WorldWideScience

Sample records for service agents admission

  1. 14 CFR 121.550 - Secret Service Agents: Admission to flight deck.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Secret Service Agents: Admission to flight... OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.550 Secret Service Agents: Admission to flight deck. Whenever an Agent of the Secret Service who is assigned the duty...

  2. Service philosophies for hospital admission planning

    NARCIS (Netherlands)

    Adan, I.J.B.F.; Vissers, J.M.H.; Vissers, J.M.H.; Beech, R.

    2005-01-01

    The ‘traditional’ service philosophy underlying hospital admission planning has been one of optimising the use of scarce hospital resources without paying much attention to the level of service offered to patients. As patients nowadays do not accept long waiting times for hospital admission, it

  3. Quality of service agents in the internet

    OpenAIRE

    Schelén, Olov

    1998-01-01

    The Internet is a multi-purpose communication network supporting users and applications with different service demands. To meet these demands, mechanisms for service differentiation in the network are proposed. This thesis presents an admission control architecture where clients can make resource reservations through agents. For each domain in the network there is an agent responsible for admission control. The architecture provides scalable resource reservations for virtual leased lines. Res...

  4. 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.

  5. 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.

  6. Emergency service admissions of patients with burn injury

    Directory of Open Access Journals (Sweden)

    Sadiye Yolcu

    2013-09-01

    Full Text Available Objective: In this study, we aimed to investigate the propertiesof burn injured patients who admitted to our hospitalemergency service.Methods: Patients were detected from the hospital recordsof emergency service during six months period andwere divided into five groups according to their ages (60 years. Age, gender totalbody surface area (TBSA, mechanism of injury and theoutcome of emergency evaluation were recorded.Results: Totally 111619 patients admitted to our emergencyservice between 01.07.2011 and 31.12.2011. Duringsix months, 2349 males and 1960 females totally4309 patients were burn injured patients. 1773 patientswere between 0-10 years, 1083 patients were 11-20years, 735 patients were between 21 and 40, 361 patientswere between 41 and 60 and 357 patients were over 60years. Most of the patients were treated in the emergencyservice (90.1%. 0-10% TBSA patients constituted 94.2%.This ratio for burn area >40% was 0.6%. Hot liquid burn(vapored water, milk etc. was 60.2%. There was a significantrelation between mechanism of burn injury andage groups (p<0.05. No corrosive and sunburn injuriesdetermined in females. Age groups were related with hospitalization(p<0.05. The highest intensive care unit admissionwas found in the 0-10 age group (1.3%.Conclusion: Emergency service is the first admission departmentof burn injury patients. Knowing the propertiesof burn injury patients, would help hard-working emergencydoctors in triage of these patients. Also, reportingthe data of emergency service burn injury patients wouldbe helpful for further studies. J Clin Exp Invest 2013; 4(3: 285-288Key words: Burn injury, emergency service, total body surface area

  7. Satisfaction with services following voluntary and involuntary admission.

    LENUS (Irish Health Repository)

    Smith, Damian

    2014-02-01

    Service user perspectives are essential for the evaluation and development of mental health services. Service users expressing less satisfaction with services subsequently have poorer treatment outcomes.

  8. From admission to discharge in mental health services: a qualitative analysis of service user involvement.

    Science.gov (United States)

    Wright, Nicola; Rowley, Emma; Chopra, Arun; Gregoriou, Kyriakos; Waring, Justin

    2016-04-01

    User involvement and recovery are now widely used terms within the mental health policy, research and practice discourse. However, there is a question mark about the impact these ideas have in everyday practice. Of interest is the degree of involvement in key transitions of care. In particular, admission to and discharge from acute inpatient mental health wards. To explore the nature of service user involvement in the admission and discharge process into and out of acute inpatient mental health care. A qualitative study using focus groups. One acute, inpatient mental health ward was the focus of the study. Seven uniprofessional focus group interviews were conducted with ward staff, community staff and service users (total number of participants = 52). Conventional, thematic qualitative techniques were used to analyse the data. The data analysed and presented in this article relate to the loss of the service user voice at the key transition points into and out of acute inpatient care. Due to the lack of resources (inpatient beds and community care follow-up), the role service users could play was diminished. In their narratives, clinical staff associated the person with the process and used language which dehumanized the individual. Service users experience numerous care transitions into and out of hospital. As there is the potential for these encounters to have a lasting negative effect, the importance of ensuring service users have a voice in what is happening to them is crucial. © 2015 John Wiley & Sons Ltd.

  9. Weathering the storm: nurses' satisfaction with a mobile admission nurse service.

    Science.gov (United States)

    Kirkbride, Geri; Floyd, Valerie; Tate, Cheryl; Wendler, M Cecilia

    2012-04-01

    To evaluate nurses' satisfaction with, and perceptions of, a practice innovation introducing a Mobile Admission Nurse service. Staff nurses identified that the admission process, while crucial to initiating safe and appropriate acute care, can be disruptive and interfere with care in progress. A pilot project implementing the role of a Mobile Admission Nurse was introduced to address this need. A self-developed web-based survey was administered to a convenience sample of 104 RNs who had used the services during the pilot project. Staff nurses (n = 78) reported a chaotic, demanding work environment within which the admission process disrupts the flow of care. The Mobile Admission Nurse helped them in 'weathering the storm', which was the overarching theme that emerged during data analysis. Having an admission nurse complete the admission process steadied workflow processes for nurses. Improved patient safety and increased staff and family satisfaction were also reported. The strongly positive feedback led to expansion of the service. Proactively redesigning work processes, using a structured theoretical model such as the (Plan-Do-Study-Act) PDSA approach, may improve outcomes in a chaotic practice environment. © 2011 Blackwell Publishing Ltd.

  10. Experience of care home residents with Parkinson's disease: Reason for admission and service use.

    Science.gov (United States)

    Walker, Richard W; Palmer, Jessica; Stancliffe, Jonathan; Wood, Brian H; Hand, Annette; Gray, William K

    2014-10-01

    The care needs of people with Parkinson's disease (PD) are poorly understood. We aimed to investigate the factors that precipitate entry to institutional care, and on-going care needs once in care, within a representative cohort of community-dwelling people with PD. All people with idiopathic PD, Parkinson's plus syndromes and vascular parkinsonism under the care of the Northumbria Healthcare NHS Foundation Trust PD service who were living in care homes on 1 January 2013 were included. Disease severity (Hoehn and Yahr stage) and demographic data were collected. Admissions to hospital over the previous 2 years and in the year before institutional care admission were documented. A total of 90 patients (51 females) with a mean age of 81.3 years were included. During care home stay, the median number of emergency department attendances, the median number of hospital admissions and the median length of stay for those admitted per year were significantly lower than before care home admission. Both before care home admission and during care home stay, falls were the most common diagnoses in people attending emergency departments, with 32 of 65 (49.2%) admissions before and 34 of 59 (57.6%) admissions during care home stay having falls recorded as a cause of attendance. Hospital attendances and admissions were relatively common, even after institutional care home placement. Events precipitating admission, such as falls, might be preventable. PD nurse specialists could be an effective way to help train staff in homes where someone is known to have PD. © 2013 Japan Geriatrics Society.

  11. Environmental Agents Service (EAS) Registry System of Records

    Data.gov (United States)

    Department of Veterans Affairs — The Environmental Agent Service (EAS) Registries is the information system encompassing the Ionizing Radiation Registry (IRR), the Agent Orange Registry (AOR), and...

  12. 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.

