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Sample records for cause-specific emergency admissions

  1. Apparent temperature and cause-specific emergency hospital admissions in Greater Copenhagen, Denmark.

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    Janine Wichmann

    Full Text Available One of the key climate change factors, temperature, has potentially grave implications for human health. We report the first attempt to investigate the association between the daily 3-hour maximum apparent temperature (Tapp(max and respiratory (RD, cardiovascular (CVD, and cerebrovascular (CBD emergency hospital admissions in Copenhagen, controlling for air pollution. The study period covered 1 January 2002-31 December 2006, stratified in warm and cold periods. A case-crossover design was applied. Susceptibility (effect modification by age, sex, and socio-economic status was investigated. For an IQR (8°C increase in the 5-day cumulative average of Tapp(max, a 7% (95% CI: 1%, 13% increase in the RD admission rate was observed in the warm period whereas an inverse association was found with CVD (-8%, 95% CI: -13%, -4%, and none with CBD. There was no association between the 5-day cumulative average of Tapp(max during the cold period and any of the cause-specific admissions, except in some susceptible groups: a negative association for RD in the oldest age group and a positive association for CVD in men and the second highest SES group. In conclusion, an increase in Tapp(max is associated with a slight increase in RD and decrease in CVD admissions during the warmer months.

  2. Fine particulate air pollution and its components in association with cause-specific emergency admissions

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    Koutrakis Petros

    2009-12-01

    Full Text Available Abstract Background Although the association between exposure to particulate matter and health is well established, there remains uncertainty as to whether certain chemical components are more harmful than others. We explored whether the association between cause-specific hospital admissions and PM2.5 was modified by PM2.5 chemical composition. Methods We estimated the association between daily PM2.5 and emergency hospital admissions for cardiac causes (CVD, myocardial infarction (MI, congestive heart failure (CHF, respiratory disease, and diabetes in 26 US communities, for the years 2000-2003. Using meta-regression, we examined how this association was modified by season- and community-specific PM2.5 composition, controlling for seasonal temperature as a surrogate for ventilation. Results For a 10 μg/m3 increase in 2-day averaged PM2.5 concentration we found an increase of 1.89% (95% CI: 1.34- 2.45 in CVD, 2.25% (95% CI: 1.10- 3.42 in MI, 1.85% (95% CI: 1.19- 2.51 in CHF, 2.74% (95% CI: 1.30- 4.2 in diabetes, and 2.07% (95% CI: 1.20- 2.95 in respiratory admissions. The association between PM2.5 and CVD admissions was significantly modified when the mass was high in Br, Cr, Ni, and Na+, while mass high in As, Cr, Mn, OC, Ni, and Na+ modified MI, and mass high in As, OC, and SO42- modified diabetes admissions. For these species, an interquartile range increase in their relative proportion was associated with a 1-2% additional increase in daily admissions per 10 μg/m3 increase in mass. Conclusions We found that PM2.5 mass higher in Ni, As, and Cr, as well as Br and OC significantly increased its effect on hospital admissions. This result suggests that particles from industrial combustion sources and traffic may, on average, have greater toxicity.

  3. Cause-specific hospital admissions on hot days in Sydney, Australia.

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    Pavla Vaneckova

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

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

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

    2016-01-01

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

  5. Short-term associations of fine particulate matter components and emergency hospital admissions among a privately insured population in Greater Houston

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    Liu, Suyang; Ganduglia, Cecilia M.; Li, Xiao; Delclos, George L.; Franzini, Luisa; Zhang, Kai

    2016-12-01

    A number of time-series studies have associated PM2.5 (particulate matter with aerodynamic diameter less than 2.5 μm) mass and components with various health outcomes. No studies have yet examined the associations between PM2.5 components and hospital admissions among a privately insured population. We estimated the short-term associations between exposure to PM2.5 mass and components and emergency hospital admissions for all-cause and cause-specific diseases in Greater Houston, Texas, during 2008-2013 using Blue Cross Blue Shield Texas claims data. A total of 90,085 emergency hospital admissions were included in this study, with an average of 34 ± 10 admissions per day. We selected 20 PM2.5 components from the U.S. Environmental Protection Agency's Chemical Speciation Network site located in Houston, and then applied Poisson regression models to assess the short-term effects of PM2.5 mass and species on emergency hospital admissions. Effects were estimated without adjustment for other airborne pollutants. PM2.5 mass was not statistically significantly associated with increased all-cause emergency hospital admissions and selected cause-specific admissions. For selected PM2.5 species, we found interquartile range increases in arsenic (0.001 μg/m3) and copper (0.017 μg/m3) were significantly (P air pollution.

  6. [Psychogeriatric emergency admissions in the area Eindhoven and the Kempen].

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    Schrijver, T L

    1992-02-01

    In the Netherlands a special arrangement between the Regional Institute for Outpatient Mental Health Care (RIAGG) and nursing homes exists in region Eindhoven to deal with emergency admissions of psychogeriatric patients. Such an arrangement is necessary, because of long waiting lists for psychogeriatric nursing homes. This article describes the circumstances of 47 patients, who were admitted by this special arrangement. The group which had not been known before the crisis by RIAGG or nursing home (n = 21) is compared to those who had already been waiting some time for admission (n = 26). It appears that in the latter group the burden on the care taker becomes too heavy due to behavioural disturbances of the patient, while in the first group the coping abilities of the system decline due to acute illness or death of the care taker.

  7. The full moon and admission to emergency rooms

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    Zargar Moosa

    2004-05-01

    Full Text Available OBJECTIVE: The purpose of this study was to investigate an ancient hypothesis; the moon effect might increase incidence of injuries and hence admission of patients with trauma to Emergency Rooms (ERs on full moon days. METHODS: During thirteen months, 58000 trauma patients admitted in three hospitals that had the highest load of trauma patients in Tehran were studied. Due to lack of complete data, 3543 patients (6.1% were excluded from the study, leaving 54457 cases for further analysis. We selected lunar calendar for our study, so dates of patients′ admissions were converted to lunar months and three day- periods with 15th as middle day were defined as full moon days. RESULTS: In our study the number of trauma patients was not increased during the full moon days against other days of lunar month. Statistical analyses of data didn′t exhibit a positive relation between full moon days and increasing of trauma patient admission to ERs. An association between assault and attempted suicide was not observed around the full moon days either. The results did not show significant reduction of GCS score of patients on full moon days and there was not any increase in severity of traumatic injury sustained during full moon days. CONCLUSIONS: It seems necessary to conduct studies regarding the probability of moon effect through on different database, geographic areas and for appropriate periods in order to reach a conclusive result.

  8. Prospective payments to hospitals: should emergency admissions have higher rates?

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    Melnick, G A; Serrato, C A; Mann, J M

    1989-01-01

    Systematic variation in patient resource use can be a significant problem for a system based on diagnosis-related groups (DRG's) if this variation is not evenly distributed across hospitals. If certain hospitals routinely treat patients who require more services than average under DRG's, the long-run financial viability of these hospitals will be threatened. In this study, the authors examine whether patients who are admitted on an emergency or urgent basis represent an identifiable group of patients whose costs are systematically higher than those of electively admitted patients, controlling for DRG. Alternative approaches for incorporating admission status into a DRG payment system are developed and tested.

  9. After-hours equine emergency admissions at a university referral hospital (1998 - 2007) : causes and interventions

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    Viljoen, A; M.N. Saulez; C.M. Donnellan; Bester, L; B. Gummow

    2009-01-01

    Medical records of equine after-hours admissions from 1998 to 2007 are reviewed. Data extracted from the medical records included signalment, reason for admission, pre-admission treatment, clinical presentation, procedures performed, final diagnoses, complications occurring in hospital, length of stay and outcome. Eight hundred and twenty after-hours admissions were available of which 75 % were classified as emergencies. Most horses originated from Gauteng province (82 %), with Thoroughbred, ...

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

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    Jeffrey J. Guterman

    2016-09-01

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

  11. What aspects of primary care predict emergency admission rates? A cross sectional study

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    Gunther Stephen

    2013-01-01

    Full Text Available Abstract Background From 2004 to 2009 there was almost a 12% rise in emergency admissions in England. This can be explained partly by an aging population and other socio-demographic characteristics, but much cannot be explained by these factors. We explored aspects of care, in addition to known demographic characteristics in general practice, that are associated with emergency admissions. Methods A cross-sectional design employing hospital admission data from 76 general practices in Northamptonshire, England for 2006–08, including demographic data, quality and outcomes framework points and GP patient survey outcomes. Results There were statistically significant associations between emergency admissions and age, gender, distance from hospital and proportion classified as white. There was also a statistically significant relationship between emergency admissions and being able to book an appointment with a preferred doctor; this relationship was stronger in less deprived communities. Conclusions Enabling patients to book with a preferred doctor, particularly those in less deprived communities could have an impact on reducing emergency admissions. It is possible that being able to consult a preferred GP gives patient’s confidence to avoid an emergency admission or it facilitates consistent clinical management that helps prevent the need for admission. However the findings only explained some of the variation.

  12. Using the MDRD value as an outcome predictor in emergency medical admissions.

    LENUS (Irish Health Repository)

    Chin, Jun Liong

    2011-10-01

    Both physiological- and laboratory-derived variables, alone or in combination, have been used to predict mortality among acute medical admissions. Using the Modification of Diet in Renal Disease (MDRD) not as an estimate of glomerular filtration rate but as an outcome predictor for hospital mortality, we examined the relationship between the MDRD value and in-hospital death during an emergency medical admission.

  13. After-hours equine emergency admissions at a university referral hospital (1998 - 2007 : causes and interventions

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    A. Viljoen

    2009-05-01

    Full Text Available Medical records of equine after-hours admissions from 1998 to 2007 are reviewed. Data extracted from the medical records included signalment, reason for admission, pre-admission treatment, clinical presentation, procedures performed, final diagnoses, complications occurring in hospital, length of stay and outcome. Eight hundred and twenty after-hours admissions were available of which 75 % were classified as emergencies. Most horses originated from Gauteng province (82 %, with Thoroughbred, Arabian, and Warmbloods representing 46 %, 10 % and 7 % of horses. Horses had a median age of 7 years and were predominantly male (60 %. Gastrointestinal (64 % and musculoskeletal (19 % disorders were the primary reasons for admission. Anti-inflammatories, sedation and antibiotics were given in 51 %, 20 % and 15 % of cases respectively prior to referral. On admission, 23 % of horses had surgical intervention. Intravenous catheterisation (64 %, rectal examination (61 %, nasogastric intubation (56 %, abdominocentesis (33 % and ultrasonography (19 % were the procedures performed most frequently. Surgical and medical colics constituted 28 % and 27 % respectively of the overall diagnoses, while piroplasmosis was diagnosed in 5 % of horses. Post-admission complications occurred in <2 % of horses. The median length of stay was 4 days (95 % CI: 1 to 21 days. Overall survival to discharge was 74 %. This study demonstrates that the majority of after-hours equine admissions to a university referral hospital required medical intervention and were mostly due to gastrointestinal disorders. Information obtained from this study can be used in emergency referral planning.

  14. Decreasing avoidable hospital admissions with the implementation of an emergency department case management program.

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    Sharieff, Ghazala Q; Cantonis, Matt; Tressler, Michelle; Whitehead, Mary; Russe, Jamie; Lovell, Eric

    2014-01-01

    With the passage of the Affordable Care Act, increased emphasis has been placed on optimizing quality and reducing expenditures. The use of an emergency department case manager (EDCM) is reemerging as an important initiative in the quest to provide high-quality care and decrease unnecessary hospital admissions. A pilot study of the use of EDCMs was conducted in one of the authors' EDs during a 6-month trial period. By using evidence-based criteria, the EDCM helped in real time to verify admission criteria, assisted with inpatient versus outpatient designation, found community alternatives to hospital admission, and initiated discharge planning for patients who required admission and were at high risk for readmission. EDCMs also worked with pharmacists to assist with medication management for patients who required assistance with obtaining prescriptions. Because of the pilot study's success, the authors' health care system will be implementing EDCMs throughout the organization.

  15. Cause-specific mortality after stroke

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    Mogensen, Ulla Brasch; Olsen, Tom Skyhøj; Andersen, Klaus Kaae

    2013-01-01

    We investigated cause-specific mortality in relation to age, sex, stroke severity, and cardiovascular risk factor profile in the Copenhagen Stroke Study cohort with 10 years of follow-up. In a Copenhagen community, all patients admitted to the hospital with stroke during 1992-1993 (n = 988) were...... registered on admission. Evaluation included stroke severity, computed tomography scan, and a cardiovascular risk profile. Cause of death within 10 years according to death certificate information was classified as stroke, heart/arterial disease, or nonvascular disease. Competing-risks analyses were...... performed by cause-specific Cox regression after multiple imputation of missing data, assuming that values were missing at random. Death was due to stroke in 310 patients (31%), to heart/arterial disease in 209 patients (21%), and to nonvascular diseases in 289 patients (29%); 180 patients were still alive...

  16. Process redesign for time-based emergency admission targets.

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    G Leggat, Sandra; Gough, Richard; Bartram, Timothy; Stanton, Pauline; Bamber, Greg J; Ballardie, Ruth; Sohal, Amrik

    2016-09-19

    Purpose Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care. Design/methodology/approach A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010. Non-probability sampling identified interview subjects who, through their participation in the redesign initiative, had a detailed understanding of the implementation and outcomes of the initiative. Between April 2012 and January 2013 26 in-depth semi-structured interviews were conducted and analysed with thematic content analysis. Findings There were four important findings. First, when asked to comment on the impact of the LSS implementation, without prompting the staff spoke of quality of care. Second, there was little agreement among the participants as to whether the project had been successful. Third, despite the recognition of the need for a coordinated effort across the hospital to improve ED access, the redesign process was not successful in reducing existing divides among clinicians and among managers and clinicians. Finally, staff expressed tension between production processes to move patients more quickly and their duty of care to their patients as individuals. Originality/value One of the first studies to explore the impact of process redesign through in-depth interviews with participating staff, this study adds further evidence that organisations implementing process redesign must ensure the supporting management practices are in place.

  17. The Effects of Air Pollution on Cardiovascular and Respiratory Causes of Emergency Admission

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    Shahi, Ali Mohammad; Omraninava, Ali; Goli, Mitra; Soheilarezoomand, Hamid Reza; Mirzaei, Nader

    2014-01-01

    Introduction: Today, air pollution is one of the critical problems in metropolitans and necessary preparations are needed for confronting this crisis. The present study was based on the goal of determining the relationship of air pollutant levels with the rate of emergency admissions for respiratory and cardiovascular patients. Methods: In the present retrospective cross-sectional study, all respiratory and cardiovascular patients, referred to emergency department during 2012, were assessed. The meteorological and air pollution data were collected. Information regarding the numbers and dates (month, day) of admission for respiratory and cardiovascular diseases was achieved from the hospital's electronic registration system. The relation of air pollution and respiratory and cardiovascular admissions were analyzed by generalize additive model (GAM). Results: 5922 patients were assessed which included 4048 (68.36%) cardiovascular and 1874 (31.64%) respiratory. Carbon monoxide (CO) level was an independent risk factor of cardiovascular disease on the same day (RR=1.49; 95% CI: 1.25- 1.77; P<0.001), the day before (RR=1.22; 95% CI: 1.02- 1.45; P=0.03), and the last two days (RR=1.3; 95% CI: 1.09- 1.54; P<0.001). The same process was repeated for ozone (O3). In addition, the O3 level on the same day (RR=1.49; 95% CI: 1.25- 1.77; P<0.001), the day before (RR=1.22; 95% CI: 1.02- 1.45; P=0.03), the last two days (RR=1.3; 95% CI: 1.09- 1.54; P<0.001), and the last week (RR=1.004; 95% CI: 1.0007-1.008; P=0.02) were independent risk factors of respiratory admissions. The increased level of particulate matter less than 2.5 micrometers in diameter (PM2.5) like O3 led to growth in the admissions to emergency department. Conclusion: The findings of the present study suggested that rising levels of CO and O3 during two days leads to a significant increase in cardiovascular admission on the third day. Furthermore, increase in O3, PM2.5, nitrogen dioxide (NO2), and CO levels causes a

  18. No effect of lunar cycle on psychiatric admissions or emergency evaluations.

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    McLay, Robert N; Daylo, Amado A; Hammer, Paul S

    2006-12-01

    It is a popularly held belief that psychiatric behavior worsens during a full moon. Research in this area has yielded mixed results. Records from Naval Medical Center San Diego for 1993-2001 were examined to see whether there were higher rates of psychiatric admission associated with particular phases of the moon. Records from 8,473 admissions revealed that there were no more admission on days with a full moon, a new moon, any quarter of the moon, a waxing moon, or a waning moon. This held true for psychiatric patients as a whole, as well as for individuals with particular diagnoses, such as those with a mood disorder or psychotic disorder. Records from 1,909 emergency psychiatric evaluations that occurred between 2002 and 2003 were also examined to see whether a higher percentage of patients might present, but not require hospitalization, during a particular phase of the moon. Once again, no significant effect was found. In summary, lunar phase was not associated in any significant way with psychiatric admissions or emergency presentation.

  19. Health utility after emergency medical admission: a cross-sectional survey

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    Goodacre Steve W

    2012-02-01

    Full Text Available Abstract Objectives Health utility combines health related quality of life and mortality to produce a generic outcome measure reflecting both morbidity and mortality. It has not been widely used as an outcome measure in evaluations of emergency care and little is known about the feasibility of measurement, typical values obtained or baseline factors that predict health utility. We aimed to measure health utility after emergency medical admission, to compare health utility to age, gender and regional population norms, and identify independent predictors of health utility. Methods We selected 5760 patients across three hospitals who were admitted to hospital by ambulance as a medical emergency. The EQ-5D questionnaire was mailed to all who were still alive 30 days after admission. Health utility was estimated by applying tariff values to the EQ-5D responses or imputing a value of zero for those who had died. Multivariable analysis was used to identify independent predictors of health utility at 30 days. Results Responses were received from 2488 (47.7% patients, while 541 (9.4% had died. Most respondents reported some or severe problems with each aspect of health. Mean health utility was 0.49 (standard deviation 0.35 in survivors and 0.45 (0.36 including non-survivors. Some 75% had health utility below their expected value (mean loss 0.32, 95% confidence interval 0.31 to 0.33 and 11% had health utility below zero (worse than death. On multivariable modelling, reduced health utility was associated with increased age and lower GCS, varied according to ICD10 code and was lower among females, patients with recent hospital admission, steroid therapy, or history of chronic respiratory disease, malignancy, diabetes or epilepsy. Conclusions Health utility can be measured after emergency medical admission, although responder bias may be significant. Health utility after emergency medical admission is poor compared to population norms. We have identified

  20. Internal medicine and emergency admissions: from a national hospital discharge records (SDO study to a regional analysis

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    Filomena Pietrantonio

    2016-02-01

    Full Text Available In Italy, the number of internists has grown by 10% since 1990 reaching 11,435 units, they manage 39,000 beds in 1060 Internal Medicine (IM wards. The Internists are expected to ensure a cost-effective management of poly-pathological and complex patients. A collaborative study between the Federation of Associations of Hospital Doctors on Internal Medicine (FADOI and the Consortium for Applied Health Economics Research (C.R.E.A. Sanità based on data from hospital discharge records has been conducted starting from November 2014. In this article the preliminary results are shown with focus on emergency admissions characteristics to contribute to define the role of hospital IM. Evaluation is performed comparing emergency and planned admissions, IM impact on hospital admissions, availability of community-based healthcare services, diagnosis-related groups (DRGs weight in IM and regional differences in managing hospital admissions with focus on IM department. In 2013 IM wards discharged 1,073,526 patients (16.18% of the total discharged by hospitals with a total economic value of 3,426,279.88 € (average DRG 3882.80 €, from 3682.19 to 4083.42. The average length of stay (LOS in IM was 9.3 days. IM covers 27% of admissions from Emergency Room. Determinants significantly affecting the emergency admissions are old age and comorbidities of the patients that also have a role in increasing LOS. 55% of Italian hospital admissions are emergency admissions. Hospitalization rates in emergency are systematically higher than those in election and the greatest differences are in the regions with inefficiently organized regional network. The role of the hospital IM appears central in the offer of beds to the emergency room by accepting 27% of urgent admissions. The increasing impact of IM on hospital management will put the internists as authoritative stakeholders in health policy.

  1. Vital Signs Predict Rapid-Response Team Activation within Twelve Hours of Emergency Department Admission

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    James M. Walston

    2016-05-01

    Full Text Available Introduction: Rapid-response teams (RRTs are interdisciplinary groups created to rapidly assess and treat patients with unexpected clinical deterioration marked by decline in vital signs. Traditionally emergency department (ED disposition is partially based on the patients’ vital signs (VS at the time of hospital admission. We aimed to identify which patients will have RRT activation within 12 hours of admission based on their ED VS, and if their outcomes differed. Methods: We conducted a case-control study of patients presenting from January 2009 to December 2012 to a tertiary ED who subsequently had RRT activations within 12 hours of admission (early RRT activations. The medical records of patients 18 years and older admitted to a non-intensive care unit (ICU setting were reviewed to obtain VS at the time of ED arrival and departure, age, gender and diagnoses. Controls were matched 1:1 on age, gender, and diagnosis. We evaluated VS using cut points (lowest 10%, middle 80% and highest 10% based on the distribution of VS for all patients. Our study adheres to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology guidelines for reporting observational studies. Results: A total of 948 patients were included (474 cases and 474 controls. Patients who had RRT activations were more likely to be tachycardic (odds ratio [OR] 2.02, 95% CI [1.25-3.27], tachypneic (OR 2.92, 95% CI [1.73-4.92], and had lower oxygen saturations (OR 2.25, 95% CI [1.42-3.56] upon arrival to the ED. Patients who had RRT activations were more likely to be tachycardic at the time of disposition from the ED (OR 2.76, 95% CI [1.65-4.60], more likely to have extremes of systolic blood pressure (BP (OR 1.72, 95% CI [1.08-2.72] for low BP and OR 1.82, 95% CI [1.19-2.80] for high BP, higher respiratory rate (OR 4.15, 95% CI [2.44-7.07] and lower oxygen saturation (OR 2.29, 95% CI [1.43-3.67]. Early RRT activation was associated with increased healthcare

  2. Excellence and diversity: The Emergence of Selective Admission Policies in Dutch Higher Education - A Case Study on Amsterdam University College

    NARCIS (Netherlands)

    Reumer, Christoffel; Wende, van der Marijk

    2010-01-01

    This paper explores the emergence of selective admission policies in Dutch university education. Such policies are being developed to promote excellence in a higher education system that is generally known to be “egalitarian” and increasingly criticized for a lack of differentiation. The changing po

  3. Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yu Wang; Adrian Barnett; Yu-Ming Guo; Wei-Wei Yu; Xiao-Ming Shen; Shi-Lu Tong

    2014-01-01

    Background: Heatwaves have a significant impact on population health including both morbidity and mortality. In this study we examined the association between heatwaves and emergency hospital admissions (EHAs) for renal diseases in children (aged 0-14 years) in Brisbane, Australia. Methods: Daily data on EHAs for renal diseases in children and exposure to temperature and air pollution were obtained for Brisbane city from January 1, 1996 to December 31, 2005. A time-stratified case-crossover design was used to compare the risks for renal diseases between heatwave and non-heatwave periods. Results: There were 1565 EHAs for renal diseases in children during the study period. Heatwaves exhibited a signifi cant impact on EHAs for renal diseases in children after adjusting for confounding factors (odds ratio: 3.6; 95% confidence interval: 1.4-9.5). The risk estimates differed with lags and the use of different heatwave defi nitions. Conclusions: There was a significant increase in EHAs for renal diseases in children during heatwaves in Brisbane, a subtropical city where people are well accustomed to warm weather. This finding may have significant implications for pediatric renal care, particularly in subtropical and tropical regions.

  4. The association between space weather conditions and emergency hospital admissions for myocardial infarction during different stages of solar activity

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    Vencloviene, J.; Antanaitiene, J.; Babarskiene, R.

    2016-11-01

    A number of studies have established the effects of space weather on the human cardio-vascular system. We investigated whether geomagnetic storms (GS), solar proton events (SPEs), and X-class solar flare affect the risk of emergency hospitalization for acute myocardial infarction (MI) separately during declining (2004-2006) and rising (2010-2012) phases of solar activity. The data on hospital admissions for MI were obtained from the computer database of Lithuanian University of Health sciences from January 1, 2004 to December 31, 2012. We evaluated the associations between space weather conditions and the daily number of emergency admissions for MI by Poisson regression, controlling for seasonal variation and weekdays. During 2004-2006, an increase in the risk of hospital admission for MI was observed on days of the daily mean proton >10 MeV flux >100 pfu (by 63%, phospital admission for MI was observed on days of the daily mean proton >10 MeV flux >100 pfu (by 52%, p=0.015) and on days of GS and 1-2 days after GS (by 17%, p=0.024). These findings suggest that the impact of hazardous space weather conditions on human health depends of the strength of space storm during the investigated period.

  5. Diagnostic accuracy of PAT-POPS and ManChEWS for admissions of children from the emergency department

    OpenAIRE

    Cotterill, Sarah; Rowland, Andrew G; Kelly, Jacqueline; Lees, Helen; Kamara, Mohammed

    2016-01-01

    Background The Pennine Acute Trust (PAT) Paediatric Observation Priority Score (PAT-POPS) is a specific emergency department (ED) physiological and observational aggregate scoring system, with scores of 0–18. A higher score indicates greater likelihood of admission. The Manchester Children's Early Warning System (ManChEWS) assesses six physiological observations to create a trigger score, classified as Green, Amber or Red. Methods Prospectively collected data were used to calculate PAT-POPS a...

  6. The impact of the Lisbon Football Derby on the profile of emergency department admissions.

    Science.gov (United States)

    Almeida, André; Eusébio, Mónica; Almeida, Jaime; Boattini, Matteo

    2014-01-01

    IntroduçÉo: Está descrita a ocorrência de variações nas admissões ao serviço de urgência como resultado de eventos desportivos importantes. O estudo que apresentamos avaliou mudanças no volume e tipo de visitas a um serviço de urgência central de Lisboa durante e após o derby futebolístico da cidade.Material e Métodos: Analisámos retrospectivamente o volume de admissões e a categoria de urgência atribuída pela Triagem de Manchester, de 2008 a 2011. Recolhemos dados relativos a períodos de 24 horas com início 45 minutos antes dos jogos, assim como dados relativos a períodos semelhantes nos dias da semana correspondentes dos anos anteriores, para controlo. Organizaram-se os dados por espaços temporais (durante e pós-jogo) e categoria de urgência, após o que se emparelharam.Resultados: Analisaram-se 14 períodos (sete com jogo e sete sem jogo) e um total de 5861 admissões. Durante o jogo verificou-se uma reduçÉo de 20,6% (p = 0,06) no número total de admissões face aos dias controlo. Na sub-análise das categorias da Triagem de Manchester a reduçÉo foi estatisticamente significativa (26,5%; p = 0,05) apenas nas admissões menos urgentes (categorias verdeazul). Comparado com o controlo, o pós-jogo mostrou um aumento global do número de admissões (5,6%; p = 0,45), significativo somente quando consideradas as menos urgentes (18,9%; p = 0,05).DiscussÉo: Durante os jogos o número total de admissões ao serviço de urgência sofreu um decréscimo, ocorrendo nas horas subsequentes um aumento das mesmas. Estas variações só foram significativas nas categorias de triagem verde-azul.ConclusÉo: Durante eventos desportivos importantes parece dar-se uma reduçÉo nas admissões ao serviço de urgência, sobretudo devido a uma diminuiçÉo das visitas associadas a situações menos graves.

  7. Are some areas more equal than others? Socioeconomic inequality in potentially avoidable emergency hospital admissions within English local authority areas

    Science.gov (United States)

    Asaria, Miqdad; Barratt, Helen; Raine, Rosalind; Cookson, Richard

    2016-01-01

    Objectives Reducing health inequalities is an explicit goal of England’s health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000). We measured absolute inequality gradients nationally and within each administrative area using neighbourhood-level linear models of the relationship between national deprivation and age–sex-adjusted emergency admission rates. We assessed local equity performance by comparing local inequality against national inequality to identify areas significantly more or less equal than expected; evaluated stability over time; and identified where equity performance was steadily improving or worsening. We then examined associations between change in socioeconomic inequalities and change in within-area deprivation (gentrification). Finally, we used administrative area-level random and fixed effects models to examine the contribution of primary care to inequalities in admissions. Results Data on 316 administrative areas were included in the analysis. Local inequalities were fairly stable between consecutive years, but 32 areas (10%) showed steadily improving or worsening equity. In the 21 improving areas, the gap between most and least deprived fell by 3.9 admissions per 1000 (six times the fall nationally) between 2004/5 and 2011/12, while in the 11 areas worsening, the gap widened by 2.4. There was no indication that measured improvements in local equity were an artefact of gentrification or that changes in primary care supply or quality contributed to changes in

  8. Association between Ambient Air Pollution and Hospital Emergency Admissions for Respiratory and Cardiovascular Diseases in Beijing:a Time Series Study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ying; WANG Shi Gong; MA Yu Xia; SHANG Ke Zheng; CHENG Yi Fan; LI Xu; NING Gui Cai; ZHAO Wen Jing; LI Nai Rong

    2015-01-01

    Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model (GAM) was used to evaluate the specific influences of air pollutants (PM10, SO2, and NO2) on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction. Results It was found that a 10 µg/m3 increase in concentration of PM10 at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 µg/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 µg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions. Conclusion This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.

  9. Impact of short-term temperature variability on emergency hospital admissions for schizophrenia stratified by season of birth

    Science.gov (United States)

    Zhao, Desheng; Zhang, Xulai; Xu, Zhiwei; Cheng, Jian; Xie, Mingyu; Zhang, Heng; Wang, Shusi; Li, Kesheng; Yang, Huihui; Wen, Liying; Wang, Xu; Su, Hong

    2016-08-01

    Diurnal temperature range (DTR) and temperature change between neighboring days (TCN) are important meteorological indicators closely associated with global climate change. However, up to date, there have been no studies addressing the impacts of both DTR and TCN on emergency hospital admissions for schizophrenia. We conducted a time-series analysis to assess the relationship between temperature variability and daily schizophrenia onset in Hefei, an inland city in southeast China. Daily meteorological data and emergency hospital admissions for schizophrenia from 2005 to 2014 in Hefei were collected. After stratifying by season of birth, Poisson generalized linear regression combined with distributed lag nonlinear model (DLNM) was used to examine the relationship between temperature variability and schizophrenia, adjusting for long-term trend and seasonality, mean temperature, and relative humidity. Our analysis revealed that extreme temperature variability may increase the risk for schizophrenia onset among patients born in spring, while no such association was found in patients born in summer and autumn. In patients born in spring, the relative risks of extremely high DTR comparing the 95th and 99th percentiles with the reference (50th, 10 °C) at 3-day lag were 1.078 (95 % confidence interval (CI) 1.025-1.135) and 1.159 (95 % CI 1.050-1.279), respectively. For TCN effects, only comparing 99th percentile with reference (50th, 0.7 °C) was significantly associated with emergency hospital admissions for schizophrenia (relative risk (RR) 1.111, 95 % CI 1.002-1.231). This study suggested that exposure to extreme temperature variability in short-term may trigger later days of schizophrenia onset for patients born in spring, which may have important implications for developing intervention strategies to prevent large temperature variability exposure.

  10. Hospital-based inter-professional strategy to reduce in-patient admissions and emergency department visits for pediatric asthma.

    Science.gov (United States)

    Fleming, Karen; Kuzik, Brian; Chen, Chee

    2011-01-01

    Pediatric asthma is a common reason for emergency department (ED) visits and in-patient hospital admissions. Evidence demonstrates that asthma management initiated in the ED has limited benefit unless followed by ongoing coordinated inter-professional care (IPC). The Royal Victoria Hospital (RVH) of Barrie, Ontario, has developed a best practice model of care for pediatric asthma. Primary care providers and ED physicians are actively encouraged to refer children with any recurrent respiratory problems consistent with asthma to the Paediatric Asthma Clinic (PAC). Quarterly PAC visits with a certified asthma educator and a pediatrician include lung function measurement, written action plans and primary care provider communication. Ongoing outcome monitoring of patients receiving IPC has revealed that, compared with 12 months prior to enrolment in the PAC, patients show a two-thirds decrease in asthma-related ED visits and an 85% decrease in admissions. The PAC has contributed to an ongoing decline in the rates of pediatric asthma-related ED visits and admissions at RVH, which are currently less than half the rates seen at our peer hospitals. IPC for chronic diseases is best practice, and our model of care for pediatric asthma continues to provide critical data demonstrating and supporting the advantages of IPC in chronic disease management. RVH modifies practice and policy to meet best practices, optimizing the care provided to children with pediatric asthma.

  11. Relationships between deprivation and duration of children's emergency admissions for breathing difficulty, feverish illness and diarrhoea in North West England: an analysis of hospital episode statistics

    Directory of Open Access Journals (Sweden)

    Kyle Richard G

    2012-03-01

    Full Text Available Abstract Background In the United Kingdom there has been a long term pattern of increases in children's emergency admissions and a substantial increase in short stay unplanned admissions. The emergency admission rate (EAR per thousand population for breathing difficulty, feverish illness and diarrhoea varies substantially between children living in different Primary Care Trusts (PCTs. However, there has been no examination of whether disadvantage is associated with short stay unplanned admissions at PCT-level. The aim of this study was to determine whether differences between emergency hospital admission rates for breathing difficulty, feverish illness and diarrhoea are associated with population-level measures of multiple deprivation and child well-being, and whether there is variation by length of stay and age. Methods Analysis of hospital episode statistics and secondary analysis of Index of Multiple Deprivation (IMD 2007 and Local Index of Child Well-being (CWI 2009 in ten adjacent PCTs in North West England. The outcome measure for each PCT was the emergency admission rate to hospital for breathing difficulty, feverish illness and diarrhoea. Results 23,496 children aged 0-14 were discharged following emergency admission for breathing difficulty, feverish illness and/or diarrhoea during 2006/07. The emergency admission rate ranged from 27.9 to 62.7 per thousand. There were no statistically significant relationships between shorter (0 to 3 day hospitalisations and the IMD or domains of the CWI. The rate for hospitalisations of 4 or more days was associated with the IMD (Kendall's taub = 0.64 and domains of the CWI: Environment (taub = 0.60; Crime (taub = 0.56; Material (taub = 0.51; Education (taub = 0.51; and Children in Need (taub = 0.51. This pattern was also evident in children aged under 1 year, who had the highest emergency admission rates. There were wide variations between the proportions of children discharged on the day of admission

  12. Impact of admission screening for methicillin-resistant Staphylococcus aureus on the length of stay in an emergency department.

    LENUS (Irish Health Repository)

    Gilligan, P

    2010-06-01

    Preventing and controlling methicillin-resistant Staphylococcus aureus (MRSA) includes early detection and isolation. In the emergency department (ED), such measures have to be balanced with the requirement to treat patients urgently and transfer quickly to an acute hospital bed. We assessed, in a busy and overcrowded ED, the contribution made to a patient\\'s stay by previous MRSA risk group identification and by selective rescreening of those patients who were previously documented in the research hospital as being MRSA positive. Patients with a previous diagnosis of MRSA colonisation were flagged automatically as \\'risk group\\' (RG) on their arrival in the ED and were compared with \\'non-risk group\\' (NRG), i.e. not previously demonstrated in the research hospital to be infected or colonised with MRSA. Over an 18 month period, there were 16 456 admissions via the ED, of which 985 (6%) were RG patients. The expected median times to be admitted following a request for a ward bed for NRG and RG patients were 10.4 and 12.9h, respectively. Female sex, age >65 years, and RG status all independently predicted a statistically significantly longer stay in the ED following a request for a hospital bed. We consider that national and local policies for MRSA need to balance the welfare of patients in the ED with the need to comply with best practice, when there are inadequate ED and inpatient isolation facilities. Patients with MRSA requiring emergency admission must have a bed available for them.

  13. Reorganisation of acute referral to an emergency department resulted in fewer admissions for chronic obstructive pulmonary disease but in higher rates of non-invasive ventilation

    DEFF Research Database (Denmark)

    Titlestad, Ingrid Louise; Bryde, Jonas; Oberg-Hansen, Bo

    2014-01-01

    .3%) compared with 2010 (36 admissions; 4.5%), but no referrals to the intensive care unit or deaths were registered during the hospitalisation in either of the groups, but one patient died within 30 days after admission from the DEM. FUNDING: This project was funded by an Odense University Hospital research...... medical records were retrieved from two COPD cohorts: 1) all patients admitted to DEM between 1 July and 31 December 2012 and 2) all patients admitted to the Medical Emergency Ward, Odense University Hospital (MEW) in 2010. RESULTS: There were 300 eligible admissions comprising 236 unique patients in DEM......INTRODUCTION: We performed an audit on all admissions with chronic obstructive pulmonary disease (COPD) in ex-acerbation to the Department of Emergency Medicine, Odense University Hospital (DEM) in the second half of 2012 to evaluate if an organisational change had altered visitation, treatment...

  14. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Science.gov (United States)

    Pinna, Giuliano; Pascale, Claudio; Fornengo, Paolo; Arras, Sebastiana; Piras, Carmela; Panzarasa, Pietro; Carmosino, Gianpaolo; Franza, Orietta; Semeraro, Vincenzo; Lenti, Salvatore; Pietrelli, Susanna; Panzone, Sergio; Bracco, Christian; Fiorini, Roberto; Rastelli, Giovanni; Bergandi, Daniela; Zampaglione, Bruno; Musso, Roberto; Marengo, Claudio; Santoro, Giancarlo; Zamboni, Sergio; Traversa, Barbara; Barattini, Maddalena; Bruno, Graziella

    2014-01-01

    Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, phypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (phypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  15. Education and Cause-specific Mortality

    DEFF Research Database (Denmark)

    Nordahl, Helene; Lange, Theis; Osler, Merete;

    2014-01-01

    BACKGROUND: Differential exposures to behavioral risk factors have been shown to play an important mediating role on the education-mortality relation. However, little is known about the extent to which educational attainment interacts with health behavior, possibly through differential...... vulnerability. METHODS: In a cohort study of 76,294 participants 30 to 70 years of age, we estimated educational differences in cause-specific mortality from 1980 through 2009 and the mediating role of behavioral risk factors (smoking, alcohol intake, physical activity, and body mass index). With the use...... of marginal structural models and three-way effect decomposition, we simultaneously regarded the behavioral risk factors as intermediates and clarified the role of their interaction with educational exposure. RESULTS: Rate differences in mortality comparing participants with low to high education were 1...

  16. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

    Directory of Open Access Journals (Sweden)

    Giuliano Pinna

    Full Text Available Epidemiological data on the impact of hypertensive crises (emergencies and urgencies on referral to the Emergency Departments (EDs are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg. We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9, and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises were acute pulmonary edema (30.9%, stroke (22.0%,, myocardial infarction (17.9%, acute aortic dissection (7.9%, acute renal failure (5.9% and hypertensive encephalopathy (4.9%. Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p<0.001. Even among known hypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (p<0.001. Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70, independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

  17. Urban air pollution and emergency room admissions for respiratory symptoms: a case-crossover study in Palermo, Italy

    Directory of Open Access Journals (Sweden)

    Calamusa Giuseppe

    2011-04-01

    Full Text Available Abstract Background Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo, the largest metropolitan area in Sicily, urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements, and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute respiratory symptoms. Methods From January 2004 through December 2007, air pollutant concentrations and emergency room visits were collected for a case-crossover study conducted in Palermo, Sicily. Risk estimates of short-term exposures to particulate matter and gaseous ambient pollutants including carbon monoxide, nitrogen dioxide, and sulfur dioxide were calculated by using a conditional logistic regression analysis. Results Emergency departments provided data on 48,519 visits for respiratory symptoms. Adjusted case-crossover analyses revealed stronger effects in the warm season for the most part of the pollutants considered, with a positive association for PM10 (odds ratio = 1.039, 95% confidence interval: 1.020 - 1.059, SO2 (OR = 1.068, 95% CI: 1.014 - 1.126, nitrogen dioxide (NO2: OR = 1.043, 95% CI: 1.021 - 1.065, and CO (OR = 1.128, 95% CI: 1.074 - 1.184, especially among females (according to an increase of 10 μg/m3 in PM10, NO2, SO2, and 1 mg/m3 in CO exposure. A positive association was observed either in warm or in cold season only for PM10. Conclusions Our findings suggest that, in our setting, exposure to ambient levels of air pollution is an important determinant of emergency room (ER visits for acute respiratory symptoms, particularly during the warm season. ER admittance may be considered a good proxy to evaluate the adverse effects of air pollution on respiratory health.

  18. Demographic and socioeconomic inequalities in the risk of emergency hospital admission for violence: cross-sectional analysis of a national database in Wales

    Science.gov (United States)

    Fone, David; Gartner, Andrea; Bellis, Mark A

    2016-01-01

    Objectives To investigate the risk of emergency hospital admissions for violence (EHAV) associated with demographic and socioeconomic factors in Wales between 2007/2008 and 2013/2014, and to describe the site of injury causing admission. Design Database analysis of 7 years’ hospital admissions using the Patient Episode Database for Wales (PEDW). Setting and participants Wales, UK, successive annual populations ∼2.8 million aged 0–74 years. Primary outcome The first emergency admission for violence in each year of the study, defined by the International Classification of Diseases V.10 (ICD-10) codes for assaults (X85-X99, Y00-Y09) in any coding position. Results A total of 11 033 admissions for assault. The majority of admissions resulted from head injuries. The overall crude admission rate declined over the study period, from 69.9 per 100 000 to 43.2 per 100 000, with the largest decrease in the most deprived quintile of deprivation. A generalised linear count model with a negative binomial log link, adjusted for year, age group, gender, deprivation quintile and settlement type, showed the relative risk was highest in age group 18–19 years (RR=6.75, 95% CI 5.88 to 7.75) compared with the reference category aged 10–14 years. The risk decreased with age after 25 years. Risk of admission was substantially higher in males (RR=4.55, 95% CI 4.31 to 4.81), for residents of the most deprived areas of Wales (RR=3.60, 95% CI 3.32 to 3.90) compared with the least deprived, and higher in cities (RR=1.37, 95% CI 1.27 to 1.49) and towns (RR=1.32, 95% CI 1.21 to 1.45) compared with villages. Conclusions Despite identifying a narrowing in the gap between prevalence of violence in richer and poorer communities, violence remains strongly associated with young men living in areas of socioeconomic deprivation. There is potential for a greater reduction, given that violence is mostly preventable. Recommendations for reducing inequalities in the risk of

  19. Abnormal vital signs are strong predictors for Intensive Care Unit admission and in-hospital mortality in adults triaged in the Emergency Department - A prospective cohort study

    DEFF Research Database (Denmark)

    Barfod, Charlotte; Laurtizen, Marlene Mp; Danker, Jakob K

    2012-01-01

    outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerod Acute Process Triage (HAPT) system and the outcome measures; Admission to Intensive Care Unit (ICU) and in-hospital mortality, and to identify the vital signs......, scored and categorized at admission, that are most strongly associated with the outcome measures. METHODS: The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT) and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category...... for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED) from the Acute Admission Database. We performed regression...

  20. Development and validation of predictive MoSaiCo (Modello Statistico Combinato on emergency admissions: can it also identify patients at high risk of frailty?

    Directory of Open Access Journals (Sweden)

    Pasquale Falasca

    2011-01-01

    Full Text Available The prospective historical cohort study develops and validates a method of identifying patients at high risk of emergency admission to hospital in the population of the Province of Ravenna (no. = 296 641. The main outcome measure is: emergency hospital admission analyzed using multivariate logistic regression (MoSaiCo - Modello Statistico Combinato. To validate the findings, the coefficients for 30 most powerful variables found on half of the population (derivation data set were then applied to the rest of the population (validation data set. The key predicting factors included some demographic variables, social variables, clinical variables and use of health/social services. Discriminatory power and validation both reached good results. Risk score increases when variables indicating the individual vulnerability raise. The predictive frailty risk resulting from MoSaiCo allows to stratify the population, to organize care services, to provide a practical planning tool in the field of case management and management of frail patients.

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

    Science.gov (United States)

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

    2017-01-01

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

  2. The trauma patient in hemorrhagic shock: how is the C-priority addressed between emergency and ICU admission?

    Directory of Open Access Journals (Sweden)

    Peiniger Sigune

    2012-12-01

    Full Text Available Abstract Background Trauma is the leading cause of death in young people with an injury related mortality rate of 47.6/100,000 in European high income countries. Early deaths often result from rapidly evolving and deteriorating secondary complications e.g. shock, hypoxia or uncontrolled hemorrhage. The present study assessed how well ABC priorities (A: Airway, B: Breathing/Ventilation and C: Circulation with hemorrhage control with focus on the C-priority including coagulation management are addressed during early trauma care and to what extent these priorities have been controlled for prior to ICU admission among patients arriving to the ER in states of moderate or severe hemorrhagic shock. Methods A retrospective analysis of data documented in the TraumaRegister of the ‘Deutsche Gesellschaft für Unfallchirurgie’ (TR-DGU® was conducted. Relevant clinical and laboratory parameters reflecting status and basic physiology of severely injured patients (ISS ≥ 25 in either moderate or severe shock according to base excess levels (BE -2 to -6 or BE  Results A total of 517 datasets was eligible for analysis. Upon ICU admission shock was reversed to BE > -2 in 36.4% and in 26.4% according to the subgroups. Two of three patients with initially moderate shock and three out of four patients with severe shock upon ER arrival were still in shock upon ICU admission. All patients suffered from coagulation dysfunction upon ER arrival (Quick’s value ≤ 70%. Upon ICU admission 3 out of 4 patients in both groups still had a disturbed coagulation function. The number of patients with significant thrombocytopenia had increased 5-6 fold between ER and ICU admission. Conclusion The C-priority including coagulation management was not adequately addressed during primary survey and initial resuscitation between ER and ICU admission, in this cohort of severely injured patients.

  3. Effect of Air Pollution on the Emergency Admissions of Cardiovascular and Respiratory Patients, Using the Air Quality Model: A Study in Tehran, 2005-2014

    Directory of Open Access Journals (Sweden)

    Majid Kermani

    2016-04-01

    Full Text Available Background: Air pollution is one of the most important factors threatening the health of citizens. It increases the prevalence of cardiovascular and respiratory diseases as well as emergency admissions to hospitals in the polluted metropolitan cities. The present study was conducted using Air Quality (AirQ model and aimed to investigate the effects of air pollution on the number of emergency cardiovascular and respiratory patients admissions in Tehran hospitals during 2005-2014. Materials and Methods: This was cross-sectional study. First, the needed hourly information was received from the Bureau of Air Quality Control, and the Environmental Protection Agency of Tehran City. Then, the information was validated according to WHO criteria, and the statistical indicators and the stages required to quantify the harmful effects of air pollutants were calculated by using appropriate application. Results: According to the results, the number of cases admitted to the emergency ward of hospitals due to heart diseases (by exposure to particulate matter during the years 2005 to 2014 were respectively 1797, 1280, 1766, 1980, 2132, 2703, 2389, 2594, 2158, and 2291 cases, totaling 20990 persons, and for respiratory diseases (due to exposure to particulate matter during the same years were respectively 4643, 3301, 4650, 5117, 5511, 6999, 6180, 6452, 5577, and 5922 cases, totaling 54352 people. Also, the number of cases admitted to the emergency wards of hospitals due to chronic obstructive pulmonary disease caused by exposure to emissions of pollutants such as sulfur dioxide, nitrogen dioxide, and ozone were respectively, 1806, 2454, and 2941 cases. Conclusion: Air pollution in Tehran increases the load of emergency visits to hospitals and increases the risk of respiratory and heart diseases. Therefore, measures to reduce and control air pollution and to prepare, equip, and mobilize hospitals, particularly emergency wards, are among important priorities that

  4. Cost-effectiveness of an intervention to reduce emergency re-admissions to hospital among older patients.

    Directory of Open Access Journals (Sweden)

    Nicholas Graves

    Full Text Available BACKGROUND: The objective is to estimate the cost-effectiveness of an intervention that reduces hospital re-admission among older people at high risk. A cost-effectiveness model to estimate the costs and health benefits of the intervention was implemented. METHODOLOGY/PRINCIPAL FINDINGS: The model used data from a randomised controlled trial conducted in an Australian tertiary metropolitan hospital. Participants were acute medical admissions aged >65 years with at least one risk factor for re-admission: multiple comorbidities, impaired functionality, aged >75 years, recent multiple admissions, poor social support, history of depression. The intervention was a comprehensive nursing and physiotherapy assessment and an individually tailored program of exercise strategies and nurse home visits with telephone follow-up; commencing in hospital and continuing following discharge for 24 weeks. The change to cost outcomes, including the costs of implementing the intervention and all subsequent use of health care services, and, the change to health benefits, represented by quality adjusted life years, were estimated for the intervention as compared to existing practice. The mean change to total costs and quality adjusted life years for an average individual over 24 weeks participating in the intervention were: cost savings of $333 (95% Bayesian credible interval $ -1,932:1,282 and 0.118 extra quality adjusted life years (95% Bayesian credible interval 0.1:0.136. The mean net-monetary-benefit per individual for the intervention group compared to the usual care condition was $7,907 (95% Bayesian credible interval $5,959:$9,995 for the 24 week period. CONCLUSIONS/SIGNIFICANCE: The estimation model that describes this intervention predicts cost savings and improved health outcomes. A decision to remain with existing practices causes unnecessary costs and reduced health. Decision makers should consider adopting this program for elderly hospitalised patients.

