian R

2013-11-01

School-based social-emotional and character development (SECD) programs can influence not only SECD but also academic-related outcomes. This study evaluated the impact of one SECD program, Positive Action (PA), on educational outcomes among low-income, urban youth. The longitudinal study used a matched-pair, cluster-randomized controlled design. Student-reported disaffection with learning and academic grades, and teacher ratings of academic ability and motivation were assessed for a cohort followed from grades 3 to 8. Aggregate school records were used to assess standardized test performance (for entire school, cohort, and demographic subgroups) and absenteeism (entire school). Multilevel growth-curve analyses tested program effects. PA significantly improved growth in academic motivation and mitigated disaffection with learning. There was a positive impact of PA on absenteeism and marginally significant impact on math performance of all students. There were favorable program effects on reading for African American boys and cohort students transitioning between grades 7 and 8, and on math for girls and low-income students. A school-based SECD program was found to influence academic outcomes among students living in low-income, urban communities. Future research should examine mechanisms by which changes in SECD influence changes in academic outcomes. © 2013, American School Health Association.

Young African American Children Constructing Academic and Disciplinary Identities in an Urban Science Classroom

ERIC Educational Resources Information Center

Kane, Justine M.

2012-01-01

In this paper, I offer a framework for exploring the academic and disciplinary identities young African American children construct in urban science classrooms. Using interviews, fieldnotes, and videotapes of classroom lessons, I juxtapose the ways in which two children tell about their experiences in school and science with their performances of…

Urban Schools that Have Narrowed the Achievement Gap: Middle School Math Achievement in an Urban Setting

ERIC Educational Resources Information Center

Sagun, Theodore

2010-01-01

The achievement gap is a persistent academic disparity between White and Asian students and ethnic minorities, English Language Learners, and low-income students. The academic disparity exists within the realm of mathematics. Although many factors are cited for contributing to the achievement gap, this study reviews institutional racism, meager…

Demographic and Educational Influences on Academic Motivation, Competence, and Achievement in Minority Urban Students.

ERIC Educational Resources Information Center

Marcon, Rebecca A.

Using the Scale of Intrinsic versus Extrinsic Orientation in the Classroom (S. Harter, 1980) and the Self-Perception Profile for Children (S. Harter, 1985), this study of 222 urban early adolescents (median age=149 months) examined differences in motivation that might affect academic achievement and perceptions of competence. Socioeconomic status…

Connecting the Dots: How Connectedness to Multiple Contexts Influences the Psychological and Academic Adjustment of Urban Youth

ERIC Educational Resources Information Center

Witherspoon, Dawn; Schotland, Marieka; Way, Niobe; Hughes, Diane

2009-01-01

Cluster analyses and hierarchical linear modeling were used to investigate the impact of perceptions of connectedness to family, school, and neighborhood contexts on academic and psycho-social outcomes for 437 urban ethnically diverse adolescents. Five profiles of connectedness to family, school, and neighborhood were identified. Two profiles were…

Adolescents' Motivation in the Context of an Academic Vocabulary Intervention in Urban Middle School Classrooms

ERIC Educational Resources Information Center

Lesaux, Nonie K.; Harris, Julie Russ; Sloane, Phoebe

2012-01-01

In a large urban district's ELA classrooms, an academic vocabulary intervention designed to improve linguistically diverse 6th-graders' reading and language skills was implemented and evaluated. These classrooms were characterized by high numbers of struggling readers, and linguistic diversity was the norm. As part of the evaluation, this study…

Math and Science Academic Success in Three Large, Diverse, Urban High Schools: A Teachers' Story

ERIC Educational Resources Information Center

McKenzie, Kathryn Bell; Skrla, Linda; Scheurich, James Joseph; Rice, Delores; Hawes, Daniel P.

2011-01-01

Large, traditional urban high schools are among the most difficult education environments in the United States. These schools, which serve a high percentage of the Black and Latino students in the United States, often have low academic performance, high dropout rates, high teacher and school leader turnover, and inexperienced teachers. They often…

Increasing Academic Engagement during Writing Activities in an Urban Elementary Classroom

ERIC Educational Resources Information Center

Aitken, Angelique; Harlan, Alison; Hankins, Katy; Michels, John; Moore, Tara C.; Oakes, Wendy P.; Lane, Kathleen Lynne

2011-01-01

In this study, the authors examined the effects of a systematic functional assessment-based intervention (FABI) to identify the function of a third-grade student's off-task behavior and create a plan to increase academic engaged time (AET). The FABI was designed and implemented in an urban elementary school with a comprehensive, integrated,…

Non-Intellective Factors in the Prediction of Academic Success of Urban College Freshmen.

ERIC Educational Resources Information Center

Fox, James Arthur

The purpose of this study was to determine which personality traits as measured by the California Psychological Inventory (CPI) are predictive of academic achievement in urban college freshmen of the Federal City College. The measures of achievement were grade point average (GPA) and the Comparative Guidance and Placement Program (CGPP) test…

Exploring the Development of Classroom Group Identities in an Urban High School Chemistry Class

ERIC Educational Resources Information Center

Macaluso, Stefania

2014-01-01

A key to achieving academic success in science is providing students with meaningful experiences and skills to negotiate how these experiences affect them and the society in which they live. Although students strive for academic success, a challenge that faces many urban science students and their teachers is finding ways to promote student…

A Structural Analysis of Success and Failure of Asian Americans: A Case of Korean Americans in Urban Schools

ERIC Educational Resources Information Center

Lew, Jamie

2007-01-01

In this article, the author examines how variability of socioeconomic backgrounds affects parental strategies and academic achievement among Korean American youths. The study compares experiences of high- and low-achieving Korean American high school students in New York City urban schools: 1) academically achieving students attending a…

Do Intervention Impacts on Academic Achievement Vary by School Climate? Evidence from a Randomized Trial in Urban Elementary Schools

ERIC Educational Resources Information Center

McCormick, Meghan P.; Cappella, Elise; O'Connor, Erin E.; McClowry, Sandee G.

2015-01-01

Given established links between social-emotional skills and academic achievement, there is growing support for implementing universal social/behavioral interventions in early schooling (Jones & Bouffard, 2012). Advocates have been particularly interested in implementing such programming in low income urban schools where students are likely to…

The Urban Public Hospital: Its Importance to the Black Community.

ERIC Educational Resources Information Center

Rice, Mitchell F.

1986-01-01

Describes the health care functions provided for the Black community by urban public hospitals; considers the impact of Federal retrenchment on these institutions; and examines the negative impact on Blacks, other minorities, and the poor that the sale of urban public hospitals to private, for-profit chains will have. (GC)

Breast feeding promotion in an urban and a rural Jamaican hospital.

PubMed

Cunningham, W E; Segree, W

1990-01-01

Breast feeding promotion has been a national priority in Jamaica since the mid-1970s. Despite this effort, breast feeding rates have continued to decline there, especially in urban areas. Studies of the role of health professionals in promoting breast feeding have shown that specific practices encourage breast feeding, while others discourage it. In the context of declining breast feeding in a nation committed to promoting it, the goal of this study was to explore the relationship between specific health professional practices, mothers' breast feeding, and mothers' knowledge of breast feeding in rural and urban Jamaica. To accomplish this goal, a structured interview was administered to 113 mothers of infants age 0-6 months at one urban (n = 62) and one rural (n = 51) hospital, regarding (1) physician and nurse practices known to affect breast feeding, (2) mothers' own breast feeding practices, and (3) mothers knowledge of breast feeding issues. Physician and nurse visits were also directly observed to confirm responses given to the questionnaire and to assess the resources devoted to teaching mothers about breast feeding. While extensive lectures, posters and pamphlets promoting breast feeding were provided for mothers at the urban hospital, far fewer educational resources were available for mothers at the rural hospital. Overall, however, health professional practices discouraging breast feeding were observed more frequently at the urban hospital than at the rural hospital, whereas practices promoting breast feeding were more common at the rural hospital. At the rural hospital, mothers' breast feeding practices more closely approximated recommendations than at the urban hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute care hospital utilization among medical inpatients discharged with a substance use disorder diagnosis.

PubMed

Walley, Alexander Y; Paasche-Orlow, Michael; Lee, Eugene C; Forsythe, Shaula; Chetty, Veerappa K; Mitchell, Suzanne; Jack, Brian W

2012-03-01

Hospital discharge may be an opportunity to intervene among patients with substance use disorders to reduce subsequent hospital utilization. This study determined whether having a substance use disorder diagnosis was associated with subsequent acute care hospital utilization. We conducted an observational cohort study among 738 patients on a general medical service at an urban, academic, safety-net hospital. The main outcomes were rate and risk of acute care hospital utilization (emergency department visit or hospitalization) within 30 days of discharge. The main independent variable was presence of a substance use disorder primary or secondary discharge diagnosis code at the index hospitalization. At discharge, 17% of subjects had a substance use disorder diagnosis. These patients had higher rates of recurrent acute care hospital utilization than patients without substance use disorder diagnoses (0.63 vs 0.32 events per subject at 30 days, P < 0.01) and increased risk of any recurrent acute care hospital utilization (33% vs 22% at 30 days, P < 0.05). In adjusted Poisson regression models, the incident rate ratio at 30 days was 1.49 (95% confidence interval, 1.12-1.98) for patients with substance use disorder diagnoses compared with those without. In subgroup analyses, higher utilization was attributable to those with drug diagnoses or a combination of drug and alcohol diagnoses, but not to those with exclusively alcohol diagnoses. Medical patients with substance use disorder diagnoses, specifically those with drug use-related diagnoses, have higher rates of recurrent acute care hospital utilization than those without substance use disorder diagnoses.

Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center.

PubMed

Renda, Susan; Baernholdt, Marianne; Becker, Kathleen

2016-01-01

Evidence suggests that diabetes education can be delivered at the worksite to better support employees' diabetes self-management and improve productivity and health care costs. This study was conducted to address the feasibility of a diabetes worksite education program for employees at a large urban academic health care institution. The diabetes education program was delivered in the diabetes center at the institution, a resource that was previously underutilized by employees. Through collaboration with groups in the institution, 20 employees of diverse ethnicity participated in the worksite diabetes education program with positive outcomes: improved glycemic control measured (HbA1c), attainment of self-management goals, and satisfaction with the program. Work absences trended downward, but numbers of hospitalizations and emergency department visits were unchanged in the 3 months following education. Recommendations include replication of the study with more employee participation and program evaluation over a longer period of time to continue assessment of employees' educational needs. © 2015 The Author(s).

[University clinics in the competitive hospital market].

PubMed

Schmidt, C E; Möller, J; Hesslau, U; Bauer, M; Gabbert, T; Kremer, B

2005-07-01

In recent years Germany has faced a growing economization and competition among hospitals. To protect their interests hospitals have to operate similarly to other commercial businesses. Academic hospitals face difficult circumstances in this competition. They have to facilitate research and education activities which require additional financial and personnel resources but also provide maximum acute care treatment at all times. This causes additional disadvantages in terms of financial resources, compared to private hospital chains. Such examples of financial shortcomings have led to the privatization of academic research centres in Germany. An alternative strategy to privatization of academic acute care hospitals is the change of their legal status into a capital company or into a foundation, according to US experiences. Public private partnerships (PPPs) may also represent a potential alternative, as they have already produced a growing number of successful examples in the public sector in Germany. Academic acute care hospitals can also choose a strategic reorganization of their targets, similar to their privately held competitors in the market. Potential economies in scale may be achieved in areas such as medical treatment, research and personnel planning.However, it is vital that academic acute care hospitals start to act productively and also individually. This article provides a number of managerial pathways and options to maintain and strengthen operational competitiveness.

Delays in accessing electroconvulsive therapy: a comparison between two urban and two rural populations in Australia.

PubMed

Johnston, Natalie E

2015-10-01

A comparison of the timing, rates and characteristics of electroconvulsive therapy use between urban and rural populations. The medical records of patients who received an acute course of electroconvulsive therapy at two rural and two urban psychiatric hospitals in New South Wales (NSW), Australia, in 2010 were reviewed retrospectively. Main outcome measures were the time from symptom onset, diagnosis and admission to commencing electroconvulsive therapy. Rates of use of electroconvulsive therapy were also compared between rural and urban hospitals using NSW statewide data. There was a significant delay in the time it took for rural patients to receive electroconvulsive therapy compared with urban patients when measured both from the time of symptom onset and from when they received a diagnosis. There were corresponding delays in the time taken for rural patients to be admitted to hospital compared with urban patients. There was no difference in the time it took to commence electroconvulsive therapy once a patient was admitted to hospital. NSW statewide urban-rural comparisons showed rates of electroconvulsive therapy treatment were significantly higher in urban hospitals. Patients in rural areas receive electroconvulsive therapy later in their acute illness due to delays in being admitted to hospital. The rate of use of electroconvulsive therapy also differs geographically. © The Royal Australian and New Zealand College of Psychiatrists 2015.

From High Potential to Gifted Performance: Encouraging Academically Talented Urban Students

ERIC Educational Resources Information Center

Reis, Sally M.; Morales-Taylor, Miriam

2010-01-01

Academically talented students in many urban areas in the authors' Northeastern corner of the county have limited access to gifted and talented programs due to lack of funding and attention focused on students who are achieving well below grade level. In the city of Hartford, for example, no gifted program has been available for more than a…

Parent Involvement and Academic Outcomes among Urban Adolescents: Examining the Role of School Engagement

ERIC Educational Resources Information Center

Dotterer, Aryn M.; Wehrspann, Elizabeth

2016-01-01

The present study examined the extent to which parent involvement in education was directly and indirectly (via school engagement) related to academic outcomes in an effort to more fully understand the school experiences of urban adolescents. Participants (80% racial/ethnic minority; n = 108) were in grades 6, 7 or 8. In the Fall and subsequent…

Junior Reserve Officer Training Corps Career Academies and Their Impact on Academic Achievement in Urban Public Schools

ERIC Educational Resources Information Center

Neely, Sheryl Austin

2012-01-01

Low attendance, poor behavior, low test scores, and low graduation rates among at-risk students have created a concern in urban school districts. The purpose of this study was to illuminate the impact of Junior Reserve Officer Training Corps (JROTC) Academy programs on students' academic performance. The theoretical foundation of the research…

Patterns of Organized Activity Participation in Urban, Early Adolescents: Associations with Academic Achievement, Problem Behaviors, and Perceived Adult Support

ERIC Educational Resources Information Center

Metzger, Aaron; Crean, Hugh F.; Forbes-Jones, Emma L.

2009-01-01

This study examines patterns of organized activity and their concurrent association with academic achievement, problem behavior, and perceived adult support in a sample of urban, early adolescent, middle school students (mean age = 13.01; N = 2,495). Cluster analyses yielded six activity profiles: an uninvolved group (n = 775, 31.1%), a multiply…

Is the Library a "Welcoming Space"?: An Urban Academic Library and Diverse Student Experiences

ERIC Educational Resources Information Center

Elteto, Sharon; Jackson, Rose M.; Lim, Adriene

2008-01-01

This article presents a case study of an urban academic library's attempt to identify factors that influence the perceptions of students of color concerning the library as a welcoming space. The goal of this study is to determine if there are qualitative divergent factors along racial lines concerning how students use this library. The research is…

A Study of African American Male Students' Academic Achievement and School Attitude in an Urban Elementary School

ERIC Educational Resources Information Center

Mohamed, Roslyn J. F. Billy

2013-01-01

With the signing of the No Child Left Behind Act in 2001, much emphasis has been placed on the accountability of schools and school districts to ensure higher academic achievement of all students. The achievement gap remains among African American male students in urban school districts. This purposed quantitative study explored the relationship…

The Association between Externalizing Behavior Problems, Teacher-Student Relationship Quality, and Academic Performance in Young Urban Learners

ERIC Educational Resources Information Center

Sanchez Fowler, Laura T.; Banks, Tachelle I.; Anhalt, Karla; Der, Heidi Hinrichs; Kalis, Tara

2008-01-01

The present study examined the relation between teacher ratings of student social functioning and academic performance and teacher-student relationship quality. Data were collected from 230 students and 20 teachers in two high-poverty, low-performing schools in a large urban school district in the Midwest. Students were 93% African American.…

Academic urban legends

PubMed Central

2014-01-01

Many of the messages presented in respectable scientific publications are, in fact, based on various forms of rumors. Some of these rumors appear so frequently, and in such complex, colorful, and entertaining ways that we can think of them as academic urban legends. The explanation for this phenomenon is usually that authors have lazily, sloppily, or fraudulently employed sources, and peer reviewers and editors have not discovered these weaknesses in the manuscripts during evaluation. To illustrate this phenomenon, I draw upon a remarkable case in which a decimal point error appears to have misled millions into believing that spinach is a good nutritional source of iron. Through this example, I demonstrate how an academic urban legend can be conceived and born, and can continue to grow and reproduce within academia and beyond. PMID:25272616

Urban transportation: Perspectives on mobility and choice

NASA Technical Reports Server (NTRS)

Sincoff, M. Z. (Editor); Dajani, J. S. (Editor); Arnold, G. R.; Bird, J. W.; Brooks, C. M. (Editor); Cobb, W. E.; Cross, J. E.; Darby, L. F.; Erb, N. H.; Ficht, J. C.

1974-01-01

A study of urban transportation systems are presented characterized by intensive scrutiny of many ideas, philosophies, and academic perspectives. This report is intended to communicate some dimensions of the urban transportation problem to the general public.

The effect of consumer perceptions of quality and sacrifice on hospital choice: a suburban vs. urban competitive scenario.

PubMed

Gooding, S K

1996-01-01

The primary objective of this research was to determine how a suburban hospital located near an urban center fares when local consumers are selecting a hospital. A significant portion of the 161 suburban respondents to the study's mail survey perceive the quality of care available at alternative urban hospitals to be higher than that available at their local suburban hospital on the vast majority of quality-related attributes. Most respondents, however, select their local hospital for both major and minor medical treatment. Te greater value represented by suburban hospitals, due to their relative closeness to the consumer, represents a significant competitive advantage.

Quality of Care for Acute Myocardial Infarction in Rural and Urban US Hospitals

ERIC Educational Resources Information Center

Baldwin, Laura-Mae; MacLehose, Richard F.; Hart, L. Gary; Beaver, Shelli K.; Every,Nathan; Chan,Leighton

2004-01-01

Context: Acute myocardial infarction (AMI) is a common and important cause of admission to US rural hospitals, as transport of patients with AMI to urban settings can result in unacceptable delays in care. Purpose: To examine the quality of care for patients with AMI in rural hospitals with differing degrees of remoteness from urban centers.…

Self-Efficacy, Stress, and Academic Success in College

ERIC Educational Resources Information Center

Zajacova, Anna; Lynch, Scott M.; Espenshade, Thomas J.

2005-01-01

This paper investigates the joint effects of academic self-efficacy and stress on the academic performance of 107 nontraditional, largely immigrant and minority, college freshmen at a large urban commuter institution. We developed a survey instrument to measure the level of academic self-efficacy and perceived stress associated with 27…

Academic Identification as a Mediator of the Relationship between Parental Socialization and Academic Achievement

ERIC Educational Resources Information Center

Strambler, Michael J.; Linke, Lance H.; Ward, Nadia L.

2013-01-01

This study examines whether academic identification, or one's psychological and emotional investment in academics, mediates the association between child-reported parental educational socialization and standardized achievement test scores among a predominantly ethnic minority sample of 367 urban middle school students. We predicted that academic…

Trends in Rural and Urban Deliveries and Vaginal Births: California 1998-2002

ERIC Educational Resources Information Center

Hughes, Susan; Zweifler, John A.; Garza, Alvaro; Stanich, Matthew A.

2008-01-01

Context: Pregnant women in rural areas may give birth in either rural or urban hospitals. Differences in outcomes between rural and urban hospitals may influence patient decision making. Purpose: Trends in rural and urban obstetric deliveries and neonatal and maternal mortality in California were compared to inform policy development and patient…

Perceived School and Neighborhood Safety, Neighborhood Violence and Academic Achievement in Urban School Children

PubMed Central

AJ, Milam; CDM, Furr-Holden; PJ, Leaf

2010-01-01

Community and school violence continue to be a major public health problem, especially among urban children and adolescents. Little research has focused on the effect of school safety and neighborhood violence on academic performance. This study examines the effect of the school and neighborhood climate on academic achievement among a population of 3rd-5th grade students in an urban public school system. Community and school safety were assessed using the School Climate Survey, an annual city-wide assessment of student’s perception of school and community safety. Community violence was measured using the Neighborhood Inventory for Environmental Typology, an objective observational assessment of neighborhood characteristics. Academic achievement was measured using the Maryland State Assessment (MSA), a standardized exam given to all Maryland 3rd-8th graders. School Climate Data and MSA data were aggregated by school and grade. Objective assessments of neighborhood environment and students’ self-reported school and neighborhood safety were both strongly associated with academic performance. Increasing neighborhood violence was associated with statistically significant decreases from 4.2%-8.7% in math and reading achievement; increasing perceived safety was associated with significant increases in achievement from 16%-22%. These preliminary findings highlight the adverse impact of perceived safety and community violence exposure on primary school children’s academic performance. PMID:21197388

A Study of At-Risk Students' Perceptions of an Online Academic Credit Recovery Program in an Urban North Texas Independent School District

ERIC Educational Resources Information Center

Buckley, Mychl K.

2012-01-01

The purpose of this research study was to describe and analyze at-risk high school students' perceptions of their experiences with online academic credit recovery classes offered to them through an urban school district's dropout prevention department. The review of literature concerning curricula for online programs revealed that the variety of…

Recognizing Internet Addiction: Prevalence and Relationship to Academic Achievement in Adolescents Enrolled in Urban and Rural Greek High Schools

ERIC Educational Resources Information Center

Stavropoulos, Vasilis; Alexandraki, Kiriaki; Motti-Stefanidi, Frosso

2013-01-01

This study aims: a) to estimate the prevalence of internet addiction among adolescents of urban and rural areas in Greece, b) to examine whether the Internet Addiction Test cut-off point is applicable to them and c) to investigate the phenomenon's association with academic achievement. Participants were 2090 adolescents (mean age 16, 1036 males,…

The Effect of the Flipped Classroom on Urban High School Students' Motivation and Academic Achievement in a High School Science Course

ERIC Educational Resources Information Center

Dixon, Keshia L.

2017-01-01

This study investigated the effect of the flipped classroom on urban high school students' motivation and academic achievement in a high school science course. In this quantitative study, the sample population was comprised of North Star High School 12th grade students enrolled in human anatomy and physiology. A quasi-experimental,…

Using Social-Emotional and Character Development to Improve Academic Outcomes: A Matched-Pair, Cluster-Randomized Controlled Trial in Low-Income, Urban Schools

ERIC Educational Resources Information Center

Bavarian, Niloofar; Lewis, Kendra M.; DuBois, David L.; Acock, Alan; Vuchinich, Samuel; Silverthorn, Naida; Snyder, Frank J.; Day, Joseph; Ji, Peter; Flay, Brian R.

2013-01-01

Background: School-based social-emotional and character development (SECD) programs can influence not only SECD but also academic-related outcomes. This study evaluated the impact of one SECD program, Positive Action (PA), on educational outcomes among low-income, urban youth. Methods: The longitudinal study used a matched-pair, cluster-randomized…

Variations in inpatient pediatric anesthesia in California from 2000 to 2009: a caseload and geographic analysis.

PubMed

Mudumbai, Seshadri C; Honkanen, Anita; Chan, Jia; Schmitt, Susan; Saynina, Olga; Hackel, Alvin; Gregory, George; Phibbs, Ciaran S; Wise, Paul H

2014-12-01

Regional referral systems are considered important for children hospitalized for surgery, but there is little information on existing systems. To examine geographic variations in anesthetic caseloads in California for surgical inpatients ≤6 years and to evaluate the feasibility of regionalizing anesthetic care. We reviewed California's unmasked patient discharge database between 2000 and 2009 to determine surgical procedures, dates, and inpatient anesthetic caseloads. Hospitals were classified as urban or rural and were further stratified as low, intermediate, high, and very high volume. We reviewed 257,541 anesthetic cases from 402 hospitals. Seventeen California Children's Services (CCS) hospitals conducted about two-thirds of all inpatient anesthetics; 385 non-CCS hospitals accounted for the rest. Urban hospitals comprised 82% of low- and intermediate-volume centers (n = 297) and 100% of the high- and very high-volume centers (n = 41). Ninety percent (n = 361) of hospitals performed <100 cases annually. Although potentially lower risk procedures such as appendectomies were the most frequent in urban low- and intermediate-volume hospitals, fairly complex neurosurgical and general surgeries were also performed. The median distance from urban lower-volume hospitals to the nearest high- or very high-volume center was 12 miles. Up to 98% (n = 40,316) of inpatient anesthetics at low- or intermediate-volume centers could have been transferred to higher-volume centers within 25 miles of smaller centers. Many urban California hospitals maintained low annual inpatient anesthetic caseloads for children ≤6 years while conducting potentially more complex procedures. Further efforts are necessary to define the scope of pediatric anesthetic care at urban low- and intermediate-volume hospitals in California. © 2014 John Wiley & Sons Ltd.

Population characteristics of markets of safety-net and non-safety-net hospitals.

PubMed

Gaskin, D J; Hadley, J

1999-09-01

To compare and contrast the markets of urban safety-net (USN) hospitals with the markets of other urban hospitals. To develop profiles of the actual inpatient markets of hospitals, we linked 1994 patient-level information from hospital discharge abstracts from nine states with 1990 data at the ZIP code level from the US Census Bureau. Each hospital's market was characterized by its racial and ethnic composition, median household income, poverty rate, and educational attainment. Measures of hospital competition were also calculated for each hospital. The analysis compared the market profiles of USN hospitals to those of other urban hospitals. We also compared the level of hospital competition and financial status of USN and other urban hospitals. The markets of USN hospitals had higher proportions of racial and ethnic minorities and non-English-speaking residents. Adults residing in markets of USN hospitals were less educated. Families living in markets of USN hospitals had lower incomes and were more likely to be living at or below the federal poverty level. USN hospitals and other urban hospitals faced similar levels of competition and had similar margins. However, USN hospitals were more dependent on Medicare disproportionate share payments and on state and local government subsidies to remain solvent. USN hospitals disproportionately serve vulnerable minority and low-income communities that otherwise face financial and cultural barriers to health care. USN hospitals are dependent on the public subsidies they receive from federal, state, and local governments. Public policies and market pressures that affect the viability of USN hospitals place the access to care by vulnerable populations at risk. Public policy that jeopardizes public subsidies places in peril the financial health of these institutions. As Medicare and Medicaid managed care grow, USN hospitals may lose these patient revenues and public subsidies based on their Medicaid and Medicare patient volumes. The loss of these funds would hinder the ability of USN hospitals to finance uncompensated care for uninsured and underinsured patients.

The Evolution of the Council of Academic Hospitals of Ontario Statement of Principles--A Successful Harmonization Initiative

ERIC Educational Resources Information Center

Porter, Katie; Lampson, Sarah

2011-01-01

To improve efficiency, consistency and transparency in clinical trial contract negotiations with industry sponsors, a Council of Academic Hospitals of Ontario (CAHO) committee facilitated the development of standard principles for member hospitals to follow during contract negotiation. Hospitals were encouraged to provide a link to the CAHO…

Five-Year Experience of an Inpatient Palliative Care Unit at an Academic Referral Center.

PubMed

Shinall, Myrick C; Martin, Sara F; Nelson, Jill; Miller, Richard S; Semler, Matthew W; Zimmerman, Eli E; Noblit, Christy C; Ely, E Wesley; Karlekar, Mohana

2018-01-01

Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017. Over these 5 years, there were 3321 admissions to the PCU. No single underlying disease process accounted for the majority of the patients, but the largest single category of patients were those with malignancy, who accounted for 38% of admissions. Transfers from the intensive care unit accounted for 50% of admissions, with 43% of admissions from a hospital floor and 7% coming from the emergency department or a clinic. Median length of stay in the PCU was 3 days. In hospital deaths occurred for 50% of admitted patients, while 38% of patients were discharged from the PCU to hospice. These data show that a successful PCU is enabled by buy in from a wide variety of referring specialists and by a multidisciplinary palliative care team focused on care of the actively dying patient as well as pain and symptom management, advance care planning, and hospice referral since a large proportion of referred patients do not die in house.

A Statistical Interaction Model for Examining Compensatory Effects on Academic Performance.

ERIC Educational Resources Information Center

Ritchey, Ferris J.; Lewis, Barbara Lawhon

A 2-year study of 206 college students at an urban research university in a southern state examined personal, environmental, academic, and non-academic predictors of: (1) course grade performance; and (2) academic retention. Of particular interest were "high-risk" or "disadvantaged" students and how they compensated for their…

A Preliminary Investigation of Academic Disidentification, Racial Identity, and Academic Achievement among African American Adolescents

ERIC Educational Resources Information Center

Cokley, Kevin; McClain, Shannon; Jones, Martinique; Johnson, Samoan

2012-01-01

The purpose of this study was to examine academic disidentification along with demographic and psychological factors related to the academic achievement of African American adolescents. Participants included 96 African American students (41 males, 55 females) in an urban high school setting located in the Southwest. Consistent with previous…

Psychiatric Hospitalization and Academic Performance

ERIC Educational Resources Information Center

Ganz, Varda Peller; Pao, Jane

1978-01-01

Studies of college students hospitalized for psychiatric disturbances revealed that diagnosis did not significantly affect academic performance, nor did leave of absence following hospitalization ensure better re-entry adjustment. It is recommended that students be evaluated individually and be allowed to re-enter as soon as the acute illness…

Clinical Laboratory Automation: A Case Study.

PubMed

Archetti, Claudia; Montanelli, Alessandro; Finazzi, Dario; Caimi, Luigi; Garrafa, Emirena

2017-04-13

This paper presents a case study of an automated clinical laboratory in a large urban academic teaching hospital in the North of Italy, the Spedali Civili in Brescia, where four laboratories were merged in a unique laboratory through the introduction of laboratory automation. The analysis compares the preautomation situation and the new setting from a cost perspective, by considering direct and indirect costs. It also presents an analysis of the turnaround time (TAT). The study considers equipment, staff and indirect costs. The introduction of automation led to a slight increase in equipment costs which is highly compensated by a remarkable decrease in staff costs. Consequently, total costs decreased by 12.55%. The analysis of the TAT shows an improvement of nonemergency exams while emergency exams are still validated within the maximum time imposed by the hospital. The strategy adopted by the management, which was based on re-using the available equipment and staff when merging the pre-existing laboratories, has reached its goal: introducing automation while minimizing the costs.

A Comparative Analysis of Demographic and Academic Characteristics and NCLEX-RN Passing among Urban and Rural Campus Students in a Midwest Associate Degree Nursing Program

ERIC Educational Resources Information Center

Nacos-Burds, Kathleen J.

2010-01-01

A retrospective study was initiated to determine: (1) the predictive relationship between demographic and academic variables and NCLEX-RN success; and (2) if there were significant differences between urban and rural nursing students that could account for an increased percentage of rural NCLEX-RN failures. A convenience sample was comprised of…

Using Book Clubs to Enhance Social-Emotional and Academic Learning with Urban Adolescent Females of Color

ERIC Educational Resources Information Center

Polleck, Jody N.

2011-01-01

The purpose of this article is to elucidate how book clubs can be used as a forum to enhance students' social-emotional and academic learning. The author conducted a study in a small urban high school with 2 different book clubs: The younger group consisted of 2 African American 9th graders, 2 Latina 9th graders, and 1 African American 10th…

Survey of academic pediatric hospitalist programs in the US: organizational, administrative, and financial factors.

PubMed

Gosdin, Craig; Simmons, Jeffrey; Yau, Connie; Sucharew, Heidi; Carlson, Douglas; Paciorkowski, Natalia

2013-06-01

Many pediatric academic centers have hospital medicine programs. Anecdotal data suggest that variability exists in program structure. To provide a description of the organizational, administrative, and financial structures of academic pediatric hospital medicine (PHM). This online survey focused on the organizational, administrative, and financial aspects of academic PHM programs, which were defined as hospitalist programs at US institutions associated with accredited pediatric residency program (n = 246) and identified using the Accreditation Council for Graduate Medical Education (ACGME) Fellowship and Residency Electronic Interactive Database. PHM directors and/or residency directors were targeted by both mail and the American Academy of Pediatrics Section on Hospital Medicine LISTSERV. The overall response rate was 48.8% (120/246). 81.7% (98/120) of hospitals reported having an academic PHM program, and 9.1% (2/22) of hospitals without a program reported plans to start a program in the next 3 years. Over a quarter of programs provide coverage at multiple sites. Variability was identified in many program factors, including hospitalist workload and in-house coverage provided. Respondents reported planning increased in-house hospitalist coverage coinciding with the 2011 ACGME work-hour restrictions. Few programs reported having revenues greater than expenses (26% single site, 4% multiple site). PHM programs exist in the majority of academic centers, and there appears to be variability in many program factors. This study provides the most comprehensive data on academic PHM programs and can be used for benchmarking as well as program development. Copyright © 2013 Society of Hospital Medicine.

Patient Safety Outcomes in Small Urban and Small Rural Hospitals

ERIC Educational Resources Information Center

Vartak, Smruti; Ward, Marcia M.; Vaughn, Thomas E.

2010-01-01

Purpose: To assess patient safety outcomes in small urban and small rural hospitals and to examine the relationship of hospital and patient factors to patient safety outcomes. Methods: The Nationwide Inpatient Sample and American Hospital Association annual survey data were used for analyses. To increase comparability, the study sample was…

Hospital mortality prediction for intermediate care patients: Assessing the generalizability of the Intermediate Care Unit Severity Score (IMCUSS).

PubMed

Hager, David N; Tanykonda, Varshitha; Noorain, Zeba; Sahetya, Sarina K; Simpson, Catherine E; Lucena, Juan Felipe; Needham, Dale M

2018-05-19

The Intermediate Care Unit Severity Score (IMCUSS) is an easy to calculate predictor of in-hospital death, and the only such tool developed for patients in the intermediate care setting. We sought to examine its external validity. Using data from patients admitted to the intermediate care unit (IMCU) of an urban academic medical center from July to December of 2012, model discrimination and calibration for predicting in-hospital death were assessed using the area under the receiver operating characteristic (AUROC) and the Hosmer-Lemeshow goodness-of-fit chi-squared (HL GOF X 2 ) test, respectively. The standardized mortality ratio (SMR) with 95% confidence intervals (95% CI) was also calculated. The cohort included data from 628 unique admissions to the IMCU. Overall hospital mortality was 8.3%. The median IMCUSS was 10 (Interquartile Range: 0-16), with 229 (36%) patients having a score of zero. The AUROC for the IMCUSS was 0.72 (95% CI: 0.64-0.78), the HL GOF X 2  = 30.7 (P < 0.001), and the SMR was 1.22 (95% CI: 0.91-1.60). The IMCUSS exhibited acceptable discrimination, poor calibration, and underestimated mortality. Other centers should assess the performance of the IMCUSS before adopting its use. Copyright © 2018. Published by Elsevier Inc.

24 CFR 242.57 - Maintenance of hospital facility.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Maintenance of hospital facility. 242.57 Section 242.57 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF...

Bystander Cardiopulmonary Resuscitation Is Clustered and Associated With Neighborhood Socioeconomic Characteristics: A Geospatial Analysis of Kent County, Michigan.

PubMed

Uber, Amy; Sadler, Richard C; Chassee, Todd; Reynolds, Joshua C

2017-08-01

Geographic clustering of bystander cardiopulmonary resuscitation (CPR) is associated with demographic and socioeconomic features of the community where out-of-hospital cardiac arrest (OHCA) occurred, although this association remains largely untested in rural areas. With a significant rural component and relative racial homogeneity, Kent County, Michigan, provides a unique setting to externally validate or identify new community features associated with bystander CPR. Using a large, countywide data set, we tested for geographic clustering of bystander CPR and its associations with community socioeconomic features. Secondary analysis of adult OHCA subjects (2010-2015) in the Cardiac Arrest Registry to Enhance Survival (CARES) data set for Kent County, Michigan. After linking geocoded OHCA cases to U.S. census data, we used Moran's I-test to assess for spatial autocorrelation of population-weighted cardiac arrest rate by census block group. Getis-Ord Gi statistic assessed for spatial clustering of bystander CPR and mixed-effects hierarchical logistic regression estimated adjusted associations between community features and bystander CPR. Of 1,592 subjects, 1,465 met inclusion criteria. Geospatial analysis revealed significant clustering of OHCA in more populated/urban areas. Conversely, bystander CPR was less likely in these areas (99% confidence) and more likely in suburban and rural areas (99% confidence). Adjusting for clinical, demographic, and socioeconomic covariates, bystander CPR was associated with public location (odds ratio [OR] = 1.19; 95% confidence interval [CI] = 1.03-1.39), initially shockable rhythms (OR = 1.48; 95% CI = 1.12-1.96), and those in urban neighborhoods (OR = 0.54; 95% CI = 0.38-0.77). Out-of-hospital cardiac arrest and bystander CPR are geographically clustered in Kent County, Michigan, but bystander CPR is inversely associated with urban designation. These results offer new insight into bystander CPR patterns in mixed urban and rural regions and afford the opportunity for targeted community CPR education in areas of low bystander CPR prevalence. © 2017 by the Society for Academic Emergency Medicine.

Risk of Social Isolation among Older Patients: What Factors Affect the Availability of Family, Friends, and Neighbors upon Hospitalization?

PubMed

Ha, Jung-Hwa; Hougham, Gavin W; Meltzer, David O

2018-03-02

To examine the prevalence of social isolation among older patients admitted to a hospital, and the effects of sociodemographic and health-related factors on the availability of their family, friends, and neighbor networks. Analyses are based on interviews with a sample of 2,449 older patients admitted to an urban academic medical center in the United States. A nine-item version of Lubben's Social Network Scale was developed and used to assess the availability of different social networks. About 47% of the sample was at risk of social isolation. The oldest old and non-White older adults showed greater risk. The availability of family networks was associated with age, sex, marital status, and prior hospitalization; friend networks with age, race, education, prior hospitalization, and functional limitations; neighbor networks with race, education, marital status, and functional limitations. The risk of social isolation and the availability of social support for hospitalized older adults varies by both patient and network characteristics. Health professionals should attend to this risk and the factors associated with such risk. By assessing the availability of various types and frequency of support among older patients, health professionals can better identify those who may need additional support after discharge. Such information should be used in discharge planning to help prevent unnecessary complications and potential readmission.

The Relationship among Achievement Goals, Standardized Test Scores, and Elementary Students' Focus in School

ERIC Educational Resources Information Center

Jones, Martin H.; Mueller, Christian E.

2017-01-01

The study examined whether an academic, social, or both an academic and social focus might relate with achievement goals and academic achievement. Participants were 412 urban elementary school students. Results suggest that students with an academic focus toward school have more mastery-approach and less mastery-avoid achievement goals. Academic…

Social responsibility and the academic medical center: building community-based systems for the nation's health.