  13. Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

    Science.gov (United States)

    Thomas, Kali S; Keohane, Laura; Mor, Vincent

    2014-11-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

  14. 46 CFR 515.24 - Agent for service of process.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Agent for service of process. 515.24 Section 515.24... agent for service of process. Any person serving the Secretary must also send to the ocean... Secretary. (c) Service of administrative process, other than subpoenas, may be effected upon the legal agent...

  15. Admission and Preventive Load Control for Delivery of Multicast and Broadcast Services via S-UMTS

    Science.gov (United States)

    Angelou, E.; Koutsokeras, N.; Andrikopoulos, I.; Mertzanis, I.; Karaliopoulos, M.; Henrio, P.

    2003-07-01

    An Admission Control strategy is proposed for unidirectional satellite systems delivering multicast and broadcast services to mobile users. In such systems, both the radio interface and the targeted services impose particular requirements on the RRM task. We briefly discuss the RRM requirements that stem from the services point of view and from the features of the SATIN access scheme that differentiate it from the conventional T-UMTS radio interface. The main functional entities of RRM and the alternative modes of operation are outlined and the proposed Admission Control algorithm is described in detail. The results from the simulation study that demonstrate its performance for a number of different scenarios are finally presented and conclusions derived.

  16. Services Use of Children and Adolescents before Admission to Psychiatric Inpatient Care.

    Science.gov (United States)

    Zechmeister-Koss, Ingrid; Winkler, Roman; Fritz, Corinna; Thun-Hohenstein, Leonhard; Tuechler, Heinz

    2016-06-01

    Although 20% of children and adolescents in Europe suffer from overt mental health problems, their illness-related service utilisation is often unknown. If at all, existing research has only addressed the health care sector while services requirements in mental health care go far beyond the health care system, including the social, the educational and the criminal justice system. This paper aims at describing the service contact patterns of children and adolescents within and outside the health care sector before they are admitted to a child and adolescent mental health hospital. Additionally, we evaluate the private out-of-pocket payments that occur for primary carers. A cohort of consecutive admissions to a child and adolescent hospital in Austria was prospectively analysed. We collected data on service use and out-of-pocket expenses before hospital admission from primary carers through face-to-face interviews using an adapted version of the European Child and Adolescent Mental Health Service Receipt Inventory (EU-CAMHSRI). Clinical data came from validated questionnaires (CBCL, YSR) and from the anamnestic documentation. Ninety percent from a cohort of 441 patients had some contact with services or took medication before they were admitted to hospital. Most often, services in the health care outpatient setting were used. Outside of the health care system, support in school, as well as counselling services, were used most frequently, whereas the persons hardly sought support in living or employment. Roughly 32,400 per 100 patients was spent privately, yet these out-of pocket expenses were very unevenly distributed. Service use and out-of-pocket spending increased with social status and were gender-specific. The more severe external behaviour symptoms were, the more non-health care services were used. Mentally ill children and adolescents use a broad range of services across sectors before admission to hospital. Service use is associated with specific symptoms of

  17. Relationship between Admission, Extracurricular Services and Academic Achievement in Secondary Schools: A Partial Least Square (PLS) Approach

    Science.gov (United States)

    Suleiman, Yusuf; Hanaf, Zahyah Bt; Bin Taslikhan, Muhajir

    2016-01-01

    This study investigates the nexus between two dimensions of student personnel services (Admission Services, Extracurricular Services) academic achievement in secondary schools with the particular interest to know the significant impact of these services on students' academic achievement. It is believed that the provision of these services are…

  18. Pre-admission factors and utilization of tutoring services in health professions educational programs.

    Science.gov (United States)

    Olivares-Urueta, Mayra; Williamson, Jon W

    2013-01-01

    Pre-admission factors tend to serve as indicators of student success in health professions educational programs, but less is known about the effects that academic assistance programs have on student success. This study sought to determine whether specific pre-admission factors could help to identify students who may require academic support during their health professions education. This retrospective analysis aimed to identify differences in pre-admission variables between those students requiring tutoring and a matched sample of students who did not require tutoring. One-way ANOVA was used to assess differences for dependent variables-age, cumulative GPA (cGPA), science GPA (sGPA), verbal graduate record examination (GRE) score, quantitative GRE score, analytical GRE score and combined GRE score, community college hours, average credit hours per semester, and highest semester credit hour load-across three groups of students who received no tutoring (NT 0 hrs), some tutoring (ST tutoring (MT >8 hrs). Total GRE and average semester hours differentiated NT from ST from MT (ptutoring: quantitative GRE, sGPA, cGPA and average semester hours taken. The combination of lower GRE scores and lighter average semester course load were most predictive of the need for academic assistance as defined by hours of tutoring. While the value of the GRE in admissions processes is generally accepted, the average semester hour load in college can also provide important information regarding academic preparation and the need for tutoring services.

  19. Extension agents\\' marketing related services: The relevance to ...

    African Journals Online (AJOL)

    This study investigated the marketing related services provided to farmers by extension agents in Osun State, Nigeria. Data were collected from the extension agents in the services of Osun State Agricultural Development Projects, which is the government outfit to provide such services to farmers on one hand and their ...

  20. Virtual customer service agents: using social presence and personalization to shape online service encounters

    NARCIS (Netherlands)

    Verhagen, T.; van Nes, J; Feldberg, F; van Dolen, W.

    2014-01-01

    By performing tasks traditionally fulfilled by service personnel and having a humanlike appearance, virtual customer service agents bring classical service elements to the web, which may positively influence customer satisfaction through eliciting social responses and feelings of personalization.

  1. Virtual Customer Service Agents: Using Social Presence and Personalization to Shape Online Service Encounters

    NARCIS (Netherlands)

    Verhagen, T.; van Nes, J.; Feldberg, J.F.M.; van Dolen, W.M.

    2014-01-01

    By performing tasks traditionally fulfilled by service personnel and having a humanlike appearance, virtual customer service agents bring classical service elements to the web, which may positively influence customer satisfaction through eliciting social responses and feelings of personalization.

  2. Using Roadside Billboard Posters to Increase Admission Rates to Problem Gambling Services: Reflections on Failure.

    Science.gov (United States)

    Calderwood, Kimberly A; Wellington, William J

    2015-07-01

    Based on the stimulus-response model of advertising, this study sought to increase admission rates to a local problem gambling service (PGS) in Windsor, Ontario, Canada, by adding a series of locally based 10 foot by 20 foot roadside billboard posters to PGS's existing communications tools for a 24-week period. Using proof of performance reports, a pre-post survey of new callers to PGS, a website visit counter, and a media awareness survey, the findings showed that at least some individuals were influenced by billboard exposure, but admission rates continued to decline during the billboard campaign period. While one possible explanation for the communications failure was that the whole PGS communications campaign was below the minimal threshold for communications perception, another possible explanation is that the stimulus-response model of advertising used may not have been appropriate for such advertising that targets behavior change. Reflections on using an information-processing model instead of a stimulus-response model, and considerations of a two-step flow of communication, are provided. Recommendations are made regarding matching communications messages to stages of behavior change, use of online promotion, and strategies for future research. © 2015 Society for Public Health Education.

  3. Enhancing E-Learning through Web Service and Intelligent Agents

    Directory of Open Access Journals (Sweden)

    Nasir Hussain

    2006-04-01

    Full Text Available E-learning is basically the integration of various technologies. E-Learning technology is now maturing and we can find a multiplicity of standards. New technologies such as agents and web services are promising better results. In this paper we have proposed an e-learning architecture that is dependent on intelligent agent systems and web services. These communication technologies will make the architecture more robust, scalable and efficient.