  5. Validity of the International Classification of Diseases 10th revision code for hyperkalaemia in elderly patients at presentation to an emergency department and at hospital admission

    Science.gov (United States)

    Fleet, Jamie L; Shariff, Salimah Z; Gandhi, Sonja; Weir, Matthew A; Jain, Arsh K; Garg, Amit X

    2012-01-01

    Objectives Evaluate the validity of the International Classification of Diseases, 10th revision (ICD-10) code for hyperkalaemia (E87.5) in two settings: at presentation to an emergency department and at hospital admission. Design Population-based validation study. Setting 12 hospitals in Southwestern Ontario, Canada, from 2003 to 2010. Participants Elderly patients with serum potassium values at presentation to an emergency department (n=64 579) and at hospital admission (n=64 497). Primary outcome Sensitivity, specificity, positive-predictive value and negative-predictive value. Serum potassium values in patients with and without a hyperkalaemia code (code positive and code negative, respectively). Results The sensitivity of the best-performing ICD-10 coding algorithm for hyperkalaemia (defined by serum potassium >5.5 mmol/l) was 14.1% (95% CI 12.5% to 15.9%) at presentation to an emergency department and 14.6% (95% CI 13.3% to 16.1%) at hospital admission. Both specificities were greater than 99%. In the two settings, the positive-predictive values were 83.2% (95% CI 78.4% to 87.1%) and 62.0% (95% CI 57.9% to 66.0%), while the negative-predictive values were 97.8% (95% CI 97.6% to 97.9%) and 96.9% (95% CI 96.8% to 97.1%). In patients who were code positive for hyperkalaemia, median (IQR) serum potassium values were 6.1 (5.7 to 6.8) mmol/l at presentation to an emergency department and 6.0 (5.1 to 6.7) mmol/l at hospital admission. For code-negative patients median (IQR) serum potassium values were 4.0 (3.7 to 4.4) mmol/l and 4.1 (3.8 to 4.5) mmol/l in each of the two settings, respectively. Conclusions Patients with hospital encounters who were ICD-10 E87.5 hyperkalaemia code positive and negative had distinct higher and lower serum potassium values, respectively. However, due to very low sensitivity, the incidence of hyperkalaemia is underestimated. PMID:23274674

  6. Admission rates for emergency department patients with venous thromboembolism and estimation of the proportion of low risk pulmonary embolism patients: a US perspective

    Science.gov (United States)

    Singer, Adam J.; Thode, Henry C.; Peacock, W. Frank

    2016-01-01

    Objective Introduction of target specific anticoagulants and recent guidelines encourage outpatient management of low risk patients with venous thromboembolism. We describe hospital admission rates over time for patients presenting to US emergency departments (EDs) with deep vein thrombosis (DVT) and pulmonary embolism (PE) and estimate the proportion of low-risk PE patients who could potentially be managed as outpatients. Methods We performed a structured analysis of the National Hospital Ambulatory Medical Care Survey (a nationally representative weighted sampling of US ED visits) database for the years 2006–2010 including all adult patients with a primary diagnosis of DVT or PE. Simplified pulmonary embolus scoring index (sPESI) scores were determined in patients with PE to identify low risk patients. Results There were an estimated 652,000 and 394,000 ED visits for DVT and PE over the 5-year period (0.17%). Mean (SE) age was 59 (1.3), 50% were female, and 40% were > 65 years. Admission rates for DVT and PE were 52% and 90% respectively with no significant changes over time. In patients with DVT, predictors for admission were age (odds ratio, 1.03 per year of age [95% confidence interval, 1.01 to 1.05]) and race (odds ratio, 4.1 [95% confidence interval, 0.9 to 19.8] for Hispanics and 2.9 [1.2 to 7.4] for Blacks). Of all ED patients with PE, 51% were low risk based on sPESI scores. Conclusion Admission rates for DVT and PE have remained high and unchanged, especially with PE, minorities, and in older patients. Based on sPESI scores, up to half of PE patients might be eligible for early discharge or outpatient therapy.

  7. Vitamin D status and cause-specific mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta;

    2012-01-01

    Vitamin D deficiency is associated with an increased risk of all-cause mortality in observational studies. The specific causes of death underlying this association lack clarity. We investigated the association between vitamin D status and cause-specific mortality.......Vitamin D deficiency is associated with an increased risk of all-cause mortality in observational studies. The specific causes of death underlying this association lack clarity. We investigated the association between vitamin D status and cause-specific mortality....

  8. Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerød Acute Process Triage (HAPT system and the outcome measures; Admission to Intensive Care Unit (ICU and in-hospital mortality, and to identify the vital signs, scored and categorized at admission, that are most strongly associated with the outcome measures. Methods The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED from the Acute Admission Database. We performed regression analysis to evaluate the association between the covariates and the outcome measures. Results The covariates, Tvitals, Tcomplaint and Tfinal were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs best predicting in-hospital mortality were saturation of peripheral oxygen (SpO2, respiratory rate (RR, systolic blood pressure (BP and Glasgow Coma Score (GCS. Not only the type, but also the number of abnormal vital signs, were predictive for adverse outcome. The presenting complaints associated with the highest in-hospital mortality were 'dyspnoea' (11.5% and 'altered level of consciousness' (10.6%. More than half of the patients had a Tcomplaint more urgent than Tvitals

  9. Admissions Testing & Institutional Admissions Processes

    Science.gov (United States)

    Hossler, Don; Kalsbeek, David

    2009-01-01

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

  10. Prediction of Mobility Limitations after Hospitalization in Older Medical Patients by Simple Measures of Physical Performance Obtained at Admission to the Emergency Department

    DEFF Research Database (Denmark)

    Bodilsen, Ann Christine; Hedegaard Klausen, Henrik; Petersen, Janne

    2016-01-01

    .86–0.95), gait speed, OR 0.35 (0.26–0.46), chair-stand, OR 0.04 (0.02–0.08) and Cumulated Ambulation Score OR 0.49 (0.38–0.64). Adjustment for potential confounders did not change the results and the associations were not modified by any of the covariates: age, gender, cognitive status, the severity of the acute......Objective: Mobility limitations relate to dependency in older adults. Identification of older patients with mobility limitations after hospital discharge may help stratify treatment and could potentially counteract dependency seen in older adults after hospitalization. We investigated the ability...... of four physical performance measures administered at hospital admission to identify older medical patients who manifest mobility limitations 30 days after discharge. Design: Prospective cohort study of patients (≥65 years) admitted to the emergency department for acute medical illness. During the first...

  11. 标准操作规范在急诊接诊与分流中的应用%Application of a standard operation norm in admission and triage of emergency departments

    Institute of Scientific and Technical Information of China (English)

    王宁; 刘臻; 姜萍; 韩翠

    2011-01-01

    Objective To discuss the methods and effects of the standard operation norm in admission and triage of emergency departments.Methods The measures included formulation of standard operation norm of admission and triage in emergency departments and rational allocation of human resources and training. Results The emergency admission and triage speed was accelerated ( P < 0.05 ). The triage error rate was reduced ( P < 0. 01 ), and the satisfaction degree of patients was increased ( P < 0.05 ). Conclusion The standard and scientific operation norm can speed up the process of emergency admission and triage and improve the satisfaction degree of patients.%目的 探讨急诊接诊与分流中应用标准操作规范的方法与效果.方法 制订急诊接诊与分流标准操作规范,合理配置人力资源并进行培训.结果 加快了急诊接诊与分流速度(P<0.05),分诊失误率下降(P<0.01),患者满意度提高(P<0.05).结论 规范化、科学的急诊接诊与分流标准实现了快速救治,提高了患者满意度.

  12. The role of neopterine in the diagnosis of patients with acute pancreatitis on admission to the emergency department

    Directory of Open Access Journals (Sweden)

    Keziban Ucar Karabulut

    2016-03-01

    Full Text Available Purpose: There are difficulties observed in the diagnosis of acute pancreatitis in emergency departments due to its different clinical properties and the insufficiencies in the methods of diagnosis. Since there is no specific biochemical indicator, the diagnosis is made usually late or with difficulty. Neopterine is an enzyme secreted from the macrophages and is an indicator of cellular immunity activation. The aim of this study was to determine the role of neopterine in the early diagnosis of acute pancreatitis . Material and Methods: 39 patients, who had been hospitalized with the complaints of abdominal pain and diagnosed as acute pancreatitis via laboratory and screening methods, and 30 healthy controls were included in the study. Amylase, lipase, cholesterol and neopterine were measured in the patients' samples. The diagnoses were confirmed with abdominal ultrasound and computed tomography. Results: The neopterine values in patients with acute pancreatitis were significantly higher than those of the control group. Conclusion: Neopterine is an indicator which is elevated in certain inflammatory and autoimmune situations. We believe that it is important in the early diagnosis of acute pancreatitis. Further experimental and clinical studies should be conducted on the subject. [Cukurova Med J 2016; 41(1.000: 51-54

  13. Cause-specific measures of life years lost

    Directory of Open Access Journals (Sweden)

    Per Kragh Andersen

    2013-12-01

    Full Text Available Background: A new measure of the number of life years lost due to specific causes of death is introduced. Methods: This measure is based on the cumulative incidence of death, it does not require "independence" of causes, and it satisfies simple balance equations: "total number of life years lost = sum of cause-specific life years lost", and "total number of life years lost before age x + temporary life expectancy between birth and age x = x". Results: The measure is contrasted to alternatives suggested in the demographic literature and allmethods are illustrated using Danish and Russian multiple decrement life-tables.

  14. Cause-specific measures of life years lost

    DEFF Research Database (Denmark)

    Andersen, Per Kragh; Canudas-Romo, Vladimir; Keiding, Niels

    2013-01-01

    Background: A new measure of the number of life years lost due to specific causes of death is introduced. Methods: This measure is based on the cumulative incidence of death, it does not require "independence" of causes, and it satisfies simple balance equations: "total number of life years lost...... = sum of cause-specific life years lost", and "total number of life years lost before age x + temporary life expectancy between birth and age x = x". Results: The measure is contrasted to alternatives suggested in the demographic literature and all methods are illustrated using Danish and Russian...

  15. Selling patients and other metaphors: a discourse analysis of the interpretive frames that shape emergency department admission handoffs.

    Science.gov (United States)

    Hilligoss, Brian

    2014-02-01

    This paper reports a discourse analysis of the language doctors used as they talked about and engaged in patient handoffs between the emergency department (ED) and various inpatient services at one highly specialized academic tertiary teaching and referral hospital in the Midwest United States. Although interest in handoff improvement has grown considerably in recent years, progress has been hampered, perhaps in part, because of a widely used but limiting conceptual model of handoff as an information transmission. The purpose of the study reported here is to analyze the way doctors make sense of handoff interactions, including uncovering the interpretive frames they use, in order to provide empirical findings to expand conceptual models of handoff. All data reported were drawn from a two-year ethnographic study (2009-2011) and include semi-structured interviews (n = 48), non-participant observations (349 h), and recorded telephone handoff conversations (n = 48). A total of eighty-six individuals participated, including resident and attending doctors from the ED, internal medicine and surgical services, as well as hospital administrators. Findings are organized around four metaphors doctors used: sales, sports and games, packaging, and teamwork. Each metaphor, in turn, reveals an underlying interpretive frame that appears to be influenced by organizational and social structures and to shape the possibilities for action that doctors perceive. The four underlying interpretive frames are: handoff as persuasion, handoff as competition, handoff as expectation matching, and handoff as collaboration. Taken together, these interpretive frames highlight the complex, socially interactive nature of handoff and provide an empirical basis for grounding and enriching the conceptual model of handoff that guides research and practice improvement efforts.

  16. Attributing death to cancer: cause-specific survival estimation.

    Directory of Open Access Journals (Sweden)

    Mathew A

    2002-10-01

    Full Text Available Cancer survival estimation is an important part of assessing the overall strength of cancer care in a region. Generally, the death of a patient is taken as the end point in estimation of overall survival. When calculating the overall survival, the cause of death is not taken into account. With increasing demand for better survival of cancer patients it is important for clinicians and researchers to know about survival statistics due to disease of interest, i.e. net survival. It is also important to choose the best method for estimating net survival. Increase in the use of computer programmes has made it possible to carry out statistical analysis without guidance from a bio-statistician. This is of prime importance in third- world countries as there are a few trained bio-statisticians to guide clinicians and researchers. The present communication describes current methods used to estimate net survival such as cause-specific survival and relative survival. The limitation of estimation of cause-specific survival particularly in India and the usefulness of relative survival are discussed. The various sources for estimating cancer survival are also discussed. As survival-estimates are to be projected on to the population at large, it becomes important to measure the variation of the estimates, and thus confidence intervals are used. Rothman′s confidence interval gives the most satisfactory result for survival estimate.

  17. The formation and design of the 'Acute Admission Database'- a database including a prospective, observational cohort of 6279 patients triaged in the emergency department in a larger Danish hospital

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Management and care of the acutely ill patient has improved over the last years due to introduction of systematic assessment and accelerated treatment protocols. We have, however, sparse knowledge of the association between patient status at admission to hospital and patient outcome. A likely explanation is the difficulty in retrieving all relevant information from one database. The objective of this article was 1 to describe the formation and design of the 'Acute Admission Database', and 2 to characterize the cohort included. Methods All adult patients triaged at the Emergency Department at Hillerød Hospital and admitted either to the observationary unit or to a general ward in-hospital were prospectively included during a period of 22 weeks. The triage system used was a Danish adaptation of the Swedish triage system, ADAPT. Data from 3 different data sources was merged using a unique identifier, the Central Personal Registry number; 1 Data from patient admission; time and date, vital signs, presenting complaint and triage category, 2 Blood sample results taken at admission, including a venous acid-base status, and 3 Outcome measures, e.g. length of stay, admission to Intensive Care Unit, and mortality within 7 and 28 days after admission. Results In primary triage, patients were categorized as red (4.4%, orange (25.2%, yellow (38.7% and green (31.7%. Abnormal vital signs were present at admission in 25% of the patients, most often temperature (10.5%, saturation of peripheral oxygen (9.2%, Glasgow Coma Score (6.6% and respiratory rate (4.8%. A venous acid-base status was obtained in 43% of all patients. The majority (78% had a pH within the normal range (7.35-7.45, 15% had acidosis (pH 7.45. Median length of stay was 2 days (range 1-123. The proportion of patients admitted to Intensive Care Unit was 1.6% (95% CI 1.2-2.0, 1.8% (95% CI 1.5-2.2 died within 7 days, and 4.2% (95% CI 3.7-4.7 died within 28 days after admission

  18. Overall and cause-specific mortality in ulcerative colitis

    DEFF Research Database (Denmark)

    Jess, Tine; Gamborg, Michael; Munkholm, Pia

    2007-01-01

    OBJECTIVES: It remains debated whether patients with ulcerative colitis (UC) are at greater risk of dying and whether a possible alteration in mortality can be attributed to specific causes of death. We aimed to clarify this issue by conducting a meta-analysis of population-based inception cohort...... studies on overall and cause-specific mortality in patients with UC. METHODS: The MEDLINE search engine and abstracts from international conferences were searched for relevant literature by use of explicit search criteria. STATA meta-analysis software was used to calculate pooled risk estimates (SMR...... estimate was 1.1 (95% confidence interval [CI] 0.9-1.2, P= 0.42). However, greater risk of dying was observed during the first years of follow-up, in patients with extensive colitis, and in patients from Scandinavia. Metaregression analysis showed an increase in SMR by increasing cohort size. UC...

  19. Correlates of Performance of Healthcare Workers in Emergency, Triage, Assessment and Treatment plus Admission Care (ETAT+ Course in Rwanda: Context Matters.

    Directory of Open Access Journals (Sweden)

    Celestin Hategekimana

    Full Text Available The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+ course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied.To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills.We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals.374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI 20.5, 25.1. In adjusted models, bilingual (French & English participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2 and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR = 2.60; 95% CI 1.25, 5.40 than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44 than those who attended one within their health facility.The current study shows a positive impact of ETAT+ course on improving participants' knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes demonstrate the importance of considering key

  20. Hypertonic/hyperoncotic solution in hypovolemic patients: experience in the emergency room Solução hipertônica hiperoncótica em pacientes com hipovolemia: experiência na sala de admissão

    OpenAIRE

    Riad N Younes; Dario Birolini

    2002-01-01

    Hypertonic solutions have been studied extensively in the treatment of hypovolemic shock, both in experimental and clinical models. Safety, efficacy, and long-term effects on animals and patients have been evaluated. The present article reviews indications, safety, mortality rates, and outcome in patients with hemorrhagic hypovolemic shock who were treated after admission with a hypertonic/hyperoncotic solution under strict observation in the emergency room.As soluções hipertônicas têm sido e...

  1. 10-y Risks of Death and Emergency Re-admission in Adolescents Hospitalised with Violent, Drug- or Alcohol-Related, or Self-Inflicted Injury: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Annie Herbert

    2015-12-01

    Full Text Available Hospitalisation for adversity-related injury (violent, drug/alcohol-related, or self-inflicted injury has been described as a "teachable moment", when intervention may reduce risks of further harm. Which adolescents are likely to benefit most from intervention strongly depends on their long-term risks of harm. We compared 10-y risks of mortality and re-admission after adversity-related injury with risks after accident-related injury.We analysed National Health Service admissions data for England (1 April 1997-31 March 2012 for 10-19 y olds with emergency admissions for adversity-related injury (violent, drug/alcohol-related, or self-inflicted injury; n = 333,009 or for accident-related injury (n = 649,818. We used Kaplan-Meier estimates and Cox regression to estimate and compare 10-y post-discharge risks of death and emergency re-admission. Among adolescents discharged after adversity-related injury, one in 137 girls and one in 64 boys died within 10 y, and 54.2% of girls and 40.5% of boys had an emergency re-admission, with rates being highest for 18-19 y olds. Risks of death were higher than in adolescents discharged after accident-related injury (girls: age-adjusted hazard ratio 1.61, 95% CI 1.43-1.82; boys: 2.13, 95% CI 1.98-2.29, as were risks of re-admission (girls: 1.76, 95% CI 1.74-1.79; boys: 1.41, 95% CI 1.39-1.43. Risks of death and re-admission were increased after all combinations of violent, drug/alcohol-related, and self-inflicted injury, but particularly after any drug/alcohol-related or self-inflicted injury (i.e., with/without violent injury, for which age-adjusted hazard ratios for death in boys ranged from 1.67 to 5.35, compared with 1.25 following violent injury alone (girls: 1.09 to 3.25, compared with 1.27. The main limitation of the study was under-recording of adversity-related injuries and misclassification of these cases as accident-related injuries. This misclassification would attenuate the relative risks of death

  2. Cause-Specific Deaths in Non-Dialysis-Dependent CKD.

    Science.gov (United States)

    Navaneethan, Sankar D; Schold, Jesse D; Arrigain, Susana; Jolly, Stacey E; Nally, Joseph V

    2015-10-01

    CKD is associated with higher risk of death, but details regarding differences in cause-specific death in CKD are unclear. We examined the leading causes of death among a non-dialysis-dependent CKD population using an electronic medical record-based CKD registry in a large healthcare system and the Ohio Department of Health mortality files. We included 33,478 white and 5042 black patients with CKD who resided in Ohio between January 2005 and September 2009 and had two measurements of eGFRCauses of death (before ESRD) were classified into cardiovascular, malignancy, and non-cardiovascular/non-malignancy diseases and non-disease-related causes. During a median follow-up of 2.3 years, 6661 of 38,520 patients (17%) with CKD died. Cardiovascular diseases (34.7%) and malignant neoplasms (31.8%) were the leading causes of death, with malignancy-related deaths more common among those with earlier stages of kidney disease. After adjusting for covariates, each 5 ml/min per 1.73 m(2) decline in eGFR was associated with higher risk of death due to cardiovascular disease (hazard ratio [HR], 1.10; 95% confidence interval [95% CI], 1.08 to 1.12) and non-cardiovascular/non-malignancy diseases (HR, 1.12; 95% CI, 1.09 to 1.14) but not to malignancy. In the adjusted models, blacks had overall-mortality hazard ratios similar to those of whites but higher hazard ratios for cardiovascular deaths. Further studies to confirm these findings and explain the mechanisms for differences are warranted. In addition to lowering cardiovascular burden in CKD, efforts to target known risk factors for cancer at the population level are needed.

  3. Nonimmigrant Admissions - Annual Report

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  4. Nationwide Assessment of Cause-Specific Mortality in Patients with Rosacea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Fowler, Joseph F; Gislason, Gunnar H

    2016-01-01

    BACKGROUND: Emerging data suggest that rosacea is associated with several comorbidities; however, the causes of mortality in patients with rosacea have not yet been investigated. OBJECTIVE: We evaluated all-cause and cause-specific death rates in patients with rosacea in a population-based Danish...... cohort study. METHODS: All Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2012 with rosacea diagnosed by hospital dermatologists were linked in nationwide registers and compared with age- and sex-matched general-population subjects (1:5 ratio). Death rates were calculated per...... 1000 person-years, and hazard ratios (HRs) were estimated using Cox regression models. RESULTS: The total cohort (n = 35,958) included 5993 patients with rosacea and 29,965 age- and sex-matched individuals from the general population. During the maximum 15 years of follow-up, 664 (11.1 %) patients...

  5. Cause-Specific Mortality and Death Certificate Reporting in Adults with Moderate to Profound Intellectual Disability

    Science.gov (United States)

    Tyrer, F.; McGrother, C.

    2009-01-01

    Background: The study of premature deaths in people with intellectual disability (ID) has become the focus of recent policy initiatives in England. This is the first UK population-based study to explore cause-specific mortality in adults with ID compared with the general population. Methods: Cause-specific standardised mortality ratios (SMRs) and…

  6. Modeling lifetime data with multiple causes using cause specific reversed hazard rates

    Directory of Open Access Journals (Sweden)

    Paduthol Godan Sankaran

    2014-09-01

    Full Text Available In this paper we introduce and study cause specific reversed hazard rates in the context of left censored lifetime data with multiple causes. Nonparametric inference procedure for left censored lifetime data with multiple causes using cause specific reversed hazard rate is discussed. Asymptotic properties of the estimators are studied. Simulation studies are conducted to assess the efficiency of the estimators. Further, the proposed method is applied to mice mortality data (Hoel 1972 and Australian twin data (Duffy et al. 1990.

  7. Hypertonic/hyperoncotic solution in hypovolemic patients: experience in the emergency room Solução hipertônica hiperoncótica em pacientes com hipovolemia: experiência na sala de admissão

    Directory of Open Access Journals (Sweden)

    Riad N. Younes

    2002-06-01

    Full Text Available Hypertonic solutions have been studied extensively in the treatment of hypovolemic shock, both in experimental and clinical models. Safety, efficacy, and long-term effects on animals and patients have been evaluated. The present article reviews indications, safety, mortality rates, and outcome in patients with hemorrhagic hypovolemic shock who were treated after admission with a hypertonic/hyperoncotic solution under strict observation in the emergency room.As soluções hipertônicas têm sido estudadas no tratamento de choque hipovolêmico, tanto em protocolos experimentais quanto clínicos. A eficácia, a segurança e os efeitos a longo prazo em animais e pacientes foram avaliados. O presente estudo apresenta uma revisão da literatura sobre as indicações, as taxas de morbidade e de mortalidade e a evolução de pacientes com choque hipovolêmico, admitidos e tratados com soluções hipertônicas/hiperoncóticas, admitidos e tratados sob observação contínua na sala de emergência do pronto socorro.

  8. Nonimmigrant Admissions: Fiscal Year 2008

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  9. Nonimmigrant Admissions: Fiscal Year 2009

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  10. Nonimmigrant Admission: Fiscal Year 2007

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  11. Nonimmigrant Admissions: Fiscal Year 2005

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  12. Nonimmigrant Admissions: Fiscal Year 2006

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  13. Nonimmigrant Admissions: Fiscal Year 2012

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  14. Nonimmigrant Admissions: Fiscal Year 2011

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  15. Nonimmigrant Admissions - Fiscal Year 2013

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  16. Nonimmigrant Admissions: Fiscal Year 2010

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  17. Overall and cause-specific mortality in HIV-positive subjects compared to the general population

    Directory of Open Access Journals (Sweden)

    Belen Alejos

    2014-11-01

    Full Text Available Introduction: Emerging non-AIDS related causes of death have been observed in HIV-positive subjects in industrialized countries. We aimed to analyze overall and cause-specific excess of mortality of HIV-positive patients compared to the general population and to assess the effect of prognostic factors. Material and Methods: We used generalized linear models with Poisson error structure to estimate overall and cause-specific excess of mortality in HIV-positive patients from 2004 to 2012 in the cohort of the Spanish Network of HIV Research (CoRIS, compared to Spanish general population and to assess the impact of multiple risk factors. We investigated differences between short-term and long-term risk factors effects on excess of mortality. Multiple Imputation by Chained Equations was used to deal with missing data. Results: In 9162 patients there were 363 deaths, 16.0% were non-AIDS malignancies, 10.5% liver and 0.3% cardiovascular related. Excess mortality was 1.20 deaths per 100 person years (py for all-cause mortality, 0.16 for liver, 0.10 for non-AIDS malignancies and 0.03 for cardiovascular. Short-term (first-year follow-up excess Hazard Ratio (eHR for global mortality for baseline AIDS was 4.27 (95% CI 3.06–6.01 and 1.47 (95% CI 0.95–2.27 for HCV coinfection; long-term (subsequent follow-up eHR for baseline AIDS was 0.88 (95% CI 0.58–1.35 and 4.48 (95% CI 2.71–7.42 for HCV coinfection. Lower CD4 count and higher viral load at entry, lower education, being male and over 50 years were predictors for overall excess mortality. Excess of liver mortality was higher in patients with CD4 counts at entry below 200 cells compared to those above 350 (eHR: 6.49, 95% CI 1.21–34.84 and in HCV-coinfected patients (eHR: 3.85, 95% CI 0.85– 17.37, although it was borderline significant. Patients over 50 years old (eHR: 5.55, 95%CI 2.4–12.85 and HCV coinfected (eHR: 5.81, 95% CI 2.6–13 showed a higher risk of non-AIDS malignancies mortality

  18. Derivation and Validation of Predictive Factors for Clinical Deterioration after Admission in Emergency Department Patients Presenting with Abnormal Vital Signs Without Shock

    Directory of Open Access Journals (Sweden)

    Daniel J. Henning

    2015-12-01

    Full Text Available Introduction: Strategies to identify high-risk emergency department (ED patients often use markedly abnormal vital signs and serum lactate levels. Risk stratifying such patients without using the presence of shock is challenging. The objective of the study is to identify independent predictors of in-hospital adverse outcomes in ED patients with abnormal vital signs or lactate levels, but who are not in shock. Methods: We performed a prospective observational study of patients with abnormal vital signs or lactate level defined as heart rate ≥130 beats/min, respiratory rate ≥24 breaths/min, shock index ≥1, systolic blood pressure 4.0mmol/L (OR 5.1, 95% CI [2.1–12.2], age ≥80 yrs (OR 1.9, CI [1.0–3.7], bicarbonate <21mEq/L (OR 2.5, CI [1.3–4.9], and initial HR≥130 (OR 3.1, CI [1.5–6.1]. Conclusion: Patients exhibiting abnormal vital signs or elevated lactate levels without shock had significant rates of deterioration after hospitalization. ED clinical data predicted patients who suffered adverse outcomes with reasonable reliability.

  19. Unemployment and early cause-specific mortality: a study based on the Swedish twin registry

    DEFF Research Database (Denmark)

    Voss, Margaretha; Nylén, Lotta; Floderus, Birgitta;

    2004-01-01

    OBJECTIVES: We investigated the association between unemployment and early cause-specific mortality to determine whether the relationship was modified by other risk indicators. METHODS: Female and male twins (n=20632) were followed with regard to mortality from 1973 through 1996. Questionnaire data...

  20. Cause-Specific Colostomy Rates After Radiotherapy for Anal Cancer: A Danish Multicentre Cohort Study

    DEFF Research Database (Denmark)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli;

    2011-01-01

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy...

  1. Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death

    NARCIS (Netherlands)

    Seshasai, Sreenivasa Rao Kondapally; Kaptoge, Stephen; Thompson, Alexander; Di Angelantonio, Emanuele; Gao, Pei; Sarwar, Nadeem; Whincup, Peter H.; Mukamal, Kenneth J.; Gillum, Richard F.; Holme, Ingar; Njolstad, Inger; Fletcher, Astrid; Nilsson, Peter; Lewington, Sarah; Collins, Rory; Gudnason, Vilmundur; Thompson, Simon G.; Sattar, Naveed; Selvin, Elizabeth; Hu, Frank B.; Danesh, John

    2011-01-01

    BACKGROUND The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain. METHODS We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-partic

  2. Diabetes mellitus, fasting glucose, and risk of cause-specific death

    NARCIS (Netherlands)

    Kromhout, D.

    2011-01-01

    Background The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain. Methods We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-partic

  3. The Joint Effect of Sleep Duration and Disturbed Sleep on Cause-Specific Mortality

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Kumari, Meena; Lange, Theis

    2014-01-01

    Both sleep duration and sleep quality are related to future health, but their combined effects on mortality are unsettled. We aimed to examine the individual and joint effects of sleep duration and sleep disturbances on cause-specific mortality in a large prospective cohort study....

  4. Flexible parametric modelling of the cause-specific cumulative incidence function.

    Science.gov (United States)

    Lambert, Paul C; Wilkes, Sally R; Crowther, Michael J

    2016-12-22

    Competing risks arise with time-to-event data when individuals are at risk of more than one type of event and the occurrence of one event precludes the occurrence of all other events. A useful measure with competing risks is the cause-specific cumulative incidence function (CIF), which gives the probability of experiencing a particular event as a function of follow-up time, accounting for the fact that some individuals may have a competing event. When modelling the cause-specific CIF, the most common model is a semi-parametric proportional subhazards model. In this paper, we propose the use of flexible parametric survival models to directly model the cause-specific CIF where the effect of follow-up time is modelled using restricted cubic splines. The models provide smooth estimates of the cause-specific CIF with the important advantage that the approach is easily extended to model time-dependent effects. The models can be fitted using standard survival analysis tools by a combination of data expansion and introducing time-dependent weights. Various link functions are available that allow modelling on different scales and have proportional subhazards, proportional odds and relative absolute risks as particular cases. We conduct a simulation study to evaluate how well the spline functions approximate subhazard functions with complex shapes. The methods are illustrated using data from the European Blood and Marrow Transplantation Registry showing excellent agreement between parametric estimates of the cause-specific CIF and those obtained from a semi-parametric model. We also fit models relaxing the proportional subhazards assumption using alternative link functions and/or including time-dependent effects. Copyright © 2016 John Wiley & Sons, Ltd.

  5. Admissible and Restrained Revision

    CERN Document Server

    Booth, R; 10.1613/jair.1874

    2011-01-01

    As partial justification of their framework for iterated belief revision Darwiche and Pearl convincingly argued against Boutiliers natural revision and provided a prototypical revision operator that fits into their scheme. We show that the Darwiche-Pearl arguments lead naturally to the acceptance of a smaller class of operators which we refer to as admissible. Admissible revision ensures that the penultimate input is not ignored completely, thereby eliminating natural revision, but includes the Darwiche-Pearl operator, Nayaks lexicographic revision operator, and a newly introduced operator called restrained revision. We demonstrate that restrained revision is the most conservative of admissible revision operators, effecting as few changes as possible, while lexicographic revision is the least conservative, and point out that restrained revision can also be viewed as a composite operator, consisting of natural revision preceded by an application of a "backwards revision" operator previously studied by Papini. ...

  6. Patient Admission Preferences and Perceptions

    Science.gov (United States)

    Wu, Clayton; Melnikow, Joy; Dinh, Tu; Holmes, James F.; Gaona, Samuel D.; Bottyan, Thomas; Paterniti, Debora; Nishijima, Daniel K.

    2015-01-01

    Introduction Understanding patient perceptions and preferences of hospital care is important to improve patients’ hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions. Methods This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed-ended questionnaire. Results Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated “very important,” while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated “very important.” When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference. Conclusion Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed. PMID:26587095

  7. The Admissions Equity Struggle

    Science.gov (United States)

    Freedman, Eric

    2012-01-01

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

  8. Mathematics Admission Test Remarks

    Directory of Open Access Journals (Sweden)

    Ideon Erge

    2016-12-01

    Full Text Available Since 2014, there have been admission tests in mathematics for applicants to the Estonian University of Life Sciences for Geodesy, Land Management and Real Estate Planning; Civil Engineering; Hydraulic Engineering and Water Pollution Control; Engineering and Technetronics curricula. According to admission criteria, the test must be taken by students who have not passed the specific mathematics course state exam or when the score was less than 20 points. The admission test may also be taken by those who wish to improve their state exam score. In 2016, there were 126 such applicants of whom 63 took the test. In 2015, the numbers were 129 and 89 and in 2014 150 and 47 accordingly. The test was scored on scale of 100. The arithmetic average of the score was 30.6 points in 2016, 29.03 in 2015 and 18.84 in 2014. The test was considered to be passed with 1 point in 2014 and 20 points in 2015 and 2016. We analyzed test results and gave examples of problems which were solved exceptionally well or not at all.

  9. Clinical research of Terson's syndrome among spontaneous subarachnoid hemorrhage patients at emergency admission%急诊入院的自发性蛛网膜下腔出血患者中Terson综合征的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨乾军; 毛剑波; 尹波; 佘相均; 曹婵媛; 沈丽君

    2013-01-01

    Objective To investigate the incidence,risk factors and relationship with intraocular hemorrhage of Terson's syndrome among patients with spontaneous subarachnoid hemorrhage (SSAH) after emergency admission.Methods Seventy-four consecutive patients with SSAH from June 2010 to September 2011 were prospectively examined.A direct ophthalmoscope examination was performed in all participants within three hours after emergency admission.If circumstances permit,fundus photos were taken.When initial fundus examination was conducted,the Hunt-Hess grade was classified by the brain surgeon.The fundus examination was taken on the 1st,3rd,and 7th day,2 weeks,1 month,and 3 months after emergency admission.The details were recorded,including sex,age,bleeding patterns,Hunt-Hess grade and death.The incidence of Terson's syndrome was analyzed and correlated with sex,age and Hunt-Hess grade.The relationship between intraocular hemorrhage and Hunt-Hess grade and mortality was analyzed.Results Among the 74 patients,19 were suffering from Terson's syndrome,31 eyes involved.The incidence of Terson's syndrome was 25.7%.Statistical analysis demonstrated that the sex of the patient was randomly distributed (x2=0.071,P=0.790),and the age components were also randomly distributed (Fisher's exact test,P=0.203).The Hunt-Hess grade components were non-randomly distributed (Fisher's exact test,P=0.000).Among the patients with preretinal hemorrhage and vitreous hemorrhage,HuntHess grade V was in 76.9% patients; among inter-retinal hemorrhage,Hunt-Hess grade was in 16..7% ofpatients.The distribution was non-random (Fisher's exact test,P=0.041).All intraocular hemorrhages were found at the time of first fundus examination.The mortality from Terson's syndrome was 68.4 % (13/19) according to the follow-up investigation.The mortality in patients with vitreous hemorrhage and preretinal hemorrhage was statistically different (Fisher's exact test,P=0.046) from patients with interretinal hemorrhage

  10. Efecto del tiempo de exposición a PM10 en las urgencias por bronquitis aguda Effect of exposure time to PM10 on emergency admissions for acute bronchitis

    Directory of Open Access Journals (Sweden)

    Franz Muñoz

    2009-03-01

    Full Text Available Este trabajo analiza el efecto de las horas de exposición a PM10 en las urgencias diarias por bronquitis aguda, controlando por temperatura y humedad. El estudio fue realizado en seis sectores de la ciudad de Santiago, Chile, durante el período de invierno de los años 2002 al 2004, para lactantes ( 65 años. Analizamos el retraso de la respuesta mediante una función polinomial distributiva (pdl, incluida en un modelo lineal generalizado (GLM-pdl, y la estructura del efecto de la exposición, mediante modelos aditivos generalizados (GAM, utilizando regresión spline como técnica de estimación. Los resultados mostraron que al cuarto día de retardo, el efecto de la exposición fue mayor, especialmente en lactantes, y varió en la medida que incrementó la concentración atmosférica de PM10. El efecto de las horas de exposición a PM10 mostró una variación significativa, según el sector geográfico. Al estimar linealmente este efecto en el sector Oeste, notamos que el incremento de consultas diarias en lactantes fue de 3% por cada hora de exposición sobre os 150µg/m³.To study the health effect of air pollution, measured as particulate matter greater than 10mm in diameter (PM10, we analyzed the effect of daily hours of exposure on the number of urgency admissions for acute bronchitis, adjusting for temperature and humidity on the same day. The study was conducted in six regions of Santiago, Chile, during the winter of years 2002 to 2004, for infants and elders. The delay between pollution time series and disease was modeled using a polynomial distributed lag (PDL function included in a generalized linear model. The linearity assumption was evaluated using a smooth-spline model approach. The highest effect for exposure to PM10 was detected with 4 days of delay. For both groups, the effect of temperature was linear, but that of humidity was not. Air pollution effect varied according to level of exposure and geographic region, increasing

  11. Cause-specific mortality in British coal workers and exposure to respirable dust and quartz

    Energy Technology Data Exchange (ETDEWEB)

    Miller, B.G.; MacCalman, L. [Institute of Occupational Medicine, Edinburgh (United Kingdom)

    2010-04-15

    In the 1950s the Pneumoconiosis Field Research (PFR) programme was set up to study the health of British coal workers. Studies included regular health surveys, an intensive characterisation of workers' individual exposures, and entry to a cohort followed up to the present for cause-specific mortality. This study reports on analyses of cause-specific mortality in a cohort of almost 18 000 men from 10 British collieries. External analyses used standardised mortality ratios (SMRs), comparing observed mortality with reference rates from the regions in which the collieries were situated. Causes investigated include lung and stomach cancers, chronic obstructive pulmonary disease and cardiovascular endpoints. Internal analyses used Cox regression models with time-dependent exposures adjusting for the confounding effects of age, smoking, cohort entry date and regional differences in population mortality rates. Several causes showed evidence of a healthy worker effect early in the follow-up, with a deficit in the SMR diminishing over time. For most of the causes there was a significant excess in the latter part of follow-up. Internal analyses found evidence of an association between increased risks of lung cancer and increased quartz exposure, particularly at a lag of 15 years. Risks of mortality from non-malignant respiratory disease showed increases with increased exposure to respirable dust. This paper adds to the evidence on the long-term effects of exposure to coalmine dust on mortality from respiratory diseases.

  12. Cause-specific mortality in British coal workers and exposure to respirable dust and quartz

    Energy Technology Data Exchange (ETDEWEB)

    Brian G Miller; Laura MacCalman [Institute of Occupational Medicine, Edinburgh (United Kingdom)

    2010-04-15

    In the 1950s the Pneumoconiosis Field Research (PFR) programme was set up to study the health of British coal workers. Studies included regular health surveys, an intensive characterisation of workers' individual exposures, and entry to a cohort followed up to the present for cause-specific mortality. This study reports on analyses of cause-specific mortality in a cohort of almost 18?000 men from 10 British collieries. External analyses used standardised mortality ratios (SMRs), comparing observed mortality with reference rates from the regions in which the collieries were situated. Causes investigated include lung and stomach cancers, chronic obstructive pulmonary disease and cardiovascular endpoints. Internal analyses used Cox regression models with time-dependent exposures adjusting for the confounding effects of age, smoking, cohort entry date and regional differences in population mortality rates. Several causes showed evidence of a healthy worker effect early in the follow-up, with a deficit in the SMR diminishing over time. For most of the causes there was a significant excess in the latter part of follow-up. Internal analyses found evidence of an association between increased risks of lung cancer and increased quartz exposure, particularly at a lag of 15 years. Risks of mortality from non-malignant respiratory disease showed increases with increased exposure to respirable dust. This paper adds to the evidence on the long-term effects of exposure to coalmine dust on mortality from respiratory diseases.

  13. The formation and design of 'The Acute Admission Database'- a database including a prospective, observational cohort of 6279 patients triaged in the Emergency Department in a larger Danish hospital

    DEFF Research Database (Denmark)

    Barfod, Charlotte; Lauritzen, Marlene Mp; Danker, Jakob K

    2012-01-01

    to Intensive Care Unit, and mortality within 7 and 28 days after admission. RESULTS: In primary triage, patients were categorized as red (4.4%), orange (25.2%), yellow (38.7%) and green (31.7%). Abnormal vital signs were present at admission in 25% of the patients, most often temperature (10.5%), saturation......ABSTRACT: BACKGROUND: Management and care of the acutely ill patient have improved over the last years due to introduction of systematic assessment and accelerated treatment protocols. We have, however, sparse knowledge of the association between patient status at admission to hospital and patient...... (range 1-123). The proportion of patients admitted to Intensive Care Unit was 1.6% (95% CI 1.2-2.0), 1.8% (95% CI 1.5-2.2) died within 7 days, and 4.2% (95% CI 3.7-4.7) died within 28 days after admission. CONCLUSIONS: Despite challenges of data registration, we succeeded in creating a database...

  14. Cause-specific mortality in adult epilepsy patients from Tyrol, Austria: hospital-based study.

    Science.gov (United States)

    Granbichler, Claudia A; Oberaigner, Willi; Kuchukhidze, Giorgi; Bauer, Gerhard; Ndayisaba, Jean-Pierre; Seppi, Klaus; Trinka, Eugen

    2015-01-01

    Epilepsy is a devastating condition with a considerable increase in mortality compared to the general population. Few studies have focused on cause-specific mortality which we analyse in detail in over 4,000 well-characterized epilepsy patients. The cohort comprised of epilepsy patients ≥ 18, treated between 1970 and 2009 at the epilepsy clinic of Innsbruck Medical University, Austria, and living in the province of Tyrol, Austria. Epilepsy diagnosis was based on ILAE guidelines (1989); patients with brain tumor were excluded. Deceased patients and causes of death (ICD-codes) were obtained via record linkage to the national death registry. We computed age-, sex-, and period-adjusted standardized mortality rates (SMR) for 36 diagnoses subgroups in four major groups. Additional analyses were performed for an incidence cohort. Overall cohort: 4,295 patients, 60,649.1 person-years, 822 deaths, overall SMR 1.7 (95 % CI 1.6-1.9), highest elevated cause-specific SMR: congenital anomalies [7.1 (95 % CI 2.3-16.6)], suicide [4.2 (95 % CI 2.0-8.1)], alcohol dependence syndrome [3.9 (95 % CI 1.8-7.4)], malignant neoplasm of esophagus [3.1 (95 % CI 1.2-6.4)], pneumonia [2.7 (95 % CI 1.6-4.2)]. Incidence cohort: 1,299 patients, 14,215.4 person-years, 267 deaths, overall SMR 1.8 (95 % CI 1.6-2.1), highest elevated cause-specific SMR congenital anomalies [10.8 (95 % CI 1.3-39.3)], suicide [6.8 (95 % CI 1.4-19.8)], alcohol dependence syndrome (6.4 [95 % CI 1.8-16.5)], pneumonia [3.9 (95 % CI 1.8-7.4)], cerebrovascular disease at 3.5 (95 % CI 2.6-4.6). Mortality due to mental health problems, such as suicide or alcohol dependence syndrome, malignant neoplasms, and cerebrovascular diseases was highly increased in our study. In addition to aim for seizure freedom, we suggest improving general health promotion, including cessation of smoking, lowering of alcohol intake, and reduction of weight as well as early identification of psychiatric comorbidity in patients with epilepsy.

  15. Shift work and overall and cause-specific mortality in the Danish nurse cohort.

    Science.gov (United States)

    Jørgensen, Jeanette Therming; Karlsen, Sashia; Stayner, Leslie; Andersen, Johnni; Andersen, Zorana Jovanovic

    2017-03-01

    Objectives Evidence of an effect of shift work on all-cause and cause-specific mortality is inconsistent. This study aims to examine whether shift work is associated with increased all-cause and cause-specific mortality. Methods We linked 28 731 female nurses (age ≥44 years), recruited in 1993 or 1999 from the Danish nurse cohort where they reported information on shift work (night, evening, rotating, or day), to the Danish Register of Causes of Death to identify deaths up to 2013. We used Cox regression models with age as the underlying scale to examine the associations between night, evening, and rotating shift work (compared to day shift work) and all-cause and cause-specific mortality in models adjusted for potentially confounding variables. Results Of 18 015 nurses included in this study, 1616 died during the study time period from the following causes: cardiovascular disease (N=217), cancer (N= 945), diabetes (N=20), Alzheimer's disease or dementia (N=33), and psychiatric diseases (N=67). We found that working night [hazard ratio (HR) 1.26, 95% confidence interval 95% CI) 1.05-1.51] or evening (HR 1.29, 95% CI 1.11-1.49) shifts was associated with a significant increase in all-cause mortality when compared to working day shift. We found a significant association of night shift work with cardiovascular disease (HR 1.71, 95% CI 1.09-2.69) and diabetes (HR 12.0, 95% CI 3.17-45.2, based on 8 cases) and none with overall cancer mortality (HR 1.05, 95% CI 0.81-1.35) or mortality from psychiatric diseases (HR 1.17, 95% CI 0.47-2.92). Finally, we found strong association between evening (HR 4.28, 95% CI 1.62-11.3) and rotating (HR 5.39, 95% CI 2.35-12.3) shift work and mortality from Alzheimer's disease and dementia (based on 8 and 14 deaths among evening and rotating shift workers, respectively). Conclusions Women working night and evening shifts have increased all-cause, cardiovascular, diabetes, and Alzheimer's and dementia mortality.

  16. Education and adult cause-specific mortality--examining the impact of family factors shared by 871 367 Norwegian siblings

    DEFF Research Database (Denmark)

    Næss, Oyvind; Hoff, Dominic A; Lawlor, Debbie;

    2012-01-01

    To estimate the impact family factors shared by siblings has on the association between length of education and cause-specific mortality in adulthood.......To estimate the impact family factors shared by siblings has on the association between length of education and cause-specific mortality in adulthood....

  17. Undertaking cause-specific mortality measurement in an unregistered population: an example from Tigray Region, Ethiopia

    Directory of Open Access Journals (Sweden)

    Hagos Godefay

    2014-09-01

    Full Text Available Background: The lack of adequate documentation of deaths, and particularly their cause, is often noted in African and Asian settings, but practical solutions for addressing the problem are not always clear. Verbal autopsy methods (interviewing witnesses after a death have developed rapidly, but there remains a lack of clarity as to how these methods can be effectively applied to large unregistered populations. This paper sets out practical details for undertaking a representative survey of cause-specific mortality in a population of several million, taking Tigray Region in Ethiopia as a prototype. Sampling: Sampling was designed around an expected level of maternal mortality ratio of 400 per 100,000 live births, which needed measuring within a 95% confidence interval of approximately ±100. Taking a stratified cluster sample within the region at the district level for logistic reasons, and allowing for a design effect of 2, this required a population of around 900,000 people, equating to six typical districts. Since the region is administered in six geographic zones, one district per zone was randomly selected. Implementation: The survey was implemented as a two-stage process: first, to trace deaths that occurred in the sampled districts within the preceding year, and second to follow them up with verbal autopsy interviews. The field work for both stages was undertaken by health extension workers, working in their normally assigned areas. Most of the work was associated with tracing the deaths, rather than undertaking the verbal autopsy interviews. Discussion: This approach to measuring cause-specific mortality in an unregistered Ethiopian population proved to be feasible and effective. Although it falls short of the ideal situation of continuous civil registration and vital statistics, a survey-based strategy of this kind may prove to be a useful intermediate step on the road towards full civil registration and vital statistics implementation.