PubMed

Foreman, S

1994-02-01

Academic medical centers have fulfilled several of their missions with immense success but have failed to fulfill others. They have responded only modestly to the needs of the nation's underserved rural and urban communities. The author calls on academic medical centers to take an aggressively active role in building the medical infrastructure now missing in these communities and outlines a multi-part agenda for institutional commitment. It includes developing community-based systems of primary care, outreach programs, and social supports; training professionals committed to serving isolated and poor communities; and performing research that will extend the knowledge base to include the health and social issues of the disadvantaged. (Examples are given of institutions that have pioneered these kinds of community-based activities.) To build the new infrastructure, financing must be secured (various sources are discussed), a community-based faculty must be developed, and each institution's leadership--the medical school dean, the hospital executive, and the department chairmen--must come together around a new agenda and support it materially and psychologically, making whatever changes are needed in the corporate culture. The author warns that if centers do not undertake this responsibility for the health of the underserved, a critical job will go undone, a huge opportunity will have been missed, and American society will be the poorer.

Development of Cities Mentor Project: An Intervention to Improve Academic Outcomes for Low-Income Urban Youth through Instruction in Effective Coping Supported by Mentoring Relationships and Protective Settings

ERIC Educational Resources Information Center

Grant, Kathryn E.; Farahmand, Farahnaz; Meyerson, David A.; Dubois, David L.; Tolan, Patrick H.; Gaylord-Harden, Noni K.; Barnett, Alexandra; Horwath, Jordan; Doxie, Jackie; Tyler, Donald; Harrison, Aubrey; Johnson, Sarah; Duffy, Sophia

2014-01-01

This manuscript summarizes an iterative process used to develop a new intervention for low-income urban youth at risk for negative academic outcomes (e.g., disengagement, failure, drop-out). A series of seven steps, building incrementally one upon the other, are described: 1) identify targets of the intervention; 2) develop logic model; 3)…

Preventing hospital-acquired venous thromboembolism: Improving patient safety with interdisciplinary teamwork, quality improvement analytics, and data transparency.

PubMed

Schleyer, Anneliese M; Robinson, Ellen; Dumitru, Roxana; Taylor, Mark; Hayes, Kimberly; Pergamit, Ronald; Beingessner, Daphne M; Zaros, Mark C; Cuschieri, Joseph

2016-12-01

Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE. Pre/post assessment. Urban academic tertiary referral center, level 1 trauma center, safety net hospital; all patients. We formed a multidisciplinary VTE task force to review all HA-VTE events, assess prevention practices relative to evidence-based institutional guidelines, and identify improvement opportunities. The task force developed an electronic tool to facilitate efficient VTE event review and designed decision-support and reporting tools, now integrated into the electronic health record, to bring optimal VTE prevention practices to the point of care. Performance is shared transparently across the institution. Harborview benchmarks process and outcome performance, including patient safety indicators and core measures, against hospitals nationally using Hospital Compare and Vizient data. Our program has resulted in >90% guideline-adherent VTE prevention and zero preventable HA-VTEs. Initiatives have resulted in a 15% decrease in HA-VTE and a 21% reduction in postoperative VTE. Keys to success include the multidisciplinary approach, clinical roles of task force members, senior leadership support, and use of quality improvement analytics for retrospective review, prospective reporting, and performance transparency. Ongoing task force collaboration with frontline providers is critical to sustained improvements. Journal of Hospital Medicine 2016;11:S38-S43. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Digital expression among urban, low-income African American adolescents.

PubMed

Baker, Christina M; Staiano, Amanda E; Calvert, Sandra L

2011-01-01

Digital production is a means through which African American adolescents communicate and express their experiences with peers. This study examined the content and the form of the digital productions of 24 urban, low-income African American adolescents who attended a summer academic program. The content of student digital productions focused on academic experiences and friendships. Their production styles revealed that youth used perceptually salient production features, such as rapid scene changes and loud rap music. The results suggest that when placed in a supportive, academic environment and provided with digital production resources, students who traditionally face barriers due to cultural and economic inequalities digitally express to their peers an interest in academics and positive peer relationships, and that these youth communicate their experiences through a shared production style that reflects their broader cultural experiences.

Predicting Children's Asthma Hospitalizations: Rural and Urban Differences in Texas

ERIC Educational Resources Information Center

Grineski, Sara E.

2009-01-01

Asthma is the number one chronic health condition facing children today; however, little is known about rural-urban inequalities in asthma. This "area effects on health" study examines rural-urban differences in childhood asthma hospitalizations within the state of Texas using negative binomial regression models. Effects associated with…

Comparison of Primary Cesarean Delivery Rates Among Low-Risk Women in Urban and Rural Hospitals in Hawaii.

PubMed

Chang, Ann Lee; Pacheco, Misty; Yoshino, Kurt; Miyamura, Jill; Maddock, Jay

2016-09-01

Objective The purpose of this study was to examine primary cesarean delivery rates among women with low risk pregnancies in urban and rural hospitals in Hawaii. Methods This is a retrospective study of all low-risk women (term, vertex, singleton) who had a primary cesarean delivery in any Hawaii hospital from 2010 to 2011 using a statewide health information database. Hospitals were divided into two categories: rural and urban. Results Of the 27,096 women who met criteria for this study, 7105 (26.2 %) delivered in a rural hospital. Low-risk women who delivered in a rural hospital had a primary cesarean delivery rate of 18.5 % compared to 11.8 % in the urban hospitals, p < .0001. Low-risk women who delivered at rural hospitals had significantly higher unadjusted and adjusted odds ratios for cesarean delivery. The association with rural hospital was stronger after adjusting for confounders, aOR 2.47 (95 % CI 2.23-2.73) compared to unadjusted OR 1.70 (95 % CI 1.58-1.83) for primary cesarean delivery. Conclusions on practice In a geographically isolated population, rates of primary cesarean delivery among low-risk women are significantly higher in rural hospitals. This disparity should be investigated further.

NATIONAL URBAN DATABASE AND ACCESS PORTAL TOOL (NUDAPT): FACILITATING ADVANCEMENTS IN URBAN METEOROLOGY AND CLIMATE MODELING WITH COMMUNITY-BASED URBAN DATABASES

EPA Science Inventory

We discuss the initial design and application of the National Urban Database and Access Portal Tool (NUDAPT). This new project is sponsored by the USEPA and involves collaborations and contributions from many groups from federal and state agencies, and from private and academic i...

Accessing Resources for Identity Development by Urban Students and Teachers: Foregrounding Context

ERIC Educational Resources Information Center

Luehmann, April Lynn

2009-01-01

Many attempt to address the documented achievement gap between urban and suburban students by offering special programs to enrich urban students' academic experiences and proficiencies. Such was the case in the study described by DeGennaro and Brown in which urban students participated in an after-school technology course intended to address the…

The Economics and Financing of Urban Schools: Toward a Productive, Solution-Oriented Discourse

ERIC Educational Resources Information Center

Crampton, Faith E.

2010-01-01

Across the nation, a surprising number of both critics and advocates of urban schools demonstrate a naivete about the limits and possibilities of funding in relationship to the academic success of urban students. On one hand, critics often argue, without solid evidence or informed analysis, that urban school districts have sufficient funds to…

Community Violence Exposure and Children's Academic Functioning.

ERIC Educational Resources Information Center

Schwartz, David; Gorman, Andrea Hopmeyer

2003-01-01

Reports a cross-sectional investigation of the link between community violence exposure and academic difficulties for 237 urban elementary school children. Analyses indicated that community violence exposure was associated with poor academic performance. These relations appear to be mediated by symptoms of depression and disruptive behavior.…

Time Perspective and School Membership as Correlates to Academic Achievement among African American Adolescents

ERIC Educational Resources Information Center

Adelabu, Detris Honora

2007-01-01

This study examined the relationship of academic achievement to time perspective (future, present) and school membership (belonging, acceptance, rejection) among 232 low-income, urban African American adolescents. Findings indicated positive, significant relationships among academic achievement, future time perspective, school belonging, and…

Academic Success of Adolescents in Poverty

ERIC Educational Resources Information Center

Palomar-Lever, Joaquina; Victorio-Estrada, Amparo

2017-01-01

This study identified significant predictors of important academic results such as academic performance and school desertion by adolescent students living in poverty in both urban and rural settings. The results indicate the relative importance of individual, family, educational and social variables reported by the young people, and the…

Roles and methods of performance evaluation of hospital academic leadership.

PubMed

Zhou, Ying; Yuan, Huikang; Li, Yang; Zhao, Xia; Yi, Lihua

2016-01-01

The rapidly advancing implementation of public hospital reform urgently requires the identification and classification of a pool of exceptional medical specialists, corresponding with incentives to attract and retain them, providing a nucleus of distinguished expertise to ensure public hospital preeminence. This paper examines the significance of academic leadership, from a strategic management perspective, including various tools, methods and mechanisms used in the theory and practice of performance evaluation, and employed in the selection, training and appointment of academic leaders. Objective methods of assessing leadership performance are also provided for reference.

Organization of Care for Acute Myocardial Infarction in Rural and Urban Hospitals in Kansas

ERIC Educational Resources Information Center

Ellerbeck, Edward F.; Bhimaraj, Arvind; Perpich, Denise

2004-01-01

One in 4 Americans lives in a rural community and relies on rural hospitals and medical systems for emergent care of acute myocardial infarctions (AMI). The infrastructure and organization of AMI care in rural and urban Kansas hospitals was examined. Using a nominal group process, key elements within hospitals that might influence quality of AMI…

Comparison of self-esteem and maternal attitude between children with learning disability and unaffected siblings.

PubMed

Lahane, Sandeep; Shah, Henal; Nagarale, Vivek; Kamath, Ravindra

2013-09-01

To compare self-esteem and maternal attitude between children with learning disability and their unaffected siblings. This cross sectional study was conducted at a tertiary care hospital in an urban setting. It comprised of 31 pairs of children with a learning disability, their unaffected siblings and input from their mothers. All children were assessed with Rosenberg self-esteem scale. Mothers were asked to fill Index of parental attitude (IPA) and semi structured proforma with demographic data and questionnaire about her children with a learning disability and his/her unaffected sibling. Self-esteem was found to be lower in children with learning disability. They felt they do not have much to be proud of and have a fewer number of good qualities. They are also inclined to consider themselves as failures. In factors affecting self-esteem, index of parental attitude was found to be unfavorable towards children with learning disability. Mothers felt child was interfering with their activities and was getting on their nerves. In addition, they also felt that they do not understand their child, feel like they do not love their child and wished that child was more like others they know off. More academic failures, academic difficulties and negative school report were also perceived by mother as lowering child's self-esteem. Self-esteem was lower in children with learning disability. In factors affecting self-esteem maternal attitude, academic difficulties, academic failure and negative school reports was found to be unfavorable.

Examining patterns in medication documentation of trade and generic names in an academic family practice training centre.

PubMed

Summers, Alexander; Ruderman, Carly; Leung, Fok-Han; Slater, Morgan

2017-09-22

Studies in the United States have shown that physicians commonly use brand names when documenting medications in an outpatient setting. However, the prevalence of prescribing and documenting brand name medication has not been assessed in a clinical teaching environment. The purpose of this study was to describe the use of generic versus brand names for a select number of pharmaceutical products in clinical documentation in a large, urban academic family practice centre. A retrospective chart review of the electronic medical records of the St. Michael's Hospital Academic Family Health Team (SMHAFHT). Data for twenty commonly prescribed medications were collected from the Cumulative Patient Profile as of August 1, 2014. Each medication name was classified as generic or trade. Associations between documentation patterns and physician characteristics were assessed. Among 9763 patients prescribed any of the twenty medications of interest, 45% of patient charts contained trade nomenclature exclusively. 32% of charts contained only generic nomenclature, and 23% contained a mix of generic and trade nomenclature. There was large variation in use of generic nomenclature amongst physicians, ranging from 19% to 93%. Trade names in clinical documentation, which likely reflect prescribing habits, continue to be used abundantly in the academic setting. This may become part of the informal curriculum, potentially facilitating undue bias in trainees. Further study is needed to determine characteristics which influence use of generic or trade nomenclature and the impact of this trend on trainees' clinical knowledge and decision-making.

Characterization of children hospitalized with traumatic brain injuries after building falls.

PubMed

Loftus, Kirsten V; Rhine, Tara; Wade, Shari L; Pomerantz, Wendy J

2018-04-10

Unintentional falls cause a substantial proportion of pediatric traumatic brain injury (TBI), with building falls carrying particularly high risk for morbidity and mortality. The cohort of children sustaining building fall-related TBI has not been well-examined. We sought to characterize children hospitalized with building fall-related TBIs and evaluate if specific factors distinguished these children from children hospitalized with TBI due to other fall mechanisms. We secondarily assessed if TBI severity among children injured due to a building fall varied between children from urban versus non-urban areas. This was a secondary analysis of the Pediatric Health Information System (PHIS), an administrative database from pediatric hospitals. We identified children < 15 years old, hospitalized between 2009 and 2014, with an associated TBI-related diagnosis due to a fall as determined by International Classification of Diseases, Clinical Modification, Ninth revision (ICD9-CM) diagnosis codes. Urban versus non-urban status was determined using PHIS-assigned Rural-Urban Commuting Area codes. Injury severity (i.e. Injury Severity Score (ISS) and head Abbreviated Injury Scale (AIS) score) were calculated. Head AIS scores were dichotomized into minor/moderate (1-2) and serious/severe (3-6) for analysis. Frequencies, descriptive statistics, Chi-square analysis, and Mann-Whitney U analysis characterized populations and determined group differences. The study cohort included 23,813 children, of whom 933 (3.9%) fell from buildings. Within the building fall cohort, 707 (75.8%) resided in urban areas, 619 (66.3%) were male, 513 (55.0%) were white, and 528 (56.6%) had government insurance; the mean age was 3.8 years (SD 2.9). There was a larger proportion of children with serious/severe TBI among those injured from building falls relative to other falls (63.4% vs 53.9%, p <  0.01). Among children injured from building falls, those from non-urban areas were more likely to sustain a serious/severe TBI relative to urban children (58.9% vs 53.6%, p <  0.01). Children hospitalized following buildings falls with TBI sustained more severe injuries relative to other fall types. Although a majority of children hospitalized with building fall related-TBIs were from urban areas, those from non-urban areas frequently sustained serious head injuries. Future research should target expanding prevention efforts to include non-urban areas.

Mentoring Urban Black Middle School Male Students: Implications for Academic Achievement

ERIC Educational Resources Information Center

Gordon, Derrick M.; Iwamoto, Derek K.; Ward, Nadia; Potts, Randolph; Boyd, Elizabeth

2009-01-01

Researchers have called for innovative and culturally responsive intervention programs to enhance male, Black middle school students' academic achievement. Mentoring has received considerable attention as a novel remedy. Although anecdotal evidence supports the positive role of mentoring on academic achievement, these results are not consistent.…

Teaching Quality, Learning Satisfaction, and Academic Performance among Hospitality Students in Taiwan

ERIC Educational Resources Information Center

Ko, Wen-Hwa; Chung, Feng-Ming

2014-01-01

The purpose of this study is to examine the effect of the teaching quality of culinary arts teachers and student learning satisfaction on the academic performance of hospitality students. This study surveys the students in hospitality departments at universities in Taiwan. A total of 406 (81.2%) valid questionnaires were received. Research results…

Urbanization and Spatial Organization: Hospital and Orphanage Location in Chicago, 1848-1916

ERIC Educational Resources Information Center

Britton, Marcus; Ocasio, William

2007-01-01

What factors affect where organizations locate facilities in local communities? This paper examines how urban development influenced the neighborhood location of two very different types of facilities, general hospitals and orphanages, over the 70-year period during which Chicago emerged as an urban metropolis. Our results suggest that the human…

Helpful or harmful? The impact of strategic change on the performance of U.S. urban hospitals.

PubMed

Trinh, Hanh Q; O'Connor, Stephen J

2002-02-01

To contribute to the debate as to whether strategic change helps or harms organizations by empirically examining how strategic change influences performance change in urban hospitals. AHA Annual Survey (1994 and 1996), Health Care Financing Administration's Medicare Cost Reports (1994 and 1996) and Medicare HMO Files (1994), U.S. Bureau of the Census' County Business Patterns Files (1994), and Area Resources File (1994). This work employed a longitudinal approach using a panel design to study the effect of environmental and organizational characteristics on urban hospital strategic behavior and performance. A path analytic model was used to examine the simultaneous effects of environmental and organizational characteristics (1994) on strategic behavior (change in strategies to enhance HMO business and change in strategies to control costs 1994-96), as well as the effects of all of these variables on change in urban hospital performance (change in market share, change in operational efficiency, change in financial performance 1994-96). (1) Environmental context exerts a greater influence on urban hospitals' HMO business enhancement strategies, whereas organizational characteristics have more influence on cost-control strategies. (2) Between the two strategies, HMO business enhancement and cost control, strategic change to enhance business with HMOs is much more complex. (3) Strategic change observed across the 1994 to 1996 time period can be either helpful or harmful to urban hospitals. A strategic change that contributes positively to one type of performance can negatively impact the other. Although differences of opinion persist in the strategic change debate, results of this study indicate that strategic change can be helpful or harmful to urban hospitals, and its consequences are far more complex than previously thought. Strategic rationality has its own limitations and cannot always be relied on to yield expected results. Hospital strategic changes require coordination to achieve greater performance results.

Health Services Utilization Among Fee-for-Service Medicare and Medicaid Patients Under Age 65 with Behavioral Health Illness at an Urban Safety Net Hospital.

PubMed

Cancino, Ramon S; Jack, Brian W; Jarvis, John; Cummings, Alice Kate; Cooper, Ellie; Cremieux, Pierre-Yves; Burgess, James F

2017-07-01

In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011. We compared patients with and without behavioral health illness. The main outcome measures were hospital admission and ED use. Chi-square and Wilcoxon rank-sum tests were used for descriptive statistics on categorical and continuous variables, respectively. Greedy propensity score matching was used to control for confounding factors. Rate ratios (RR) and 95% confidence intervals (CI) were determined after matching and after adjusting for those variables that remained significantly different after matching. In 2011, 10% of all fee-for-service dual eligible patients aged less than 65 years in Massachusetts were seen at Boston Medical Center. Data before propensity score matching showed significant differences in age, sex, race/ethnicity, marital status, education, employment, physical comorbidities, and Charlson Comorbidity Index score between patients with and without behavioral health illness. Analysis after propensity score matching found significant differences in sex, Hispanic race, and other education and employment status. Compared with patients without behavioral health illness, patients with behavioral health illness had a higher RR for hospital admissions (RR = 2.07; 95% CI = 1.81-2.38; P < 0.001) and ED use (RR = 1.61; 95% CI = 1.46-1.77; P < 0.001). Results were robust after adjusting for characteristics that remained statistically significantly different after propensity score matching. Adult dual eligible patients aged less than 65 years with behavioral health illness in the Medicaid fee-for-service plan had significantly higher rates of hospital admission and ED use compared with dual eligible patients without behavioral health illness at the largest urban safety net medical center in New England. Safety net hospitals care for a large proportion of dual eligible patients with behavioral health illness. Further research is needed to elucidate the systems-related and patient-centered factors contributing to the utilization behaviors of this patient population. This research was funded in part by a National Research Service Award (T3HP10028-14-01). The authors have no conflicts of interests to disclose. Cancino had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design were contributed by Cancino, Jack, and Burgess, with assistance from Cremieux. Cancino and Cremieux took the lead in data collection, along with Jack and Burgess, and data interpretation was performed by Jarvis, Cummings, and Cooper, along with the other authors. The manuscript was written primarily by Cancino, along with Jack and Burgess, and revised primarily by Cancino, along with the other authors.

Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.

PubMed

Unaka, Ndidi I; Statile, Angela; Haney, Julianne; Beck, Andrew F; Brady, Patrick W; Jerardi, Karen E

2017-02-01

The average American adult reads at an 8th-grade level. Discharge instructions written above this level might increase the risk of adverse outcomes for children as they transition from hospital to home. We conducted a cross-sectional study at a large urban academic children's hospital to describe readability levels, understandability scores, and completeness of written instructions given to families at hospital discharge. Two hundred charts for patients discharged from the hospital medicine service were randomly selected for review. Written discharge instructions were extracted and scored for readability (Fry Readability Scale [FRS]), understandability (Patient Education Materials Assessment Tool [PEMAT]), and completeness (5 criteria determined by consensus). Descriptive statistics enumerated the distribution of readability, understandability, and completeness of written discharge instructions. Of the patients included in the study, 51% were publicly insured. Median age was 3.1 years, and median length of stay was 2.0 days. The median readability score corresponded to a 10th-grade reading level (interquartile range, 8-12; range, 1-13). Median PEMAT score was 73% (interquartile range, 64%-82%; range, 45%-100%); 36% of instructions scored below 70%, correlating with suboptimal understandability. The diagnosis was described in only 33% of the instructions. Although explicit warning signs were listed in most instructions, 38% of the instructions did not include information on the person to contact if warning signs developed. Overall, the readability, understandability, and completeness of discharge instructions were subpar. Efforts to improve the content of discharge instructions may promote safe and effective transitions home. Journal of Hospital Medicine 2017;12:98-101. © 2017 Society of Hospital Medicine.

Gender disparities in leadership and scholarly productivity of academic hospitalists.

PubMed

Burden, Marisha; Frank, Maria G; Keniston, Angela; Chadaga, Smitha R; Czernik, Zuzanna; Echaniz, Marisa; Griffith, Jennifer; Mintzer, David; Munoa, Anna; Spence, Jeffrey; Statland, Barbara; Teixeira, Joao Pedro; Zoucha, Jeff; Lones, Jason; Albert, Richard K

2015-08-01

Gender disparities still exist for women in academic medicine but may be less evident in younger cohorts. Hospital medicine is a new field, and the majority of hospitalists are <41 years of age. To determine whether gender disparities exist in leadership and scholarly productivity for academic hospitalists and to compare the findings to academic general internists. Prospective and retrospective observational study. University programs in the United States. Gender distribution of (1) academic hospitalists and general internists, (2) division or section heads for both specialties, (3) speakers at the 2 major national meetings of the 2 specialties, and (4) first and last authors of articles from the specialties' 2 major journals We found equal gender representation of hospitalists and general internists who worked in university hospitals. Divisions or sections of hospital medicine and general internal medicine were led by women at 11/69 (16%) and 28/80 (35%) of university hospitals, respectively (P = 0.008). Women hospitalists and general internists were listed as speakers on 146/557 (26%) and 291/580 (50%) of the presentations at national meetings, respectively (P < 0.0001), first authors on 153/464 (33%) and 423/895 (47%) publications, respectively (P < 0.0001), and senior authors on 63/305 (21%) and 265/769 (34%) articles, respectively (P < 0.0001). Despite hospital medicine being a newer field, gender disparities exist in leadership and scholarly productivity. © 2015 Society of Hospital Medicine.

Closing the Achievement Gap: Urban Schools. CSR Connection.

ERIC Educational Resources Information Center

Porter, Kathleen; Soper, Stephanie

This report reviews efforts to reform urban schools, focusing on initiatives in Tennessee and California as examples from which distric leaders may draw useful lessons. The report suggests that comprehensive school reform (CSR) offers promise to struggling urban schools by focusing on transforming the academic climate, school culture, and…

After-School Literacy Engagements with Struggling Readers

ERIC Educational Resources Information Center

Piazza, Susan V.; Duncan, Lonnie E.

2012-01-01

Parental incarceration, poverty, urban violence, and drug use can be underlying factors of academic achievement gaps between Black urban males and their counterparts. These risk factors have the potential to position low-income urban students as struggling readers. Two qualitative case studies obtained from a larger mixed methods study illustrate…

Contribution of case-mix classification to profiling hospital characteristics and productivity.

PubMed

Kuwabara, Kazuaki; Matsuda, Shinya; Fushimi, Kiyohide; Ishikawa, Koichi B; Horiguchi, Hiromasa; Hayashida, Kenshi; Fujimori, Kenji

2011-01-01

Case-mix classification has made it possible to analyze acute care delivery case volumes and resources. Data arising from observed differences have a role in planning health policy. Aggregated length of hospital stay (LOS) and total charges (TC) as measures of resource use were calculated from 34 case-mix groups at 469 hospitals (1,721,274 eligible patients). The difference between mean resource use of all hospitals and the mean resource use of each hospital was subdivided into three components: amount of variation attributable to hospital practice behavior (efficiency); amount attributable to hospital case-mix (complexity); and amount attributable to the interaction. Hospital characteristics were teaching status (academic or community), ownership, disease coverage, patients, and hospital volume. Multivariate analysis was employed to determine the impact of hospital characteristics on efficiency. Mean LOS and TC were greater for academic than community hospitals. Academic hospitals were least associated with LOS and TC efficiency. Low disease coverage was a predictor of TC efficiency while low patient volume was a predictor of unnecessarily long hospital stays. There was an inverse correlation between complexity and efficiency for both LOS and TC. Policy makers should acknowledge that differentiation of hospital function needs careful consideration when measuring efficiency. Copyright © 2010 John Wiley & Sons, Ltd.

Are Australasian academic physicians an endangered species?

PubMed

Wilson, A

2007-11-01

It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient-based services as well as a corporate health-care ethos or does it relate to innate problems in the training process and career structure for academic clinicians? A better understanding of the barriers to involvement in academic practice, including the effect of gender, the role and effect of overseas training, expectation of further research degrees and issues pertaining to the Australian academic workplace will facilitate recruitment and retention of the next generation of academic clinicians. Physician-scientists remain highly relevant as medical practice and education evolves in the 21st century. Hospital-based academics carry out a critical role in the ongoing mentoring of trainees and junior colleagues, whose training is still largely hospital based in most specialty programmes. Academic clinicians are uniquely placed to translate the rapid advances in medical biology into the clinical sphere, by guiding and carrying out translational research as well as leading clinical studies. Academic physicians also play key leadership in relations with government and industry, in professional groups and medical colleges. Thus, there is a strong case to assess the problems facing recruitment and retention of physician-scientists in academic practice and to develop workable solutions.

Comparing Academic Library Spending with Public Libraries, Public K-12 Schools, Higher Education Public Institutions, and Public Hospitals between 1998-2008

ERIC Educational Resources Information Center

Regazzi, John J.

2012-01-01

This study compares the overall spending trends and patterns of growth of Academic Libraries with Public Libraries, K-12 schools, higher education institutions, and hospitals in the period of 1998 to 2008. Academic Libraries, while showing a growth of 13% over inflation for the period, far underperformed the growth of the other public institutions…

Academic season does not influence cardiac surgical outcomes at US Academic Medical Centers.

PubMed

Lapar, Damien J; Bhamidipati, Castigliano M; Mery, Carlos M; Stukenborg, George J; Lau, Christine L; Kron, Irving L; Ailawadi, Gorav

2011-06-01

Previous studies have demonstrated the influence of academic season on outcomes in select surgical populations. However, the influence of academic season has not been evaluated nationwide in cardiac surgery. We hypothesized that cardiac surgical outcomes were not significantly influenced by time of year at both cardiothoracic teaching hospitals and non-cardiothoracic teaching hospitals nationwide. From 2003 to 2007, a weighted 1,614,394 cardiac operations were evaluated using the Nationwide Inpatient Sample database. Patients undergoing cardiac operations at cardiothoracic teaching and non-cardiothoracic teaching hospitals were identified using the Association of American Medical College's Graduate Medical Education Tracking System. Hierarchic multivariable logistic regression analyses were used to estimate the effect of academic quarter on risk-adjusted outcomes. Mean patient age was 65.9 ± 10.9 years. Women accounted for 32.8% of patients. Isolated coronary artery bypass grafting was the most common operation performed (64.7%), followed by isolated valve replacement (19.3%). The overall incidence of operative mortality and composite postoperative complication rate were 2.9% and 27.9%, respectively. After accounting for potentially confounding risk factors, timing of operation by academic quarter did not independently increase risk-adjusted mortality (p = 0.12) or morbidity (p = 0.24) at academic medical centers. Risk-adjusted mortality and morbidity for cardiac operations were not associated with time of year in the US at teaching and nonteaching hospitals. Patients should be reassured of the safety of performance of cardiac operations at academic medical centers throughout a given academic year. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli: comparison between urban and rural hospitals.

PubMed

Cheng, Ming-Fang; Chen, Wan-Ling; Huang, I-Fei; Chen, Jung-Ren; Chiou, Yee-Hsuan; Chen, Yao-Shen; Lee, Susan Shin-Jung; Hung, Wan-Yu; Hung, Chih-Hsin; Wang, Jiun-Ling

2016-08-01

Community-acquired urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is an emerging problem. Compared with urban infants, rural infants may encounter different distributions of community-acquired resistant strains and various barriers to efficient management. A retrospective survey and comparison was conducted for infants with UTI caused by ESBL-producing E. coli admitted to an urban hospital (n = 111) and a rural hospital (n = 48) in southern Taiwan from 2009 to 2012. Compared with 2009 and 2010, the total number of cases at both hospitals significantly increased in 2011 and 2012 (p < 0.001). Compared with the rural patients, the urban patients were significantly younger, and they had fewer days of fever before and after admission, fewer presentations of poor activity and poor appetite, and a lower serum creatinine level. Most of the patients had no prior history of illness, and we could not identify any significant different risk factors for acquiring ESBL-producing E. coli, such as past antimicrobial use, hospitalization, UTI, and underlying renal diseases, between the urban and rural populations. The increase in community-acquired UTI in infants caused by ESBL-producing E. coli was similar between the urban and rural populations. Our preliminary data suggest that the rural-urban disparities were probably related to easy access to health care by the urban population. ESBL complicates disease management, and the increase in the prevalence of ESBL producers is a major health concern and requires further healthy carrier and environmental surveillance.

Recruitment and retention strategies for hospital laboratory personnel in urban and rural settings.

PubMed

Slagle, Derek R

2013-01-01

Laboratory directors and administrators play vital roles in the recruitment and retention processes of their employees. A total of 71 laboratory directors from hospitals across 51 counties in Tennessee responded to questionnaires regarding recruitment and retention strategies. Respondents reported strategies for recruitment and retention, which were agreed to be effective by management. Overall, these major strategies were consistent regardless of geographic location and limited differences were noted with regard to urban-rural locations. The findings that varied significantly between urban and rural locations included: 1) rural employees needed additional supervision; 2) rural hospitals relied on local residents more so than urban hospitals; 3) rural laboratory administrators noted more limited access to resources; and the 4) lower effectiveness of recruitment agencies and family relocation programs for rural hospitals. This is significant given the disparities often associated with rural areas, and the potential to develop more successful recruitment and retention strategies for those areas. Active managers in clinical laboratory science programs in the hospital setting should note effective strategies for both, recruitment and retention of personnel, and note the potential impact of geography on such processes.

Quality of Care for Myocardial Infarction in Rural and Urban Hospitals

ERIC Educational Resources Information Center

Baldwin, Laura-Mae; Chan, Leighton; Andrilla, C. Holly A.; Huff, Edwin D.; Hart, L. Gary

2010-01-01

Background: In the mid-1990s, significant gaps existed in the quality of acute myocardial infarction (AMI) care between rural and urban hospitals. Since then, overall AMI care quality has improved. This study uses more recent data to determine whether rural-urban AMI quality gaps have persisted. Methods: Using inpatient records data for 34,776…

[GPs' self-perception of their own role compared with hospital, ambulatory, academic, and health organisation physicians].

PubMed

Daghio, Maria Monica; Gaglianò, Giuseppe; Bevini, Massimo; Cadioli, Tiziano; Delvecchio, Carlo; Guidetti, Patrizia; Lorenzetti, Manuela; Fattori, Giuseppe; Ciardullo, Anna Vittoria

2005-05-01

Aim of the present study was to explore how the 76 general practitioners (GPs) - serving Carpi district (90,000 residents) - value their own role compared with the hospital, ambulatory, academic, and health organisation physicians'. GPs had a positive self-image only in comparison with health organisation doctors (7 vs 7 grades). GPs disappointed with themselves when comparing their role with ambulatory (-1.6 grades), academic (-1.9 grades) and hospital doctors (-2.2 grades). Secondarily, GPs perceived patients' valuing their professional role mostly 'subordinate' to the other physicians', except health organisation colleagues'.

Academic health centers in competitive markets.

PubMed

Reuter, J; Gaskin, D

1997-01-01

Academic health center (AHC) hospitals and other major teaching hospitals have funded a portion of their academic missions through patient care revenues. Using all-payer state discharge data, this DataWatch presents information on how these institutions are being affected by market changes. Although AHCs are not as successful as other hospitals are in attracting managed care patients, competitive pressures had not eroded AHCs' financial status as of 1994. However, increasing enrollment in managed care and potential changes in both Medicare and Medicaid suggest that pressure on the financing of these institutions' social missions will continue to grow over time.

Mobile Robotic Telepresence Solutions for the Education of Hospitalized Children.

PubMed

Soares, Neelkamal; Kay, Jeffrey C; Craven, Geoff

2017-01-01

Hospitalization affects children's school attendance, resulting in poor academic and sociodevelopmental outcomes. The increasing ubiquity of mobile and tablet technology in educational and healthcare environments, and the growth of the mobile robotic telepresence (MRT) industry, offer opportunities for the use of MRT to connect hospitalized children to their school environments. This article describes an approach at one rural healthcare center in collaboration with local school districts with the aim of describing strategies and limitations of MRT use. Future research is needed on MRT implementation, from user experiences to operational strategies, and outcome metrics need to be developed to measure academic and socioemotional outcomes. By partnering with educational systems and using this technology, hospital information technology personnel can help hospitalized children engage with their school environments to maintain connections with peers and access academic instruction.

Reflections of Academic Experiences from Formerly Incarcerated African American Males

ERIC Educational Resources Information Center

Jeffers, Adam R.

2017-01-01

This research examines academic experiences of African American males (ages 18-25) who attended urban schools in southern California. The participants were incarcerated for at least one year prior to being housed in a pre-release program where they reflected on their academic experiences and perceptions of the school environment. The participants'…

A networking approach to reduce academic and social isolation for junior doctors working in rural hospitals in India.

PubMed

Vyas, R; Zachariah, A; Swamidasan, I; Doris, P; Harris, I

2012-07-01

Graduates from Christian Medical College (CMC) Vellore face many challenges while doing their service obligation in smaller hospitals, including academic and social isolation. To overcome these challenges, CMC aspired through its Fellowship in Secondary Hospital Medicine (FSHM), a 1-year blended on-site and distance-learning program, to provide academic and social support through networking for junior doctors working in rural areas. The purpose of this paper is to report the evaluation of the networking components of the FSHM program, with a focus on whether it succeeded in providing academic and social support for these junior doctors. A mixed method evaluation was done using written surveys for students and faculty and telephone interviews for students. Evidence for validity was gathered for the written survey. Criteria for validity were also applied for the qualitative data analysis. The major strengths of networking with faculty and peers identified were that it provided social support,, academic support through discussion about patient management problems and a variety of cases seen in the hospital, guidance on projects and reminders about deadlines. Recommendations for improvement included use of videoconferencing and Yahoo Groups. It is useful to incorporate networking into distance-learning educational programs for providing support to junior doctors working in rural hospitals.

Traumatic brain injury in a rural and an urban Tanzanian hospital--a comparative, retrospective analysis based on computed tomography.

PubMed

Maier, Daniel; Njoku, Innocent; Schmutzhard, Erich; Dharsee, Jaffer; Doppler, Magdalena; Härtl, Roger; Winkler, Andrea Sylvia

2014-01-01

In a resource-poor environment such as rural East Africa, expensive medical devices such as computed tomographic (CT) scanners are rare. The CT scanner at the rural Haydom Lutheran Hospital (HLH) in Tanzania therefore offers a unique chance to observe possible differences with urban medical centers in the disease pattern of trauma-related cranial pathologies. The purpose of this study was to compare traumatic brain injuries (TBIs) between a rural and an urban area of Tanzania. HLH has 350 beds and one CT scanner. The urban Aga Khan Hospital is a private hospital with 80 beds and one CT scanner. This was a retrospective study. Data of 248 patients at HLH and of 432 patients at Aga Khan Hospital with TBI could be collected. The prevalence of TBI was significantly higher in the rural area compared to the urban area (34.2% vs. 21.9%, P < 0.0001). TBI due to violence was noted to occur more frequently at HLH, whereas road traffic accidents were more frequent at the Aga Khan Hospital. The number of patients showing a normal CT result was significantly higher in the urban area (53.0% vs. 35.9%, P < 0.0001). Bone fractures (35.9% vs. 15.7%, P < 0.0001) and pneumocephalus (6.9% vs. 0.9%, P < 0.0001) were diagnosed significantly more frequently in the rural survey. Soft tissue swelling (11.6% vs. 1.2%, P < 0.0001) and frontal sinus injuries (7.4% vs. 0.4%, P < 0.0001) were observed significantly more often in the urban setting. This study documents the burden of TBI and the differences in TBI-related CT diagnoses and their incidence between urban and rural areas in Eastern Africa. These results are important as they demonstrate that patients with severe TBI are not a primarily urban concern. Management of TBI should be included in the training curricula for health personnel alike irrespective of whether their workplace is primarily urban or rural. Copyright © 2014 Elsevier Inc. All rights reserved.

Without the Academic Part, It Wouldn't Be Squash": Youth Development in an Urban Squash Program

ERIC Educational Resources Information Center

Hemphill, Michael A.; Richards, K. Andrew R.

2016-01-01

Purpose: The purpose of this study was to examine youth development outcomes in an Urban Squash program. Methods: A mixed method approach to was employed to address three research questions: 1) to what extent did the Urban Squash program exhibit features of a quality OST program?; 2) what aspects of the Urban Squash program were most valued by…

Aetiologies of diarrhoea in adults from urban and rural treatment facilities in Bangladesh.

PubMed

Ferdous, F; Ahmed, S; Farzana, F D; Das, J; Malek, M A; Das, S K; Salam, M A; Faruque, A S G

2015-05-01

The objective of our analysis was to describe the aetiology, clinical features, and socio-demographic background of adults with diarrhoea attending different urban and rural diarrhoeal disease hospitals in Bangladesh. Between January 2010 and December 2011, a total of 5054 adult diarrhoeal patients aged ⩾20 years were enrolled into the Diarrhoeal Disease Surveillance Systems at four different hospitals (two rural and two urban) of Bangladesh. Middle-aged [adjusted odds ratio (aOR) 0·28, 95% confidence interval (CI) 0·23-0·35, P < 0·001] and elderly (aOR 0·15, 95% CI 0·11-0·20, P < 0·001) patients were more likely to present to rural diarrhoeal disease facilities than urban ones. Vibrio cholerae was the most commonly isolated pathogen (16%) of the four pathogens tested followed by rotavirus (5%), enterotoxigenic Escherichia coli (ETEC) (4%), and Shigella (4%). Of these pathogens, V. cholerae (19% vs. 11%, P < 0·001), ETEC (9% vs. 4%, P < 0·001), and rotavirus (5% vs. 3%, P = 0·013) were more commonly detected from patients presenting to urban hospitals than rural hospitals, but Shigella was more frequently isolated from patients presenting to rural hospitals than urban hospitals (7% vs. 2%, P < 0·001). The isolation rate of Shigella was higher in the elderly than in younger adults (8% vs. 3%, P < 0·001). Some or severe dehydration was higher in urban adults than rural adults (P < 0·001). Our findings indicate that despite economic and other progress made, conditions facilitating transmission of V. cholerae and Shigella prevail in adults with diarrhoea in Bangladesh and further efforts are needed to control these infections.

Orientation program for hospital-based nurse practitioners.