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

    Science.gov (United States)

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

    2016-04-01

    People with dementia have worse outcomes associated with hospital admission, are more likely to have interventions and are less likely to be offered palliative care than people without dementia. Advance care planning for care home residents has been shown to reduce hospital admissions without increasing mortality. Studies have shown that staff confidence in managing delirium, a common reason for admission, improves with training. A service combining education for care home staff and advance care planning for care home residents with dementia was introduced to care homes in Boston, UK. There were improvements in staff confidence in recognition, prevention, management and knowledge of factors associated with delirium and dysphagia. 92% of carers rated the service >9/10. Admissions fell by 37% from baseline in the first year and 55% in the second and third years. All but one resident died in the preferred place of care. © 2016 Royal College of Physicians.

  5. Service orientation in holonic and multi agent manufacturing and robotics

    CERN Document Server

    Thomas, Andre; Trentesaux, Damien

    2013-01-01

    The book covers four research domains representing a trend for modern manufacturing control: Holonic and Multi-agent technologies for industrial systems; Intelligent Product and Product-driven Automation; Service Orientation of Enterprise’s strategic and technical processes; and Distributed Intelligent Automation Systems. These evolution lines have in common concepts related to service orientation derived from the Service Oriented Architecture (SOA) paradigm.     The service-oriented multi-agent systems approach discussed in the book is characterized by the use of a set of distributed autonomous and cooperative agents, embedded in smart components that use the SOA principles, being oriented by offer and request of services, in order to fulfil production systems and value chain goals.   A new integrated vision combining emergent technologies is offered, to create control structures with distributed intelligence supporting the vertical and horizontal enterprise integration and running in truly distributed ...

  6. Protecting Dynamic Mobile Agent against Denial of Service Attacks

    Science.gov (United States)

    Aggarwal, Mayank; Nipur, Pallavi

    2010-11-01

    Mobile Agents are softwares migrating from one node to another to fulfill the task of its owner. The introduction of mobile agents has reduced network latency, network traffic a lot but at the same time it has increased the vulnerability for attacks by malicious hosts. One such attack is `Denial of Service', once the agent is launched it is free to roam without any control of its owner, this on one hand decreases the cost of agent—owner interaction and on the other hand increases the chances of `Denial Of Service'. In Denial Of Service attack the malicious host may deny resources required by the agent and kill the agent, thus the result computed so far is lost and this may happen every time the agent visits any malicious host. In this paper we continued the work done in [10] in which the authors proposed techniques by which owner can detect the malicious host for `Denial Of Service' but they did not covered technique for dynamic routes i.e. where the host or agent initiate migrations to hosts which were not contained in the route composed by the owner. We introduced an algorithm and a model which can be useful for the above purpose.

  7. Agent-based Personal Network (PN) service architecture

    DEFF Research Database (Denmark)

    Jiang, Bo; Olesen, Henning

    2004-01-01

    In this paper we proposte a new concept for a centralized agent system as the solution for the PN service architecture, which aims to efficiently control and manage the PN resources and enable the PN based services to run seamlessly over different networks and devices. The working principle...

  8. MAINS: MULTI-AGENT INTELLIGENT SERVICE ARCHITECTURE FOR CLOUD COMPUTING

    Directory of Open Access Journals (Sweden)

    T. Joshva Devadas

    2014-04-01

    Full Text Available Computing has been transformed to a model having commoditized services. These services are modeled similar to the utility services water and electricity. The Internet has been stunningly successful over the course of past three decades in supporting multitude of distributed applications and a wide variety of network technologies. However, its popularity has become the biggest impediment to its further growth with the handheld devices mobile and laptops. Agents are intelligent software system that works on behalf of others. Agents are incorporated in many innovative applications in order to improve the performance of the system. Agent uses its possessed knowledge to react with the system and helps to improve the performance. Agents are introduced in the cloud computing is to minimize the response time when similar request is raised from an end user in the globe. In this paper, we have introduced a Multi Agent Intelligent system (MAINS prior to cloud service models and it was tested using sample dataset. Performance of the MAINS layer was analyzed in three aspects and the outcome of the analysis proves that MAINS Layer provides a flexible model to create cloud applications and deploying them in variety of applications.

  9. Preventable Admissions on a General Medicine Service: Prevalence, Causes and Comparison with AHRQ Prevention Quality Indicators-A Cross-Sectional Analysis.

    Science.gov (United States)

    Patel, Krishna K; Vakharia, Nirav; Pile, James; Howell, Erik H; Rothberg, Michael B

    2016-06-01

    Rates of preventable admissions will soon be publicly reported and used in calculating performance-based payments. The current method of assessing preventable admissions, the Agency of Healthcare Research and Quality (AHRQ) Preventable Quality Indicators (PQI) rate, is drawn from claims data and was originally designed to assess population-level access to care. To identify the prevalence and causes of preventable admissions by attending physician review and to compare its performance with the PQI tool in identifying preventable admissions. Cross-sectional survey. General medicine service at an academic medical center. Consecutive inpatient admissions from December 1-15, 2013. Survey of inpatient attending physicians regarding the preventability of the admissions, primary contributing factors and feasibility of prevention. For the same patients, the PQI tool was applied to determine the claims-derived preventable admission rate. Physicians rated all 322 admissions and classified 122 (38 %) as preventable, of which 31 (25 %) were readmissions. Readmissions were more likely to be rated preventable than other admissions (49 % vs. 35 %, p = 0.04). Application of the AHRQ PQI methodology identified 75 (23 %) preventable admissions. Thirty-one admissions (10 %) were classified as preventable by both methods, and the majority of admissions considered preventable by the AHRQ PQI method (44/78) were not considered preventable by physician assessment (K = 0.04). Of the preventable admissions, physicians assigned patient factors in 54 (44 %), clinician factors in 36 (30 %) and system factors in 32 (26 %). A large proportion of admissions to a general medicine service appeared preventable, but AHRQ's PQI tool was unable to identify these admissions. Before initiation of the PQI rate for use in pay-for-performance programs, further study is warranted.

  10. Location-based admission control for differentiated services in 3G cellular networks

    NARCIS (Netherlands)

    Núñez-Queija, R.; Tan, H.-P.

    2006-01-01

    Third generation wireless systems can simultaneously accommodate flow transmissions of users with widely heterogeneous applications. As resources are limited (particularly in the air interface), admission control is necessary to ensure that all active users are accommodated with sufficient capacity

  11. A framework of call admission control procedures for integrated services mobile wireless networks

    International Nuclear Information System (INIS)

    Mahmoud, Ashraf S. Hasan; Al-Qahtani, Salman A.

    2007-01-01

    This paper presents a general framework for a wide range of call admission control (CAC) algorithms. For several CAC schemes, which are a subset of this general framework, an analytical performance evaluation is presented for a multi-traffic mobile wireless network. These CAC algorithms consider a variety of mechanisms to prioritize traffic in an attempt to support different levels of quality of service (QoS) for different types of calls. These mechanisms include dividing the handoff traffic into more than one class and using guard channels or allowing channel splitting to admit more handoff calls. Other mechanisms aimed at adding priority for handoff calls consider employing queuing of handoff calls or dynamically reducing the number lower priority calls. Furthermore our analysis relaxes the typically used assumptions of equal channel holding time and equal resource usage for voice and data calls. The main contribution of this paper is the development of an analytical model for each of the three CAC algorithms specified in this study. In addition to the call blocking and termination probabilities which are usually cited as the performance metrics, in this work we derive and evaluate other metrics that not have be considered by the previous work such as the average queue length, the average queue residency, and the time-out probability for handoff calls. We also develop a simulation tool to test and verify our results. Finally, we present numerical examples to demonstrate the performance of the proposed CAG algorithms and we show that analytical and simulation results are in total agreement. (author)

  12. Screening for tuberculosis upon admission to shelters and free-meal services

    International Nuclear Information System (INIS)

    Solsona, J.; Cayla, J.A.; Nadal, J.; Bedia, M.; Mata, C.; Brau, J.; Maldonado, J.; Mila, C.; Alcaide, J.; Altet, N.; Galdos-Tangueis, H.