  18. Hospital admissions: An examination of race and health insurance

    Directory of Open Access Journals (Sweden)

    Eric Gass

    2008-06-01

    Full Text Available This study examined the effects of racial differences and differences in insurance status on source of hospital admissions.  The data source was the 2001 National Hospital Discharge Survey and included a sub-sample of 104,185 patients.  58.3% of patients were admitted through the emergency room, 75.0% of patients were White, 19.7% were Black, and 61.5% were on government insurance or uninsured.  Black patients were found to have significantly higher levels of emergency room admissions (69.1%=p < .0001, regardless of insurance status (gov’t/self-pay, 73.7%=p < .0001, private insurance, 59.5%=p < .0001.  Patients on government insurance or self-payment had significantly higher levels of emergency room admissions (65.8%=p < .0001.  Regression analysis showed that both race and insurance type are significant predictors (p < .0001 of Source of Admission to the hospital.  Percent probabilities confirmed this finding.  Thus, it was concluded that racial differences witnessed in source of admission were not mediated by insurance type and that race and insurance type are significant, independent predictors of hospital admission source.

  19. Hospital admissions: An examination of race and health insurance

    Directory of Open Access Journals (Sweden)

    Eric Gass

    2008-06-01

    Full Text Available This study examined the effects of racial differences and differences in insurance status on source of hospital admissions. The data source was the 2001 National Hospital Discharge Survey and included a sub-sample of 104,185 patients. 58.3% of patients were admitted through the emergency room, 75.0% of patients were White, 19.7% were Black, and 61.5% were on government insurance or uninsured. Black patients were found to have significantly higher levels of emergency room admissions (69.1%=p < .0001, regardless of insurance status (gov’t/self-pay, 73.7%=p < .0001, private insurance, 59.5%=p < .0001. Patients on government insurance or self-payment had significantly higher levels of emergency room admissions (65.8%=p < .0001. Regression analysis showed that both race and insurance type are significant predictors (p < .0001 of Source of Admission to the hospital. Percent probabilities confirmed this finding. Thus, it was concluded that racial differences witnessed in source of admission were not mediated by insurance type and that race and insurance type are significant, independent predictors of hospital admission source.

  20. Optimal admission to higher education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    2016-01-01

    that documents the relevance of theory and illustrates how to apply optimal admission procedures. Indirect gains from optimal admission procedures include the potential for increasing entire cohorts of students' probability of graduating with a higher education degree, thereby increasing the skill level...

  1. Optimal Admission to Higher Education

    Science.gov (United States)

    Albaek, Karsten

    2017-01-01

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

  2. Nationwide population-based study of cause-specific death rates in patients with psoriasis

    DEFF Research Database (Denmark)

    Salahadeen, E; Torp-Pedersen, C; Gislason, G;

    2015-01-01

    with severe psoriasis. The age at time of death varied by psoriasis status, i.e. 76.5 ± 14.0, 74.4 ± 12.8 and 72.0 ± 13.4 years, for the general population, mild psoriasis and severe psoriasis respectively. In general, the highest death rates were observed in patients with severe psoriasis. Overall death...... and nationwide data have not been presented previously. METHODS: In a nationwide population-based cohort we evaluated all-cause and cause-specific death rates in patients with psoriasis as compared to the general population. RESULTS: The entire Danish population aged 18 and above, corresponding to a total of 5......,458,627 individuals (50.7% female, 40.9 years ± 19.7), including 94,069 with mild psoriasis (53% female, 42.0 ± 17.0 years) and 28,253 with severe psoriasis (53.4% female, 43.0 ± 16.5 years), was included. A total of 884,661 deaths were recorded, including 10 916 in patients with mild psoriasis and 3699 in patients...

  3. Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Thorsteinsson, Kristinn; Andreasen, Jan Jesper; Torp-Pedersen, Christian

    2015-01-01

    . Methods: All patients who underwent isolated CABG in 1996-2012 in Denmark were identified through nationwide administrative registers and included. The cumulative incidence of admission to a nursing home after CABG was estimated. A cause specific Cox-regression model was constructed to identify predictors......O5 Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery: A nationwide cohort study Kristinn Thorsteinsson, Jan Jesper Andreasen, Christian Torp Pedersen, Kirsten Fonager, Rikke Nørmark Mortensen, Kristian Kragholm, Gunnar Gislason, Lars Køber....... Aalborg, Denmark Background: Data on nursing home admission in patients >80 years of age after isolated coronary artery bypass grafting (CABG) are scarce. Aim: The purpose of this study was to evaluate longevity and subsequent admission to nursing home stratified by age in a nationwide CABG cohort...

  4. Asian dust effect on cause-specific mortality in five cities across South Korea and Japan

    Science.gov (United States)

    Kashima, Saori; Yorifuji, Takashi; Bae, Sanghyuk; Honda, Yasushi; Lim, Youn-Hee; Hong, Yun-Chul

    2016-03-01

    Desert dust is considered to be potentially toxic and its toxicity may change during long-range transportation. In Asian countries, the health effects of desert dust in different locations are not well understood. We therefore evaluated the city-combined and city-specific effects of Asian dust events on all-cause and cause-specific mortality in five populous cities in South Korea (Seoul) and Japan (Nagasaki, Matsue, Osaka and Tokyo). We obtained daily mean concentrations of Asian dust using light detection and ranging (lidar) between 2005 and 2011. We then evaluated city-specific and pooled associations of Asian dust with daily mortality for elderly residents (≥65 years old) using time-series analyses. Each 10 μg/m3 increase in the concentration of same-day (lag 0) or previous-day (lag 1) Asian dust was significantly associated with an elevated pooled risk of all-cause mortality (relative risk (RR): 1.003 [95% CI: 1.001-1.005] at lag 0 and 1.001 [95% CI: 1.000-1.003] at lag 1) and cerebrovascular disease (RR: 1.006 [95% CI: 1.000-1.011] at lag 1). This association was especially apparent in Seoul and western Japan (Nagasaki and Matsue). Conversely, no significant associations were observed in Tokyo, which is situated further from the origin of Asian dust and experiences low mean concentrations of Asian dust. Adverse health effects on all-cause and cerebrovascular disease mortality were observed in South Korea and Japan. However, the effects of Asian dust differed across the cities and adverse effects were more apparent in cities closer to Asian dust sources.

  5. General Practitioners and Involuntary Admission

    DEFF Research Database (Denmark)

    Jepsen, Britta; Lomborg, Kirsten; Engberg, Marianne

    2010-01-01

    in involuntary admissions. Setting: General practice, Aarhus, Denmark. Method: One focus group interview and six individual interviews were conducted with 13 Danish GPs, who had recently sectioned one of their own patients. Results: GPs experienced stress and found the admission procedure time consuming....... They felt that sectioning patients was unpleasant, and felt nervous, but experienced relief and professional satisfaction if things went well. The GPs experienced the doctor-patient relationship to be at risk, but also reported that it could be improved. GPs felt that they were not taken seriously...... by the psychiatric system. Conclusion: The unpleasant experiences and induced feelings resulting from involuntary admissions reflect an undesirable and stressful working environment....

  6. Admissibility of logical inference rules

    CERN Document Server

    Rybakov, VV

    1997-01-01

    The aim of this book is to present the fundamental theoretical results concerning inference rules in deductive formal systems. Primary attention is focused on: admissible or permissible inference rules the derivability of the admissible inference rules the structural completeness of logics the bases for admissible and valid inference rules. There is particular emphasis on propositional non-standard logics (primary, superintuitionistic and modal logics) but general logical consequence relations and classical first-order theories are also considered. The book is basically self-contained and

  7. Modeling the effect of short stay units on patient admissions

    NARCIS (Netherlands)

    Zonderland, Maartje E.; Boucherie, Richard J.; Carter, Michael W.; Stanford, David A.

    2015-01-01

    Two purposes of Short Stay Units (SSU) are the reduction of Emergency Department crowding and increased urgent patient admissions. At an SSU urgent patients are temporarily held until they either can go home or transferred to an inpatient ward. In this paper we present an overflow model to evaluate

  8. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies

    DEFF Research Database (Denmark)

    NN, NN; Whitlock, Gary; Lewington, Sarah;

    2009-01-01

    BACKGROUND: The main associations of body-mass index (BMI) with overall and cause-specific mortality can best be assessed by long-term prospective follow-up of large numbers of people. The Prospective Studies Collaboration aimed to investigate these associations by sharing data from many studies....

  9. The Ambiguous Effect of GP Competition: The Case of Hospital Admissions.

    Science.gov (United States)

    Islam, M Kamrul; Kjerstad, Egil

    2016-10-14

    In the theoretical literature on general practitioner (GP) behaviour, one prediction is that intensified competition induces GPs to provide more services resulting in fewer hospital admissions. This potential substitution effect has drawn political attention in countries looking for measures to reduce the growth in demand for hospital care. However, intensified competition may induce GPs to secure hospital admissions a signal to attract new patients and to keep the already enlisted ones satisfied, resulting in higher admission rates at hospitals. Using both static and dynamic panel data models, we aim to enhance the understanding of whether such relations are causal. Results based on ordinary least square (OLS) models indicate that aggregate inpatient admissions are negatively associated with intensified competition both in the full sample and for the sub-sample patients aged 45 to 69, while outpatient admissions are positively associated. Fixed-effect estimations do not confirm these results though. However, estimations of dynamic models show significant negative (positive) effects of GP competition on aggregate inpatient (outpatient) admissions in the full sample and negative effects on aggregate inpatient admissions and emergency admissions for the sub-sample. Thus, intensified GP competition may reduce inpatient hospital admissions by inducing GPs to provide more services, whereas, the alternative hypothesis seems valid for outpatient admissions. © 2016 The Authors. Health Economics Published by John Wiley & Sons, Ltd.

  10. Probabilistic Anonymity and Admissible Schedulers

    CERN Document Server

    Garcia, Flavio D; Sokolova, Ana

    2007-01-01

    When studying safety properties of (formal) protocol models, it is customary to view the scheduler as an adversary: an entity trying to falsify the safety property. We show that in the context of security protocols, and in particular of anonymizing protocols, this gives the adversary too much power; for instance, the contents of encrypted messages and internal computations by the parties should be considered invisible to the adversary. We restrict the class of schedulers to a class of admissible schedulers which better model adversarial behaviour. These admissible schedulers base their decision solely on the past behaviour of the system that is visible to the adversary. Using this, we propose a definition of anonymity: for all admissible schedulers the identity of the users and the observations of the adversary are independent stochastic variables. We also develop a proof technique for typical cases that can be used to proof anonymity: a system is anonymous if it is possible to `exchange' the behaviour of two...

  11. CHANGES IN THE COSTS OF HYPERTENSIVE CRISIS THERAPY DUE TO OPTIMIZATION OF DRUG SUPPLY IN THE PRE-ADMISSION CARE

    Directory of Open Access Journals (Sweden)

    N. I. Gaponova

    2012-01-01

    Full Text Available Aim. To assess the changes in the costs of treatment of patients with hypertensive crisis (HC in pre-admission care in Moscow from 2005 to 2010. Material and methods. Comparative analysis of the treatment costs was performed depending on outcomes in patients with HC at Moscow Emergency Medical Care Station named after A.S. Puchkov. HC arresting excluding the need of admission was taken into account in addition to antihypertensive effect and safety in evaluation of pre-admission care efficacy. Results. Introduction in practice of modern algorithms of emergency pre-admission care, supply of ambulance crews with modern antihypertensive drugs reduced the rate of admission from 71% in 2005 to 44% in 2010 among patients with HC. Total savings amounted to 403,691,808 rubles. Conclusion. Introduction of modern technologies in the emergency pre-admission care for patients with HC is economically reasonable.

  12. CHANGES IN THE COSTS OF HYPERTENSIVE CRISIS THERAPY DUE TO OPTIMIZATION OF DRUG SUPPLY IN THE PRE-ADMISSION CARE

    Directory of Open Access Journals (Sweden)

    N. I. Gaponova

    2015-12-01

    Full Text Available Aim. To assess the changes in the costs of treatment of patients with hypertensive crisis (HC in pre-admission care in Moscow from 2005 to 2010. Material and methods. Comparative analysis of the treatment costs was performed depending on outcomes in patients with HC at Moscow Emergency Medical Care Station named after A.S. Puchkov. HC arresting excluding the need of admission was taken into account in addition to antihypertensive effect and safety in evaluation of pre-admission care efficacy. Results. Introduction in practice of modern algorithms of emergency pre-admission care, supply of ambulance crews with modern antihypertensive drugs reduced the rate of admission from 71% in 2005 to 44% in 2010 among patients with HC. Total savings amounted to 403,691,808 rubles. Conclusion. Introduction of modern technologies in the emergency pre-admission care for patients with HC is economically reasonable.

  13. Optimal Admission to Higher Education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    This paper constructs higher education admission rules that maximise graduation rates and thus increase the skill level of the work force. An application shows that students with a low level in mathematics in secondary school ought to find it easier to be admitted to an economics programme than...... to law or psychology programmes, even though economics is the most difficult programme from which to graduate without a strong background in mathematics. Indirect gains from optimal admission include the potential of making whole cohorts of students more able to graduate with a higher education degree....

  14. College Admissions: Beyond Conventional Testing

    Science.gov (United States)

    Sternberg, Robert J.

    2012-01-01

    Standardized admissions tests such as the SAT (originally stood for "Scholastic Aptitude Test") and the ACT measure only a narrow segment of the skills needed to become an active citizen and possibly a leader who makes a positive, meaningful, and enduring difference to the world. The problem with these tests is that they promised, under…

  15. Admissions Plan Goes beyond Numbers

    Science.gov (United States)

    Hoover, Eric

    2007-01-01

    Northeastern University's Torch Scholars Program is designed to seek out first-generation students who would not qualify under the university's regular admissions process. The scholarships go to motivated students who have shown determination in overcoming personal challenges. Northeastern believes the experiment will enhance the socioeconomic…

  16. Does mental health service integration affect compulsory admissions?

    Directory of Open Access Journals (Sweden)

    André I. Wierdsma

    2009-09-01

    Full Text Available Background: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services. Methods: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991–1993 and 2001–2003. We included patients aged 18–60, who had a first emergency compulsory admission (n=830. Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up. Results: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district. Conclusions: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions.

  17. The number of years lived with obesity and the risk of all-cause and cause-specific mortality

    DEFF Research Database (Denmark)

    Abdullah, Asnawi; Wolfe, Rory; Stoelwinder, Johannes U;

    2011-01-01

    ) of the Framingham Cohort Study were followed up every 2 years from 1948 for up to 48 years. The association between obesity duration and all-cause and cause-specific mortality was analysed using time-dependent Cox models adjusted for body mass index. The role of biological intermediates and chronic diseases...... with the risk of mortality. This needs to be taken into account when estimating its burden on mortality....

  18. [Triage in acute medical admission units.

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Folkestad, Lars; Hallas, Peter

    2010-01-01

    . At 87% of the MAUs, a doctor was contacted by the admitting physician, while the contact was the responsibility of a nurse in 13% of MAUs. None of the contacted MAUs used a validated triage tool and 95% answered that they triaged on the basis of individual clinical assessment of patients. However, 22......INTRODUCTION: Many emergency departments use validated triage tools. It is currently undocumented if such a practice is common in Danish medical admission units (MAU). The current study was conducted in order to clarify this. MATERIAL AND METHODS: Questionnaire survey with data collected from......% answered that selected groups of patients were routinely assessed by a senior physician. CONCLUSION: None of the Danish MAUs uses a validated triage tool to prioritize acutely admitted medical patients. Udgivelsesdato: 2010-May-31...

  19. Perfil de ingresos y urgencias pediátricas en período epidémico de rotavirus en Valladolid: Utilidad de un modelo predictivo Profile of paediatric admissions and emergencies during an epidemic period of rotavirus in Valladolid [Spain]: Utility of a predictive model

    Directory of Open Access Journals (Sweden)

    Francisco Javier Luquero

    2009-02-01

    Full Text Available Introducción: Este estudio pretende determinar las semanas de alta circulación de rotavirus en valladolid, y comparar las características de los ingresos y urgencias en período epidémico con respecto al período no epidémico. Métodos: Se utilizaron las declaraciones al sistema de información microbiológica, el conjunto mínimo básico de datos y el registro de urgencias. Se calcularon los casos esperados para 2006 a partir de un modelo elaborado previamente. Si los casos observados superaban el umbral superior del 95% de los esperados, la semana se consideró epidémica. Se compararon las características de los ingresos y urgencias en ambos períodos. Resultados: En 2006 se diagnosticaron un 42% menos de los casos esperados. La media de ingresos diarios fue superior en período epidémico (diferencia=1,49; p=0,01, y también fue mayor la duración media del ingreso. Conclusión: La actividad del servicio de pediatría se incrementó en período epidémico, por lo que es oportuna la implantación de actividades de vigilancia, programas de prevención y control frente a rotavirus en el ámbito hospitalario.Introduction: The aim of this study was to determine the weeks of high rotavirus circulation in Valladolid (Spain and to compare the characteristics of hospitalizations and emergencies in epidemic and nonepidemic periods. Methods: The information sources consisted of the weekly notifications to the Microbiological Information System, the Minimum Data Set, and the Emergency Registry. Expected cases for 2006 were calculated using a previously developed model. Weeks with observed cases over the upper limit of the 95% confidence interval for expected cases were considered epidemic periods. Hospitalization and emergencies in epidemic and nonepidemic periods were compared. Results: The number of cases in 2006 was 42% less than the expected number. The mean number of daily admissions was higher in epidemic periods (d=1.49; p=0.01 and the

  20. Why Do Students Repeat Admissions Tests?

    Science.gov (United States)

    Jones, Martha S.

    Attitudes and beliefs about the admissions process, especially the role of standardized testing in admissions, were examined for students who took a standardized admissions test more than once. Their attitudes were compared with those of students who did not repeat the test. About 200 preveterinary students who had taken the Veterinary Aptitude…

  1. Toward a Sociology of Law School Admissions.

    Science.gov (United States)

    Erlanger, Howard S.

    1984-01-01

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

  2. Seasonal variations in hospital admissions for mania

    DEFF Research Database (Denmark)

    Medici, Clara Reece; Vestergaard, Claus Høstrup; Hadzi-Pavlovic, Dusan;

    2016-01-01

    Central Research Register. The Danish Meteorological Institute provided the meteorological variables. The association between weather and admissions was tested using linear regression. RESULTS: Our database comprised 24,313 admissions with mania. There was a seasonal pattern with admission rates peaking...

  3. Admissibility of Linear Systems in Banach Spaces

    Institute of Scientific and Technical Information of China (English)

    GUO Fa-ming

    2005-01-01

    In this paper, infinite-time p-admissibility of unbounded operators is introduced and the Co-semigroup characterization of the infinite-time p-admissibility of unbounded observation operators is given. Moreover, the analogous result for the infinite-time p-admissibility of unbounded control operators is presented.

  4. Can advanced paramedics in the field diagnose patients and predict hospital admission?

    LENUS (Irish Health Repository)

    Cummins, Niamh Maria

    2013-02-13

    BACKGROUND: Accurate patient diagnosis in the prehospital environment is essential to initiate suitable care pathways. The advanced paramedic (AP) is a relatively recent role in Ireland, and refers to a prehospital practitioner with advanced life-support skills and training. OBJECTIVES: The objectives of this study were to compare the diagnostic decisions of APs with emergency medicine (EM) physicians, and to investigate if APs, as currently trained, can predict the requirement for hospital admission. METHODS: A prospective study was initiated, whereby each emergency ambulance call received via the statutory 999 system was recorded by the attending AP. The AP was asked to provide a clinical diagnosis for each patient, and to predict if hospital admission was required. The data was then cross-referenced with the working diagnosis of the receiving emergency physician and the hospital admission records. RESULTS: A total of 17 APs participated in the study, and 1369 emergency calls were recorded over a 6-month period. Cases where a general practitioner attended the scene were excluded from the concordance analysis. Concordance with the receiving emergency physician represents 70% (525\\/748) for all cases of AP diagnosis, and is mirrored with 70% (604\\/859) correct hospital admission predictions. CONCLUSIONS: AP diagnosis and admission prediction for emergency calls is similar to other emergency medical services systems despite the relative recency of the AP programme in Ireland. Recognition of non-concordance case types may identify priorities for AP education, and drive future AP practice in areas such as \\'treat and refer\\'.

  5. Childhood cause-specific mortality in rural Western Kenya: application of the InterVA-4 model

    Directory of Open Access Journals (Sweden)

    Nyaguara O. Amek

    2014-10-01

    Full Text Available Background: Assessing the progress in achieving the United Nation's Millennium Development Goals in terms of population health requires consistent and reliable information on cause-specific mortality, which is often rare in resource-constrained countries. Health and demographic surveillance systems (HDSS have largely used medical personnel to review and assign likely causes of death based on the information gathered from standardized verbal autopsy (VA forms. However, this approach is expensive and time consuming, and it may lead to biased results based on the knowledge and experience of individual clinicians. We assessed the cause-specific mortality for children under 5 years old (under-5 deaths in Siaya County, obtained from a computer-based probabilistic model (InterVA-4. Design: Successfully completed VA interviews for under-5 deaths conducted between January 2003 and December 2010 in the Kenya Medical Research Institute/US Centers for Disease Control and Prevention HDSS were extracted from the VA database and processed using the InterVA-4 (version 4.02 model for interpretation. Cause-specific mortality fractions were then generated from the causes of death produced by the model. Results: A total of 84.33% (6,621 childhood deaths had completed VA data during the study period. Children aged 1–4 years constituted 48.53% of all cases, and 42.50% were from infants. A single cause of death was assigned to 89.18% (5,940 of cases, 8.35% (556 of cases were assigned two causes, and 2.10% (140 were assigned ‘indeterminate’ as cause of death by the InterVA-4 model. Overall, malaria (28.20% was the leading cause of death, followed by acute respiratory infection including pneumonia (25.10%, in under-5 children over the study period. But in the first 5 years of the study period, acute respiratory infection including pneumonia was the main cause of death, followed by malaria. Similar trends were also reported in infants (29 days–11 months and

  6. Disparities in death: Inequality in cause-specific infant and child mortality in Stockholm, 1878-1926

    DEFF Research Database (Denmark)

    Molitoris, Joseph John

    2017-01-01

    socioeconomic groups. OBJECTIVE The aim of this study is to examine the development of socioeconomic inequalities in cause-specific infant and child mortality during Stockholm’s demographic transition. METHODS Using an individual-level longitudinal population register for Stockholm, Sweden between 1878 and 1926......Abstract BACKGROUND The decline of child mortality during the late nineteenth century is one of the most significant demographic changes in human history. There is evidence, however, suggesting the substantial reductions in mortality during the era did little to reduce mortality inequality between...

  7. The influence of primary care quality on hospital admissions for people with dementia in England: a regression analysis.

    Directory of Open Access Journals (Sweden)

    Panagiotis Kasteridis

    Full Text Available To test the impact of a UK pay-for-performance indicator, the Quality and Outcomes Framework (QOF dementia review, on three types of hospital admission for people with dementia: emergency admissions where dementia was the primary diagnosis; emergency admissions for ambulatory care sensitive conditions (ACSCs; and elective admissions for cataract, hip replacement, hernia, prostate disease, or hearing loss.Count data regression analyses of hospital admissions from 8,304 English general practices from 2006/7 to 2010/11. We identified relevant admissions from national Hospital Episode Statistics and aggregated them to practice level. We merged these with practice-level data on the QOF dementia review. In the base case, the exposure measure was the reported QOF register. As dementia is commonly under-diagnosed, we tested a predicted practice register based on consensus estimates. We adjusted for practice characteristics including measures of deprivation and uptake of a social benefit to purchase care services (Attendance Allowance.In the base case analysis, higher QOF achievement had no significant effect on any type of hospital admission. However, when the predicted register was used to account for under-diagnosis, a one-percentage point improvement in QOF achievement was associated with a small reduction in emergency admissions for both dementia (-0.1%; P=0.011 and ACSCs (-0.1%; P=0.001. In areas of greater deprivation, uptake of Attendance Allowance was consistently associated with significantly lower emergency admissions. In all analyses, practices with a higher proportion of nursing home patients had significantly lower admission rates for elective and emergency care.In one of three analyses at practice level, the QOF review for dementia was associated with a small but significant reduction in unplanned hospital admissions. Given the rising prevalence of dementia, increasing pressures on acute hospital beds and poor outcomes associated with

  8. Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

    Directory of Open Access Journals (Sweden)

    P. Kim Streatfield

    2014-10-01

    Full Text Available Background: Childhood mortality, particularly in the first 5 years of life, is a major global concern and the target of Millennium Development Goal 4. Although the majority of childhood deaths occur in Africa and Asia, these are also the regions where such deaths are least likely to be registered. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering deaths and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available. Objective: To present a description of cause-specific mortality rates and fractions over the first 15 years of life as documented by INDEPTH Network sites in sub-Saharan Africa and south-east Asia. Design: All childhood deaths at INDEPTH sites are routinely registered and followed up with verbal autopsy (VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provided person-time denominators for mortality rates. Cause-specific mortality rates and cause-specific mortality fractions are presented according to WHO 2012 VA cause groups for neonatal, infant, 1–4 year and 5–14 year age groups. Results: A total of 28,751 childhood deaths were documented during 4,387,824 person-years over 18 sites. Infant mortality ranged from 11 to 78 per 1,000 live births, with under-5 mortality from 15 to 152 per 1,000 live births. Sites in Vietnam and Kenya accounted for the lowest and highest mortality rates reported. Conclusions: Many children continue to die from relatively preventable causes, particularly in areas with high rates of malaria and HIV/AIDS. Neonatal mortality persists at relatively high, and perhaps sometimes under-documented, rates

  9. Admission Criteria for MBA Programs

    Directory of Open Access Journals (Sweden)

    Silvana Dakduk

    2016-11-01

    Full Text Available This paper reports a review of studies on admission criteria for MBA programs. The method consisted in a literary review based on a systematic search in international databases (Emerald, ABI/INFORM Global, ProQuest Education Journals, ProQuest European Business, ProQuest Science Journal, ProQuest Research Library, ProQuest Psychology Journals, ProQuest Social Science Journals and Business Source Complete of studies published from January 1990 to December 2013, which explore the academic performance of students or graduates of MBA programs. A quantitative review was performed. Results show that most researchers studied relations between GMAT (Graduate Management Admission Test and UGPA (Undergraduate Grade Point Average as predictors of GGPA (Graduate Grade Point Average. On the other hand, work experience and personal traits (such as personality, motivation, learning strategies, self-efficacy beliefs and achievement expectations and their relation with GGPA had been less studied, and results are not consistent enough to consider them valid predictors of student performance at this time.

  10. Physical activity, sedentary behavior, and cause-specific mortality in black and white adults in the Southern Community Cohort Study.

    Science.gov (United States)

    Matthews, Charles E; Cohen, Sarah S; Fowke, Jay H; Han, Xijing; Xiao, Qian; Buchowski, Maciej S; Hargreaves, Margaret K; Signorello, Lisa B; Blot, William J

    2014-08-15

    There is limited evidence demonstrating the benefits of physical activity with regard to mortality risk or the harms associated with sedentary behavior in black adults, so we examined the relationships between these health behaviors and cause-specific mortality in a prospective study that had a large proportion of black adults. Participants (40-79 years of age) enrolled in the Southern Community Cohort Study between 2002 and 2009 (n = 63,308) were prospectively followed over 6.4 years, and 3,613 and 1,394 deaths occurred in blacks and whites, respectively. Black adults who reported the highest overall physical activity level (≥32.3 metabolic equivalent-hours/day vs. 12 hours/day vs. mortality in blacks and whites. Blacks who reported the most time spent being sedentary (≥10.5 hours/day) and lowest level of physical activity (mortality risk in black adults.

  11. Cause-specific excess mortality in siblings of patients co-infected with HIV and hepatitis C virus

    DEFF Research Database (Denmark)

    Hansen, Ann-Brit Eg; Lohse, Nicolai; Gerstoft, Jan;

    2007-01-01

    -years, compared with siblings of matched population controls. Substance abuse-related deaths contributed most to the elevated mortality among siblings [EMR = 2.25 (1.09-3.40)] followed by unnatural deaths [EMR = 0.67 (-0.05-1.39)]. No siblings of HIV/HCV co-infected patients had a liver-related diagnosis......BACKGROUND: Co-infection with hepatitis C in HIV-infected individuals is associated with 3- to 4-fold higher mortality among these patients' siblings, compared with siblings of mono-infected HIV-patients or population controls. This indicates that risk factors shared by family members partially...... account for the excess mortality of HIV/HCV-co-infected patients. We aimed to explore the causes of death contributing to the excess sibling mortality. METHODOLOGY AND PRINCIPAL FINDINGS: We retrieved causes of death from the Danish National Registry of Deaths and estimated cause-specific excess mortality...

  12. Cause-specific excess mortality in siblings of patients co-infected with HIV and hepatitis C virus

    DEFF Research Database (Denmark)

    Hansen, Ann-Brit Eg; Lohse, Nicolai; Gerstoft, Jan;

    2007-01-01

    BACKGROUND: Co-infection with hepatitis C in HIV-infected individuals is associated with 3- to 4-fold higher mortality among these patients' siblings, compared with siblings of mono-infected HIV-patients or population controls. This indicates that risk factors shared by family members partially...... account for the excess mortality of HIV/HCV-co-infected patients. We aimed to explore the causes of death contributing to the excess sibling mortality. METHODOLOGY AND PRINCIPAL FINDINGS: We retrieved causes of death from the Danish National Registry of Deaths and estimated cause-specific excess mortality...... rates (EMR) for siblings of HIV/HCV-co-infected individuals (n = 436) and siblings of HIV mono-infected individuals (n = 1837) compared with siblings of population controls (n = 281,221). Siblings of HIV/HCV-co-infected individuals had an all-cause EMR of 3.03 (95% CI, 1.56-4.50) per 1,000 person...

  13. Cause-specific cardiovascular risk associated with nonsteroidal anti-inflammatory drugs among myocardial infarction patients--a nationwide study.

    Directory of Open Access Journals (Sweden)

    Anne-Marie Schjerning Olsen

    Full Text Available BACKGROUND: Non steroidal anti-inflammatory drugs (NSAIDs increase mortality and morbidity after myocardial infarction (MI. We examined cause-specific mortality and morbidity associated with NSAIDs in a nationwide cohort of MI patients. METHODS AND RESULTS: By individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark, patients aged >30 years admitted with first-time MI during 1997-2009 and their subsequent NSAID use were identified. The risk of three cardiovascular specific endpoints: cardiovascular death, the composite of coronary death and nonfatal MI, and the composite of fatal and nonfatal stroke, associated with NSAID use was analyzed by Cox proportional hazard analyses. Of 97,698 patients included 44.0% received NSAIDs during follow-up. Overall use of NSAIDs was associated with an increased risk of cardiovascular death (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.36-1.49. In particular use of the nonselective NSAID diclofenac and the selective cyclooxygenase-2 inhibitor rofecoxib was associated with increased risk of cardiovascular death (HR 1.96 [1.79-2.15] and HR1.66 [1.44-1.91], respectively with a dose dependent increase in risk. Use of ibuprofen was associated with increased risk of cardiovascular death (HR 1.34[1.26-1.44], whereas naproxen was associated with the lowest risk of (e.g., HR 1.27[1.01-1.59]. CONCLUSION: Use of individual NSAIDs is associated with different cause-specific cardiovascular risk and in particular rofecoxib and diclofenac were associated with increased cardiovascular morbidity and mortality. These results support caution with use of all NSAIDs in patients with prior MI.

  14. Specialty-specific admission: a cost-effective intervention?

    LENUS (Irish Health Repository)

    Slattery, E

    2012-02-01

    INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.

  15. Graduate admissions in clinical neuropsychology: the importance of undergraduate training.

    Science.gov (United States)

    Karazsia, Bryan T; Stavnezer, Amy Jo; Reeves, Jonathan W

    2013-11-01

    Discussions of and recommendations for the training of clinical neuropsychologists exist at the doctoral, internship, and post-doctoral level. With few exceptions, the literature on undergraduate preparations in clinical neuropsychology is sparse and lacks empirical evidence. In the present study, graduate-level faculty and current trainees completed surveys about graduate school preparations. Faculty expectations of minimum and ideal undergraduate training were highest for research methods, statistics, and assessment. Preferences for "goodness of fit" also emerged as important admissions factors. These results offer evidence for desirable undergraduate preparations for advanced study in clinical neuropsychology. Although undergraduate training in psychology is intentionally broad, results from this study suggest that students who desire advanced study in clinical neuropsychology need to tailor their experiences to be competitive in the application process. The findings have implications for prospective graduate students, faculty who train and mentor undergraduates, and faculty who serve on admissions committees.

  16. The Predictive Validity of using Admissions Testing and Multiple Mini-interviews in Undergraduate University Admissions

    DEFF Research Database (Denmark)

    Makransky, Guido; Havmose, Philip; Vang, Maria Louison;

    2016-01-01

    to the grade-based admissions procedure. Finally, students admitted through the MMI scored significantly higher on academic learning self-efficacy and critical thinking compared to students selected by grades. The implications for higher education admissions are discussed....

  17. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger

    2008-01-01

    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  18. The relationship of walking intensity to total and cause-specific mortality. Results from the National Walkers' Health Study.

    Directory of Open Access Journals (Sweden)

    Paul T Williams

    Full Text Available PURPOSE: Test whether: 1 walking intensity predicts mortality when adjusted for walking energy expenditure, and 2 slow walking pace (≥24-minute mile identifies subjects at substantially elevated risk for mortality. METHODS: Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. RESULTS: The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10(-5, cardiovascular diseases (2.4% increase, P=0.001, 637 deaths, ischemic heart disease (2.8% increase, P=0.003, 336 deaths, heart failure (6.5% increase, P=0.001, 36 deaths, hypertensive heart disease (6.2% increase, P=0.01, 31 deaths, diabetes (6.3% increase, P=0.004, 32 deaths, and dementia (6.6% increase, P=0.0004, 44 deaths. Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001, cardiovascular diseases (43.9% increased risk, P=0.03, and dementia (5.0-fold increased risk, P=0.0002 even though they satisfied the current exercise recommendations by walking ≥7.5 metabolic equivalent (MET-hours per week. CONCLUSIONS: The risk for mortality: 1 decreases in association with walking intensity, and 2 increases substantially in association for walking pace ≥24 minute mile (equivalent to <400 m during a six-minute walk test even among subjects who exercise regularly.

  19. Effects on the estimated cause-specific mortality fraction of providing physician reviewers with different formats of verbal autopsy data

    Directory of Open Access Journals (Sweden)

    Chow Clara

    2011-08-01

    Full Text Available Abstract Background The process of data collection and the methods used to assign the cause of death vary significantly among different verbal autopsy protocols, but there are few data to describe the consequences of the choices made. The aim of this study was to objectively define the impact of the format of data presented to physician reviewers on the cause-specific mortality fractions defined by a verbal autopsy-based mortality-surveillance system. Methods Verbal autopsies were done by primary health care workers for all deaths between October 2006 and September 2007 in a community in rural Andhra Pradesh, India (total population about 180,162. Each questionnaire had a structured section, composed of a series of check boxes, and a free-text section, in which a narrative description of the events leading to death was recorded. For each death, a physician coder was presented first with one section and then the other in random order with a 20- to 40-day interval between. A cause of death was recorded for each data format at the level of ICD 10 chapter headings or else the death was documented as unclassified. After another 20- to 40-day interval, both the structured and free-text sections of the questionnaire were presented together and an index cause of death was assigned. Results In all, 1,407 verbal autopsies were available for analysis, representing 94% of all deaths recorded in the population that year. An index cause of death was assigned using the combined data for 1,190 with the other 217 remaining unclassified. The observed cause-specific mortality fractions were the same regardless of whether the structured, free-text or combined data sources were used. At the individual level, the assignments made using the structured format matched the index in 1,012 (72% of cases with a kappa statistic of 0.66. For the free-text format, the corresponding figures were 989 (70% and 0.64. Conclusions The format of the verbal autopsy data used to assign

  20. Combined impact of lifestyle-related factors on total and cause-specific mortality among Chinese women: prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah J Nechuta

    2010-09-01

    Full Text Available BACKGROUND: Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese and other non-Western populations. The objective of this study was to quantify the overall impact of lifestyle-related factors beyond that of active cigarette smoking and alcohol consumption on all-cause and cause-specific mortality in Chinese women. METHODS AND FINDINGS: We used data from the Shanghai Women's Health Study, an ongoing population-based prospective cohort study in China. Participants included 71,243 women aged 40 to 70 years enrolled during 1996-2000 who never smoked or drank alcohol regularly. A healthy lifestyle score was created on the basis of five lifestyle-related factors shown to be independently associated with mortality outcomes (normal weight, lower waist-hip ratio, daily exercise, never exposed to spouse's smoking, higher daily fruit and vegetable intake. The score ranged from zero (least healthy to five (most healthy points. During an average follow-up of 9 years, 2,860 deaths occurred, including 775 from cardiovascular disease (CVD and 1,351 from cancer. Adjusted hazard ratios for mortality decreased progressively with an increasing number of healthy lifestyle factors. Compared to women with a score of zero, hazard ratios (95% confidence intervals for women with four to five factors were 0.57 (0.44-0.74 for total mortality, 0.29 (0.16-0.54 for CVD mortality, and 0.76 (0.54-1.06 for cancer mortality. The inverse association between the healthy lifestyle score and mortality was seen consistently regardless of chronic disease status at baseline. The population attributable risks for not having 4-5 healthy lifestyle factors were 33% for total deaths, 59% for CVD deaths, and 19% for cancer deaths

  1. Unethical Admissions: Academic Integrity in Question.

    Science.gov (United States)

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

    2016-11-28

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

  2. Admission to Law School: New Measures

    Science.gov (United States)

    Shultz, Marjorie M.; Zedeck, Sheldon

    2012-01-01

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

  3. Impact of Hospital Admission Care At a Pediatric Unit: A Qualitative Study.

    Science.gov (United States)

    Macías, Marta; Zornoza, Carmen; Rodriguez, Elena; García, José A; Fernández, José A; Luque, Rafaela; Collado, Rosa

    2015-01-01

    The time of admission to a hospital, especially when unplanned, has been reported as the most stressful moment of hospitalization for both parents and children (Odievre, 2001). This qualitative study explored parents and hospital staff's perceptions and experiences related to the process of admission to a pediatric unit. Focus groups, two with parents (total n = 12) and one with health care professionals (n = 6), were conducted, and content analysis inspired by Graneheim and Lundman (2004) was performed. Parents identified four categories of perceptions: 1) management of an uncertain situation at the time of admission, 2) feelings related to the child's illness, 3) parent perception of professional's performance, and 4) parent experience of their role. Health care professionals identified two categories: 1) hospital admission as a continuous care process, and 2) undertaking improvements in the admission process. A common theme emerged about the importance of parents' trust in professionals in order to build a therapeutic relationship. Findings underscore the need for strategies to improve the hospital pediatric admission process based on a parent-professional relationship of trust and confidence through continuous quality communication and support. These strategies would include providing a nurse in charge of the admission process to assure continuity of care throughout the child's hospitalization.

  4. Perceived stress and cause-specific mortality among men and women: results from a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Kristensen, Tage S; Schnohr, Peter

    2008-01-01

    was most pronounced for deaths due to respiratory diseases (high vs. low stress: HR = 1.79, 95% CI: 1.10, 2.91), external causes (HR = 3.07, 95% CI: 1.65, 5.71), and suicide (HR = 5.91, 95% CI: 2.47, 14.16). High stress was related to a 2.59 (95% CI: 1.20, 5.61) higher risk of ischemic heart disease......The authors assessed the effect of psychological stress on total and cause-specific mortality among men and women. In 1981-1983, the 12,128 Danish participants in the Copenhagen City Heart Study were asked two questions on stress intensity and frequency and were followed in a nationwide registry...... until 2004, with stress and mortality (p = 0.02). After adjustments, men with high stress versus low stress had higher all-cause mortality (hazard ratio (HR) = 1.32, 95% confidence interval (CI): 1.15, 1.52). This finding...

  5. Association of Coffee Consumption With Overall and Cause-Specific Mortality in a Large US Prospective Cohort Study.

    Science.gov (United States)

    Loftfield, Erikka; Freedman, Neal D; Graubard, Barry I; Guertin, Kristin A; Black, Amanda; Huang, Wen-Yi; Shebl, Fatma M; Mayne, Susan T; Sinha, Rashmi

    2015-12-15

    Concerns about high caffeine intake and coffee as a vehicle for added fat and sugar have raised questions about the net impact of coffee on health. Although inverse associations have been observed for overall mortality, data for cause-specific mortality are sparse. Additionally, few studies have considered exclusively decaffeinated coffee intake or use of coffee additives. Coffee intake was assessed at baseline by self-report in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Hazard ratios were estimated using Cox proportional hazards models. Among 90,317 US adults without cancer at study baseline (1998-2001) or history of cardiovascular disease at study enrollment (1993-2001), 8,718 deaths occurred during 805,644 person-years of follow-up from 1998 through 2009. Following adjustment for smoking and other potential confounders, coffee drinkers, as compared with nondrinkers, had lower hazard ratios for overall mortality (coffee and coffee additives. Inverse associations were observed for deaths from heart disease, chronic respiratory diseases, diabetes, pneumonia and influenza, and intentional self-harm, but not cancer. Coffee may reduce mortality risk by favorably affecting inflammation, lung function, insulin sensitivity, and depression.

  6. A Logical Characterization of Iterated Admissibility

    CERN Document Server

    Halpern, Joseph Y

    2009-01-01

    Brandenburger, Friedenberg, and Keisler provide an epistemic characterization of iterated admissibility (i.e., iterated deletion of weakly dominated strategies) where uncertainty is represented using LPSs (lexicographic probability sequences). Their characterization holds in a rich structure called a complete structure, where all types are possible. Here, a logical charaacterization of iterated admisibility is given that involves only standard probability and holds in all structures, not just complete structures. A stronger notion of strong admissibility is then defined. Roughly speaking, strong admissibility is meant to capture the intuition that "all the agent knows" is that the other agents satisfy the appropriate rationality assumptions. Strong admissibility makes it possible to relate admissibility, canonical structures (as typically considered in completeness proofs in modal logic), complete structures, and the notion of ``all I know''.

  7. Patient-controlled hospital admission for patients with severe mental disorders

    DEFF Research Database (Denmark)

    Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling

    2016-01-01

    INTRODUCTION: Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous...... studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient......-controlled hospital admission on the use of coercion and of healthcare services. DESIGN AND METHODS: We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare...

  8. Impact of changes in specificity of data recording on cause-specific injury mortality in the United States, 1999–2010

    OpenAIRE

    Hu, Guoqing; Mamady, Keita

    2014-01-01

    Background We aimed to examine changes in the specificity of data recording and assess the impact on cause-specific injury mortality during 1999–2010. Methods A longitudinal study was designed to analyze injury mortality data of 1999-2010. Mortality rates for unspecified injury and for cause-specific injury were obtained using CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™). The proportion of unspecified injury was used to measure the specificity of injury data recordi...

  9. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy

    Science.gov (United States)

    May, Margaret T.; Vehreschild, Janne; Obel, Niels; Gill, Michael John; Crane, Heidi; Boesecke, Christoph; Samji, Hasina; Grabar, Sophie; Cazanave, Charles; Cavassini, Matthias; Shepherd, Leah; d’Arminio Monforte, Antonella; Smit, Colette; Saag, Michael; Lampe, Fiona; Hernando, Vicky; Montero, Marta; Zangerle, Robert; Justice, Amy C.; Sterling, Timothy; Miro, Jose; Ingle, Suzanne; Sterne, Jonathan A. C.

    2016-01-01

    Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and survived for more than ten years. Methods We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. Results During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Conclusions Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. PMID:27525413

  10. Cause-specific inequalities in mortality in Scotland: two decades of change. A population-based study

    Directory of Open Access Journals (Sweden)

    McLoone Philip

    2007-07-01

    Full Text Available Abstract Background Socioeconomic inequalities in mortality have increased in recent years in many countries. We examined age-, sex-, and cause-specific mortality rates for social groups in and regions of Scotland to understand the patterning of inequalities and the causes contributing to these inequalities. Methods We used death records for 1980–82, 1991–92 and 2000–02 together with mid-year population estimates for 1981, 1991 and 2001 covering the whole of Scotland to calculate directly standardised mortality rates. Deaths and populations were coded to small areas (postcode sectors and data zones, and deprivation was assessed using area based measures (Carstairs scores and the Scottish Index of Multiple Deprivation. We measured inequalities using rate ratios and the Slope Index of Inequality (SII. Results Substantial overall decreases in mortality rates disguised increases for men aged 15–44 and little change for women at the same ages. The pattern at these ages was mostly attributable to increases in suicides and deaths related to the use of alcohol and drugs. Under 65 a 49% fall in the mortality of men in the least deprived areas contrasted with a fall of just 2% in the most deprived. There were substantial increases in the social gradients for most causes of death. Excess male mortality in the Clydeside region was largely confined to more deprived areas, whilst for women in the region mortality was in line with the Scottish experience. Relative inequalities for men and women were greatest between the ages of 30 and 49. Conclusion General reductions in mortality in the major causes of death (ischaemic heart disease, malignant neoplasms are encouraging; however, such reductions were socially patterned. Relative inequalities in mortality have increased and are greatest among younger adults where deaths related to unfavourable lifestyles call for direct social policies to address poverty.

  11. The combined effect of smoking tobacco and drinking alcohol on cause-specific mortality: a 30 year cohort study

    Directory of Open Access Journals (Sweden)

    Watt Graham CM

    2010-12-01

    Full Text Available Abstract Background Smoking and consuming alcohol are both related to increased mortality risk. Their combined effects on cause-specific mortality were investigated in a prospective cohort study. Methods Participants were 5771 men aged 35-64, recruited during 1970-73 from various workplaces in Scotland. Data were obtained from a questionnaire and a screening examination. Causes of death were all cause, coronary heart disease (CHD, stroke, alcohol-related, respiratory and smoking-related cancer. Participants were divided into nine groups according to their smoking status (never, ex or current and reported weekly drinking (none, 1-14 units and 15 or more. Cox proportional hazards models were used to obtain relative rates of mortality, adjusted for age and other risk factors. Results In 30 years of follow-up, 3083 men (53.4% died. Compared with never smokers who did not drink, men who both smoked and drank 15+ units/week had the highest all-cause mortality (relative rate = 2.71 (95% confidence interval 2.31-3.19. Relative rates for CHD mortality were high for current smokers, with a possible protective effect of some alcohol consumption in never smokers. Stroke mortality increased with both smoking and alcohol consumption. Smoking affected respiratory mortality with little effect of alcohol. Adjusting for a wide range of confounders attenuated the relative rates but the effects of alcohol and smoking still remained. Premature mortality was particularly high in smokers who drank 15 or more units, with a quarter of the men not surviving to age 65. 30% of men with manual occupations both smoked and drank 15+ units/week compared with only 13% with non-manual ones. Conclusions Smoking and drinking 15+ units/week was the riskiest behaviour for all causes of death.

  12. A retrospective cohort study of cause-specific mortality and incidence of hematopoietic malignancies in Chinese benzene-exposed workers.