PubMed

Bahouth, Mona N; Esposito-Herr, Mary Beth

2009-01-01

The transition from student to practicing clinician is often a challenging and difficult period for many nurse practitioners. Newly graduated nurse practitioners commonly describe feelings of inadequacy in assuming clinical responsibilities, lack of support by team members, unclear expectations for the orientation period, and role isolation. This article describes the formal nurse practitioner orientation program implemented at the University of Maryland Medical Center, a large urban academic medical center, to facilitate the transition of new nurse practitioners into the workforce. This comprehensive program incorporates streamlined administrative activities, baseline didactic and simulation-based critical care education, ongoing and focused peer support, access to formalized resources, and individualized clinical preceptor programs. This formalized orientation program has proven to be one of the key variables to successful integration of nurse practitioners into our acute care clinical teams.

A Tale of Two Cancers: Traveling to Treat Pancreatic and Thyroid Cancer.

PubMed

White, Michael G; Applewhite, Megan K; Kaplan, Edwin L; Angelos, Peter; Huo, Dezheng; Grogan, Raymon H

2017-07-01

Patients diagnosed with a malignancy must decide whether to travel for care at an academic center or receive treatment at a nearby hospital. Here we examine differences in demographics, treatment, and outcomes of those traveling to academic centers for their care vs those not traveling, as well as compare travel for an aggressive vs indolent malignancy. All patients with papillary thyroid carcinoma (PTC) or pancreatic ductal adenocarcinoma (PDAC) undergoing surgical resection and in the National Cancer Database were examined. Travel for care was abstracted from "crowfly" distance between patients' ZIP codes and treatment facility, region, county size, urban/metro/rural status, and facility type. In total, 105,677 patients with PTC and 22,983 patients with PDAC were analyzed. There were no survival differences by travel in the PTC group. Survival was improved for patients with PDAC traveling from urban/rural settings (hazard ratio = 0.89; 95% CI 0.82 to 0.96; p = 0.002). Patients traveling with PDAC were more likely to have a complete resection and lymph node dissection. Those traveling were less likely to receive chemotherapy or radiotherapy (all p < 0.001). Those traveling with PTC were older, more likely to be male, have Medicare insurance, and had a higher stage of disease (all p < 0.001). Rates of radioactive iodine were lower, American Thyroid Association guidelines were more likely followed, and lymph node dissection was more common for those traveling for care of their PTC (all p < 0.001). There are improvements in both quality and survival for those traveling to academic centers for their cancer care. In the case of PTC, this difference in quality did not affect overall survival. In PDAC, however, differences in quality translated to a survival advantage. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

"No One Ever Asked Me": Urban African American Students' Perceptions of Educational Resilience

ERIC Educational Resources Information Center

Williams, Joseph M.; Portman, Tarrell Awe Agahe

2014-01-01

This qualitative study examined high-achieving urban African American high school graduates' (N = 5) retrospective appraisal of what K-12 students from high-risk urban areas need to succeed academically despite seemingly insurmountable social, financial, and educational barriers. Findings revealed 6 themes: shared responsibility for…

Comparing the Effectiveness of Two Models of College Summit Programs in an Urban School Setting

ERIC Educational Resources Information Center

Davis, Wanda

2013-01-01

The inclusion of college preparation programs promote and forecast academic success in postsecondary studies among individual at-risk, African American urban high school students. Past research has shown ongoing, college acceptance, performance, and graduation gaps between at-risk, African American urban high school students when compared to…

What's RITE in St. Louis? Empowering Urban Youth through a Community Tutoring Collaborative

ERIC Educational Resources Information Center

Cochran, Judith A.; Gardner-Andrews, Anna; Benson, Prescott W.; Durbin, Timothy; Peeler, Michelle

2017-01-01

This study profiles tutoring programs that empower urban youth within the Regional Institute of Tutorial Education (RITE), a community collaborative of universities, youth agencies, community service organizations, and school districts. Representative members of RITE detail how they address shared urban problems of academic deficits, school…

Proximal Processes in Urban Classrooms: Engagement and Disaffection in Urban Youth of Color

ERIC Educational Resources Information Center

Wallace, Tanner LeBaron; Chhuon, Vichet

2014-01-01

We examine adolescents' interpretations of instructional interactions to understand the academic and developmental implications of pedagogy for urban youth of color. In doing so, we seek to advance existing knowledge regarding student engagement in two ways--enhancing the ecological validity of such theories and making the links to teacher…

Rural-Urban Gaps in Academic Achievement, Schooling Conditions, Student, and Teachers' Characteristics in Pakistan

ERIC Educational Resources Information Center

Tayyaba, Saadia

2012-01-01

Purpose: Recent educational research has demonstrated rural-urban gaps in achievement and schooling conditions. Evidence from developing countries is still sparse. This study seeks to report rural-urban disparities in achievement, student, teacher, and school characteristics based on a nationally representative sample of grade four students from…

Applying Classification Trees to Hospital Administrative Data to Identify Patients with Lower Gastrointestinal Bleeding

PubMed Central

Siddique, Juned; Ruhnke, Gregory W.; Flores, Andrea; Prochaska, Micah T.; Paesch, Elizabeth; Meltzer, David O.; Whelan, Chad T.

2015-01-01

Background Lower gastrointestinal bleeding (LGIB) is a common cause of acute hospitalization. Currently, there is no accepted standard for identifying patients with LGIB in hospital administrative data. The objective of this study was to develop and validate a set of classification algorithms that use hospital administrative data to identify LGIB. Methods Our sample consists of patients admitted between July 1, 2001 and June 30, 2003 (derivation cohort) and July 1, 2003 and June 30, 2005 (validation cohort) to the general medicine inpatient service of the University of Chicago Hospital, a large urban academic medical center. Confirmed cases of LGIB in both cohorts were determined by reviewing the charts of those patients who had at least 1 of 36 principal or secondary International Classification of Diseases, Ninth revision, Clinical Modification (ICD-9-CM) diagnosis codes associated with LGIB. Classification trees were used on the data of the derivation cohort to develop a set of decision rules for identifying patients with LGIB. These rules were then applied to the validation cohort to assess their performance. Results Three classification algorithms were identified and validated: a high specificity rule with 80.1% sensitivity and 95.8% specificity, a rule that balances sensitivity and specificity (87.8% sensitivity, 90.9% specificity), and a high sensitivity rule with 100% sensitivity and 91.0% specificity. Conclusion These classification algorithms can be used in future studies to evaluate resource utilization and assess outcomes associated with LGIB without the use of chart review. PMID:26406318

Pharmacy density in rural and urban communities in the state of Oregon and the association with hospital readmission rates.

PubMed

Bissonnette, Sarah; Goeres, Leah M; Lee, David S H

2016-01-01

To characterize the pharmacy density in rural and urban communities with hospitals and to examine its association with readmission rates. Ecologic study. Forty-eight rural and urban primary care service areas (PCSAs) in the state of Oregon. All hospitals in the state of Oregon. Pharmacy data were obtained from the Oregon Board of Pharmacy based on active licensure. Pharmacy density was calculated by determining the cumulative number of outpatient pharmacy hours in a PCSA. Oregon hospital 30-day all-cause readmission rates were obtained from the Centers for Medicare and Medicaid Services and were determined with the use of claims data of patients 65 years of age or older who were readmitted to the hospital within 30 days from July 2012 to June 2013. Readmission rates for Oregon hospitals ranged from 13.5% to 16.5%. The cumulative number of pharmacy hours in PCSAs containing a hospital ranged from 54 to 3821 hours. As pharmacy density increased, the readmission rates decreased, asymptotically approaching a predicted 14.7% readmission rate for areas with high pharmacy density. Urban hospitals were in communities likely to have more pharmacy access compared with rural hospitals. Future research should determine if increasing pharmacy access affects readmission rates, especially in rural communities. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Variations in Rural Hospital Costs: Effects of Market Concentration and Location

PubMed Central

Vogel, W. Bruce; Miller, Michael K.

1995-01-01

This article explores two neglected questions: (1) Does the relationship between hospital concentration and costs vary between urban and rural markets? and (2) Do hospital costs in non-metropolitan areas vary with rurality? Covariance model results using 1992 data reveal that: (1) Although metropolitan and urban markets exhibit a negative relationship between hospital average costs and market concentration, non-metropolitan and rural markets fail to exhibit any relationship between costs and concentration; and (2) among non-metropolitan hospitals, only hospitals located in single-hospital communities have lower costs than their counterparts in multiple-hospital communities, once other factors are held constant. PMID:10153476

Parental migration and children's academic engagement: The case of China

NASA Astrophysics Data System (ADS)

Chen, Shuang; Adams, Jennifer; Qu, Zhiyong; Wang, Xiaohua; Chen, Li

2013-12-01

In the context of China's increasing rural-urban migration, few studies have investigated how parental migration affects children's experience in school. The high cost of schooling, taken together with the institutional barriers in destination cities, have compelled many rural parents in China to migrate without their children, leaving them in the care of their spouses, grandparents, relatives or other caregivers. Still other parents migrate with their children, many of whom then attend urban migrant schools in their destination city. Understanding the academic engagement of children of migrant workers is particularly salient because the poor qualities of migrant schools, a lack of parental support, and exposure to competing alternatives to schooling may render both migrant children in the cities and left-behind children in the rural villages vulnerable to disengagement, and ultimately school dropout. Using data collected in 2008 in the urban Haidian and Changping districts of Beijing and rural Henan and Shaanxi provinces, the authors of this paper investigate the association between parental migration status and two measures of academic engagement, academic aspirations and the odds of liking school, by comparing migrant children attending migrant schools and left-behind children with their rural counterparts who do not have migrant parents. The authors' findings show that migrant children attending migrant schools have lower academic engagement compared to rural children of non-migrant parents. The correlation between academic engagement and parental migration status can be accounted for in part by the support children receive from family and teachers. The association between certain measures of family and school support and academic engagement also varies by parental migration status: for example, high teacher turnover rates significantly reduce migrant children's odds of liking schools, but do not affect children of non-migrant parents.

Urban-Rural Differences in the Availability of Hospital Information Technology Applications: A Survey of Georgia Hospitals

ERIC Educational Resources Information Center

Culler, Steven D.; Atherly, Adam; Walczak, Sandra; Davis, Anne; Hawley, Jonathan N.; Rask, Kimberly J.; Naylor, Vi; Thorpe, Kenneth E.

2006-01-01

Context: Information technology (IT) has been identified as a potential tool for improving the safety of health care delivery. Purpose: To determine if there are significant differences between urban and rural community hospitals in the availability of selected IT functional applications and technological devices. Methods: A mailed survey of…

The Rural – Urban Divide: Health Services Utilization Among Older Mexicans in Mexico

PubMed Central

Salinas, Jennifer J.; Al Snih, Soham; Markides, Kyriakos; Ray, Laura A.; Angel, Ronald J.

2010-01-01

Context Mexico Purpose Using the health care service utilization model as a framework, this paper will analyze the differences in health care service use among older Mexicans living in urban and rural areas in Mexico. Methods The Mexican Health and Aging Survey (MHAS) data were used to test the applicability of Andersen’s “model of health services” of predisposing (ie, age, sex, etc.), enabling (education, insurance coverage, etc.) and need factors (diabetes, hypertension, etc.) to predict ever being in the hospital and physician visits in the past year by place of residence (urban, rural, semi-rural). Findings Results showed that older Mexicans living in the most rural areas (populations of 2500 or fewer) were significantly less likely to have been hospitalized in the previous year and visited the physician less often (P < .0001) than their urban counterparts. The significant difference in hospitalization between rural and urban residing older Mexicans was largely accounted for by having health care coverage. Certain need factors such as diabetes, previous heart attack, hypertension, depression, and functional limitations predicted frequency of physician visits and hospitalization, but they did not explain variations between rural and urban older Mexicans. Conclusions Not having insurance coverage was associated with a lower likelihood of spending an overnight visit in the hospital and visiting a physician for older Mexicans. This lower utilization may be due to barriers to access rather than better health. PMID:21029168

Career plans and perceptions in readiness to practice of graduating general surgery residents in Canada.

PubMed

Nadler, Ashlie; Ashamalla, Shady; Escallon, Jaime; Ahmed, Najma; Wright, Frances C

2015-01-01

Overall, 25% of American general surgery residents identified as not feeling confident operating independently at graduation, which may contribute to 70% pursuing further training. This study was undertaken to identify intended career plans of general surgery graduates in Canada on a national level, and perceived strengths and weaknesses of training that would affect transition to early practice. Questionnaires were distributed to graduating general surgery residents at a Canadian national review course in 2012 and 2013. Data were analyzed for overall trends. Overall, 75% (78/104) of graduating residents responded in 2012 and 53% (50/95) in 2013. Greater than 60% of respondents were entering a fellowship program upon graduation (49/78 in 2012 and 37/50 in 2013); the most common fellowship choices were minimally invasive surgery (24% in 2012 and 39% in 2013) or surgical oncology (16% in 2012). Most residents reported that they were completing subspecialty training to meet career goals (64/85 overall) rather than feeling unprepared for practice (0/85 overall). Most residents planned on practicing in urban centers (54%) and academic hospitals (73%). Residents perceived a need for assistance for laparoscopic adrenalectomy, neck dissection, laparoscopic splenectomy, laparoscopic low anterior resection, groin dissection, and thyroidectomy. An overwhelming majority of general surgery graduates plan to pursue fellowship training to meet career goals of working in urban, academic centers, rather than a perceived lack of competence. It is vital to describe operative competency expectations for residents and to promote a variety of practice opportunities following graduation. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Professor in Residence: An Innovative Academic-Practice Partnership.

PubMed

Hinic, Katherine; Kowalski, Mildred Ortu; Silverstein, Wendy

2017-12-01

This article describes an academic-practice partnership between an American Nurses Credentialing Center Magnet ® -designated hospital and an academic nurse educator that has increased the hospital's capacity for research, evidence-based practice, and support for nurses continuing their education. Through close collaboration with the full-time nurse researcher and members of the nursing education department, the professor in residence consults with clinical staff to support completion of research and evidence-based practice projects. The collaboration also has resulted in the development of a formal year-long mentoring program for clinical nurses in the area of evidence-based practice. Individual support and academic consults are offered to nurses enrolled in school to promote advancement of nurses' educational level. This collaboration has been beneficial for both the hospital and the university, increasing the capacity for scholarly activities for nurses in the hospital and serving as a forum for ongoing faculty practice and scholarship. J Contin Educ Nurs. 2017;48(12):552-556. Copyright 2017, SLACK Incorporated.

Urban-Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment-Elevation Myocardial Infarction in China From 2001 to 2011: A Retrospective Analysis From the China PEACE Study (Patient-Centered Evaluative Assessment of Cardiac Events).

PubMed

Li, Xi; Murugiah, Karthik; Li, Jing; Masoudi, Frederick A; Chan, Paul S; Hu, Shuang; Spertus, John A; Wang, Yongfei; Downing, Nicholas S; Krumholz, Harlan M; Jiang, Lixin

2017-11-01

In response to urban-rural disparities in healthcare resources, China recently launched a healthcare reform with a focus on improving rural care during the past decade. However, nationally representative studies comparing medical care and patient outcomes between urban and rural areas in China during this period are not available. We created a nationally representative sample of patients in China admitted for ST-segment-elevation myocardial infarction in 2001, 2006, and 2011, using a 2-stage random sampling design in 2 urban and 3 rural strata. In China, evidence-based treatments were provided less often in 2001 in rural hospitals, which had lower volume and less availability of advanced cardiac facilities. However, these differences diminished by 2011 for reperfusion therapy (54% in urban versus 57% in rural; P =0.1) and reversed for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (66% versus 68%; P =0.04) and early β-blockers (56% versus 60%; P =0.01). The risk-adjusted rate of in-hospital death or withdrawal from treatment was not significantly different between urban and rural hospitals in any study year, with an adjusted odds ratio of 1.13 (0.77-1.65) in 2001, 0.99 (0.77-1.27) in 2006, and 0.94 (0.74-1.19) in 2011. Although urban-rural disparities in evidence-based treatment for myocardial infarction in China have largely been eliminated, substantial gaps in quality of care persist in both settings. In addition, urban hospitals providing more resource-intensive care did not achieve better outcomes. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01624883. © 2017 American Heart Association, Inc.

Nurses' knowledge of inhaler technique in the inpatient hospital setting.

PubMed

De Tratto, Katie; Gomez, Christy; Ryan, Catherine J; Bracken, Nina; Steffen, Alana; Corbridge, Susan J

2014-01-01

High rates of inhaler misuse in patients with chronic obstructive pulmonary disease and asthma contribute to hospital readmissions and increased healthcare cost. The purpose of this study was to examine inpatient staff nurses' self-perception of their knowledge of proper inhaler technique compared with demonstrated technique and frequency of providing patients with inhaler technique teaching during hospitalization and at discharge. A prospective, descriptive study. A 495-bed urban academic medical center in the Midwest United States. A convenience sample of 100 nurses working on inpatient medical units. Participants completed a 5-item, 4-point Likert-scale survey evaluating self-perception of inhaler technique knowledge, frequency of providing patient education, and responsibility for providing education. Participants demonstrated inhaler technique to the investigators using both a metered dose inhaler (MDI) and Diskus device inhaler, and performance was measured via a validated checklist. Overall misuse rates were high for both MDI and Diskus devices. There was poor correlation between perceived ability and investigator-measured performance of inhaler technique. Frequency of education during hospitalization and at discharge was related to measured level of performance for the Diskus device but not for the MDI. Nurses are a key component of patient education in the hospital; however, nursing staff lack adequate knowledge of inhaler technique. Identifying gaps in nursing knowledge regarding proper inhaler technique and patient education about proper inhaler technique is important to design interventions that may positively impact patient outcomes. Interventions could include one-on-one education, Web-based education, unit-based education, or hospital-wide competency-based education. All should include return demonstration of appropriate technique.

Academic Achievement of African American Boys: A City-Wide, Community-Based Investigation of Risk and Resilience

ERIC Educational Resources Information Center

Fantuzzo, John; LeBoeuf, Whitney; Rouse, Heather; Chen, Chin-Chih

2012-01-01

In light of persistent Black-White achievement gaps for boys, this study examined publicly monitored risks believed to be associated with being behind academically for an entire subpopulation of African American boys in a large urban public school district. Also examined were indicators of academic engagement hypothesized to mediate the relations…

The Effects of School, Family, and Community Support on the Academic Achievement of African American Adolescents.

ERIC Educational Resources Information Center

Sanders, Mavis G.

1998-01-01

Effects of school, family, and community support on academic attitudes and achievement were examined in 827 eighth-grade black students in an urban school district in the southeastern U.S. Students' church involvement and perceptions of teacher and parental support positively influence academic self-concepts and school behaviors. (MMU)

Investigating the Link between Home-School Dissonance and Academic Cheating among High School Students

ERIC Educational Resources Information Center

Brown-Wright, Lynda; Tyler, Kenneth M.; Stevens-Watkins, Danelle; Thomas, Deneia; Mulder, Shambra; Hughes, Travonia; Stevens-Morgan, Ruby; Roan-Belle, Clarissa; Gadson, Nadia; Smith, La Toya

2013-01-01

The current study examined the association between home-school dissonance and academic cheating among 344 high school juniors and seniors at two urban high schools. Students completed two subscales of the Patterns of Adaptive Learning Scale (PALS) and one subscale of the Academic Motivation Scale (AMS). Analyses revealed that home-school…

Intellect and Public Life: Essays on the Social History of Academic Intellectuals in the United States.

ERIC Educational Resources Information Center

Bender, Thomas

Eight essays discuss the relation of urban patterns of intellectual life and academic forms of higher learning. Themes that run through the essays include: the increasing incorporation of academic culture into the center of American life, socially and intellectually, is accompanied and causally related to a progressive impoverishment of the public…

Academic Performance and Personality Traits of Chinese Children: "Onlies" versus Others.

ERIC Educational Resources Information Center

Poston, Dudley L., Jr.; Falbo, Toni

1990-01-01

Using data from a 1987 survey of 1,460 schoolchildren, their parents and teachers, in urban and rural areas of Changchun, China, examines academic and personality outcomes in only children. Finds results similar to Western surveys: only children are more likely to be academically talented. Reveals, however, Chinese rural only children do not score…

Motivation, Self-Regulated Learning Efficacy, and Academic Achievement among International and Domestic Students at an Urban Community College: A Comparison

ERIC Educational Resources Information Center

Liao, Hsiang-Ann; Ferdenzi, Anita Cuttita; Edlin, Margot

2012-01-01

This study is designed to examine how intrinsic motivation, extrinsic motivation, and self-regulated learning efficacy influence academic achievement of international and domestic community college students. Results show that for both international and domestic students, motivation did not directly affect academic achievement. Self-regulated…

The Relationship between Latino Students' Learning Styles and Their Academic Performance

ERIC Educational Resources Information Center

Torres, Sonia Maldonado

2014-01-01

The purpose of this study was to explore the relationship between Latino Students' learning styles and their academic performance. Students' academic performance was measured using their overall grade point average (GPA). A group of 229 Latino students who were enrolled at an urban community college in New York City participated in the study. Two…

Financial Aid Tipping Points: An Analysis of Aid and Academic Achievement at a California Community College

ERIC Educational Resources Information Center

Coria, Elizabeth; Hoffman, John L.

2016-01-01

The purpose of this study was to explore relationships between financial aid awards and measures of student academic achievement. Financial aid and academic records for 11,956 students attending an urban California community college were examined and analyzed using simultaneous linear regression and two-way factorial ANOVAs. Findings revealed a…

Is Tobacco Use Associated with Academic Failure among Government School Students in Urban India?

ERIC Educational Resources Information Center

Dhavan, Poonam; Stigler, Melissa H.; Perry, Cheryl L.; Arora, Monika; Reddy, K. Srinath

2010-01-01

Background: Not much is known about the academic correlates of tobacco use among students in developing countries. This study investigated associations between multiple forms of tobacco use, psychosocial risk factors, and academic failure among 10- to 16-year-old government school students in Delhi and Chennai, India. Methods: This study was a…

Improved Attitude and Achievement: A Case Study of an Elementary School Academic Advisement Intervention

ERIC Educational Resources Information Center

Kamrath, Barry; Brooker, Teresa

2018-01-01

School counselors are often called upon to develop and implement academic interventions. In this case study of one urban elementary school, a school counselor conducted a small group academic advisement intervention. The results suggest that integrating the activities into the elementary school counseling program can be an effective Response to…

Removing Non-Academic Barriers in Urban Schools: School-Linked Social Services

ERIC Educational Resources Information Center

Muñoz, Marco A.; Owens, Deborah; Bartlett, Carol

2015-01-01

Current societal demands have increased the role of schools. The Family Resource and Youth Services Centers (FRYSC) seek to link students, families, and communities, using the school as the nexus for much needed services. The FRYSC offer a myriad of interventions aimed at removing non-academic barriers that hinder academic success for students…

Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

PubMed

Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

2009-02-01

The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

Variations in costs for the care of low-birth-weight infants among academic hospitals.

PubMed

Herrod, Henry G; Chang, Cyril F; Steinberg, Stephanie S

2010-05-01

To determine the relative role that academic hospitals (AHs) play in providing neonatal care for low-birth-weight infants within a single state and to determine if there are variations in inpatient costs for neonatal services among AHs. Retrospective analysis of hospital costs for low-birth-weight infants. Cases were identified using 2003-2005 data from the Tennessee Hospital Discharge Data System. A specific focus was discharge data from the 5 AHs that support obstetrical residencies and have a neonatal intensive care unit. Cases included all discharged infants with a birth weight of <2500 grams. The 5 AHs discharged 18% of the total normal-birth-weight infants and 30% of the low-birth-weight infants for the entire state. AHs had higher costs associated with these infants than did other hospitals, with a single exception The difference in costs at this hospital was consistent with the finding of lower utilization rates of hospital services, a shorter average length of stay, and lower costs for infants insured by the state Medicaid program. Academic obstetrical hospitals discharged a disproportionately high percentage of low-birth-weight infants compared with other Tennessee hospitals. The lower costs observed in the Shelby County hospital indicates that other hospitals could potentially lower their costs for the care of low-birth-weight infants.

Negative Academic Emotion and Psychological Well-being in Chinese Rural-to-Urban Migrant Adolescents: Examining the Moderating Role of Cognitive Reappraisal

PubMed Central

Wang, Daoyang; Li, Shuting; Hu, Mingming; Dong, Dan; Tao, Sha

2017-01-01

The study aimed to explore the relationship among negative academic emotions (e.g., anxiety, shame, anger, boredom, hopelessness, disappointment, and hatred), psychological well-being (including life vitality, health concern, altruism commitment, self-value, friendly relationship, and personal development), and cognitive reappraisal in rural-to-urban migrant adolescents in China. Specifically, it was hypothesized that the relationship between psychological well-being and negative academic emotions is moderated by cognitive reappraisal. A total of 311 migrant adolescents aged 14–20 years were selected, including 132 boys and 179 girls. Results of a regression analysis showed that cognitive reappraisal (positive) and negative academic emotions were significant predictors of psychological well-being. The interaction effect between cognitive reappraisal and negative academic emotion was also a significant predictor of psychological well-being. In the simple slope analysis the group with a below average cognitive reappraisal score the negative academic emotions were associated with lower psychological well-being, whereas in the group with above average cognitive reappraisal the effect of negative academic emotions on psychological well-being was not significant. However, for those with a cognitive reappraisal score of 1 standard deviation above the average, the effect of negative academic emotions on psychological well-being was not significant. These results suggest that cognitive reappraisal was a significant moderator in the relationship between negative academic emotion and psychological well-being. PMID:28824495

Negative Academic Emotion and Psychological Well-being in Chinese Rural-to-Urban Migrant Adolescents: Examining the Moderating Role of Cognitive Reappraisal.

PubMed

Wang, Daoyang; Li, Shuting; Hu, Mingming; Dong, Dan; Tao, Sha

2017-01-01

The study aimed to explore the relationship among negative academic emotions (e.g., anxiety, shame, anger, boredom, hopelessness, disappointment, and hatred), psychological well-being (including life vitality, health concern, altruism commitment, self-value, friendly relationship, and personal development), and cognitive reappraisal in rural-to-urban migrant adolescents in China. Specifically, it was hypothesized that the relationship between psychological well-being and negative academic emotions is moderated by cognitive reappraisal. A total of 311 migrant adolescents aged 14-20 years were selected, including 132 boys and 179 girls. Results of a regression analysis showed that cognitive reappraisal (positive) and negative academic emotions were significant predictors of psychological well-being. The interaction effect between cognitive reappraisal and negative academic emotion was also a significant predictor of psychological well-being. In the simple slope analysis the group with a below average cognitive reappraisal score the negative academic emotions were associated with lower psychological well-being, whereas in the group with above average cognitive reappraisal the effect of negative academic emotions on psychological well-being was not significant. However, for those with a cognitive reappraisal score of 1 standard deviation above the average, the effect of negative academic emotions on psychological well-being was not significant. These results suggest that cognitive reappraisal was a significant moderator in the relationship between negative academic emotion and psychological well-being.

Two-year survey of specific hospital wastewater treatment and its impact on pharmaceutical discharges.

PubMed

Wiest, Laure; Chonova, Teofana; Bergé, Alexandre; Baudot, Robert; Bessueille-Barbier, Frédérique; Ayouni-Derouiche, Linda; Vulliet, Emmanuelle

2018-04-01

It is well known that pharmaceuticals are not completely removed by conventional activated sludge wastewater treatment plants. Hospital effluents are of major concern, as they present high concentrations of pharmaceutically active compounds. Despite this, these specific effluents are usually co-treated with domestic wastewaters. Separate treatment has been recommended. However, there is a lack of information concerning the efficiency of separate hospital wastewater treatment by activated sludge, especially on the removal of pharmaceuticals. In this context, this article presents the results of a 2-year monitoring of conventional parameters, surfactants, gadolinium, and 13 pharmaceuticals on the specific study site SIPIBEL. This site allows the characterization of urban and hospital wastewaters and their separate treatment using the same process. Flow proportional sampling, solid-phase extraction, and liquid chromatography coupled with tandem mass spectrometry were used in order to obtain accurate data and limits of quantification consistent with ultra-trace detection. Thanks to these consolidated data, an in-depth characterization of urban and hospital wastewaters was realized, as well as a comparison of treatment efficiency between both effluents. Higher concentrations of organic carbon, AOX, phosphates, gadolinium, paracetamol, ketoprofen, and antibiotics were observed in hospital wastewaters compared to urban wastewaters. Globally higher removals were observed in the hospital wastewater treatment plant, and some parameters were shown to be of high importance regarding removal efficiencies: hydraulic retention time, redox conditions, and ambient temperature. Eleven pharmaceuticals were still quantified at relevant concentrations in hospital and urban wastewaters after treatment (e.g., up to 1 μg/L for sulfamethoxazole). However, as the urban flow was about 37 times higher than the hospital flow, the hospital contribution appeared relatively low compared to domestic discharges. Thanks to the SIPIBEL site, data obtained from this 2-year program are useful to evaluate the relevance of separate hospital wastewater treatment.

The benefits of utilising geo-mapping for visualising the vitamin D status of Dublin city and the surrounding urban districts.

PubMed

Laird, E; Shannon, T; Crowley, V E F; Healy, M

2017-11-01

There have been few published reports of visualising vitamin D status at a micro level, i.e., within large individual urban centres of countries. To produce a visual map of the vitamin D status [25-hydroxy vitamin D-25(OH)D] of a large urban centre (n > 350,000) incorporating the regions of Dublin city that constitute the general practitioner catchment area of a large academic teaching adult hospital. An observational investigation of 5287 free living Irish adults (>18 years). Approximately, 15.2 % of those sampled in the winter period (October-February) were vitamin D deficient (<30 nmol/L) compared with 10.8 % of those sampled in the summer period (March-September). Vitamin D tests requested from the most social economically deprived urban locations (Dublin 8 and Lucan postal districts) had the highest rates of deficiency (23.5 and 20.4 %, respectively, both seasons). On average, females had a significantly higher 25(OH)D concentration compared with males (57.9 vs 52.3 nmol/L, respectively), while the younger participants (18-50 years) mean 25(OH)D concentration was 27 % lower in winter and 20.7 % lower in summer in comparison with the older participants (>50 years) (P < 0.0001). For the first time in Ireland, a visual depiction of data can be used to aid in the rapid identification of vitamin D status trends within a major urban area. These findings provide useful data to help inform public health policy regarding endemic vitamin D insufficiency to help target the population groups and resident location areas most at risk.

Privatization of local public hospitals: effect on budget, medical service quality, and social welfare.

PubMed

Aiura, Hiroshi; Sanjo, Yasuo

2010-09-01

We analyze a duopolistic health care market in which a rural public hospital competes against an urban public hospital on medical quality, by using a Hotelling-type spatial competition model extended into a two-region model. We show that the rural public hospital provides excess quality for each unit of medical service as compared to the first-best quality, and the profits of the rural public hospital are lower than those of the urban public hospital because the provision of excess quality requires larger expenditure. In addition, we investigate the impact of the partial (or full) privatization of local public hospitals.

Vulnerability of Rural Hospitals to Medicare Outpatient Payment Reform

PubMed Central

Mohr, Penny E.; Franco, Sheila J.; Blanchfield, Bonnie B.; Cheng, C. Michael; Evans, William N.

1999-01-01

Because the Balanced Budget Act (BBA) of 1997 requires implementation of a Medicare prospective payment system (PPS) for hospital outpatient services, the authors evaluated the potential impact of outpatient PPS on rural hospitals. Areas examined include: (1) How dependent are rural hospitals on outpatient revenue? (2) Are they more likely than urban hospitals to be vulnerable to payment reform? (3) What types of rural hospitals will be most vulnerable to reform? Using Medicare cost report data, the authors found that small size and government ownership are more common among rural than urban hospitals and are the most important determinants of vulnerability to payment reform. PMID:11481724

Majority Teachers' Perceptions of Urban Adolescents and Their Abilities: Probes from Self-Reflection and Teacher Autobiographies

ERIC Educational Resources Information Center

Harushimana, Immaculee

2010-01-01

This article presents a small scale, qualitative study of nine majority alternate-route teachers and the perceptions they hold about themselves as urban educators and their urban students' academic abilities. Data for this study was collected through self-reflective, written interviews and meta-reflective responses to two published teacher…

Embracing Urban Youth Culture in the Context of Education

ERIC Educational Resources Information Center

Sealey-Ruiz, Yolanda; Greene, Perry

2011-01-01

The rise of post industrial urban centers and global communication technologies has created a distinctive Urban Youth Culture (UYC) with roots in Black history and social activism. In the discourse on education and Black youth, UYC is rarely seen as a positive force promoting academic achievement and self esteem. Drawing on the voices of Black…

Inspection Judgements on Urban Schools: A Case for the Defence

ERIC Educational Resources Information Center

Gorton, Julian; Williams, Melanie; Wrigley, Terry

2014-01-01

This article is co-authored by two urban school Heads in the north of England with the support of an academic partner. The article begins with the phenomenon of official judgements of urban schools, made by the Office for Standards in Education, Children's Services and Skills, a semi-privatised and supposedly independent arm of government. The…

Urban School Superintendents: Characteristics, Tenure, and Salary. Seventh Survey and Report. Urban Indicator, Fall 2010

ERIC Educational Resources Information Center

Council of the Great City Schools, 2010

2010-01-01

Urban school superintendents hold one of the most important and challenging jobs in America's education system. In this era of accountability and standards, superintendents are charged with making visible and rapid improvements in the academic achievement of the nation's most vulnerable children. They must break down barriers to reform and build…

The Impact of Schools on Learning: Inner-City Children in Suburban Schools

ERIC Educational Resources Information Center

Mahan, Thomas W.; Mahan, Aline M.

1971-01-01

Hypotheses tested were that the average achievement level of the classroom is a determining factor in achievement of urban minority group children and that social acceptance of the urban minority child by white middle class peers is related to academic achievement. Results using urban and suburban schools supported the hypotheses. (Author/CG)

Characteristics of Students in Traditional versus Alternative High Schools: A Cross-Sectional Analysis of Enrollment in One Urban District

ERIC Educational Resources Information Center

Perzigian, Aaron B.; Afacan, Kemal; Justin, Whitney; Wilkerson, Kimber L.

2017-01-01

Urban school districts are comprised of many diverse high school environments including comprehensive neighborhood schools as well as a variety of smaller alternative models that focus on innovative practices, behavior remediation, or academic recovery. In terms of enrollment distribution, urban school districts are increasingly offering…

Retaining Effective Urban Teachers in the Age of Accountability: How Do Successful Urban Schools Address Staffing Challenges?

ERIC Educational Resources Information Center

Davis, Cove Johnstone

2010-01-01

Many urban schools struggle to retain their best teachers because of challenging work environments, poor salaries, and ineffective school leadership. The additional requirements of the No Child Left Behind legislation for teachers to be highly qualified and the increased academic requirements of raising students to a proficient level in reading…

Small Steps Make Meaningful Change in Transforming Urban Schools

ERIC Educational Resources Information Center

Miranda, Antoinette Halsell; Radliff, Kisha M.; Della Flora, Olympia A.

2018-01-01

Urban schools in the United States are generally viewed as having greater challenges than their suburban and rural counterparts. Most notably, they often have lower academic achievement and much of the educational reform movement has been aimed at urban schools in an attempt to close the achievement gap. Although much of the focus in recent years…

Urban Renewal: The Urban School Leader Takes on a New Role

ERIC Educational Resources Information Center

Knapp, Michael S.; Copland, Michael A.; Honig, Meredith I.; Plecki, Margaret L.; Portin, Bradley S.

2010-01-01

A diverse and historically underserved urban student population struggles with academic learning and social adjustment in a context of limited resources. Support for staff efforts or special student needs is also limited, making it harder to attract and retain qualified staff. Given the conditions that educators must contend with in such settings,…

Renewing Awe in the Urban Experience: Historic Changes in Land-Based Education

ERIC Educational Resources Information Center

Leduc, Timothy B.

2016-01-01

What role can awe play in the practice of environmental education as our lives become increasingly urbanized? This paper looks at the historic emergence of land experience in environmental education and thinking as a means for examining its potential role in an urban academic setting. Many early environmental scholars proposed that the mind is…

At-Risk Urban Students and College Success: A Framework for Effective Preparation.

ERIC Educational Resources Information Center

Jun, Alexander; Tierney, William G.

1999-01-01

Changes in higher-education policy make it harder for underrepresented minorities in urban environments to gain access to or succeed in higher education. A framework is offered for effective college preparation programs to address the unique needs of low-income, urban minority youth. The framework focuses on development of both academic and…

Challenges and Opportunities for School Improvement: Recommendations for Urban School Principals

ERIC Educational Resources Information Center

Dolph, David

2017-01-01

Insofar as urban school systems that are often identified as ineffective include such a large segment of U.S. P-12 students, it is vital to improve academic success. To provide context, the article first discusses key challenges facing urban schools. Second, the article identifies and briefly reviews a variety of approaches to reform models often…

Clinical and psycho-social profile of child and adolescent mental health care users and services at an urban child mental health clinic in South Africa.

PubMed

Raman, N; Janse van Rensburg, A B

2013-09-01

National and international child and adolescent mental healthcare policy and action advocate that the health and well being of children should be increasingly given greater attention. The purpose of this study was to describe the demographic, socio economic and clinical profile of the users at the child and adolescent mental health clinic of the Rahima Moosa Mother and Child Hospital (RMMCH). A descriptive, retrospective clinical audit from users' clinical files was performed over a one-year period from January to December 2007. Descriptive statistical analyses of demographic and socio-economic variables were made and these variables were compared with the presenting clinical problems. Odds ratios were calculated for variables that showed a statistically significant association (p-value less than 0.05). A total of 303 users attended this clinic. Statistical comparisons between demographic data and disorders revealed that being male increased the likelihood of presenting with AHDH and disruptive behaviour disorders; being female increased the likelihood of being sexually abused. Race showed a significant association with parent-child relationship difficulties. Regarding socio-economic variables, the identity of the caregiver of the child influenced the risk of disruptive behaviour disorders, sexual abuse, neglect and academic problems. Where the child was placed was a risk factor for disruptive behaviour disorders, sexual abuse, neglect and academic problems. Whether the mother of a user was alive or deceased, was found to be related to ADHD and disruptive behaviour and whether the father of a user was alive or deceased, was found to be related to sexual abuse and academic problems. The education level of the caregiver showed a significant association with sexual abuse, neglect and academic problems; the marital status of the parent (widowed mother) showed a significant association with bereavement. Household income was associated with sexual abuse, neglect and academic problems. This study demonstrated the impact that socio-economic circumstances have on the prevalence of childhood disorders; hence the urgent need for government and social welfare departments to improve the socio-economic status of communities. There is a need to improve psychiatric services for the population served by this hospital, including more clinics in its catchment area, as well as child psychiatry training posts and extended social work services.

The Center for Healthy Weight: an academic medical center response to childhood obesity

PubMed Central

Robinson, T N; Kemby, K M

2012-01-01

Childhood obesity represents a worldwide medical and public health challenge. Academic medical centers cannot avoid the effects of the obesity epidemic, and must adopt strategies for their academic, clinical and public policy responses to childhood obesity. The Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford provides an example and model of one such strategy. The design provides both breadth and depth through six cores: Research, Patient Care, Community Programs, Advocating for Public Policy Change, Training and Professional Education, and the Healthy Hospital Initiative. The Center and its cores are designed to facilitate interdisciplinary collaboration across the university, medical school, children's hospital and surrounding community. The foci of these cores are likely to be relevant to almost any academic medical center's mission and functions. PMID:25089192

[Historical and social perspective from the 64-65 Mexican medical movement].