    2001-01-01

    Background: The homeless are at very high risk of suffering tuberculosis (TB). The aims of this study were to determine the prevalence and risk factors for tuberculosis infection and disease among the homeless in Barcelona and to evaluate the roles of case finding and contact investigation. Methods: Observational prevalence study carried out between 1997 and 1998. Participants: 447 homeless patients (394 men and 53 women) were evaluated before admission to shelters and free-meal services. At the same time, 48 co-residents with smear-positive TB patients in 2 long-term shelters were evaluated too. A chest X-ray and Tuberculin Skin Test were performed on all subjects. Sputum smears were processed by the Ziehl-Neelsen and Loewenstein-Jensen procedures in patients with radiographic findings consistent with pulmonary TB. Results: Of the 447 homeless examined, 335 (75%) were infected with Mycobacterium tuberculosis. Active pulmonary TB was diagnosed in five persons (1.11%), and 62 (13.8%) had radiographic evidence of inactive pulmonary TB. Tuberculosis infection was associated with age and smoking, but not with sex or alcohol abuse. No significant differences in infection rates were found between the main group and 48 homeless co-residents of smear-positive subjects. Only 16.9% of the homeless with active TB in Barcelona in the same period were diagnosed through active case-finding, the remainder being mainly detected in hospitals (69.8%) and other several centres (13.3%). Conclusions: Homeless individuals have a very high risk of TB infection and disease and contact investigation requires specific methods for them. Programmes of screening and supervised treatment should be ensured in this group

  13. Co-creating value through agents interaction within service network

    Energy Technology Data Exchange (ETDEWEB)

    Okdinawati, L.; Simatupang, T.M.; Sunitiyoso, Y.

    2017-07-01

    The purpose of this paper is to gives further understanding on value co-creation mechanisms in B-to-B service network by reinforcing the processes, the relationships, and influences of other agents where Collaborative Transportation Management (CTM) forms might be best employed. Design/methodology/approach: In order to model the interactions among agents in the collaboration processes and the value co-creation processes, this research used three collaboration cases in Indonesia. Then, the agent-based simulation was used to capture both the collaboration process and the value co-creation process of the three collaboration cases. Findings: The interactions among the agents both inside and outside their collaboration environment determined agent’s role as a value co-creator. The willingness of an agent to accept the opinion of another agent determined the degree of their willingness to co-operate and to change their strategies, and perceptions. Therefore, influenced the size of the value obtained by them in each collaboration process. Research limitations/implications: The findings of the simulations subject to assumptions based on the collaboration cases. Further research is related to how to encourage agents to co-operate and adjust their perceptions. Practical implications: It is crucial for the practitioners to interact with another agent both inside and outside their collaboration environment. The opinions of another agent inside the collaboration environment also need to be considered. Originality/value: This research is derived from its emphasis on how a value is co-created by reinforcing both the collaborative processes and the interactions among agents as well as on how CTM might be best employed.

  14. Co-creating value through agents interaction within service network

    International Nuclear Information System (INIS)

    Okdinawati, L.; Simatupang, T.M.; Sunitiyoso, Y.

    2017-01-01

    The purpose of this paper is to gives further understanding on value co-creation mechanisms in B-to-B service network by reinforcing the processes, the relationships, and influences of other agents where Collaborative Transportation Management (CTM) forms might be best employed. Design/methodology/approach: In order to model the interactions among agents in the collaboration processes and the value co-creation processes, this research used three collaboration cases in Indonesia. Then, the agent-based simulation was used to capture both the collaboration process and the value co-creation process of the three collaboration cases. Findings: The interactions among the agents both inside and outside their collaboration environment determined agent’s role as a value co-creator. The willingness of an agent to accept the opinion of another agent determined the degree of their willingness to co-operate and to change their strategies, and perceptions. Therefore, influenced the size of the value obtained by them in each collaboration process. Research limitations/implications: The findings of the simulations subject to assumptions based on the collaboration cases. Further research is related to how to encourage agents to co-operate and adjust their perceptions. Practical implications: It is crucial for the practitioners to interact with another agent both inside and outside their collaboration environment. The opinions of another agent inside the collaboration environment also need to be considered. Originality/value: This research is derived from its emphasis on how a value is co-created by reinforcing both the collaborative processes and the interactions among agents as well as on how CTM might be best employed.

  15. Merging Agents and Cloud Services in Industrial Applications

    Directory of Open Access Journals (Sweden)

    Francisco P. Maturana

    2014-01-01

    Full Text Available A novel idea to combine agent technology and cloud computing for monitoring a plant floor system is presented. Cloud infrastructure has been leveraged as the main mechanism for hosting the data and processing needs of a modern industrial information system. The cloud offers unlimited storage and data processing in a near real-time fashion. This paper presents a software-as-a-service (SaaS architecture for augmenting industrial plant-floor reporting capabilities. This reporting capability has been architected using networked agents, worker roles, and scripts for building a scalable data pipeline and analytics system.

  16. Agent-based services for B2B electronic commerce

    Science.gov (United States)

    Fong, Elizabeth; Ivezic, Nenad; Rhodes, Tom; Peng, Yun

    2000-12-01

    The potential of agent-based systems has not been realized yet, in part, because of the lack of understanding of how the agent technology supports industrial needs and emerging standards. The area of business-to-business electronic commerce (b2b e-commerce) is one of the most rapidly developing sectors of industry with huge impact on manufacturing practices. In this paper, we investigate the current state of agent technology and the feasibility of applying agent-based computing to b2b e-commerce in the circuit board manufacturing sector. We identify critical tasks and opportunities in the b2b e-commerce area where agent-based services can best be deployed. We describe an implemented agent-based prototype system to facilitate the bidding process for printed circuit board manufacturing and assembly. These activities are taking place within the Internet Commerce for Manufacturing (ICM) project, the NIST- sponsored project working with industry to create an environment where small manufacturers of mechanical and electronic components may participate competitively in virtual enterprises that manufacture printed circuit assemblies.

  17. A Multi Agent Based Model for Airport Service Planning

    Directory of Open Access Journals (Sweden)

    W.H. Ip

    2010-09-01

    Full Text Available Aviation industry is highly dynamic and demanding in nature that time and safety are the two most important factors while one of the major sources of delay is aircraft on ground because of it complexity, a lot of machinery like vehicles are involved and lots of communication are involved. As one of the aircraft ground services providers in Hong Kong International Airport, China Aircraft Services Limited (CASL aims to increase competitiveness by better its service provided while minimizing cost is also needed. One of the ways is to optimize the number of maintenance vehicles allocated in order to minimize chance of delay and also operating costs. In the paper, an agent-based model is proposed for support decision making in vehicle allocation. The overview of the aircrafts ground services procedures is firstly mentioned with different optimization methods suggested by researchers. Then, the agent-based approach is introduced and in the latter part of report and a multi-agent system is built and proposed which is decision supportive for CASL in optimizing the maintenance vehicles' allocation. The application provides flexibility for inputting number of different kinds of vehicles, simulation duration and aircraft arrival rate in order to simulation different scenarios which occurs in HKIA.