    Science.gov (United States)

    Linet, Martha S; Yin, Song-Nian; Gilbert, Ethel S; Dores, Graça M; Hayes, Richard B; Vermeulen, Roel; Tian, Hao-Yuan; Lan, Qing; Portengen, Lutzen; Ji, Bu-Tian; Li, Gui-Lan; Rothman, Nathaniel

    2015-11-01

    Benzene exposure has been causally linked with acute myeloid leukemia (AML), but inconsistently associated with other hematopoietic, lymphoproliferative and related disorders (HLD) or solid tumors in humans. Many neoplasms have been described in experimental animals exposed to benzene. We used Poisson regression to estimate adjusted relative risks (RR) and the likelihood ratio statistic to derive confidence intervals for cause-specific mortality and HLD incidence in 73,789 benzene-exposed compared with 34,504 unexposed workers in a retrospective cohort study in 12 cities in China. Follow-up and outcome assessment was based on factory, medical and other records. Benzene-exposed workers experienced increased risks for all-cause mortality (RR = 1.1, 95% CI = 1.1, 1.2) due to excesses of all neoplasms (RR = 1.3, 95% CI = 1.2, 1.4), respiratory diseases (RR = 1.7, 95% CI = 1.2, 2.3) and diseases of blood forming organs (RR = ∞, 95% CI = 3.4, ∞). Lung cancer mortality was significantly elevated (RR = 1.5, 95% CI = 1.2, 1.9) with similar RRs for males and females, based on three-fold more cases than in our previous follow-up. Significantly elevated incidence of all myeloid disorders reflected excesses of myelodysplastic syndrome/acute myeloid leukemia (RR = 2.7, 95% CI = 1.2, 6.6) and chronic myeloid leukemia (RR = 2.5, 95% CI = 0.8, 11), and increases of all lymphoid disorders included excesses of non-Hodgkin lymphoma (RR = 3.9, 95%CI = 1.5, 13) and all lymphoid leukemia (RR = 5.4, 95%CI = 1.0, 99). The 28-year follow-up of Chinese benzene-exposed workers demonstrated increased risks of a broad range of myeloid and lymphoid neoplasms, lung cancer, and respiratory diseases and suggested possible associations with other malignant and non-malignant disorders.

  13. Cause-specific premature death from ambient PM2.5 exposure in India: Estimate adjusted for baseline mortality.

    Science.gov (United States)

    Chowdhury, Sourangsu; Dey, Sagnik

    2016-05-01

    In India, more than a billion population is at risk of exposure to ambient fine particulate matter (PM2.5) concentration exceeding World Health Organization air quality guideline, posing a serious threat to health. Cause-specific premature death from ambient PM2.5 exposure is poorly known for India. Here we develop a non-linear power law (NLP) function to estimate the relative risk associated with ambient PM2.5 exposure using satellite-based PM2.5 concentration (2001-2010) that is bias-corrected against coincident direct measurements. We show that estimate of annual premature death in India is lower by 14.7% (19.2%) using NLP (integrated exposure risk function, IER) for assumption of uniform baseline mortality across India (as considered in the global burden of disease study) relative to the estimate obtained by adjusting for state-specific baseline mortality using GDP as a proxy. 486,100 (811,000) annual premature death in India is estimated using NLP (IER) risk functions after baseline mortality adjustment. 54.5% of premature death estimated using NLP risk function is attributed to chronic obstructive pulmonary disease (COPD), 24.0% to ischemic heart disease (IHD), 18.5% to stroke and the remaining 3.0% to lung cancer (LC). 44,900 (5900-173,300) less premature death is expected annually, if India achieves its present annual air quality target of 40μgm(-3). Our results identify the worst affected districts in terms of ambient PM2.5 exposure and resulting annual premature death and call for initiation of long-term measures through a systematic framework of pollution and health data archive.

  14. Early life origins of all-cause and cause-specific disability pension: findings from the Helsinki Birth Cohort Study.

    Directory of Open Access Journals (Sweden)

    Mikaela B von Bondorff

    Full Text Available There is some evidence linking sub-optimal prenatal development to an increased risk of disability pension (DP. Our aim was to investigate whether body size at birth was associated with transitioning into all-cause and cause-specific DP during the adult work career.10 682 people born in 1934-44 belonging to the Helsinki Birth Cohort Study had data on birth weight extracted from birth records, and on time, type and reason of retirement between 1971 and 2011 extracted from the Finnish Centre for Pensions.Altogether 21.3% transitioned into DP during the 40-year follow-up, mainly due to mental disorders, musculoskeletal disorders and cardiovascular disease. Average age of transitioning into DP was 51.3 (SD 8.4 for men and 52.2 (SD 7.6 for women. Cohort members who did not transition into DP retired 10 years later on average. Among men, higher birth weight was associated with a lower hazard of transitioning into DP, adjusted hazard ratio (HR being 0.94 (95% confidence interval [CI] 0.88-0.99 for 1 SD increase in birth weight. For DP due to mental disorders the adjusted HR was 0.90, 95% CI 0.81, 0.99. A similar but non-significant trend was found for DP due to cardiovascular disease. Among women there were no associations between body size at birth and all-cause DP (p for interaction gender*birth weight on DP p = 0.007.Among men disability pension, particularly due to mental disorders, may have its origins in prenatal development. Given that those who retire due to mental health problems are relatively young, the loss to the workforce is substantial.

  15. The role of the asthma nurse in treatment compliance and self-management following hospital admission.

    Science.gov (United States)

    Morice, A H; Wrench, C

    2001-11-01

    Effective self-management and treatment compliance is important in achieving good symptom control in asthma. The aim of this study was to determine whether asthma nurse intervention during hospital admission could increase knowledge and improve self-management and whether this would influence the number of emergency call-out visits by Genera Practitioners (GPs) and hospital re-admissions. Patients with acute asthma (n=80) were assessed by the asthma nurse within 24 h of admission using a British Thoracic Society (BTS) guideline-based questionnaire. Main outcome measures were: know edge of inhalers, self-management plans, peak flow monitoring, recognition of worsening symptoms and appropriate emergency action, Following randomization, half received nurse intervention during hospitalization. All received a follow-up questionnaire 6 weeks post-discharge and again at 6 months (response rates 86% and 81% respectively). GPs were contacted by postal questionnaire after 4 months. Questionnaire responses indicated an increase in knowledge in the intervention group, along with an ability to identify appropriate action on worsening symptoms. Emergency GP call-outs were more frequent in the control group in the 4 months post-discharge. Hospital re-admission rates were similar in both groups. Asthma nurse intervention appeared to increase knowledge of asthma management, maintained throughout the study period, but had no significant impact on reducing re-admissions to hospital.

  16. Effect of air pollution control on mortality and hospital admissions in Ireland.

    Science.gov (United States)

    Dockery, Douglas W; Rich, David Q; Goodman, Patrick G; Clancy, Luke; Ohman-Strickland, Pamela; George, Prethibha; Kotlov, Tania

    2013-07-01

    During the 1980s the Republic of Ireland experienced repeated severe pollution episodes. Domestic coal burning was a major source of this pollution. In 1990 the Irish government introduced a ban on the marketing, sale, and distribution of coal in Dublin. The ban was extended to Cork in 1995 and to 10 other communities in 1998 and 2000. We previously reported decreases in particulate black smoke (BS*) and sulfur dioxide (SO2) concentrations, measured as total gaseous acidity, in Dublin after the 1990 coal ban (Clancy et al. 2002). In the current study we explored and compared the effectiveness of the sequential 1990, 1995, and 1998 bans in reducing community air pollution and in improving public health. We compiled records of daily BS, total gaseous acidity (SO2), and counts of cause-specific deaths from 1981 to 2004 for Dublin County Borough (1990 ban), county Cork (1995 ban), and counties Limerick, Louth, Wexford, and Wicklow (1998 ban). We also compiled daily counts of hospital admissions for cardiovascular, respiratory, and digestive diagnoses for Cork County Borough (1991 to 2004) and counties Limerick, Louth, Wexford, and Wicklow (1993 to 2004). We compared pre-ban and post-ban BS and SO2 concentrations for each city. Using interrupted time-series methods, we estimated the change in cause-specific, directly standardized mortality rates in each city or county after the corresponding local coal ban. We regressed weekly age- and sex-standardized mortality rates against an indicator of the post- versus pre-ban period, adjusting for influenza epidemics, weekly mean temperature, and a season smooth of the standardized mortality rates in Coastal counties presumably not affected by the bans. We compared these results with similar analyses in Midlands counties also presumably unaffected by the bans. We also estimated the change in cause-specific, directly standardized, weekly hospital admissions rates normalized for underreporting in each city or county after the 1995

  17. Estimating the phenology of elk brucellosis transmission with hierarchical models of cause-specific and baseline hazards

    Science.gov (United States)

    Cross, Paul C.; Maichak, Eric J.; Rogerson, Jared D.; Irvine, Kathryn M.; Jones, Jennifer D; Heisey, Dennis M.; Edwards, William H.; Scurlock, Brandon M.

    2015-01-01

    Understanding the seasonal timing of disease transmission can lead to more effective control strategies, but the seasonality of transmission is often unknown for pathogens transmitted directly. We inserted vaginal implant transmitters (VITs) in 575 elk (Cervus elaphus canadensis) from 2006 to 2014 to assess when reproductive failures (i.e., abortions or still births) occur, which is the primary transmission route of Brucella abortus, the causative agent of brucellosis in the Greater Yellowstone Ecosystem. Using a survival analysis framework, we developed a Bayesian hierarchical model that simultaneously estimated the total baseline hazard of a reproductive event as well as its 2 mutually exclusive parts (abortions or live births). Approximately, 16% (95% CI = 0.10, 0.23) of the pregnant seropositive elk had reproductive failures, whereas 2% (95% CI = 0.01, 0.04) of the seronegative elk had probable abortions. Reproductive failures could have occurred as early as 13 February and as late as 10 July, peaking from March through May. Model results suggest that less than 5% of likely abortions occurred after 6 June each year and abortions were approximately 5 times more likely in March, April, or May compared to February or June. In western Wyoming, supplemental feeding of elk begins in December and ends during the peak of elk abortions and brucellosis transmission (i.e., Mar and Apr). Years with more snow may enhance elk-to-elk transmission on supplemental feeding areas because elk are artificially aggregated for the majority of the transmission season. Elk-to-cattle transmission will depend on the transmission period relative to the end of the supplemental feeding season, elk seroprevalence, population size, and the amount of commingling. Our statistical approach allowed us to estimate the probability density function of different event types over time, which may be applicable to other cause-specific survival analyses. It is often challenging to assess the

  18. Cause-specific temporal and spatial trends in green sea turtle strandings in the Hawaiian Archipelago (1982-2003)

    Science.gov (United States)

    Chaloupka, Milani; Work, Thierry M.; Balazs, George H.; Murakawa, Shawn K. K.; Morris, Robert

    2008-01-01

    We investigated cause-specific temporal and spatial trends in sea turtle strandings in the Hawaiian Archipelago. Five species of sea turtle were recorded in 3,861 strandings over a 22-year period (1982-2003). Green turtles comprised 97% of these strandings with size and gender composition reflecting the demographic structure of the resident green turtle population and relative green turtle abundance in Hawaiian waters. The cause of strandings was determined by necropsy based on a complete gross external and internal examination. Totally 75% of the 3,732 green turtle strandings were from Oahu where strandings occur year-round. The most common known cause of the green turtle strandings was the tumour-forming disease, fibropapillomatosis (28%) followed by hook-and-line fishing gear-induced trauma (7%), gillnet fishing gear-induced trauma (5%), boat strike (2.5%), and shark attack (2.7%). Miscellaneous causes comprised 5.4% of strandings whereas 49% of green turtle strandings could not be attributed to any known cause. Green turtle strandings attributable to boat strike were more likely from Kauai and Oahu while fibropapilloma strandings were more likely from Oahu and Maui. Hook-and-line gear strandings were more likely from Oahu due to higher per capita inshore fishing effort. The specific mortality rate (conditional probability) for fibropapillomatosis was 88%, 69% for gillnet gear and 52% for hook-and-line gear. The probability of a dead green turtle stranding increased from 1982 but levelled off by the mid-1990s. The declining mortality risk was because the prevalence and severity of fibropapillomatosis has decreased recently and so has the mortality risk attributable to gillnet gear. Despite exposure to disease and inshore fishing gears, the Hawaiian green turtle stock continues to recover following protection since the late 1970s. Nevertheless, measures to reduce incidental capture of sea turtles in coastal Hawaiian fisheries would be prudent, especially since

  19. Association of mortality with out-of-hours admission in patients with perforated peptic ulcer

    DEFF Research Database (Denmark)

    Knudsen, N V; Møller, M H

    2015-01-01

    surgically treated for benign gastric or duodenal perforated peptic ulcer in Denmark between September 1, 2011 and August 31, 2013 were included. Patients were identified through The Danish Clinical Register of Emergency Surgery. The association between 90-day mortality and time and day of admission......BACKGROUND: Perforated peptic ulcer is a serious emergency surgical condition. The aim of the present nationwide cohort study was to evaluate the association between mortality and out-of-hours admission in patients surgically treated for perforated peptic ulcer. METHODS: All Danish patients...... with the primary analysis. The overall 90-day mortality rate was 25.6% (186/726). CONCLUSION: No statistically significant adjusted association between 90-day mortality and out-of-hours admission was found in patients surgically treated for perforated peptic ulcer....

  20. Admissible Strategies in Semimartingale Portfolio Selection

    CERN Document Server

    Biagini, Sara

    2009-01-01

    The choice of admissible trading strategies in mathematical modelling of financial markets is a delicate issue, going back to Harrison and Kreps (1979). In the context of optimal portfolio selection with expected utility preferences this question has been a focus of considerable attention over the last twenty years. We propose a novel notion of admissibility that has many pleasant features -- admissibility is characterized purely under the objective measure $P$; the wealth of any admissible strategy is a supermartingale under all pricing measures; local boundedness of the price process is not required; neither strict monotonicity, strict concavity nor differentiability of the utility function are necessary; the definition encompasses both the classical mean-variance preferences and the monotone expected utility. For utility functions finite on the real line, our class represents a minimal set containing simple strategies which also contains the optimizer, under conditions that are substantially milder than th...

  1. Every seventh acute medical admission is preventable

    DEFF Research Database (Denmark)

    Jepsen, Henrik Koldborg; Hendriksen, Carsten; Nielsen, Henrik;

    2013-01-01

    The majority of patients who are admitted to the departments of internal medicine are admitted acutely. The aim of this study was to evaluate the appropriateness of admissions to a community hospital in Copenhagen....

  2. The Parent Role in College Admission.

    Science.gov (United States)

    Krugman, Mary K.

    1990-01-01

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

  3. Call Admission Control in Mobile Cellular Networks

    CERN Document Server

    Ghosh, Sanchita

    2013-01-01

    Call Admission Control (CAC) and Dynamic Channel Assignments (DCA) are important decision-making problems in mobile cellular communication systems. Current research in mobile communication considers them as two independent problems, although the former greatly depends on the resulting free channels obtained as the outcome of the latter. This book provides a solution to the CAC problem, considering DCA as an integral part of decision-making for call admission. Further, current technical resources ignore movement issues of mobile stations and fluctuation in network load (incoming calls) in the control strategy used for call admission. In addition, the present techniques on call admission offers solution globally for the entire network, instead of considering the cells independently.      CAC here has been formulated by two alternative approaches. The first approach aimed at handling the uncertainty in the CAC problem by employing fuzzy comparators.  The second approach is concerned with formulation of CAC ...

  4. Intensive care unit admission in patients following rapid response team activation: call factors, patient characteristics and hospital outcomes.

    Science.gov (United States)

    Le Guen, M P; Tobin, A E; Reid, D

    2015-03-01

    Rapid Response Systems (RRSs) have been widely introduced throughout hospital health systems, yet there is limited research on the characteristics and outcomes of patients admitted to an intensive care unit (ICU) following RRS activation. Using database extraction, this study examined the factors associated with ICU admission and patient outcome in patients receiving RRS activation in a tertiary level hospital between 2009 and 2013. Of 3004 RRS activations, 392 resulted in ICU admissions. Call factors associated with ICU admission and increased hospital mortality included tachypnoea (P Medical Emergency Team call triggers breached simultaneously (P admission included young age (P admission and hospital mortality post RRS activation. This information may be useful for risk stratification of deteriorating patients and determination of appropriate escalation.

  5. Every seventh acute medical admission is preventable

    DEFF Research Database (Denmark)

    Jepsen, Henrik Koldborg; Hendriksen, Carsten; Nielsen, Henrik;

    2013-01-01

    The majority of patients who are admitted to the departments of internal medicine are admitted acutely. The aim of this study was to evaluate the appropriateness of admissions to a community hospital in Copenhagen.......The majority of patients who are admitted to the departments of internal medicine are admitted acutely. The aim of this study was to evaluate the appropriateness of admissions to a community hospital in Copenhagen....

  6. Acute effects of particulate air pollution on respiratory admissions - Results from APHEA 2 project

    NARCIS (Netherlands)

    Atkinson, RW; Anderson, HR; Sunyer, J; Ayres, J; Baccini, M; Vonk, JM; Boumghar, A; Forastiere, F; Forsberg, B; Touloumi, G; Schwartz, J; Katsouyanni, K

    2001-01-01

    The APHEA 2 project investigated short-term health effects of particles in eight European cities. In each city associations between particles with an aerodynamic diameter of less than 10 mum (PM10) and black smoke and daily counts of emergency hospital admissions for asthma (0-14 and 15-64 yr), chro

  7. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit

    Directory of Open Access Journals (Sweden)

    Gladman John RF

    2011-05-01

    Full Text Available Abstract Background Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective. Methods/design We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care. Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'. Sample size is 300 per group. The evaluation design has been adapted to accommodate pressures on bed management and patient flows. If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards. Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected. Quality of care and patient experience are assessed in a non-participant observer study. Outcomes are ascertained at a follow up home visit 90 days after randomisation, by a researcher blind to allocation. The primary outcome is days spent at home (for those admitted from home, or days spent in the same care home (if admitted from a care home. Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of

  8. Identification of risk factors for hospital admission using multiple-failure survival models: a toolkit for researchers

    Directory of Open Access Journals (Sweden)

    Leo D. Westbury

    2016-04-01

    Full Text Available Abstract Background The UK population is ageing; improved understanding of risk factors for hospital admission is required. Linkage of the Hertfordshire Cohort Study (HCS with Hospital Episode Statistics (HES data has created a multiple-failure survival dataset detailing the characteristics of 2,997 individuals at baseline (1998–2004, average age 66 years and their hospital admissions (regarded as ‘failure events’ over a 10 year follow-up. Analysis of risk factors using logistic regression or time to first event Cox modelling wastes information as an individual’s admissions after their first are disregarded. Sophisticated analysis techniques are established to examine risk factors for admission in such datasets but are not commonly implemented. Methods We review analysis techniques for multiple-failure survival datasets (logistic regression; time to first event Cox modelling; and the Andersen and Gill [AG] and Prentice, Williams and Peterson Total Time [PWP-TT] multiple-failure models, outline their implementation in Stata, and compare their results in an analysis of housing tenure (a marker of socioeconomic position as a risk factor for different types of hospital admission (any; emergency; elective; >7 days. The AG and PWP-TT models include full admissions histories in the analysis of risk factors for admission and account for within-subject correlation of failure times. The PWP-TT model is also stratified on the number of previous failure events, allowing an individual’s baseline risk of admission to increase with their number of previous admissions. Results All models yielded broadly similar results: not owner-occupying one’s home was associated with increased risk of hospital admission. Estimated effect sizes were smaller from the PWP-TT model in comparison with other models owing to it having accounted for an increase in risk of admission with number of previous admissions. For example, hazard ratios [HR] from time to first

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

    Science.gov (United States)

    British Columbia Council on Admissions and Transfer, 2008

    2008-01-01

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

  10. The Predictive Validity of using Admissions Testing and Multiple Mini-interviews in Undergraduate University Admissions

    DEFF Research Database (Denmark)

    Makransky, Guido; Havmose, Philip; Vang, Maria Louison;

    2016-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  12. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    NARCIS (Netherlands)

    Geleijnse, J.M.

    2015-01-01

    Background

    Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countrie

  13. The therapeutic relationship after psychiatric admission.

    LENUS (Irish Health Repository)

    Roche, Eric

    2014-03-01

    The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.

  14. Affirmative action policy in medical school admissions.

    Science.gov (United States)

    Frazer, Ricardo A

    2005-02-01

    Legal challenges to affirmative action are growing, a trend suggesting that a proactive stance is needed to maintain a policy that still has viability, legitimacy, and utility. Medical schools admissions offices in the United States emphasize the Medical College Admissions Test (MCAT), even though many studies have found that grade point averages are better single predictors of future academic achievement, regardless of the student's socioeconomic or racial category. The current essay suggests there is an overreliance on the MCAT in medical school admissions. Medical colleges should encourage the development of additional applicant selection criteria, while continuing to use affirmative action programs, in part to address the need for increased community-oriented health care.

  15. Modeling admissible behavior using event signals.

    Science.gov (United States)

    Pinzon, Luz; Jafari, Mohsen A; Hanisch, Hans-Michael; Zhao, Peng

    2004-06-01

    We describe here how to obtain a model for the admissible behavior of a discrete event system that is represented by a safe Petri net (PN) model. The transitions of this PN model may be controllable or uncontrollable. Also given is a sequential specification which is modeled with a special state machine. Then, using the condition and event arcs of net condition/event systems, a combined model of plant and specification is obtained. We use only the structure of this combined model to develop a method which gives the admissible behavior of the system. Thus, we avoid the complexity of a complete state enumeration.

  16. Entropy Production and Admissibility of Shocks

    Institute of Scientific and Technical Information of China (English)

    Tai-Ping Liu; Tommaso Ruggeri

    2003-01-01

    In shock wave theory there are two considerations in selecting the physically relevant shock waves.There is the admissibility criterion for the well-posedness of hyperbolic conservation laws. Another consideration concerns the entropy production across the shocks. The latter is natural from the physical point of view, but is not sufficient in its straightforward formulation, if the system is not genuinely nonlinear. In this paper we propose the principles of increasing entropy production and that of the superposition of shocks. These principles are shown to be equivalent to the admissibility criterion.

  17. Bernoulli measure of complex admissible kneading sequences

    CERN Document Server

    Bruin, Henk

    2012-01-01

    Iterated quadratic polynomials give rise to a rich collection of different dynamical systems that are parametrized by a simple complex parameter $c$. The different dynamical features are encoded by the \\emph{kneading sequence} which is an infinite sequence over $\\{0,\\1\\}$. Not every such sequence actually occurs in complex dynamics. The set of admissible kneading sequences was described by Milnor and Thurston for real quadratic polynomials, and by the authors in the complex case. We prove that the set of admissible kneading sequences has positive Bernoulli measure within the set of sequences over $\\{0,\\1\\}$.

  18. Racial disparities in receiving total hip/knee replacement surgery: the effect of hospital admission sources.

    Science.gov (United States)

    Chen, Jie; Rizzo, John A; Parasuraman, Shreekant; Gunnarsson, Candace

    2013-02-01

    Using a nationally-representative inpatient care dataset (the HCUP National Inpatient Sample from 2002 to 2007) we examined racial disparities in receiving total hip replacement (THR) and total knee replacement (TKR) surgeries. Multivariable logistic regression models revealed that racial minorities were significantly less likely to receive THR or TKR than Whites, controlling for patients' hospital admission source and hospital characteristics. Employing Blinder-Oaxaca decomposition techniques, we found that observed difference in population characteristics explained 55%-67% and 78% of the racial disparities in THR and TKR, respectively. Differences in patients' hospital admission source emerged as the major individual factor associated with these disparities, explaining 57%-77% of racial disparities in THR and 26%-50% of racial disparities in TKR. This study suggests that substantive racial and ethnic disparities exist in utilization of THR and TKR surgery. Observed population characteristics accounted for most of these differences, with hospital admission source being the key factor.

  19. Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children : a systematic review

    Directory of Open Access Journals (Sweden)

    Waugh Norman

    2007-12-01

    Full Text Available Abstract Background Patients with type 1 diabetes are known to have a higher hospital admission rate than the underlying population and may also be admitted for procedures that would normally be carried out on a day surgery basis for non-diabetics. Emergency admission rates have sometimes been used as indicators of quality of diabetes care. In preparation for a study of hospital admissions, a systematic review was carried out on hospital admissions for children diagnosed with type 1 diabetes, whilst under the age of 15. The main thrust of this review was to ascertain where there were gaps in the literature for studies investigating post-diagnosis hospitalisations, rather than to try to draw conclusions from the disparate data sets. Methods A systematic search of the electronic databases PubMed, Cochrane LibrarMEDLINE and EMBASE was conducted for the period 1986 to 2006, to identify publications relating to hospital admissions subsequent to the diagnosis of type 1 diabetes under the age of 15. Results Thirty-two publications met all inclusion criteria, 16 in Northern America, 11 in Europe and 5 in Australasia. Most of the studies selected were focussed on diabetic ketoacidosis (DKA or diabetes-related hospital admissions and only four studies included data on all admissions. Admission rates with DKA as primary diagnosis varied widely between 0.01 to 0.18 per patient-year as did those for other diabetes-related co-morbidity ranging from 0.05 to 0.38 per patient year, making it difficult to interpret data from different study designs. However, people with Type 1 diabetes are three times more likely to be hospitalised than the non-diabetic populations and stay in hospital twice as long. Conclusion Few studies report on all admissions to hospital in patients diagnosed with type 1 diabetes whilst under the age of 15 years. Health care costs for type 1 patients are higher than those for the general population and information on associated patterns of

  20. Of special humanitarian concern: U.S. refugee admissions since passage of the Refugee Act.

    Science.gov (United States)

    Gallagher, D; Forbes, S; Fagan, P W

    1986-01-01

    The Refugee Act of 1980 is the 1st comprehensive legislation on the admission of refugees to the US; in the 5+ years since its enactment, over 500,000 refugees from more than 25 countries have been admitted to the US. This report assesses the effectiveness of the law in achieving its objectives in making and implementing decisions about the admission of refugees. The objectives of the Act include 1) a desire for a humanitarian response to refugee emergencies and a desire for control over that response, 2) a concern that ideological and geographic restrictions on refugee admissions be removed, and 3) a desire to balance international concerns and domestic impacts in making decisions on refugee admissions. The authors conclude that the refugee program does not serve the broad humanitarian purposes of previous parole programs, due to its stringent review requirements. The formal Congressional Consultations on refugee numbers should be rescheduled to allow regular Congressional input. The program needs a contingency budget for changing situations. The program needs more input from nongovernmental agencies and information sources. Recommendations on refugee admission numbers and allocations have not been well substantiated. Determinations as to which refugees are of "special humanitarian concern" are made solely on the basis of nationality; these decisions should also incorporate other factors. Admissions priorities are generally based on ties to this country, but this makes the refugee program a surrogate immigration program. Although the application of the refugee definition is difficult in practice, it forms the essence of the admission process. US staff must be trained to make these decisions; indecisiveness must not be allowed to jeopardize refugees.

  1. Factors Associated with ICU Admission following Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Andrea Bellone

    2016-01-01

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

  2. 32 CFR 242.5 - Admission procedures.

    Science.gov (United States)

    2010-07-01

    ..., Attn: Assistant Dean for Academic Support. The School of Medicine shall not process a military person's...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE... to the School of Medicine shall make direct application following instructions published in...

  3. False confessions, expert testimony, and admissibility.

    Science.gov (United States)

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

    2010-01-01

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

  4. Differential Prediction Generalization in College Admissions Testing

    Science.gov (United States)

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

    2016-01-01

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

  5. The National Center Test for University Admissions

    Science.gov (United States)

    Watanabe, Yoshinori

    2013-01-01

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

  6. Hospital admissions before and after shipyard closure.

    Science.gov (United States)

    Bartley, M; Fagin, L

    1990-03-01

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

  7. Reporting Subscores from College Admission Tests

    Science.gov (United States)

    Lyren, Per-Erik

    2009-01-01

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

  8. 7 CFR 15a.16 - Admission.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Admission. 15a.16 Section 15a.16 Agriculture Office of the Secretary of Agriculture EDUCATION PROGRAMS OR ACTIVITIES RECEIVING OR BENEFITTING FROM FEDERAL... institutions, subpart C applies only to institutions of vocational education, professional education,...

  9. Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS--A Rural Setting in Western India.

    Science.gov (United States)

    Ingole, Vijendra; Rocklöv, Joacim; Juvekar, Sanjay; Schumann, Barbara

    2015-12-02

    Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18-2.10). There was an increase in the risk of total mortality in the age group 12-59 years on lag 0 day (RR = 1.43; CI: 1.02-1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05-1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003-2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures.

  10. Homecare Nurses' Decision-Making During Admission Care Planning.

    Science.gov (United States)

    Sockolow, Paulina; Bass, Ellen J; Eberle, Carl L; Bowles, Kathryn H

    2016-01-01

    The re-hospitalization rate of homecare patients within 60 days of hospital discharge is 30%. Enhanced care planning based on better information may reduce this rate. However, very little is known about the homecare admission and care planning processes. The research team collected data during observations of three nursing visits to admit homecare patients in Camden NJ, and conducted thematic content analysis on these data. Human factors methods helped to identify nurse decision-making related to selection of the plan of care problems, non-nursing resources, and the nursing visit pattern. They identified how the electronic health record (EHR) assisted the nurse in visit pattern frequency decisions. Major themes that emerged included reduced efficiency due to use of redundant intra-team communication methods to augment EHR documentation, redundant documentation, and workarounds and reorganization of clinical workflow.

  11. The Predictive Validity of using Admissions Testing and Multiple Mini-interviews in Undergraduate University Admissions

    DEFF Research Database (Denmark)

    Makransky, Guido; Havmose, Philip S.; Vang, Maria

    2016-01-01

    The aim of this study was to evaluate the predictive validity of a two-step admissions procedure that included a cognitive ability test followed by multiple mini-interviews (MMI) used to assess non-cognitive skills compared to a grade-based admissions relative to subsequent drop-out rates...... and academic achievement after one and two years of study. The participants consisted of the entire population of 422 psychology students who were admitted to the University of Southern Denmark between 2010 and 2013. The results showed significantly lower drop-out rates after the first year of study, and non......-significant lower drop-out rates after the second year of study for the admission procedure that included the assessment of non-cognitive skills though the MMI. Furthermore, this admission procedure resulted in a significant lower risk of failing the final exam after the first and second year of study, compared...

  12. Whole-grain products and whole grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort

    DEFF Research Database (Denmark)

    Johnsen, Nina Føns; Frederiksen, Kirsten; Christensen, Jane

    2015-01-01

    No study has yet investigated the intake of different types of whole grain (WG) in relation to all-cause and cause-specific mortality in a healthy population. The aim of the present study was to investigate the intake of WG products and WG types in relation to all-cause and cause-specific mortali......%CI 0·86, 0·91) for a doubling of intake). In particular, intake of breakfast cereals and non-white bread was associated with lower mortality. We also found lower all-cause mortality with total intake of different WG types (women: MRR 0·88 (95%CI 0·86, 0·92); men: MRR 0·88 (95%CI 0·86, 0...... quartile compared with the lowest for breakfast cereals, non-white bread, total WG products, oat, rye (only men), wheat and total WG types. The MRR for highest v. lowest quartile of intake of total WG products was 0·68 (95% CI 0·62, 0·75, P for trend over quartiles , 0·0001) for women and 0·75 (95%CI 0......, the analyses of cause-specific mortality according to quartiles of WG intake supported these results. In conclusion, higher intake of WG products and WG types was associated with lower mortality among participants in the HELGA cohort. The study indicates that intake of WG is an important aspect of diet...

  13. Treatment Episode Data Set: Admissions (TEDS-A-1995)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  14. Treatment Episode Data Set: Admissions (TEDS-A-2001)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  15. Treatment Episode Data Set: Admissions (TEDS-A-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  16. Treatment Episode Data Set: Admissions (TEDS-A-2000)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  17. Treatment Episode Data Set: Admissions (TEDS-A-1992)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  18. Treatment Episode Data Set: Admissions (TEDS-A-1999)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  19. Treatment Episode Data Set: Admissions (TEDS-A-2005)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  20. Treatment Episode Data Set: Admissions (TEDS-A-1994)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  1. Treatment Episode Data Set: Admissions (TEDS-A-1998)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  2. Treatment Episode Data Set: Admissions (TEDS-A-2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  3. Treatment Episode Data Set: Admissions (TEDS-A-1997)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  4. Treatment Episode Data Set: Admissions (TEDS-A-1996)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  5. Treatment Episode Data Set: Admissions (TEDS-A-1993)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  6. Treatment Episode Data Set: Admissions (TEDS-A-2004)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  7. Treatment Episode Data Set: Admissions (TEDS-A-2006)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  8. Treatment Episode Data Set: Admissions (TEDS-A-2013)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  9. Treatment Episode Data Set: Admissions (TEDS-A-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  10. Treatment Episode Data Set: Admissions (TEDS-A-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  11. Treatment Episode Data Set: Admissions (TEDS-A-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  12. Treatment Episode Data Set: Admissions (TEDS-A-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  13. Treatment Episode Data Set: Admissions (TEDS-A-2007)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  14. Treatment Episode Data Set: Admissions (TEDS-A-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  15. Clinical pharmacist’s contribution to medication reconciliation on admission to hospital in Ireland

    LENUS (Irish Health Repository)

    Galvin, Mairead

    2012-10-08

    Background Medication reconciliation has been mandated by the Irish government at transfer of care. Research is needed to determine the contribution of clinical pharmacists to the process. Objective To describe the contribution of emergency department based clinical pharmacists to admission medication reconciliation in Ireland. Main Outcome Measure Frequency of clinical pharmacist\\'s activities. Setting Two public university teaching hospitals. Methodology Adults admitted via the accident and emergency department, from a non-acute setting, reporting the use of at least three regular prescription medications, were eligible for inclusion. Medication reconciliation was provided by clinical pharmacists to randomly-selected patients within 24-hours of admission. This process includes collecting a gold-standard pre-admission medication list, checking this against the admission prescription and communicating any changes. A discrepancy was defined as any difference between the gold-standard pre-admission medication list and the admission prescription. Discrepancies were communicated to the clinician in the patient\\'s healthcare record. Potentially harmful discrepancies were also communicated verbally. Pharmacist activities and unintentional discrepancies, both resolved and unresolved at 48-hours were measured. Unresolved discrepancies were confirmed verbally by the team as intentional or unintentional. A reliable and validated tool was used to assess clinical significance by medical consultants, clinical pharmacists, community pharmacists and general practitioners. Results In total, 134 patients, involving 1,556 medications, were included in the survey. Over 97 % of patients (involving 59 % of medications) experienced a medication change on admission. Over 90 % of patients (involving 29 % of medications) warranted clinical pharmacy input to determine whether such changes were intentional or unintentional. There were 447 interventions by the clinical pharmacist regarding

  16. Equity of Access. New Approaches to Minority Admissions

    Science.gov (United States)

    Bingham, Rebecca Saady

    1978-01-01

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

  17. Reclaiming the Educational Role of Chief Admission Officers.

    Science.gov (United States)

    McDonough, Patricia; Robertson, Larry

    1995-01-01

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

  18. 22 CFR 142.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-04-01

    ... who has a handicap that impairs sensory, manual, or speaking skills, the test results accurately... denied admission or be subjected to discrimination in admission or recruitment by a recipient to which... persons who may be admitted; (2) May not make use of any test or criterion for admission that has...

  19. 22 CFR 217.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-04-01

    ... applicant who has a handicap that impairs sensory, manual, or speaking skills, the test results accurately... denied admission or be subjected to discrimination in admission or recruitment by a recipient to which... who may be admitted; (2) May not make use of any test or criterion for admission that has...

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

    Science.gov (United States)

    Avery, Christopher; Levin, Jonathan D.

    2009-01-01

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

  1. Admission criteria and diversity in medical school

    DEFF Research Database (Denmark)

    O'Neill, Lotte; Vonsild, Maria; Wallstedt, Birgitta;

    2013-01-01

    of students admitted via the two tracks between the years 2002-2007. Method: This prospective cohort study included 1074 medical students admitted between the years 2002-2007 to the University of Southern Denmark (USD) medical school. Of these, 454 were admitted by grade-based selection and 620 were selected......Introduction: The underrepresentation of students from lower socioeconomic backgrounds in medical education is an important social issue. There is currently little evidence about whether changes in admission strategy could increase the diversity of medical students. Denmark introduced an “attribute......-based or attribute-based) had no statistically significant effect on the social diversity of medical students admitted to USD. Discussion: It may be a myth that attribute-based admission widens access and increases social diversity. To the contrary, there is evidence that combining grade-based with attribute...

  2. Lie Admissible Non-Associative Algebras

    Institute of Scientific and Technical Information of China (English)

    H.Mohammad Ahmadi; Ki-Bong Nam; Jonathan Pakinathan

    2005-01-01

    A non-associative ring which contains a well-known associative ring or Lie ring is interesting. In this paper, a method to construct a Lie admissible non-associative ring is given; a class of simple non-associative algebras is obtained; all the derivations of the non-associative simple N0,0,1 algebra defined in this paper are determined; and finally, a solid algebra is defined.

  3. THE OBJECT OF THE ADMISSION OF GUILT

    Directory of Open Access Journals (Sweden)

    Constantin NEDELCU

    2015-07-01

    Full Text Available This paper aims at studying how elements of negotiated justice specific to common law systems entered into the Romanian criminal procedural law system. It particularly deals with the admission of guilt and about one of its most controversial aspects – the object of recognition. The research concludes that what is recognized within this simplified procedure it is the deed and not its legal classification given by the criminal prosecution bodies.

  4. An observational study of patient characteristics associated with the mode of admission to acute stroke services in North East, England.

    Directory of Open Access Journals (Sweden)

    Christopher I Price

    Full Text Available OBJECTIVE: Effective provision of urgent stroke care relies upon admission to hospital by emergency ambulance and may involve pre-hospital redirection. The proportion and characteristics of patients who do not arrive by emergency ambulance and their impact on service efficiency is unclear. To assist in the planning of regional stroke services we examined the volume, characteristics and prognosis of patients according to the mode of presentation to local services. STUDY DESIGN AND SETTING: A prospective regional database of consecutive acute stroke admissions was conducted in North East, England between 01/09/10-30/09/11. Case ascertainment and transport mode were checked against hospital coding and ambulance dispatch databases. RESULTS: Twelve acute stroke units contributed data for a mean of 10.7 months. 2792/3131 (89% patients received a diagnosis of stroke within 24 hours of admission: 2002 arrivals by emergency ambulance; 538 by private transport or non-emergency ambulance; 252 unknown mode. Emergency ambulance patients were older (76 vs 69 years, more likely to be from institutional care (10% vs 1% and experiencing total anterior circulation symptoms (27% vs 6%. Thrombolysis treatment was commoner following emergency admission (11% vs 4%. However patients attending without emergency ambulance had lower inpatient mortality (2% vs 18%, a lower rate of institutionalisation (1% vs 6% and less need for daily carers (7% vs 16%. 149/155 (96% of highly dependent patients were admitted by emergency ambulance, but none received thrombolysis. CONCLUSION: Presentations of new stroke without emergency ambulance involvement were not unusual but were associated with a better outcome due to younger age, milder neurological impairment and lower levels of pre-stroke dependency. Most patients with a high level of pre-stroke dependency arrived by emergency ambulance but did not receive thrombolysis. It is important to be aware of easily identifiable

  5. Characteristics of delayed admission to stroke unit.

    Science.gov (United States)

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

    2006-01-01

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

  6. Perceived coercion in voluntary hospital admission.

    LENUS (Irish Health Repository)

    O'Donoghue, Brian

    2014-01-30

    The legal status of service users admitted to psychiatric wards is not synonymous with the level of coercion that they can perceive during the admission. This study aimed to identify and describe the proportion of individuals who were admitted voluntarily but experienced levels of perceived coercion comparable to those admitted involuntarily. Individuals admitted voluntarily and involuntarily to three psychiatric hospitals were interviewed using the MacArthur Admission Experience Interview and the Structured Clinical Interview for DSM-IV diagnoses. One hundered sixty-one individuals were interviewed and 22% of the voluntarily admitted service users had levels of perceived coercion similar to that of the majority of involuntarily admitted service users. Voluntarily admitted service users who experienced high levels of perceived coercion were more likely to have more severe psychotic symptoms, have experienced more negative pressures and less procedural justices on admission. Individuals brought to hospital under mental health legislation but who subsequently agreed to be admitted voluntarily and those treated on a secure ward also reported higher levels of perceived coercion. It needs to be ensured that if any service user, whether voluntary or involuntary, experiences treatment pressures or coercion that there is sufficient oversight of the practice, to ensure that individual\\'s rights are respected.

  7. [Supervision of junior doctors and allocation of work tasks regarding admissions and further treatment of acute admitted patients.

    DEFF Research Database (Denmark)

    Folkestad, Lars; Brabrand, Mikkel; Hallas, Peter

    2010-01-01

    -up of patients with clinical deterioration at the wards. RESULTS: A total of 88 interns with an average of 2.8 months of experience were included in the survey. Sixty percent of the interns answered that they initially dealt with acute admissions. During the day, patients with clinical deterioration......INTRODUCTION: It is being debated whether medical staff working at the emergency departments with acute admission services dealing with medical patients have the required professional competence level. It has not previously been documented which doctors see the acute admissions initially...... are the responsibility of the physicians doing their rounds at the ward. During evening and night hours, 80% of interns say that patients with clinical deterioration are their responsibility. Fifty four percent of participants care for medical patients as they initially arrive at the emergency room. The interns consult...

  8. Sickness absence due to specific mental diagnoses and all-cause and cause-specific mortality: a cohort study of 4.9 million inhabitants of Sweden.

    Directory of Open Access Journals (Sweden)

    Ellenor Mittendorfer-Rutz

    Full Text Available BACKGROUND: Despite the magnitude and increase of sickness absence due to mental diagnoses, little is known regarding long-term health outcomes. The aim of this nationwide population-based, prospective cohort study was to investigate the association between sickness absence due to specific mental diagnoses and the risk of all-cause and cause-specific mortality. METHODS: A cohort of all 4 857 943 individuals living in Sweden on 31.12.2004 (aged 16-64 years, not sickness absent, or on retirement or disability pension, was followed from 01.01.2005 through 31.12.2008 for all-cause and cause-specific mortality (suicide, cancer, circulatory disease through linkage of individual register data. Individuals with at least one new sick-leave spell with a mental diagnosis in 2005 were compared to individuals with no sickness absence. Hazard ratios (HR and 95% confidence intervals (CI were estimated by Cox regression, adjusting for age, sex, education, country of birth, family situation, area of residence, and pre-existing morbidity (diagnosis-specific hospital inpatient (2000-2005 and outpatient (2001-2005 care. RESULTS: In the multivariate analyses, mental sickness absence in 2005 was associated with an increased risk for all-cause mortality: HR: 1.65, 95% CI: 1.47-1.86 in women and in men: 1.73, 1.57-1.91; for suicide, cancer (both smoking and non-smoking related as well as mortality due to circulatory disease only in men. Estimates for cause-specific mortality ranged from 1.48 to 3.37. Associations with all-cause mortality were found for all mental sickness absence diagnostic groups studied. CONCLUSIONS: Knowledge about the prognosis of patients sickness absent with specific mental diagnoses is of crucial clinical importance in health care. Sickness absence due to specific mental diagnoses may here be used as a risk indictor for subsequent mortality.

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

    Directory of Open Access Journals (Sweden)

    Ortiga Berta

    2012-06-01

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

  10. Single nucleotide polymorphisms in obesity-related genes and all-cause and cause-specific mortality: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Ruczinski Ingo

    2009-10-01

    Full Text Available Abstract Background The aim of this study was to examine the associations between 16 specific single nucleotide polymorphisms (SNPs in 8 obesity-related genes and overall and cause-specific mortality. We also examined the associations between the SNPs and body mass index (BMI and change in BMI over time. Methods Data were analyzed from 9,919 individuals who participated in two large community-based cohort studies conducted in Washington County, Maryland in 1974 (CLUE I and 1989 (CLUE II. DNA from blood collected in 1989 was genotyped for 16 SNPs in 8 obesity-related genes: monoamine oxidase A (MAOA, lipoprotein lipase (LPL, paraoxonase 1 and 2 (PON1 and PON2, leptin receptor (LEPR, tumor necrosis factor-α (TNFα, and peroxisome proliferative activated receptor-γ and -δ (PPARG and PPARD. Data on height and weight in 1989 (CLUE II baseline and at age 21 were collected from participants at the time of blood collection. All participants were followed from 1989 to the date of death or the end of follow-up in 2005. Cox proportional hazards regression was used to obtain the relative risk (RR estimates and 95% confidence intervals (CI for each SNP and mortality outcomes. Results The results showed no patterns of association for the selected SNPs and the all-cause and cause-specific mortality outcomes, although statistically significant associations (p PPARG rs4684847 and all-cause mortality (CC: reference; CT: RR 0.99, 95% CI 0.89, 1.11; TT: RR 0.60, 95% CI 0.39, 0.93 and cancer-related mortality (CC: reference; CT: RR 1.01, 95% CI 0.82, 1.25; TT: RR 0.22, 95% CI 0.06, 0.90 and TNFα rs1799964 and cancer-related mortality (TT: reference; CT: RR 1.23, 95% CI 1.03, 1.47; CC: RR 0.83, 95% CI 0.54, 1.28. Additional analyses showed significant associations between SNPs in LEPR with BMI (rs1137101 and change in BMI over time (rs1045895 and rs1137101. Conclusion Findings from this cohort study suggest that the selected SNPs are not associated with overall

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

    Science.gov (United States)

    Wabwoba, Franklin; Mwakondo, Fullgence M.

    2011-01-01

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

  12. Admission Hyperglycemia in Head Injured Patients

    Directory of Open Access Journals (Sweden)

    Yousefzadeh Chabok Sh

    2009-04-01

    Full Text Available Hyperglycemia, in trauma patient, is commonly associated with a hyper metabolic stress response. Our objective is to determine the effects of hyperglycemia on the overall outcome of head trauma patients. In this descriptive study data were collected from head trauma patients' admitted to Intensive Care Unit (ICU of Poursina University Hospital in a one-year period (Jan 2004-Jan 2005, retrospectively. All patients had stayed in the ICU for more than 48 hours post-injuries. They were divided into two groups according to their serum glucose levels at the time of admission (<200mg/dl or >200mg/dl, age, gender and Injury Severity Score (ISS. Patients with diabetes mellitus were excluded .We determined the outcome according to duration of hospitalization and ICU stay as well as mortality rates. Variables were analyzed with t-test and chi square test. Out of 115 patients, 89.6% were men. About 36 % of patients had serum glucose levels ≥ 200 mg/dl over the study period and this group had significantly greater mortality rate but without necessarily longer ICU or hospital stay. In this study we have shown that admission hyperglycemia has significant effect on patient's mortality but it is still unclear whether it can be a cause for longer ICU/hospital stay."n© 2009 Tehran University of Medical Sciences. All rights reserved.

  13. The influence of duration of follow-up on the association between alcohol and cause-specific mortality in a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Thygesen, Lau Caspar; Johansen, Ditte;

    2005-01-01

    PURPOSE: To investigate whether duration of follow-up influences the association between alcohol and cause-specific mortality in a prospective cohort study with only baseline assessment of alcohol intake. METHODS: In a cohort of 14,223 men and women participating in the first investigation...... of the Copenhagen City Heart Study between 1976 and 1978 and followed until 2001, we assessed whether the association between alcohol and mortality was modified by duration of follow-up. The 24 years of follow-up were divided into four intervals, and Cox survival analyses were conducted separately for these four...... of a moderate alcohol consumption on coronary heart disease attenuated during prolonged follow-up, whereas high alcohol consumption became associated with higher risk of death from cancer with longer follow-up. CONCLUSIONS: This study accentuates the importance of taking duration of follow-up into consideration...

  14. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013

    DEFF Research Database (Denmark)

    Peterson, Carrie Beth

    2015-01-01

    disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus......BACKGROUND: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries......, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were...