PubMed

Cabello-López, Alejandro; Gopar-Nieto, Rodrigo; Aguilar-Madrid, Guadalupe; Juárez-Pérez, Cuauhtémoc Arturo; Haro-García, Luis Cuauhtémoc

2015-01-01

The Mexican Medical Movement from 1964-1965 constitutes an important event from the rising urban middle-class, besides it was the first time medical doctors claimed for fair working conditions. The background of this movement is the so-called Crisis of 1958, which included the Movements from the educators union, oil workers union, telegraph workers union and the railroad workers union. The conflict began because interns and residents from the "Hospital 20 de Noviembre" would not get a payment at the end of the year, so on November 26th, 1964, the movement started. The Asociación Mexicana de Médicos Residentes e Internos (AMMRI) was created and their demands were the following: 1) Full working site restitution without retaliations, 2) Legal examination of the scholarship-contract terms, in order to get annual, renewable and progressive contracts, and a fixed salary with the usual working-hours and characteristics of each institution, 3) To have preference to get an adscription at the hospital where the resident studied, 4) Active participation from the resident in the elaboration of the academic plans, and 5) Resolution of each hospital's problems. This movement had social impact for Mexico's contemporary life, nevertheless some of the demands are still unchanged among medical residents.

Lessons From the Boston Marathon Bombing: An Orthopaedic Perspective on Preparing for High-Volume Trauma in an Urban Academic Center.

PubMed

Tobert, Daniel; von Keudell, Arvind; Rodriguez, Edward K

2015-10-01

The 2013 Boston Marathon bombing resulted in a mass casualty event that tested the limits of Boston-area trauma centers. The explosions, 12 seconds apart, led to the rapid influx of 124 patients with primarily lower extremity injuries in 5 different adult level 1 trauma centers. This study aimed to examine the existing hospital systems in place for disaster scenarios at the time of the event and identify areas for improvement. Preparation before the Boston Marathon bombing included coordinating the delivery of patients to area facilities and creating a framework for response at an institutional level. These simulations, coupled with the fact that the explosions occurred at a nexus of medical facilities, helped provide impactful care preventing any fatalities in patients who arrived at a Boston hospital that day. The experience at our institution led to the implementation of a more robust communication infrastructure and reinforced the value of preparatory drills. Within the Orthopaedic Surgery Department, we developed a more robust organizational hierarchy for mass casualty events and implemented a multitrauma follow-up clinic. We believe that it is the responsibility of every hospital to have systems in place to handle the rapid arrival of patients with multiple-trauma, and we hope that others can learn from our experience.

Data-Driven Identification of Risk Factors of Patient Satisfaction at a Large Urban Academic Medical Center.

PubMed

Li, Li; Lee, Nathan J; Glicksberg, Benjamin S; Radbill, Brian D; Dudley, Joel T

2016-01-01

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is the first publicly reported nationwide survey to evaluate and compare hospitals. Increasing patient satisfaction is an important goal as it aims to achieve a more effective and efficient healthcare delivery system. In this study, we develop and apply an integrative, data-driven approach to identify clinical risk factors that associate with patient satisfaction outcomes. We included 1,771 unique adult patients who completed the HCAHPS survey and were discharged from the inpatient Medicine service from 2010 to 2012. We collected 266 clinical features including patient demographics, lab measurements, medications, disease categories, and procedures. We developed and applied a data-driven approach to identify risk factors that associate with patient satisfaction outcomes. We identify 102 significant risk factors associating with 18 surveyed questions. The most significantly recurrent clinical risk factors were: self-evaluation of health, education level, Asian, White, treatment in BMT oncology division, being prescribed a new medication. Patients who were prescribed pregabalin were less satisfied particularly in relation to communication with nurses and pain management. Explanation of medication usage was associated with communication with nurses (q = 0.001); however, explanation of medication side effects was associated with communication with doctors (q = 0.003). Overall hospital rating was associated with hospital environment, communication with doctors, and communication about medicines. However, patient likelihood to recommend hospital was associated with hospital environment, communication about medicines, pain management, and communication with nurse. Our study identified a number of putatively novel clinical risk factors for patient satisfaction that suggest new opportunities to better understand and manage patient satisfaction. Hospitals can use a data-driven approach to identify clinical risk factors for poor patient satisfaction to support development of specific interventions to improve patients' experience of care.

Rural-urban disparities in child abuse management resources in the emergency department.

PubMed

Choo, Esther K; Spiro, David M; Lowe, Robert A; Newgard, Craig D; Hall, Michael Kennedy; McConnell, Kenneth John

2010-01-01

To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs. Multivariate analysis was performed to examine the association between a variety of hospital characteristics, in addition to rural location, and presence of child abuse resources. Fifty-five Oregon hospitals were surveyed. A smaller proportion of rural EDs had written abuse policies (62% vs 95%, P= .006) or on-site child abuse advocates (35% vs 71%, P= .009). Thirty-two percent of rural EDs had none of the examined abuse resources (vs 0% of urban EDs, P= .01). Of hospital characteristics studied in the multivariate model, only rural location was associated with decreased availability of child abuse resources (OR 0.19 [95% CI, 0.05-0.70]). Rural EDs have fewer resources than urban EDs for the management of child abuse. Other studied hospital characteristics were not associated with availability of abuse resources. Further work is needed to identify barriers to resource utilization and to create resources that can be made accessible to all ED settings. © 2010 National Rural Health Association.

Short-term outcome and differences between rural and urban trauma patients treated by mobile intensive care units in Northern Finland: a retrospective analysis.

PubMed

Raatiniemi, Lasse; Liisanantti, Janne; Niemi, Suvi; Nal, Heini; Ohtonen, Pasi; Antikainen, Harri; Martikainen, Matti; Alahuhta, Seppo

2015-11-05

Emergency medical services are an important part of trauma care, but data comparing urban and rural areas is needed. We compared 30-day mortality and length of intensive care unit (ICU) stay for trauma patients injured in rural and urban municipalities and collected basic data on trauma care in Northern Finland. We examined data from all trauma patients treated by the Finnish Helicopter Emergency Medical Services in 2012 and 2013. Only patients surviving to hospital were included in the analysis but all pre-hospital deaths were recorded. All data was retrieved from the national Helicopter Emergency Medical Services database, medical records, and the Finnish Causes of Death Registry. Patients were defined as urban or rural depending on the type of municipality where the injury occurred. A total of 472 patients were included. Age and Injury Severity Score did not differ between rural and urban patients. The pre-hospital time intervals and distances to trauma centers were longer for rural patients and a larger proportion of urban patients had intentional injuries (23.5% vs. 9.3%, P <0.001). The 30-day mortality for severely injured patients (Injury Severity Score >15) was 23.9% in urban and 13.3% in rural municipalities. In the multivariate regression analysis the odds ratio (OR) for 30-day mortality was 2.8 (95% confidence interval 1.0 to 7.9, P = 0.05) in urban municipalities. There was no difference in the length of ICU stay or scores. Twenty patients died on scene or during transportation and 56 missions were aborted because of pre-hospital death. The severely injured urban trauma patients had a trend toward higher 30-day mortality compared with patients injured in rural areas but the length of ICU stay was similar. However, more pre-hospital deaths occurred in rural municipalities. The time before mobile ICU arrival appears to be critical for trauma patients' survival, especially in rural areas.

Impacts of Campus Involvement on Hospitality Student Achievement and Satisfaction

ERIC Educational Resources Information Center

Yin, Dean; Lei, Simon A.

2007-01-01

Campus involvement affecting satisfaction and academic achievement (overall grade point average) of hospitality undergraduate students at a state university in the Midwest (University X) was investigated through a survey research. A four-part survey instrument was developed to facilitate this study. There were a number of academic, professional,…

Financial impact of tertiary care in an academic medical center.

PubMed

Huber, T S; Carlton, L M; O'Hern, D G; Hardt, N S; Keith Ozaki, C; Flynn, T C; Seeger, J M

2000-06-01

To analyze the financial impact of three complex vascular surgical procedures to both an academic hospital and a department of surgery and to examine the potential impact of decreased reimbursements. The cost of providing tertiary care has been implicated as one potential cause of the financial difficulties affecting academic medical centers. Patients undergoing revascularization for chronic mesenteric ischemia, elective thoracoabdominal aortic aneurysm repair, and treatment of infected aortic grafts at the University of Florida were compared with those undergoing elective infrarenal aortic reconstruction and carotid endarterectomy. Hospital costs and profit summaries were obtained from the Clinical Resource Management Office. Departmental costs and profit summary were estimated based on the procedural relative value units (RVUs), the average clinical cost per RVU ($33.12), surgeon charges, and the collection rate for the vascular surgery division (30.2%) obtained from the Faculty Group Practice. Surgeon work effort was analyzed using the procedural work RVUs and the estimated total care time. The analyses were performed for all payors and the subset of Medicare patients, and the potential impact of a 15% reduction in hospital and physician reimbursement was analyzed. Net hospital income was positive for all but one of the tertiary care procedures, but net losses were sustained by the hospital for the mesenteric ischemia and infected aortic graft groups among the Medicare patients. In contrast, the estimated reimbursement to the department of surgery for all payors was insufficient to offset the clinical cost of providing the RVUs for all procedures, and the estimated losses were greater for the Medicare patients alone. The surgeon work effort was dramatically higher for the tertiary care procedures, whereas the reimbursement per work effort was lower. A 15% reduction in reimbursement would result in an estimated net loss to the hospital for each of the tertiary care procedures and would exacerbate the estimated losses to the department. Caring for complex surgical problems is currently profitable to an academic hospital but is associated with marginal losses for a department of surgery. Economic forces resulting from further decreases in hospital and physician reimbursement may limit access to academic medical centers and surgeons for patients with complex surgical problems and may compromise the overall academic mission.

[State of development of the role of academic nursing staff at German university hospitals in 2015].

PubMed

Tannen, Antje; Feuchtinger, Johanna; Strohbücker, Barbara; Kocks, Andreas

2017-02-01

In order to meet the requirements of the increasing complexity of patient care it is recommended to promote more differentiated nursing staff structures and to integrate academic nurses, which is international standard and recommended by the German Science Council. The implementation level is unclear. What is the percentage of nurses with an academic degree at German university hospitals, and what are their task profiles? Standardised written survey by nursing directors of all 32 German university hospitals and medical universities in 2015. The response rate was 75 %. The ratio of nurses with an academic degree amounted to 1.7 % overall, and to 1.0 % in direct patient care. The activities of nurses with an academic degree correspond to international Advanced Nursing Practice approaches including conceptual development (76 %), support of evidence-based care (72 %), practice projects (64 %) and patient counselling (56 %). There were significant variations among hospitals nationwide concerning pay rates with a current lack of reliable pay structures. This is the first national survey to determine the quota of nurses with an academic degree in direct patient care. The ratio of 1 % is well below the 10 to 20 % recommended by the German Science Council - hence the need for immediate action and comprehensive reforms. A follow-up survey is planned for 2017. Copyright © 2016. Published by Elsevier GmbH.

Combining clinical practice and academic work in nursing: A qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

PubMed

van Oostveen, Catharina J; Goedhart, Nicole S; Francke, Anneke L; Vermeulen, Hester

2017-12-01

To obtain in-depth insight into the perceptions of nurse academics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Combining clinical practice and academic work facilitates the use of research findings for high-quality patient care. However, nurse academics move away from the bedside because clinical academic careers for nurses have not yet been established in the Netherlands. This qualitative study was conducted in two Dutch university hospitals and their affiliated medical faculties and universities of applied sciences. Data were collected between May 2015 and August 2016. We used purposive sampling for 24 interviews. We asked 14 participants in two focus groups for their perceptions of importance, facilitators and barriers in nurses' combined clinical and academic work in education and research. We audiotaped, transcribed and thematically analysed the interviews and focus groups. Three themes related to perceived importance, facilitators and barriers: culture, leadership and infrastructure. These themes represent deficiencies in facilitating clinical academic careers for nurses. The current nursing culture emphasises direct patient care, which is perceived as an academic misfit. Leadership is lacking at all levels, resulting in the underuse of nurse academics and the absence of supporting structures for nurses who combine clinical and academic work. The present nursing culture appears to be the root cause of the dearth of academic positions and established clinical academic posts. A culture change would require a show of leadership that would promote and enable combined research, teaching and clinical practice and that would introduce clinical academic career pathways for nurses. Meanwhile, nurse academics should collaborate with established medical academics for whom combined roles are mainstream, and they should take advantage of their established infrastructure for success. © 2017 John Wiley & Sons Ltd.

Relationships between pediatric asthma and socioeconomic/urban variables in Baltimore, Maryland

NASA Technical Reports Server (NTRS)

Kimes, Daniel; Ullah, Asad; Levine, Elissa; Nelson, Ross; Timmins, Sidey; Weiss, Sheila; Bollinger, Mary E.; Blaisdell, Carol

2004-01-01

Spatial relationships between clinical data for pediatric asthmatics (hospital and emergency department utilization rates), and socioeconomic and urban characteristics in Baltimore City were analyzed with the aim of identifying factors that contribute to increased asthma rates. Socioeconomic variables and urban characteristics derived from satellite data explained 95% of the spatial variation in hospital rates. The proportion of families headed by a single female was the most important variable accounting for 89% of the spatial variation. Evidence suggests that the high rates of hospital admissions and emergency department (ED) visits may partially be due to the difficulty of single parents with limited resources managing their child's asthma condition properly. This knowledge can be used for education towards mitigating ED and hospital events in Baltimore City.

The Professional Mentor Program Plus: An Academic Success and Retention Tool for Adult Learners

ERIC Educational Resources Information Center

Scott, Chaunda L.; Homant, Robert J.

2008-01-01

To promote the academic success of and to retain adult students of color, the Academic Services Unit at the University of Detroit Mercy (UDM), an urban Catholic university, in Detroit Michigan, has designed and implemented the Professional Mentor Program Plus, funded by the State of Michigan's King-Chavez-Parks (KCP) higher education initiative,…

Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores among Urban Youth in the United States

ERIC Educational Resources Information Center

Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

2014-01-01

Background: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement,…

Student Voices: A Phenomenological Exploration of Minority Girls' Experiences and Beliefs Related to Academic Achievement

ERIC Educational Resources Information Center

Alpren, Kathleen

2012-01-01

For decades, measures of academic outcomes have demonstrated the underachievement of minority students. The purpose of this study was to include student voices in a discussion of achievement by exploring the experiences and beliefs of minority girls that related to academic achievement in one single-sex urban high school. Moreover, the research…

Improving First Grade Academic Skills through the Integration of Music into the First Grade Curriculum.

ERIC Educational Resources Information Center

Hart-Davis, Charity

This study designed a music program for improving academic skills of first grade students after the teaching staff found the students doing average work in the classroom. The school involved in the study was located in an urban, middle class community in Northern Illinois. Results of standardized tests showed the extent of the academic problems of…

Yoga Improves Academic Performance in Urban High School Students Compared to Physical Education: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Hagins, Marshall; Rundle, Andrew

2016-01-01

Yoga programs within schools have become more widespread but research regarding the potential effect on academic achievement remains limited. This study cluster-randomized 112 students within a single New York City public high school to participate in either school-based yoga or physical education (PE) for an entire academic year. The primary…

Examining Cognitive Predictors of Academic Cheating among Urban Middle School Students: The Role of Home-School Dissonance

ERIC Educational Resources Information Center

Tyler, Kenneth M.

2015-01-01

Academic cheating within the middle grades has become a prevalent schooling dilemma for teachers and administrators. Among the various contextual and cognitive factors that promote academic cheating is home-school dissonance, which has been shown to predict the phenomenon among high school students. The current study extends this line of research…

Comparison of College/Career Readiness Outcomes between the Advancement via Individual Determination (AVID) Program and the Traditional High School Academic Program

ERIC Educational Resources Information Center

Day, Sandra K.

2012-01-01

This study compared selected college/career readiness outcomes for students attending an urban high school who voluntarily participated in an academic support program, Advancement Via Individual Determination (AVID), to demographically similar/same school peers who completed the traditional academic program (TAP) of study. Grade point average,…

Use of a Web-Based Academic Alert System for Identification of Underachieving Students at an Urban Research Institution

ERIC Educational Resources Information Center

Donnelly, John E.

2010-01-01

Early alert strategies are an increasingly common way to address students' ongoing needs for greater academic and social engagement by enabling a positive campus environment and appropriate academic support; Kuh et al. find these to be necessary engagement conditions. Young and Fry show the benefits of student metacognition, or awareness of…

Interest Differences between Male and Female Students and Correlation to Their Academic Grades.

ERIC Educational Resources Information Center

Mena, Ileana F.

A six week study in an urban district was conducted attempting to compare the academic interests between male and female students at the second and third grade levels, and correlate these with the students' academic performance, as put forth on the Record of Student Growth, or Report Card. The children completed teacher made interest inventories.…

Academic Engagement and Achievement among Latina/o and Non-Latina/o Adolescents

ERIC Educational Resources Information Center

Boutakidis, Ioakim P.; Rodríguez, James L.; Miller, Kari Knutson; Barnett, Mathew

2014-01-01

This article presents an exploratory study of the relation between academic engagement and academic achievement for Latina/o and non-Latina/o adolescents attending a predominantly low-income, Latina/o urban middle school in Southern California. A sample of 61 students (37 Latinas/os and 24 non-Latinas/os) participated in the study. The Latina/o…

Perceived Benefits, Facilitators, Disadvantages, and Barriers for Physical Activity Amongst South Asian Adolescents in India and Canada.

PubMed

Rajaraman, Divya; Correa, Natasha; Punthakee, Zubin; Lear, Scott A; Jayachitra, Krishnaswamy G; Vaz, Mario; Swaminathan, Sumathi

2015-07-01

The purpose of this study was to understand perceived benefits, facilitators, disadvantages, and barriers for physical activity among South Asian adolescents in India and Canada. Thirteen focus group discussions with South Asian (origin) adolescent boys and girls of different nutritional status and socioeconomic status in rural and urban India and urban Canada. Across the groups, fitness and 'energy' were perceived to be major benefits of physical activity. In India, better academic performance was highlighted, while health benefits were well detailed in Canadian groups. In all settings, friends, family, and teachers were perceived as facilitators of as well as barriers to physical activity. Lack of a safe space to play was a major concern for urban adolescents, while academic pressures and preference for other sedentary recreational activities were common barriers across all groups. Girls were less likely than boys to be interested in physical activity, with girls' participation in India further limited by societal restrictions. The study suggests key areas for promotion of physical activity among South Asian adolescents: balance between academic pressure and opportunities for physical activity, especially in India; urban planning for a built environment conducive to physical activity; and gender-sensitive programming to promote girls' activity which also addresses culture-specific barriers.

Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

ERIC Educational Resources Information Center

Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

2009-01-01

Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

Successful White teachers of Black students: Teaching across racial lines in urban middle school science classrooms

NASA Astrophysics Data System (ADS)

Coleman, Bobbie

The majority of urban minority students, particularly Black students, continue to perform below proficiency on standardized state and national testing in all areas that seriously impact economically advanced career options, especially in areas involving science. If education is viewed as a way out of poverty, there is a need to identify pedagogical methodologies that assist Black students in achieving higher levels of success in science, and in school in general. The purpose of this study was to explore White teachers' and Black students' perceptions about the teaching strategies used in their low socioeconomic status (LSES) urban science classrooms, that led to academic success for Black students. Participants included three urban middle school White teachers thought to be the best science teachers in the school, and five randomly selected Black students from each of their classrooms. Methods of inquiry involving tenets of grounded theory were used to examine strategies teachers used to inspire Black students into academic success. Data collection included teacher and student interviews, field notes from classroom observations, group discussions, and questionaires. Data were analyzed using open, axial, and selective coding. The teachers' perceptions indicated that their prior belief systems, effective academic and personal communication, caring and nurturing strategies, using relevant and meaningful hands-on activities in small learner-centered groups, enhanced the learning capabilities of all students in their classrooms, especially the Black students. Black students' perceptions indicated that their academic success was attributable to what teachers personally thought about them, demonstrated that they cared, communicated with them on a personal and academic level, gave affirmative feedback, simplified, and explained content matter. Black students labeled teachers who had these attributes as "nice" teachers. The nurturing and caring behaviors of "nice" teachers caused Black students to feel a sense of community and a sense of belonging in their classrooms. Black students demonstrated that they respected and always "had the back" of these "nice" teachers. Results from this study could play a significant role in teacher retention and in informing best practices for preservice and other teachers who are struggling to meet the needs of LSES urban students.

Urban Agrarians.

ERIC Educational Resources Information Center

White, Kerry A.

1996-01-01

Chicago's High School for Agricultural Sciences is a popular and successful urban school devoted to agriculture. This agriculturally focused high school features a tough academic curriculum and hands-on learning designed to prepare the predominantly Black and Hispanic student body for college and careers in agriculture. (SM)

Leveraging community-academic partnerships to improve healthy food access in an urban, Kansas City, Kansas, community.

PubMed

Mabachi, Natabhona M; Kimminau, Kim S

2012-01-01

Americans can combat overweight (OW) and obesity by eating unprocessed, fresh foods. However, all Americans do not have equal access to these recommended foods. Low-income, minority, urban neighborhoods in particular often have limited access to healthy resources, although they are vulnerable to higher levels of OW and obesity. This project used community-based participatory research (CBPR) principles to investigate the food needs of residents and develop a business plan to improve access to healthy food options in an urban, Kansas City, Kansas, neighborhood. Partner community organizations were mobilized to conduct a Community Food Assessment survey. The surveys were accompanied by flyers that were part of the communication engagement strategy. Statistical analysis of the surveys was conducted. We engaged low-income, minority population (40% Latino, 30% African American) urban communities at the household level. Survey results provided in-depth information about residents' food needs and thoughts on how to improve food access. Results were reported to community members at a town hall style meeting. Developing a strategic plan to engage a community and develop trust is crucial to sustaining a partnership particularly when working with underserved communities. This project demonstrates that, if well managed, the benefits of academic and community partnerships outweigh the challenges thus such relationships should be encouraged and supported by communities, academic institutions, local and national government, and funders. A CBPR approach to understanding an urban community's food needs and opinions is important for comprehensive food access planning.

Urban Culturally and Ethnically Diverse Doctoral Students and Their Perceptions of Doctoral Program Design Features and Procedures: An Evaluation Report

ERIC Educational Resources Information Center

Nevin, Ann I.; Barbetta, Patricia; Cramer, Elizabeth

2009-01-01

The mission for Urban SEALS (Special Education Academic Leaders), a federally funded doctoral preparation program, is to prepare doctoral-level special educators, including those who are culturally and/or linguistically diverse (CLD) to assume leadership roles in the education of urban students with disabilities who are CLD. This report provides…

Case Studies of Leading Edge Small Urban High Schools. Core Academic Strategic Designs: 1. Academy of the Pacific Rim

ERIC Educational Resources Information Center

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case Studies of Leading Edge Small Urban High Schools. Core Academic Strategic Designs: 2. Noble Street Charter High School

ERIC Educational Resources Information Center

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Case Studies of Leading Edge Small Urban High Schools. Core Academic Strategic Designs: 3. University Park Campus School

ERIC Educational Resources Information Center

Shields, Regis Anne; Ireland, Nicole; City, Elizabeth; Derderian, Julie; Miles, Karen Hawley

2008-01-01

This report is one of nine detailed case studies of small urban high schools that served as the foundation for the Education Resource Strategies (ERS) report "Strategic Designs: Lessons from Leading Edge Small Urban High Schools." These nine schools were dubbed "Leading Edge Schools" because they stand apart from other high…

Gifted and at Risk: A Cross-District Comparison of Gifted Student Growth and Solutions for Urban Schools

ERIC Educational Resources Information Center

Kurt, Layla J.; Chenault, Krystel H.

2017-01-01

In this study, the researchers highlight differences in district level value-added growth data of gifted students in urban and suburban districts, as categorized by the Ohio Department of Education. In addition to analyzing the difference between the academic growth of urban and suburban gifted students, the researchers sought to synthesize…

"I Do but I Don't": The Search for Identity in Urban African American Adolescents

ERIC Educational Resources Information Center

Gullan, Rebecca Lakin; Hoffman, Beth Necowitz; Leff, Stephen S.

2011-01-01

Achievement of a coherent and strong sense of self is critical to positive academic outcomes for urban minority youth. The present study utilized a mixed-methods approach to explore key aspects of identity development for African American adolescents living in a high-poverty, urban neighborhood. Results suggest that efforts to develop a sense of…

IAIMS and JCAHO: implications for hospital librarians. Integrated Academic Information Management Systems. Joint Commission on Accreditation of Healthcare Organizations.

PubMed Central

Doyle, J D

1999-01-01

The roles of hospital librarians have evolved from keeping print materials to serving as a focal point for information services and structures within the hospital. Concepts that emerged from the Integrated Academic Information Management Systems (IAIMS) as described in the Matheson Report and the 1994 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards have combined to propel hospital libraries into many new roles and functions. This paper will review the relationship of the two frameworks, provide a view of their commonalities, and establish the advantages of both for hospital librarianship as a profession. PMID:10550022

A Reengineered Hospital Discharge Program to Decrease Rehospitalization

PubMed Central

Jack, Brian W.; Chetty, Veerappa K.; Anthony, David; Greenwald, Jeffrey L.; Sanchez, Gail M.; Johnson, Anna E.; Forsythe, Shaula R.; O'Donnell, Julie K.; Paasche-Orlow, Michael K.; Manasseh, Christopher; Martin, Stephen; Culpepper, Larry

2009-01-01

Background: Emergency department visits and rehospitalization are common after hospital discharge. Objective: To test the effects of an intervention designed to minimize hospital utilization after discharge. Design: Randomized trial using block randomization of 6 and 8. Randomly arranged index cards were placed in opaque envelopes labeled consecutively with study numbers, and participants were assigned a study group by revealing the index card. Setting: General medical service at an urban, academic, safety-net hospital. Patients: 749 English-speaking hospitalized adults (mean age, 49.9 years). Intervention: A nurse discharge advocate worked with patients during their hospital stay to arrange follow-up appointments, confirm medication reconciliation, and conduct patient education with an individualized instruction booklet that was sent to their primary care provider. A clinical pharmacist called patients 2 to 4 days after discharge to reinforce the discharge plan and review medications. Participants and providers were not blinded to treatment assignment. Measurements: Primary outcomes were emergency department visits and hospitalizations within 30 days of discharge. Secondary outcomes were self-reported preparedness for discharge and frequency of primary care providers′ follow-up within 30 days of discharge. Research staff doing follow-up were blinded to study group assignment. Results: Participants in the intervention group (n = 370) had a lower rate of hospital utilization than those receiving usual care (n = 368) (0.314 vs. 0.451 visit per person per month; incidence rate ratio, 0.695 [95% CI, 0.515 to 0.937]; P = 0.009). The intervention was most effective among participants with hospital utilization in the 6 months before index admission (P = 0.014). Adverse events were not assessed; these data were collected but are still being analyzed. Limitation: This was a single-center study in which not all potentially eligible patients could be enrolled, and outcome assessment sometimes relied on participant report. Conclusion: A package of discharge services reduced hospital utilization within 30 days of discharge. PMID:19189907

The professional role of massage therapists in patient care in Canadian urban hospitals--a mixed methods study.

PubMed

Kania-Richmond, Ania; Reece, Barb Findlay; Suter, Esther; Verhoef, Marja J

2015-02-07

Massage therapy (MT) is becoming established as a recognized health care profession in Canada. It has been integrated as a core service in settings such as health spas, private integrative health centers, and there is indication that MT is starting to be integrated into hospitals. Research in the area of hospital-based MT has primarily focused on the efficacy, effectiveness, and increasingly, the safety of MT. However, little is known about the professional role of massage therapists in the hospital setting. The purpose of this study was to conduct an in-depth exploration and description of massage therapists' professional role in patient care in the context of Canadian urban hospitals. A sequential mixed methods study design was used. For the quantitative phase, a survey was sent to urban hospitals where MT services were organized by hospitals and provided by licensed massage therapists to patients to a) provide a contextual description of the hospitals and b) identify a sampling frame for the qualitative phase. The subsequent qualitative phase entailed semi structured interviews with a purposively diverse sample of participants massage therapists from the surveyed sites to explore their role perceptions. The quantitative and qualitative approaches were integrated during data collection and analysis. Of the hospitals that responded, sixteen urban hospitals across Canada (5%) provided MT to patients by licensed therapists. The majority of hospitals were located in Ontario and ranged from specialized small community hospitals to large multi-site hospitals. Based on interviews with 25 participants, six components of the massage therapists' professional role emerged: health care provider, team member, program support, educator, promoter of the profession, and researcher. While hospital-based MT in Canada is not a new phenomenon, MT is not yet an established health care profession in such settings. However, there is significant potential for the inclusion of the massage therapists' role in Canadian hospitals that should be evidence based for effective implementation.

Use of continuous positive airway pressure (CPAP) in neonatal units--a survey of current preferences and practice in Germany.

PubMed

Roehr, C C; Schmalisch, G; Khakban, A; Proquitté, H; Wauer, R R

2007-04-26

There is only limited evidence regarding the equipment or the settings (pressure and flow) at which CPAP should be applied in neonatal care. Aims of this nationwide survey of German neonatal units were to investigate (1) for which clinical indications CPAP was employed, (2) which CPAP equipment was used, (3) which CPAP settings were applied. A questionnaire on the use of CPAP was sent to all children's hospitals in Germany. Data were stratified and compared by level of medical care provided (non-academic children's hospital, academic teaching hospital and university children's hospital). 274 institutions were contacted by mailed questionnaire. The response rate was 86%, 90 non-academic children's hospitals, 119 academic teaching hospitals and 26 university children's hospitals replied. (1) There were no statistically significant difference in CPAP use between the institutions: 231 (98%) used CPAP for treating respiratory distress syndrome, 225 (96%) for treating apnoea-bradycardia-syndrome and 230 (98%) following extubation. (2) Commercial CPAP systems were employed by 71% of units, the others used a combination of different devices. Respirator generated CPAP was most commonly used. Exclusively mononasal CPAP was used by only 9%, and binasal CPAP by 55% of institutions. (3) Median CPAP was 4.5 cm H2O (range 3-7), median maximum CPAP was 7 cm H2O (range 4-10), with no statistically significant differences between the hospitals. Between units, CPAP was given via a broad range of CPAP systems and at varying pressure settings. The reported differences reflects personal experiences and preferences, rather than sound evidence from clinical trials.

The co-integration analysis of relationship between urban infrastructure and urbanization - A case of Shanghai

NASA Astrophysics Data System (ADS)

Wang, Qianlu

2017-10-01

Urban infrastructure and urbanization influence each other, and quantitative analysis of the relationship between them will play a significant role in promoting the social development. The paper based on the data of infrastructure and the proportion of urban population in Shanghai from 1988 to 2013, use the econometric analysis of co-integration test, error correction model and Granger causality test method, and empirically analyze the relationship between Shanghai's infrastructure and urbanization. The results show that: 1) Shanghai Urban infrastructure has a positive effect for the development of urbanization and narrowing the population gap; 2) when the short-term fluctuations deviate from long-term equilibrium, the system will pull the non-equilibrium state back to equilibrium with an adjust intensity 0.342670. And hospital infrastructure is not only an important variable for urban development in short-term, but also a leading infrastructure in the process of urbanization in Shanghai; 3) there has Granger causality between road infrastructure and urbanization; and there is no Granger causality between water infrastructure and urbanization, hospital and school infrastructures of social infrastructure have unidirectional Granger causality with urbanization.

Cultural Diversity in the Curriculum: Perceptions and Attitudes of Irish Hospitality and Tourism Academics

ERIC Educational Resources Information Center

Devine, Frances; Hearns, Niamh; Baum, Tom; Murray, Anna

2008-01-01

Academics are facing significant challenges in preparing indigenous students for employment in the multicultural working environment of hospitality and tourism organisations. In dealing with the impact of the new skills and flexibilities demanded by increasing globalisation, the indigenous workforce needs to possess a multicultural perspective and…

The Volume and Mix of Inpatient Services Provided by Academic Medical Centers.

ERIC Educational Resources Information Center

Moy, Ernest; And Others

1996-01-01

A study examined trends in the volume and type of inpatient clinical diagnoses, common medical services, and specialized services in academic medical centers (AMCs)--integrated and independent, other teaching hospitals, and nonteaching hospitals. Results indicate that despite rapid change in the health care environment, little change has occurred…

A framework to support preceptors' evaluation and development of new nurses' clinical judgment.

PubMed

Nielsen, Ann; Lasater, Kathie; Stock, Mary

2016-07-01

In today's complex, fast-paced world of hospital nursing, new graduate nurses do not have well-developed clinical judgment skills. Nurse preceptors are charged with bridging the gap between new graduates' learning in school and their autonomous practice as RNs. In one large, urban medical center in the U.S., a clinical judgment model and rubric were used as a framework for a new evaluation and orientation process. Preceptors of new graduate nurses who had used the former and new processes described their experiences using the framework. The findings indicated that having a structured framework provided objective ways to evaluate and help develop new graduate nurses' clinical judgment. It is hypothesized that academic clinical supervisors may find such a framework useful to prepare students for transition to practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Timeliness of Pediatric Influenza Vaccination Compared With Seasonal Influenza Activity in an Urban Community, 2004–2008

PubMed Central

Hofstetter, Annika M.; Natarajan, Karthik; Rabinowitz, Daniel; Martinez, Raquel Andres; Vawdrey, David; Arpadi, Stephen

2013-01-01

Objectives. We assessed pediatric influenza vaccination in relation to community influenza activity. Methods. We examined seasonal influenza vaccination in 34 012 children aged 6 months through 18 years from 5 academically affiliated clinics in northern Manhattan, New York (an urban low-income community) during the 2004–2008 seasons using hospital and city immunization registries. We calculated the cumulative number of administered influenza vaccine doses and proportion of children with any (≥ 1 dose) or full (1–2 doses per age recommendations) vaccination at the onset and peak of community polymerase chain reaction–confirmed influenza activity according to state surveillance reports and by March 31 each season. Results. Influenza vaccine administration began before October 1, peaked before influenza activity onset, and declined gradually over each season. Coverage at influenza activity onset, peak, and by March 31 increased over the 5 seasons. However, most children lacked full vaccination at these time points, particularly adolescents, minorities, and those requiring 2 doses. Conclusions. Despite early initiation of influenza vaccination, few children were fully vaccinated when influenza began circulating. Interventions should address factors negatively affecting timely influenza vaccination, especially in high-risk populations. PMID:23678935

Visiting professorship in hospital medicine: An innovative twist for a growing specialty.

PubMed

Cumbler, Ethan; Herzke, Carrie; Smalligan, Roger; Glasheen, Jeffrey J; O'Malley, Cheryl; Pierce, J Rush

2016-10-01

As an emerging and rapidly growing specialty, academic hospitalists face unique challenges in career advancement. Key mentoring needs, especially developing reputation and relationships outside of their institution are often challenging. We describe the structure of a novel Visiting Professorship in Hospital Medicine Program. It utilizes reciprocal exchanges of hospitalist faculty at the rank of late assistant to early associate professor. The program is designed explicitly to facilitate spread of innovation between institutions through a presentation by the visiting professor and exposure to an innovation at the host hospital medicine group. It provides a platform to advance the career success of both early- and midcareer hospitalist faculty through 1-on-1 coaching sessions between the visiting professor and early-career faculty at the host institution and commitment by visiting professors to engage in mentoring after the visit. Five academic hospitalist groups participated. Seven visiting professors met with 29 early-career faculty. Experience following faculty exchange visits demonstrates program effectiveness, as perceived by both early-career faculty and the visiting professors, in advancing the goals of mentorship and career advancement. One-year follow-up suggests that 62% of early-career faculty will engage in subsequent interactions with the visiting professor, and half report spread of innovation between academic hospital medicine groups. The Visiting Professorship in Hospital Medicine offers a low-cost framework to promote collaboration between academic hospital medicine groups and facilitate interinstitutional hospitalist mentoring. It is reported to be effective for the goal of professional development for midcareer hospitalists. Journal of Hospital Medicine 2016;11:714-718. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Family Characteristics and Elementary School Achievement in an Urban Ghetto

ERIC Educational Resources Information Center

Solomon, Daniel; And Others

1972-01-01

The relationships of sex, father absence, family size, and birth order to factor scores representing general academic achievement'' were investigated in a sample of urban black ghetto fifth-grade children. Significant main effects were found for sex and family size. (Author)

A Sustained Partnership between a Haitian Children’s Hospital and North American Academic Medical Centers

PubMed Central

Koster, Michael P.; Williams, Jackson H.; Gautier, Jacqueline; Alce, Renee; Trappey, Bernard E.

2017-01-01

Global health initiatives from academic medical centers have rapidly proliferated over the last decade. This paper endeavors to describe our 5-year experience as an academic medical collaborative supporting healthcare delivery, medical training, and research at Hôpital Saint Damien-Nos Petits Frères et Soeurs, the only freestanding children’s hospital in Haiti. Descriptions of the history and current activities of our academic medical collaborative, its partnership and communication structure, its evolution to fill the expressed needs of our host site, its funding mechanisms, and its challenges and opportunities for the future are included. PMID:28611976

The changing paradigm in surgery is system integration: How do we respond?

PubMed

Zenilman, Michael E; Freischlag, Julie-Ann

2017-12-08

With expansion of health care systems across the country, close relationships need to be developed between academic medical centers and their affiliated community hospitals. This creates opportunity to integrate surgical programs across different hospitals. Herein we describe a model of surgical integration at the system level of five large hospitals. We discuss utilizing advantages that both the academic and community hospital bring to the model. A close relationship between an interdisciplinary team, which includes the academic surgical chair, a regional director liaison who was embedded in the community, individual hospital leadership, and practice plan leaders was created. Three pillars as a foundation to success were physician leadership, the use of system infrastructure and development of new processes. This resulted in development of trust, leading to successful recruitments, models of employment and expansion into novel areas of patient safety. Once created, new opportunities for programming for surgical safety across the health care were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

A Phenomenological Study: The Identification of Faculty Member Characteristics and Environmental Factors That Influence the Reporting of Student Academic Misconduct at a Private Urban University

ERIC Educational Resources Information Center

Rupprecht, Stephen M.

2016-01-01

The issue of student academic misconduct, most often seen as cheating or plagiarism, has plagued higher education professionals and institutions for decades. Negative faculty member feelings associated with having to deal with incidents of student academic misconduct are well documented, and only serve to support reasons why faculty members might…

The Difference in the Academic Achievement of Hispanic High School Students Based on the Theme of the Small Learning Community

ERIC Educational Resources Information Center

Martinez, Beate M. Winter

2010-01-01

The purpose of this study is to describe the difference in the academic achievement of urban Hispanic high school students based on the small learning community theme. The study used a quantitative method of ex post facto research to examine how the academic achievement of Hispanic high school students differs across the themes of small…

Dental visits to a North Carolina emergency department: a painful problem.