  18. Retailing and service activities: main agents and their urban insertion

    Directory of Open Access Journals (Sweden)

    Heliana Comin Vargas

    2000-12-01

    Full Text Available This article presents the im portance of retailing and service activities in term s of social and econom ic developm ent, and the action of the different retailing and services agents related to the urban space. It tries to make clear the conflicts among all these agents, showing the present scenery of big cities, having as a reference the city of São Paulo, which are facing a strong increase on the retailing offer com pared to the demand. Finally, it points out som e aspects which should be thought or rethought in order to prepare efficient urban policies that could be able to control the relationship between retail and city searching for better patterns of urban quality

  19. Merging Agents and Cloud Services in Industrial Applications

    OpenAIRE

    Francisco P. Maturana; Juan L. Asenjo; Neethu S. Philip; Shweta Chatrola

    2014-01-01

    A novel idea to combine agent technology and cloud computing for monitoring a plant floor system is presented. Cloud infrastructure has been leveraged as the main mechanism for hosting the data and processing needs of a modern industrial information system. The cloud offers unlimited storage and data processing in a near real-time fashion. This paper presents a software-as-a-service (SaaS) architecture for augmenting industrial plant-floor reporting capabilities. This reporting capability has...

  20. Pricing the Services in Dynamic Environment: Agent Pricing Model

    Science.gov (United States)

    Žagar, Drago; Rupčić, Slavko; Rimac-Drlje, Snježana

    New Internet applications and services as well as new user demands open many new issues concerning dynamic management of quality of service and price for received service, respectively. The main goals of Internet service providers are to maximize profit and maintain a negotiated quality of service. From the users' perspective the main goal is to maximize ratio of received QoS and costs of service. However, achieving these objectives could become very complex if we know that Internet service users might during the session become highly dynamic and proactive. This connotes changes in user profile or network provider/s profile caused by high level of user mobility or variable level of user demands. This paper proposes a new agent based pricing architecture for serving the highly dynamic customers in context of dynamic user/network environment. The proposed architecture comprises main aspects and basic parameters that will enable objective and transparent assessment of the costs for the service those Internet users receive while dynamically change QoS demands and cost profile.

  1. An agent-based model for energy service companies

    International Nuclear Information System (INIS)

    Robinson, Marguerite; Varga, Liz; Allen, Peter

    2015-01-01

    Highlights: • An agent-based model for household energy efficiency upgrades is considered. • Energy service companies provide an alternative to traditional utility providers. • Household self-financing is a limiting factor to widespread efficiency upgrading. • Longer term service contracts can lead to reduced household energy costs. • Future energy price increases enable service providers to retain their customer base. - Abstract: The residential housing sector is a major consumer of energy accounting for approximately one third of carbon emissions in the United Kingdom. Achieving a sustainable, low-carbon infrastructure necessitates a reduced and more efficient use of domestic energy supplies. Energy service companies offer an alternative to traditional providers, which supply a single utility product to satisfy the unconstrained demand of end users, and have been identified as a potentially important actor in sustainable future economies. An agent-based model is developed to examine the potential of energy service companies to contribute to the large scale upgrading of household energy efficiency, which would ultimately lead to a more sustainable and secure energy infrastructure. The migration of households towards energy service companies is described by an attractiveness array, through which potential customers can evaluate the future benefits, in terms of household energy costs, of changing provider. It is shown that self-financing is a limiting factor to the widespread upgrading of residential energy efficiency. Greater reductions in household energy costs could be achieved by committing to longer term contracts, allowing upgrade costs to be distributed over greater time intervals. A steadily increasing cost of future energy usage lends an element of stability to the market, with energy service companies displaying the ability to retain customers on contract expiration. The model highlights how a greater focus on the provision of energy services, as

  2. Substance Use Disorders in Elderly Admissions to an Academic Psychiatric Inpatient Service over a 10-Year Period

    Directory of Open Access Journals (Sweden)

    Dennis Dombrowski

    2016-01-01

    Full Text Available Objective. There is a paucity of research on substance use disorders (SUDs in the elderly psychiatric population. This study examines SUDs in a geriatric psychiatry inpatient service over a 10-year period. Methods. Data from 1788 elderly psychiatric inpatients from a ten-year period was collected. Variables collected included psychiatric diagnoses, SUD, number of psychiatric admissions, and length of stay. Those with and without a SUD were compared using Chi-Square or Student’s t-test as appropriate using SPSS. Results. 11.7% (N=210 of patients had a SUD, and the most common substance was alcohol at 73.3% (N=154 or 8.6% of all admissions. Other SUDs were sedative-hypnotics (11%, opiate (2.9%, cannabis (1%, tobacco (1.4%, and unspecified SUD (38.6%. SUD patients were significantly younger, divorced, male, and less frequently readmitted and had shorter lengths of stay. The most common comorbid diagnoses were major depression (26.1%, bipolar disorder (10.5%, and dementia (17.1%. Conclusions. Over 10% of psychogeriatric admissions were associated with a SUD, with alcohol being the most common. Considering the difficulties in diagnosing SUD in this population and the retrospective study design, the true prevalence in elderly psychiatric inpatients is likely higher. This study adds to sparse literature on SUD in elderly psychiatric patients.

  3. Service orientation in holonic and multi-agent manufacturing

    CERN Document Server

    Thomas, André; Trentesaux, Damien

    2015-01-01

    This volume gathers the peer reviewed papers presented at the 4th edition of the International Workshop “Service Orientation in Holonic and Multi-agent Manufacturing – SOHOMA’14” organized and hosted on November 5-6, 2014 by the University of Lorraine, France in collaboration with the CIMR Research Centre of the University Politehnica of Bucharest and the TEMPO Laboratory of the University of Valenciennes and Hainaut-Cambrésis.   The book is structured in six parts, each one covering a specific research line which represents a trend in future manufacturing: (1) Holonic and Agent-based Industrial Automation Systems; (2) Service-oriented Management and Control of Manufacturing Systems; (3) Distributed Modelling for Safety and Security in Industrial Systems; (4) Complexity, Big Data and Virtualization in Computing-oriented Manufacturing; (5) Adaptive, Bio-inspired and Self-organizing Multi-Agent Systems for Manufacturing, and (6) Physical Internet Simulation, Modelling and Control.   There is a clear ...

  4. A Computational Agent-Based Modeling Approach for Competitive Wireless Service Market

    KAUST Repository

    Douglas, C C; Hyoseop Lee,; Wonsuck Lee,

    2011-01-01

    Using an agent-based modeling method, we study market dynamism with regard to wireless cellular services that are in competition for a greater market share and profit. In the proposed model, service providers and consumers are described as agents

  5. A retrospective study of the impact of a telephone alert service (Healthy Outlook) on hospital admissions for patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Sarran, Christophe; Halpin, David; Levy, Mark L; Prigmore, Samantha; Sachon, Patrick

    2014-10-23

    Healthy Outlook is a service delivered by the UK Met Office directly to patients with chronic obstructive pulmonary disease (COPD) that has been in place since 2006. Its objective is to reduce the severity and length of COPD exacerbations, hence improving the quality of life and life expectancy. To assess the effect of the Healthy Outlook service on hospital admission rates of all general practitioners that have used the service. Control practices were selected for each of the 661 participating practices. The number of hospital admissions for each practice was extracted from the Hospital Episode Statistics database. The differences in admission rates per practice between the first year of use of the Healthy Outlook service and the previous year were compared by paired t-test analyses. For admissions with a primary diagnosis of COPD, the difference between participating and control practices was -0.8% (95% confidence interval (CI)=-1.8 to 0.2%; P=0.13). For admissions with a primary or co-morbid diagnosis of COPD, the difference was -2.3% (95% CI=-4.2 to -0.4%; P=0.02). Participation in the Healthy Outlook service reduces hospital admission rates for patients coded on discharge with COPD (including co-morbid).

  6. 49 CFR 40.331 - To what additional parties must employers and service agents release information?