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

    Science.gov (United States)

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

    1997-12-01

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

  16. The contribution of psychological distress to socio-economic differences in cause-specific mortality: a population-based follow-up of 28 years

    Directory of Open Access Journals (Sweden)

    Ostamo Aini I

    2011-02-01

    Full Text Available Abstract Background Psychological factors associated with low social status have been proposed as one possible explanation for the socio-economic gradient in health. The aim of this study is to explore whether different indicators of psychological distress contribute to socio-economic differences in cause-specific mortality. Methods The data source is a nationally representative, repeated cross-sectional survey, "Health Behaviour and Health among the Finnish Adult Population" (AVTK. The survey results were linked with socio-economic register data from Statistics Finland (from the years 1979-2002 and mortality follow-up data up to 2006 from the Finnish National Cause of Death Register. The data included 32451 men and 35420 women (response rate 73.5%. Self-reported measures of depression, insomnia and stress were used as indicators of psychological distress. Socio-economic factors included education, employment status and household income. Mortality data consisted of unnatural causes of death (suicide, accidents and violence, and alcohol-related mortality and coronary heart disease (CHD mortality. Adjusted hazard ratios were calculated using the Cox regression model. Results In unnatural mortality, psychological distress accounted for some of the employment status (11-31% and income level (4-16% differences among both men and women, and for the differences related to the educational level (5-12% among men; the educational level was associated statistically significantly with unnatural mortality only among men. Psychological distress had minor or no contribution to socio-economic differences in CHD mortality. Conclusions Psychological distress partly accounted for socio-economic disparities in unnatural mortality. Further studies are needed to explore the role and mechanisms of psychological distress associated with socio-economic differences in cause-specific mortality.

  17. Student incentives and preferential treatment in college admissions

    OpenAIRE

    2012-01-01

    We consider a framework in which the optimal admissions policy of a purely academicquality oriented college implements preferential treatment in favor of the student from the deprived socioeconomic background which maximizes the competition between candidates. We find that the exact form of the preferential treatment admissions policy matters for student incentives and hence for student-body diversity in equilibrium. Preferential treatment policy in college admissions often tak...

  18. Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland.

    LENUS (Irish Health Repository)

    Grimes, Tamasine

    2012-02-01

    OBJECTIVES: to describe hospital pharmacy involvement in medication management in Ireland, both generally and at points of transfer of care, and to gain a broad perspective of the hospital pharmacy workforce. METHODS: a survey of all adult, acute, public hospitals with an accident and emergency (A&E) department (n = 36), using a semi-structured telephone interview. KEY FINDINGS: there was a 97% (n = 35) response rate. The majority (n = 25, 71.4%) of hospitals reported delivery of a clinical pharmacy service. On admission, pharmacists were involved in taking or verifying medication histories in a minority (n = 15, 42.9%) of hospitals, while few (n = 6,17.1%) deployed staff to the A&E\\/acute medical admissions unit. On discharge, the majority (n = 30,85.7%) did not supply any take-out medication, a minority (n =5,14.3%) checked the discharge prescription, 51.4% (n = 18) counselled patients, 42.9% (n = 15) provided medication compliance charts and one hospital (2.9%) communicated with the patient\\'s community pharmacy. The number of staff employed in the pharmacy department in each hospital was not proportionate to the number of inpatient beds, nor the volume of admissions from A&E. There were differences identified in service delivery between hospitals of different type: urban hospitals with a high volume of admissions from A&E were more likely to deliver clinical pharmacy. CONCLUSIONS: the frequency and consistency of delivering pharmacy services to facilitate medication reconciliation at admission and discharge could be improved. Workforce constraints may inhibit service expansion. Development of national standards of practice may help to eliminate variation between hospitals and support service development.

  19. Superconformal minimal models and admissible Jack polynomials

    CERN Document Server

    Blondeau-Fournier, Olivier; Ridout, David; Wood, Simon

    2016-01-01

    We give new proofs of the rationality of the N=1 superconformal minimal model vertex operator superalgebras and of the classification of their modules in both the Neveu-Schwarz and Ramond sectors. For this, we combine the standard free field realisation with the theory of Jack symmetric functions. A key role is played by Jack symmetric polynomials with a certain negative parameter that are labelled by admissible partitions. These polynomials are shown to describe free fermion correlators, suitably dressed by a symmetrising factor. The classification proofs concentrate on explicitly identifying Zhu's algebra and its twisted analogue. Interestingly, these identifications do not use an explicit expression for the non-trivial vacuum singular vector. While the latter is known to be expressible in terms of an Uglov symmetric polynomial or a linear combination of Jack superpolynomials, it turns out that standard Jack polynomials (and functions) suffice to prove the classification.

  20. Namibia's exceptional admission to the ILO.

    Science.gov (United States)

    Fromont, M

    1998-01-01

    Namibia officially became the 136th ¿member state¿ of the International Labour Office (ILO) on October 3, 1978. At that time Namibia was politically dependent on South Africa and lived under apartheid. This stood in contradiction to international law, given that since October 1966 the UN General Assembly had terminated the Republic of South Africa's mandate over the territory. In 1967 it had entrusted its official administration to the UN Council for Namibia, which requested Namibia's admission to the ILO as a full member. Namibia met all the criteria required of a state: an established population and territory, a stable and internationally recognized legal structure, together with the capacity to enter into relations with other states. Namibia was recognized by the Conference as the de-facto authentic government through an election in which 368 voted in favor of Namibia with no oppositions and 50 abstentions.

  1. Allocation and Admission Policies for Service Streams

    CERN Document Server

    Mazzucco, Michele; Fisher, Mike; McKee, Paul

    2011-01-01

    A service provisioning system is examined, where a number of servers are used to offer different types of services to paying customers. A customer is charged for the execution of a stream of jobs; the number of jobs in the stream and the rate of their submission is specified. On the other hand, the provider promises a certain quality of service (QoS), measured by the average waiting time of the jobs in the stream. A penalty is paid if the agreed QoS requirement is not met. The objective is to maximize the total average revenue per unit time. Dynamic policies for making server allocation and stream admission decisions are introduced and evaluated. The results of several simulations are described.

  2. Contribution of ED admissions to inpatient hospital revenue.

    Science.gov (United States)

    Sacchetti, Alfred; Harris, Russell H; Warden, Todd; Roth, Sandra

    2002-01-01

    Emergency department (ED) practices are traditionally profiled in terms of their patient encounters. Such evaluations reflect a preponderance of outpatient visits while crediting income from admitted patients to traditional hospital-based services. This study evaluates the contribution of ED admissions to inpatient hospital revenue. The study was set at an urban tertiary care community hospital with university affiliation. Information referable to ED patients was collected from the hospital's Universal Billing Code (UB-92)-based patient information warehouse. Data fields referable to hospital charges, insurance type, and disposition were used for analysis of a 1-year period from September 1, 1998 to August 31, 1999. Statistical analysis was through chi square and ANOVA. During the study period 33,174 patients were treated in the ED with 6,671 (20%) admitted to inpatient services. Total hospital charges for all ED patients during this time were $107 million dollars with $9.1 million (8.5%) generated from discharged patients and $98.0 million (91.5%) from admitted ED patients (P revenue for inpatient services for the study period was $288 million of which 34% was contributed from admitted ED patients. ED services represent a major source of inpatient hospital revenue. The recognition of the ED's potential in this area may be lost if income from patients admitted through the ED is credited to traditional hospital-based services.

  3. Assisted admissions? A national survey of general practitioner experience of involuntary admissions.

    LENUS (Irish Health Repository)

    Kelly, M

    2011-10-01

    The 2001 Mental Health Act introduced in 2006, changed how a patient is admitted involuntarily to a psychiatric unit. This paper reports on a national survey of general practitioners\\' experience implementing the Act. Five hundred and sixty eight (568) GPs completed the survey. Twenty five percent (25%) of respondants had not used it. When used, twenty four percent (24%) report that it takes seven hours or more to complete an admission. Fifty percent (50%) of respondents are confident to complete the necessary paperwork. Overall GPs are dissatisfied with arrangements for transport of patients (mean Likert score 3.5), primarily due to the time delay. GPs believe this places risk on the patient, family and GP. Only thirty-three percent (33%) of respondents feel that the Mental Health Act has improved the patient, GP and family experience of involuntary admission.

  4. Suicide Mortality of Suicide Attempt Patients Discharged from Emergency Room, Nonsuicidal Psychiatric Patients Discharged from Emergency Room, Admitted Suicide Attempt Patients, and Admitted Nonsuicidal Psychiatric Patients

    Science.gov (United States)

    Choi, Jae W.; Park, Subin; Yi, Ki K.; Hong, Jin P.

    2012-01-01

    The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients…

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

    Science.gov (United States)

    Mathis, Daniel

    2010-01-01

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

  6. Environmental Scan of BC Post-Secondary Admissions: 2009

    Science.gov (United States)

    Heath, Nick

    2009-01-01

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

  7. Evaluating Admission Criteria Effects for Under-Represented Groups

    Science.gov (United States)

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

    2016-01-01

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

  8. 24 CFR 1720.425 - Presentation and admission of evidence.

    Science.gov (United States)

    2010-04-01

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

  9. 28 CFR 541.47 - Admission to control unit.

    Science.gov (United States)

    2010-07-01

    ... the inmate's confinement in a control unit; (b) Notice of the type of personal property which is... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Admission to control unit. 541.47 Section... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.47 Admission to control...

  10. 45 CFR 1170.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-10-01

    ... impairs sensory, manual, or speaking skills, the test results accurately reflect the applicant's aptitude... subjected to discrimination in admission or recruitment by a recipient to which this subpart applies. (b... make use of any test or criterion for admission that has a disproportionate, adverse effect...

  11. 7 CFR 15b.30 - Admissions and recruitment.

    Science.gov (United States)

    2010-01-01

    ... handicap that impairs sensory, manual, or speaking skills, the test results accurately reflect the... be subjected to discrimination in admission or recruitment by a recipient to which this subpart... admitted; (2) May not make use of any test or criterion for admission that has a disproportionate,...

  12. 45 CFR 605.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-10-01

    ... administered to an applicant who has a handicap that impairs sensory, manual, or speaking skills, the test..., on the basis of handicap, be denied admission or be subjected to discrimination in admission or... proportion of handicapped persons who may be admitted; (2) May not make use of any test or criterion...

  13. 45 CFR 84.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-10-01

    ... administered to an applicant who has a handicap that impairs sensory, manual, or speaking skills, the test... basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment by... proportion of handicapped persons who may be admitted; (2) May not make use of any test or criterion...

  14. 42 CFR 418.25 - Admission to hospice care.

    Science.gov (United States)

    2010-10-01

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

  15. Affirmative Action in College and University Admissions: Yes.

    Science.gov (United States)

    Michaelson, Martin

    1999-01-01

    Argues in support of affirmative action in college and university admissions, noting the actual, relatively small effect of affirmative action on white admission and opportunity, and suggesting other possible reasons for the heated debate. Notes two related Supreme Court decisions made a century apart and reviews statistical studies in support of…

  16. Communications Is from Mars, Admissions Is from Venus

    Science.gov (United States)

    Scully, Maura King

    2010-01-01

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

  17. UCT's Admissions Policies: Is the Playing Field Level?

    Science.gov (United States)

    Favish, J.; Hendry, J.

    2010-01-01

    The article outlines how UCT's commitment to redress and diversity has officially guided the university's approach to admissions planning. In 2009 the Senate requested the Vice Chancellor to conduct a review of the admissions policy particularly to determine whether race continued to be an adequate proxy for disadvantage. This article analyses…

  18. Using Social Media "Smartly" in the Admissions Process

    Science.gov (United States)

    Parrot, Teresa Valerio; Tipton, Stacia

    2010-01-01

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

  19. 14 CFR 125.315 - Admission to flight deck.

    Science.gov (United States)

    2010-01-01

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

  20. 29 CFR 458.71 - Procedure upon admission of facts.

    Science.gov (United States)

    2010-07-01

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

  1. 10 CFR 590.308 - Admissions of facts.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Admissions of facts. 590.308 Section 590.308 Energy... WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.308 Admissions of facts. (a) At... proceeding that relate to statements or opinions of fact or of the application of law to fact. (b) A...

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

    Science.gov (United States)

    Lown, Maris A.

    2010-01-01

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

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

    Science.gov (United States)

    Sireci, Stephen G.; Talento-Miller, Eileen

    2006-01-01

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

  4. Low hospital admission rates for respiratory diseases in children.

    NARCIS (Netherlands)

    Uijen, J.H.J.M.; Schellevis, F.G.; Bindels, P.J.E.; Willemsen, S.P.; Wouden, J.C. van der

    2010-01-01

    BACKGROUND: Population-based data on hospital admissions for children aged 0-17 years concerning all respiratory diseases are scarce. This study examined hospital admissions in relation to the preceding consultations in general practice in this age group. METHODS: Data on children aged 0-17 years wi

  5. SOFTWARE OPTIMIZATION OF BUSINESS PROCESS “UNIVERSITY ADMISSION CAMPAIGN”

    Directory of Open Access Journals (Sweden)

    Victor V. Babenko

    2015-01-01

    Full Text Available Admission campaign is an important part of the main business processes system of the university. Admission campaign is analyzed on the base of different modeling tools. The conceptual basis of CRM-system as information support of the process is proposed. It should be significant optimizing resource of business process. 

  6. Psychiatric Inpatient Admissions of Adults with Intellectual Disabilities: Predictive Factors

    Science.gov (United States)

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

    2005-01-01

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

  7. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  8. Childhood Emergencies

    Science.gov (United States)

    ... emergency physicians. They receive comprehensive training in treating childhood emergencies and have more training in pediatric emergencies than other physicians, including pediatricians. Does Your Child's School Know About Food Allergies? - 8/10/2015 The nation's emergency physician ...

  9. Nest success, cause-specific nest failure, and hatchability of aquatic birds at selenium-contaminated Kesterson Reservoir and a reference site

    Science.gov (United States)

    Ohlendorf, Harry M.; Hothem, Roger L.; Welsh, Daniel

    1989-01-01

    During 1983-1985, we studied the reproductive success of several species of aquatic birds (coots, ducks, shorebirds, and grebes) nesting at two sites in Merced County, California: a selenium-contaminated site (Kesterson Reservoir) and a nearby reference site (Volta Wildlife Area). We used a computer program (MICROMORT) developed for the analysis of radiotelemetry data (Heisey and Fuller 1985) to estimate nest success and cause-specific failure rates, and then compared these parameters and hatchability between sites and among years. Nest success and causes of failure varied by species, site, and year. The most important causes of nest failure were usually predation, desertion, and water-level changes. However, embryotoxicosis (mortality, deformity, and lack of embryonic development) was the most important cause of nest failure in Eared Grebes (Podiceps nigricollis) at Kesterson Reservoir. Embryotoxicosis also reduced the hatchability of eggs of all other species at Kesterson in one or more years; embryonic mortality occurred rarely at Volta, and abnormalities were not observed.

  10. Transformation of admission interview to documentation for nursing practice

    DEFF Research Database (Denmark)

    Højskov, Ida E; Glasdam, Stinne

    2014-01-01

    The admission interview is usually the first structured meeting between patient and nurse. The interview serves as the basis for personalised nursing and care planning and is the starting point for the clinic's documentation of the patient and his course of treatment. In this way, admission...... interviews constitute a basis for reporting by each nurse on the patient to nursing colleagues. This study examined how, by means of the admission interview, nurses constructed written documentation of the patient and his course of treatment for use by fellow nurses. A qualitative case study inspired...... by Ricoeur was conducted and consisted of five taped admission interviews, along with the written patient documentation subsequently worked out by the nurse. The findings were presented in four constructed themes: Admission interviews are the nurse's room rather than the patient's; Information on a surgical...

  11. The Student Admission to Medicine (SAM) Program: First Steps toward the Paperless Processing of Medical School Admissions.

    Science.gov (United States)

    Harasym, P. H.; And Others

    1995-01-01

    The University of Calgary (Canada) medical school admissions process has been streamlined with the Student Admission to Medicine computer program, largely paperless, that creates a database from student applications. The database then converts grades to the university's standards and assists with administrative details, statistical analyses, and…

  12. Involuntary admission: the case of anorexia nervosa.

    Science.gov (United States)

    Douzenis, Athanasios; Michopoulos, Ioannis

    2015-01-01

    Involuntary treatment of psychiatric disorders has always been controversial; this is especially true for eating disorders. Patients with anorexia nervosa of life threatening severity frequently refuse psychiatric hospitalization. Ambivalence toward treatment is characteristic of eating disorders and patients are often admitted to inpatient programs under pressure from family and doctors. In this article, we report research on the positive or negative impact of involuntary admission in the treatment of eating disorders, its application and effectiveness as well as the adverse consequences of coercive treatment in eating disorders. A literature review was done. From a total of 134 publications which were retrieved from the literature search, 50 studies were directly relevant to the scope of this review and fulfilled all inclusion criteria. There are trends and arguments for both sides; for and against involuntary treatment in anorexia nervosa. The scientific literature so far is inconclusive, although in the short term, involuntary hospitalization has benefits. This review has also shown that involuntary hospitalization can have adverse long-term consequences for the patient-therapist allegiance. We conclude that in some cases, involuntary treatment can save lives of young patients with anorexia nervosa; however, in other cases, it can break the psychotherapeutic relationship and make the patient abandon treatment. It is the clinician who has to decide for whom and when to approve involuntary treatment or not.

  13. Admissibility, stable units and connected components

    CERN Document Server

    Xarez, J J

    2011-01-01

    Consider a reflection from a finitely-complete category $\\mathbb{C}$ into its full subcategory $\\mathbb{M}$, with unit $\\eta :1_\\mathbb{C}\\rightarrow HI$. Suppose there is a left-exact functor $U$ into the category of sets, such that $UH$ reflects isomorphisms and $U(\\eta_C)$ is a surjection, for every $C\\in\\mathbb{C}$. If, in addition, all the maps $\\mathbb{M}(T,M)\\rightarrow \\mathbf{Set}(1,U(M))$ induced by the functor $UH$ are surjections, where $T$ and 1 are respectively terminal objects in $\\mathbb{C}$ and $\\mathbf{Set}$, for every object $M$ in the full subcategory $\\mathbb{M}$, then it is true that: the reflection $H\\vdash I$ is semi-left-exact (admissible in the sense of categorical Galois theory) if and only if its connected components are "connected"; it has stable units if and only if any finite product of connected components is "connected". Where the meaning of "connected" is the usual in categorical Galois theory, and the definition of connected component with respect to the ground structure wil...

  14. Routing and admission control in general topology networks with poisson arrivals

    Energy Technology Data Exchange (ETDEWEB)

    Kamath, A.; Palmon, O.; Plotkin, S. [Stanford Univ., CA (United States)

    1996-12-31

    Emerging high speed networks will carry traffic for services such as video-on-demand and video teleconferencing - that require resource reservation along the path on which the traffic is sent. High bandwidth-delay product of these networks prevents circuit rerouting, i.e. once it is routed on a certain path, the bandwidth a circuit taken by this circuit remains unavailable for the duration (holding time) of this circuit. As a result, such networks will need effective routing and admission control strategies. Recently developed online routing and admission control strategies have logarithmic competitive ratios with respect to the admission ratio (the fraction of admitted circuits). Such guarantees on performance are rather weak in the most interesting case where the rejection ratio of the optimum algorithm is very small or even 0. Unfortunately, these guarantees can not be improved in the context of the considered models, making it impossible to use these models to identify algorithms that are going to perform well in practice.

  15. Does sickness absence due to psychiatric disorder predict cause-specific mortality? A 16-year follow-up of the GAZEL occupational cohort study.

    Science.gov (United States)

    Melchior, Maria; Ferrie, Jane E; Alexanderson, Kristina; Goldberg, Marcel; Kivimaki, Mika; Singh-Manoux, Archana; Vahtera, Jussi; Westerlund, Hugo; Zins, Marie; Head, Jenny

    2010-09-15

    Mental disorders are a frequent cause of morbidity and sickness absence in working populations; however, the status of psychiatric sickness absence as a predictor of mortality is not established. The authors tested the hypothesis that psychiatric sickness absence predicts mortality from leading medical causes. Data were derived from the French GAZEL cohort study (n = 19,962). Physician-certified sickness absence records were extracted from administrative files (1990-1992) and were linked to mortality data from France's national registry of mortality (1993-2008, mean follow-up: 15.5 years). Analyses were conducted by using Cox regression models. Compared with workers with no sickness absence, those absent due to psychiatric disorder were at increased risk of cause-specific mortality (hazard ratios (HRs) adjusted for age, gender, occupational grade, other sickness absence-suicide: 6.01, 95% confidence interval (CI): 3.07, 11.75; cardiovascular disease: 1.84, 95% CI: 1.10, 3.08; and smoking-related cancer: 1.65, 95% CI: 1.07, 2.53). After full adjustment, the excess risk of suicide remained significant (HR = 5.13, 95% CI: 2.60, 10.13) but failed to reach statistical significance for fatal cardiovascular disease (HR = 1.59, 95% CI: 0.95, 2.66) and smoking-related cancer (HR = 1.31, 95% CI: 0.85, 2.03). Psychiatric sickness absence records could help identify individuals at risk of premature mortality and serve to monitor workers' health.

  16. Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection.

    Science.gov (United States)

    Alejos, Belén; Hernando, Victoria; Iribarren, Jose; Gonzalez-García, Juan; Hernando, Asuncion; Santos, Jesus; Asensi, Victor; Gomez-Berrocal, Ana; Del Amo, Julia; Jarrin, Inma

    2016-09-01

    We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates.In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality.Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality.

  17. Occupational class inequalities in all-cause and cause-specific mortality among middle-aged men in 14 European populations during the early 2000s.

    Directory of Open Access Journals (Sweden)

    Marlen Toch-Marquardt

    Full Text Available This study analyses occupational class inequalities in all-cause mortality and four specific causes of death among men, in Europe in the early 2000s, and is the most extensive comparative analysis of occupational class inequalities in mortality in Europe so far. Longitudinal data, obtained from population censuses and mortality registries in 14 European populations, from around the period 2000-2005, were used. Analyses concerned men aged 30-59 years and included all-cause mortality and mortality from all cancers, all cardiovascular diseases (CVD, all external, and all other causes. Occupational class was analysed according to five categories: upper and lower non-manual workers, skilled and unskilled manual workers, and farmers and self-employed combined. Inequalities were quantified with mortality rate ratios, rate differences, and population attributable fractions (PAF. Relative and absolute inequalities in all-cause mortality were more pronounced in Finland, Denmark, France, and Lithuania than in other populations, and the same countries (except France also had the highest PAF values for all-cause mortality. The main contributing causes to these larger inequalities differed strongly between countries (e.g., cancer in France, all other causes in Denmark. Relative and absolute inequalities in CVD mortality were markedly lower in Southern European populations. We conclude that relative and absolute occupational class differences in all-cause and cause specific mortality have persisted into the early 2000's, although the magnitude differs strongly between populations. Comparisons with previous studies suggest that the relative gap in mortality between occupational classes has further widened in some Northern and Western European populations.

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

    Science.gov (United States)

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

    2013-03-01

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

  19. Admissions for personality disorders in Italy from 1988 to 1998

    Directory of Open Access Journals (Sweden)

    Barbui Corrado

    2006-08-01

    Full Text Available Abstract Background Personality disorders affect a substantial proportion of the population. It is unclear, however, whether the burden of personality disorders on modern mental health services has been increasing. To fill this gap, we analyzed trends in admissions for personality disorders in Italy from 1988 to 1998. Methods We used the yearly data from the Italian Central Institute of Statistics to analyse trends in the total number of admissions for personality disorders and in the total number of first admissions for personality disorders. Results The absolute number of admissions for personality disorders almost trebled from 1988 to 1998, as well as the proportion of all psychiatric admissions that were for personality disorders. Whilst there has been a marked increase in the absolute number of first admissions, the proportion of all first psychiatric admissions that were for personality disorders showed a steady but modest increase, from 5.7% to 7.6%. Conclusion In Italy, the burden of personality disorders on modern mental health services has been increasing. In terms of public health, these findings highlight the urgent need of developing policies to tackle the increasing demand of care of this difficult-to-treat patient population.

  20. The Transit/Admission Lounge study.

    LENUS (Irish Health Repository)

    Gilligan, P

    2009-01-01

    In response to persistent overcrowding of Emergency Departments in Ireland, the Department of Health and Health Service Executive provided funding for "Transit Lounge" areas to be built. These lounges were to provide a location for patients to wait in beds pending the availability of a ward bed. This research was performed to assess the impact of such a lounge on the overcrowding of the Emergency Department and on patient outcomes. The time period from the opening of the Transit Lounge was compared with the same period a year earlier. The Transit Lounge delivers a comfortable place for patients to wait. It does not reduce Emergency Department overcrowding and has been associated with an increased time waiting for a ward bed. The solution to overcrowding is the creation of real capacity in the system so that ward beds are available in acute hospitals for the "unscheduled unwell".

  1. Low hospital admission rates for respiratory diseases in children

    Directory of Open Access Journals (Sweden)

    Willemsen Sten P

    2010-10-01

    Full Text Available Abstract Background Population-based data on hospital admissions for children aged 0-17 years concerning all respiratory diseases are scarce. This study examined hospital admissions in relation to the preceding consultations in general practice in this age group. Methods Data on children aged 0-17 years with respiratory diseases included in the Second Dutch National Survey of General Practice (DNSGP-2 were linked to all hospital admissions in the Dutch National Medical Registration. Admission rates for respiratory diseases were calculated. Data were analysed using multivariate logistic regression. Results Of all 79,272 children within the DNSGP-2, 1.8% were admitted to hospital for any respiratory diagnosis. The highest admission rates per 1000 children were for chronic disease of tonsils and adenoids (12.9; pneumonia and influenza (0.97; and asthma (0.92. Children aged 0-4 years and boys were admitted more frequently. Of children with asthma, 2.3% were admitted for respiratory diseases. For asthma, admission rates varied by urbanisation level: 0.47/1000 children/year in cities with ≤ 30,000 inhabitants, 1.12 for cities with ≥ 50,000 inhabitants, and 1.73 for the three largest cities (p = 0.002. Multivariate logistic regression showed that within two weeks after a GP consultation, younger age (OR 0.81, 95% CI 0.76-0.88 and more severe respiratory diseases (5.55, 95% CI 2.99-8.11 predicted hospital admission. Conclusions Children in the general population with respiratory diseases (especially asthma had very low hospital admission rates. In urban regions children were more frequently admitted due to respiratory morbidity. For effectiveness studies in a primary care setting, hospital admission rates should not be used as quality end-point.

  2. TRICARE; elimination of the non-availability statement (NAS) requirement for non-emergency inpatient mental health care. Final rule.

    Science.gov (United States)

    2013-02-26

    This final rule eliminates the requirement that states a NAS is needed for non-emergency inpatient mental health care in order for a TRICARE Standard beneficiary's claim to be paid. Currently, NAS are required for non-emergency inpatient mental health care for TRICARE Standard beneficiaries who live within a military treatment facility catchment area. At this time, the number of NASs issued is negligible as most mental health admissions are emergency admissions. Requiring a NAS for a relatively few non-emergency inpatient mental health admissions is disproportionate to the cost of maintaining the systems necessary to process and coordinate the NAS.

  3. Discovery of Association Rules from University Admission System Data

    Directory of Open Access Journals (Sweden)

    Abdul Fattah Mashat

    2013-05-01

    Full Text Available Association rules discovery is one of the vital data mining techniques. Currently there is an increasing interest in data mining and educational systems, making educational data mining (EDM as a new growing research community. In this paper, we present a model for association rules discovery from King Abdulaziz University (KAU admission system data. The main objective is to extract the rules and relations between admission system attributes for better analysis. The model utilizes an apriori algorithm for association rule mining. Detailed analysis and interpretation of the experimental results is presented with respect to admission office perspective.

  4. A scalable admission control scheme based on time label

    Institute of Scientific and Technical Information of China (English)

    杨松岸; 杨华; 杨宇航

    2004-01-01

    Resource reservation protocols allow communicating hosts to reserve resources such as bandwidth to offer guaranteed service. However, current resource reservation architectures do not scale well for a large number of flows. In this paper, we present a simple reservation protocol and a scalable admission control algorithm, which can provide QoS guarantees to individual flows without per-flow management in the network core. By mapping each flow to a definite time, this scheme addresses the problems that limit the effectiveness of current endpoint admission control schemes. The overall admission control process is described. Analysis is used to explain the reasonability of our scheme and simulation validates its performance.

  5. Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study

    Science.gov (United States)

    Ferri, Cleusa P.; Acosta, Daisy; Guerra, Mariella; Huang, Yueqin; Llibre-Rodriguez, Juan J.; Salas, Aquiles; Sosa, Ana Luisa; Williams, Joseph D.; Gaona, Ciro; Liu, Zhaorui; Noriega-Fernandez, Lisseth; Jotheeswaran, A. T.; Prince, Martin J.

    2012-01-01

    Background Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. Methods and Findings The vital status of 12,373 people aged 65 y and over was determined 3–5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89–0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. Conclusions Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the

  6. Long term cause specific mortality among 34 489 five year survivors of childhood cancer in Great Britain: population based cohort study

    Science.gov (United States)

    Fidler, Miranda M; Reulen, Raoul C; Winter, David L; Kelly, Julie; Jenkinson, Helen C; Skinner, Rod; Frobisher, Clare

    2016-01-01

    Objective To determine whether modern treatments for cancer are associated with a net increased or decreased risk of death from neoplastic and non-neoplastic causes among survivors of childhood cancer. Design Population based cohort study. Setting British Childhood Cancer Survivor Study. Participants Nationwide population based cohort of 34 489 five year survivors of childhood cancer with a diagnosis from 1940 to 2006 and followed up until 28 February 2014. Main outcome measures Cause specific standardised mortality ratios and absolute excess risks are reported. Multivariable Poisson regression models were utilised to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity or trend. Results Overall, 4475 deaths were observed, which was 9.1 (95% confidence interval 8.9 to 9.4) times that expected in the general population, corresponding to 64.2 (95% confidence interval 62.1 to 66.3) excess deaths per 10 000 person years. The number of excess deaths from all causes declined among those treated more recently; those treated during 1990-2006 experienced 30% of the excess number of deaths experienced by those treated before 1970. The corresponding percentages for the decline in excess deaths from recurrence or progression and non-neoplastic causes were 30% and 60%, respectively. Among survivors aged 50-59 years, 41% and 22% of excess deaths were attributable to subsequent primary neoplasms and circulatory conditions, respectively, whereas the corresponding percentages among those aged 60 years or more were 31% and 37%. Conclusions The net effects of changes in cancer treatments, and surveillance and management for late effects, over the period 1940 to 2006 was to reduce the excess number of deaths from both recurrence or progression and non-neoplastic causes among those treated more recently. Among survivors aged 60 years or more, the excess number of deaths from circulatory causes exceeds the excess number

  7. Burden of total and cause-specific mortality related to tobacco smoking among adults aged ≥ 45 years in Asia: a pooled analysis of 21 cohorts.

    Directory of Open Access Journals (Sweden)

    Wei Zheng

    2014-04-01

    Full Text Available BACKGROUND: Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest. METHODS AND FINDINGS: We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51 and 1.48-fold (1.38-1.58 elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2% and 3.3% (2.6%-4.0% of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700. Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y. CONCLUSIONS: Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are

  8. Socioeconomic factors and all cause and cause-specific mortality among older people in Latin America, India, and China: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Cleusa P Ferri

    2012-02-01

    Full Text Available BACKGROUND: Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking. METHODS AND FINDINGS: The vital status of 12,373 people aged 65 y and over was determined 3-5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox's proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89-0.98. Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites. CONCLUSIONS: Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older

  9. Seasonal variations of all-cause and cause-specific mortality by age, gender, and socioeconomic condition in urban and rural areas of Bangladesh

    Directory of Open Access Journals (Sweden)

    Burkart Katrin

    2011-08-01

    Full Text Available Abstract Background Mortality exhibits seasonal variations, which to a certain extent can be considered as mid-to long-term influences of meteorological conditions. In addition to atmospheric effects, the seasonal pattern of mortality is shaped by non-atmospheric determinants such as environmental conditions or socioeconomic status. Understanding the influence of season and other factors is essential when seeking to implement effective public health measures. The pressures of climate change make an understanding of the interdependencies between season, climate and health especially important. Methods This study investigated daily death counts collected within the Sample Vital Registration System (VSRS established by the Bangladesh Bureau of Statistics (BBS. The sample was stratified by location (urban vs. rural, gender and socioeconomic status. Furthermore, seasonality was analyzed for all-cause mortality, and several cause-specific mortalities. Daily deviation from average mortality was calculated and seasonal fluctuations were elaborated using non parametric spline smoothing. A seasonality index for each year of life was calculated in order to assess the age-dependency of seasonal effects. Results We found distinctive seasonal variations of mortality with generally higher levels during the cold season. To some extent, a rudimentary secondary summer maximum could be observed. The degree and shape of seasonality changed with the cause of death as well as with location, gender, and SES and was strongly age-dependent. Urban areas were seen to be facing an increased summer mortality peak, particularly in terms of cardiovascular mortality. Generally, children and the elderly faced stronger seasonal effects than youths and young adults. Conclusion This study clearly demonstrated the complex and dynamic nature of seasonal impacts on mortality. The modifying effect of spatial and population characteristics were highlighted. While tropical regions have

  10. Hypernatremia in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Neslihan YÜCE

    2012-05-01

    Full Text Available INTRODUCTION: To determine the symptoms, clinical characteristics, prevalence and outcome of patients with hypernatremia who presented at the emergency department. MATERIAL and METHODS: We retrospectively studied patients who presented at the emergency department with hypernatremia (Na>148 meq/l from January 2008 to December 2008. RESULTS: A total of 25.545 cases presented at the Emergency Department and hypernatremia was seen in 86 patients. The prevalence of hypernatremia was 0.34%. The mean age was 69.5±15.2 (20- 96, median age: 75 years and 51 of them (59% were male. Forty percent of the patients died. There were no significant differences according to age, gender and admission Na levels. A comorbid disease were seen 99% of patients. Cerebrovascular disease(CVD, dementia/Alzheimer and hypertension were the most common co-morbid diseases (respectively, 34%, 34%,and 27%. Central neurological system disorders (such as thrombotic or hemorrhagic CVD, Alzheimer, etc. were seen in 72% of the cases. Fifty patients had acute infection at the time of admission. Acute urinary infection, pneumonia and acute CVD were the most common acute illnesses. CONCLUSION: Hypernatremia is usually seen in the geriatric population and associated with a high mortality and morbidity rate and the majority of patients with hypernatremia have a comorbid disease. The prevalence of hypernatremia was 0.34% in our emergency department.

  11. 14 CFR 121.547 - Admission to flight deck.

    Science.gov (United States)

    2010-01-01

    ... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.547 Admission to flight deck... holder. However, the certificate holder may not admit employees of traffic, sales, or other...

  12. 49 CFR 386.44 - Request for admissions.

    Science.gov (United States)

    2010-10-01

    ... serve upon any other party a request for admission of any relevant matter or the authenticity of any... other proceeding. (c) If a party refuses to admit a matter or the authenticity of a document which...

  13. 49 CFR 1114.27 - Request for admission.

    Science.gov (United States)

    2010-10-01

    ... OF TRANSPORTATION RULES OF PRACTICE EVIDENCE; DISCOVERY Discovery § 1114.27 Request for admission. (a... of information or knowledge as a reason for failure to admit or deny unless he states that he...

  14. 16 CFR 1025.34 - Requests for admission.

    Science.gov (United States)

    2010-01-01

    ... PROCEEDINGS Discovery, Compulsory Process § 1025.34 Requests for admission. (a) Procedure for request. A party... and qualify or deny the remainder. An answering party may not give lack of information or knowledge...

  15. Relating Admissibility Standards for Digital Evidence to Attack Scenario Reconstruction

    Directory of Open Access Journals (Sweden)

    Changwei Liu

    2014-09-01

    Full Text Available Attackers tend to use complex techniques such as combining multi-step, multi-stage attack with anti-forensic tools to make it difficult to find incriminating evidence and reconstruct attack scenarios that can stand up to the expected level of evidence admissibility in a court of law. As a solution, we propose to integrate the legal aspects of evidence correlation into a Prolog based reasoner to address the admissibility requirements by creating most probable attack scenarios that satisfy admissibility standards for substantiating evidence. Using a prototype implementation, we show how evidence extracted by using forensic tools can be integrated with legal reasoning to reconstruct network attack scenarios. Our experiment shows this implemented reasoner can provide pre-estimate of admissibility on a digital crime towards an attacked network.

  16. A NEW ADMISSION CONTROL APPROACH BASED ON PREDICTION

    Institute of Scientific and Technical Information of China (English)

    Lu Kaining; Jin Zhigang; Zou Jun

    2002-01-01

    Admission control plays an important role in providing QoS to network users. Motivated by the measurement-based admission control algorithm, this letter proposed a new admission control approach for integrated service packet network based on traffic prediction. In the letter, FARIMA(p, d, q) models in the admission control algorithm is deployed. A method to simplify the FARIMA model fitting procedure and hence to reduce the time of traffic modeling and prediction is suggested. The feasibility-study experiments show that FARIMA models which have less number of parameters can be used to model and predict actual traffic on quite a large time scale. Simulation results validate the promising approach.

  17. Spatial variation in nitrogen dioxide concentrations and cardiopulmonary hospital admissions

    NARCIS (Netherlands)

    Dijkema, Marieke B A; van Strien, Robert T; van der Zee, Saskia C; Mallant, Sanne F; Fischer, Paul; Hoek, Gerard; Brunekreef, Bert; Gehring, Ulrike

    2016-01-01

    BACKGROUND: Air pollution episodes are associated with increased cardiopulmonary hospital admissions. Cohort studies showed associations of spatial variation in traffic-related air pollution with respiratory and cardiovascular mortality. Much less is known in particular about associations with cardi

  18. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Groen, Aard J.; Sijde, van der Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies an

  19. A Supply and Demand Model of the College Admissions Problem

    OpenAIRE

    2009-01-01

    We develop the first Bayesian model of decentralized college admissions, with heterogeneous students, costly portfolio applications, and noisy college evaluations. Students face a nontrivial portfolio choice, and colleges choose admissions standards that act like market-clearing prices. We derive the two college model equilibrium, deriving a “law of demand”. Surprisingly, the worse college might impose higher standards, and weaker students sometimes apply more aggressively. The lesser coll...

  20. Prediction of mortality 1 year after hospital admission.

    LENUS (Irish Health Repository)

    Kellett, J

    2012-09-01

    Hospital admission, especially for the elderly, can be a seminal event as many patients die within a year. This study reports the prediction of death within a year of admission to hospital of the Simple Clinical Score (SCS) and ECG dispersion mapping (ECG-DM). ECG-DM is a novel technique that analyzes low-amplitude ECG oscillations and reports them as the myocardial micro-alternation index (MMI).

  1. Towards an understanding of graduate admissions practices in physics

    Science.gov (United States)

    Potvin, Geoff; Chari, Deepa

    2017-01-01

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

  2. ASCERTAINMENT OF ADMISSIBLE SYSTEMATIC OVERLOADS IN THE DISTRIBUTIVE OIL-TRANSFORMERS

    Directory of Open Access Journals (Sweden)

    V. A. Anishchenko

    2015-01-01

    Full Text Available The capacity of power-distributive oil-transformers is selected on the basis of their operational mode cost-effectiveness and power-supply reliability of the electrical recipients on condition that the transformers duty should not lead to reduction of their normal life-in-service. Unconscionable and protracted overloads intrinsically decrease reliability and respectively service life of the transformers owing to increased wear of the winding insulation because of the excessive heat. The unaccounted previous loading history and possible changes of the risen overload in the course of its further development can lead to poor accuracy in the admissible overload time estimation. Therefore, that may lead to intolerable excessive heat in the winding insulation or underutilization of the potential overload capacity of the transformers. Which limits the potentiality of complete demand satisfaction of the electrical consumers. This is exactly why the acting GOST 14209–97 strongly recommends the consumers to make their own calculations of the load-carrying capacity based on the real load curves.The authors present a method for ascertainment of the admissible duration of the systematic non-emergency overload of a distributive oil-transformer. The ascertainment method accounts for the overload repetition-factor alteration on the time-interval of its occurrence and respectively the variation in the transformer thermal state. The employment of this method will allow improving accuracy in ascertainment of the admissible duration of the systematic non-emergency overloads and eventually the reliability of the transformer operation and the power-supply system in its entirety. The method realization is intended by means of the transformer-load monitoring as one of the tasks of the electric-energy automated control and accounting system.

  3. Routine perineal shaving on admission in labour.

    Science.gov (United States)

    Basevi, Vittorio; Lavender, Tina

    2014-01-01

    outcome. There were no differences in maternal satisfaction between groups in the larger trial reporting this outcome (mean difference (MD) 0.00, 95% CI -0.13 to 0.13). No trial reported on perineal trauma. One trial reported on side-effectsand these included irritation, redness, burning and itching.The overall quality of evidence ranged from very low (for the outcomes postpartum maternal febrile morbidity and neonatal infection)to low (for the outcome maternal satisfaction and wound infection).Authors’ conclusionsThere is insufficient evidence to recommend perineal shaving for women on admission in labour.

  4. Admission of elderly medical patients to fast track or standard hospitalisation

    DEFF Research Database (Denmark)

    Strøm, Camilla; Rasmussen, Lars Simon; Rasmussen, Søren Wistisen

    2016-01-01

    INTRODUCTION: Emergency department-based short stay units (SSUs) are increasingly being introduced to provide accelerated care. The effects of treatment in SSUs for elderly medical patients are not well-studied. METHODS: The ELDER trial is a single-blinded, randomised parallel trial with 1......:1 allocation between hospitalisation in an SSU (intervention) and the Department of Internal Medicine (standard care). The study is conducted at Holbaek Hospital, Denmark. Elderly patients are screened for inclusion if an emergency physician assesses that treatment in an SSU is possible. Eligible participants...... are patients aged ≥ 75 years needing in-hospital treatment of an acute medical problem and who are stable upon admission. The primary outcome is 90-day all-cause mortality. Secondary outcomes include: length of stay in hospital, incidence of complications during hospitalisation, rate of unplanned readmissions...

  5. Agreement between the 2009 STOPP Criteria and the 2003 Beers Criteria at the time of hospital admission

    Directory of Open Access Journals (Sweden)

    María Muñoz García

    2016-12-01

    Full Text Available Potentially inappropriate prescription in elderly patients can be evaluated by different methods. The STOPP Criteria and Beers Criteria stand out among the explicit criteria most widely used. Objective: The main objective of this study is to identify the agreement in the detection of potentially inappropriate prescribing between the STOPP criteria and the Beers Criteria, in elderly patients assessed at the time of hospital admission. Method: An observational retrospective study was designed in order to estimate the prevalence of potentially inappropriate prescription in the habitual treatment before admission, and to compare the agreement in detection capability between the 2003 Beers Criteria and the 2009 STOPP Criteria, in >70-yearold patients with an emergency hospital admission. There was also a specific analysis of the prescription of first-generation antihistamines, tricyclic antidepressants, benzodiazepines, and selective serotonin reuptake inhibitors, which are considered drugs with irregular management and potential toxicity. Results: The total prevalence of patients with a potentially inappropriate prescription was 23.8% using the Beers Criteria and 33.3% using the STOPP Criteria. There was a low level of agreement between both questionnaires. First-generation antihistamines (Beers and pharmacological duplication (STOPP J were the criteria most frequently found. There were differences in the prevalence of potentially inappropriate prescription in the four pharmacological groups selected; and in all cases, detection by Beers Criteria was superior. Conclusion: There is no agreement between the STOPP Criteria and the Beers Criteria regarding the detection of patients with potentially inappropriate prescribing at the time of hospital admission.

  6. Frequent visitors to psychiatric emergency services: staff attitudes and temporal patterns.

    Science.gov (United States)

    Arfken, Cynthia; Zeman, Lori Lackman; Yeager, Lindsay; Mischel, Edward; Amirsadri, Alireza

    2002-11-01

    Providing quality psychiatric emergency services is becoming more difficult as utilization rates soar, especially by individuals who are frequent visitors. To address this issue, a staff survey and analysis of admission patterns were conducted. Staff were more likely to believe that frequent visitors sought care because they had difficulty accessing alternative services, had basic needs unmet, were substance abusers, wanted inpatient admission, and were noncompliant with treatment plans. The 1999 temporal admission pattern documented that frequent visitors' admissions were higher during the first week of the month and inclement weather. Surprisingly, the infrequent visitors' admissions also were higher during the first week of the month. Together, these findings suggest that, in this urban location, frequent visitors are disadvantaged individuals lacking support and alternative treatment settings who use psychiatric emergency services to meet basic needs.