PubMed

Hocker, Michael B; Villani, John J; Borawski, Joseph B; Evans, Christopher S; Nelson, Scott M; Gerardo, Charles J; Limkakeng, Alex T

2012-01-01

Emergency departments (EDs) act as the safety net and alternative care site for patients without insurance who have dental pain. We conducted a retrospective chart review of visits to an urban teaching hospital ED over a 12-month period, looking at patients who presented with a chief complaint or ICD code indicating dental pain, toothache, or dental abscess. The number of visits to this ED by patients with a dental complaint was 1,013, representing approximately 1.3% of all visits to this ED. Dental patients had a mean age of 32 (+/- 13) years, and 60% of all dental visits were made by African Americans. Dental patients were more likely to be self-pay than all other ED patients (61% versus 22%, P < 0.001). At the vast majority of dental ED visits (97%), the patient was treated and discharged; at most visits (90%) no dental procedure was performed. ED treatment typically consisted of pain control and antibiotics; at 81% of visits, the patient received an opiate prescription on discharge, and at 69% of visits, the patient received an antibiotic prescription on discharge. This retrospective chart review covered a limited period of time, included only patients at a large urban academic medical center, and did not incorporate follow-up analysis. Although they make up a small percentage of all ED visits, dental ED visits are more common among the uninsured, seldom result in definitive care or hospital admission, and often result in prescription of an opioid or antibiotic. These findings are cause for concern and have implications for public policy.

Implementation of a pharmacy technician-centered medication reconciliation program at an urban teaching medical center.

PubMed

Sen, Sanchita; Siemianowski, Laura; Murphy, Michelle; McAllister, Susan Coutinho

2014-01-01

An inpatient medication reconciliation (MR) program emphasizing pharmacy technicians' role in the MR process is described. As part of quality-improvement (QI) efforts focused on MR-related adverse drug events, an urban academic medical center in New Jersey implemented a pharmacy technician-centered MR (PTMR) program targeting patients on its internal medicine, oncology, and clinical decision units. The program is staffed by five full- or part-time technicians who are trained in MR methods and work under direct pharmacist supervision, interviewing newly admitted patients and using other information sources (e.g., community pharmacies, physician offices, nursing facilities) to compile an accurate and complete medication list. About 30% of all patients admitted to the hospital are served by the PTMR program, which averages more than 500 cases each month. During one three-month period, 1748 discrepancies on preadmission medication lists were identified, most of which involved the omission of drugs (65.7% of cases) and incorrect information on dose and frequency of use (14.4%). Efforts to overcome resource constraints and other program challenges (e.g., privacy concerns, delays in community pharmacy transmittal of prescription refill lists) are ongoing. To date, most research on PTMR has been conducted in emergency departments or perioperative settings; experience with the PTMR program suggests that this approach can be applied in other hospital areas to improve MR processes and, ultimately, enhance pharmacotherapy safety and effectiveness across transitions of care. Based on experience, providers' perspectives, and QI data, the PTMR program is an effective method to obtain, document, and communicate accurate MR data for patients at this institution.

Association between work-family conflict and musculoskeletal pain among hospital patient care workers.

PubMed

Kim, Seung-Sup; Okechukwu, Cassandra A; Buxton, Orfeu M; Dennerlein, Jack T; Boden, Leslie I; Hashimoto, Dean M; Sorensen, Glorian

2013-04-01

A growing body of evidence suggests that work-family conflict is an important risk factor for workers' health and well-being. The goal of this study is to examine association between work-family conflict and musculoskeletal pain among hospital patient care workers. We analyzed a cross-sectional survey of 1,119 hospital patient care workers in 105 units in two urban, academic hospitals. Work-family conflict was measured by 5-item Work-Family Conflict Scale questionnaire. Multilevel logistic regression was applied to examine associations between work-family conflict and self-reported musculoskeletal pain in the past 3 months, adjusting for covariates including work-related psychosocial factors and physical work factors. In fully adjusted models, high work-family conflict was strongly associated with neck or shoulder pain (OR: 2.34, 95% CI: 1.64-3.34), arm pain (OR: 2.79, 95% CI: 1.64-4.75), lower extremity pain (OR: 2.20, 95% CI: 1.54-3.15) and any musculoskeletal pain (OR: 2.45, 95% CI: 1.56-3.85), and a number of body areas in pain (OR: 2.47, 95% CI: 1.82-3.36) in the past 3 months. The association with low back pain was attenuated and became non-significant after adjusting for covariates. Given the consistent associations between work-family conflict and self-reported musculoskeletal pains, the results suggest that work-family conflict could be an important domain for health promotion and workplace policy development among hospital patient care workers. Copyright © 2012 Wiley Periodicals, Inc.

Association between work-family conflict and musculoskeletal pain among hospital patient care workers

PubMed Central

Kim, Seung-Sup; Okechukwu, Cassandra; Buxton, Orfeu M.; Dennerlein, Jack T.; Boden, Leslie I.; Hashimoto, Dean M.; Sorensen, Glorian

2014-01-01

Background A growing body of evidence suggests that work-family conflict is an important risk factor for workers' health and well-being. The goal of this study is to examine association between work-family conflict and musculoskeletal pain among hospital patient care workers. Methods We analyzed a cross-sectional survey of 1119 hospital patient care workers in 105 units in two urban, academic hospitals. Work-family conflict was measured by 5-item Work-Family Conflict Scale questionnaire. Multilevel logistic regression was applied to examine associations between work-family conflict and self-reported musculoskeletal pain in the past 3 months, adjusting for confounders including work-related psychosocial factors and physical work factors. Results In fully adjusted models, high work-family conflict was strongly associated with neck or shoulder pain (OR: 2.34, 95% CI: 1.64 - 3.34), arm pain (OR: 2.79, 95% CI: 1.64 - 4.75), lower extremity pain (OR: 2.20, 95% CI: 1.54- 3.15) and any musculoskeletal pain (OR: 2.45, 95% CI: 1.56 - 3.85), and a number of body areas in pain (OR: 2.47, 95% CI: 1.82 - 3.36) in the past 3 months. The association with low back pain was attenuated and became non-significant after adjusting for confounders. Conclusions Given the consistent associations between work-family conflict and self-reported musculoskeletal pains, the results suggest that work-family conflict could be an important domain for health promotion and workplace policy development among hospital patient care workers. PMID:23019044

Implementation of a Computerized Order Entry Tool to Reduce the Inappropriate and Unnecessary Use of Cardiac Stress Tests With Imaging in Hospitalized Patients.

PubMed

Gertz, Zachary M; O'Donnell, William; Raina, Amresh; Balderston, Jessica R; Litwack, Andrew J; Goldberg, Lee R

2016-10-15

The rising use of imaging cardiac stress tests has led to potentially unnecessary testing. Interventions designed to reduce inappropriate stress testing have focused on the ambulatory setting. We developed a computerized order entry tool intended to reduce the use of imaging cardiac stress tests and improve appropriate use in hospitalized patients. The tool was evaluated using preimplementation and postimplementation cohorts at a single urban academic teaching hospital. All hospitalized patients referred for testing were included. The co-primary outcomes were the use of imaging stress tests as a percentage of all stress tests and the percentage of inappropriate tests, compared between the 2 cohorts. There were 478 patients in the precohort and 463 in the postcohort. The indication was chest pain in 66% and preoperative in 18% and was not significantly different between groups. The use of nonimaging stress tests increased from 4% in the pregroup to 15% in the postgroup (p <0.001). Among very low-risk chest pain patients, the use of nonimaging stress tests increased from 7% to 25% (p <0.001). Inappropriate testing did not change significantly between groups (12% vs 11%). Inappropriate tests were most often preoperative evaluations (83%). In conclusion, our computerized ordering tool significantly increased the use of nonimaging cardiac stress tests and reduced the use of imaging tests yet was not able to reduce inappropriate use. Our study highlights the differences in cardiac stress testing between hospitalized and ambulatory patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States.

PubMed

Kozhimannil, Katy B; Hung, Peiyin; Henning-Smith, Carrie; Casey, Michelle M; Prasad, Shailendra

2018-03-27

Hospital-based obstetric services have decreased in rural US counties, but whether this has been associated with changes in birth location and outcomes is unknown. To examine the relationship between loss of hospital-based obstetric services and location of childbirth and birth outcomes in rural counties. A retrospective cohort study, using county-level regression models in an annual interrupted time series approach. Births occurring from 2004 to 2014 in rural US counties were identified using birth certificates linked to American Hospital Association Annual Surveys. Participants included 4 941 387 births in all 1086 rural counties with hospital-based obstetric services in 2004. Loss of hospital-based obstetric services in the county of maternal residence, stratified by adjacency to urban areas. Primary outcomes were county rates of (1) out-of-hospital births; (2) births in hospitals without obstetric units; and (3) preterm births (<37 weeks' gestation). Between 2004 and 2014, 179 rural counties lost hospital-based obstetric services. Of the 4 941 387 births studied, the mean (SD) maternal age was 26.2 (5.8) years. A mean (SD) of 75.9% (23.2%) of women who gave birth were non-Hispanic white, and 49.7% (15.6%) were college graduates. Rural counties not adjacent to urban areas that lost hospital-based obstetric services had significant increases in out-of-hospital births (0.70 percentage points [95% CI, 0.30 to 1.10]); births in a hospital without an obstetric unit (3.06 percentage points [95% CI, 2.66 to 3.46]); and preterm births (0.67 percentage points [95% CI, 0.02 to 1.33]), in the year after loss of services, compared with those with continual obstetric services. Rural counties adjacent to urban areas that lost hospital-based obstetric services also had significant increases in births in a hospital without obstetric services (1.80 percentage points [95% CI, 1.55 to 2.05]) in the year after loss of services, compared with those with continual obstetric services, and this was followed by a decreasing trend (-0.19 percentage points per year [95% CI, -0.25 to -0.14]). In rural US counties not adjacent to urban areas, loss of hospital-based obstetric services, compared with counties with continual services, was associated with increases in out-of-hospital and preterm births and births in hospitals without obstetric units in the following year; the latter also occurred in urban-adjacent counties. These findings may inform planning and policy regarding rural obstetric services.

Afterschool Participation and School Engagement: A Case Study of an Urban East Coast Public Elementary School

ERIC Educational Resources Information Center

DeFigueiredo, Rafaela

2013-01-01

Students attending schools in urban areas with high concentrations of poverty are at risk for academic failure. Besides being more likely to live in poverty, urban students in comparison to suburban students are more likely to be English language learners and to be exposed to violence and other health and safety risks linked to negative school and…

Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use-A One Year Study from Vietnam.

PubMed

Lien, La Thi Quynh; Hoa, Nguyen Quynh; Chuc, Nguyen Thi Kim; Thoa, Nguyen Thi Minh; Phuc, Ho Dang; Diwan, Vishal; Dat, Nguyen Thanh; Tamhankar, Ashok J; Lundborg, Cecilia Stålsby

2016-06-14

Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital's wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital's wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001).

Use of Warfarin at Discharge Among Acute Ischemic Stroke Patients With Nonvalvular Atrial Fibrillation in China.

PubMed

Yang, Xiaomeng; Li, Zixiao; Zhao, Xingquan; Wang, Chunjuan; Liu, Liping; Wang, Chunxue; Pan, Yuesong; Li, Hao; Wang, David; Hart, Robert G; Wang, Yilong; Wang, Yongjun

2016-02-01

Guidelines recommend oral anticoagulation for ischemic stroke patients with atrial fibrillation, and previous studies have shown the underuse of anticoagulation for these patients in China. We sought to explore the underlying reasons and factors that currently affect the use of warfarin in China. From June 2012 to January 2013, 19 604 patients with acute ischemic stroke were admitted to 219 urban hospitals voluntarily participating in the China National Stroke Registry II. Multivariable logistic regression models using the generalized estimating equation method were used to identify patient/hospital factors independently associated with warfarin use at discharge. Among the 952 acute ischemic stroke patients with nonvalvular atrial fibrillation, 19.4% were discharged on warfarin. The risk of bleeding (52.8%) and patient refusal (31.9%) were the main reasons for not prescribing anticoagulation. Larger/teaching hospitals were more likely to prescribe warfarin. Older patients, heavy drinkers, patients with higher National Institutes of Health Stroke Scale score on admission were less likely to be given warfarin, whereas patients with history of heart failure and an international normalized ratio between 2.0 and 3.0 during hospitalization were significantly associated with warfarin use at discharge. The rate of warfarin use remains low among patients with ischemic stroke and known nonvalvular atrial fibrillation in China. Hospital size and academic status together with patient age, heart failure, heavy alcohol drinking, international normalized ratio in hospital, and stroke severity on admission were each independently associated with the use of warfarin at discharge. There is much room for improvement for secondary stroke prevention in nonvalvular atrial fibrillation patients in China. © 2015 American Heart Association, Inc.

Oiling the gate: a mobile application to improve the admissions process from the emergency department to an academic community hospital inpatient medicine service.

PubMed

Fung, Russell; Hyde, Jensen Hart; Davis, Mike

2018-01-01

The process of admitting patients from the emergency department (ED) to an academic internal medicine (AIM) service in a community teaching hospital is one fraught with variability and disorder. This results in an inconsistent volume of patients admitted to academic versus private hospitalist services and results in frustration of both ED and AIM clinicians. We postulated that implementation of a mobile application (app) would improve provider satisfaction and increase admissions to the academic service. The app was designed and implemented to be easily accessible to ED physicians, regularly updated by academic residents on call, and a real-time source of the number of open AIM admission spots. We found a significant improvement in ED and AIM provider satisfaction with the admission process. There was also a significant increase in admissions to the AIM service after implementation of the app. We submit that the implementation of a mobile app is a viable, cost-efficient, and effective method to streamline the admission process from the ED to AIM services at community-based hospitals.

Rural-Urban Differences in Preventable Hospitalizations among Community-Dwelling Veterans with Dementia

ERIC Educational Resources Information Center

Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.

2010-01-01

Context: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods: Medicare…

The financial impact of a clinical academic practice partnership.

PubMed

Greene, Mary Ann; Turner, James

2014-01-01

New strategies to provide clinical experiences for nursing students have caused nursing schools and hospitals to evaluate program costs. A Microsoft Excel model, which captures costs and associated benefits, was developed and is described here. The financial analysis shows that the Clinical Academic Practice Program framework for nursing clinical education, often preferred by students, can offer financial advantages to participating hospitals and schools of nursing. The model is potentially a tool for schools of nursing to enlist hospitals and to help manage expenses of clinical education. Hospitals may also use the Hospital Nursing Unit Staffing and Expense Worksheet in planning staffing when students are assigned to units and the cost/benefit findings to enlist management support.

A Comparison of the Academic Achievement and Perceptions of Leadership Skills and Citizenship Traits of JROTC, Student Athletes, and Other Students in an Urban High School Setting

ERIC Educational Resources Information Center

Williams-Bonds, Carmen

2013-01-01

The purpose of this study was to compare three groups: JROTC students, student athletes, and other students, to determine if there were differences in academic achievement. Gaining an understanding of the necessary skills required to become academically successful and make healthy life choices, could provide educators working within an urban…

Education Management Organizations' Collaborative Leadership Practices for Low-Performing Urban Charter Schools

ERIC Educational Resources Information Center

Cupidore, Calvin C., Jr.

2017-01-01

Educators have regarded building leader-member relationships using collaboration as a fundamental component to successfully improve students' academic achievement. Ineffective collaborative leadership practices may lead to achievement deficits particularly for many urban charter schools operated by educational management organizations. The purpose…

Exam Scams and Classroom Flimflams: Urban Legends as an Alternative Lens for Viewing the College Classroom Experience

ERIC Educational Resources Information Center

Major, Claire Howell; Bray, Nathaniel

2008-01-01

Campus-based urban legends have the potential to convey and construct student culture in higher education. Basic qualitative and humanistic research methods were used to collect, analyze, and interpret legends related to the academic experience of collegiate life.

Breakfast and the Achievement Gap among Urban Minority Youth

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of breakfast consumption among school-aged urban minority youth, causal pathways through which skipping breakfast adversely affects academic achievement, and proven or promising approaches for schools to increase breakfast consumption. Methods: Literature review. Results: On any given day a…

Inattention and Hyperactivity and the Achievement Gap among Urban Minority Youth

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of inattention and hyperactivity among school-aged urban minority youth, causal pathways through which inattention and hyperactivity adversely affects academic achievement, and proven or promising approaches for schools to address these problems. Methods: Literature review. Results:…

Financial implications of nonoperative fracture care at an academic trauma center.

PubMed

Appleton, Paul; Chacko, Aron; Rodriguez, Edward K

2012-11-01

To determine if nonoperative fracture Current Procedural Technology codes generate a significant portion of annual revenues in an academic practice. Retrospective review of an orthopaedic trauma practice billings during fiscal year 2008. An urban level-1 trauma center. Outpatient clinic, and all consults, to the orthopaedic trauma service in the emergency room and hospital wards staffed by an attending traumatologist. An analysis was made of relative value units (RVUs) generated by operative and nonoperative care, separating the later into clinic, consults, and closed (nonoperative) fracture treatment. A total of 19,815 RVUs were generated by the trauma service during the 2008 fiscal year. Emergency department and ward consults generated 2176 (11%) of RVUs, whereas outpatient clinic generated an additional 1313 (7%) of RVUs. Nonoperative (closed) fracture care generated 2725 (14%) RVUs, whereas surgical procedures were responsible for the remaining 13,490 (68%) of RVUs. In terms of overall financial reimbursement, nonoperative management, consults, and office visits generated 31% of income for the trauma service. Although the largest financial contribution to a busy surgical practice is operative procedures, 1 must not overlook the important impact of nonoperative fracture care and consults. In our academic center, nearly one-third of all income was generated from nonsurgical procedures. In the current medical/financial climate, 1 must be diligent in optimizing the finances of trauma care to sustain an economically viable practice. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

An Environmental Scan of Academic Emergency Medicine at the 17 Canadian Medical Schools: Why Does this Matter to Emergency Physicians?

PubMed

Stiell, Ian G; Artz, Jennifer D; Lang, Eddy S; Sherbino, Jonathan; Morrison, Laurie J; Christenson, James; Perry, Jeffrey J; Topping, Claude; Woods, Robert; Green, Robert S; Lim, Rodrick; Magee, Kirk; Foote, John; Meckler, Garth; Mensour, Mark; Field, Simon; Chung, Brian; Kuuskne, Martin; Ducharme, James; Klein, Vera; McEwen, Jill

2017-01-01

We sought to conduct a major objective of the CAEP Academic Section, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools. We developed an 84-question questionnaire, which was distributed to academic heads. The responses were validated by phone by the lead author to ensure that the questions were answered completely and consistently. Details of pediatric emergency medicine units were excluded from the scan. At eight of 17 universities, emergency medicine has full departmental status and at two it has no official academic status. Canadian academic emergency medicine is practiced at 46 major teaching hospitals and 13 specialized pediatric hospitals. Another 69 Canadian hospital EDs regularly take clinical clerks and emergency medicine residents. There are 31 full professors of emergency medicine in Canada. Teaching programs are strong with clerkships offered at 16/17 universities, CCFP(EM) programs at 17/17, and RCPSC residency programs at 14/17. Fourteen sites have at least one physician with a Master's degree in education. There are 55 clinical researchers with salary support at 13 universities. Sixteen sites have published peer-reviewed papers in the past five years, ranging from four to 235 per site. Annual budgets range from $200,000 to $5,900,000. This comprehensive review of academic activities in emergency medicine across Canada identifies areas of strengths as well as opportunities for improvement. CAEP and the Academic Section hope we can ultimately improve ED patient care by sharing best academic practices and becoming better teachers, educators, and researchers.

Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: identification of ecologically relevant pharmaceuticals.

PubMed

Santos, Lúcia H M L M; Gros, Meritxell; Rodriguez-Mozaz, Sara; Delerue-Matos, Cristina; Pena, Angelina; Barceló, Damià; Montenegro, M Conceição B S M

2013-09-01

The impact of effluent wastewaters from four different hospitals: a university (1456 beds), a general (350 beds), a pediatric (110 beds) and a maternity hospital (96 beds), which are conveyed to the same wastewater treatment plant (WWTP), was evaluated in the receiving urban wastewaters. The occurrence of 78 pharmaceuticals belonging to several therapeutic classes was assessed in hospital effluents and WWTP wastewaters (influent and effluent) as well as the contribution of each hospital in WWTP influent in terms of pharmaceutical load. Results indicate that pharmaceuticals are widespread pollutants in both hospital and urban wastewaters. The contribution of hospitals to the input of pharmaceuticals in urban wastewaters widely varies, according to their dimension. The estimated total mass loadings were 306 g d(-1) for the university hospital, 155 g d(-1) for the general one, 14 g d(-1) for the pediatric hospital and 1.5 g d(-1) for the maternity hospital, showing that the biggest hospitals have a greater contribution to the total mass load of pharmaceuticals. Furthermore, analysis of individual contributions of each therapeutic group showed that NSAIDs, analgesics and antibiotics are among the groups with the highest inputs. Removal efficiency can go from over 90% for pharmaceuticals like acetaminophen and ibuprofen to not removal for β-blockers and salbutamol. Total mass load of pharmaceuticals into receiving surface waters was estimated between 5 and 14 g/d/1000 inhabitants. Finally, the environmental risk posed by pharmaceuticals detected in hospital and WWTP effluents was assessed by means of hazard quotients toward different trophic levels (algae, daphnids and fish). Several pharmaceuticals present in the different matrices were identified as potentially hazardous to aquatic organisms, showing that especial attention should be paid to antibiotics such as ciprofloxacin, ofloxacin, sulfamethoxazole, azithromycin and clarithromycin, since their hazard quotients in WWTP effluent revealed that they could pose an ecotoxicological risk to algae. Copyright © 2013 Elsevier B.V. All rights reserved.

Freshmen Dropouts

ERIC Educational Resources Information Center

Barr, Jim

2007-01-01

This study examines second-term and second-year persistence of 19,489 freshmen at American River College (ARC), a large, urban, public community college near Sacramento, California. Academic and non-academic characteristics are compared between first year dropouts and those students that enroll one year after the first fall term at ARC for two…

Cultural Mistrust, Academic Outcome Expectations, and Outcome Values among African American Adolescent Men

ERIC Educational Resources Information Center

Irving, Miles Anthony; Hudley, Cynthia

2005-01-01

This study measured the relationship between outcome expectations, outcome value, and cultural mistrust among African American male high school students (N = 75) attending an urban, Southern California school. We hypothesized that a negative perception of the dominant culture would negatively affect academic outcome expectations and academic…

Using Genre Pedagogy to Teach Adolescent English Learners to Write Academic Persuasive Essays

ERIC Educational Resources Information Center

Ramos, Kathleen Ann

2015-01-01

The new "Common Core State Standards" (CCSS) (NGACBP & CCSSO, 2010) require teachers to prepare all learners, including adolescent English learners (ELs), to develop academic literacy practices. This article describes an instructional intervention in an urban public high school using the genre-based "Reading to Learn" (Rose…

A theoretical model of continuity in anxiety and links to academic achievement in disaster-exposed school children.

PubMed

Weems, Carl F; Scott, Brandon G; Taylor, Leslie K; Cannon, Melinda F; Romano, Dawn M; Perry, Andre M

2013-08-01

This study tested a theoretical model of continuity in anxious emotion and its links to academic achievement in disaster-exposed youth. An urban school based sample of youths (n = 191; Grades 4-8) exposed to Hurricane Katrina were assessed at 24 months (Time 1) and then again at 30 months (Time 2) postdisaster. Academic achievement was assessed through end of the school year standardized test scores (~31 months after Katrina). The results suggest that the association of traumatic stress to academic achievement was indirect via linkages from earlier (Time 1) posttraumatic stress disorder symptoms that predicted later (Time 2) test anxiety. Time 2 test anxiety was then negatively associated with academic achievement. Age and gender invariance testing suggested strong consistency across gender and minor developmental variation in the age range examined. The model presented advances the developmental understanding of the expression of anxious emotion and its links to student achievement among disaster-exposed urban school children. The findings highlight the importance of identifying heterotypic continuity in anxiety and suggest potential applied and policy directions for disaster-exposed youth. Avenues for future theoretical refinement are also discussed.

Impact of Institution of a Stroke Program upon Referral Bias at a Rural Academic Medical Center

ERIC Educational Resources Information Center

Riggs, Jack E.; Libell, David P.; Brooks, Claudette E.; Hobbs, Gerald R.

2005-01-01

Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a…

Impact of Institution of a Stroke Program Upon Referral Bias at a Rural Academic Medical Center

ERIC Educational Resources Information Center

Riggs, Jack E.; Libell, David P.; Brooks, Claudette E.; Hobbs, Gerald R.

2005-01-01

Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a…

Experiences of violence and deficits in academic achievement among urban primary school children in Jamaica.

PubMed

Baker-Henningham, Helen; Meeks-Gardner, Julie; Chang, Susan; Walker, Susan

2009-05-01

The aim of this study was to examine the relationship between children's experiences of three different types of violence and academic achievement among primary school children in Kingston, Jamaica. A cross-sectional study of 1300 children in grade 5 [mean (S.D.) age: 11 (0.5) years] from 29 government primary schools in urban areas of Kingston and St. Andrew, Jamaica, was conducted. Academic achievement (mathematics, reading, and spelling) was assessed using the Wide Range Achievement Test. Children's experiences of three types of violence - exposure to aggression among peers at school, physical punishment at school, and exposure to community violence - were assessed by self-report using an interviewer administered questionnaire. Fifty-eight percent of the children experienced moderate or high levels of all three types of violence. Boys had poorer academic achievement and experienced higher levels of aggression among peers and physical punishment at school than girls. Children's experiences of the three types of violence were independently associated with all three indices of academic achievement. There was a dose-response relationship between children's experiences of violence and academic achievement with children experiencing higher levels of violence having the poorest academic achievement and children experiencing moderate levels having poorer achievement than those experiencing little or none. Exposure to three different types of violence was independently associated with poor school achievement among children attending government, urban schools in Jamaica. Programs are needed in schools to reduce the levels of aggression among students and the use of physical punishment by teachers and to provide support for children exposed to community violence. Children in Jamaica and the wider Caribbean experience significant amounts of violence in their homes, communities, and schools. In this study, we demonstrate a dose-response relationship between primary school children's experiences of three different types of violence and their academic achievement. The study points to the need for validated violence prevention programs to be introduced in Jamaican primary schools. Such programs need to train teachers in appropriate classroom management and discipline strategies and to promote children's social and emotional competence and prevent aggression.

An ecological study of food desert prevalence and 4th grade academic achievement in new york state school districts.

PubMed

Frndak, Seth E

2014-12-02

This ecological study examines the relationship between food desert prevalence and academic achievement at the school district level. Sample included 232 suburban and urban school districts in New York State. Multiple open-source databases were merged to obtain: 4(th) grade science, English and math scores, school district demographic composition (NYS Report Card), regional socioeconomic indicators (American Community Survey), school district quality (US Common Core of Data), and food desert data (USDA Food Desert Atlas). Multiple regression models assessed the percentage of variation in achievement scores explained by food desert variables, after controlling for additional predictors. The proportion of individuals living in food deserts significantly explained 4th grade achievement scores, after accounting for additional predictors. School districts with higher proportions of individuals living in food desert regions demonstrated lower 4th grade achievement across science, English and math. Food deserts appear to be related to academic achievement at the school district level among urban and suburban regions. Further research is needed to better understand how food access is associated with academic achievement at the individual level. Significance for public healthThe prevalence of food deserts in the United States is of national concern. As poor nutrition in United States children continues to spark debate, food deserts are being evaluated as potential sources of low fruit and vegetable intake and high obesity rates. Cognitive development and IQ have been linked to nutrition patterns, suggesting that children in food desert regions may have a disadvantage academically. This research evaluates if an ecological relationship between food desert prevalence and academic achievement at the school district level can be demonstrated. Results suggest that food desert prevalence may relate to poor academic performance at the school district level. Significant variation in academic achievement among urban and suburban school districts is explained by food desert prevalence, above additional predictors. This research lays the groundwork for future studies at the individual level, with possible implications for community interventions in school districts containing food desert regions.

Nursing leadership in an academic hospital in Gauteng.

PubMed

Maboko, D R

2012-10-01

This study was aimed at describing nursing leadership in an academic hospital in Gauteng, South Africa. Nurse managers' leadership styles affect nurses' attitudes, behaviour and work performance. However, little is known about how nurses experience nurse leadership and what leadership styles are found in academic hospitals in Gauteng. The study was based on Maxwell's framework of leadership (relationships, equipping, leadership and attitude). A qualitative design was used in order to describe the experiences of registered nurses and nurse managers. The population of the study was all registered nurses and nurse managers of the hospital in which the study was conducted. In phase one of the study, a discussion group with 35 registered nurses using the nominal group technique was held to respond to the following statement: 'Please explain how you have experienced leadership by nurse managers in this hospital'. In phase two of the study, five nurse managers were interviewed individually, using a semi-structured interview guide. Some nurse managers were practising autocratic leadership in this hospital. he nurse managers need to be taught about contemporary leadership styles such as transformational leadership and visionary leadership and also about supervision, role modelling and caring. © 2011 Blackwell Publishing Ltd.

Utilization of hospital services by cardiovascular patients, Alberta, Canada.

PubMed Central

Bay, K S; Maher, M; Lee, S J

1989-01-01

Using hospital discharge records, and United States DRG (diagnosis related groups) data, we studied hospital utilization by cardiovascular patients, associated hospital expenditures, and the per capita cost of treating cardiovascular diseases in Alberta, Canada between 1971 and 1986. Expressed in constant 1984 Canadian dollars, the estimated total hospital cost increased from $84 million in 1971 to $131 million in 1986; during this period the Province of Alberta spent about $51 Canadian per resident each year for cardiovascular hospital services. It was noted that rural residents consumed a higher volume of resources per capita than their urban counterparts. A patient origin-destination analysis indicated an increasing dependence of rural patients on urban hospitals for secondary or tertiary care, underscoring the effects of medical technology on referral patterns. PMID:2499201

Asthma and the Achievement Gap among Urban Minority Youth

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of asthma among school-aged urban minority youth, causal pathways through which poorly controlled asthma adversely affects academic achievement, and proven or promising approaches for schools to address these problems. Methods: Literature review. Results: Asthma is the most common chronic…

Turn up that Radio, Teacher: Popular Cultural Pedagogy in New Century Urban Schools

ERIC Educational Resources Information Center

Duncan-Andrade, Jeffrey M. R.; Morrell, Ernest

2005-01-01

Synthesizing literature from critical pedagogy, sociocultural psychology, and cultural studies with popular cultural texts and experiences from actual classroom practice, this article conceptualizes the critical teaching of popular culture as a viable strategy to increase academic and critical literacies in urban secondary classrooms. Relying on…

Graduation Coaching in High-Need Urban, High Schools

ERIC Educational Resources Information Center

Lacefield, Warren E.; Zeller, Pamela J.; Van Kannel-Ray, Nancy

2010-01-01

This study documents the impact of placing graduation coaches as a GEAR UP intervention in urban high schools. The overall goal was improvement of students' academic performance, particularly for students not passing core courses. This longitudinal study began with data collection in feeder middle schools where results indicated improved student…

Promoting School Connectedness among Minority Youth through Experience-Based Urban Farming

ERIC Educational Resources Information Center

Fifolt, Matthew; Morgan, Amy Ferguson; Burgess, Zoe Ripple

2018-01-01

Background: The public education system in the United States faces significant challenges in understanding and addressing issues of student disengagement among high-poverty youth in urban centers. Academic and community leaders are encouraged to seek new and innovative strategies to engage students in meaningful learning experiences that promote…

Feasibility and Preliminary Outcomes of a School-Based Mindfulness Intervention for Urban Youth

ERIC Educational Resources Information Center

Mendelson, Tamar; Greenberg, Mark T.; Dariotis, Jacinda K.; Gould, Laura Feagans; Rhoades, Brittany L.; Leaf, Philip J.

2010-01-01

Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper…

Differing Circumstances, Shared Challenges: Finding Common Ground between Urban and Rural Schools

ERIC Educational Resources Information Center

Truscott, Diane M.; Truscott, Stephen D.

2005-01-01

The shared struggles facing urban and rural schools, such as changing cultural and linguistic classroom profiles, increased childhood poverty, and residential segregation patterns, influence financial inequities between people and communities thus contributing to gaps in academic achievement and teacher shortages in both settings. The…

Physical Activity and the Achievement Gap among Urban Minority Youth

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of physical activity among school-aged urban minority youth, causal pathways through which low levels of physical activity and fitness adversely affects academic achievement, and proven or promising approaches for schools to increase physical activity and physical fitness among youth. Methods:…

School Uniforms in Urban Public High Schools

ERIC Educational Resources Information Center

Draa, Virginia Ann Bendel

2005-01-01

The purpose of this study was to determine whether or not the implementation of a mandatory uniform policy in urban public high schools improved school performance measures at the building level for rates of attendance, graduation, academic proficiency, and student conduct as measured by rates of suspensions and expulsions. Sixty-four secondary…

Vision and the Achievement Gap among Urban Minority Youth

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of vision problems among school-aged urban minority youth, causal pathways through which vision problems adversely affects academic achievement, and proven or promising approaches for schools to address these problems. Methods: Literature review. Results: More than 20% of school-aged youth have…

Aggression and Violence and the Achievement Gap among Urban Minority Youth

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of aggression and violence among school-aged urban minority youth, causal pathways through which aggression and violence adversely affects academic achievement, and proven or promising approaches for schools to address these problems. Methods: Literature review. Results: Recent national data…

The Effects of Belonging and Racial Identity on Urban African American High School Students' Achievement

ERIC Educational Resources Information Center

Boston, Colette; Warren, Susan R.

2017-01-01

A growing body of literature suggests students' feelings of belongingness influence academic achievement (Faircloth & Hamm, 2005). Additionally, research indicates that many urban African American students are disconnected from the school setting because of a cultural divide between students and educators (Thompson, 2004). This investigation…

Urban Preschool Teachers' Instructional Technology Integration Perceptions and Practices

ERIC Educational Resources Information Center

Sargent, Amanda R.

2017-01-01

Instructional technology use in United States preschool classrooms remains a limited and widely debated practice. In urban communities, preparing preschool students for academic, social, and economic success is further threatened by the well-documented digital divide. This qualitative phenomenological study included ten subjects and examined the…

A Study of Preservice Educators' Dispositions to Change Behavior Management Strategies

ERIC Educational Resources Information Center

Shook, Alison C.

2012-01-01

Student behavior problems contribute to poor academic achievement and poor teacher retention. This study investigated preservice teachers' dispositions to implement positive and proactive strategies for managing behavior in the general education elementary urban classroom. The author interviewed 19 preservice teachers in a large urban school…

Teaching Africa's Cities through Meja Mwangi's Novels

ERIC Educational Resources Information Center

Smiley, Sarah L.

2009-01-01

This article presents a lesson plan used to teach about African urbanization using Kenyan novels. Specifically, three urban novels written by Meja Mwangi are used. Based on a qualitative survey of student preference and learning, this lesson plan uses these novels alongside more traditional academic texts to achieve effective student learning.…

Voices of Queer Youth in Urban Schools: Possibilities and Limitations

ERIC Educational Resources Information Center

Blackburn, Mollie V.; McCready, Lance T.

2009-01-01

This article reviews scholarship that represents urban students who self-identify as lesbian, gay, bisexual, transgender, queer, or questioning. It draws on empirical examples to illustrate prominent themes across this scholarship, including the homophobia they experience, the impact it has on their academic performance, and the activism it…

Evaluation of Cooper 12-minute walk/run test as a marker of cardiorespiratory fitness in young urban children with persistent asthma.

PubMed

Weisgerber, Michael; Danduran, Michael; Meurer, John; Hartmann, Kathryn; Berger, Stuart; Flores, Glenn

2009-07-01

To evaluate Cooper 12-minute run/walk test (CT12) as a one-time estimate of cardiorespiratory fitness and marker of fitness change compared with treadmill fitness testing in young children with persistent asthma. A cohort of urban children with asthma participated in the asthma and exercise program and a subset completed pre- and postintervention fitness testing. Treadmill fitness testing was conducted by an exercise physiologist in the fitness laboratory at an academic children's hospital. CT12 was conducted in a college recreation center gymnasium. Forty-five urban children with persistent asthma aged 7 to 14 years participated in exercise interventions. A subset of 19 children completed pre- and postintervention exercise testing. Participants completed a 9-week exercise program where they participated in either swimming or golf 3 days a week for 1 hour. A subset of participants completed fitness testing by 2 methods before and after program completion. CT12 results (meters), maximal oxygen consumption ((.)Vo2max) (mL x kg(-1) x min(-1)), and treadmill exercise time (minutes). CT12 and maximal oxygen consumption were moderately correlated (preintervention: 0.55, P = 0.003; postintervention: 0.48, P = 0.04) as one-time measures of fitness. Correlations of the tests as markers of change over time were poor and nonsignificant. In children with asthma, CT12 is a reasonable one-time estimate of fitness but a poor marker of fitness change over time.

"Not a shack in the woods": architecture for tuberculosis in Muskoka and Toronto.

PubMed

Adams, Annmarie; Burke, Stacie

2006-01-01

This paper explores architecture as a primary source in the history of tuberculosis. In comparing five Ontario sanatoria built between 1897 and 1923, we identify a range of types and a growing resemblance of ex-urban TB sanatoria to urban hospitals. Existing literature on Canadian TB hospital architecture suggests the endurance of picturesque architecture, but the cottage plan was only one of the types deemed appropriate for consumptives in the early 20th century, even in Muskoka. Furthermore we argue that urban and ex-urban TB ideologies actually coalesce about 1923, best illustrated in the boldly modern architecture of Muskoka's new Gage pavilion.

Provider perceptions of the social work environment and the state of pediatric care in a downsized urban public academic medical center.

PubMed

Tataw, David Besong

2011-05-01

The author's purpose through this study was to document and analyze health provider perceptions of their social work environment and the state of pediatric care at Los Angeles County King/Drew Hospital and Medical Center in 2000, after the restructuring and downsizing of the hospital and its community clinics. The research results showed nurses and physicians reporting that both the quality of pediatric care and the provider social work environment were poor. Negative factors in the social work environment included: low employee morale, poorly staffed clinical teams, lack of professional autonomy, perceptions of low quality of care for pediatric patients, and interpersonal issues of poor communication and collaboration among providers. Providers also perceived a non-supportive work environment, sense of powerlessness, poor quality of work, lack of goal clarity from leadership, lack of fairness in leadership behavior, and an organizational leadership that is abandoning its core mission and values, thereby making it difficult for providers to carry out their professional functions. The author's findings in this study suggest a relationship between intra-role conflict, social employment environment and quality of care at King/Drew Medical Center in 2000. Lessons for practice are presented.

Contributing to the Community: The Economic Significance of Academic Health Centers and Their Role in Neighborhood Development. Report IV. Report of the Task Force on Academic Health Centers.

ERIC Educational Resources Information Center

Commonwealth Fund, New York, NY.

This report is a selective analysis and assessment of quantitative data and field studies that reflect the economic role of the Academic Health Center (AHC) in the urban economy and in neighborhood revitalization. It describes the effect of a variety of cooperative efforts between local community organizations and AHCs, which usually include a…

Physicians' job satisfaction and motivation in a public academic hospital.