    Science.gov (United States)

    2010-10-01

    ... service agents release information? 40.331 Section 40.331 Transportation Office of the Secretary of... Release of Information § 40.331 To what additional parties must employers and service agents release information? As an employer or service agent you must release information under the following circumstances...

  7. Semantic Web Services with Web Ontology Language (OWL-S) - Specification of Agent-Services for DARPA Agent Markup Language (DAML)

    National Research Council Canada - National Science Library

    Sycara, Katia P

    2006-01-01

    CMU did research and development on semantic web services using OWL-S, the semantic web service language under the Defense Advanced Research Projects Agency- DARPA Agent Markup Language (DARPA-DAML) program...

  8. 31 CFR 401.1 - Secret Service agents authorized to make seizures.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Secret Service agents authorized to... Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY SEIZURE AND FORFEITURE OF VESSELS, VEHICLES... Secret Service agents authorized to make seizures. All officers of the U.S. Secret Service engaged in the...

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

    Science.gov (United States)

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

    2018-01-01

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

  10. Surgical assessment clinic - One stop emergency out-patient clinic for rapid assessment, reduced admissions and improved acute surgical service: A quality improvement study

    Directory of Open Access Journals (Sweden)

    Christina A.W. Macano

    2017-11-01

    Conclusion: By providing suitable guidance for referring practitioners we have optimised our clinic use significantly and improved our acute ambulatory surgical care. We have reduced admissions, provided rapid treatment and have established a service that helps address the ever increasing demand on acute services within the NHS.

  11. Parallel Agent-as-a-Service (P-AaaS Based Geospatial Service in the Cloud

    Directory of Open Access Journals (Sweden)

    Xicheng Tan

    2017-04-01

    Full Text Available To optimize the efficiency of the geospatial service in the flood response decision making system, a Parallel Agent-as-a-Service (P-AaaS method is proposed and implemented in the cloud. The prototype system and comparisons demonstrate the advantages of our approach over existing methods. The P-AaaS method includes both parallel architecture and a mechanism for adjusting the computational resources—the parallel geocomputing mechanism of the P-AaaS method used to execute a geospatial service and the execution algorithm of the P-AaaS based geospatial service chain, respectively. The P-AaaS based method has the following merits: (1 it inherits the advantages of the AaaS-based method (i.e., avoiding transfer of large volumes of remote sensing data or raster terrain data, agent migration, and intelligent conversion into services to improve domain expert collaboration; (2 it optimizes the low performance and the concurrent geoprocessing capability of the AaaS-based method, which is critical for special applications (e.g., highly concurrent applications and emergency response applications; and (3 it adjusts the computing resources dynamically according to the number and the performance requirements of concurrent requests, which allows the geospatial service chain to support a large number of concurrent requests by scaling up the cloud-based clusters in use and optimizes computing resources and costs by reducing the number of virtual machines (VMs when the number of requests decreases.

  12. Predictors of mental health-related acute service utilisation and treatment costs in the 12 months following an acute psychiatric admission.

    Science.gov (United States)

    Siskind, Dan; Harris, Meredith; Diminic, Sandra; Carstensen, Georgia; Robinson, Gail; Whiteford, Harvey

    2014-11-01

    A key step in informing mental health resource allocation is to identify the predictors of service utilisation and costs. This project aims to identify the predictors of mental health-related acute service utilisation and treatment costs in the year following an acute public psychiatric hospital admission. A dataset containing administrative and routinely measured outcome data for 1 year before and after an acute psychiatric admission for 1757 public mental health patients was analysed. Multivariate regression models were developed to identify patient- and treatment-related predictors of four measures of service utilisation or cost: (a) duration of index admission; and, in the year after discharge from the index admission (b) acute psychiatric inpatient bed-days; (c) emergency department (ED) presentations; and (d) total acute mental health service costs. Split-sample cross-validation was used. A diagnosis of psychosis, problems with living conditions and prior acute psychiatric inpatient bed-days predicted a longer duration of index admission, while prior ED presentations and self-harm predicted a shorter duration. A greater number of acute psychiatric inpatient bed-days in the year post-discharge were predicted by psychosis diagnosis, problems with living conditions and prior acute psychiatric inpatient admissions. The number of future ED presentations was predicted by past ED presentations. For total acute care costs, diagnosis of psychosis was the strongest predictor. Illness acuity and prior acute psychiatric inpatient admission also predicted higher costs, while self-harm predicted lower costs. The development of effective models for predicting acute mental health treatment costs using existing administrative data is an essential step towards a workable activity-based funding model for mental health. Future studies would benefit from the inclusion of a wider range of variables, including ethnicity, clinical complexity, cognition, mental health legal status

  13. [Validation of a triage scale: first step in patient admission and in emergency service models].

    Science.gov (United States)

    Legrand, A; Thys, F; Vermeiren, E; Touwaide, M; D'Hoore, W; Hubin, V; Reynaert, M S

    2003-03-01

    At present, most emergency services handle the multitude of various demands in the same unity of place and by the same team of nurses aides, with direct consequences on the waiting time and in the handling of problems of varying degrees of importance. Our service examines other administrative models based on a triage of time and of orientation. In a prospective study on 679 patients, we have validated a triage tool inspired from the ICEM model (International Cooperation of Emergency Medicine) allowing patients to receive, while they wait, information and training, based on the resources provided, in order to deal with their particular medical problem. The validation of this tool was carried out in terms of its utilization as well as its reliability. It appears that, with the type of triage offered, there is a theoretical reserve of waiting time for the patients in which the urgency is relative, and which could be better used in the handling of more vital cases.

  14. A hospital-based palliative care service for patients with advanced organ failure in sub-Saharan Africa reduces admissions and increases home death rates.

    Science.gov (United States)

    Desrosiers, Taylor; Cupido, Clint; Pitout, Elizabeth; van Niekerk, Lindi; Badri, Motasim; Gwyther, Liz; Harding, Richard

    2014-04-01

    Despite emerging data of cost savings under palliative care in various regions, no such data have been generated in response to the high burden of terminal illness in Africa. This evaluation of a novel hospital-based palliative care service for patients with advanced organ failure in urban South Africa aimed to determine whether the service reduces admissions and increases home death rates compared with the same fixed time period of standard hospital care. Data on admissions and place of death were extracted from routine hospital activity records for a fixed period before death, using standard patient daily expense rates. Data from the first 56 consecutive deaths under the new service (intervention group) were compared with 48 consecutive deaths among patients immediately before the new service (historical controls). Among the intervention and control patients, 40 of 56 (71.4%) and 47 of 48 (97.9%), respectively, had at least one admission (P home death was achieved by 33 of 56 (58.9%) and nine of 48 (18.8%), respectively (P ≤ 0.001). These data demonstrate that an outpatient hospital-based service reduced admissions and improved the rate of home deaths and offers a feasible and cost-effective model for such settings. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  15. Analysing admission rules to a service system with two job classes and mandatory pre-emption

    DEFF Research Database (Denmark)

    Larsen, Christian

    , the pre-emptive action will cause a time delay before the server can start the service. Therefoe, the administrator might in some instances deny a class 2 job access to an idle server and instead hold it back in queue. We develop a semi-Markov decision model for this problem. In order to compute......We consider a queueing system consisting of S identical servers and two job classes, where class 1 jobs must always be processed as soon as possible. Therefore, the administrator of the system must, if neccesary, pre-empt a class 2 job and allocate the server to an arriving class 1 job. However...