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

    Science.gov (United States)

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

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

  8. Potential Utility of Non-Cognitive Constructs in Graduate Admissions

    Science.gov (United States)

    Miller, Casey

    2015-03-01

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

  9. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

    NARCIS (Netherlands)

    Wang, Haidong; Naghavi, Mohsen; Allen, Christine; Barber, Ryan M.; Bhutta, Zulfiqar A.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Chen, Alan Zian; Coates, Matthew M.; Coggeshall, Megan; Dandona, Lalit; Dicker, Daniel J.; Erskine, Holly E.; Ferrari, Alize J.; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H.; Fraser, Maya S.; Pullman, Nancy; Gething, Peter W.; Goldberg, Ellen M.; Graetz, Nicholas; Haagsma, Juanita A.; Hay, Simon I.; Huynh, Chantal; Johnson, Catherine; Kassebaum, Nicholas J.; Kinfu, Yohannes; Kulikoff, Xie Rachel; Kutz, Michael; Kyu, Hmwe H.; Larson, Heidi J.; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S.; Lind, Margaret; Lozano, Rafael; Marquez, Neal; Mensah, George A.; Mikesell, Joe; Mokdad, Ali H.; Mooney, Meghan D.; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M.; Pinho, Christine; Roth, Gregory A.; Salomon, Joshua A.; Sandar, Logan; Silpakit, Naris; Sligar, Amber; Sorensen, Reed J. D.; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A.; Troeger, Christopher; VanderZanden, Amelia; Vollset, Stein Emil; Wanga, Valentine; Whiteford, Harvey A.; Wolock, Timothy; Zoeckler, Leo; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abera, Semaw Ferede; Abreu, Daisy M. X.; Abu-Raddad, Laith J.; Abyu, Gebre Yitayih; Achoki, Tom; Adelekan, Ademola Lukman; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C.; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ajala, Oluremi N.; Akanda, All Shafqat; Akinyemi, Rufus Olusola; Akinyemiju, Tomi F.; Akseer, Nadia; Al Lami, Faris Hasan; Alabed, Samer; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K. M.; Alasfoor, Deena; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alegretti, Miguel Angel; Aleman, Alicia V.; Alemu, Zewdie Aderaw; Alexander, Lily T.; Alhabib, Samia; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A.; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amegah, Adeladza Kofi; Ameh, Emmanuel A.; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H.; Anderson, Benjamin; Anderson, Gregory M.; Antonio, Carl Abelardo T.; Aregay, Atsede Fantahun; Arnlov, Johan; Arsenijevic, Valentina S. Arsic; Al Artaman, Ali; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Arthur Avokpaho, Euripide Frinel G.; Awasthi, Ashish; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C.; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L.; Barnighausen, Till; Barregard, Lars; Barrero, Lope H.; Basu, Arindam; Basu, Sanjay; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Belay, Haileeyesus Adamu; Bell, Brent; Bell, Michelle L.; Bello, Aminu K.; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhalla, Ashish; Biadgilign, Sibhatu; Bikbov, Boris; Bin Abdulhak, Aref A.; Biroscak, Brian J.; Biryukov, Stan; Bjertness, Espen; Blore, Jed D.; Blosser, Christopher D.; Bohensky, Megan A.; Borschmann, Rohan; Bose, Dipan; Bourne, Rupert R. A.; Brainin, Michael; Brayne, Carol E. G.; Brazinova, Alexandra; Breitborde, Nicholas J. K.; Brenner, Hermann; Brewer, Jerry D.; Brown, Alexandria; Brown, Jonathan; Brugha, Traolach S.; Buckle, Geoffrey Colin; Butt, Zahid A.; Calabria, Bianca; Campos-Novato, Ismael Ricardo; Campuzano, Julio Cesar; Carapetis, Jonathan R.; Cardenas, Rosario; Carpenter, David; Carrero, Juan Jesus; Castaneda-Oquela, Carlos A.; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Cavalleri, Fiorella; Cercy, Kelly; Cerda, Jorge; Chen, Wanqing; Chew, Adrienne; Chiang, Peggy Pei -Chia; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chimed-Ochir, Odgerel; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G.; Cirillo, Massimo; Cohen, Aaron J.; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M.; Cooper, Cyrus; Cooper, Leslie Trumbull; Cortinovis, Monica; Cowie, Benjamin C.; Crump, John A.; Damsere-Derry, James; Danawi, Hadi; Dandona, Rakhi; Daoud, Farah; Darby, Sarah C.; Dargan, Paul I.; das Neves, Jose; Davey, Gail; Davis, Adrian C.; Davitoiu, Dragos V.; de Castro, E. Filipa; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert P.; Deribe, Kebede; Deribew, Amare; Dharmaratne, Samath D.; Dhillon, Preet K.; Diaz-Torne, Cesar; Ding, Eric L.; dos Santos, Kadine Priscila Bender; Dossou, Edem; Driscoll, Tim R.; Duan, Leilei; Dubey, Manisha; Bartholow, Bruce; Ellenbogen, Richard G.; Lycke, Christian; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Faghmous, Imad D. A.; Fahimi, Saman; Jose, Emerito; Farid, Talha A.; Sa Farinha, Carla Sofia e; Faro, Andre; Farvid, Maryam S.; Farzadfar, Farshad; Feigin, Valery L.; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G.; Fernandes, Joao C.; Fischer, Florian; Fitchett, Joseph R. A.; Flaxman, Abraham; Foigt, Nataliya; Fowkes, F. Gerry R.; Franca, Elisabeth Barboza; Franklin, Richard C.; Friedman, Joseph; Frostad, Joseph; Hirst, Thomas; Futran, Neal D.; Gall, Seana L.; Gambashidze, Ketevan; Gamkrelidze, Amiran; Ganguly, Parthasarathi; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebrehiwot, Tsegaye Tsewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M.; Gessner, Bradford D.; Ghoshal, Aloke Gopal; Gibney, Katherine B.; Gillum, Richard F.; Gilmour, Stuart; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Giussani, Giorgia; Glaser, Elizabeth; Godwin, William W.; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gosselin, Richard A.; Gotay, Carolyn C.; Goto, Atsushi; Gouda, Hebe N.; Greaves, Felix; Gugnani, Harish Chander; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutierrez, Reyna A.; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A.; Hamadeh, Randah Ribhi; Hamidi, Samer; Hancock, Jamie; Handal, Alexis J.; Hankey, Graeme J.; Hao, Yuantao; Harb, Hilda L.; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Havmoeller, Rasmus; Heckbert, Susan R.; Heredia-Pi, Ileana Beatriz; Heydarpour, Pouria; Hilderink, Henk B. M.; Hoek, Hans W.; Hogg, Robert S.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hotez, Peter J.; Hoy, Damian G.; Hsairi, Mohamed; Htet, Aung Soe; Than Htike, Maung Maung; Hu, Guoqing; Huang, Cheng; Huang, Hsiang; Huiart, Laetitia; Husseini, Abdullatif; Huybrechts, Inge; Huynh, Grace; Iburg, Kim Moesgaard; Innos, Kaire; Inoue, Manami; Iyer, Veena J.; Jacobs, Troy A.; Jacobsen, Kathryn H.; Jahanmehr, Nader; Jakovljevic, Mihajlo B.; James, Peter; Javanbakht, Mehdi; Jayaraman, Sudha P.; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jensen, Paul N.; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jonas, Jost B.; Joshi, Tushar Kant; Kabir, Zubair; Karnak, Ritul; Kan, Haidong; Kant, Surya; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Karletsos, Dimitris; Karthikeyan, Ganesan; Kasaeian, Amir; Katibeh, Marzieh; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Keiyoro, Peter Njenga; Kemmer, Laura; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A.; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khera, Sahil; Muthafer Khoja, Tawfik Ahmed; Kieling, Christian; Kim, Daniel; Kim, Yun Jin; Kissela, Brett M.; Kissoon, Niranjan; Knibbs, Luke D.; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A.; Kosen, Soewarta; Koul, Parvaiz A.; Koyanagi, Ai; Krog, Norun Hjertager; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A.; Kuipers, Ernst J.; Kulkarni, Veena S.; Kumar, G. Anil; Kwan, Gene F.; Lal, Aparna; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O.; Langan, Sinead M.; Lansingh, Van C.; Larsson, Anders; Laryea, Dennis Odai; Latif, Asma Abdul; Lawrynowicz, Alicia Elena Beatriz; Leigh, James; Levi, Miriam; Li, Yongmei; Lindsay, M. Patrice; Lipshultz, Steven E.; Liu, Patrick Y.; Liu, Shiwei; Liu, Yang; Lo, Loon-Tzian; Logroscino, Giancarlo; Lotufo, Paulo A.; Lucas, Robyn M.; Lunevicius, Raimundas; Lyons, Ronan A.; Ma, Stefan; Pedro Machado, Vasco Manuel; Mackay, Mark T.; MacLachlan, Jennifer H.; Abd El Razek, Hassan Magdy; Abd El Razek, Mohammed Magdy; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Ayele Manamo, Wondimu Ayele; Mandisarisa, John; Mangalam, Srikanth; Mapoma, Chabila C.; Marcenes, Wagner; Margolis, David Joel; Martin, Gerard Robert; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Masiye, Felix; Mason-Jones, Amanda J.; Massano, Joao; Matzopoulos, Richard; Mayosi, Bongani M.; McGarvey, Stephen Theodore; McGrath, John J.; Mckee, Martin; McMahon, Brian J.; Meaney, Peter A.; Mehari, Alem; Mehndiratta, Man Mohan; Mena-Rodriguez, Fabiola; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A.; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J.; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R.; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N.; Abdulmuhsin Mohammad, Karzan; Mohammadi, Alireza; Mohammed, Shafiu; Mohan, Viswanathan; Mola, Glen Liddell D.; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montero, Pablo; Montico, Marcella; Montine, Thomas J.; Moradi-Lakeh, Maziar; Morawska, Lidia; Morgan, Katherine; Mori, Rintaro; Mozaffarian, Dariush; Mueller, Ulrich; Satyanarayana Murthy, Gudlavalleti Venkata; Murthy, Srinivas; Musa, Kamarul Imran; Nachega, Jean B.; Nagel, Gabriele; Naidoo, Kovin S.; Naik, Nitish; Naldi, Luigi; Nangia, Vinay; Nash, Denis; Nejjari, Chakib; Neupane, Subas; Newton, Charles R.; Newton, John N.; Ng, Marie; Ngalesoni, Frida Namnyak; Ngirabega, Jean de Dieu; Quyen Le Nguyen, [Unknown; Nisar, Muhammad Imran; Nkamedjie Pete, Patrick Martial; Nomura, Marika; Norheim, Ole F.; Norman, Paul E.; Norrving, Bo; Nyakarahuka, Luke; Ogbo, Felix Akpojene; Ohkubo, Takayoshi; Ojelabi, Foluke Adetola; Olivares, Pedro R.; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osman, Majdi; Ota, Erika; Ozdemir, Raziye; Pa, Mahesh; Pandian, Jeyaraj D.; Pant, Puspa Raj; Papachristou, Christina; Park, Eun-Kee; Park, Jae-Hyun; Parry, Charles D.; Parsaeian, Mahboubeh; Caicedo, Angel J. Paternina; Patten, Scott B.; Patton, George C.; Paul, Vinod K.; Pearce, Neil; Pedro, Joao Mario; Stokic, Ljiljana Pejin; Pereira, David M.; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B.; Pillay, Julian David; Plass, Dietrich; Platts-Mills, James A.; Polinder, Suzanne; Pope, C. Arden; Popova, Svetlana; Poulton, Richie G.; Pourmalek, Farshad; Prabhakaran, Dorairaj; Qorbani, Mostafa; Quame-Amaglo, Justice; Quistberg, D. Alex; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajavi, Zhale; Rajsic, Sasa; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M.; Ranabhat, Chhabi L.; Rangaswamy, Thara; Rao, Puja; Rao, Sowmya R.; Refaat, Amany H.; Rehm, Jurgen; Reitsma, Marissa B.; Remuzzi, Giuseppe; Resnikofff, Serge; Ribeiro, Antonio L.; Ricci, Stefano; Blancas, Maria Jesus Rios; Roberts, Bayard; Roca, Anna; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Rothenbacher, Dietrich; Roy, Ambuj; Roy, Nawal K.; Ruhago, George Mugambage; Sagar, Rajesh; Saha, Sukanta; Sahathevan, Ramesh; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sanchez-Nino, Maria Dolores; Sanchez-Riera, Lidia; Santos, Itamar S.; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schaub, Michael P.; Schmidt, Maria Ines; Schneider, Ione J. C.; Schottker, Ben; Schutte, Aletta E.; Schwebel, David C.; Seedat, Soraya; Sepanlou, Sadaf G.; Servan-Mori, Edson E.; Shackelford, Katya A.; Shaddick, Gavin; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Shakh-Nazarova, Marina; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Shen, Ziyan; Shepard, Donald S.; Sheth, Kevin N.; Shetty, Balakrishna P.; Shi, Peilin; Shibuya, Kenji; Shin, Min-Jeong; Shiri, Rahman; Shiue, Ivy; Shrime, Mark G.; Sigfusdottir, Inga Dora; Silberberg, Donald H.; Silva, Diego Augusto Santos; Silveira, Dayane Gabriele Alves; Silverberg, Jonathan I.; Simard, Edgar P.; Singh, Abhishek; Singh, Gitanjali M.; Singh, Jasvinder A.; Singh, Om Prakash; Singh, Prashant Kumar; Singh, Virendra; Soneji, Samir; Soreide, Kjetil; Soriano, Joan B.; Sposato, Luciano A.; Sreeramareddy, Chandrashekhar T.; Stathopoulou, Vasiliki; Stein, Dan J.; Stein, Murray B.; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F.; Sur, Patrick; Swaminathan, Soumya; Sykes, Bryan L.; Szoeke, Cassandra E. I.; Tabares-Seisdedos, Rafael; Tabb, Karen M.; Takahashi, Ken; Takala, Jukka S.; Talongwa, Roberto Tchio; Tandon, Nikhil; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R.; Ao, Braden J. Te; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Ten Have, Margreet; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thomson, Alan J.; Thorne-Lyman, Andrew L.; Thrift, Amanda G.; Thurston, George D.; Tillmann, Taavi; Tirschwell, David L.; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Nx, Jeffrey Allen Towb; Traebert, Jefferson; Tran, Bach Xuan; Truelsen, Thomas; Trujillo, Ulises; Tura, Abera Kenay; Tuzcu, Emin Murat; Uchendu, Uche S.; Ukwaja, Kingsley N.; Undurraga, Eduardo A.; Uthman, Olalekan A.; Van Dingenen, Rita; Van Donkelaar, Aaron; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Vidavalur, Ramesh; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S.; Vlassov, Vasiliy Victorovich; Wagner, Joseph A.; Wagner, Gregory R.; Wallin, Mitchell T.; Wang, Linhong; Watkins, David A.; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G.; Werdecker, Andrea; Westerman, Ronny; White, Richard A.; Wijeratne, Tissa; Wilkinson, James D.; Williams, Hywel C.; Wiysonge, Charles Shey; Woldeyohannes, Solomon Meseret; Wolfe, Charles D. A.; Won, Sungho; Wong, John Q.; Woolf, Anthony D.; Xavier, Denis; Xiao, Qingyang; Xu, Gelin; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yan, Lijing L.; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yirsaw, Biruck Desalegn; Yonemoto, Naohiro; Yonga, Gerald; Younis, Mustafa Z.; Yu, Shicheng; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zannad, Faiez; Zavala, Diego E.; Zeeb, Hajo; Zeleke, Berihun M.; Zhang, Hao; Zodpey, Sanjay; Zonies, David; Zuhlke, Liesl Joanna; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.

    2016-01-01

    Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes

  10. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2016-01-01

    also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality...

  11. Emerging Hopes

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China looks to strategically important emerging industries for innovation-driven economic growthc hina will soon announce a decision to rev up seven strategically impor- tant emerging industries,said the National

  12. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... prevents pregnancy in the same way as regular birth control pills: By preventing or delaying the release of an ...

  13. Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review

    Directory of Open Access Journals (Sweden)

    Pooler A

    2014-03-01

    Full Text Available Alison Pooler,1,2 Roger Beech21School of Nursing and Midwifery, Clinical Education Centre, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK; 2Health Services Research, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK Objectives: Exacerbations of chronic obstructive pulmonary disease (COPD are the third largest cause of emergency hospital admissions in the UK. This systematic literature review explored the relationship between the hospitalization rates and the COPD comorbidities, anxiety, and depression.Methods: The Centre for Research Dissemination's framework for systematic reviews was followed using search terms relating to COPD, anxiety, depression, and hospital admission. Papers identified were assessed for relevance and quality, using a suitable Critical Appraisal Skills Programme tool and Mixed Methods Assessment Tool.Results: Twenty quantitative studies indicated that anxiety and depression led to a statistically significant increase in the likelihood of COPD patients being hospitalized. These comorbidities also led to an increased length of stay and a greater risk of mortality postdischarge. Other significant factors included lower Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise scores, female gender, lower socioeconomic status, poorer patient perceived quality of life, increased severity of lung function, and less improvement in dyspnea from admission to discharge. It was also highlighted that only 27%–33% of those with depression were being treated for it. Four qualitative studies revealed that patients saw anxiety and depression as a major factor that affected their ability to cope with and self-manage their condition.Implications: Findings from the systematic review have highlighted a need for better recognition and treatment of anxiety and depression amongst individuals with COPD. Ongoing research will develop and test strategies for promoting better management

  14. Tuberculosis in hospitalized patients: clinical characteristics of patients receiving treatment within the first 24 h after admission

    Directory of Open Access Journals (Sweden)

    Denise Rossato Silva

    2014-06-01

    Full Text Available Objective: To evaluate clinical characteristics and outcomes in patients hospitalized for tuberculosis, comparing those in whom tuberculosis treatment was started within the first 24 h after admission with those who did not. Methods: This was a retrospective cohort study involving new tuberculosis cases in patients aged ≥ 18 years who were hospitalized after seeking treatment in the emergency room. Results: We included 305 hospitalized patients, of whom 67 (22.0% received tuberculosis treatment within the first 24 h after admission ( ≤24h group and 238 (88.0% did not (>24h group. Initiation of tuberculosis treatment within the first 24 h after admission was associated with being female (OR = 1.99; 95% CI: 1.06-3.74; p = 0.032 and with an AFB-positive spontaneous sputum smear (OR = 4.19; 95% CI: 1.94-9.00; p 24h groups, respectively, the ICU admission rate was 22.4% and 15.5% (p = 0.258; mechanical ventilation was used in 22.4% and 13.9% (p = 0.133; in-hospital mortality was 22.4% and 14.7% (p = 0.189; and a cure was achieved in 44.8% and 52.5% (p = 0.326. Conclusions: Although tuberculosis treatment was initiated promptly in a considerable proportion of the inpatients evaluated, the rates of in-hospital mortality, ICU admission, and mechanical ventilation use remained high. Strategies for the control of tuberculosis in primary care should consider that patients who seek medical attention at hospitals arrive too late and with advanced disease. It is therefore necessary to implement active surveillance measures in the community for earlier diagnosis and treatment.

  15. Asymptotic admissibility of priors and elliptic differential equations

    CERN Document Server

    Hartigan, J A

    2010-01-01

    We evaluate priors by the second order asymptotic behavior of the corresponding estimators.Under certain regularity conditions, the risk differences between efficient estimators of parameters taking values in a domain D, an open connected subset of R^d, are asymptotically expressed as elliptic differential forms depending on the asymptotic covariance matrix V. Each efficient estimator has the same asymptotic risk as a 'local Bayes' estimate corresponding to a prior density p. The asymptotic decision theory of the estimators identifies the smooth prior densities as admissible or inadmissible, according to the existence of solutions to certain elliptic differential equations. The prior p is admissible if the quantity pV is sufficiently small near the boundary of D. We exhibit the unique admissible invariant prior for V=I,D=R^d-{0). A detailed example is given for a normal mixture model.

  16. Advanced Fuzzy Logic Based Admission Control for UMTS System

    Directory of Open Access Journals (Sweden)

    P. Kejik

    2010-12-01

    Full Text Available The capacity of CDMA (Code Division Multiple Access systems is interference limited. Therefore radio resources management (RRM functions are used. They are responsible for supplying optimum coverage, ensuring efficient use of physical resources, and providing the maximum planned capacity. This paper deals with admission control techniques for UMTS (Universal Mobile Telecommunication System. A UMTS system model and four fuzzy logic based admission control algorithms are presented in this paper. Two new versions of fuzzy logic based admission control algorithms are presented there. All algorithms are mutually compared via simulations. Simulations show that the novel advanced fuzzy algorithm outperforms the other simulated algorithms (in terms of blocking probability, dropping probability and the number of active UEs in cell.

  17. A scalable admission control scheme based on time label

    Institute of Scientific and Technical Information of China (English)

    杨松岸; 杨华; 杨宇航

    2004-01-01

    Resource reservation protocols allow communicating hosts to reserve resources such as bandwidth to offer guaranteed service. However,current resource reservation architectures do not scale well for a large number of flows. In this paper,we present a simple reservation protocol and a scalable admission control algorithm,which can provide QoS guarantees to individual flows without per-flow management in the network core. By mapping each flow to a definite time,this scheme addresses the problems that limit the effectiveness of current endpoint admission control schemes. The overall admission control process is described. Analysis is used to explain the reasonability of our scheme and simulation validates its performance.

  18. An Intelligent Call Admission Control Decision Mechanism for Wireless Networks

    CERN Document Server

    S., Ramesh Babu H; S, Satyanarayana P

    2010-01-01

    The Call admission control (CAC) is one of the Radio Resource Management (RRM) techniques plays instrumental role in ensuring the desired Quality of Service (QoS) to the users working on different applications which have diversified nature of QoS requirements. This paper proposes a fuzzy neural approach for call admission control in a multi class traffic based Next Generation Wireless Networks (NGWN). The proposed Fuzzy Neural Call Admission Control (FNCAC) scheme is an integrated CAC module that combines the linguistic control capabilities of the fuzzy logic controller and the learning capabilities of the neural networks .The model is based on Recurrent Radial Basis Function Networks (RRBFN) which have better learning and adaptability that can be used to develop the intelligent system to handle the incoming traffic in the heterogeneous network environment. The proposed FNCAC can achieve reduced call blocking probability keeping the resource utilisation at an optimal level. In the proposed algorithm we have c...

  19. Drug-related hospital admissions in a generic pharmaceutical system.

    Science.gov (United States)

    Zargarzadeh, A H; Emami, M H; Hosseini, F

    2007-01-01

    1. Generically based pharmaceutical systems exist in a few countries of the world, such as Iran. Most developed countries have free market pharmaceutical systems. Drug-related problems (DRP) have been reported mostly in the Western world but few data are available for generic systems. In this study, we tried to measure the prevalence of drug-related problems leading to hospital admissions in Isfahan, Iran. 2. One thousand consecutive hospital admissions in three major teaching hospitals were studied for a period of 6 months for the presence of DRP as a cause of hospital admissions. Two subcategories of DRP were considered: (i) drug therapy failure; and (ii) adverse drug reactions. Preventability and outcome measures were also assessed. Medications responsible for DRP were classified according to the Anatomic Therapeutic Chemical (ATC) classification of the World Health Organization. 3. Of the 1000 admissions studied, 115 (11.5%) were owing to DRP, 81% as a result of drug therapy failure and 19% as adverse drug reactions. A total of 106 out of the 115 DRP cases (92%) were either preventable or probably preventable, most of which had to do with either prescriber or patient error. An overview of DRP showed that 58.3% resulted in complete recovery, 33.9% in relative recovery and 7.8% in death. Close to 1% of hospital admissions resulted in DRP-related deaths. 4. The overall prevalence of hospital admissions caused by DRP is similar to that in free market pharmaceutical systems. The high preventability rate of these problems should alert clinicians and policy makers to design strategies to curtail this. Also, reasons for differences in subtypes of DRP between the results of this study and those of the literature from free market systems needs to be investigated further.

  20. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  1. Traumatic injuries: radiological hemostatic intervention at admission

    Energy Technology Data Exchange (ETDEWEB)

    Dondelinger, R.F.; Trotteur, G.; Ghaye, B.; Szapiro, D. [Department of Medical Imaging, University Hospital Sart Tilman, Liege (Belgium)

    2002-05-01

    Blunt trauma victims and selected patients with penetrating trauma are systematically investigated after resuscitation and hemodynamic stabilization with cross-sectional imaging. Computed tomography is a good predictor of the need for hemostatic arteriographic embolization, based on contrast medium extravasation observed on CT. In centers admitting polytrauma patients, the CT and angiography units should be installed together within the emergency environment. Trauma-dedicated interventional radiologists should be on call for optimal patient management. Posttraumatic retroperitoneal and pelvic bleeding is a primary indication for angiographic hemostasis, together with orthopedic fixation of pelvic bone fractures. Angiography should be carried out rapidly, before the patient decompensates for considerable blood loss. In patients with visceral bleeding, arterial embolization can obviate primary surgery or potentializes surgical intervention and contributes to changing hierarchy of injuries to be treated surgically. Failure to achieve primary hemostasis may occur according to the type of specific organ injury and coagulation and metabolic parameters of the patient. Postembolization complications are few and are usually non-life-threatening and rarely carry definitive sequelae. (orig.)

  2. Admission Control Algorithm for Guaranteeing Real-Time Anycast Flow

    Institute of Scientific and Technical Information of China (English)

    Weijia Jia; Zhang Chuanlin

    2002-01-01

    In this paper, we study admission control algorithm for anycast flow with real-time constraints. With the given time requirement, when the result of this algorithm give succeed information, we find route for the anycast flow requesting. Therefore, what we need to do is testing if the corresponding path rj has enough bandwidth for coming anycast flow requirement at source S with end-to-end deadline D. This admission control is scalable in terms of the number of flows can be admitted through local information of the routes.

  3. Admissibility of false-confession testimony: know thy standard.

    Science.gov (United States)

    Quintieri, Peter; Weiss, Kenneth J

    2005-01-01

    The reliability of confessions is subject to a variety of factors, some of which give rise to expert testimony. To the degree that prosecutors construe the determination of reliability as an objective standard, they may attempt to bar testimony. Moreover, when the testimony is theoretical rather than clinical, there are additional challenges. Depending on jurisdiction, the admissibility of expert testimony on whether a confession was knowing, intelligent, and voluntary is subject to a legal threshold such as the Frye or Daubert standard. The authors review a 2002 New Jersey Superior Court ruling that illustrates the forces that shape the admissibility of confessions.

  4. A lexicographic approach to constrained MDP admission control

    Science.gov (United States)

    Panfili, Martina; Pietrabissa, Antonio; Oddi, Guido; Suraci, Vincenzo

    2016-02-01

    This paper proposes a reinforcement learning-based lexicographic approach to the call admission control problem in communication networks. The admission control problem is modelled as a multi-constrained Markov decision process. To overcome the problems of the standard approaches to the solution of constrained Markov decision processes, based on the linear programming formulation or on a Lagrangian approach, a multi-constraint lexicographic approach is defined, and an online implementation based on reinforcement learning techniques is proposed. Simulations validate the proposed approach.

  5. Topological vector spaces admissible in economic equilibrium theory

    DEFF Research Database (Denmark)

    Keiding, Hans

    2009-01-01

    In models of economic equilibrium in markets with infinitely many commodities, the commodity space is an ordered topological vector space endowed with additional structure. In the present paper, we consider ordered topological vector spaces which are admissible (for equilibrium analysis) in the s......In models of economic equilibrium in markets with infinitely many commodities, the commodity space is an ordered topological vector space endowed with additional structure. In the present paper, we consider ordered topological vector spaces which are admissible (for equilibrium analysis...

  6. Mortality and postoperative care pathways after emergency gastrointestinal surgery in 2904 patients

    DEFF Research Database (Denmark)

    Vester-Andersen, M; Lundstrøm, Lars Hyldborg; Møller, M H

    2014-01-01

    operation in the standard ward, with a 30 day mortality of 14.3%, and 4.8% were admitted to the intensive care unit (ICU) after a median stay of 2 days (inter-quartile range: 1-6). When compared with 'admission to standard ward', 'admission to standard ward before ICU admission' and 'ICU admission after......BACKGROUND: Emergency major gastrointestinal (GI) surgery carries a considerable risk of mortality and postoperative complications. Effective management of complications and appropriate organization of postoperative care may improve outcome. The importance of the latter is poorly described...... in emergency GI surgical patients. We aimed to present mortality data and evaluate the postoperative care pathways used after emergency GI surgery. METHODS: A population-based cohort study with prospectively collected data from six Capital Region hospitals in Denmark. We included 2904 patients undergoing major...

  7. Risk stratification in emergency patients by copeptin

    DEFF Research Database (Denmark)

    Iversen, Kasper; Gøtze, Jens P; Dalsgaard, Morten

    2014-01-01

    BACKGROUND: Rapid risk stratification is a core task in emergency medicine. Identifying patients at high and low risk shortly after admission could help clinical decision-making regarding treatment, level of observation, allocation of resources and post discharge follow-up. The purpose of the pre......BACKGROUND: Rapid risk stratification is a core task in emergency medicine. Identifying patients at high and low risk shortly after admission could help clinical decision-making regarding treatment, level of observation, allocation of resources and post discharge follow-up. The purpose...... to 0.1% (1/693) for patients with normal copeptin concentrations (that is, ≤11.3 pmol/L) (P figures for one-year mortality and for the entire...

  8. The effect of seatbelt legislation on hospital admissions with road traffic injuries in an oil-rich, fast-developing country.

    Science.gov (United States)

    Bener, Abdulbari; Al Humoud, Suhail M Q; Price, Penny; Azhar, Abdulaziz; Khalid, Muayad K; Rysavy, Martin; Crundall, David

    2007-06-01

    The objective of the study was to examine the effect of seat-belt legislation on hospital admissions with road traffic injuries and was designed as a retrospective descriptive study. All motor vehicle crashes recorded during the period 2001 - 2004 were extracted from the Emergency Medical Service Department. Details of the crashes, injuries and safety devices used were studied. The present study revealed that safety belt usage rates have increased from 8% in 2001 to 67% in 2004 among patients admitted to hospital with injury after road traffic crashes. The admission rate of patients with road traffic injuries per 100 000 population reduced by 17.7%. The enforcement of the seat-belt legislation played a vital role in reduction of hospital admissions due to road traffic crashes.

  9. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    Science.gov (United States)

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  10. 38 CFR 18.442 - Admissions and recruitment.

    Science.gov (United States)

    2010-07-01

    ..., manual, or speaking skills, the test results accurately reflect the applicant's aptitude or achievement... use any test or criterion for admission that has a disproportionate, adverse effect on handicapped persons or any class of handicapped persons unless: (i) The test or criterion, as used by the...

  11. Reflections on a Century of College Admissions Tests

    Science.gov (United States)

    Atkinson, Richard C.; Geiser, Saul

    2009-01-01

    The College Boards started as achievement tests designed to measure students' mastery of college preparatory subjects. Admissions testing has significantly changed since then with the introduction of the Scholastic Aptitude Test, Lindquist's creation of the ACT, renewed interest in subject-specific assessments, and current efforts to adapt K-12…

  12. A Normative Code of Conduct for Admissions Officers

    Science.gov (United States)

    Hodum, Robert L.

    2012-01-01

    The increasing competition for the desired quantity and quality of college students, along with the rise of for-profit institutions, has amplified the scrutiny of behavior and ethics among college admissions professionals and has increased the need for meaningful ethical guidelines and codes of conduct. Many other areas of responsibility within…

  13. Hyponatraemia at hospital admission is a predictor of overall mortality

    DEFF Research Database (Denmark)

    Balling, L; Gustafsson, F; Goetze, J P;

    2015-01-01

    BACKGROUND: Hyponatraemia is a prognostic marker of increased mortality and morbidity in selected groups of hospitalised patients. The aim of the present study was to examine the prevalence and prognostic significance of hyponatraemia at hospital admission in an unselected population with a broad...

  14. Investigating the Reliability of the Medical School Admissions Interview

    Science.gov (United States)

    Kreiter, Clarence D.; Yin, Ping; Solow, Catherine; Brennan, Robert L.

    2004-01-01

    Purpose: Determining the valid and fair use of the interview for medical school admissions is contingent upon a demonstration of the reproducibility of interview scores. This study seeks to establish the generalizability of interview scores, first assessing the existing research evidence, and then analyzing data from a non-experimental independent…

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

    Science.gov (United States)

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

    2016-01-01

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

  16. Objectivity in needs assessment practice : admission to a residential home

    NARCIS (Netherlands)

    Jörg, F; Boeije, H R; Huijsman, R; de Weert, G H; Schrijvers, A J P; Jorg, Frederike

    2002-01-01

    In 1997, the Dutch government installed independent agencies to assess the long-term care needs of individual clients and to give advice on the allocation of appropriate services. Needs assessors assess, among other things, the eligibility of clients requesting admission to a residential home. Accor

  17. Power Admission Control with Predictive Thermal Management in Smart Buildings

    DEFF Research Database (Denmark)

    Yao, Jianguo; Costanzo, Giuseppe Tommaso; Zhu, Guchuan

    2015-01-01

    This paper presents a control scheme for thermal management in smart buildings based on predictive power admission control. This approach combines model predictive control with budget-schedulability analysis in order to reduce peak power consumption as well as ensure thermal comfort. First...

  18. Relationship Between Standardized Admissions Variables and Certain Interpersonal Skills

    Science.gov (United States)

    Hurst, Michael W.; Shatkin, Stephen D.

    1974-01-01

    An admissions model was developed that included standardized intellective and nonintellective variables. It was found that linear combinations of grade point average, quality of undergraduate college, major area of study, and recommendations and work experience were generally unrelated to pre- or post-training ratings of empathy, respect, and…

  19. Increased Guillain-Barre Syndrome Admissions in Shiraz, Southern Iran

    Directory of Open Access Journals (Sweden)

    Seyed Taghi Heydari

    2013-01-01

    Full Text Available Background: Guillain-Barre syndrome (GBS is an acute immune-mediated peripheral neuropathy usually after an incident. This study was performed to investigate the basic epidemiologic features of GBS in south of Iran.Methods: We studied consecutive patients with GBS in Namazi Hospital of Shiraz, southern Iran. Demographic characteristics of the subjects, i.e. age, sex, and length of hospital stay were extracted. Information regarding yearly admissions for the entire hospital was also gathered. The prevalence of GBS per 10,000 hospital admissions was calculated and stratified by sex and year. Yearly prevalence was compared using the odds ratio (OR and 95% confidence intervals (CI.Results: From January 2000 to December 2009, 389 (232 males and 157 females patients with GBS were admitted in our center. The mean age of patients was 29.8 ± 23.0 years and their mean length of hospital stay was 12.9 ± 11.6 days. The overall mortality rate was 6%. The ratio of admissions due to GBS to the total admissions was significantly higher in 2009, the year of an influenza A (H1N1 virus pandemic.Conclusion: There appears to be an increase in the incidence of GBS in Shiraz. This is in parallel with the increasing trend of some other autoimmune diseases.

  20. 38 CFR 51.80 - Admission, transfer and discharge rights.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.80 Admission, transfer... resident and, if known, a family member or legal representative of the resident of the transfer or..., address and telephone number of the State long term care ombudsman. (7) Orientation for transfer...

  1. Using Technology in Undergraduate Admission: A Student Perspective

    Science.gov (United States)

    Lindbeck, Robin; Fodrey, Brian

    2010-01-01

    The relationship that currently exists between undergraduate admission, technology and the Millennial generation continues to be an area of constant change. As technology trends come-and-go and resources continue to be limited, what are colleges and universities doing to ensure they are being as effective and efficient as possible when it comes to…

  2. Institutional Admissions Policies in Higher Education: A Widening Participation Perspective

    Science.gov (United States)

    Greenbank, Paul

    2006-01-01

    Purpose: This article analyses how higher education institutions (HEIs) have responded to government policy to increase the participation rates of students from lower social classes through their admissions policies. Design/methodology/approach: The article uses documentary evidence and interviews with institutional policy makers to examine HEI…

  3. LGBT Applicants and Challenges for Admission: Five Cases

    Science.gov (United States)

    Baum, Benjamin S.

    2012-01-01

    Few professional processes are more personally intrusive than the college application. It demands information about your family, your finances, your interests, and your desires. For lesbian, gay, bisexual, and transgender (LGBT) applicants in their teenage years who may not be comfortable with their sexuality, admission officers need be sensitive…

  4. 78 FR 62415 - Refugee Admissions for Fiscal Year 2014

    Science.gov (United States)

    2013-10-21

    ... in the Federal Register. (Presidential Sig.) THE WHITE HOUSE, Washington, October 2, 2013 [FR Doc... Documents#0;#0; ] Presidential Determination No. 2014-01 of October 2, 2013 Refugee Admissions for Fiscal... up to 70,000 refugees to the United States during fiscal year (FY) 2014 is justified by...

  5. Continuous admission to primary school and mental health problems

    NARCIS (Netherlands)

    Reijneveld, S.A.; Wiefferink, C.H.; Brugman, E.; Verhulst, F.C.; Verloove-Vanhorick, S.P.; Paulussen, T.G.W.

    2006-01-01

    Background: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We assessed men

  6. The effects of Montessori education: evidence from admission lotteries

    NARCIS (Netherlands)

    Ruijs, N.

    2014-01-01

    Little is known about the effects of Montessori education, even though many students in many countries are educated in Montessori classrooms. This study investigates the causal effects of Montessori secondary education by exploiting admission lotteries in Dutch Montessori schools. The results indica

  7. Student Attitudes toward Affirmative Action in College Admissions.

    Science.gov (United States)

    Arredondo, Marisol; Sax, Linda J.

    1999-01-01

    A national survey of 277,850 college freshmen examined attitudes toward affirmative action in college admissions for four racial/ethnic groups: Whites, African-Americans, Asian-Americans, and Mexican-Americans. The study analyzed the extent to which student opposition to affirmative action is driven by factors such as self-interest, political…

  8. The Demise of Affirmative Action in College Admission.

    Science.gov (United States)

    Arredondo, David G.

    2002-01-01

    The legal activity in federal courts related to affirmative action indicates a strong possibility the Supreme Court will abolish affirmative action in college admission. Such a decision would inevitably alter the landscape of higher education. Campus diversity will have to be achieved without using race or ethnicity to offer preference to some at…

  9. The Declining Significance of Race in College Admissions Decisions

    Science.gov (United States)

    Grodsky, Eric; Kalogrides, Demetra

    2008-01-01

    Using 18 years of data from more than 1,300 four-year colleges and universities in the United States, we investigate the extent to which institutional characteristics and contextual factors influence the propensity of colleges to indicate that they engage in affirmative action in their admissions decisions. Consideration of race/ethnicity in…

  10. Practices of Whiteness: Racialization in College Admissions Viewbooks

    Science.gov (United States)

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

    2013-01-01

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

  11. Admissibility and Refutation : Some Characterisations of Intermediate Logics

    NARCIS (Netherlands)

    Goudsmit, J.P.

    2014-01-01

    Refutation systems are formal systems for inferring the falsity of formulae. These systems can, in particular, be used to syntactically characterise logics. In this paper, we explore the close connection between refutation systems and admissible rules. We develop technical machinery to construct ref

  12. 8 CFR 1101.1 - Presumption of lawful admission.

    Science.gov (United States)

    2010-01-01

    ... Section 1101.1 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE... the United States prior to July 1, 1924, provided that a record of his admission exists. (e) Chinese and Japanese aliens—(1) Prior to July 1, 1924. A Chinese alien for whom there exists a record of...

  13. Hospital mortality is associated with ICU admission time

    NARCIS (Netherlands)

    Kuijsten, H.A.J.M.; Brinkman, S.; Meynaar, I.A.; Spronk, P.E.; van der Spoel, J.I.; Bosman, R.J.; de Keizer, N.F.; Abu-Hanna, A.; de Lange, D.W.

    2010-01-01

    Previous studies have shown that patients admitted to the intensive care unit (ICU) after "office hours" are more likely to die. However these results have been challenged by numerous other studies. We therefore analysed this possible relationship between ICU admission time and in-hospital mortality

  14. The Effects of Extrinsic Rewards on Admissions Counselors' Performance

    Science.gov (United States)

    Gardner-Engel, Miriam

    2010-01-01

    This study examines the best ways to motivate college admissions counselors. A review of literature revealed multiple perspectives on intrinsic and extrinsic as well as tangible and intangible rewards. Primary research was designed to examine the impact of tangible rewards and verbal reinforcements with a convenience sample of nine college…

  15. Rising rates of hospital admissions for atrial fibrillation

    DEFF Research Database (Denmark)

    Friberg, Jens; Buch, Nina Pernille Gardshodn; Scharling, Henrik;

    2003-01-01

    Atrial fibrillation is a common arrhythmia associated with excess morbidity and mortality. We studied temporal changes in hospital admission rates for atrial fibrillation using data from a prospective population-based cohort study spanning 2 decades (the Copenhagen City Heart Study)....

  16. Should Universities Be Permitted to Set Their Own Admission Criteria?

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    For high school students in Shanghai, this year's college admission process is a bit different from that in previous years. Locally based Fudan University and Shanghai Jiaotong University (Jiaoda) have been allowed to make some changes in their enrollment procedures. In addition to taking an independently designed entrance exam

  17. Job Admission and Resource Allocation in Distributed Streaming Systems

    Science.gov (United States)

    Wolf, Joel; Bansal, Nikhil; Hildrum, Kirsten; Parekh, Sujay; Rajan, Deepak; Wagle, Rohit; Wu, Kun-Lung

    This paper describes a new and novel scheme for job admission and resource allocation employed by the SODA scheduler in System S. Capable of processing enormous quantities of streaming data, System S is a large-scale, distributed stream processing system designed to handle complex applications. The problem of scheduling in distributed, stream-based systems is quite unlike that in more traditional systems. And the requirements for System S, in particular, are more stringent than one might expect even in a “standard” stream-based design. For example, in System S, the offered load is expected to vastly exceed system capacity. So a careful job admission scheme is essential. The jobs in System S are essentially directed graphs, with software “processing elements” (PEs) as vertices and data streams as edges connecting the PEs. The jobs themselves are often heavily interconnected. Thus resource allocation of individual PEs must be done carefully in order to balance the flow. We describe the design of the SODA scheduler, with particular emphasis on the component, known as macroQ, which performs the job admission and resource allocation tasks. We demonstrate by experiments the natural trade-offs between job admission and resource allocation.

  18. Predicting MBA Student Success and Streamlining the Admissions Process

    Science.gov (United States)

    Pratt, William R.

    2015-01-01

    Within this study the author examines factors commonly employed as master of business administration applicant evaluation criteria to see if these criteria are important in determining an applicant's potential for success. The findings indicate that the Graduate Management Admissions Test (GMAT) is not a significant predictor of student success…

  19. Confronting the Categories: Equitable Admissions without Apartheid Race Classification

    Science.gov (United States)

    Erasmus, Z.

    2010-01-01

    South Africa's government requires information on apartheid race classification to implement and monitor racial redress. This has sparked resistance to race classification as a criterion for redress in higher education admissions. I argue that (1) jettisoning apartheid race categories now in favour of either class or "merit" would set back the few…

  20. Differential Item Functioning on the Graduate Management Admission Test.

    Science.gov (United States)

    O'Neill, Kathleen A.; And Others

    The purpose of this study was to identify differentially functioning items on operational administrations of the Graduate Management Admission Test (GMAT) through the use of the Mantel-Haenszel statistic. Retrospective analyses of data collected over 3 years are reported for black/white and female/male comparisons for the Verbal and Quantitative…

  1. 8 CFR 235.11 - Admission of conditional permanent residents.

    Science.gov (United States)

    2010-01-01

    ... alien entrepreneur (as defined in section 216A(f)(1) of the Act) or the spouse or unmarried minor child of an alien entrepreneur shall be admitted conditionally for a period of 2 years. At the time of admission, the alien shall be notified that the principal alien (entrepreneur) must file a Form...

  2. 8 CFR 1235.11 - Admission of conditional permanent residents.

    Science.gov (United States)

    2010-01-01

    ... immigrant visa as an alien entrepreneur (as defined in section 216A(f)(1) of the Act) or the spouse or unmarried minor child of an alien entrepreneur shall be admitted conditionally for a period of 2 years. At the time of admission, the alien shall be notified that the principal alien (entrepreneur) must file...

  3. 28 CFR 549.41 - Voluntary admission and psychotropic medication.

    Science.gov (United States)

    2010-07-01

    ... medication. 549.41 Section 549.41 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Administrative Safeguards for Psychiatric Treatment and Medication § 549.41 Voluntary admission and psychotropic medication. (a) A sentenced inmate may be...

  4. Predictors of Specialized Inpatient Admissions for Adults with Intellectual Disability

    Science.gov (United States)

    Modi, Miti; McMorris, Carly; Palucka, Anna; Raina, Poonam; Lunsky, Yona

    2015-01-01

    Individuals with intellectual disability (ID) have complex mental health needs and may seek specialized ID psychiatric services. This study reports on predictors of specialized inpatient admissions for 234 individuals with ID who received outpatient services at a psychiatric hospital. Overall, from 2007-2012, 55 of the 234 outpatients were triaged…

  5. Angioedema Related to Angiotensin-Converting Enzyme Inhibitors: Attack Severity, Treatment, and Hospital Admission in a Prospective Multicenter Study.

    Science.gov (United States)

    Javaud, Nicolas; Achamlal, Jallal; Reuter, Paul-George; Lapostolle, Frédéric; Lekouara, Akim; Youssef, Mustapha; Hamza, Lilia; Karami, Ahmed; Adnet, Frédéric; Fain, Olivier

    2015-11-01

    The number of cases of acquired angioedema related to angiotensin converting enzyme inhibitors induced (ACEI-AAE) is on the increase, with a potential concomitant increase in life-threatening attacks of laryngeal edema. Our objective was to determine the main characteristics of ACEI-AAE attacks and, in doing so, the factors associated with likelihood of hospital admission from the emergency department (ED) after a visit for an attack.A prospective, multicenter, observational study (April 2012-December 2014) was conducted in EDs of 4 French hospitals in collaboration with emergency services (SAMU 93) and a reference center for bradykinin-mediated angioedema. For each patient presenting with an attack, emergency physicians collected demographic and clinical presentation data, treatments, and clinical course. They recorded time intervals from symptom onset to ED arrival and to treatment decision, from ED arrival to specific treatment with plasma-derived C1-inhibitor (C1-INH) or icatibant, and from specific treatment to onset of symptom relief. Attacks requiring hospital admission were compared with those not requiring admission.Sixty-two eligible patients with ACEI-AAE (56% men, median age 63 years) were included. Symptom relief occurred significantly earlier in patients receiving specific treatment than in untreated patients (0.5 [0.5-1.0] versus 3.9 [2.5-7.0] hours; P < 0.0001). Even though icatibant was injected more promptly than plasma-derived C1-INH, there, however, was no significant difference in median time to onset of symptom relief between the 2 drugs (0.5 [0.5-1.3] versus 0.5 [0.4-1.0] hours for C1-INH and icatibant, respectively, P = 0.49). Of the 62 patients, 27 (44%) were admitted to hospital from the ED. In multivariate analysis, laryngeal involvement and progressive swelling at ED arrival were independently associated with admission (Odds ratio [95% confidence interval] = 6.2 [1.3-28.2] and 5.9 [1.3-26.5], respectively). A favorable course

  6. Admission glycaemia and outcome in patients with acute coronary syndrome.

    Science.gov (United States)

    Müdespacher, Damaris; Radovanovic, Dragana; Camenzind, Edoardo; Essig, Manfred; Bertel, Osmund; Erne, Paul; Eberli, Franz Robert; Gutzwiller, Felix

    2007-12-01

    Some studies of patients with acute myocardial infarction have reported that hyperglycaemia at admission may be associated with a worse outcome. This study sought to evaluate the association of blood glucose at admission with the outcome of unselected patients with acute coronary syndrome (ACS). Using the Acute Myocardial Infarction and unstable angina in Switzerland (AMIS Plus) registry, ACS patients were stratified according to their blood glucose on admission: group 1: 2.80-6.99 mmol/L, group 2: 7.00-11.09 mmol/L and group 3: > 11.10 mmol/L. Odds ratios for in-hospital mortality were calculated using logistic regression models. Of 2,786 patients, 73% were male and 21% were known to have diabetes. In-hospital mortality increased from 3% in group 1 to 7% in group 2 and to 15% in group 3. Higher glucose levels were associated with larger enzymatic infarct sizes (p<0.001) and had a weak negative correlation with angiographic or echographic left ventricular ejection fraction. High admission glycaemia in ACS patients remains a significant independent predictor of in-hospital mortality (adjusted OR 1.08; 95% confidence intervals [CI] 1.05-1.14, p<0.001) per mmol/L. The OR for in-hospital mortality was 1.04 (95% CI 0.99-1.1; p=0.140) per mmol/L for patients with diabetes but 1.21 (95% CI 112-1.30; p<0.001) per mmol/L for non-diabetic patients. In conclusion, elevated glucose level in ACS patients on admission is a significant independent predictor of in-hospital mortality and is even more important for patients who do not have known diabetes.

  7. Dental Emergencies

    OpenAIRE

    Domb, Ivor

    1982-01-01

    Emergency dental problems can result from trauma, dental pathology, or from dental treatment itself. While the physician can treat many instances of dental trauma, the patient should see a dentist as soon as possible so that teeth can be saved. Emergency treatment of dental pathology usually involves relief of pain and/or swelling. Bleeding is the most frequent post-treatment emergency. The physician should be able to make the patient comfortable until definitive dental treatment can be avail...

  8. Motivation of trauma patients to stop smoking after admission to the emergency department

    DEFF Research Database (Denmark)

    Weiss-Gerlach, E; Franck, M; Neuner, B;

    2008-01-01

    Every smoker should be offered smoking cessation treatment when they present for clinical care. The Readiness to Change-Smokers (RTC-S) questionnaire and the Heidelberg Smoking History (HSH) are brief questionnaires that divide patients into three stages. The purpose of this study was to prospect......Every smoker should be offered smoking cessation treatment when they present for clinical care. The Readiness to Change-Smokers (RTC-S) questionnaire and the Heidelberg Smoking History (HSH) are brief questionnaires that divide patients into three stages. The purpose of this study...

  9. Effects of community-care networks on psychiatric emergency contacts, hospitalisation and involuntary admission

    NARCIS (Netherlands)

    A.I. Wierdsma (André); H.D. Poodt (Hilde); C.L. Mulder (Niels)

    2007-01-01

    textabstractBackground: Community-care networks are a partnership between the local police force, housing corporations, general social services, specialised home care and mental healthcare services. The networks were set up to improve the healthcare for patients with (chronic) psychiatric problems t

  10. Admissions to emergency department may be classified into specific complaint categories

    DEFF Research Database (Denmark)

    Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik; Mogensen, Christian Backer

    2014-01-01

    . MATERIAL AND METHODS: This was a cross-sectional study of all acute patients admitted to a Danish ED in 2010. Information was collected from electronic screens where the ED nurses registered the presenting symptoms or complaints according to the referring doctor or patient. A list of complaint categories...... covering all patient complaints was produced. Presumptive diagnoses and categories with frequencies less than 1% were pooled with other groups, unless keeping them was clinically relevant. RESULTS: Among the 9,863 patients, 49% were medical, 31% surgical, 15% orthopaedic and 5% vascular surgical patients...

  11. Re-emergence of posttraumatic stress disorder nightmares with nursing home admission: treatment with prazosin.

    Science.gov (United States)

    Johnson, Kim G; Rosen, Jules

    2013-02-01

    Seniors with a history of emotional trauma decades earlier can experience a recurrence of posttraumatic stress disorder symptoms when transitioning to a nursing home. We present the case of an 86-year-old male Holocaust survivor admitted to a nursing home for physical therapy and rehabilitation 6 weeks after the death of his wife; the patient was expressing a persistent death wish. Despite the multiple risk factors for depression, his distress was specifically related to the reemergence of nightly posttraumatic nightmares. Over the course of 1 week of treatment with 1 mg prazosin at bedtime, his nightmares and his death wish completely resolved. He achieved his rehabilitation goals and was discharged to a community setting. This report highlights the importance of considering posttraumatic stress disorder in nursing home residents with a history of emotional trauma, and understanding how to address these symptoms pharmacologically and nonpharmacologically.