PubMed

de Oliveira Vasconcelos Filho, Paulo; de Souza, Miriam Regina; Elias, Paulo Eduardo Mangeon; D'Ávila Viana, Ana Luiza

2016-12-07

Physician shortage is a global issue that concerns Brazil's authorities. The organizational structure and the environment of a medical institution can hide a low-quality life of a physician. This study examines the relationship between the hospital work environment and physicians' job satisfaction and motivation when working in a large public academic hospital. The study was restricted to one large, multispecialty Brazil's hospital. Six hundred hospital physicians were invited to participate by e-mail. A short version of the Physician Worklife Survey (PWS) was used to measure working satisfaction. Physicians were also asked for socio-demographic information, medical specialty, and the intention to continue working in the hospital. Data from 141 questionnaires were included in the analyses. Forty-five physicians graduated from the hospital's university, and they did not intend to leave the hospital under any circumstance (affective bond). The motivating factor for beginning the career at the hospital and to continue working there were the connection to the medical school and the hospital status as a "prestigious academic hospital"; the physicians were more satisfied with the career than the specialty. Only 30% completely agreed with the statement "If I had to start my career over again, I would choose my current specialty," while 45% completely agreed with the statement "I am not well compensated given my training and experience." The greater point of satisfaction was the relationship with physician colleagues. They are annoyed about the amount of calls they are requested to take and about how work encroaches on their personal time. No significant differences between medical specialties were found in the analysis. The participants were satisfied with their profession. The fact that they remained at the hospital was related to the academic environment, the relationship with colleagues, and the high prestige in which society holds the institution. The points of dissatisfaction were inadequate remuneration and the fact that work invaded personal time. Routinely, there is a need for organizations to examine the impact of their structures, policies, and procedures on the stress and quality of life of physicians.

Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology.

PubMed

Tagge, Edward P; Thirumoorthi, Arul S; Lenart, John; Garberoglio, Carlos; Mitchell, Kenneth W

2017-06-01

Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools. Results for Children's Hospital scheduled main operating room (OR) cases were analyzed, where the surgical attending followed themselves. Six hundred twelve cases were included in the seven Children's Hospital operating rooms (OR) over a 6-month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased from a median 41min in the baseline period to 32min in the intervention period (p<0.0001). Turnaround Time (interval between surgical dressing application and subsequent surgical incision) decreased from a median 81.5min in the baseline period to 71min in the intervention period (p<0.0001). These results demonstrate that a coordinated multidisciplinary process improvement redesign can significantly improve efficiency in an academic Children's Hospital without preselecting specific services, removing surgical residents, or incorporating new personnel or technology. Prospective comparative study, Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

Bundled Payments for Care Improvement

PubMed Central

Hardin, Lauran; Kilian, Adam; Murphy, Elizabeth

2017-01-01

BACKGROUND The Centers for Medicare and Medicaid Services Innovation Center introduced the Bundled Payments for Care Improvement (BPCI) initiative in 2011 as 1 strategy to encourage healthcare organizations and clinicians to improve healthcare delivery for patients, both when they are in the hospital and after they are discharged. Mercy Health Saint Mary’s, a large urban academic medical center, engaged in BPCI primarily with a group of medical diagnosis-related groups (DRGs). OBJECTIVES In this article, we describe our experience creating a system of response for the diverse people and diagnoses that fall into the medical DRG bundles and specifically identify organizational factors for enabling successful implementation of bundled payments. RESULTS Our experience suggests that interprofessional collaboration enabled program success. CONCLUSIONS Although still in its early phases, observations from our program’s strategies and tactics may provide potential insights for organizations considering engagement in the BPCI initiative. PMID:28509721

Bouncers, brokers, and glue: the self-described roles of social workers in urban hospitals.

PubMed

Craig, Shelley L; Muskat, Barbara

2013-02-01

Social workers delivering services in health care settings face unique challenges and opportunities. The purpose of this study was to solicit input from social workers employed in urban hospitals about their perceptions of the roles, contribution, and professional functioning of social work in a rapidly changing health care environment. Using qualitative methods, the university and hospital-based research team conducted seven focus groups (n = 65) at urban hospitals and analyzed the data using an interpretive framework with ATLAS.ti software. Seven major themes emerged from the participants' description of their roles: bouncer, janitor, glue, broker, firefighter, juggler, and challenger. Along with descriptions of the ways social workers fulfilled those roles, participants articulated differences in status within those roles, the increasing complexity of discharge planning, and expectations to provide secondary support to other health care professionals on their teams. Implications for practice and research are discussed.

[A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

PubMed

Maisch, Bernhard

2005-03-01

1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state government, may be unrealistic, when the 4th biggest university hospital in Germany will be created by the merger. University hospitals recrute the patients for high end medicine beyond their region because of the specialized academic competence and advanced technical possibilities. Additional recruitment of patients for routine hospital can hardly be expected.d) A private management will have to consider primarily the "shareholder value", even when investing in infrastructure and buildings, as it can be expected for one partner. On the longterm this will not be possible without a substantial reduction of employees in both institutions. There are, however, also substantial efforts of some private hospital chains in clinical research, e. g. by Helios in Berlin and Rhön Gmbh at the Leipzig Heart Center.e) There is a yet underestimated but very substantial risk because of the taxation for the private owner when academic staff is transferred from the university to hospital care in their dual function as academic teachers and doctors. This risk also applies for the university if the transfer should come from hospital to the university. These costs would add to the financial burden, which has to be carried in addition to the DRGs.

The devil is in the details: trends in avoidable hospitalization rates by geography in British Columbia, 1990–2000

PubMed Central

Cloutier-Fisher, Denise; Penning, Margaret J; Zheng, Chi; Druyts, Eric-Bené F

2006-01-01

Background Researchers and policy makers have focussed on the development of indicators to help monitor the success of regionalization, primary care reform and other health sector restructuring initiatives. Certain indicators are useful in examining issues of equity in service provision, especially among older populations, regardless of where they live. AHRs are used as an indicator of primary care system efficiency and thus reveal information about access to general practitioners. The purpose of this paper is to examine trends in avoidable hospitalization rates (AHRs) during a period of time characterized by several waves of health sector restructuring and regionalization in British Columbia. AHRs are examined in relation to non-avoidable and total hospitalization rates as well as by urban and rural geography across the province. Methods Analyses draw on linked administrative health data from the province of British Columbia for 1990 through 2000 for the population aged 50 and over. Joinpoint regression analyses and t-tests are used to detect and describe trends in the data. Results Generally speaking, non-avoidable hospitalizations constitute the vast majority of hospitalizations in a given year (i.e. around 95%) with AHRs constituting the remaining 5% of hospitalizations. Comparing rural areas and urban areas reveals that standardized rates of avoidable, non-avoidable and total hospitalizations are consistently higher in rural areas. Joinpoint regression results show significantly decreasing trends overall; lines are parallel in the case of avoidable hospitalizations, and lines are diverging for non-avoidable and total hospitalizations, with the gap between rural and urban areas being wider at the end of the time interval than at the beginning. Conclusion These data suggest that access to effective primary care in rural communities remains problematic in BC given that rural areas did not make any gains in AHRs relative to urban areas under recent health sector restructuring initiatives. It remains important to continue to monitor the discrepancy between them as a reflection of inequity in service provision. In addition, it is important to consider alternative explanations for the observed trends paying particular attention to the needs of rural and urban populations and the factors influencing local service provision. PMID:16914056

Prescription opioid poisoning across urban and rural areas: identifying vulnerable groups and geographic areas.

PubMed

Cerdá, Magdalena; Gaidus, Andrew; Keyes, Katherine M; Ponicki, William; Martins, Silvia; Galea, Sandro; Gruenewald, Paul

2017-01-01

To determine (1) whether prescription opioid poisoning (PO) hospital discharges spread across space over time, (2) the locations of 'hot-spots' of PO-related hospital discharges, (3) how features of the local environment contribute to the growth in PO-related hospital discharges and (4) where each environmental feature makes the strongest contribution. Hierarchical Bayesian Poisson space-time analysis to relate annual discharges from community hospitals to postal code characteristics over 10 years. California, USA. Residents of 18 517 postal codes in California, 2001-11. Annual postal code-level counts of hospital discharges due to PO poisoning were related to postal code pharmacy density, measures of medical need for POs (i.e. rates of cancer and arthritis-related hospital discharges), economic stressors (i.e. median household income, percentage of families in poverty and the unemployment rate) and concentration of manual labor industries. PO-related hospital discharges spread from rural and suburban/exurban 'hot-spots' to urban areas. They increased more in postal codes with greater pharmacy density [rate ratio (RR) = 1.03; 95% credible interval (CI) = 1.01, 1.05], more arthritis-related hospital discharges (RR = 1.08; 95% CI = 1.06, 1.11), lower income (RR = 0.85; 95% CI = 0.83, 0.87) and more manual labor industries (RR = 1.15; 95% CI = 1.10, 1.19 for construction; RR = 1.12; 95% CI = 1.04, 1.20 for manufacturing industries). Changes in pharmacy density primarily affected PO-related discharges in urban areas, while changes in income and manual labor industries especially affected PO-related discharges in suburban/exurban and rural areas. Hospital discharge rates for prescription opioid (PO) poisoning spread from rural and suburban/exurban hot-spots to urban areas, suggesting spatial contagion. The distribution of age-related and work-place-related sources of medical need for POs in rural areas and, to a lesser extent, the availability of POs through pharmacies in urban areas, partly explain the growth of PO poisoning across California, USA. © 2016 Society for the Study of Addiction.

Shaping Patient Education in Rural Hospitals: Learning from the Experiences of Patients

ERIC Educational Resources Information Center

Scheckel, Martha; Hedrick-Erickson, Jennifer; Teunis, Jamie; Deutsch, Ashley; Roers, Anna; Willging, Anne; Pittman, Kelly

2012-01-01

Patient education is a crucial aspect of nursing practice, but much of the research about it is quantitative and has been conducted in urban medical centers. These urban-based studies have limited utility for nurses working in rural hospitals where the populations they serve often have unique and challenging health contexts and cultures. Since…

Bouncers, Brokers, and Glue: The Self-Described Roles of Social Workers in Urban Hospitals

ERIC Educational Resources Information Center

Craig, Shelley L.; Muskat, Barbara

2013-01-01

Social workers delivering services in health care settings face unique challenges and opportunities. The purpose of this study was to solicit input from social workers employed in urban hospitals about their perceptions of the roles, contribution, and professional functioning of social work in a rapidly changing health care environment. Using…

Schools as Radical Sanctuaries: Decolonizing Urban Education through the Eyes of Youth of Color. Issues in the Research, Theory, Policy, and Practice of Urban Education

ERIC Educational Resources Information Center

Antrop-Gonzalez, Rene

2011-01-01

Large, comprehensive urban high schools were designed and constructed with the belief that they could meet the needs of all its students, academic and otherwise. By and large, however, these schools have only done a good job of sorting students for specific jobs in a society based on capitalism and White supremacy. Consequently, students schooled…

Historical evidence for the origin of teaching hospital, medical school and the rise of academic medicine.

PubMed

Modanlou, H D

2011-04-01

Historical progression and the development of current teaching hospitals, medical schools and biomedical research originated from the people of many civilizations and cultures. Greeks, Indians, Syriacs, Persians and Jews, assembled first in Gondi-Shapur during the Sasanian empire in Persia, and later in Baghdad during the Golden Age of Islam, ushering the birth of current academic medicine.

A national analysis of the relationship between hospital factors and post-cardiac arrest mortality.

PubMed

Carr, Brendan G; Goyal, Munish; Band, Roger A; Gaieski, David F; Abella, Benjamin S; Merchant, Raina M; Branas, Charles C; Becker, Lance B; Neumar, Robert W

2009-03-01

We sought to generate national estimates for post-cardiac arrest mortality, to assess trends, and to identify hospital factors associated with survival. We used a national sample of US hospitals to identify patients resuscitated after cardiac arrest from 2000 to 2004 to describe the association between hospital factors (teaching status, location, size) and mortality, length of stay, and hospital charges. Analyses were performed using logistic regression. A total of 109,739 patients were identified. In-hospital mortality was 70.6%. A 2% decrease in unadjusted mortality from 71.6% in 2000 to 69.6% in 2004 (OR 0.96, P < 0.001) was observed. Mortality was lower at teaching hospitals (OR 0.58, P = 0.001), urban hospitals (OR 0.63, P = 0.004), and large hospitals (OR 0.55, P < 0.001). Mortality after in-hospital cardiac arrest decreased over 5 years. Mortality was lower at urban, teaching, and large hospitals. There are implications for dissemination of best practices or regionalization of post-cardiac arrest care.

Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services.

PubMed

Arch, Allison E; Weisman, David C; Coca, Steven; Nystrom, Karin V; Wira, Charles R; Schindler, Joseph L

2016-03-01

The failure to recognize an ischemic stroke in the emergency department is a missed opportunity for acute interventions and for prompt treatment with secondary prevention therapy. Our study examined the diagnosis of acute ischemic stroke in the emergency department of an academic teaching hospital and a large community hospital. A retrospective chart review was performed from February 2013 to February 2014. A total of 465 patients with ischemic stroke were included in the analysis; 280 patients from the academic hospital and 185 patients from the community hospital. One hundred three strokes were initially misdiagnosed that is 22% of the included strokes at the combined centers. Fifty-five of these were missed at the academic hospital (22%) [corrected] and 48 were at the community hospital (26%, P=0.11). Thirty-three percent of missed cases presented within a 3-hour time window for recombinant tissue-type plasminogen activator eligibility. An additional 11% presented between 3 and 6 hours of symptom onset for endovascular consideration. Symptoms independently associated with greater odds of a missed stroke diagnosis were nausea/vomiting (odds ratio, 4.02; 95% confidence interval, 1.60-10.1), dizziness (odds ratio, 1.99; 95% confidence interval, 1.03-3.84), and a positive stroke history (odds ratio, 2.40; 95% confidence interval, 1.30-4.42). Thirty-seven percent of posterior strokes were initially misdiagnosed compared with 16% of anterior strokes (P<0.001). Atypical symptoms associated with posterior circulation strokes lead to misdiagnoses. This was true at both an academic center and a large community hospital. Future studies need to focus on the evaluation of identification systems and tools in the emergency department to improve the accuracy of stroke diagnosis. © 2016 American Heart Association, Inc.

Hospital Characteristics are Associated With Readiness to Attain Stage 2 Meaningful Use of Electronic Health Records.

PubMed

Kim, Jungyeon; Ohsfeldt, Robert L; Gamm, Larry D; Radcliff, Tiffany A; Jiang, Luohua

2017-06-01

To examine the difference between rural and urban hospitals as to their overall level of readiness for stage 2 meaningful use of electronic health records (EHRs) and to identify other key factors that affect their readiness for stage 2 meaningful use. A conceptual framework based on the theory of organizational readiness for change was used in a cross-sectional multivariate analysis using 2,083 samples drawn from the HIMSS Analytics survey conducted with US hospitals in 2013. Rural hospitals were less likely to be ready for stage 2 meaningful use compared to urban hospitals in the United States (OR = 0.49) in our final model. Hospitals' past experience with an information exchange initiative, staff size in the information system department, and the Chief Information Officer (CIO)'s responsibility for health information management were identified as the most critical organizational contextual factors that were associated with hospitals' readiness for stage 2. Rural hospitals lag behind urban hospitals in EHR adoption, which will hinder the interoperability of EHRs among providers across the nation. The identification of critical factors that relate to the adoption of EHR systems provides insights into possible organizational change efforts that can help hospitals to succeed in attaining meaningful use requirements. Rural hospitals have increasingly limited resources, which have resulted in a struggle for these facilities to attain meaningful use. Given increasing closures among rural hospitals, it is all the more important that EHR development focus on advancing rural hospital quality of care and linkages with patients and other organizations supporting the care of their patients. © 2016 National Rural Health Association.

School Climate and Academic Achievement in Suburban Schools

ERIC Educational Resources Information Center

Sulak, Tracey N.

2016-01-01

School climate research has indicated a relationship between the climate of a school and academic achievement. The majority of explanatory models have been developed in urban schools with less attention given to suburban schools. Due to the process of formation of suburban schools, there is a likelihood these campuses differ from the traditional…

Improving Academic Outcomes in Poor Urban Schools through Nature-Based Learning

ERIC Educational Resources Information Center

Camasso, Michael J.; Jagannathan, Radha

2018-01-01

This paper presents results from the evaluation of the Nurture thru Nature (NtN) programme, a natural science and environmental education intervention designed to help elementary school children from disadvantaged backgrounds increase their knowledge of science and strengthen overall academic performance. Using an experimental design the pilot NtN…

Effectiveness of the Self-Regulation Empowerment Program with Urban High School Students

ERIC Educational Resources Information Center

Cleary, Timothy J.; Platten, Peter; Nelson, Amy

2008-01-01

Impacting the academic performance of high school students in core academic content areas is important because of the high-stakes nature of secondary school course grades relative to their vocational and post-secondary pursuits. Getting students to become more active, strategic participants in their learning by teaching them empirically supported…

Beyond "Acting White": Affirming Academic Identities by Establishing Symbolic Boundaries through Talk

ERIC Educational Resources Information Center

Olitsky, Stacy

2015-01-01

This article investigates interactional processes by which students from non-dominant groups develop academic identities within schools that privilege the dominant group. It draws on an ethnographic study of an urban magnet school, focusing on a discourse analysis of conversations between 3 eighth-grade girls. Findings include that students…

Enhancing the Academic Development of Shy Children: A Test of the Efficacy of INSIGHTS

ERIC Educational Resources Information Center

O'Connor, Erin E.; Cappella, Elise; McCormick, Meghan P.; McClowry, Sandee G.

2014-01-01

This study investigated the efficacy of the INSIGHTS into Children's Temperament intervention in supporting the academic development of shy kindergarten and first-grade children. INSIGHTS is a temperament-based intervention with teacher, parent, and classroom programs. The participants included 345 children from 22 low-income, urban elementary…

Student Success: Stories That Inform High School Change

ERIC Educational Resources Information Center

Shepard, Jerri; Salina, Chuck; Girtz, Suzann; Cox, Jonas; Davenport, Nika; Hillard, Tammy L.

2012-01-01

Sunnyside High School in rural Washington faces many tough issues common to urban schools but has shown a remarkable ability to help students at risk for academic failure. The Sunnyside Intervention Program was developed for students with a history of poor academic performance, many of whom were involved in dangerous activities, including gangs.…

New-to-College "Academic Transformation" Distance Learning: A Paradox

ERIC Educational Resources Information Center

Goomas, David T.; Clayton, Alexis

2013-01-01

At an urban Dallas community college, first-time-in-college (FTIC) distance learning students enrolled in a three-credit academic transformation class were compared with FTIC students enrolled in the same course in on-campus classes. The distance-learning students were more at risk as measured by final semester grades and retention compared to…

The Academic Achievement Gap: The Suburban Challenge. CSR Connection.

ERIC Educational Resources Information Center

Alson, Allan

Suburban schoolchildren of color, in the aggregate, do not perform as well as their white counterparts. In fact, the academic achievement gaps in many suburban communities are actually greater than those in urban school districts. This research brief looks at the achievement gap in suburban schools, offering preliminary answers to the following…

National Roster of Local Practices in the Integration of Vocational and Academic Education.

ERIC Educational Resources Information Center

Reid, Mark E.; Tsuzuki, Mayo

This catalog describes local programs in the eight models of academic/vocational curriculum integration on the secondary level identified by the National Center for Research in Vocational Education (NCRVE). The roster highlights models from nearly every state, representing a cross-section of rural, suburban, and urban school districts. Each model…

Real Estate Values, School Quality, and the Pattern of Urban Development in Charlotte, North Carolina.

ERIC Educational Resources Information Center

Jud, G. Donald; Watts, James M.

1981-01-01

A model is constructed to test the comparative effects of public schools' racial composition and academic quality on neighborhood housing prices. Empirical results suggest that a school's academic quality (measured by reading levels) is a stronger determinant of local housing costs than its racial composition. (Author/RW)

School Mobility and Students' Academic and Behavioral Outcomes

ERIC Educational Resources Information Center

Han, Seunghee

2014-01-01

The study examined estimated effects of school mobility on students' academic and behaviouiral outcomes. Based on data for 2,560 public schools from the School Survey on Crime and Safety (SSOCS) 2007-2008, the findings indicate that high schools, urban schools, and schools serving a total student population of more than 50 percent minority…

Student Growth from Service-Learning: A Comparison of First-Generation and Non-First-Generation College Students

ERIC Educational Resources Information Center

Pelco, Lynn E.; Ball, Christopher T.; Lockeman, Kelly S.

2014-01-01

The effect of service-learning courses on student growth was compared for 321 first-generation and 782 non-first-generation undergraduate students at a large urban university. Student growth encompassed both academic and professional skill development. The majority of students reported significant academic and professional development after…

Concrete Roses: Examining the Resilience of Academically Successful Latino Students

ERIC Educational Resources Information Center

Alfaro, Daisy Denise

2013-01-01

This study focuses on the academic resilience exhibited by urban, low-income, first college generation Latino students, as they navigated numerous risk factors and persisted from early education to law school. In order to uncover the protective factors that allowed resilient Latino students to overcome adversity within the K-20 educational…

Measure for Measure: How Proficiency-Based Accountability Systems Affect Inequality in Academic Achievement

ERIC Educational Resources Information Center

Jennings, Jennifer; Sohn, Heeju

2014-01-01

How do proficiency-based accountability systems affect inequality in academic achievement? This article reconciles mixed findings in the literature by demonstrating that three factors jointly determine accountability's impact. First, by analyzing student-level data from a large urban school district, we find that when educators face accountability…

Student Engagement and Academic Success in Veterans' Post-Secondary Education

ERIC Educational Resources Information Center

Osagie, Shelley E.

2016-01-01

The major purpose of this study was to investigate whether the level of engagement, as measured by the National Survey of Student Engagement (NSSE) correlates with veterans' academic success as measured by cumulative Grade Point Average (GPA). Participants were senior college students, at a four-year urban public university who completed the…

School Attendance Patterns, Unmet Educational Needs, and Truancy: A Chronological Perspective

ERIC Educational Resources Information Center

Spencer, Andrea M.

2009-01-01

This study examines chronological patterns of attendance and academic performance of urban students who are identified as truants in Grade 8. A chronological review of 42 student records, from school entry through Grade 8, identified high frequencies of absenteeism and academic performance issues beginning at school entry and, in many cases,…

Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam

PubMed Central

Lien, La Thi Quynh; Hoa, Nguyen Quynh; Chuc, Nguyen Thi Kim; Thoa, Nguyen Thi Minh; Phuc, Ho Dang; Diwan, Vishal; Dat, Nguyen Thanh; Tamhankar, Ashok J.; Lundborg, Cecilia Stålsby

2016-01-01

Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital’s wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital’s wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001). PMID:27314366

Newly Licensed RN Retention: Hospital and Nurse Characteristics.

PubMed

Blegen, Mary A; Spector, Nancy; Lynn, Mary R; Barnsteiner, Jane; Ulrich, Beth T

2017-10-01

The aims of this study were to examine the relationship between 1-year retention of newly licensed RNs (NLRNs) employed in hospitals and personal and hospital characteristics, and determine which characteristics had the most influence. A secondary analysis of data collected in a study of transition to practice was used to describe the retention of 1464 NLRNs employed by 97 hospitals in 3 states. Hospitals varied in size, location (urban and rural), Magnet® designation, and university affiliation. The NLRNs also varied in education, age, race, gender, and experience. The overall retention rate at 1 year was 83%. Retention of NLRNs was higher in urban areas and in Magnet hospitals. The only personal characteristic that affected retention was age, with younger nurses more likely to stay. Hospital characteristics had a larger effect on NLRN retention than personal characteristics. Hospitals in rural areas have a particular challenge in retaining NLRNs.

Observational study and estimate of cost savings from use of a health information exchange in an academic emergency department.

PubMed

Carr, Christine Marie; Gilman, Charles Samuel; Krywko, Diann Marie; Moore, Haley Elizabeth; Walker, Brenda J; Saef, Steven Howard

2014-02-01

Federal initiatives to improve health care information sharing have led to the development of a new type of regional electronic medical record known as a health information exchange (HIE). Our aim was to investigate the ability of an HIE to decrease health services use for emergency department (ED) patients. We performed an observational, prospective study using a voluntary, anonymous survey among clinicians at an urban academic ED. All ED clinicians were eligible to participate. Survey items addressed clinician perception of whether information from the HIE avoided the use of hospital resources, improved quality of care, and reduced length of stay (LOS). Cost savings were estimated by multiplying the number of services the clinicians completing our survey reported they avoided through use of the HIE by the costs of those services at our facility. The study was approved by the Institutional Review Board at the study site. The study was conducted between August and December of 2011. There were 18,529 patient encounters during the study period and 60 clinicians at the study site who were eligible to participate. The clinicians consulted the HIE for 5.39% of these encounters (998 patients). Surveys were completed by the clinicians caring for 13.8% (n = 138) of these patients. Of the completed surveys, 76% (105 surveys) referenced patients for whom the HIE was found to contain information on the patient under care by the clinician participant. These 105 patients formed the sample on which our analysis was based. Within this sample of patients, the following studies were reported to have been avoided by the clinicians participating in our survey: values are percent of patients for whom a study was reported to have been avoided (actual number of studies avoided): laboratory/microbiology: 30.5% (32 studies); radiologic studies: 47.6% (50 studies); consultations: 19% (20 consultations); and admissions: 11.4% (12 admissions). Calculated cost savings based on these estimates were as follows: laboratory/microbiology: $462.85; radiologic studies: $160,893.00; consultations: $3,990.00; and admissions: $118,131.84. Total savings: $283,477. Clinicians participating in the study reported improved quality of care for 86.7% of their patients, as well as a mean time savings of 120.8 minutes. According to clinician estimates, use of an HIE in this urban academic ED resulted in reduced use of hospital resources, noteworthy cost savings, decreased LOS, and improved quality of care. Limitations included the observational nature of the study, selection bias, the Hawthorne effect, and cost estimates being from a single institution. Allowance was not made for additional services used because of information obtained from the HIE. Copyright © 2014 Elsevier Inc. All rights reserved.

How Service Learning Addresses the Mental Health Needs of Students in Urban Schools

ERIC Educational Resources Information Center

Wilczenski, Felicia L.; Cook, Amy L.

2009-01-01

Service learning promotes social-emotional and academic development through active engagement in community activities. It empowers students to think beyond themselves and to develop a commitment to serve others. In so doing, service learning builds connections with school and community that are critically important in urban settings. This paper…

Foundations for Success: Case Studies of How Urban School Systems Improve Student Achievement [and] Abstract.

ERIC Educational Resources Information Center

Snipes, Jason; Doolittle, Fred; Herlihy, Corinne

This report examines the experiences of three large urban school districts (and part of a fourth) that raised academic performance for their districts as a whole, while also reducing racial differences in achievement. Educational challenges included low achievement, political conflict, inexperienced teachers, low expectations, and lack of…

Multiple Victimization Experiences of Urban Elementary School Students: Associations with Psychosocial Functioning and Academic Performance

ERIC Educational Resources Information Center

Holt, Melissa K.; Finkelhor, David; Kantor, Glenda Kaufman

2007-01-01

Objective: This study explored the victimization experiences of urban elementary school students to determine whether subsets of youth emerged with similar victimization profiles (e.g., no victimization, multiple types of victimization). It also evaluated whether multiple victimization was associated with greater psychological distress and lower…

Research and Development and the Role of the Urban University in Strategic Economic Development Planning.

ERIC Educational Resources Information Center

Sheppard, Ronald J.

Urban universities have a definite role to play within the context of strategic economic development. Coordination between state and local government, the private sector, and the academic community can lead to effective partnerships to formulate and implement economic development plans. Declining university enrollments and fewer dollars available…

Creating a Successful Academic Climate for Urban Students

ERIC Educational Resources Information Center

Slaughter, Terri

2009-01-01

Teaching students in the inner city has been likened to hugging a porcupine--teachers nudge them toward success while getting pricked along the way. Many urban students perform below proficiency level and are difficult to manage. Their apathy toward completing class assignments, let alone homework, compounds the problem. As a whole, educators do…

Examining Relevant Influences on the Persistence of African-American College Students at a Diverse Urban University

ERIC Educational Resources Information Center

Thomas, Jackie C., Jr.; Wolters, Christopher; Horn, Catherine; Kennedy, Heidi

2014-01-01

In this study, campus involvement, faculty mentorship, motivational beliefs (self-efficacy and utility value), and sense of belonging were examined as potential predictors of African-American college student academic persistence. Participants (n = 139) in the study were African-American college students from a large-urban university. Separate…

Attrition of Women Business Majors in an Urban Community College.

ERIC Educational Resources Information Center

Karlen, Janice M.

2004-01-01

Identified intervention protocols that could help reduce the attrition of women business majors at an urban community college. Review of academic progress data and data from student surveys which examined students' reasons for leaving the institution indicated that there was a need for support mechanisms throughout the freshman year and extending…

In Spite of Our "Own" Best Interests: Lessons from an Interdisciplinary Project on Urban Sustainability

ERIC Educational Resources Information Center

Boyko, Christopher T.; MacKenzie, A. Robert; Leung, Holly

2015-01-01

To contribute effectively to academic discourse on urban sustainability, disciplines need to think outside their silos and work together more collaboratively. Although straightforward to posit in theory, the practical realities of bringing together people with different worldviews, languages and skills can be frustrating and lead to loss of…

Cultivating Noble Purpose in Urban Middle Schools: A Missing Piece in School Transformation

ERIC Educational Resources Information Center

Hatchimonji, Danielle R.; Linsky, Arielle V.; Elias, Maurice J.

2017-01-01

In urban schools overwhelmed by increasing demands to raise test scores, exclusive focus on increasing academic competencies has proven ineffective. School-wide, comprehensive social-emotional and character development (SECD), focused on the cultivation of Noble Purpose, provides an alternative pathway toward life, college, and career success. We…

Laying the Groundwork: The Journey of an Urban High School District Implementing a College Readiness Initiative

ERIC Educational Resources Information Center

Franco, Antonia O.

2012-01-01

National and state education reforms are centered on developing higher academic expectations and standards to ensure students transitions into postsecondary options, college and career ready. What does this national emphasis signify for urban school districts that are educating a significant proportion of first-generation students and that…

Tensions between Catholic Identity and Academic Achievement at an Urban Catholic High School

ERIC Educational Resources Information Center

Fuller, Carrie; Johnson, Lauri

2014-01-01

Through a secondary analysis of a case study on successful school leadership, this study inquired into the lived experiences and understandings of Catholic identity from the perspectives of administrators, faculty, staff, and students at one urban Catholic school in the northeastern United States. Participants generally spoke about Catholic…

Cultural Relevance in Urban Music Education: A Synthesis of the Literature

ERIC Educational Resources Information Center

Doyle, Jennifer Lee

2014-01-01

Recent research indicates students of low socioeconomic status (SES) who participate in the arts have better social and academic outcomes than those who do not participate in arts instruction. Because many students in urban areas are from low SES, music instruction could be particularly beneficial. However, because of various factors, enrollment…

"Be Useful to Society": Parental Academic Involvement in Rural to Urban Migrant Children's Education in China

ERIC Educational Resources Information Center

Fang, Lue; Sun, Rachel C.; Yuen, Mantak

2017-01-01

China's rural to urban migration is the largest population movement in human history. To unpack the intertwining relationship between migration and education, previous research tended to view migrant children as one universally vulnerable category, while ignoring the potential disparity in family socialization and functioning. This study…

Value of Coaching in Building Leadership Capacity of Principals in Urban Schools

ERIC Educational Resources Information Center

Farver, Anita R.; Holt, Carleton R.

2015-01-01

The purpose of this qualitative case study was to understand how coaching support structures enabled and sustained leadership practices of urban principals. The study investigated how the intervention of coaching for academic leaders can serve as evidence-based professional development for building leadership capacity. The central focus was on…

Teen Pregnancy and the Achievement Gap among Urban Minority Youth

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objectives: To outline the prevalence and disparities of teen pregnancy among school-aged urban minority youth, causal pathways through which nonmarital teen births adversely affects academic achievement, and proven or promising approaches for schools to address this problem. Methods: Literature review. Results: In 2006, the birth rate among 15-…

Advancing Adolescent Literacy in Urban Schools. Research Brief

ERIC Educational Resources Information Center

Snipes, Jason; Horwitz, Amanda

2008-01-01

The lack of sufficient literacy skills is a major factor contributing to poor performance in high school and post-secondary education. Many students, particularly those in urban schools, lack the foundational literacy skills necessary to read and comprehend the academic texts appropriate for high school and beyond. This brief provides a synthesis…

Homeless Students and Academic Achievement: Evidence from a Large Urban Area

ERIC Educational Resources Information Center

Tobin, Kerri J.

2016-01-01

Child homelessness has recently reached levels unprecedented in the United States since the Great Depression. Contemporary research has attempted to isolate the effects of homelessness on education, with mixed results. This study reports results from a study in one large urban area and finds that there is no meaningful difference in achievement…

Advancing Black Male Success: Understanding the Contributions of Urban Black Colleges and Universities

ERIC Educational Resources Information Center

Gasman, Marybeth; Nguyen, Thai-Huy; Commodore, Felecia

2017-01-01

To understand the context of urban Historically Black Colleges and Universities (HBCUs) and their role in educating Black males, we conducted a literature review examining the academic contributions of these institutions to Black males. To bolster the literature, we examined Integrated Postsecondary Education Data System data, determining a set of…

Leadership Diversity: A Study of Urban Public Libraries

ERIC Educational Resources Information Center

Winston, Mark; Li, Haipeng

2007-01-01

Diversity has been identified as a priority in library and information services for some time. The limited published research on diversity programs in libraries, though, has focused on academic libraries. This article represents the results of a study of leadership diversity in large, urban public libraries. In the study of members of the Urban…

Persistence at an Urban Community College: The Implications of Self-Efficacy and Motivation

ERIC Educational Resources Information Center

Liao, Hsiang-Ann; Edlin, Margot; Ferdenzi, Anita Cuttita

2014-01-01

This study examined how self-efficacy and motivation affected student persistence at an urban community college. Self-efficacy was studied at two dimensions: self-regulated learning efficacy and self-efficacy for academic achievement. Motivation was also investigated at two levels: intrinsic motivation and extrinsic motivation. Results show that…

Leading for Democracy in Urban Schools: Toward a Culturally Relevant Progressivism

ERIC Educational Resources Information Center

Seher, Rachel

2013-01-01

The article examines the enactment of culturally relevant progressivism on the part of the principal of the Social Justice School, a small urban public high school explicitly committed to democratic education. Drawing upon extensive interviews and field observations conducted over the course of an academic year by a teacher-researcher within the…

An Investigation of a Cross-Content Vocabulary Intervention in an Urban Middle School

ERIC Educational Resources Information Center

Cianciosi-Rimbey, Michelle

2017-01-01

This case study was designed to investigate the implementation of a cross-content academic vocabulary intervention in an urban school. Two aspects of the intervention were the focus of interest: student learning and teacher sensemaking. Participants included four content-area teachers and their sixth-grade students. Each week, students received…

An Investigation of the Teacher Advancement Program and Student Performance in Urban Schools

ERIC Educational Resources Information Center

Grant, Ginger Madonna

2010-01-01

In 2005, the achievement gap between African-American and Caucasian students doubled in the state of Louisiana. Sixty-three percent of the public schools in an urban school district in southeastern Louisiana received an Academically Unacceptable Status (AUS) rating according to Louisiana accountability standards. In 2006, the Louisiana Board of…

Health and Academic Achievement: Cumulative Effects of Health Assets on Standardized Test Scores Among Urban Youth in the United States*

PubMed Central

Ickovics, Jeannette R.; Carroll-Scott, Amy; Peters, Susan M.; Schwartz, Marlene; Gilstad-Hayden, Kathryn; McCaslin, Catherine

2014-01-01

Background The Institute of Medicine (2012) concluded that we must “strengthen schools as the heart of health.” To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. Methods Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6 months prior to standardized testing. Results On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p < .001). Conclusions Schools that utilize nontraditional instructional strategies to improve student health may also improve academic achievement, closing equity gaps in both health and academic achievement. PMID:24320151

The characteristics and impact of a hospitalist-staffed post-discharge clinic.

PubMed

Doctoroff, Lauren; Nijhawan, Ank; McNally, Diane; Vanka, Anita; Yu, Roger; Mukamal, Kenneth J

2013-11-01

Limited primary care access and care discontinuities hamper care for patients following hospital discharge. As the proportion of inpatient care delivered by hospitalists continues to increase, hybrid models that incorporate hospitalists in post-discharge care may ameliorate this problem. We established a post-discharge clinic staffed by hospitalists in a large academic urban primary care practice in October 2009. We compared visits of recently hospitalized patients seen in the post-discharge clinic with post-discharge visits elsewhere in the practice, including patient demographics, health care utilization, and duration from discharge, using generalized estimating equations to account for repeated hospitalizations. Patients seen in the post-discharge clinic and elsewhere in the practice were generally similar, although patients seen in the post-discharge clinic were particularly likely to be black and receive primary care from residents. Relative to other patients seen following discharge, patients in the post-discharge clinic were seen 8.45 ± 0.43 days earlier (P <.001). Among all 10,845 discharges of Healthcare Associates patients between 2009 and 2011, patients were 40% more likely to be seen within a week of discharge when the post-discharge clinic was open than when it was closed (adjusted odds ratio 1.41; 95% confidence interval, 1.25-1.57). In this primary care practice, a hospitalist-staffed post-discharge clinic was associated with substantially shorter time to first post-hospitalization visit and with improvement in the overall likelihood of an early visit among all hospitalized patients. It was particularly used by black patients and those seen by residents, in whom access tends to be most fragmented, and may represent a novel approach to the problem of post-discharge care. Copyright © 2013 Elsevier Inc. All rights reserved.

A hospital discharge summary quality improvement program featuring individual and team-based feedback and academic detailing.

PubMed

Axon, Robert N; Penney, Fletcher T; Kyle, Thomas R; Zapka, Jane; Marsden, Justin; Zhao, Yumin; Mauldin, Patrick D; Moran, William P

2014-06-01

Discharge summaries are an important component of hospital care transitions typically completed by interns in teaching hospitals. However, these documents are often not completed in a timely fashion or do not include pertinent details of hospitalization. This report outlines the development and impact of a curriculum intervention to improve the quality of discharge summaries by interns and residents in Internal Medicine. A previous study demonstrated that a discharge summary curriculum featuring individualized feedback was associated with improved summary quality, but few subsequent studies have described implementation of similar curricula. No information exists on the utility of other strategies such as team-based feedback or academic detailing. Study participants were 96 Internal Medicine intern and resident physicians at an academic medical center-based training program. A comprehensive evidence-based discharge summary quality improvement program was developed and implemented that featured a discharge summary template to facilitate summary preparation, individual feedback, team-based feedback, academic detailing and an objective discharge summary evaluation instrument. The discharge summary evaluation instrument had moderate interrater reliability (κ = 0.72). Discharge summary scores improved from mean score of 70% to 82% (P = 0.05). Interns and residents participating in this program also reported increased confidence in producing and critiquing summaries. A comprehensive discharge summary curriculum can be feasibly implemented within the context of a residency program. Team-based feedback and academic detailing may serve to reinforce individual feedback and extend program reach.

The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

PubMed

Linnen, Daniel T; Kornak, John; Stephens, Caroline

2018-03-28

Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p < 0.001). For hospitals in small metro counties, the odds of having such a rating were 3.7 times greater (95% confidence interval = 0.7-23.4, p = 0.12), although not statistically significant. Few ratings were provided for rural counties, and analysis of rural counties was underpowered. Hospitals in medium-sized metro counties are associated with unfavorable Medicare mortality ratings, but current methods to assign mortality ratings may hinder fair comparisons. Patient transfers from rural locations to regional medical centers may contribute to these results, a potential factor that future research should examine.

Comparison of CO2 Emissions Data for 30 Cities from Different Sources

NASA Astrophysics Data System (ADS)

Nakagawa, Y.; Koide, D.; Ito, A.; Saito, M.; Hirata, R.