  16. Agent-Based Framework for Personalized Service Provisioning in Converged IP Networks

    Science.gov (United States)

    Podobnik, Vedran; Matijasevic, Maja; Lovrek, Ignac; Skorin-Kapov, Lea; Desic, Sasa

    In a global multi-service and multi-provider market, the Internet Service Providers will increasingly need to differentiate in the service quality they offer and base their operation on new, consumer-centric business models. In this paper, we propose an agent-based framework for the Business-to-Consumer (B2C) electronic market, comprising the Consumer Agents, Broker Agents and Content Agents, which enable Internet consumers to select a content provider in an automated manner. We also discuss how to dynamically allocate network resources to provide end-to-end Quality of Service (QoS) for a given consumer and content provider.

  17. Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

    Science.gov (United States)

    Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

    2014-12-01

    Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

  18. Integrating a Patient-Controlled Admission Program Into Mental Health Hospital Service: A Multicenter Grounded Theory Study

    DEFF Research Database (Denmark)

    Ellegaard, Trine; Bliksted, Vibeke Fuglsang; Mehlsen, Mimi Yung

    2018-01-01

    Patient-controlled admissions (PCAs) enable mental health patients by means of a contract to initiate an admission at a mental health hospital unit without using traditional admission procedures. This study was part of a 3-year Danish multicenter project, and we explored how mental health...... the mental health professionals strived to integrate PCA into clinical practice. The process was motivated by the idea of establishing a partnership with patients and involved two interrelated strategies to manage (a) the patient-related duties and (b) the admission contracts. The professionals moved from...

  19. [Nutritional status in patients first hospital admissions service hematology National Cancer Institute].

    Science.gov (United States)

    Baltazar Luna, E; Omaña Guzmán, L I; Ortiz Hernández, L; Ñamendis-Silva, S A; De Nicola Delfin, L

    2013-01-01

    To determine the nutritional status of patients admitted to hospital for the first time the hematology service and who have not received treatment for cancer, to know if the nutritional status assessed by the EGS-GP and serum albumin related mortality of patients A longitudinal, prospective, analytical. EGS-Through GP assessed the nutritional status of patients, we used SPSS 19.0 for data analysis. Evaluaron 119 patients, 52.1% female and 47.9% male. The most common diagnosis was non-Hodgkin lymphoma in 43.7%. According to the EGS-GP 50.4% of patients had some degree of malnutrition or was at risk of suffering of which: 31.1% had moderate and 19.3% had severe malnutrition. The 49.6% of patients had an adequate nutritional status. 30.3% of the patients who died, 37% had severe malnutrition and 50% severe decrease in albumin concentration. The prevalence of malnutrition in hematological patients treated at the National Cancer Institute of Mexico that have not received medical treatment was high. There is an association between nutritional status and mortality in this patient group. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  20. Improvement in the distribution of services in multi-agent systems with SCODA

    Directory of Open Access Journals (Sweden)

    Jesús Ángel ROMÁN GALLEGO

    2016-06-01

    Full Text Available The distribution of services on multi-agent systems allows it to reduce to the agents their computational load. The functionality of the system does not reside in the agents themselves, however it is ubiquitously distributed so that allows you to perform tasks in parallel avoiding an additional computational cost to the elements in the system. The distribution of services that offers SCODA (Distributed and Specialized Agent Communities allows an intelligent management of these services provided by agents of the system and the parallel execution of threads that allow to respond to requests asynchronously, which implies an improvement in the performance of the system at both the computational level as the level of quality of service in the control of these services. The comparison carried out in the case of study that is presented in this paper demonstrates the existing improvement in the distribution of services on systems based on SCODA.

  1. [Structure, organization and capacity problems in emergency medical services, emergency admission and intensive care units].

    Science.gov (United States)

    Dick, W

    1994-01-01

    clinical pictures. Cost effectiveness is clearly in favor of emergency medicine. Future developments will be characterized by the consequences of new health care legislation and by effects of financial stringencies on the emergency medical services.

  2. 49 CFR 40.341 - Must service agents comply with DOT drug and alcohol testing requirements?

    Science.gov (United States)

    2010-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Roles and Responsibilities of Service Agents § 40.341 Must service agents comply with DOT drug and alcohol testing... requirements of this part and the DOT agency drug and alcohol testing regulations. (b) If you do not comply...

  3. 49 CFR 40.17 - Is an employer responsible for obtaining information from its service agents?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Is an employer responsible for obtaining... Responsibilities § 40.17 Is an employer responsible for obtaining information from its service agents? Yes, as an employer, you are responsible for obtaining information required by this part from your service agents...

  4. An Exception Handling Service for Software Agent Ensembles

    National Research Council Canada - National Science Library

    Klein, Mark

    2004-01-01

    ... (I) the creation of better contingent contracts between agents (both human and software- based) as well as (2) exception-handling agents that monitor MAS for problem symptoms, diagnose the underlying problems, and intervene as appropriate to avoid or resolve these problems.

  5. Reducing hospital admissions and improving the diagnosis of COPD in Southampton City: methods and results of a 12-month service improvement project.

    Science.gov (United States)

    Wilkinson, Tom; North, Mal; Bourne, Simon C

    2014-08-21

    The British Lung Foundation highlighted Southampton City as a hotspot for patients at future risk of chronic obstructive pulmonary disease (COPD) exacerbations due to severe deprivation levels and a high undiagnosed level of disease based on health economic modelling. We developed a strategy spanning primary and secondary care to reduce emergency admissions of patients with acute exacerbations of COPD and increase the diagnosed prevalence of COPD on general practitioner (GP) registers closer to that predicted from local modelling. A comprehensive 3-year audit of admissions was performed. Patients who had been admitted with an exacerbation to University Hospital Southampton three or more times in the previous 12 months were cohorted and cared for in a consultant-led, but community based, COPD service. Within primary care, a programme of education and case-based finding was delivered to most practices within the city. Thirty-four patients were found to be responsible for 176 admissions (22% of total COPD admissions) to the hospital. These 34 patients required 185 active interventions during the 12-month period but only 39 hospital admissions. The 30-day readmission rate dropped from 13.4 to 1.9% (Pmodel.

  6. Smart Aerospace eCommerce: Using Intelligent Agents in a NASA Mission Services Ordering Application

    Science.gov (United States)

    Moleski, Walt; Luczak, Ed; Morris, Kim; Clayton, Bill; Scherf, Patricia; Obenschain, Arthur F. (Technical Monitor)

    2002-01-01

    This paper describes how intelligent agent technology was successfully prototyped and then deployed in a smart eCommerce application for NASA. An intelligent software agent called the Intelligent Service Validation Agent (ISVA) was added to an existing web-based ordering application to validate complex orders for spacecraft mission services. This integration of intelligent agent technology with conventional web technology satisfies an immediate NASA need to reduce manual order processing costs. The ISVA agent checks orders for completeness, consistency, and correctness, and notifies users of detected problems. ISVA uses NASA business rules and a knowledge base of NASA services, and is implemented using the Java Expert System Shell (Jess), a fast rule-based inference engine. The paper discusses the design of the agent and knowledge base, and the prototyping and deployment approach. It also discusses future directions and other applications, and discusses lessons-learned that may help other projects make their aerospace eCommerce applications smarter.

  7. Agent Based Knowledge Management Solution using Ontology, Semantic Web Services and GIS

    Directory of Open Access Journals (Sweden)

    Andreea DIOSTEANU

    2009-01-01

    Full Text Available The purpose of our research is to develop an agent based knowledge management application framework using a specific type of ontology that is able to facilitate semantic web service search and automatic composition. This solution can later on be used to develop complex solutions for location based services, supply chain management, etc. This application for modeling knowledge highlights the importance of agent interaction that leads to efficient enterprise interoperability. Furthermore, it proposes an "agent communication language" ontology that extends the OWL Lite standard approach and makes it more flexible in retrieving proper data for identifying the agents that can best communicate and negotiate.