  12. Quetiapine-induced Priapism Requiring Frequent Emergency Admissions: A Case Report

    Directory of Open Access Journals (Sweden)

    Jon C. Jackson

    2015-01-01

    Full Text Available Priapism, a rare but well-known adverse reaction of first and second generation anti-psychotics, has been hypothesized to be associated with blockade of alpha 1 receptors. However, genetic abnormalities or heritability of affected cytochrome P450 alleles has not been ruled out as a causal mechanism. A case is presented with three episodes of priapism within 17 days while taking standard FDA (Food and Drug Administration approved doses of quetiapine. Cytochrome P450 3A4 genotype testing was performed and resulted with normal enzymatic activity. This case further eliminates enzymatic metabolism as a possible cause of priapism, thus strengthening the alpha one receptor blockade hypothesis.

  13. Psychiatric emergency services in Amsterdam: Experiences with acute admissions in a metropolitan area

    NARCIS (Netherlands)

    Mulder, W.; Dekker, J.J.M.; Gijsbers van WIjk, C.

    2005-01-01

    Problems in the acute sector of psychiatric care are not unique to the Netherlands and at an international level appear to be linked to problems that are significant for big cities. The search for an “acute bed” had become more difficult and patients were being placed and transported through the who

  14. Why and when citizens call for emergency help

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Ersbøll, Annette Kjær; Tolstrup, Janne Schurmann;

    2015-01-01

    BACKGROUND: A medical emergency call is citizens' access to pre-hospital emergency care and ambulance services. Emergency medical dispatchers are gatekeepers to provision of pre-hospital resources and possibly hospital admissions. We explored causes for access, emergency priority levels......, and temporal variation within seasons, weekdays, and time of day for emergency calls to the emergency medical dispatch center in Copenhagen in a two-year study period (December 1(st), 2011 to November 30(th), 2013). METHODS: Descriptive analysis was performed for causes for access and emergency priority levels....... A Poisson regression model was used to calculate adjusted ratio estimates for the association between seasons, weekdays, and time of day overall and stratified by emergency priority levels. RESULTS: We analyzed 211,193 emergency calls for temporal variation. Of those, 167,635 calls were eligible...

  15. Economic Affirmative Action in College Admissions: A Progressive Alternative to Racial Preferences and Class Rank Admissions Plans. Issue Brief Series.

    Science.gov (United States)

    Kahlenberg, Richard

    This brief explores the pros and cons of three alternative approaches to college admissions policies: race-based preferences, which are backed by most Democrats; class-rank plans (admitting the top students in each high school), which is backed by the Bush administration; and economic affirmative action for the disadvantaged of all races, which…

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

    Directory of Open Access Journals (Sweden)

    Peter Hodkinson

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

  17. Psychiatric emergency services in Copenhagen 2012

    DEFF Research Database (Denmark)

    Moltke, Katinka; Høegh, Erica B; Sæbye, Ditte;

    2015-01-01

    BACKGROUND: Since the first publication of the psychiatric emergency units (PEUs) in Copenhagen 1985, outpatient facilities have undergone considerable changes. Our aim is to examine how these changes have influenced the activities in the PEUs in the same catchment area. METHODS: We conducted...... reduced the number of visits in the PEUs considerably. The results have shown a change of diagnostic distribution and more severe conditions requiring acute admissions for emergency treatment. Close collaboration with the patients' families, GPs, social authorities and specialized psychiatric outpatient...

  18. Emergency Department Management Of Acute Infective Endocarditis.

    Science.gov (United States)

    Schauer, Steven G; Pfaff, James A; Cuenca, Peter John

    2014-11-01

    Infective endocarditis has a high rate of mortality, and most patients suspected of having the disease will require hospital admission. This review examines the literature as it pertains specifically to emergency clinicians who must maintain vigilance for risk factors and obtain a thorough history, including use of intravenous drugs, in order to guide the workup and treatment. Properly obtained cultures are critical during the evaluation, as they direct the course of antibiotic therapy. Although transthoracic echocardiography is widely available in United States emergency departments, it is not sensitive or specific enough to rule out a diagnosis of infective endocarditis. In high-risk patients, transesophageal echocardiography should be considered.

  19. Drug related hospital admissions in subspecialities of internal medicine.

    Science.gov (United States)

    Hallas, J

    1996-04-01

    It is well established in the literature that adverse drug reactions (ADRs) and drug non-compliance contribute substantially to the admissions at medical wards. Some important questions, however, remain unanswered. The purpose of this thesis was to characterise the drug-related hospital admissions (DRH) and to assess the magnitude of the problem seen in relation to the demographic parameters and drug use of the background population. In addition, an attempt was made to reduce the DRH incidence by an intervention program. The scope of the study program was adverse drug reactions, intended self-poisoning, non-compliance, underdosing and interactions. The material included 1999 admissions to six departments of internal medicine at Odense University Hospital. The patients were reviewed prospectively, while they were still in the wards, but use of standardised criteria fOR assessment of drug-ADR causality. With inclusion of a definite, probable and possible causal relationship, ADRs and toxic reactions were found as an important factor in 8.4% of all admissions. The incidense of ADR related admissions was 400 per 100,000 per year for the background population as a whole, but showing a strong increase with age. The drug-specific ADR incidences were generally small compared to the drug sales figures. Non-compliance contributed to 2.0% of admissions with diuretics and anti-asthmatics as the drugs most frequently involved. Two departments were re-investigated after an intervention program, primarily targetting general practitioners. The over-all incidence of DRHs was unaffected by the intervention, but the subset classified as avoidable DRHs showed a significant decline. The case material was subject to a blinded evaluation by an external peer group using the same criteria as the investigators. There was no indication that the observed decline in avoidable DRHs should be explained by a shift in the investigators' assessment of cases. It was concluded that the intervention

  20. Emergency Shelters

    DEFF Research Database (Denmark)

    Popovic Larsen, Olga; Lee, Daniel Sang-Hoon; Eskemose Andersen, Jørgen;

    2013-01-01

    The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture......The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture...

  1. Vascular emergencies.

    Science.gov (United States)

    Semashko, D C

    1997-01-01

    This article reviews the initial assessment and emergent management of several common as well as uncommon vascular emergencies. Aortic dissection, aneurysms, and arterial occlusive disease are familiar but challenging clinical entities. Less frequently encountered conditions are also discussed including an aortic enteric fistula, mesenteric venous thrombosis, phlegmasia alba dolens, and subclavian vein thrombosis.

  2. 77 FR 19408 - Notice of Public Meeting on FY 2013 U.S. Refugee Admissions Program

    Science.gov (United States)

    2012-03-30

    ... Delicia Spruell, PRM/Admissions Program Officer at (202) 453-9257. Information about the U.S. Refugee Admissions Program may be found at http://www.state.gov/g/prm/ . Dated: March 22, 2012. David...

  3. 76 FR 19176 - Notice of Public Meeting on FY 2012 Refugee Admissions Program

    Science.gov (United States)

    2011-04-06

    ... contact Delicia Spruell, PRM/Admissions Program Officer at (202) 453-9257. Information about the U.S. Refugee Admissions Program may be found at http://www.state.gov/g/prm/ . Dated: March 30, 2011....

  4. 75 FR 20031 - Notice of Public Meeting on FY 2011 Refugee Admissions Program

    Science.gov (United States)

    2010-04-16

    ... contact Delicia Spruell, PRM/Admissions Program Officer at (202) 663-1006. Information about the Refugee Admissions Program may be found at http://www.state.gov/g/prm/ . Dated: April 12, 2010. David...

  5. Robust Admissible Analyse of Uncertain Singular Systems via Delta Operator Method

    Institute of Scientific and Technical Information of China (English)

    WANG Wen; WANG Hui

    2016-01-01

    This paper investigates the problem of robust admissible analysis for uncertain singular delta operator systems(SDOSs). Firstly, we introduce the definition of generalized quadratic admissibility to ensure robust admissibility. Then, by means of LMI, a necessary and sufficient condition is given to prove a uncertain SDOS is generalized quadratic admissible. Finally, a numerical example is provided to demonstrate the effectiveness of the results in this paper.

  6. Emergency team calls for critically ill non-trauma patients in the emergency department

    DEFF Research Database (Denmark)

    Jensen, Søren Marker; Do, Hien Quoc; Rasmussen, Søren W.

    2015-01-01

    consultation calls for non-ED specialist physicians. Emergency team calls were two-tiered with 'orange' and 'red' calls. Additionally, intensive care unit (ICU) admission charts were reviewed to identify the total number of adult non-trauma and non-cardiac arrest patients admitted to the ICU from the ED during......BACKGROUND: Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical.......2 %) patients were admitted to the ICU, while 20/109 (18.3 %) patients were deemed ineligible for ICU admission. 30-day mortality was 34/109 (31.2 %), and circulatory problems were the most frequent cause of death (61.8 %, p = 0.02). Patients who died were significantly older than those who survived (p = 0...

  7. British Columbia Council on Admissions & Transfer Annual Report, 2008-09

    Science.gov (United States)

    British Columbia Council on Admissions and Transfer, 2009

    2009-01-01

    The role of the British Columbia Council on Admissions and Transfer (BCCAT) is to facilitate admission, articulation, and transfer arrangements in the BC post-secondary system. BCCAT carries out this work in various ways; for example, engaging in research on admissions and student transitions, evaluating the effectiveness of the transfer system…

  8. Contribution of Renal Impairment to Potentially Preventable Medication-Related Hospital Admissions

    NARCIS (Netherlands)

    Leendertse, Anne J.; van Dijk, Elisabeth A.; De Smet, Peter A. G. M.; Egberts, Toine C. G.; van den Bemt, Patricia M. L. A.

    2012-01-01

    BACKGROUND: Medication errors and renal impairment contribute to severe adverse drug events, which may lead to hospital admission. OBJECTIVE: To determine whether medication errors and renal impairment contribute to hospital admission and examine these errors for strategies to prevent admissions. ME

  9. Acute pulmonary admissions following implementation of a national workplace smoking ban.

    LENUS (Irish Health Repository)

    Kent, Brian D

    2012-09-01

    The implementation of workplace smoking bans has contributed to a significant reduction in the incidence of acute coronary syndrome admissions, but their influence on adult acute pulmonary disease admissions is unclear. We sought to assess the impact of a national smoking ban on nationwide admissions of individuals of working age with acute pulmonary illness.

  10. Why Preferences in College Admissions May Yield a More-Able Student Body

    Science.gov (United States)

    Li, Dong; Weisman, Dennis L.

    2011-01-01

    Critics of affirmative action policies contend that the elimination of racial preferences in college admissions would lead to a "more-able" student body. We develop a simple model comprised of three classes of college admissions--merit, race and legacy--to show that it is possible that a change in admissions policy that reduces racial preferences…

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

    Science.gov (United States)

    McDonough, Patricia; Robertson, Larry

    2012-01-01

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

  12. 42 CFR 456.481 - Admission certification and plan of care.

    Science.gov (United States)

    2010-10-01

    ... Individuals Under Age 21: Admission and Plan of Care Requirements § 456.481 Admission certification and plan of care. If a facility provides inpatient psychiatric services to a recipient under age 21— (a) The... 42 Public Health 4 2010-10-01 2010-10-01 false Admission certification and plan of care....

  13. 43 CFR 4.116 - Interrogatories to parties; inspection of documents; admission of facts.

    Science.gov (United States)

    2010-10-01

    ... documents; admission of facts. 4.116 Section 4.116 Public Lands: Interior Office of the Secretary of the...; admission of facts. Under appropriate circumstances, but not as a matter of course, the Board will entertain... serve upon the opposing party a request for the admission of specified facts. Such applications shall...

  14. The Medical School Admissions Process: A Review of the Literature 1955-1976. Special Report.

    Science.gov (United States)

    Cuca, Janet Melei; And Others

    This document reviews the research on the medical school admissions process that has been completed during the past twenty years. The process is put into perspective by a historical overview chapter that traces trends in medical school admissions and highlights, where possible, relationships between the admissions process and institutional and…

  15. An Admissions Model for Monitoring Applicant Quality. AIR Forum 1981 Paper.

    Science.gov (United States)

    Rosenthal, Daniel J. A.; Tantillo, Charles

    A college admissions system model is described that can be used to monitor applicants at each stage of the admissions process and to assist in planning and student recruitment. Examples are provided that demonstrate the model's broad applicability for the development of specialized admissions programs that can be targeted to accomplish…

  16. Emergency contraception.

    Science.gov (United States)

    Van Look, P F; von Hertzen, H

    1993-01-01

    The term 'emergency contraception', as employed in this paper, refers to methods that are used as emergency procedures to prevent pregnancy following unprotected intercourse. Alternative, less appropriate, terms are postcoital and 'morning-after' contraception. References to postcoital preparations can be found as far back as 1500 BC in Egyptian papyri, but it was not until fairly recently that contraceptive research has been able to at least partially fulfill that need. The development of hormonal methods of emergency contraception goes back to the 1960s when the first human trials of postcoitally administered high-dose oestrogens were undertaken. Combined oestrogen- progestogen combination therapy (the so-called Yuzpe regimen) was introduced in the early 1970s, while the postcoital insertion of an intrauterine contraceptive device (IUD) for emergency contraception was first reported in 1976. Other compounds that have been tested more recently include levonorgestrel, the antiprogestogen mifepristone, and danazol. Although there is some debate about the magnitude of the protective effect, few people question the important role that emergency contraception can play in preventing unwanted pregnancy and hence maternal mortality and morbidity resulting from unsafe abortion. Given that the most often used methods of emergency contraception, namely the Yuzpe regimen and postcoital insertion of an IUD, rely on technology that has been available for some 30 years, family planning programmes that claim to be concerned with improving women's reproductive health, cannot really be excused if they do not provide emergency contraception as part of their routine services.

  17. A structural comparison of measurement-based admission control algorithms

    Institute of Scientific and Technical Information of China (English)

    GU Yi-ran; WANG Suo-ping; WU Hai-ya

    2006-01-01

    Measurement-based admission control (MBAC)algorithm is designed for the relaxed real-time service. In contrast to traditional connection admission control mechanisms,the most attractive feature of MBAC algorithm is that it does not require a prior traffic model and that is very difficult for the user to come up with a tight traffic model before establishing a flow.Other advantages of MBAC include that it can achieve higher network utilization and offer quality service to users. In this article, the study of the equations in the MBAC shows that they can all be expressed in the same form. Based on the same form,some MBAC algorithms can achieve same performance only if they satisfy some conditions.

  18. Factors related to monitoring during admission of acute patients

    DEFF Research Database (Denmark)

    Schmidt, Thomas; Bech, Camilla Louise Nørgaard; Brabrand, Mikkel

    2017-01-01

    one measurement were analyzed using quantile regression by looking at the impact of distance from nursing office, number of concurrent patients, wing type (medical/surgical), age, sex, comorbidities, and severity conditioned on how much patients were monitored during their admissions. We registered 11......,848 admissions, of which we were able to link patient monitor readings to 3149 (26.6 %) with 50 % being monitored nursing office had little influence on patients monitored ... the office reduced the level of monitoring. Higher levels of severity were related to higher degrees of monitoring, but being admitted to the surgical wing reduce how much patients were monitored, and periods with many concurrent patients lead to a small increase in monitoring. We found a significant...

  19. NURSING ASSISTANCE FOR PATIENTS IN SURGICAL CENTER ADMISSION

    Directory of Open Access Journals (Sweden)

    Zulene Maria de Vasconcelos Varela

    2002-06-01

    Full Text Available We objectified in this study with qualitative handling, to analyze the nurse's care in the people'sadmission in Surgical Center, starting from this professional's assistematic observation, accomplishing thisprocedure. In the chosen institution, the space for admission is common to all the elements of the team, to thepeople's flow and customers, that stay close one of the other ones, generating erroneous interpretations in thecommunication, hindering of that the efective care. The nurse's concern, in developing the admission, as ownprerogative and humanização was evident. The continuity of that procedure, it is hindered by the surgical team,for the patient's liberation, what is leaving out the care alternatives and generating dissatisfaction in theprofessionals.

  20. Admission Control of VL in AFDX Under HRT Constraints

    Institute of Scientific and Technical Information of China (English)

    ZHOU Qiang; QU Zhenliang; LIN Hengqing

    2011-01-01

    Avionics full duplex switched ethernet (AFDX) is a switched interconnection technology developed to provide reliable data exchange with strong data transmission time guarantees in internal communication of the spacecraft or aircraft. Virtual link (VL) is an important concept of AFDX to meet quality of service (QoS) requirements in terms of end-to-end message deadlines. A VL admission control algorithm in AFDX network under hard real-time (HRT) constraints is studied. Based on the scheduling principle of AFDX protocol, a packet scheduling scheme under HRT constraints is proposed, and after that an efficient VL admission control algorithm is presented. Analytical proof that the algorithm can effectively determine whether VL should be admitted is given. Finally simulative examples are presented to promote the conclusion.

  1. Certain Aspects concerning Trial under Admission of Guilt

    Directory of Open Access Journals (Sweden)

    Mihai OLARIU

    2014-03-01

    Full Text Available The trial under admission of guilt is an abbreviated procedure relying on a guilty plea, and it may be applied if the conditions stipulated in the New Criminal Procedure Code are fulfilled. One of these conditions is for the defendant to fully admit of the deeds presented by the prosecutor in the indictment (he must not, however, admit the same upon the legal classification of offences. Pursuant to the simplified procedure, in the case of conviction or postponement of the application of the sanction, the punishment limits stipulated under the law are reduced by one third for imprisonment, and by one fourth for fine sanctions. The present article is a a continuation of the author’s own research and it represents a clear comment regarding trial under admission of guilt according to the New Criminal Procedure Code, in the purpose of understanding the legislator’s intention and how the new regulations will apply.

  2. Increasing the admission rate to upper secondary school

    DEFF Research Database (Denmark)

    Hoest, A.; Jensen, V.M.; Nielsen, L.P.

    2013-01-01

    Although several studies investigate the effects of school resources on student performance, these studies tend to focus more on intervention effect sizes than on their cost-effectiveness. Exploiting policy-induced variation in Denmark and using high-quality administrative data, we investigate...... the effects of a school intervention that introduces structured student career guidance in lower secondary school on upper secondary school admission. Disregarding the sunk-cost of implementation, the reform was cost-neutral. In a difference-in-difference framework, we find that the reform increases admission...... to upper secondary school between 4.0 and 6.3 percentage points for immigrants, but shows at best small improvements for the native students....

  3. A Novel Admission Control Algorithm Based on Negotiation and Price

    Institute of Scientific and Technical Information of China (English)

    ZHANG Deng-yin; ZHANG Li; TANG Zhi-yun

    2005-01-01

    Admission control algorithm is a key component of a media server which supports Quality of Service(QoS).In this paper we present an admission control algorithm that exploits the elastic properties of the user requirements and the changing properties of system conditions.The characteristic of the algorithm can be expounded from these aspects:First,it provides multiple services to satisfy the different users' requirements regarding QoS and price.Second,it uses a worth function to select from media services with different QoS characteristics in the negotiation process.Finally,it employs a novel price policy to compute the charge for the service,which has a great effect on restricting the greediness of the users and therefore increase the overall user benefit.In the end of the paper,we compare the user benefit attained by our algorithm with that of other method.

  4. Day of surgery admission for the elective surgical in-patient: successful implementation of the Elective Surgery Programme.

    LENUS (Irish Health Repository)

    Concannon, E S

    2012-09-11

    BACKGROUND AND AIMS: The aim of this prospective cross-sectional study was to determine the impact of (1) ring fencing in-patient general surgical beds and (2) introducing a pre-operative assessment clinic (PAC) on the day of surgery admission (DOSA) rate in a single Irish institution. The secondary aim was to analyse the impact of an increased rate of DOSA on cost efficiency and patient satisfaction. METHODS: An 18-month period was examined following ring-fencing of elective and emergency surgical beds. A PAC was established during the study period. Prospectively collected data pertaining to all surgical admissions were retrieved using patient administration system software (Powerterm Pro, Eircom Software) and a database of performance information from Irish Public Health Services (HealthStat). RESULTS: Ring-fencing and PAC establishment was associated with a significant increase in the overall DOSA rate from 56 to 85 %, surpassing the national target rate of DOSA (75 %). Data relating specifically to general surgery admissions mirrored this increase in DOSA rate from a median of 5 patients per month, before the advent of ring-fencing and PAC, to 42 patients per month (p < 0.0387). 100 patient surveys demonstrated high levels of satisfaction with DOSA, with a preference compared to admission one night pre-operatively. Cost analysis demonstrated overall savings of 340,370 Euro from this change in practice. CONCLUSION: The present study supports the practice of DOSA through the introduction of ring-fenced surgical beds and PAC. This has been shown to improve hospital resource utilisation and streamline surgical service provision in these economically challenging times.

  5. NURSING ASSISTANCE FOR PATIENTS IN SURGICAL CENTER ADMISSION

    OpenAIRE

    Zulene Maria de Vasconcelos Varela; Enêde Andrade da Cruz

    2002-01-01

    We objectified in this study with qualitative handling, to analyze the nurse's care in the people'sadmission in Surgical Center, starting from this professional's assistematic observation, accomplishing thisprocedure. In the chosen institution, the space for admission is common to all the elements of the team, to thepeople's flow and customers, that stay close one of the other ones, generating erroneous interpretations in thecommunication, hindering of that the efective care. The nurse's conc...

  6. Differential Weighting of Items to Improve University Admission Test Validity

    OpenAIRE

    Eduardo Backhoff Escudero; Felipe Tirado Segura; Norma Larrazolo Reyna

    2001-01-01

    This paper gives an evaluation of different ways to increase university admission test criterion-related validity, by differentially weighting test items. We compared four methods of weighting multiple-choice items of the Basic Skills and Knowledge Examination (EXHCOBA): (1) punishing incorrect responses by a constant factor, (2) weighting incorrect responses, considering the levels of error, (3) weighting correct responses, considering the item’s difficulty, based on the Classic Measur...

  7. Interviewing strategically to elicit admissions from guilty suspects

    OpenAIRE

    Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria

    2015-01-01

    In this article we introduce a novel interviewing tactic to elicit admissions from guilty suspects. By influencing the suspects’ perception of the amount of evidence the interviewer holds against them, we aimed to shift the suspects’ counterinterrogation strategies from less to more forthcoming. The proposed tactic (SUE-Confrontation) is a development of the Strategic Use of Evidence (SUE) framework and aims to affect the suspects’ perception by confronting them with statement-evidence incons...

  8. Intelligent Joint Admission Control for Next Generation Wireless Networks

    OpenAIRE

    Mohsen, Abdulqader M.; Al-Akwaa, Fadhl M.; Mohammed M. Alkhawlani

    2012-01-01

    The Heterogeneous Wireless Network (HWN) integrates different wireless networks into one common network. The integrated networks often overlap coverage in the same wireless service areas, leading to the availability of a great variety of innovative services based on user demands in a cost-efficient manner. Joint Admission Control (JAC) handles all new or handoff service requests in the HWN. It checks whether the incoming service request to the selected Radio Access Network (RAN) by the initia...

  9. Probabilistic Tracklet Characterization and Prioritization Using Admissible Regions

    Science.gov (United States)

    2014-09-01

    of deter- mining the potential threat of the object and obtaining further measurements. The solution to this problem is confounded in scenarios with...association and track initiation tasks. Well before their use in data association for asteroids and SOs, admissible regions have been used in stochastic...logic resource management.14 Milani et al.15 first proposed using ARs to assist in the optical detection and discrimination of asteroids . This work is

  10. Emergency department overcrowding: the Emergency Department Cardiac Analogy Model (EDCAM).

    Science.gov (United States)

    Richardson, Sandra K; Ardagh, Michael; Gee, Paul

    2005-01-01

    Increasing patient numbers, changing demographics and altered patient expectations have all contributed to the current problem with 'overcrowding' in emergency departments (EDs). The problem has reached crisis level in a number of countries, with significant implications for patient safety, quality of care, staff 'burnout' and patient and staff satisfaction. There is no single, clear definition of the cause of overcrowding, nor a simple means of addressing the problem. For some hospitals, the option of ambulance diversion has become a necessity, as overcrowded waiting rooms and 'bed-block' force emergency staff to turn patients away. But what are the options when ambulance diversion is not possible? Christchurch Hospital, New Zealand is a tertiary level facility with an emergency department that sees on average 65,000 patients per year. There are no other EDs to whom patients can be diverted, and so despite admission rates from the ED of up to 48%, other options need to be examined. In order to develop a series of unified responses, which acknowledge the multifactorial nature of the problem, the Emergency Department Cardiac Analogy model of ED flow, was developed. This model highlights the need to intervene at each of three key points, in order to address the issue of overcrowding and its associated problems.

  11. Aggressive behavior during the first 24 hours of psychiatric admission

    Directory of Open Access Journals (Sweden)

    Vitor Crestani Calegaro

    2014-09-01

    Full Text Available OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients.METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS. The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive.RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002 and individual component scores, and their results showed more activation (p < 0.001 and thinking disorders (p = 0.009, but less anxious-depression (p = 0.008. Violent patients had more severe psychomotor agitation (p = 0.027, hallucinations (p = 0.017 and unusual thought content (p = 0.020. Additionally, self-aggressive patients had more disorientation (p = 0.011 and conceptual disorganization (p = 0.007.CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation.

  12. Admission control with long-range dependence traffic input

    Institute of Scientific and Technical Information of China (English)

    RAO Yun-hua; ZOU Xue-cheng

    2005-01-01

    The admission control scheme is investigated for a FIFO self-similar queuing system with Quality of Service (QoS) performance guarantees. Since the self-similar queuing system performance analysis is often carried out under the condition of infinite buffer, it is difficult to deduce the upper boundary of buffer overflow probability. To overcome this shortcoming, a simple overflow condition is proposed, which defines a buffer overflow occurrence whenever the arrival rate exceeds the service rate. The analytic formula for the buffer overflow probability upper boundary is easily obtained under this condition. The required bandwidth upper boundary with long-range dependence input and determined overflow probability is then derived from this formula. Based on the above analytic formulas, the upper boundaries of the admission control regions for homogeneous and heterogeneous long-range dependence traffic sources are separately obtained. Finally, an effective admission control scheme for long-range dependence input is proposed. Simulation studies with real traffic have confirmed the validity of these results.

  13. Emergency Contraception

    Science.gov (United States)

    ... the pill that contains ulipristal acetate reduces the risk of pregnancy more effectively than pills that contain levonorgestrel.It is important to remember that emergency contraceptive pills will not prevent pregnancy if you have ...

  14. Eye emergencies

    Science.gov (United States)

    ... eds. Duane's Foundations of Clinical Ophthalmology . Philadelphia, PA: Lippincott Williams and Wilkins; 2013:vol. 3, chap 6. ... Practice of Emergency Medicine . 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009:chap 54-61. Sharma R, ...

  15. Atopy and cause-specific mortality

    DEFF Research Database (Denmark)

    Skaaby, T; Husemoen, L L N; Thuesen, Betina Heinsbæk

    2014-01-01

    BACKGROUND: Atopy is the familial or personal propensity to develop immunoglobulin E (IgE) antibodies against common environmental allergens and is associated with high risk of allergic disease. It has been proposed that atopy may have effects on risk of cardiovascular disease and cancer. OBJECTI...

  16. Emerging boundaries

    DEFF Research Database (Denmark)

    Løvschal, Mette

    2014-01-01

    This article proposes a processual ontology for the emergence of man-made, linear boundaries across northwestern Europe, particularly in the first millennium BC. Over a significant period of time, these boundaries became new ways of organizing the landscape and settlements—a phenomenon that has...... of this phenomenon emerged along equivalent trajectories. At the same time, variation in the regional incorporation of these linear phenomena points toward situation-specific applications and independent development....

  17. Community based service providers' perspectives on frequent and/or avoidable admission of older people with chronic disease in rural NSW: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ewald Dan P

    2011-10-01

    Full Text Available Abstract Background Frequent and potentially avoidable hospital admission amongst older patients with ambulatory care sensitive (ACS chronic conditions is a major topic for research internationally, driven by the imperative to understand and therefore reduce hospital admissions. Research to date has mostly focused on analysis of routine data using ACS as a proxy for 'potentially avoidable'. There has been less research on the antecedents of frequent and/or avoidable admission from the perspectives of patients or those offering community based care and support for these patients. This study aimed to explore community based service providers' perspectives on the factors contributing to admission among older patients with chronic disease and a history of frequent and potentially avoidable admission. Methods 15 semi-structured interviews with community based providers of health care and other services, and an emergency department physician were conducted. Summary documents were produced and thematic analysis undertaken. Results A range of complex barriers which limit or inhibit access to services were reported. We classified these as external and internal barriers. Important external barriers included: complexity of provision of services, patients' limited awareness of different services and their inexperience in accessing services, patients needing a higher level or longer length of service than they currently have access to, or an actual lack of available services, patient poverty, rurality, and transport. Important internal barriers included: fear (of change for example, a 'stoic' attitude to life, and for some, the difficulty of accepting their changed health status. Conclusions The factors underlying frequent and/or potentially avoidable admission are numerous and complex. Identifying strategies to improve services or interventions for this group requires understanding patient, carer and service providers' perspectives. Improving accessibility

  18. EMERGENCY CALLS

    CERN Multimedia

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  19. Anorectal emergencies.

    Science.gov (United States)

    Lohsiriwat, Varut

    2016-07-14

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.

  20. Emerging images

    KAUST Repository

    Mitra, Niloy J.

    2009-01-01

    Emergence refers to the unique human ability to aggregate information from seemingly meaningless pieces, and to perceive a whole that is meaningful. This special skill of humans can constitute an effective scheme to tell humans and machines apart. This paper presents a synthesis technique to generate images of 3D objects that are detectable by humans, but difficult for an automatic algorithm to recognize. The technique allows generating an infinite number of images with emerging figures. Our algorithm is designed so that locally the synthesized images divulge little useful information or cues to assist any segmentation or recognition procedure. Therefore, as we demonstrate, computer vision algorithms are incapable of effectively processing such images. However, when a human observer is presented with an emergence image, synthesized using an object she is familiar with, the figure emerges when observed as a whole. We can control the difficulty level of perceiving the emergence effect through a limited set of parameters. A procedure that synthesizes emergence images can be an effective tool for exploring and understanding the factors affecting computer vision techniques. © 2009 ACM.

  1. Analysis of the medication reconciliation process conducted at hospital admission

    Directory of Open Access Journals (Sweden)

    María Beatriz Contreras Rey

    2016-07-01

    Full Text Available Objective: To analyze the outcomes of a medication reconciliation process at admission in the hospital setting. To assess the role of the Pharmacist in detecting reconciliation errors and preventing any adverse events entailed. Method: A retrospective study was conducted to analyze the medication reconciliation activity during the previous six months. The study included those patients for whom an apparently not justified discrepancy was detected at admission, after comparing the hospital medication prescribed with the home treatment stated in their clinical hospital records. Those patients for whom the physician ordered the introduction of home medication without any specification were also considered. In order to conduct the reconciliation process, the Pharmacist prepared the best pharmacotherapeutical history possible, reviewing all available information about the medication the patient could be taking before admission, and completing the process with a clinical interview. The discrepancies requiring clarification were reported to the physician. It was considered that the reconciliation proposal had been accepted if the relevant modification was made in the next visit of the physician, or within 24-48 hours maximum; this case was then labeled as a reconciliation error. For the descriptive analysis, the Statistics® SPSS program, version 17.0, was used. Outcomes: 494 medications were reconciled in 220 patients, with a mean of 2.25 medications per patient. More than half of patients (59.5% had some discrepancy that required clarification; the most frequent was the omission of a medication that the patient was taking before admission (86.2%, followed by an unjustified modification in dosing or way of administration (5.9%. In total, 312 discrepancies required clarification; out of these, 93 (29.8% were accepted and considered as reconciliation errors, 126 (40% were not accepted, and in 93 cases (29,8% acceptance was not relevant due to a change in

  2. Low near infrared spectroscopic somatic oxygen saturation at admission is associated with need for lifesaving interventions among unplanned admissions to the pediatric intensive care unit.

    Science.gov (United States)

    Balakrishnan, Binod; Dasgupta, Mahua; Gajewski, Kim; Hoffmann, Raymond G; Simpson, Pippa M; Havens, Peter L; Hanson, Sheila J

    2017-03-03

    To investigate the association between low near infrared spectroscopy (NIRS) somatic oxygen saturation (admission and the need for lifesaving interventions (LSI) in the initial 24 h of a PICU admission. Retrospective chart review of all unplanned admissions to the pediatric intensive care unit (PICU) with NIRS somatic oxygen saturation data available within 4 h of admission, excluding admissions with a cardiac diagnosis. LSI data were collected for the first 24 h after admission. Hemodynamic parameters, laboratory values, illness severity scores and diagnoses were collected. Included PICU admissions were stratified by lowest NIRS value in the first 4 h after admission: low NIRS (admissions to the PICU of which 184 (44%) patients underwent NIRS monitoring. A higher proportion of patients who underwent somatic NIRS monitoring required LSIs compared to those without NIRS monitoring (36.4 vs 5.7% respectively, p medications were the most common LSIs. Multivariable modeling showed NIRS  2SD for age to be associated with LSIs. ROC curve analysis of the combination of NIRS 2SD for age had an area under the curve of 0.79 with 78% sensitivity and 76% specificity for association with LSI. Compared to the normal NIRS group, the low NIRS group had higher mortality (10.4 vs 0.7%, p = 0.005) and longer median hospital length of stay (2.9 vs 1.6 days, p admission is associated with need for higher number of subsequent lifesaving interventions up to 24 h after admission. Noninvasive, continuous, somatic NIRS monitoring may identify children at high risk of medical instability.

  3. Maximal admissible faces and asymptotic bounds for the normal surface solution space

    CERN Document Server

    Burton, Benjamin A

    2010-01-01

    The enumeration of normal surfaces is a key bottleneck in computational three-dimensional topology. The underlying procedure is the enumeration of admissible vertices of a high-dimensional polytope, where admissibility is a powerful but non-linear and non-convex constraint. The main results of this paper are significant improvements upon the best known asymptotic bounds on the number of admissible vertices, using polytopes in both the standard normal surface coordinate system and the streamlined quadrilateral coordinate system. To achieve these results we examine the layout of admissible points within these polytopes. We show that these points correspond to well-behaved substructures of the face lattice, and we study properties of the corresponding "admissible faces". Key lemmata include upper bounds on the number of maximal admissible faces of each dimension, and a bijection between the maximal admissible faces in the two coordinate systems mentioned above.

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

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg; Hartvigsen, Jan; Wallstedt, Birgitta;

    2011-01-01

    dropout. Methods  This prospective cohort study followed six cohorts of medical students admitted to the medical school at the University of Southern Denmark during 2002-2007 (n = 1544). Half of the students were admitted based on their prior achievement of highest grades (Strategy 1) and the other half......Medical Education 2011: 45: 1111-1120 Context  Very few studies have reported on the effect of admission tests on medical school dropout. The main aim of this study was to evaluate the predictive validity of non-grade-based admission testing versus grade-based admission relative to subsequent...... years after admission. Multivariate logistic regression analysis was used to model dropout. Results  Strategy 2 (admission test) students had a lower relative risk for dropping out of medical school within 2 years of admission (odds ratio 0.56, 95% confidence interval 0.39-0.80). Only the admission...

  5. Emerging Powers, Emerging Markets, Emerging Societies

    DEFF Research Database (Denmark)

    Sørensen, Camilla T. N.

    2016-01-01

    How are small states managing the shift under way in the global economic and political order from the United States and Europe towards other regions, especially Asia? In the International Relations literature, there is a tendency to focus on the great powers – they set the scene, and the small...... this in order to analyse the Danish foreign policy reactions to the changing world order and show how the emergence of new powers is gradually affecting Denmark’s foreign policy priorities and its “policy profile....

  6. Hematologic emergencies

    Directory of Open Access Journals (Sweden)

    Daniele Vallisa

    2012-01-01

    Full Text Available In recent years, the surprising progress made in other areas of hematology (advances in the understanding of leukemogenesis, improved transplant techniques has been conspicuously absent in the management of hematologic emergencies. And yet, every step toward greater knowledge, every new treatment option will be of little value unless we are able to manage the acute complications of hematologic diseases. These complications are better defined as hematologic emergencies, and they are characterized by a high rate of mortality. This review is based on a search of the literature that was initially confined to articles published in the journal Hematology from 2000 to 2009. The search was then extended to the Cochrane Library and to Pub Med in February 2010 with the following Keywords emergencies; urgencies; hematology. The same key words were employed in a search of the archives of Blood and the New England Journal of Medicine from 2000 to 2010. The results confirm that hematologic emergencies can be caused by hematologic malignancies as well as by non-neoplastic hematologic diseases. Within the former category; this review examines the causes; manifestations; treatment and prevention of disseminated intravascular coagulation; superior vena caval syndrome; spinal cord compression; tumor lysis syndrome; hyperleukocytosis; and hypercalcemia. We also review emergency situations associated with non-neoplatic haematological diseases; such as thrombotic thrombocytopenic purpura; drug-induced hemolytic anemia; and acute sickle-cell crisis.

  7. Admission Control Over Internet of Vehicles Attached With Medical Sensors for Ubiquitous Healthcare Applications.

    Science.gov (United States)

    Lin, Di; Labeau, Fabrice; Yao, Yuanzhe; Vasilakos, Athanasios V; Tang, Yu

    2016-07-01

    Wireless technologies and vehicle-mounted or wearable medical sensors are pervasive to support ubiquitous healthcare applications. However, a critical issue of using wireless communications under a healthcare scenario rests at the electromagnetic interference (EMI) caused by radio frequency transmission. A high level of EMI may lead to a critical malfunction of medical sensors, and in such a scenario, a few users who are not transmitting emergency data could be required to reduce their transmit power or even temporarily disconnect from the network in order to guarantee the normal operation of medical sensors as well as the transmission of emergency data. In this paper, we propose a joint power and admission control algorithm to schedule the users' transmission of medical data. The objective of this algorithm is to minimize the number of users who are forced to disconnect from the network while keeping the EMI on medical sensors at an acceptable level. We show that a fixed point of proposed algorithm always exists, and at the fixed point, our proposed algorithm can minimize the number of low-priority users who are required to disconnect from the network. Numerical results illustrate that the proposed algorithm can achieve robust performance against the variations of mobile hospital environments.

  8. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...... to rise as the population ages, this review summarises the evidence on which such guidance is based, and provides information about how anaesthetists might participate in audit and research aimed at improving local and national outcomes for these most vulnerable of patients....

  9. Emergency preparedness

    CERN Document Server

    Cennini, E; Oortman Gerlings, P

    2009-01-01

    On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

  10. Student characteristics, professional preferences, and admission to medical school

    Directory of Open Access Journals (Sweden)

    Kesternich, Iris

    2017-02-01

    Full Text Available Objectives: A potential new avenue to address the shortage of country doctors is to change the rules for admission to medical school. We therefore study the link between high-school grade point average and prospective physicians’ choice to work in rural areas. To further inform the discussion about rules for admission, we also study the effects of other predictors: a measure of students’ attitudes towards risk; whether they waited for their place of study (; whether their parents worked as medical doctors; and whether they have some practical experience in the medical sector.Methods: We conducted two internet surveys in 2012 and 2014. In the first survey, the sample comprised 701 students and in the second, 474 students. In both surveys, we asked students for their regional preferences; in the 2014 survey, we additionally asked students for their first, second, and third preferences among a comprehensive set of specializations, including becoming a general practitioner. In both surveys, we asked students for basic demographic information (age and gender, their parents’ occupation, a measure of subjective income expectations, a measure of risk attitudes, and their high-school grade point average (, and First National Boards Examination grade (. In 2014, we additionally asked for waiting periods ( as well as for prior professional experience in the health-care sector.Results: We find that three factors increase the probability of having a preference for working in a rural area significantly, holding constant all other influences: Moreover, we find that those willing to work in the countryside have significantly more experience in the medical sector before admission to medical school.Discussion: Our results suggest that a change in the selection process for medical school may increase the supply of country doctors. Instead of focusing on the high-school grade point average, universities could even more intensely screen for study motivation

  11. Off-hours admission and quality of hip fracture care

    DEFF Research Database (Denmark)

    Kristiansen, Nina Sahlertz; Kristensen, Pia Kjær; Nørgård, Bente Mertz;

    2016-01-01

    OBJECTIVE: Higher risks of adverse outcomes have been reported for patients admitted acutely during off-hours. However, in relation to hip fracture, the evidence is inconsistent. We examined whether time of admission influenced compliance with performance measures, surgical delay and 30-day morta...... the excess 30-day mortality. CONCLUSIONS: Patients admitted off-hours and on-hours received similar quality of care. The risk of surgical delay and 30 days mortality was higher among patients admitted during weekends; explanations need to be clarified....

  12. Business Intelligence Framework in Higher Education Admission Center (HEAC

    Directory of Open Access Journals (Sweden)

    Maryam Humaid Alwashahi

    2015-12-01

    Full Text Available - In recent year found that many organizations used Business Intelligence (BI in most of sectors in order to gather, consolidating, analyzing , and providing access to data to provide better decision-making to be faster than ever before by providing the right information to the right people at the right Time. This paper proposes Business Intelligence (BI framework for Higher Education Admission Centre (HEAC to simplify and integrate business critical data of a multi-schema database by using an Active database approach uses active rules, called EventCondition-Action (ECA rules. This paper explores the problem in HEAC, BI overview, BI component, BI features, BI framework, active DB.

  13. Unemployment and Causes of Hospital Admission Considering Different Analytical Approaches

    DEFF Research Database (Denmark)

    Berg-Beckhoff, Gabriele; Gulis, Gabriel; Kronborg Bak, Carsten

    2016-01-01

    and circulatory disease. Register-based data was analysed for the period of 2006 to 2009. In the cross-sectional analysis, a multiple logistic regression model was conducted based on the year 2006 and cohort information from the same year onward up to 2009 was available for a cox regression model. Social welfare...... to the disease. Given the significant results in the cross-sectional analysis for hospital admission due to cancer, the unfound cohort effect might indicate a reverse causation suggesting that the disease caused joblessness and finally, social welfare compensated unemployment and not vice versa. Comparing...

  14. New degradation call admission control for increasing WCDMA system capacity

    Institute of Scientific and Technical Information of China (English)

    Liu Ningqing; Lu Zhi; Gu Xuemai

    2006-01-01

    Propose a new degradation call admission control(DCAC)scheme, which can be used in wideband code division multiple access communication system. So-called degradation is that non-real time call has the characteristic of variable bit rate, so decreasing its bit rate can reduce the load of the system, consequently the system can admit new call which should be blocked when the system is close to full load, therefore new call's access probability increases. This paper brings forward design project and does system simulation, simulation proves that DCAC can effectively decrease calls' blocking probability and increase the total number of the on-line users.

  15. TCP-Call Admission Control Interaction in Multiplatform Space Architectures

    Directory of Open Access Journals (Sweden)

    Georgios Theodoridis

    2007-06-01

    Full Text Available The implementation of efficient call admission control (CAC algorithms is useful to prevent congestion and guarantee target quality of service (QoS. When TCP protocol is adopted, some inefficiencies can arise due to the peculiar evolution of the congestion window. The development of cross-layer techniques can greatly help to improve efficiency and flexibility for wireless networks. In this frame, the present paper addresses the introduction of TCP feedback into the CAC procedures in different nonterrestrial wireless architectures. CAC performance improvement is shown for different space-based architectures, including both satellites and high altitude platform (HAP systems.

  16. Unemployment and Causes of Hospital Admission Considering Different Analytical Approaches

    DEFF Research Database (Denmark)

    Berg-Beckhoff, Gabriele; Gulis, Gabriel; Bak, Carsten Kronborg;

    2016-01-01

    and circulatory disease. Register-based data were analysed for the period of 2006–2009. In the cross-sectional analysis, a multiple logistic regression model was conducted based on the year 2006, and cohort information from the same year onward up to 2009 was available for a Cox regression model. Social welfare...... to the disease. Given the significant results in the cross-sectional analysis for hospital admission due to cancer, the unfound cohort effect might indicate a reverse causation suggesting that the disease caused joblessness, and finally social welfare compensated unemployment and not vice versa. Comparing...

  17. Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study

    Science.gov (United States)

    Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling; Andersen, Per Kragh; Giacco, Domenico; Nordentoft, Merete

    2016-01-01

    Introduction Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled hospital admission on the use of coercion and of healthcare services. Design and methods We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare the use of coercive measures and of healthcare services, the use of medications and suicidal behaviour. Descriptive statistics will be used to investigate hospitalisations, global assessment of functioning (GAF) and patient satisfaction with treatment. To minimise selection bias, we will match individuals using patient-controlled hospital admission and controls with a 1:5 ratio via a propensity score based on the following factors: sex, age group, primary diagnosis, substance abuse as secondary diagnosis, coercion, number of psychiatric bed days, psychiatric history, urbanity and suicidal behaviour. Additionally, a historical control study will be undertaken in which patients serve as their own control group prior to index date. Ethics and dissemination The study has been approved by The Danish Health and Medicines Authority (j.nr.: 3-3013-934/1/) and by The Danish Data Protection Agency (j.nr.: 2012-58-0004). The study was categorised as a register study by The Danish Health Research Ethics Committee and therefore no further approval was needed (j.nr.: H-2-2014-FSP70

  18. Thyroid emergencies.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival.

  19. Emergency Preparedness

    CERN Document Server

    2001-01-01

    The trends of RPC work in the area of preparedness for nuclear and radiological accidents are listed. RPC in cooperation with Swedish Government developed the project on preparation for iodine prophylaxis in case of accident at Ignalina NPP and arranged seminar on emergency preparedness issues in 2001.

  20. Studying Emerge

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael; Selin, Cynthia; Rodegher, Sandra

    2015-01-01

    The Emerge event, held in Tempe, AZ in March 2012, brought together a range of scientists, artists, futurists, engineers and students in order to experiment with innovative methods for thinking about the future. These methodological techniques were tested through nine workshops, each of which made...

  1. Emerging Materiality

    DEFF Research Database (Denmark)

    Bertelsen, Olav Wedege; Breinbjerg, Morten; Pold, Søren

    2009-01-01

    The authors examine how materiality emerges from complex chains of mediation in creative software use. The primarily theoretical argument is inspired and illustrated by interviews with two composers of electronic music. The authors argue that computer mediated activity should not primarily...

  2. Emergence delirium

    DEFF Research Database (Denmark)

    Munk, Louise; Andersen, Lars Peter Holst; Gögenur, Ismail

    2013-01-01

    Emergence delirium (ED) is a well-known phenomenon in the postoperative period. However, the literature concerning this clinical problem is limited. This review evaluates the literature with respect to epidemiology and risk factors. Treatment strategies are discussed. The review concludes...

  3. Postmodern Emergence

    Science.gov (United States)

    Somerville, Margaret

    2007-01-01

    This paper is a work-in-progress in which the author will begin to articulate the elements of a new methodology that she is calling, for the moment, a methodology of postmodern emergence. She explores this approach through examples from her own research journals that follow her research-in-process and from observing student work-in-progress. She…

  4. Lactate clearance in cardiorespiratory emergency

    Directory of Open Access Journals (Sweden)

    Serena Greco

    2007-08-01

    Full Text Available Early goal directed therapy has been found to improve prognosis in septic patients, if the therapeutic goal is achieved within the first six hours. The aim of our study is to demonstrate that in patients with acute cardiorespiratory failure, rapid (within 2 hours lactate clearance can help define patients’ prognosis. 67 consecutive patients, admitted to our 16-bed Emergency Medicine ward for acute cardiorespiratory failure (age 75,9 ± 9,8 (APACHE II score 19,0 ± 4,1, were included in the study. Blood lactate concentration was read at admission and after 2, 6 and 24 hours. We evaluated mortality at seven days and the use of orotracheal intubation (patients with negative outcome vs. discharge or transfer to a non-emergency ward with subsequent discharge (patients with negative outcome. Lactate concentration at admission was 4,6 ± 2,5 mmol/l; lactate clearance (% at 2 hours was 40,4 ± 32,1 in patients with a positive outcome and –8,3 ± 5,0 in patients with a negative outcome (p < 0,05. Lactate clearance at 2 hours < 25% is correlated to a negative outcome with an 84,2% sensitivity and a 79,2% specificity. The positive predictive value was 61,5% and the negative predictive value was 92,2%. Systematic lactate clearance monitoring can be used in cases of acute cardiorespiratory insufficiency to identify patients with a high risk of negative outcome. In our study, low clearance at two hours was associated with an increase in mortality and/or the need for orotracheal intubation. Conversely, a clearance at two hours of > 25% in most cases confirms the therapeutic strategy undertaken. Serial evaluation of blood lactate concentration may therefore be useful in guiding treatment strategies.