2017-12-01

Many sources suggest that cities account for a large proportion of global anthropogenic greenhouse gas emissions. Therefore, in search for the best ways to reduce total anthropogenic greenhouse gas emissions, a focus on the city emission is crucial. In this study, we collected CO2 emissions data in 30 cities during 1990-2015 and evaluated the degree of variance between data sources. The CO2 emissions data were obtained from academic papers, municipal reports, and high-resolution emissions maps (CIDIACv2016, EDGARv4.2, ODIACv2016, and FFDASv2.0). To extract urban CO2 emissions from the high-resolution emissions maps, urban fraction ranging from 0 to 1 was calculated for each 1×1 degree grid cell using the global land cover data (SYNMAP). Total CO2 emissions from the grid cells in which urban fraction occupies greater than or equal to 0.9 were regarded as urban CO2 emissions. The estimated CO2 emissions varied greatly depending on the information sources, even in the same year. There was a large difference between CO2 emissions collected from academic papers, municipal reports, and those extracted from high-resolution emissions maps. One reason is that they use different city boundaries. That is, the city proper (i.e. the political city boundary) is often defined as the city boundary in academic papers and municipal reports, whereas the urban area is used in the high-resolution emissions maps. Furthermore, there was a large variation in CO2 emissions collected from academic papers and municipal reports. These differences may be due to the difference in the assumptions such as allocation ratio of CO2 emissions to producers and consumers. In general, the consumption-based assignment of emissions gives higher estimates of urban CO2 emission in comparison with production-based assignment. Furthermore, there was also a large variation in CO2 emissions extracted from high-resolution emissions maps. This difference would be attributable to differences in information used in the spatial disaggregation of emissions. To identify the CO2 emissions from cities, it is necessary to determine common definitions of city boundaries, allocation ratio of CO2 emissions to consumption and production, and refined approach of the spatial disaggregation of CO2 emissions in high-resolution emissions maps.

[Glass ceiling for women in academic medicine in France].

PubMed

Rosso, C; Leger, A; Steichen, O

2018-06-03

To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors). Women represent 49% of the medical staff but 15% of full professors. This underrepresentation of women is more important among intensivists/anesthesiologists than technique-based specialists (such as radiologists, biologists…). There is no difference in scientific output, marital status and parenthood between women and men. On the other hand, there is a difference in attitudes highlighted by the EVAR risk-taking scale as well as in the burden of familial involvement and the prejudices felt by women during the academic selection process. The glass ceiling exists in one of the largest French hospital group. Career development principles promote merit, but should decrease the benefit of "masculine" attitudes in the competition for academic positions. Academic selection criteria should evolve to limit the disadvantage of women related to deeper familial involvement and less competitive strategies and risk-taking attitudes. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Two ecological models of academic achievement among diverse students with and without disabilities in transition.

PubMed

Williams, Terrinieka T; McMahon, Susan D; Keys, Christopher B

2014-01-01

School experiences can have positive effects on student academic achievement, yet less is known about intermediary processes that contribute to these positive effects. We examined pathways between school experiences and academic achievement among 117 low-income urban students of color, many with disabilities, who transitioned to other schools following a school closure. Using structural equation modeling, we tested two ecological models that examined the relationships among self-reported school experiences, school support, academic self-efficacy, and school-reported academic achievement. The model in which the relationship between school experiences and academic achievement is mediated by both school support and academic self-efficacy, and that takes previous academic achievement into account, was an excellent fit with the data. The roles of contextual and individual factors as they relate to academic achievement, and the implications of these findings, are discussed.

Positioning academic medical centers and teaching hospitals to thrive in the next decade.

PubMed

Morris, D E

1985-06-01

Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification.

The Impact of Hospital and Patient Factors on the Emergency Department Decision to Admit.

PubMed

Warner, Leah S Honigman; Galarraga, Jessica E; Litvak, Ori; Davis, Samuel; Granovsky, Michael; Pines, Jesse M

2018-02-01

Substantial variation exists in rates of emergency department (ED) admission. We examine this variation after accounting for local and community characteristics. Elucidate the factors that contribute to admission variation that are amenable to intervention with the goal of reducing variation and health care costs. We conducted a retrospective cross-sectional study of 1,412,340 patient encounters across 18 sites from 2012-2013. We calculated the adjusted hospital-level admission rates using multivariate logistic regression. We adjusted for patient, provider, hospital, and community factors to compare admission rate variation and determine the influence of these characteristics on admission rates. The average adjusted admission rate was 22.9%, ranging from 16.1% (95% confidence interval [CI] 11.5-22%) to 32% (95% CI 26.0-38.8). There were higher odds of hospital admission with advancing age, male sex (odds ratio [OR] 1.20, 95% CI 1.91-1.21), and patients seen by a physician vs. mid-level provider (OR 2.26, 95% CI 2.23-2.30). There were increased odds of admission with rising ED volume, at academic institutions (OR 2.23, 95% CI 2.20-2.26) and at for-profit hospitals (OR 1.15, 95% CI 1.12-1.18). Admission rates were lower in communities with a higher per capita income, a higher rate of uninsured patients, and in more urban hospitals. In communities with the most primary providers, there were lower odds of admission (OR 0.60, 95% CI 0.57-0.68). Variation in hospital-level admission rates is associated with a number of local and community characteristics. However, the presence of persistent variation after adjustment suggests there are other unmeasured variables that also affect admission rates that deserve further study, particularly in an era of cost containment. Copyright © 2017 Elsevier Inc. All rights reserved.

Will Medicare Readmission Penalties Motivate Hospitals to Reduce Arthroplasty Readmissions?

PubMed

Clement, R Carter; Gray, Caitlin M; Kheir, Michael M; Derman, Peter B; Speck, Rebecca M; Levin, L Scott; Fleisher, Lee A

2017-03-01

The Centers for Medicare & Medicaid Services (CMS) recently imposed penalties against hospitals with above-average 30-day readmission rates following total joint arthroplasty (TJA). Hospitals must decide whether investments in readmission prevention are worthwhile. This study examines the financial incentives associated with unplanned readmissions before and after invocation of these penalties. Financial data were reviewed for 2028 consecutive primary TJAs performed on Medicare beneficiaries over a 2-year period at an urban academic health system. Readmission penalties were estimated in accordance with CMS policies. Unplanned readmissions generated a $4416 median contribution margin. The initial hospitalizations (when the TJA was performed) were financially unfavorable for patients subsequently readmitted relative to those not readmitted due to increased costs of care (P = .002), but these costs were more than outweighed by the increased reimbursement earned during the readmission (P < .001), ultimately making readmitted patients financially preferable (P < .001). Going forward, penalties will be levied for risk-adjusted readmission rates above the national rate of 4.8%. For the institution under review, the penalty per readmission outweighs the financial gains earned through readmission by $12,184, resulting in a net loss from readmissions if the rate exceeds 6.5%. It will be financially optimal to maintain a readmission rate (after risk adjustment) equal to the national average but exceeding that rate will be $7768 more expensive per readmission than undershooting that target. If our results are generalizable, unplanned Medicare readmissions have traditionally been financially beneficial, but CMS penalties outweigh this benefit. Thus, penalties should incentivize institutions to maintain below-average arthroplasty readmissions rates. Copyright © 2016 Elsevier Inc. All rights reserved.

An Approach to Acquiring, Normalizing, and Managing EHR Data From a Clinical Data Repository for Studying Pressure Ulcer Outcomes.

PubMed

Padula, William V; Blackshaw, Leon; Brindle, C Tod; Volchenboum, Samuel L

2016-01-01

Changes in the methods that individual facilities follow to collect and store data related to hospital-acquired pressure ulcer (HAPU) occurrences are essential for improving patient outcomes and advancing our understanding the science behind this clinically relevant issue. Using an established electronic health record system at a large, urban, tertiary-care academic medical center, we investigated the process required for taking raw data of HAPU outcomes and submitting these data to a normalization process. We extracted data from 1.5 million patient shifts and filtered observations to those with a Braden score and linked tables in the electronic health record, including (1) Braden scale scores, (2) laboratory outcomes data, (3) surgical time, (4) provider orders, (5) medications, and (6) discharge diagnoses. Braden scores are important measures specific to HAPUs since these scores clarify the daily risk of a hospitalized patient for developing a pressure ulcer. The other more common measures that may be associated with HAPU outcomes are important to organize in a single data frame with Braden scores according to each patient. Primary keys were assigned to each table, and the data were processed through 3 normalization steps and 1 denormalization step. These processes created 8 tables that can be stored efficiently in a clinical database of HAPU outcomes. As hospitals focus on organizing data for review of HAPUs and other types of hospital-acquired conditions, the normalization process we describe in this article offers directions for collaboration between providers and informatics teams using a common language and structure.

Cost Analysis of Total Joint Arthroplasty Readmissions in a Bundled Payment Care Improvement Initiative.

PubMed

Clair, Andrew J; Evangelista, Perry J; Lajam, Claudette M; Slover, James D; Bosco, Joseph A; Iorio, Richard

2016-09-01

The Bundled Payment for Care Improvement (BPCI) Initiative is a Centers for Medicare and Medicaid Services program designed to promote coordinated and efficient care. This study seeks to report costs of readmissions within a 90-day episode of care for BPCI Initiative patients receiving total knee arthroplasty (TKA) or total hip arthroplasty (THA). From January 2013 through December 2013, 1 urban, tertiary, academic orthopedic hospital admitted 664 patients undergoing either primary TKA or THA through the BPCI Initiative. All patients readmitted to our hospital or an outside hospital within 90-days from the index episode were identified. The diagnosis and cost for each readmission were analyzed. Eighty readmissions in 69 of 664 patients (10%) were identified within 90-days. There were 53 readmissions (45 patients) after THA and 27 readmissions (24 patients) after TKA. Surgical complications accounted for 54% of THA readmissions and 44% of TKA readmissions. These complications had an average cost of $36,038 (range, $6375-$60,137) for THA and $38,953 (range, $4790-$104,794) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $27,979. Medical complications of THA and TKA had an average cost of $22,775 (range, $5678-$82,940) for THA and $24,183 (range, $3306-$186,069) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $11,682. Hospital readmissions after THA and TKA are common and costly. Identifying the causes for readmission and assessing the cost will guide quality improvement efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Social science as a tool in developing scientific thinking skills in underserved, low-achieving urban students.

PubMed

Jewett, Elizabeth; Kuhn, Deanna

2016-03-01

Engagement in purposeful problem solving involving social science content was sufficient to develop a key set of inquiry skills in low-performing middle school students from an academically and economically disadvantaged urban public school population, with this skill transferring to a more traditional written scientific thinking assessment instrument 3weeks later. Students only observing their peers' activity or not participating at all failed to show these gains. Implications are addressed with regard to the mastery of scientific thinking skills among academically disadvantaged students. Also addressed are the efficacy of problem-based learning and the limits of observational learning. Copyright © 2015 Elsevier Inc. All rights reserved.

The Relationship of Learning Communities to Engineering Students' Perceptions of the Freshman Year Experience, Academic Performance, and Persistence

ERIC Educational Resources Information Center

Tolley, Patricia Ann Separ

2009-01-01

The purpose of this correlational study was to examine the effects of a residential learning community and enrollment in an introductory engineering course to engineering students' perceptions of the freshman year experience, academic performance, and persistence. The sample included students enrolled in a large, urban, public, research university…

Putting a Face on Hunger: A Community-Academic Research Project

ERIC Educational Resources Information Center

Coffey, Nancy; Canales, Mary K.; Moore, Emily; Gullickson, Melissa; Kaczmarski, Brenda

2014-01-01

Food insecurity is a growing concern for Eau Claire County residents in Western Wisconsin. A community-academic partnership studied food insecurity through the voices of families struggling to access food and institutions that assist with hunger related problems. Data were collected through focus groups held in urban and rural parts of the county.…

A Predictive Study of Community College Faculty Perceptions of Student Academic Preparation, Work Ethics, and Institutional Support

ERIC Educational Resources Information Center

Ibezim-Uche, Scholar

2013-01-01

Examined in this study were faculty perceptions of students who do not continue their college education. Also examined was how urban and rural community colleges faculty perceived academic preparation, work ethics, and institutional support as predictors of student success. In this predictive study of community college faculty, 36 faculty members…

The Influence of Classroom Drama on English Learners' Academic Language Use during English Language Arts Lessons

ERIC Educational Resources Information Center

Anderson, Alida; Loughlin, Sandra M.

2014-01-01

Teacher and student academic discourse was examined in an urban arts-integrated school to better understand facilitation of students' English language learning. Participants' discourse was compared across English language arts (ELA) lessons with and without classroom drama in a third-grade classroom of English learning (EL) students (N = 18) with…

Performing the Grade: Urban Latino Youth, Gender Performance, and Academic Success

ERIC Educational Resources Information Center

Foiles Sifuentes, A. M.

2015-01-01

This article examines the intersection of race, gender, class, and academic success through an ethnographic case study in a Texas charter high school. The 98% working-class, Latino student population was exposed to an array of stigmas ascribed to their persons based on negative social stereotypes of race, ethnicity, gender, and class due to the…

Influence of an Academic Workshop on Once-Undeclared Graduates' Selection of a Major

ERIC Educational Resources Information Center

Legutko, Robert S.

2007-01-01

This study determined the influence of an academic workshop on appropriate declaration of a major for students who graduated, but were previously undeclared, at one small, private, urban, coeducational, religiously-affiliated, four-year, commuter college in the mid-Atlantic region of the United States. A posttest only control group design revealed…

Cross-Cultural Educational Experiences and Academic Achievement of Ghanaian Immigrant Youth in Urban Public Schools

ERIC Educational Resources Information Center

Kumi-Yeboah, Alex; Smith, Patriann

2017-01-01

The past two decades have witnessed a rapid increase of immigrant population in U.S. schools. Little is known, however, about factors that promote cross-cultural experiences, academic achievement, and/or challenges of Black African immigrant youth, which is particularly significant today in the midst of the current social and political discourse…

Reflections on Multiculturalism, Social Justice, and Empowerment Groups for Academic Success: A Critical Discourse for Contemporary Schools

ERIC Educational Resources Information Center

Bemak, Fred

2005-01-01

Writing the article entitled "Empowerment Groups for Academic Success: An Innovative Approach to Prevent High School Failure for At-Risk, Urban African American Girls," Fred Bemak anticipated that there would be mixed reactions, given the unique and non traditional approach to working with a difficult and typically underserved population. The…

Leveled and Exclusionary Tracking: English Learners' Access to Academic Content in Middle School

ERIC Educational Resources Information Center

Umansky, Ilana M.

2016-01-01

This study examines the characteristics and determinants of English learners' (ELs') access to academic content in middle school (Grades 6-8). Following 10 years of data from a large urban school district in California, I identify two predominant characteristics of EL access to content: leveled tracking in which ELs are overrepresented in lower…

Implementation as a Focus of Consultation to Evaluate Academic Tutoring Services in an Urban School District: A Case Study Example

ERIC Educational Resources Information Center

Morrison, Julie Q.; English, Sarah Baker

2012-01-01

This article describes a multiagency initiative to evaluate academic tutoring services by focusing on the processes that contribute to effective program implementation. Community-based tutoring service providers serving students in the Cincinnati Public Schools (OH) partnered to initiate a "Seal of Approval" process for promoting…

Public Ethnic Regard and Academic Adjustment among Latino Adolescents

ERIC Educational Resources Information Center

Rivas-Drake, Deborah

2011-01-01

This study examined whether Latino adolescents' perceptions of personal support vis-a-vis those of ethnic regard by adults at school differentially relate to academic outcomes. Data were drawn from a sample of 156 Latino students (age M = 16.17, SD = 1.27; 61% girls, 39% boys) attending an urban high school. As expected, youth who perceived more…

Social Media Use, Loneliness, and Academic Achievement: A Correlational Study with Urban High School Students

ERIC Educational Resources Information Center

Neto, Roque; Golz, Nancy; Polega, Meaghan

2015-01-01

This study explored the association between social media use, loneliness, and academic achievement in high school students and identified the demographic characteristics associated with these three elements. This study also aimed to identify the percentage of variance in loneliness accounted for by social media use and GPA. Participants were 345…

The Poor Get Richer: Heterogeneity in the Efficacy of a School-Level Intervention for Academic Language

ERIC Educational Resources Information Center

Lawrence, Joshua F.; Francis, David; Paré-Blagoev, Juliana; Snow, Catherine E.

2017-01-01

We investigate the impact of a relatively brief cross-curricular intervention, Word Generation, on middle school students' development of taught academic vocabulary. Students (n = 8382) in forty-four middle schools in three urban districts were randomly assigned to treatment or control conditions. Treatment teachers implemented the program with…

Academic Achievement and Transcendental Meditation: A Study with At-Risk Urban Middle School Students

ERIC Educational Resources Information Center

Nidich, Sanford; Mjasiri, Shujaa; Nidich, Randi; Rainforth, Maxwell; Grant, James; Valosek, Laurent; Chang, Walter; Zigler, Ronald L.

2011-01-01

The middle school level is of particular concern to educators because of poor standardized test performance. This study evaluated change in academic achievement in public middle school students practicing the Transcendental Meditation[R] program compared to controls. A total of 189 students who were below proficiency level at baseline in English…

Hospital effluents as a source of emerging pollutants: An overview of micropollutants and sustainable treatment options

NASA Astrophysics Data System (ADS)

Verlicchi, P.; Galletti, A.; Petrovic, M.; Barceló, D.

2010-08-01

SummaryHospital wastewaters contain a variety of toxic or persistent substances such as pharmaceuticals, radionuclides, solvents and disinfectants for medical purposes in a wide range of concentrations due to laboratory and research activities or medicine excretion. Most of these compounds belong to the so called emerging contaminants; quite often unregulated pollutants which may be candidates for future regulation depending on research on their potential health effects and monitoring of their occurrence. Their main characteristic is that they do not need to persist in the environment to cause negative effects since their high transformation/removal rates can be compensated for by their continuous introduction into the environment. Some of these compounds, most of them pharmaceuticals and personal care products may also be present in urban wastewaters. Their concentrations in the effluents may vary from ng L -1 to μg L -1. In this paper, hospital effluents and urban wastewaters are compared in terms of quali-quantitative characteristics. On the basis of an in-depth survey: (i) hospital average specific daily water consumptions (L patient -1 day -1) are evaluated and compared to urban ones (L person -1 day -1), (ii) conventional parameters concentrations in hospital effluents are compared to urban ones and (iii) main pharmaceuticals and other emerging compounds contents are compared in the two wastewaters. Finally, an overview of the removal capacity of the different treatments is reported.

Apollo Quality Program.

PubMed

Sibal, Anupam; Dewan, Shaveta; Uberoi, R S; Kar, Sujoy; Loria, Gaurav; Fernandes, Clive; Yatheesh, G; Sharma, Karan

2012-01-01

Ensuring patient safety is a vital step for any hospital in achieving the best clinical outcomes. The Apollo Quality Program aimed at standardization of processes for clinical handovers, medication safety, surgical safety, patient identification, verbal orders, hand washing compliance and falls prevention across the hospitals in the Group. Thirty-two hospitals across the Group in settings varying from rural to semi urban, urban and metropolitan implemented the program and over a period of one year demonstrated a visible improvement in the compliance to processes for patient safety translating into better patient safety statistics.

Urban Sanctuary Schools for Diverse Populations: Examining Curricular Expectations and School Effectiveness for Student Learning

ERIC Educational Resources Information Center

Liou, Daniel D.; Marsh, Tyson E. J.; Antrop-González, René

2017-01-01

This ethnographic case study problematizes the current high stakes accountability efforts that have led many school leaders to inadvertently maintain a school environment in which deficit perspectives and low academic expectations in the classroom persist. Drawing from an urban sanctuary school framework, this study works to center the voices of…

School Belonging among Low-Income Urban Youth with Disabilities: Testing a Theoretical Model

ERIC Educational Resources Information Center

McMahon, Susan D.; Parnes, Anna L.; Keys, Christopher B.; Viola, Judah J.

2008-01-01

Positive school environments and school belonging have been associated with a variety of positive academic, social, and psychological outcomes among youth. Yet, it is not clear how these constructs are related, and few studies have focused on urban at-risk youth with disabilities. This study examines baseline survey data from 136 low-income…

Teaching Music in the Urban Classroom, Volume 2: A Guide to Leadership, Teacher Education, and Reform

ERIC Educational Resources Information Center

Frierson-Campbell, Carol, Ed.

2006-01-01

This second volume, the follow-on to "Teaching Music in the Urban Classroom, Volume 1: A Guide to Survival, Success, and Reform," extends the conversation to include educational leadership, teacher education, partnerships, and school reform. As with Volume 1, classroom music teachers, inner city arts administrators, well-known academics,…

Subject-Matter Experts in Urban Schools: Journeys of Enacted Identities in Science and Mathematics Classrooms

ERIC Educational Resources Information Center

Ye, Li; Varelas, Maria; Guajardo, Raphael

2011-01-01

This study explored how two mathematics/science subject-matter experts (Fellows) conceptualized urban classrooms and the students they worked with for a year, how they negotiated academic achievement with cultural and sociopolitical competence, and how their identities as educators were co-constructed and enacted. Using grounded theory, Fellows'…

Time and Attention in Urban High Schools: Lessons for School Systems

ERIC Educational Resources Information Center

Frank, Stephen

2010-01-01

There is no disputing that for high school students to be college and career ready, they need adequate time to learn, and individualized attention to meet each student's academic goals, learning styles, and social needs. Over the past decade, Education Resource Strategies (ERS) has partnered with urban schools and districts to improve their use of…

Intrinsic Motivation, Self-Perception, and Their Effects on Black Urban Elementary Students.

ERIC Educational Resources Information Center

Marchant, Gregory J.

This study examined the effects of specific motivational dimensions and self-perceptions of a group of 47 urban black fourth and fifth grade students on attendance and academic achievement. Each student's responses to a measure of intrinsic and extrinsic motivation and a self-perception inventory were compared to each other and to his or her…

Early to Bed: A Study of Adaptation among Sexually Active Urban Adolescent Girls Younger than Age Sixteen.

ERIC Educational Resources Information Center

Martin, Andres; Ruchkin, Vladislav; Caminis, Argyro; Vermeiren, Robert; Henrich, Christopher C.; Schwab-Stone, Mary

2005-01-01

Objective: To examine the association between sexual activity among urban adolescent girls and four global measures of psychosocial adaptation (academic motivation, school achievement, depressive symptoms, and expectations about the future). Method: Data derived from the Social and Health Assessment, a self-report survey administered in 1998 to…

Inputs and Student Achievement: An Analysis of Latina/o-Serving Urban Elementary Schools

ERIC Educational Resources Information Center

Heilig, Julian Vasquez; Williams, Amy; Jez, Su Jin

2010-01-01

One of the most pressing problems in the United States is improving student academic performance, especially the nation's burgeoning Latina/o student population. There is a dearth of research on variables associated with student achievement in Latina/o majority schools in urban districts. As the majority of Latina/o students are segregated into…

Reducing Risk through a Supplementary Reading Intervention: A Case Study of First- and Second-Grade Urban Students

ERIC Educational Resources Information Center

Council, Morris R., III; Cartledge, Gwendolyn; Green, DeLayna; Barber, Mariah; Gardner, Ralph, III

2016-01-01

This descriptive study examined whether a computer-based, repeated reading intervention (i.e., Reading Relevant and Culturally Engaging Stories) is associated with improved reading and social behavior for three primary-aged urban black girls who each showed both academic and behavioral risk. The Reading Relevant and Culturally Engaging Stories…

Value of Coaching in Building Leadership Capacity of Principals in Urban Schools: A Case Study

ERIC Educational Resources Information Center

Farver, Anita

2014-01-01

The purpose of this qualitative case study was to understand how coaching support structures enabled and sustained leadership practices of urban principals. The study investigated how the intervention of coaching for academic leaders can serve as evidence based professional development for building leadership capacity. The central focus was on…

Today's Urban University Students: Part 2. A Case Study of Hunter College. Final Report on the Urban University Study.

ERIC Educational Resources Information Center

Davila, Evelyn M.

Characteristics and needs of Hunter College students were studied during 1981-1983. The college's use of institutional research to accommodate an increasingly nontraditional student body was also assessed. Attention was directed to: the student population's ethnicity, income, and employment; students' academic experiences; times of day most…

The Longitudinal Effects of Residential Mobility on the Academic Achievement of Urban Elementary and Middle School Students

ERIC Educational Resources Information Center

Voight, Adam; Shinn, Marybeth; Nation, Maury

2012-01-01

Residential stability matters to a young person's educational development, and the present housing crisis has disrupted the residential stability of many families. This study uses latent growth-curve modeling to examine how changing residences affects math and reading achievement from third through eighth grade among a sample of urban elementary…

Is Increased Access Enough? Advanced Placement Courses, Quality, and Success in Low-Income Urban Schools

ERIC Educational Resources Information Center

Hallett, Ronald E.; Venegas, Kristan M.

2011-01-01

This article combines descriptive statistics and interviews with college-bound high school students to explore the connection between increased access and academic quality of Advanced Placement (AP) courses in low-income urban high schools. Results suggest that although moderately more opportunities to take AP courses exist than in previous years,…

An Unsure Start for Young Children in English Urban Primary Schools

ERIC Educational Resources Information Center

Darbyshire, Nicky; Finn, Bev; Griggs, Sarah; Ford, Chris

2014-01-01

This article, written by three research-active teachers and their academic partner, registers concerns with the ways the so-called "achievement gap" is portrayed in policy announcements in England. It charts a challenge to the current view that it is the task of urban nursery and primary schools to train children to be school-ready. It…

The Trenton Office of Policy Studies: Building Municipal-Collegiate Partnerships for Urban Revitalization.

ERIC Educational Resources Information Center

Thurber, John P.

1995-01-01

The Trenton (New Jersey) Office of Policy Studies was established in conjunction with Thomas Edison State College to analyze emerging issues in urban public policy. The program is active in the internal life of the city's government while maintaining an independent academic orientation that shields it from political and practical pressures.…

Effects of Resource Allocation on Student Academic Achievement and Self-Perceptions of Success in an Urban Setting

ERIC Educational Resources Information Center

Harris, Kimberly

2014-01-01

Civil Rights legislation, now 50 years old, "de facto" segregation based on socioeconomic factors, such as poverty and ethnicity in urban areas translates into the surrounding schools, with a legacy of limited funding, reduced services, and teachers with limited training to successfully engage students in high poverty areas. This study…

Dress Codes Blues: An Exploration of Urban Students' Reactions to a Public High School Uniform Policy

ERIC Educational Resources Information Center

DaCosta, Kneia

2006-01-01

This qualitative investigation explores the responses of 22 U.S. urban public high school students when confronted with their newly imposed school uniform policy. Specifically, the study assessed students' appraisals of the policy along with compliance and academic performance. Guided by ecological human development perspectives and grounded in…

How Best to Assess Students Taking Work Placements? An Empirical Investigation from Australian Urban and Regional Planning

ERIC Educational Resources Information Center

Jackson, John; Jones, Martyn; Steele, Wendy; Coiacetto, Eddo

2017-01-01

Work placements (including internships) are common in urban and regional planning education but the relevant literature has largely overlooked their assessment and academic standards. To address this gap, the paper presents a study of this topic undertaken within the Australian context. The research involved systematically scoping the status of…

Academic Success of Urban African American Elementary Students in Title I Schools

ERIC Educational Resources Information Center

Anderson, James Sebastian

2017-01-01

The researcher investigated the achievement of third- and fifth-grade urban African American students who attended science, technology, engineering, and mathematics (STEM), Non-STEM, and Theme Title I schools in science and mathematics on the 2015 Georgia Milestones Assessment. The researcher used data from 29 Non-STEM, 14 STEM, and 10 Theme…

Teacher Beliefs regarding Grade Retention in an Urban Elementary School

ERIC Educational Resources Information Center

Gilmore-Hook, Toni

2011-01-01

The purpose of this study was to determine if exposure to a research-based presentation on grade retention, including the academic, socio-emotional and behavioral outcomes, would yield a change in teacher beliefs regarding retention as an intervention strategy. Teachers from a small urban school district were asked to complete a pre-survey, view a…

Teachers' Perception of Team Teaching Middle School Mathematics in Urban Schools

ERIC Educational Resources Information Center

Serrano, Vanessa

2012-01-01

The purpose of this study was to examine teachers' perceptions of team teaching middle school mathematics in urban schools. The research questions focused on student academic performance and the impact that team teaching may have from the perspective of teachers. The theories of Piaget, Vygotsky, and Bruner formed the theoretical foundation…

The Relationship between Parental Involvement and Urban Secondary School Student Academic Achievement: A Meta-Analysis

ERIC Educational Resources Information Center

Jeynes, William H.

2007-01-01

A meta-analysis is undertaken, including 52 studies, to determine the influence of parental involvement on the educational outcomes of urban secondary school children. Statistical analyses are done to determine the overall impact of parental involvement as well as specific components of parental involvement. Four different measures of educational…

A Narrative Inquiry of Latina/o Teachers in Urban Elementary Schools

ERIC Educational Resources Information Center

Hernandez-Scott, Erica

2017-01-01

Latina/o teachers are underrepresented in the educational workforce. As such, the purpose of this narrative inquiry is to explore the experiences of Latinas/os who are teaching in urban school districts. The central question addressed by this narrative inquiry was: "To what do Latina/o teachers attribute to their academic and career…

Associations between Grades and Physical Activity and Food Choices: Results from YRBS from a Large Urban School District

ERIC Educational Resources Information Center

Snelling, Anastasia; Belson, Sarah Irvine; Beard, Jonathan; Young, Kathleen

2015-01-01

Purpose: The purpose of this paper is to explore the relationship between television viewing time, physical activity level, food consumption patterns, and academic performance of adolescents in a large urban school district in the USA where health disparities are prevalent, particularly among minority residents. Design/Methodology/Approach: The…

The Cognitive Environments of Urban Preschool Children: Follow-Up Phase. Final Report.

ERIC Educational Resources Information Center

Hess, Robert D.; And Others

This report describes the second or followup phase of a project begun in 1962, which was designed to analyze the effect of home and maternal influence on the cognitive development of urban preschool children from three socioeconomic levels. Reported is the academic performance and cognitive attainment of 158 original study children during their…

Wraparound Counseling: An Ecosystemic Approach to Working with Economically Disadvantaged Students in Urban School Settings

ERIC Educational Resources Information Center

West-Olatunji, Cirecie; Frazier, Kimberly N.; Kelley, Erin

2011-01-01

Urban schools are faced with challenges such as low academic performance, increased incidents of violence, lack of parental engagement with educators, and school personnel burnout. Wraparound counseling is a holistic prevention tool that combines the best practices of counseling and special education for use in the school setting. (Contains 1…

After-School Tutoring for Reading Achievement and Urban Middle School Students

ERIC Educational Resources Information Center

Nelson-Royes, Andrea M.; Reglin, Gary L.

2011-01-01

This research study's purpose or theme was to qualitatively investigate the reading component of a private after-school tutoring program that offered academic assistance to eighth-grade students. The problem with reading is many urban middle school students have poor reading skills and do not perform well on reading standardized tests. Relative to…

The Agatston Urban Nutrition Initiative: Working to Reverse the Obesity Epidemic through Academically Based Community Service

ERIC Educational Resources Information Center

Johnston, Francis E.

2009-01-01

The Agatston Urban Nutrition Initiative (AUNI) presents a fruitful partnership between faculty and students at a premier research university and members of the surrounding community aimed at addressing the problem of childhood obesity. AUNI uses a problem-solving approach to learning by focusing course activities, including service-learning, on…

Urban Youth and Schooling: The Effect of School Climate on Student Disengagement and Dropout.

ERIC Educational Resources Information Center

Pellerin, Lisa A.

This study investigated the effects of schools' academic and disciplinary climates on student disengagement and dropping out, noting whether these effects varied by race/ethnic group. Data came from the High School Effectiveness Study (HSES), which allows contextual analysis of urban youth in their high schools, and the Common Core of Data, from…

Meaningful use of health information technology by rural hospitals.

PubMed

McCullough, Jeffrey; Casey, Michelle; Moscovice, Ira; Burlew, Michele

2011-01-01

This study examines the current status of meaningful use of health information technology (IT) in Critical Access Hospitals (CAHs), other rural, and urban US hospitals, and it discusses the potential role of Medicare payment incentives and disincentives in encouraging CAHs and other rural hospitals to achieve meaningful use. Data from the American Hospital Association (AHA) Annual Survey IT Supplement were analyzed, using t tests and probit regressions to assess whether implementation rates in CAHs and other rural hospitals are significantly different from rates in urban hospitals. Of the many measures we examined, only 4 have been met by a majority of rural hospitals: electronic recording of patient demographics and electronic access to lab reports, radiology reports, and radiology images. Meaningful use is even less prevalent among CAHs. We also find that rural hospitals lag behind urban institutions in nearly every measure of meaningful use. These differences are particularly large and significant for CAHs. The meaningful use incentive system creates many challenges for CAHs. First, investments are evaluated and subsidies determined after adoption. Thus, CAHs must accept financial risk when adopting health IT; this may be particularly important for large expenditures. Second, the subsidies may be low for relatively small expenditures. Third, since the subsidies are based on observable costs, CAHs will receive no support for their intangible costs (eg, workflow disruption). A variety of policies may be used to address these problems of financial risk, uncertain returns in a rural setting, and limited resources. © 2011 National Rural Health Association.

Modeling the Interplay of Multilevel Risk Factors for Future Academic and Behavior Problems: A Person-Centered Approach

PubMed Central

Lanza, Stephanie T.; Rhoades, Brittany L.; Nix, Robert L.; Greenberg, Mark T.

2010-01-01

This study identified profiles of 13 risk factors across child, family, school, and neighborhood domains in a diverse sample of children in kindergarten from 4 US locations (n = 750; 45% minority). It then examined the relation of those early risk profiles to externalizing problems, school failure, and low academic achievement in Grade 5. A person-centered approach, latent class analysis, revealed four unique risk profiles, which varied considerably across urban African American, urban white, and rural white children. Profiles characterized by several risks that cut across multiple domains conferred the highest risk for negative outcomes. Compared to a variable-centered approach, such as a cumulative risk index, these findings provide a more nuanced understanding of the early precursors to negative outcomes. For example, results suggested that urban children in single-parent homes that have few other risk factors (i.e., show at least average parenting warmth and consistency and report relatively low stress and high social support) are at quite low risk for externalizing problems, but at relatively high risk for poor grades and low academic achievement. These findings provide important information for refining and targeting preventive interventions to groups of children who share particular constellations of risk factors. PMID:20423544

Modeling the interplay of multilevel risk factors for future academic and behavior problems: a person-centered approach.

PubMed

Lanza, Stephanie T; Rhoades, Brittany L; Nix, Robert L; Greenberg, Mark T

2010-05-01

This study identified profiles of 13 risk factors across child, family, school, and neighborhood domains in a diverse sample of children in kindergarten from four US locations (n = 750; 45% minority). It then examined the relation of those early risk profiles to externalizing problems, school failure, and low academic achievement in Grade 5. A person-centered approach, latent class analysis, revealed four unique risk profiles, which varied considerably across urban African American, urban White, and rural White children. Profiles characterized by several risks that cut across multiple domains conferred the highest risk for negative outcomes. Compared to a variable-centered approach, such as a cumulative risk index, these findings provide a more nuanced understanding of the early precursors to negative outcomes. For example, results suggested that urban children in single-parent homes that have few other risk factors (i.e., show at least average parenting warmth and consistency and report relatively low stress and high social support) are at quite low risk for externalizing problems, but at relatively high risk for poor grades and low academic achievement. These findings provide important information for refining and targeting preventive interventions to groups of children who share particular constellations of risk factors.

Hospitalizations of Adults with Intellectual Disability in Academic Medical Centers

ERIC Educational Resources Information Center

Ailey, Sarah H.; Johnson, Tricia; Fogg, Louis; Friese, Tanya R.

2014-01-01

Individuals with intellectual disability (ID) represent a small but important group of hospitalized patients who often have complex health care needs. Individuals with ID experience high rates of hospitalization for ambulatory-sensitive conditions and high rates of hospitalizations in general, even when in formal community care systems; however,…

Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.

PubMed

Smith, Mark W; Owens, Pamela L; Andrews, Roxanne M; Steiner, Claudia A; Coffey, Rosanna M; Skinner, Halcyon G; Miyamura, Jill; Popescu, Ioana

2016-04-18

Rural/urban variations in admissions for heart failure may be influenced by severity at hospital presentation and local practice patterns. Laboratory data reflect clinical severity and guide hospital admission decisions and treatment for heart failure, a costly chronic illness and a leading cause of hospitalization among the elderly. Our main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. We retrospectively analyzed discharge data on 13,998 hospital discharges for heart failure from three states, Hawai'i, Minnesota, and Virginia. Hospital discharge records from 2008 to 2012 were derived from the State Inpatient Databases of the Healthcare Cost and Utilization Project, and were merged with results of laboratory tests performed on the admission day or up to two days before admission. Regression models evaluated the relationship between clinical severity at admission and patient urban/rural residence. Models were estimated with and without use of laboratory data. Patients residing in rural areas were more likely to have missing laboratory data on admission and less likely to have abnormal or severely abnormal tests. Rural patients were also less likely to be admitted with high levels of severity as measured by the All Patient Refined Diagnosis Related Groups (APR-DRG) severity subclass, derivable from discharge data. Adding laboratory data to discharge data improved model fit. Also, in models without laboratory data, the association between urban compared to rural residence and APR-DRG severity subclass was significant for major and extreme levels of severity (OR 1.22, 95% CI 1.03-1.43 and 1.55, 95% CI 1.26-1.92, respectively). After adding laboratory data, this association became non-significant for major severity and was attenuated for extreme severity (OR 1.12, 95% CI 0.94-1.32 and 1.43, 95% CI 1.15-1.78, respectively). Heart failure patients from rural areas are hospitalized at lower severity levels than their urban counterparts. Laboratory test data provide insight on clinical severity and practice patterns beyond what is available in administrative discharge data.

The Metro Firm System: meeting the challenges of a changing health care environment.

PubMed

Dawson, N V

Changes in the health care system and especially in reimbursement systems are creating new challenges for all hospitals. These challenges are particularly critical for academic medical centers. The traditional (inpatient) teaching base is threatened by changes in the case mix of patients entering hospitals and by the associated decreasing lengths of stay. The effects of the new financial pressures are intensified in academic centers which have been shown to be less efficient and more costly than community hospitals. This paper describes the formation and evolution of the Metro Firm System, an organizational structure which is adapting to the changing demands placed on an academic medical center. Inherent in its structure is the ability to evaluate easily and rigorously changes that have been suggested in the system prior to implementing them. Operational details essential for understanding functions of and interrelationships within the system are included.

From apartheid to integration: the role of the Witwatersrand Medical library in health care services in Johannesburg, South Africa.

PubMed Central

Myers, G

1995-01-01

Adapting to change is always difficult; all the more so when changes in the administrative structure of health care are part of a national political transformation toward democracy. As South Africa moves from apartheid to integration in its health services, the Witwatersrand Medical Library (WML) will have to adopt innovative strategies to cope with increasing demands on its resources by sub-Saharan African medical libraries and with expected decreases in state funding for health and education. WML also will have to address the lack of hospital library services in the Johannesburg region by expanding its academic branches at University of the Witwatersrand Medical School's teaching hospitals to serve both hospital and academic health care staff. This article discusses these challenges in the context of rapidly changing academic health care services in Johannesburg. PMID:7703943

Management of a severe thoracoabdominal injury from motorized sawing machine in a temporary semi-urban university teaching hospital: a case report.

PubMed

Fente, B G; Nwagwu, C C; Ogulu, B N; Orukari, G I B; Okere, E O; Miss Ouserigha, O E

2012-01-01

Report of our experience and outcome of a case of severe thoracoabdominal injuries by motorized sawing machine (a rare cause) in a Semi-Urban temporary University Teaching Hospital. Literature review on the topic was done using Pubmed. Relevant journals and topics were also reviewed. Textbooks on relevant topics were also searched. A 25 year old male timber-cutter was traumatized by motorized sawing machine injuring the left half of the chest, upper abdomen, the left shoulder and left hand. It is an unusual presentation of penetrating thoracoabdominal injury. There was open pneumotharax, 3th-8th ribs fractures, diaphragmatic laceration, and eviscerations of abdominal contents without affecting other thoraco-abdominal organs. Urgent surgical intervention done was the only option. The challenges posed by severe motorized sawing machine thoraco-abdominal injuries in a Semi-Urban temporary University Teaching Hospital were successfully managed due to rapid pre-hospital transfer and co-ordinated team effort.

Effect of a brief outreach educational intervention on the translation of acute poisoning treatment guidelines to practice in rural Sri Lankan hospitals: a cluster randomized controlled trial.

PubMed

Senarathna, Lalith; Buckley, Nick A; Dibley, Michael J; Kelly, Patrick J; Jayamanna, Shaluka F; Gawarammana, Indika B; Dawson, Andrew H

2013-01-01

In developing countries, including Sri Lanka, a high proportion of acute poisoning and other medical emergencies are initially treated in rural peripheral hospitals. Patients are then usually transferred to referral hospitals for further treatment. Guidelines are often used to promote better patient care in these emergencies. We conducted a cluster randomized controlled trial (ISRCTN73983810) which aimed to assess the effect of a brief educational outreach ('academic detailing') intervention to promote the utilization of treatment guidelines for acute poisoning. This cluster RCT was conducted in the North Central Province of Sri Lanka. All peripheral hospitals in the province were randomized to either intervention or control. All hospitals received a copy of the guidelines. The intervention hospitals received a brief out-reach academic detailing workshop which explained poisoning treatment guidelines and guideline promotional items designed to be used in daily care. Data were collected on all patients admitted due to poisoning for 12 months post-intervention in all study hospitals. Information collected included type of poison exposure, initial investigations, treatments and hospital outcome. Patients transferred from peripheral hospitals to referral hospitals had their clinical outcomes recorded. There were 23 intervention and 23 control hospitals. There were no significant differences in the patient characteristics, such as age, gender and the poisons ingested. The intervention hospitals showed a significant improvement in administration of activated charcoal [OR 2.95 (95% CI 1.28-6.80)]. There was no difference between hospitals in use of other decontamination methods. This study shows that an educational intervention consisting of brief out-reach academic detailing was effective in changing treatment behavior in rural Sri Lankan hospitals. The intervention was only effective for treatments with direct clinician involvement, such as administering activated charcoal. It was not successful for treatments usually administered by non-professional staff such as forced emesis for poisoning. Controlled-Trials.com ISRCTN73983810 ISRCTN73983810.

Patterns of time use among low-income urban minority adolescents and associations with academic outcomes and problem behaviors.

PubMed

Wolf, Sharon; Aber, J Lawrence; Morris, Pamela A

2015-06-01

Time budgets represent key opportunities for developmental support and contribute to an understanding of achievement gaps and adjustment across populations of youth. This study assessed the connection between out-of-school time use patterns and academic performance outcomes, academic motivations and goals, and problem behaviors for 504 low-income urban African American and Latino adolescents (54% female; M = 16.6 years). Time use patterns were measured across eight activity types using cluster analysis. Four groups of adolescents were identified, based on their different profiles of time use: (1) Academic: those with most time in academic activities; (2) Social: those with most time in social activities; (3) Maintenance/work: those with most time in maintenance and work activities; and (4) TV/computer: those with most time in TV or computer activities. Time use patterns were meaningfully associated with variation in outcomes in this population. Adolescents in the Academic cluster had the highest levels of adjustment across all domains; adolescents in the Social cluster had the lowest academic performance and highest problem behaviors; and adolescents in the TV/computer cluster had the lowest levels of intrinsic motivation. Females were more likely to be in the Academic cluster, and less likely to be in the other three clusters compared to males. No differences by race or gender were found in assessing the relationship between time use and outcomes. The study's results indicate that time use patterns are meaningfully associated with within-group variation in adjustment for low-income minority adolescents, and that shared contexts may shape time use more than individual differences in race/ethnicity for this population.

Assessing process of paediatric care in a resource-limited setting: a cross-sectional audit of district hospitals in Rwanda.

PubMed

Hategeka, Celestin; Shoveller, Jeannie; Tuyisenge, Lisine; Lynd, Larry D

2018-05-01

Routine assessment of quality of care helps identify deficiencies which need to be improved. While gaps in the emergency care of children have been documented across sub-Saharan Africa, data from Rwanda are lacking. To assess the care of sick infants and children admitted to Rwandan district hospitals and the extent to which it follows currently recommended clinical practice guidelines in Rwanda. Data were gathered during a retrospective cross-sectional audit of eight district hospitals across Rwanda in 2012/2013. Medical records were randomly selected from each hospital and were reviewed to assess the process of care, focusing on the leading causes of under-5 mortality, including neonatal conditions, pneumonia, malaria and dehydration/diarrhoea. Altogether, 522 medical records were reviewed. Overall completion of a structured neonatal admission record was above 85% (range 78.6-90.0%) and its use was associated with better documentation of key neonatal signs (median score 6/8 and 2/8 when used and not used, respectively). Deficiencies in the processes of care were identified across hospitals and there were rural/urban disparities for some indicators. For example, neonates admitted to urban district hospitals were more likely to receive treatment consistent with currently recommended guidelines [e.g. gentamicin (OR 2.52, 95% CI 1.03-6.43) and fluids (OR 2.69, 95% CI 1.2-6.2)] than those in rural hospitals. Likewise, children with pneumonia admitted to urban hospitals were more likely to receive the correct dosage of gentamicin (OR 4.47, 95% CI 1.21-25.1) and to have their treatment monitored (OR 3.75, 95% CI 1.57-8.3) than in rural hospitals. Furthermore, children diagnosed with malaria and admitted to urban hospitals were more likely to have their treatment (OR 2.7, 95% CI 1.15-6.41) monitored than those in rural hospitals. Substantial gaps were identified in the process of neonatal and paediatric care across district hospitals in Rwanda. There is a need to (i) train health care professionals in providing neonatal and paediatric care according to nationally adopted clinical practice guidelines (e.g. ETAT+); (ii) establish a supervision and mentoring programme to ensure that the guidelines are available and used appropriately in district hospitals; and (iii) use admission checklists (e.g. neonatal and paediatric admission records) in district hospitals.

Assessment of Oropharyngeal and Laryngeal Cancer Treatment Delay in a Private and Safety Net Hospital System.

PubMed

Perlow, Haley K; Ramey, Stephen J; Silver, Ben; Kwon, Deukwoo; Chinea, Felix M; Samuels, Stuart E; Samuels, Michael A; Elsayyad, Nagy; Yechieli, Raphael

2018-04-01

Objective To examine the impact of treatment setting and demographic factors on oropharyngeal and laryngeal cancer time to treatment initiation (TTI). Study Design Retrospective case series. Setting Safety net hospital and adjacent private academic hospital. Subjects and Methods Demographic, staging, and treatment details were retrospectively collected for 239 patients treated from January 1, 2014, to June 30, 2016. TTI was defined as days between diagnostic biopsy and initiation of curative treatment (defined as first day of radiotherapy [RT], surgery, or chemotherapy). Results On multivariable analysis, safety net hospital treatment (vs private academic hospital treatment), initial diagnosis at outside hospital, and oropharyngeal cancer (vs laryngeal cancer) were all associated with increased TTI. Surgical treatment, severe comorbidity, and both N1 and N2 status were associated with decreased TTI. Conclusion Safety net hospital treatment was associated with increased TTI. No differences in TTI were found when language spoken and socioeconomic status were examined in the overall cohort.

RURAL/URBAN RESIDENCE, ACCESS, AND PERCEIVED NEED FOR TREATMENT AMONG AFRICAN AMERICAN COCAINE USERS

PubMed Central

BORDERS, TYRONE F.; BOOTH, BRENDA M.; STEWART, KATHARINE E.; CHENEY, ANN M.; CURRAN, GEOFFREY M.

2014-01-01

Objective To examine how rural/urban residence, perceived access, and other factors impede or facilitate perceived need for drug use treatment, a concept closely linked to treatment utilization. Study Design Two hundred rural and 200 urban African American cocaine users who were not receiving treatment were recruited via Respondent-Driven Sampling and completed a structured in-person interview. Bivariate and multivariate analyses were conducted to test the associations between perceived need and rural/urban residence, perceived access, and other predisposing (eg, demographics), enabling (eg, insurance), and health factors (eg, psychiatric distress). Principal Findings In bivariate analyses, rural relative to urban cocaine users reported lower perceived treatment need (37% vs 48%), availability, affordability, overall ease of access, and effectiveness, as well as lower perceived acceptability of residential, outpatient, self-help, and hospital-based services. In multivariate analyses, there was a significant interaction between rural/urban residence and the acceptability of religious counseling. At the highest level of acceptability, rural users had lower odds of perceived need (OR=.23); at the lowest level, rural users had higher odds of perceived need (OR=2.74) than urban users. Among rural users, the acceptability of religious counseling was negatively associated with perceived need (OR=.64). Ease of access was negatively associated (OR=.71) whereas local treatment effectiveness (OR=1.47) and the acceptability of hospital-based treatment (OR=1.29) were positively associated with perceived need among all users. Conclusions Our findings suggest rural/urban disparities in perceived need and access to drug use treatment. Among rural and urban cocaine users, improving perceptions of treatment effectiveness and expanding hospital-based services could promote treatment seeking. PMID:25213603

Accuracy of Intraoperative Frozen Section Diagnosis of Borderline Ovarian Tumors by Hospital Type.

PubMed

Shah, Jaimin S; Mackelvie, Michael; Gershenson, David M; Ramalingam, Preetha; Kott, Marylee M; Brown, Jubilee; Gauthier, Polly; Nugent, Elizabeth; Ramondetta, Lois M; Frumovitz, Michael

2018-04-19

To compare the accuracy of frozen section diagnosis of borderline ovarian tumors among 3 distinct types of hospital-academic hospital with gynecologic pathologists, academic hospital with nongynecologic pathologists, and community hospital with nongynecologic pathologists-and to determine if surgical staging alters patient care or outcomes for women with a frozen section diagnosis of borderline ovarian tumor. Retrospective study (Canadian Task Force classification II-1). Tertiary care, academic, and community hospitals. Women with an intraoperative frozen section diagnosis of borderline ovarian tumor at 1 of 3 types of hospital from April 1998 through June 2016. Comparison of final pathology with intraoperative frozen section diagnosis. Two hundred twelve women met the inclusion criteria. The frozen section diagnosis of borderline ovarian tumor correlated with the final pathologic diagnosis in 192 of 212 cases (90.6%), and the rate of correlation did not differ among the 3 hospital types (p = .82). Seven tumors (3.3%) were downgraded to benign on final pathologic analysis and 13 (6.1%) upgraded to invasive carcinoma. The 3 hospital types did not differ with respect to the proportion of tumors upgraded to invasive carcinoma (p = .62). Mucinous (odds ratio, 7.1; 95% confidence interval, 2.1-23.7; p = .002) and endometrioid borderline ovarian tumors (odds ratio, 32.4; 95% confidence interval, 1.8-595.5; p = .02) were more likely than serous ovarian tumors to be upgraded to carcinoma. Only 88 patients (41.5%) underwent lymphadenectomy, and only 1 (1.1%) had invasive carcinoma in a lymph node. A frozen section diagnosis of borderline ovarian tumor correlates with the final pathologic diagnosis in a variety of hospital types. Copyright © 2018 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

Influence of health-related quality of life on health service utilization in Chinese rural-to-urban female migrant workers.

PubMed

Lu, Chu-Hong; Wang, Pei-Xi; Lei, Yi-Xiong; Luo, Zhong-Cheng

2014-08-15

Rural-to-urban migrant workers have been increasing rapidly in China over recent decades. Health related quality of life (HRQOL) may affect health service utilization. There is a lack of data on HRQOL in relation to health service utilization in Chinese rural-to-urban migrant workers. This study was aimed to explore the influence of HRQOL on health service utilization in Chinese rural-to-urban female migrant workers. This was a cross-sectional survey of 1,438 female rural-to-urban migrant workers in Shenzhen-Dongguan economic zone, China in 2013. HRQOL was assessed by the 36-items Health Survey Short Form (SF-36). Health service utilization was measured by any physician visit over the recent two weeks and any hospitalization over the last 1-year (annual hospitalization). Clustered logistic regression was used to analyze the influence of HRQOL on health service utilization. Lower scores in three HRQOL domains (bodily pain, general health, role physical) were associated with more frequent health service utilization in female rural-to-urban migrant workers. Bodily pain and general health were associated with an independent influence of 15.6% on the risk of recent two-week physician visit, while role physical and general health were associated with an independent influence of 21.2% on the risk of annual hospitalization. The independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and health-related variables. HRQOL may have a modest influence on health service utilization in Chinese rural-to-urban female migrant workers - an underprivileged population in urban China.

Effect of post-discharge follow-up care on re-admissions among US veterans with congestive heart failure: a rural-urban comparison.

PubMed

Muus, Kyle J; Knudson, Alana; Klug, Marilyn G; Gokun, Jane; Sarrazin, Mary; Kaboli, Peter

2010-01-01

Hospital re-admissions for patients with congestive heart failure (CHF) are relatively common and costly occurrences within the US health infrastructure, including the Veterans Affairs (VA) healthcare system. Little is known about CHF re-admissions among rural veteran patients, including the effects of socio-demographics and follow-up outpatient visits on these re-admissions. To examine socio-demographics of US veterans with CHF who had 30 day potentially preventable re-admissions and compare the effect of 30 day VA post-discharge service use on these re-admissions for rural- and urban-dwelling veterans. The 2005-2007 VA data were analyzed to examine patient characteristics and hospital admissions for 36 566 veterans with CHF. The CHF patients who were and were not re-admitted to a VA hospital within 30 days of discharge were identified. Logistic regression was used to examine and compare the effect of VA post-acute service use on re-admissions between rural- and urban-dwelling veterans. Re-admitted veterans tended to be older (p=.002), had disability status (p=.024) and had longer hospital stays (p<.001). Veterans Affairs follow-up visits were negatively associated with re-admissions for both rural and urban veterans with CHF (ORs 0.16-0.76). Rural veterans aged 65 years and older who had VA emergency room visits following discharge were at high risk for re-admission (OR=2.66). Post-acute follow-up care is an important factor for promoting recovery and good health among hospitalized veterans with CHF, regardless of their rural or urban residence. Older, rural veterans with CHF are in need of special attention for VA discharge planning and follow up with primary care providers.

Rural-urban differences in end-of-life nursing home care: facility and environmental factors.

PubMed

Temkin-Greener, Helena; Zheng, Nan Tracy; Mukamel, Dana B

2012-06-01

This study examines urban-rural differences in end-of-life (EOL) quality of care provided to nursing home (NH) residents. We constructed 3 risk-adjusted EOL quality measures (QMs) for long-term decedent residents: in-hospital death, hospice referral before death, and presence of severe pain. We used CY2005-2007 100% Minimum Data Set, Medicare beneficiary file, and inpatient and hospice claims. Logistic regression models were estimated to predict the probability of each outcome conditional on decedents' risk factors. For each facility, QMs were calculated as the difference between the actual and the expected risk-adjusted outcome rates. We fit multivariate linear regression models, with fixed state effects, for each QM to assess the association with urban-rural location. We found urban-rural differences for in-hospital death and hospice QMs, but not for pain. Compared with NHs located in urban areas, facilities in smaller towns and in isolated rural areas have significantly (p < .001) worse EOL quality for in-hospital death and hospice use. Whereas the differences in these QMs are statistically significant between facilities located in large versus small towns, they are not statistically significant between facilities located in small towns and isolated rural areas. This study provides empirical evidence for urban-rural differences in EOL quality of care using a national sample of NHs. Identifying differences is a necessary first step toward improving care for dying NH residents and for bridging the urban-rural gap.

Management of the Hospital Environment

ERIC Educational Resources Information Center

Turner, Alvis G.

1976-01-01

Hospital studies indicate the need for an environmental/sanitarian specialist for control of nosocomial infection and maintenance of a quality environment. The author recommends these requirements for certification as a hospital environmentalist: academic studies including toxicology, epidemiology, hygiene, management, and an internship in…

Awareness of Patients' Rights among Inpatients of a Tertiary Care Teaching Hospital- A Cross-sectional Study.

PubMed

Agrawal, Upasana; D'Souza, Brayal C; Seetharam, Arun Mavaji

2017-09-01

The rights of a patient are a set of rules of conduct which govern the interaction between the patients' and healthcare professionals. Every patient has a right to be informed about their rights and also the responsibility of the healthcare provider. To assess awareness among inpatient about patients' rights at an academic accredited hospital. A questionnaire based cross-sectional study was carried out among 350 patients admitted to the wards of a Tertiary Care Teaching Hospital. A 21-point questionnaire was developed based on standards of the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and patients' charter of rights and validated. This charter of rights is also displayed in the hospital for patient's awareness. Frequencies and percentages were depicted. Chi-square test was used for statistical analysis. Positive awareness among the patients ranged from 28% to 97.4%. Females were more aware of their rights than males for 11 out of the 21 patient rights items. Younger adults were more aware than any other age group participants. Participants who were admitted to wards of higher categories (deluxe rooms) had high degree of awareness about patients' rights and education. Patients from urban areas and higher educational status were more aware than patients coming from rural areas. The study concludes that effective measures should be taken to improve the overall awareness not only among patients but also among different stakeholders in the healthcare delivery system. Readability of the patients' rights charter with good readability score, developing and distributing patient education materials in simple language about the rights and responsibilities to the patient and their family/relatives during their stay in the hospital or at the time of registration.Continuing nursing and medical education in medical teaching institutions and hospitals should focus on patients' rights and its importance, its need for awareness and its consequences should be taught to students and hospital staff. Patient Right Committee in the hospital should be established for supervision monitoring and observance of patients' rights.

Evaluating the Impact of Conflict Resolution on Urban Children's Violence-Related Attitudes and Behaviors in New Haven, Connecticut, through a Community-Academic Partnership

ERIC Educational Resources Information Center

Shuval, Kerem; Pillsbury, Charles A.; Cavanaugh, Brenda; McGruder, La'rie; McKinney, Christy M.; Massey, Zohar; Groce, Nora E.

2010-01-01

Numerous schools are implementing youth violence prevention interventions aimed at enhancing conflict resolution skills without evaluating their effectiveness. Consequently, we formed a community-academic partnership between a New Haven community-based organization and Yale's School of Public Health and Prevention Research Center to examine the…

The Effects of Career Academies on Academic Achievement and College Readiness

ERIC Educational Resources Information Center

Frost, Mandy J.

2017-01-01

This quantitative ex post facto study investigated the effects of career academies on academic achievement and college readiness. A total of 1,206 12th-grade participants (196 career academy and 1,010 nonacademy students) were used in this study. These participants came from six high schools located in one large urban school district. Each of the…

An Ecological Analysis of After-School Program Participation and the Development of Academic Performance and Motivational Attributes for Disadvantaged Children

ERIC Educational Resources Information Center

Mahoney, Joseph L.; Lord, Heather; Carryl, Erica

2005-01-01

This longitudinal study evaluated after-school program (ASP) participation and the development of academic performance (school grades, reading achievement) and teacher-rated motivational attributes (expectancy of success, effectance motivation) over a school year. Participants were 599 boys and girls (6.3 to 10.6 years) from an urban,…

An Academic Innovation: The Executive Ph.D. in Urban Higher Education at a Historically Black University

ERIC Educational Resources Information Center

Stevenson, Joseph Martin; Payne, Alfredda Hunt

2016-01-01

This chapter describes how data analysis and data-driven decision making were critical for designing, developing, and assessing a new academic program. The authors--one, the program's founder; the other, an alumna--begin by highlighting some of the elements in the program's incubation and, subsequently, describe some of the components for data…

A Residence Life Plan for Success for At-Risk College Students: Reviving "In Loco Parentis"

ERIC Educational Resources Information Center

Johnson, Marques; Flynn, Ellen; Monroe, Maxine

2016-01-01

In this study, we explored whether a residence life plan designed to meet the academic and psychosocial development of at-risk housing students, where oversight and support were provided on a weekly basis, and a proactive, intrusive counseling approach was implemented, would be effective for academic success. Participants included 74 urban at-risk…

Violence Exposure, IQ, Academic Performance, and Children's Perception of Safety: Evidence of Protective Effects

ERIC Educational Resources Information Center

Ratner, Hilary Horn; Chiodo, Lisa; Covington, Chandice; Sokol, Robert J.; Ager, Joel; Delaney-Black, Virginia

2006-01-01

Community violence exposure (CVE), a critical urban problem, is associated with negative academic outcomes. Children who report feeling safe, however, may perform better than those who do not. The purpose of this study was to examine the relations among CVE, feelings of safety, and cognitive outcomes among 6- and 7-year-olds born to women…

Racial Identity Attitudes, Self-Esteem, and Academic Achievement among African American Adolescents

ERIC Educational Resources Information Center

Bonvillain, Jocelyn Freeman; Honora, Detris

2004-01-01

The purpose of the present study was to explore the extent to which racial identity attitudes and self-esteem could predict academic performance for African American middle school students. A total of 175 African American adolescents in 7th grade attending one of two urban schools participated in the study. The Multi-Ethnic Identity Measure (MEIM)…

Developmental Cascades: Linking Academic Achievement and Externalizing and Internalizing Symptoms Over 20 Years

ERIC Educational Resources Information Center

Masten, Ann S.; Roisman, Glenn I.; Long, Jeffrey D.; Burt, Keith B.; Obradovic, Jelena; Riley, Jennifer R.; Boelcke-Stennes, Kristen; Tellegen, Auke

2005-01-01

A developmental cascade model linking competence and symptoms was tested in a study of a normative, urban school sample of 205 children (initially 8 to 12 years old). Internalizing and externalizing symptoms and academic competence were assessed by multiple methods at the study outset and after 7, 10, and 20 years. A series of nested cascade…

Experiences of Violence and Deficits in Academic Achievement among Urban Primary School Children in Jamaica

ERIC Educational Resources Information Center

Baker-Henningham, Helen; Meeks-Gardner, Julie; Chang, Susan; Walker, Susan

2009-01-01

Objective: The aim of this study was to examine the relationship between children's experiences of three different types of violence and academic achievement among primary school children in Kingston, Jamaica. Methods: A cross-sectional study of 1300 children in grade 5 [mean (S.D.) age: 11 (0.5) years] from 29 government primary schools in urban…

The Relationship between Out-of-School-Suspension and English Language Arts Achievement of Students from Low Socio-Economic Settings

ERIC Educational Resources Information Center

Lobban, Carol Janet

2012-01-01

Out-of-school suspension (OSS) links low academic achievement to at risk students. Middle school students in one low socioeconomic urban setting experience lower academic achievement and higher rates of OSS. The purpose of this study was to determine the relationship between students' English Language Arts (ELA) achievement and OSS. Glasser's…

Academic Attitudes and Achievement in Students of Urban Public Single-Sex and Mixed-Sex High Schools

ERIC Educational Resources Information Center

Else-Quest, Nicole M.; Peterca, Oana

2015-01-01

Publicly funded single-sex schooling (SSS) has proliferated in recent years and is touted as a remedy to gaps in academic attitudes and achievement, particularly for low-income students of color. Research on SSS is rife with limitations, stemming from selective admissions processes, selection effects related to socioeconomic status, a lack of…

Academic Performance, Persistence, and Degree Completion of Associate in Arts Degree Recipients Transferring to a Four-Year Multi-Campus Institution

ERIC Educational Resources Information Center

Reyes, Saul

2010-01-01

This study assessed if there were differences in the academic performance, persistence, and degree completion for Associate in Arts transfer students in selected majors who enrolled in the different campuses of a multi-campus university. This causal comparative study analyzed historical student enrollment data from a large, urban, public, research…

A Study of the Relationship between Academic Achievement Motivation and Home Environment among Standard Eight Pupils

ERIC Educational Resources Information Center

Muola, J. M.

2010-01-01

The objective of this study was to investigate the relationship between academic achievement motivation and home environment among standard eight pupils. The study was carried out on 235 standard eight Kenyan pupils from six urban and rural primary schools randomly selected from Machakos district. Their age ranged between 13 and 17 years. Two…

"That "Fuego," That Fire in Their Stomach": Academically Successful Latinas/os and "Racial Opportunity Cost"

ERIC Educational Resources Information Center

Venzant Chambers, Terah T.; Locke, Leslie A.; Tagarao, Annel M.

2015-01-01

This article discusses the racial opportunity cost of academic achievement for Latina/o students who graduated from urban high schools and participated in a larger study of 18 high-achieving students of color. The article focuses on the ways the school context influenced their success. Interviews with the seven Latina/o participants reveal that…

Narrowing the Achievement Gap: Factors That Support English Learner and Hispanic Student Academic Achievement in an Urban Intermediate School

ERIC Educational Resources Information Center

Flores, Patricia Arleen

2010-01-01

A persistent and pervasive disparity in academic achievement exists between ethnic minority and English Learner students and their White and Asian peers. This qualitative single-case study of a high-poverty, high-performing middle school focused on the cultural norms, practices, and programs that were perceived to be contributing to narrowing the…

The Relationship of a Systemic Student Support Intervention to Academic Achievement in Urban Catholic Schools

ERIC Educational Resources Information Center

Shields, Katherine A.; Walsh, Mary E.; Lee-St. John, Terrence J.

2016-01-01

Much of the achievement gap between rich and poor students can be attributed to out-of-school factors, yet few schools have a comprehensive, coordinated system for addressing students' nonacademic needs. Within a group of Catholic schools located in one city, this study examined academic achievement on the Stanford Achievement Test battery in…

Academic Achievements and Study Habits of College Students of District Pulwama

ERIC Educational Resources Information Center

Bhat, Younis Illahi; Khandai, Hemant

2016-01-01

This study was undertaken to study the academic achievement and study habits of male and female college students of district Pulwama (J and k). The sample for the study was 410 including 193 male and 217 female college students .which was further divided into different groups of rural-urban dichotomy. For this purpose descriptive survey method was…

Academic Achievements and Study Habits of College Students of District Pulwama

ERIC Educational Resources Information Center

Illahi, Bhat Younes; Khandai, Hemant

2015-01-01

This study was undertaken to study the academic achievement and study habits of male and female college students of district Pulwama (J and K). The sample for the study was 410 including 193 male and 217 female college students, which was further divided into different groups of rural-urban dichotomy. For this purpose descriptive survey method was…

Measuring the Relationship between Parent, Teacher, and Student Problem Behavior Reports and Academic Achievement: Implications for School Counselors

ERIC Educational Resources Information Center

Johnson, Kaprea; Hannon, Michael D.

2014-01-01

This study investigates the relationship between academic achievement and reports of student problem behavior from teachers, parents, and child self-reports. Participants included 108 teachers, 113 parents/caregivers, and 129 students from an urban school in the Northeast region of the United States. Results suggest parent and child reports were…

Does Geographic Setting Alter the Roles of Academically Supportive Factors? African American Adolescents' Friendships, Math Self-Concept, and Math Performance

ERIC Educational Resources Information Center

Jones, Martin H.; Irvin, Matthew J.; Kibe, Grace W.

2012-01-01

The study is one of few to examine how living in rural, suburban, or urban settings may alter factors supporting African Americans adolescents' math performance. The study examines the relationship of math self-concept and perceptions of friends' academic behaviors to African American students' math performance. Participants (N = 1,049) are…

College Women in the 21st Century: A Closer Look at Academic, Family and Work Demands on Levels of Burnout

ERIC Educational Resources Information Center

Valoy, Glenny A.

2012-01-01

This study explored the contributions of background characteristics, family, academic, and work demands on levels of burnout among undergraduate females in an urban college setting and to what extent informal/formal support is related to levels of burnout. Data were obtained through the use of self-administered questionnaires, which were…

Impacts of a Discussion-Based Academic Language Program on Classroom Interactions in 4th through 7th Grades

ERIC Educational Resources Information Center

LaRusso, Maria; Jones, Stephanie M.; Kim, Ha Yeon; Kim, James; Donovan, Suzanne; Snow, Catherine

2016-01-01

This paper presents an exploratory analysis of treatment-control differences in the quality of classroom interactions in 4th through 7th grade urban classrooms. Word Generation (WG) is a research-based academic language program for middle school students designed to teach novel vocabulary and literacy through language arts, math, science, and…

Making Their Voices Count: Using Students' Perspectives to Inform Literacy Instruction for Striving Middle Grade Readers with Academic Difficulties

ERIC Educational Resources Information Center

Groff, Carolyn

2014-01-01

The consequences of lack of reading and poor reading skills are problematic for all students, regardless of background; however, for middle grade striving readers with academic difficulties these problems can lead to lower self-efficacy and motivation to engage in literacy tasks. Using the perspectives of urban, middle grade special education…

Nonmydriatic fundus photography for teleophthalmology diabetic retinopathy screening in rural and urban clinics.

PubMed

Chin, Eric K; Ventura, Bruna V; See, Kai-Yin; Seibles, Joann; Park, Susanna S

2014-02-01

To evaluate the relative diagnostic value of nonmydriatic fundus photography (nFP) among patients screened for diabetic retinopathy in remote rural medical clinics and an urban academic medical center for nonadherence to recommended annual dilated eye examination. A retrospective cross-sectional study was performed among diabetic patients seen in primary outpatient clinics between 2006 and 2011 who were screened for diabetic retinopathy with nFP for history of nonadherence to recommended annual dilated eye examination. A single nonstereoscopic, 45°, 10-megapixel digital image of the disc and macula of both eyes was obtained locally and transmitted electronically to a retinal specialist for remote review. The results from remote rural Native American Indian reservations were compared with those from an urban academic family practice clinic. The proportion of subjects diagnosed with diabetic retinopathy and the quality of fundus images were compared. Among 872 patients (1,744 eyes) screened from rural sites and 517 subjects (1,034 eyes) screened from an urban site, images were of good quality for evaluation in 82.4% and 85.7% of subjects, respectively. Diabetic retinopathy was noted in 12.6% of rural subjects and 29.6% of urban subjects (p<0.001). nFP can be a useful tool in both rural and urban settings to screen for diabetic retinopathy in patients who are nonadherent to the recommended dilated annual eye exam. In our study population, a surprisingly higher percentage of diabetic subjects screened from the urban clinic had retinopathy compared with subjects screened in rural clinics.

Medicare Hospital Charges in the Last Year of Life: Distribution by Quarter for Rural and Urban Nursing Home Decedents with Cognitive Impairment

ERIC Educational Resources Information Center

Gessert, Charles E.; Haller, Irina V.

2008-01-01

Background: Medicare beneficiaries incur 27%-30% of lifetime charges in the last year of life; most charges occur in the last quarter. Factors associated with high end-of-life Medicare charges include less advanced age, non-white race, absence of advance directive, and urban residence. Methods: We analyzed Medicare hospital charges in the last…

The History of the Bellevue Hospital Chest Service (1903-2015).

PubMed

Rom, William N; Reibman, Joan

2015-10-01

For more than 100 years, the Bellevue Hospital Chest Service in New York City has contributed major advances in our understanding of pulmonary disease. Research from the cardiopulmonary laboratory of the Chest Service by Drs. Cournand and Richards resulted in the shared Nobel Prize in Physiology or Medicine in 1956 for the development of human cardiac catheterization. In more recent years, continuing its mission to serve the underserved and respond to health crises, the Bellevue Chest Service has served as a leader in the management of HIV infections, multiple drug-resistant tuberculosis epidemics, early detection of lung cancer, and management of urban asthma. Members of the Chest Service founded the World Trade Center Environmental Health Center shortly after collapse of the towers in 2001. The Chest Service became New York's infectious isolation unit caring for the first patient in New York infected with Ebola virus. Recent research has focused on disease management, with the first in-house Directly Observed Therapy Clinic for treatment of tuberculosis, clinical trials of aerosolized IFN-γ, and translational research on host defense against tuberculosis infection. Studies of the airway mucosa have revealed mechanisms by which ambient pollutants promote asthma. Studies on the World Trade Center firefighters and community populations have promoted understanding of systemic inflammation and small airways function. Today, the partnership between a public hospital and an academic institution promotes the synergy that leads to cost-effective and state-of-the art care for an underserved population as well as cutting-edge training and research.

More than a pretty place: assessing the impact of environmental education on children's knowledge and attitudes about outdoor play in nature.

PubMed

Beyer, Kirsten M M; Heller, Elizabeth F; Bizub, Jessica M; Kistner, Amy J; Szabo, Aniko; Shawgo, Erin E; Zetts, Corey J

2015-02-12

Our work assessed the influence of an urban environmental education program on children's attitudes toward outdoor play, as well as knowledge of neighborhood features that can facilitate this type of activity. The project team engaged 6 schools near the newest Urban Ecology Center location in Milwaukee, Wisconsin, USA, through a community-academic partnership entitled More Than a Pretty Place. Intervention classrooms participated in programming over the 2012-2013 academic year and pre and post surveys were implemented in classrooms. Data were analyzed using multilevel regression models. The intervention group reported reduced fears of outdoor play in nature and increased frequency of visits to the Urban Ecology Center. The proportion of students who acknowledged knowing of a place to play outside in nature increased significantly in both groups. Our findings indicate an important role for environmental education in addressing fears that may dissuade children from engaging in outdoor play in natural areas.

The effect of an STC orientation to teaching on student academic performance and motivation in secondary earth science

NASA Astrophysics Data System (ADS)

Corbin, Robert Arthur

Student achievement gaps among subgroups remain a prevalent and critical issue in urban education systems. In many classes these students remain the target---and often the victims---of test-driven curriculum. Missing from their urban education is one of the most important aspects of a true education: a sense of place within that education. Science educators and educational researchers might consider the benefits of Sociotransformative Constructivism (STC) as a means of creating a more meaningful education for urban youth. This study examined the impact of an STC teaching orientation on student motivation and academic performance in secondary earth science students. The mixed methodology employed used both qualitative and quantitative data. Data collection consisted of STC activities, survey data, classroom observations, studentgenerated work and threaded discussions. Statistical analysis included independent t-tests of pre- and post-instruction concept maps. The results showed that the adaptation of an STC teaching orientation has a positive impact on student motivation and performance in secondary earth science.

More than a Pretty Place: Assessing the Impact of Environmental Education on Children’s Knowledge and Attitudes about Outdoor Play in Nature

PubMed Central

Beyer, Kirsten M. M.; Heller, Elizabeth F.; Bizub, Jessica M.; Kistner, Amy J.; Szabo, Aniko; Shawgo, Erin E.; Zetts, Corey J.

2015-01-01

Our work assessed the influence of an urban environmental education program on children’s attitudes toward outdoor play, as well as knowledge of neighborhood features that can facilitate this type of activity. The project team engaged 6 schools near the newest Urban Ecology Center location in Milwaukee, Wisconsin, USA, through a community-academic partnership entitled More Than a Pretty Place. Intervention classrooms participated in programming over the 2012–2013 academic year and pre and post surveys were implemented in classrooms. Data were analyzed using multilevel regression models. The intervention group reported reduced fears of outdoor play in nature and increased frequency of visits to the Urban Ecology Center. The proportion of students who acknowledged knowing of a place to play outside in nature increased significantly in both groups. Our findings indicate an important role for environmental education in addressing fears that may dissuade children from engaging in outdoor play in natural areas. PMID:25685953

Toward late career transitioning: a proposal for academic surgeons.

PubMed

Richards, Robin; McLeod, Robin; Latter, David; Keshavjee, Shaf; Rotstein, Ori; Fehlings, Michael G; Ahmed, Najma; Nathens, Avery; Rutka, James

2017-09-01

In the absence of a defined retirement age, academic surgeons need to develop plans for transition as they approach the end of their academic surgical careers. The development of a plan for late career transition represents an opportunity for departments of surgery across Canada to initiate a constructive process in cooperation with the key stakeholders in the hospital or institution. The goal of the process is to develop an individual plan for each faculty member that is agreeable to the academic surgeon; informs the surgical leadership; and allows the late career surgeon, the hospital, the division and the department to make plans for the future. In this commentary, the literature on the science of aging is reviewed as it pertains to surgeons, and guidelines for late career transition planning are shared. It is hoped that these guidelines will be of some value to academic programs and surgeons across the country as late career transition models are developed and adopted.

Does difference matter? Diversity and human rights in a hospital workplace.

PubMed

Sulman, Joanne; Kanee, Marylin; Stewart, Paulette; Savage, Diane

2007-01-01

The urban hospital workplace is a dynamic environment that mirrors the cultural and social diversity of the modern city. This paper explores the literature relating to diversity in the workplace and then describes an urban Canadian teaching hospital's comprehensive approach to the promotion of an equitable and inclusive diverse environment. With this goal, four years ago the hospital established an office of Diversity and Human Rights staffed by a social worker. The office provides education, training, policy development and complaints management. The administration also convened a hospital-wide committee to advise on the outcomes, and to plan a process for diversity and human rights organizational change. The committee worked with a social work research consultant to design a qualitative focus group study, currently ongoing, to explore the perspectives of hospital staff. The lessons learned from the process have the potential to increase overall cultural competency of staff that can translate into more sensitive work with patients.

Affiliation with Antisocial Crowds and Psychosocial Outcomes in a Gang-Impacted Urban Middle School

ERIC Educational Resources Information Center

Schwartz, David; Hopmeyer, Andrea; Luo, Tana; Ross, Alexandra C.; Fischer, Jesse

2017-01-01

This longitudinal study examined the psychosocial adjustment of adolescents who affiliate with antisocial crowds in a gang-impacted urban environment. We followed 405 adolescents (219 boys, 186 girls; average age of 11.51 years, SD = 0.61; 84% Latino, 9% Asian, and 7% other or unclassified) for one academic year. These youth attended a middle…

Home Environment, Self-Concept and Urban Student Achievement: A Bibliography and Review of Research. NJ Urban Education Research Reports No. 5.

ERIC Educational Resources Information Center

Shapiro, Carol; Bloom, Joel S.

This review analyzes recent research on student personality, social and home environment, and the influence of these factors on academic achievement, particularly among minority and disadvantaged students. Several factors which purportedly affect student achievement and which are examined in the review include: (1) socioeconomic status and its…

Science in the City: Meeting the Needs of Urban Gifted Students with Project Clarion

ERIC Educational Resources Information Center

Bland, Lori C.; Coxon, Steve; Chandler, Kimberley; VanTassel-Baska, Joyce

2010-01-01

Urban gifted children encounter many forces that derail the development of their full potential. A report by the Jack Kent Cooke Foundation and Civic Enterprises found that more than a million children in poverty rank in the top quartile academically, but few of these children will find adequate opportunities to fulfill such potential in urban…