  5. Characteristics of frequent emergency department presenters to an Australian emergency medicine network

    Directory of Open Access Journals (Sweden)

    Markham Donna

    2011-12-01

    Full Text Available Abstract Background To describe the characteristics of emergency department (ED patients defined as frequent presenters (FP presenting to an Australian emergency department network and compare these with a cohort of non-frequent presenters (NFP. Method A retrospective chart review utilising an electronic emergency medicine patient medical record database was performed on patients presenting to Southern Health EDs from March 2009 to March 2010. Non-frequent presenters were defined as patients presenting less than 5 times and frequent presenters as presenting 8 or more times in the study period. Characteristics of both groups were described and compared. Results During the 12-month study period there were 540 FP patients with 4549 admissions and 73,089 NFP patients with 100,943 admissions. FP patients were slightly older with a significant increase in frequency of patients between the ages of 70 to 79 years and they were more likely to be divorced or separated than NFP patients. Frequent presenters to the emergency department were more likely to utilise the ambulance service to arrive at the hospital, or in the custody of police than NFP patients. FPs were more likely to be admitted to hospital, more likely to have an admission to a mental health bed than NFP patients and more likely to self-discharge from the emergency department while waiting for care. Conclusions There are major implications for the utilisation of limited ED resources by frequent presenters. By further understanding the characteristics of FP we may be able to address the specific health care needs of this population in more efficient and cost effective ways. Further research analysing the effectiveness of targeted multidisciplinary interventions aiming to reduce the frequency of ED attendances may be warranted.

  6. Evaluation of emergency medical technicians intermediate prediction about their transported patients final disposition in emergency department of Imam Khomeini Hospital.

    Science.gov (United States)

    Afzalimoghadam, Mohammad; Mozafari, Javad; Talebian, Mohammad Taghi; Mohammadnejad, Esmaeil; Kasaeian, Amir

    2013-08-07

    This was a prospective cross-sectional study of consecutive transported patients by emergency medical service (EMS) to a referral hospital. The goal of this study was the evaluation of emergency medical technician intermediate prediction about their transported patients disposition in Emergency Department of Imam Khomeini Hospital. 2950 patients were transported to this hospital, Questionnaires were submitted in 300 of consecutive patient transports and completed data were obtained and available upon arrival at hospital for 267 of these cases. Emergency medical technicians intermediate (EMT-I) were asked to predict whether the transported patient would require admission to the hospital, and if so, what will be their prediction of patient actual disposition. Their predictions were compared with emergency specialist physicians. EMT-I predicted that 208 (78%) transports would lead to admission to the hospital, after actual disposition, 232 (%87) patients became admitted. The sensitivity of predicting any admission was 65%, with positive predictive value (PPV) of 39% and specificity of 86% with negative predictive value (NPV) of 94%. The sensitivity of predicting trauma patients (56.2% of total patients) was 55% with PPV of 38%, specificity of 86% and for Non-trauma patients' sensitivity was 80% with PPV of 40% and specificity of 82%. EMT-I in our emergency medical system have very limited ability in prediction of admission and disposition in transported patients and their prediction were better in Non-trauma patients. So in our EMS, the pre-hospital diversion and necessity of transporting policies should not be based on EMS personnel disposition.

  7. Evaluation of emergency medical technicians intermediate prediction about their transported patients final disposition in emergency department of Imam Khomeini Hospital.

    Directory of Open Access Journals (Sweden)

    Mohammad Afzalimoghadam

    2013-07-01

    Full Text Available This was a prospective cross-sectional study of consecutive transported patients by emergency medical service (EMS to a referral hospital. The goal of this study was the evaluation of emergency medical technician intermediate prediction about their transported patients disposition in Emergency Department of Imam Khomeini Hospital. 2950 patients were transported to this hospital, Questionnaires were submitted in 300 of consecutive patient transports and completed data were obtained and available upon arrival at hospital for 267 of these cases. Emergency medical technicians intermediate (EMT-I were asked to predict whether the transported patient would require admission to the hospital, and if so, what will be their prediction of patient actual disposition. Their predictions were compared with emergency specialist physicians. EMT-I predicted that 208 (78% transports would lead to admission to the hospital, after actual disposition, 232 (%87 patients became admitted. The sensitivity of predicting any admission was 65%, with positive predictive value (PPV of 39% and specificity of 86% with negative predictive value (NPV of 94%. The sensitivity of predicting trauma patients (56.2% of total patients was 55% with PPV of 38%, specificity of 86% and for Non-trauma patients' sensitivity was 80% with PPV of 40% and specificity of 82%. EMT-I in our emergency medical system have very limited ability in prediction of admission and disposition in transported patients and their prediction were better in Non-trauma patients. So in our EMS, the pre-hospital diversion and necessity of transporting policies should not be based on EMS personnel disposition.

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

    Directory of Open Access Journals (Sweden)

    Jaime Lynn Speiser

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

  9. Clinical Predictors of Intensive Care Unit Admission for Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Mohammad Hasan Kargar Maher

    2015-07-01

    Full Text Available IntroductionChildren with severe asthma attack are a challenging group of patients who could be difficult to treat and leading to significant morbidity and mortality. Asthma attack severity is qualitatively estimated as mild, moderate and severe attacks and respiratory failure based on conditions such as respiration status, feeling of dyspnea, and the degree of unconsciousness. part of which are subjective rather than objective. We investigated clinical findings as predictors of severe attack and probable requirement for Pediatric Intensive Care Unit (PICU admission.Materials and MethodsIn a cross sectional and analytical study 120 patients with asthma attack were enrolled from April 2010 to April 2014 (80 admitted in the ward and 40 in pediatric intensive care unit. Predictors of PICU admission were investigated regarding to initial heart rate(HR, respiratory rate (RR, Arterial Oxygen Saturation(SaO2 and PaCo2 and clinically evident cyanosis.ResultsInitial heart rate(p-value=0.02, respiratory rate (p-value=0.03, Arterial Oxygen Saturation(p-value=0.02 and PaCo2(p-value=0.03 and clinically evident cyanosis were significantly different in two groups(Ward admitted and PICU admittedConclusion There was a significant correlation between initial vital sign and blood gas analysis suggesting usefulness of these factors as predictors of severe asthma attack and subsequent clinical course.

  10. Interviewing strategically to elicit admissions from guilty suspects.

    Science.gov (United States)

    Tekin, Serra; Granhag, Pär Anders; Strömwall, Leif; Giolla, Erik Mac; Vrij, Aldert; Hartwig, Maria

    2015-06-01

    In this article we introduce a novel interviewing tactic to elicit admissions from guilty suspects. By influencing the suspects' perception of the amount of evidence the interviewer holds against them, we aimed to shift the suspects' counterinterrogation strategies from less to more forthcoming. The proposed tactic (SUE-Confrontation) is a development of the Strategic Use of Evidence (SUE) framework and aims to affect the suspects' perception by confronting them with statement-evidence inconsistencies. Participants (N = 90) were asked to perform several mock criminal tasks before being interviewed using 1 of 3 interview techniques: (a) SUE-Confrontation, (b) Early Disclosure of Evidence, or (c) No Disclosure of Evidence. As predicted, the SUE-Confrontation interview generated more statement-evidence inconsistencies from suspects than the Early Disclosure interview. Importantly, suspects in the SUE-Confrontation condition (vs. Early and No disclosure conditions) admitted more self-incriminating information and also perceived the interviewer to have had more information about the critical phase of the crime (the phase where the interviewer lacked evidence). The findings show the adaptability of the SUE-technique and how it may be used as a tool for eliciting admissions.

  11. Admission Control and Interference Management in Dynamic Spectrum Access Networks

    Directory of Open Access Journals (Sweden)

    Jorge Martinez-Bauset

    2010-01-01

    Full Text Available We study two important aspects to make dynamic spectrum access work in practice: the admission policy of secondary users (SUs to achieve a certain degree of quality of service and the management of the interference caused by SUs to primary users (PUs. In order to limit the forced termination probability of SUs, we evaluate the Fractional Guard Channel reservation scheme to give priority to spectrum handovers over new arrivals. We show that, contrary to what has been proposed, the throughput of SUs cannot be maximized by configuring the reservation parameter. We also study the interference caused by SUs to PUs. We propose and evaluate different mechanisms to reduce the interference, which are based on simple spectrum access algorithms for both PUs and SUs and channel repacking algorithms for SUs. Numerical results show that the reduction can be of one order of magnitude or more with respect to the random access case. Finally, we propose an adaptive admission control scheme that is able to limit simultaneously the forced termination probability of SUs and what we define as the probability of interference. Our scheme does not require any configuration parameters beyond the probability objectives. Besides, it is simple to implement and it can operate with any arrival process and distribution of the session duration.

  12. Emergency Contraception

    Directory of Open Access Journals (Sweden)

    Gemzell-Danielsson K

    2010-01-01

    Full Text Available There have been numerous attempts to control fertility after unprotected sexual intercourse. From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel, known as the Yuzpe regimen. The first dose had to be taken within 72 hours of unprotected intercourse, a second one 12 hours later. Later on, levonorgestrel alone, at first in a regimen similar to the Yuzpe method (2 × 0.75 mg 12 hours apart showed to be more successful, eventually resulting in the development of a 1.5 mg levonorgestrel pill that combined good efficacy with a high ease of use. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for emergency contraception, which show a high efficacy. Their disadvantages lie in the fact that emergency contraception is considered an off label use and that they might not be acceptable for every patient. Mifepristone in doses of 10 or 25 mg is being used successfully as an emergency contraceptive in China, but has never received any significant consideration in Western countries. The most recent development is the approval of the selective progesterone receptor modulator ulipristal acetate in the dosage of 30 mg for emergency contraception up to 5 days after unprotected intercourse, combining the safe and easy application of the single dose levonorgestrel pill with an even higher efficacy. Several efficacious and easy to use methods for emergency contraception are available on the market today with the most widely spread being levonorgestrel in a single dose of 1.5 mg (given as one tablet of 1.5 mg or 2 tablets of 0.75 mg each for administration up to 3 days after

  13. Emerging Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter

    ) and books (e.g. Goldstein 2007; Benito and Narula 2007). This paper takes stock of the mounting trend of outward FDI from emerging economies, with special focus on a group of five countries, which are becoming increasingly economically and politically influential, viz. the ‘BRICS' countries. An ‘S......' is appended here to the conventional acronym of ‘BRIC' (Brazil, Russia, India, China) to include the largest economy on the African continent, South Africa. The five BRICS countries produced some USD25 billion of outward FDI flows in 2004, corresponding to some 3 percent of world FDI flows and well over half...... (61 percent) of total developing country outflows. OFDI from the BRICS countries has grown rapidly over the last few years, while still remaining modest compared to many developed countries. Following a brief discussion of FDI and emerging economies in general the article proceeds to hypothesise...

  14. Emerging Technologies

    OpenAIRE

    Salgar, S. M.

    2004-01-01

    Phenomenal advancements have taken place in the field of Information and communication technologies in the last decade. Spectacular and innovative changes are expected to take place in these fields in coming decade. Networking technologies are going through a sea change. This paper enumerates the likely networking technologies which are emerging, particularly WLANs. Most of the personal communication in the country will be through cellular/ mobile technologies, which are also covered in the p...

  15. The impact of virtual admission on self-efficacy in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Emme, Christina; Mortensen, Erik L; Rydahl-Hansen, Susan

    2014-01-01

    AIMS AND OBJECTIVES: To investigate how virtual admission during acute exacerbation influences self-efficacy in patients with chronic obstructive pulmonary disease, compared with conventional hospital admission. BACKGROUND: Telemedicine solutions have been highlighted as a possible way to increase...... self-efficacy in patients with chronic diseases, such as chronic obstructive pulmonary disease. However, little is known about how telemedicine-based virtual admission as a replacement of hospital admission during acute exacerbation affects chronic obstructive pulmonary disease patients' self-efficacy......: Participants were consecutively randomised to virtual admission or conventional hospital admission. Data from 50 patients were analysed. Self-efficacy was assessed at baseline, three days after discharge, and also six weeks and three months after discharge, using the Danish version of 'The chronic obstructive...

  16. Emerging jets

    Energy Technology Data Exchange (ETDEWEB)

    Schwaller, Pedro; Stolarski, Daniel [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Weiler, Andreas [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2015-02-15

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  17. Trampoline injury in New Zealand: emergency care.

    Science.gov (United States)

    Hume, P A; Chalmers, D J; Wilson, B D

    1996-01-01

    OBJECTIVE: To examine trampoline related injuries resulting in emergency department attendance. METHODS: Cases were identified by searching free text descriptions of the circumstances of injury contained in the records of the emergency department of a large city hospital. RESULTS: 114 cases were identified for a 12 month period, giving an incidence rate of 108 per 100,000 population per year (95% confidence interval = 89 to 129) compared with 9.3 hospital admissions per 100,000 population per year (95% confidence interval = 8.3 to 10.4) for a corresponding period reported in earlier research from New Zealand. This suggested that for every one hospital admission there are approximately 12 emergency department attendances. Of the cases, 95% were aged less than 20 years. As for the earlier research, falls from the trampoline to the surrounding surface were the commonest cause of injury. In the present study, sprains and strains were the commonest type of injury (40%), and the body site most frequently involved was the lower limb (46%). CONCLUSIONS: The findings support the conclusion from earlier research that although existing trampoline standards address many of the issues relating to trampoline safety, the need remains for measures to reduce the impact of falls from the trampoline to the ground surface and to prohibit the use of trampolines as unsupervised "play equipment". PMID:9015596

  18. Non-uniqueness of Admissible Weak Solutions to Compressible Euler Systems with Source Terms

    OpenAIRE

    Luo, Tianwen; Xie, Chunjing; Xin, Zhouping

    2015-01-01

    We consider admissible weak solutions to the compressible Euler system with source terms, which include rotating shallow water system and the Euler system with damping as special examples. In the case of anti-symmetric sources such as rotations, for general piecewise Lipschitz initial densities and some suitably constructed initial momentum, we obtain infinitely many global admissible weak solutions. Furthermore, we construct a class of finite-states admissible weak solutions to the Euler sys...

  19. Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

    DEFF Research Database (Denmark)

    Wilson, Emilija; Maier, Rolf F; Norman, Mikael

    2016-01-01

    OBJECTIVE: To investigate the association between body temperature at admission to neonatal intensive care and in-hospital mortality in very preterm infants, stratified by postnatal age of death. Moreover, we assessed the association between admission temperature and neonatal morbidity. STUDY...... DESIGN: In this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (

  20. Salford alcohol assertive outreach team: a new model for reducing alcohol-related admissions

    OpenAIRE

    Hughes, Neill R; Houghton, Natalie; Nadeem, Haitham; Bell, Jackie; McDonald, Suzanne; Glynn, Noel; Scarfe, Christopher; Mackay, Bev; Rogers, Anthony; Walters, Melanie; Smith, Martin; McDonald, Andrew; Dalton, David

    2013-01-01

    Objective Alcohol-related admissions are increasing. A significant number of these admissions are attributable to a small number of complex patients with other comorbidities who do not engage well with mainstream services. Assertive outreach teams have been used in the field of psychiatry to engage patients who are poorly compliant. This study examines whether an alcohol assertive outreach team (AAOT) can engage with this group and reduce hospital admissions. Design The AAOT is a multidiscipl...

  1. Does Emotional Intelligence at Medical School Admission Predict Future Academic Performance?

    OpenAIRE

    Humphrey-Murto, Susan; Leddy, John J.; Wood, Timothy J.; Puddester, Derek; Moineau, Geneviève

    2014-01-01

    Purpose Medical school admissions committees are increasingly considering noncognitive measures like emotional intelligence (EI) in evaluating potential applicants. This study explored whether scores on an EI abilities test at admissions predicted future academic performance in medical school to determine whether EI could be used in making admissions decisions. Method The authors invited all University of Ottawa medical school applicants offered an interview in 2006 and 2007 to complete the M...

  2. Causes of Raptor Admissions to a Wildlife Rehabilitation Center in Tenerife (Canary Islands)full access

    OpenAIRE

    2010-01-01

    We studied the causes of raptor admissions to the only wildlife rehabilitation center on the largest island of the Canarian Archipelago (Tenerife) over ten years (1998–2007). A total of 2611 birds of prey, belonging to nine falconiform diurnal raptor and four strigiform species, were admitted. The Eurasian Kestrel (Falco tinnunculus) and the Long-eared Owl (Asio otus) were the species most commonly admitted and jointly made up 85.6% of admissions. The most frequent causes of admission to the ...

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

    Science.gov (United States)

    Sullivan, Paul

    2017-01-01

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

  4. Outcome of mechanically ventilated patients initially denied admission to an intensive care unit and subsequently admitted.

    Science.gov (United States)

    Naser, Wasim; Schwartz, Naama; Finkelstein, Richard; Bisharat, Naiel

    2016-11-01

    The outcome of mechanically ventilated patients initially denied admission to an intensive care unit (ICU) and subsequently admitted is unclear. We compared outcomes of patients denied ICU admission and subsequently admitted, to those of patients admitted to the ICU and to patients refused ICU admission. The medical records of all the patients who were subjected to mechanical ventilation for at least 24h over a 4year period (2010-2014) were reviewed. Of 707 patients (757 admissions), 124 (18%) were initially denied ICU admission and subsequently admitted. Multivariate stepwise logistic regression analysis showed significant association with death of: age, length of stay, nursing home residency, duration of mechanical ventilation, previous admission with mechanical ventilation, cause for mechanical ventilation, rate of failed extubations, associated morbidity (previous cerebrovascular accident, dementia, chronic renal failure), and occurrence of nosocomial bacteremia. The odds for death among patients denied ICU admission and subsequently transferred to the ICU compared to patients admitted directly to the ICU was 3.6 (95% CI: 1.9-6.7) (Padmission compared to those who were initially denied and subsequently admitted were not statistically significant (OR=1.7, 95% CI: 0.8-3.8). In conclusion, patients denied ICU admission and subsequently admitted face a considerable risk of morbidity and mortality. Their odds of death are nearly three times those admitted directly to the ICU. Late admission to the ICU does not appear to provide benefit compared to patients who remain in general medicine wards.

  5. Introduction of new guidelines for emergency patients: motivational counselling among smokers

    DEFF Research Database (Denmark)

    Nelbom, Bente Munkholm; Duus, Benn Rønnow; Tønnesen, Hanne;

    2007-01-01

    Smoking is the most important risk factor for morbidity and mortality in hospital patients. Patient contact with the healthcare system should include smoking cessation counselling. Emergency admissions are seldom given this opportunity. Objective: The aim of the study was to illustrate the implem......Smoking is the most important risk factor for morbidity and mortality in hospital patients. Patient contact with the healthcare system should include smoking cessation counselling. Emergency admissions are seldom given this opportunity. Objective: The aim of the study was to illustrate...... the implementation of motivational counselling in a department of acute surgery....

  6. Secondary-care costs associated with lung cancer diagnosed at emergency hospitalisation in the United Kingdom.

    Science.gov (United States)

    Kennedy, Martyn P T; Hall, Peter S; Callister, Matthew E J

    2017-01-30

    Lung cancer diagnosis during emergency hospital admission has been associated with higher early secondary-care costs and lower longer-term costs than outpatient diagnoses. This retrospective cohort study analyses the secondary-care costs of 3274 consecutive patients with lung cancer. Patients diagnosed during emergency admissions incurred greater costs during the first month and had a worse prognosis compared with outpatient diagnoses. In patients who remained alive, costs after the first month were comparable between diagnostic routes. In addition to improving patient experience and outcome, strategies to increase earlier diagnosis may reduce the additional healthcare costs associated with this route to diagnosis.

  7. Introduction of new guidelines for emergency patients: motivational counselling among smokers

    DEFF Research Database (Denmark)

    Backer, Vibeke; Nelbom, Bente Munkholm; Duus, Benn Rønnow

    2007-01-01

    Smoking is the most important risk factor for morbidity and mortality in hospital patients. Patient contact with the healthcare system should include smoking cessation counselling. Emergency admissions are seldom given this opportunity. Objective: The aim of the study was to illustrate the implem......Smoking is the most important risk factor for morbidity and mortality in hospital patients. Patient contact with the healthcare system should include smoking cessation counselling. Emergency admissions are seldom given this opportunity. Objective: The aim of the study was to illustrate...

  8. Emergency Aeromedical Services in Ireland – A Single-Centre Study in 2014

    LENUS (Irish Health Repository)

    Sheridan, G.A.

    2017-03-01

    This retrospective analysis includes patients requiring Emergency Aeromedical Services (EAS) in 2014. The aim of this paper is to evaluate the HEMS service in a single centre and to accurately assess whether certain internationally validated criteria can predict admission rates better than the currently used criteria. Using the American College of Surgeons (ACS) trauma-related dispatch criteria, each case was retrospectively evaluated. Results showed the mean total criteria met were 2.73 (σ=0.88) and 1.45 (σ=0.82) in admitted and discharged patients respectively. The total criteria met had a significant predictive value on admission rates (p<0.05). Increased admission rates were shown in patients with a high Mechanism of Injury (MOI) (p<0.05). False positive rates of HEMS transfer were higher when applying the current criteria compared to the ACS criteria. ACS total criteria can predict admission in HEMS patients with a higher specificity than currently used guidelines.

  9. Is it an Emergency?

    Science.gov (United States)

    ... Emergency 101 Share this! Home » Emergency 101 Is it an Emergency? Medical emergencies can be frightening and ... situation. Here you can find information about emergencies. It is essential to know how to recognize the ...

  10. Off-Hours Admission and Acute Stroke Care Quality

    DEFF Research Database (Denmark)

    Kristiansen, Nina Sahlertz; Mainz, Jan; Nørgård, Bente Mertz;

    2014-01-01

    stroke care processes, including the effect of a systematic quality improvement program, and to examine 30 days case-fatality. Methods-A population-based historical cohort study, including patients admitted to Danish hospitals with a first ever acute stroke (January 1, 2003, to December 31, 2011; N=64...... characteristics (in particular, stroke severity) decreased the odds ratio to 1.03 (95% confidence interval, 0.97-1.10). Additional adjustment for hospital characteristics and compliance with performance measures had no effect on the odds ratio. Conclusion-Patients admitted off-hours received a poorer quality...... of care. However, the admission time-related differences in care were substantially reduced over time, and the differences in 30 days case-fatality appeared primarily to be explained by differences in stroke severity....

  11. Optimizing Voip Using A Cross Layer Call Admission Control Scheme

    Directory of Open Access Journals (Sweden)

    Mumtaz AL-Mukhtar

    2013-07-01

    Full Text Available Deployingwireless campus network becomes popular in many world universities for the services that areprovided.However, it suffers from different issues such as low VoIP network capacity, network congestioneffect on VoIP QoS and WLAN multi rate issue due to linkadaptation technique. In this paper a cross layercall admission control (CCAC scheme is proposed to reduce the effects of these problems on VoWLANbased on monitoring RTCPRR(RealTime Control Protocol ReceiverReportthat provides the QoS levelfor VoIP and monitoring the MAC layer for any change in the data rate. If the QoS level degrades due toone of the aforementioned reasons, a considerable change in the packet size or the codec type will be thesolution. A wireless campus network issimulatedusing OPNET 14.5 modeler and many scenarios aremodeled to improve this proposed scheme.

  12. Differential Weighting of Items to Improve University Admission Test Validity

    Directory of Open Access Journals (Sweden)

    Eduardo Backhoff Escudero

    2001-05-01

    Full Text Available This paper gives an evaluation of different ways to increase university admission test criterion-related validity, by differentially weighting test items. We compared four methods of weighting multiple-choice items of the Basic Skills and Knowledge Examination (EXHCOBA: (1 punishing incorrect responses by a constant factor, (2 weighting incorrect responses, considering the levels of error, (3 weighting correct responses, considering the item’s difficulty, based on the Classic Measurement Theory, and (4 weighting correct responses, considering the item’s difficulty, based on the Item Response Theory. Results show that none of these methods increased the instrument’s predictive validity, although they did improve its concurrent validity. It was concluded that it is appropriate to score the test by simply adding up correct responses.

  13. [Meningococcal disease admissions in a paediatric intensive care unit].

    Science.gov (United States)

    Mação, Patrícia; Januário, Gustavo; Ferreira, Sofia; Dias, Andrea; Dionísio, Teresa; Pinto, Carla; Carvalho, Leonor

    2014-01-01

    Introdução: A infecção meningocócica tem uma elevada mortalidade e morbilidade em crianças. O tratamento agressivo do choque, a referenciação precoce, o transporte secundário especializado e a vacinação são factores com impacto potencial na redução da mortalidade. Foram objectivos caracterizar as crianças com doença invasiva meningocócica admitidas em cuidados intensivos, avaliar parâmetros de gravidade e mortalidade. Material e Métodos: Estudo observacional, cujo método de colheita de dados foi retrospectivo. Foram constituídos dois períodos, de seis anos cada, de acordo com o ano de admissão (A: 2000-2005 e B: 2006-2011) e nestes compararam-se índices de gravidade, disfunção orgânica e mortalidade. Resultados: Foram admitidas 70 crianças com doença invasiva meningocócica. Quando comparadas com as outras causas verificouse uma redução nas admissões por doença invasiva meningocócica (período A: 3,4%; período B: 1,5%; p = 0,001). A ocorrência de meningite foi de 41% no período A e de 29% no período B (p = 0,461). Tiveram púrpura rapidamente progressiva 78% no período A e 50% no período B (p = 0,0032). As crianças do período A tiveram disfunção multi-órgão (80%), coagulação intravascular disseminada (76%) e coma (22%) mais frequentemente que as crianças do período B (29%, 29%, 0%; p < 0,05). A mortalidade foi 26% no período A e 0% no período B (p = 0,006) e a mortalidade estandardizada pelo PRISM foi 1,3 e 0 no período A e B respectivamente. Discussão: A redução do número de admissões por doença menigocócica invasiva pode ser explicada pela introdução da vacina anti-meningocócica C em 2006. Pensa-se que a redução da mortalidade observada, possa ser atribuível à melhoria da estabilização inicial e ao transporte secundário. Conclusão: Nos últimos anos houve uma redução significativa no número de admissões e na mortalidade por doença invasiva meningocócica.

  14. Transtrochanteric fractures: evaluation of data between hospital admission and discharge,

    Directory of Open Access Journals (Sweden)

    Christiano Saliba Uliana

    2014-04-01

    Full Text Available OBJECTIVE: to evaluate the data obtained from patients with transtrochanteric fractures who were attended at a tertiary-level trauma referral hospital, between admission and discharge, gathered prospectively by means of the SINPE(c software.METHODS: 109 consecutive patients who were admitted between April 2011 and January 2012 were evaluated using an electronic storage and analysis database in SINPE(c . The data were gathered prospectively, including evaluations on personal information about the patients, history-taking, fracture classification (Evans-Jensen, AO/OTA and Tronzo, treatment and discharge.RESULTS: the sample was composed of 43 men and 66 women. Their ages ranged from 20 to 105 years, with a mean of 69 years. Falling was the trauma mechanism for 92 patients and traffic accidents for 17. The most prevalent chronic diseases were systemic arterial hypertension and diabetes mellitus. According to the AO/OTA classification, the commonest fracture type was 31 A1. According to the Tronzo classification, type III was commonest. The fracture was fixed by means of a cephalomedullary nail in 64 cases and a sliding screw-plate in 44 cases. One fracture was fixed with a 95◦ screw-plate. Seven patients presented some form of clinical complication and three died during the hospital stay. All the patients who were discharged were instructed to only partially bear weight on the repair.CONCLUSION: through SINPE(c , it was possible to evaluate the personal information, history-taking, classification, treatment and discharge of patients with transtrochanteric fractures, from hospital admission to discharge.

  15. Vitamin D deficiency at pediatric intensive care admission

    Directory of Open Access Journals (Sweden)

    Corsino Rey

    2014-04-01

    Full Text Available OBJECTIVE:to assess whether 25hydroxivitaminD or 25(OHvitD deficiency has a high prevalence at pediatric intensive care unit (PICU admission, and whether it is associated with increased prediction of mortality risk scores.METHOD:prospective observational study comparing 25(OHvitD levels measured in 156 patients during the 12 hours after critical care admission with the 25(OHvitD levels of 289 healthy children. 25(OHvitD levels were also compared between PICU patients with pediatric risk of mortality III (PRISM III or pediatric index of mortality 2 (PIM 2 > p75 [(group A; n = 33 vs. the others (group B; n = 123]. Vitamin D deficiency was defined as < 20 ng/mL levels.RESULTS:median (p25-p75 25(OHvitD level was 26.0 ng/mL (19.2-35.8 in PICU patients vs. 30.5 ng/mL (23.2-38.6 in healthy children (p = 0.007. The prevalence of 25(OHvitD < 20 ng/mL was 29.5% (95% CI: 22.0-37.0 vs. 15.6% (95% CI: 12.2-20.0 (p = 0.01. Pediatric intensive care patients presented an odds ratio (OR for hypovitaminosis D of 2.26 (CI 95%: 1.41-3.61. 25(OHvitD levels were 25.4 ng/mL (CI 95%: 15.5-36.0 in group A vs. 26.6 ng/mL (CI 95%: 19.3-35.5 in group B (p = 0.800.CONCLUSIONS:hypovitaminosis D incidence was high in PICU patients. Hypovitaminosis D was not associated with higher prediction of risk mortality scores.

  16. The Preventable Admissions Care Team (PACT): A Social Work-Led Model of Transitional Care.

    Science.gov (United States)

    Basso Lipani, Maria; Holster, Kathleen; Bussey, Sarah

    2015-10-01

    In 2010, the Preventable Admissions Care Team (PACT), a social work-led transitional care model, was developed at Mount Sinai to reduce 30-day readmissions among high-risk patients. PACT begins with a comprehensive bedside assessment to identify the psychosocial drivers of readmission. In partnership with the patient and family, a patient-centered action plan is developed and carried out through phone calls, accompaniments, navigations and home visits, as needed, in the first 30 days following discharge. 620 patients were enrolled during the pilot from September 2010-August 2012. Outcomes demonstrated a 43% reduction in inpatient utilization and a 54% reduction in emergency department visits among enrollees. In addition, 93% of patients had a follow-up appointment within 7-10 days of discharge and 90% of patients attended the appointment. The success of PACT has led to additional funding from the Centers for Medicare and Medicaid Services under the Community-based Care Transitions Program and several managed care companies seeking population health management interventions for high risk members.

  17. Prognostic value of blood glucose levels in diabetic patients upon admission and its outcomes in patients with acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Adel Hamed Elbaih

    2017-01-01

    Full Text Available Background: Coronary heart disease (CHD is the main leading cause of morbidity and mortality in patients with diabetes mellitus. Hyperglycemia on admission was associated with a worse outcome for all patients admitted with ACS. Aim: To correlate the relationship between hyperglycemia with acute coronary syndrome and poor outcome. Methodology: Clinical evaluation of the patients were carried out on arrival to Emergency Department regarding: Initial assessment of patient general condition either stable or not through; ABCDE (air way and cervical spine control, breathing, circulation, neurological dysfunction and exposure. Then determine the characters and types of chest pain. Assess the condition of the patients either stable or unstable which will determine the needed investigations and plane of management. Results: the mortality was higher in patients with RBG more than 300 mg/dl (68.4 %, (10.5 % of the patients had ranged from 250 ─ < 300 mg/dl, and the patients had ranged from 200 ─ < 250 mg/dl were (10.5 %. The patients had ranged from 160 ─ < 200 mg/dl were (5.3 and there were (5.3 of the patients had ranged from 70 ─ < 160mg/dl. Conclusions: The data from this study have shown that hyperglycemia on admission was associated with a worse outcome for all patients admitted with ACS.

  18. Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit.

    Science.gov (United States)

    Aslam, Muhammad I; Martin-Ucar, Antonio E; Nakas, Apostolos; Waller, David A

    2011-11-01

    A preoperative delay in emergency surgery for spontaneous pneumothorax is associated with a poor outcome after surgery and a prolonged hospital stay. To reduce preoperative delays, all tertiary referrals from district general hospitals to our thoracic surgery unit were processed through a 'clinical decisions unit' (CDU). Prior to the establishment of the CDU, these patients were added to a waiting list for a surgical bed. This study has reviewed the effect of this change in admission policy on the efficiency of treatment for non-elective spontaneous pneumothorax. An intergroup comparison (pre-CDU group vs. post-CDU group) was made of the following parameters: referral to transfer time, transfer to surgery time and length of inpatient stay in the referring and tertiary hospitals. There were no significant differences in gender, diagnosis, treatment in the referring hospitals, postoperative clinical outcome, or indications for or type of surgery. The total length of inpatient stay in the referring and tertiary hospitals was significantly reduced for the post-CDU group (12 vs. 15 days; P<0.001), which was attributed to the earlier transfer of patients (18 vs. 78 hours; P<0.001) hours. Allowing surgical access to a traditional medical admission unit is therefore, cost-effective and significantly improves the efficiency of non-elective pneumothorax surgery.

  19. Emergency readmissions to paediatric surgery and urology: The impact of inappropriate coding.

    Science.gov (United States)

    Peeraully, R; Henderson, K; Davies, B

    2016-04-01

    Introduction In England, emergency readmissions within 30 days of hospital discharge after an elective admission are not reimbursed if they do not meet Payment by Results (PbR) exclusion criteria. However, coding errors could inappropriately penalise hospitals. We aimed to assess the accuracy of coding for emergency readmissions. Methods Emergency readmissions attributed to paediatric surgery and urology between September 2012 and August 2014 to our tertiary referral centre were retrospectively reviewed. Payment by Results (PbR) coding data were obtained from the hospital's Family Health Directorate. Clinical details were obtained from contemporaneous records. All readmissions were categorised as appropriately coded (postoperative or nonoperative) or inappropriately coded (planned surgical readmission, unrelated surgical admission, unrelated medical admission or coding error). Results Over the 24-month period, 241 patients were coded as 30-day readmissions, with 143 (59%) meeting the PbR exclusion criteria. Of the remaining 98 (41%) patients, 24 (25%) were inappropriately coded as emergency readmissions. These readmissions resulted in 352 extra bed days, of which 117 (33%) were attributable to inappropriately coded cases. Conclusions One-quarter of non-excluded emergency readmissions were inappropriately coded, accounting for one-third of additional bed days. As a stay on a paediatric ward costs up to £500 a day, the potential cost to our institution due to inappropriate readmission coding was over £50,000. Diagnoses and the reason for admission for each care episode should be accurately documented and coded, and readmission data should be reviewed at a senior clinician level.

  20. Epidemiologia de internações por doença falciforme no Brasil Epidemiology of sickle cell disease hospital admissions in Brazil

    Directory of Open Access Journals (Sweden)

    Monique Morgado Loureiro

    2005-12-01

    Full Text Available OBJETIVO: A doença falciforme é uma enfermidade hereditária que afeta principalmente a população negra. O estudo teve por objetivo analisar as internações devido às complicações da doença, com enfoque nos aspectos epidemiológicos e clínicos. MÉTODOS: A população estudada foi constituída de 9.349 pacientes com diagnóstico de doença falciforme internados em hospitais da Bahia, Rio de Janeiro e São Paulo, no período de 2000 a 2002. Utilizaram-se os dados do Sistema de Internações Hospitalares do Sistema Único de Saúde. As variáveis respostas foram o óbito e o tempo médio de permanência hospitalar. As covariáveis foram o sexo, a idade, o tipo de admissão e a natureza jurídica do hospital. As proporções foram comparadas utilizando-se o teste qui-quadrado ou de Fischer; e para as variáveis contínuas, foi utilizado o teste Mann-Whitney ou Kruskall-Wallis. RESULTADOS: A mediana de idade variou de 11,0 a 12,0 anos e cerca de 70% das internações foram abaixo dos 20 anos. A mediana de dias de permanência hospitalar variou com a idade e o tipo de admissão. O tipo de admissão mais freqüente foi pela emergência (65,6 a 90,8%. Foi observada maior letalidade hospitalar entre adultos. A mediana da idade do óbito foi baixa (26,5 a 31,5 anos. CONCLUSÕES: Os resultados confirmaram a alta morbidade na população jovem e evidenciaram predominância de óbitos entre adultos jovens.OBJECTIVE: Sickle cell disease is a hereditary disease, which affects mainly the black population. The aim of the present study was to analyze hospital admissions due to acute events resulting from sickle cell disease, at the epidemiological and clinical levels. METHODS: The study population included 9,349 patients with sickle cell disease admitted to hospitals in Bahia, Rio de Janeiro, and Sao Paulo, between 2000 and 2002. The national hospital database of the Brazilian Healthcare System was used. Response variables were death and mean duration

  1. Referral pathways for patients with TIA avoiding hospital admission: a scoping review

    Science.gov (United States)

    Evans, Bridie Angela; Ali, Khalid; Bulger, Jenna; Ford, Gary A; Jones, Matthew; Moore, Chris; Porter, Alison; Pryce, Alan David; Quinn, Tom; Seagrove, Anne C; Whitman, Shirley; Rees, Nigel

    2017-01-01

    Objective To identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital. Design Scoping review. Data sources PubMed, CINAHL Web of Science, Scopus. Study selection Reports of primary research on referral of patients with suspected TIA directly to specialist outpatient services. Data extraction We screened studies for eligibility and extracted data from relevant studies. Data were analysed to describe setting, assessment and referral processes, treatment, implementation and outcomes. Results 8 international studies were identified, mostly cohort designs. 4 pathways were used by family doctors and 3 pathways by emergency department physicians. No pathways used by paramedics were found. Referrals were made to specialist clinic either directly or via a 24-hour helpline. Practitioners identified TIA symptoms and risk of further events using a checklist including the ABCD2 tool or clinical assessment. Antiplatelet medication was often given, usually aspirin unless contraindicated. Some patients underwent tests before referral and discharge. 5 studies reported reduced incident of stroke at 90 days, from 6–10% predicted rate to 1.3–2.1% actual rate. Between 44% and 83% of suspected TIA cases in these studies were referred through the pathways. Conclusions Research literature has focused on assessment and referral by family doctors and ED physicians to reduce hospitalisation of patients with TIA. No pathways for paramedical use were reported. We will use results of this scoping review to inform development of a paramedical referral pathway to be tested in a feasibility trial. Trial registration number ISRCTN85516498. Stage: pre-results. PMID:28196949

  2. [Urological emergencies].

    Science.gov (United States)

    Danuser, H; Ackermann, D K; Studer, U E

    1993-04-17

    Every general practitioner has to deal with urologic emergencies. The most frequent illnesses are urinary retention, acute scrotum, priapism, macrohematuria, nephritic colic, obstructive pyelonephritis and pyonephrosis. Whereas urinary retention, as well as acute ureteric stone colic must generally be treated by the practitioner, the urologist must often be consulted in case of an acute scrotum or for priapism. Testicular torsion is one situation, where surgical treatment needs to be performed within 6 hours. Of utmost importance is his timely assistance with the obstructive pyelonephritis and pyonephrosis. These are initially often not recognized, especially because the first ultrasound examination of the intrarenal pyelone may not show a dilatation of the collecting system despite obstruction. If the adequate treatment with drainage and antibiotics is applied too late, this can result in serious and potentially lethal consequences.

  3. [Care for the dying patient in emergency departments].

    Science.gov (United States)

    Iglesias, M L; Lafuente, A

    2010-01-01

    The aim of this article is to provide professionals in the hospital emergency departments with sufficient tools to face, according to the organisation and possibilities of each hospital, the admission of patients in the final days of life. It is primordial to provide a professional, technical and human environment based on concepts, attitudes and skills that make it possible to deal with the demands of comfort and the emotional and psycho-social requirements generated by these situations.

  4. Combined Admission Control and Scheduling for QoS Differentiation in LTE Uplink

    DEFF Research Database (Denmark)

    Anas, Mohmmad; Rosa, Claudio; Calabrese, Francesco Davide

    2008-01-01

    Long term evolution (LTE) architecture shall support end-to-end quality of service (QoS). For the QoS support and service differentiation it is important that the admission control and packet scheduling functionalities are QoS-aware. In this paper a combined admission control and a decoupled time...

  5. 24 CFR 5.856 - When must I prohibit admission of sex offenders?

    Science.gov (United States)

    2010-04-01

    ... sex offenders? 5.856 Section 5.856 Housing and Urban Development Office of the Secretary, Department... Denying Admissions § 5.856 When must I prohibit admission of sex offenders? You must establish standards... lifetime registration requirement under a State sex offender registration program. In the screening...

  6. AN AUTOMATED IMPLEMENTATION OF INDIAN UNIVERSITY ADMISSION SYSTEM USING ARTIFICIAL NEURAL NETWORKS

    Directory of Open Access Journals (Sweden)

    B. Sankarasubramanian

    2014-04-01

    Full Text Available Indian University Admission is a complex phenomenon encompassing various factors both tangible and intangible. Apart from Merit - Caste, Community and Religion play a crucial role in getting admission to various courses offered by Universities. The Single Window Admission System followed by almost all Government Universities (for example: Anna University, Chennai is, so far, the best practice to offer Admission sought by student community. But, still, in Private Universities, the Admission process is done manually since number of students seeking a course is smaller in size. This manual process is fraught with some drawbacks: such as slower in time, cumbersome and costlier, bias by the Admission Officer, manual errors while processing, due to influence exercised by powerful people qualified students not getting their course of choice and unqualified students getting into their course of willingness and etc. This paper addresses these problems via neural network architecture based Admission system which will eliminate all the pitfalls and drawbacks inherent in the current system and offers a smooth, clearer, easier and cost effective way of student admission system implementation in Indian Universities.

  7. 40 CFR 85.1512 - Admission of catalyst and O2 sensor-equipped vehicles.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Admission of catalyst and O2 sensor... Vehicles and Motor Vehicle Engines § 85.1512 Admission of catalyst and O2 sensor-equipped vehicles. (a)(1... system and/or O2 sensor; (iii) Is labeled in accordance with 40 CFR part 86, subpart A or subpart S,...

  8. Admissions Policies as a Mechanism for Social Engineering: The Case of the Bulgarian Communist Regime

    Science.gov (United States)

    Boyadjieva, Pepka Alexandrova

    2013-01-01

    This article discusses admissions policies to higher education during the Communist regime in Bulgaria (1946-89). It argues that under the conditions of the Bulgarian Communist regime, admissions policies were not only a component of the higher education system--viewed as an institution--but part and parcel of the process through which power was…

  9. Admission and Graduation Requirements for Special Education Doctoral Programs at 20 Top American Universities

    Science.gov (United States)

    Walker, Gabriela

    2009-01-01

    A quantitative analysis of the admissions and graduation requirements guidelines of the special education doctoral programs at 20 top American universities was conducted. Admission requirements typically include an application fee, previous coursework GPA, previous field experience, GRE scores, TOEFL scores, professional writing sample(s), and…

  10. Experiences of patients with borderline personality disorder with the brief admission intervention: A phenomenological study

    NARCIS (Netherlands)

    Helleman, M.; Goossens, P.J.J.; Kaasenbrood, A.; Achterberg, T. van

    2014-01-01

    Brief admission is a crisis intervention for patients with borderline personality disorder (BPD), and refers to a clinical admission at a psychiatric hospital for a period of 1-5 nights. Patients formulate a treatment plan together with their community mental health nurse about the maximum frequency

  11. A Survey of PCN-Based Admission Control and Flow Termination

    NARCIS (Netherlands)

    Menth, Michael; Lehrieder, Frank; Briscoe, Bob; Eardley, Philip; Moncaster, Tony; Babiarz, Jozef; Charny, Anna; Zhang, Xinyang (Joy); Taylor, Tom; Chan, Kwok-Ho; Satoh, Daisuke; Geib, Ruediger; Karagiannis, Georgios

    2010-01-01

    Pre-congestion notification (PCN) provides feedback about load conditions in a network to its boundary nodes. The PCN working group of the IETF discusses the use of PCN to implement admission control (AC) and flow termination (FT) for prioritized realtime traffic in a DiffServ domain. Admission cont

  12. Deliberate self-harm before psychiatric admission and risk of suicide

    DEFF Research Database (Denmark)

    Madsen, Trine; Agerbo, Esben; Mortensen, Preben B;

    2013-01-01

    Psychiatric illness and deliberate self-harm (DSH) are major risk factors of suicide. In largely 15 % of psychiatric admissions in Denmark, the patient had an episode of DSH within the last year before admission. This study examined the survival and predictors of suicide in a suicidal high...

  13. What To Look for in ESL Admission Tests: Cambridge Certificate Exams, IELTS, and TOEFL.

    Science.gov (United States)

    Chalhoub-Deville, Micheline; Turner, Carolyn E.

    2000-01-01

    Familiarizes test users with issues to consider when employing assessments for screening and admission purposes. Examines the purpose, content, and scoring methods of three English-as-a-Second-Language admissions tests--the Cambridge certificate exams, International English Language Teaching System, and Test of English as a Foreign…

  14. m Components-Admissible Solutions of Systems of Higher-Order Partial Differential Equations on Cm

    Institute of Scientific and Technical Information of China (English)

    Ling-yun Gao

    2008-01-01

    Using value distribution theory and techniques in severed complex variables,we investigate the problem of existence of m components-admissible solutions of a class of systems of higher-order partied differential equations in several complex variables and estimate the number of admissible components of solutions.Some related results will also be obtained.

  15. Supreme Court Hearing in Texas Admissions Case Exposes Gaps in Affirmative-Action Law

    Science.gov (United States)

    Schmidt, Peter

    2012-01-01

    The author reports on the U.S. Supreme Court hearing regarding the Texas admissions case that exposes gaps in the affirmative-action law. As the Supreme Court heard oral arguments in a lawsuit challenging race-conscious admissions at the University of Texas at Austin, it became evident that the court's past rulings on such policies have failed to…

  16. Contextual Admissions and Affirmative Action: Developments in Higher Education Policy in England

    Science.gov (United States)

    Lane, Laura; Birds, Rachel

    2013-01-01

    This paper explores the value of explaining contextual admissions policy directives through the conceptual lenses of meritocracy and social reproduction. It is suggested that examining these concepts can assist in highlighting some of the ideological and practical complexities associated with contextual admissions whilst providing opportunities to…

  17. Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

    LENUS (Irish Health Repository)

    O'Donoghue, Brian

    2013-05-01

    OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.

  18. Aspiring to the Baccalaureate: Attitudes of Community College Students Toward Affirmative Action in College Admissions.

    Science.gov (United States)

    Zamani, Eboni Mie'l

    This dissertation, written in April 2000, focuses on African American, Hispanic, and White community college students' attitudes toward affirmative action in college admissions. Specifically, the study examines the association between attitudes toward affirmative action in college admissions, student background characteristics, educational…

  19. Admission medical records made at night time have the same quality as day and evening time

    DEFF Research Database (Denmark)

    Amirian, Ilda; Mortensen, Jacob F; Rosenberg, Jacob

    2014-01-01

    INTRODUCTION: A thorough and accurate admission medical record is an important tool in ensuring patient safety during the hospital stay. Surgeons' performance might be affected during night shifts due to sleep deprivation. The aim of the study was to assess the quality of admission medical records...

  20. Local Authority Approaches to the School Admissions Process. LG Group Research Report

    Science.gov (United States)

    Rudd, Peter; Gardiner, Clare; Marson-Smith, Helen

    2010-01-01

    What are the challenges, barriers and facilitating factors connected to the various school admissions approaches used by local authorities? This report gathers the views of local authority admissions officers on the strengths and weaknesses of different approaches, as well as the issues and challenges they face in this important area. It covers:…