  8. BROSMAP: A Novel Broadcast Based Secure Mobile Agent Protocol for Distributed Service Applications

    Directory of Open Access Journals (Sweden)

    Dina Shehada

    2017-01-01

    Full Text Available Mobile agents are smart programs that migrate from one platform to another to perform the user task. Mobile agents offer flexibility and performance enhancements to systems and service real-time applications. However, security in mobile agent systems is a great concern. In this paper, we propose a novel Broadcast based Secure Mobile Agent Protocol (BROSMAP for distributed service applications that provides mutual authentication, authorization, accountability, nonrepudiation, integrity, and confidentiality. The proposed system also provides protection from man in the middle, replay, repudiation, and modification attacks. We proved the efficiency of the proposed protocol through formal verification with Scyther verification tool.

  9. Decentralized Services Orchestration Using Intelligent Mobile Agents with Deadline Restrictions

    OpenAIRE

    Magalhães , Alex; Lung , Lau Cheuk; Rech , Luciana

    2010-01-01

    International audience; The necessity for better performance drives service orchestration towards decentralization. There is a recent approach where the integrator - that traditionally centralizes all corporative services and business logics - remains as a repository of interface services, but now lacks to know all business logics and business workflows. There are several techniques using this recent approach, including hybrid solutions, peer-to-peer solutions and trigger-based mechanisms. A ...

  10. A framework for service enterprise workflow simulation with multi-agents cooperation

    Science.gov (United States)

    Tan, Wenan; Xu, Wei; Yang, Fujun; Xu, Lida; Jiang, Chuanqun

    2013-11-01

    Process dynamic modelling for service business is the key technique for Service-Oriented information systems and service business management, and the workflow model of business processes is the core part of service systems. Service business workflow simulation is the prevalent approach to be used for analysis of service business process dynamically. Generic method for service business workflow simulation is based on the discrete event queuing theory, which is lack of flexibility and scalability. In this paper, we propose a service workflow-oriented framework for the process simulation of service businesses using multi-agent cooperation to address the above issues. Social rationality of agent is introduced into the proposed framework. Adopting rationality as one social factor for decision-making strategies, a flexible scheduling for activity instances has been implemented. A system prototype has been developed to validate the proposed simulation framework through a business case study.

  11. 49 CFR 551.66 - What is the legal effect of service of process on an agent?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false What is the legal effect of service of process on... Service of Process on Foreign Manufacturers and Importers Method of Service of Process § 551.66 What is the legal effect of service of process on an agent? Service on an agent of administrative or judicial...

  12. Modeling the Interaction Between Semantic Agents and Semantic Web Services Using MDA Approach

    NARCIS (Netherlands)

    Kardas, Geylani; Göknil, Arda; Dikenelli, Oguz; Topaloglu, N. Yasemin

    2007-01-01

    In this paper, we present our metamodeling approach for integrating semantic web services and semantic web enabled agents under Model Driven Architecture (MDA) view which defines a conceptual framework to realize model driven development. We believe that agents must have well designed environment

  13. 49 CFR 40.329 - What information must laboratories, MROs, and other service agents release to employees?

    Science.gov (United States)

    2010-10-01

    ... other service agents release to employees? 40.329 Section 40.329 Transportation Office of the Secretary... Confidentiality and Release of Information § 40.329 What information must laboratories, MROs, and other service agents release to employees? (a) As an MRO or service agent you must provide, within 10 business days of...

  14. 49 CFR 40.403 - Must a service agent notify its clients when the Department issues a PIE?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Must a service agent notify its clients when the... Must a service agent notify its clients when the Department issues a PIE? (a) As a service agent, if... clients, in writing, about the issuance, scope, duration, and effect of the PIE. You may meet this...

  15. Service Orientation in Holonic and Multi-Agent Manufacturing Control

    CERN Document Server

    Thomas, André; Trentesaux, Damien

    2012-01-01

    Service orientation is emerging nowadays at multiple organizational levels in enterprise business, and it leverages technology in response to the growing need for greater business integration, flexibility and agility of manufacturing enterprises. This book gathers contributions from scientists, researchers and industrialists on concepts, methods, frameworks and implementing issues addressing trends in the service orientation of control technology and management applied to manufacturing enterprise. It analyzes a Service Oriented Architecture (SOA) representing a technical architecture, a business modelling concept, a type of infrastructure, an integration source and a new way of viewing units of automation within the enterprise. The presents how SOA aligns the business world with the world of information technology in a way that makes both more effective.  

  16. Distributing emotional services in ambient intelligence through cognitive agents

    NARCIS (Netherlands)

    Acampora, G.; Loia, V.; Vitiello, A.

    2011-01-01

    Ambient Intelligence (AmI) is a pervasive computing paradigm whose main aim is to design smart environments composed of invisible, connected, intelligent and interactive systems, which are naturally sensitive and responsive to the presence of people, providing advanced services for improving the

  17. Semantics of agent-based service delegation and alignment

    NARCIS (Netherlands)

    Balsters, H; Huitema, GB; Szirbik, NB; Meersman, R; Tari, Z; Herrero, P; Mendez, G; Cavedon, L; Martin, D; Hinze, A; Buchanan, G; Perez, MS; Robles,; Humble, J; Albani, A; Dietz, JLG; Panetto, H; Scannapieco, M; Halpin, T; Spyns, P; Zaha, JM; Zimanyi, E; Stefanakis, E; Dillon, T; Feng, L; Jarrar, M; Lehmann, J; DeMoor, A; Duval, E; Aroyo, L

    2005-01-01

    In this paper we concentrate on conceptual modeling and semantics of service delegation and alignment in information systems. In delegation, a source company wishes to hand over parts of its functionality together with related responsibilities to a supplying party. From the side of the outsourcer

  18. Ethics in Providing Tourism Services by Travel Agents in Serbia

    OpenAIRE

    Ivana Mišković

    2012-01-01

    This paper attempts to answer the usually neglected ethical questions of the interaction between tourism workers and participants in tourism movements and users of tourism services in general. Contact with numerous people in the work place, dynamic work with customers, continuous phone calls and stress due to constant responsibility, are just some of the conditions which tourism workers encounter on the daily basis and which sometimes make them ask themselves: Am I really able t...

  19. Opportunities of creating multi-agent systems in the service sector

    Directory of Open Access Journals (Sweden)

    Shatsky A.A.

    2017-03-01

    Full Text Available the paper seeks to examine opportunities to create multi-agent systems (MAS in the service sector. Using methods of theoretical analysis and synthesis, the author attempts to apply a multi-agent technology to description of the socio-economic system, such as the service sector. As a result, the author identifies three types of MAS in the service sector based on different types of architecture of intelligent information systems. The research shows that the problem posed by the author requires further study and clarification of results

  20. 6th Workshop on Service Orientation in Holonic and Multi-Agent Manufacturing

    CERN Document Server

    Trentesaux, Damien; Thomas, André; Leitão, Paulo; Oliveira, José

    2017-01-01

    The book offers an integrated vision on Cloud and HPC, Big Data, Analytics and virtualization in computing-oriented manufacturing, combining information and communication technologies, service-oriented control of holonic architectures as well as enterprise integration solutions based on SOA principles. It is structured in eight parts, each one grouping research and trends in digital manufacturing and service oriented manufacturing control: Cloud and Cyber-Physical Systems for Smart Manufacturing, Reconfigurable and Self-organized Multi-Agent Systems for Industry and Service, Sustainability Issues in Intelligent Manufacturing Systems, Holonic and Multi-agent System Design for Industry and Service, Should Intelligent Manufacturing Systems be Dependable and Safe?, Service-oriented Management and Control of Manufacturing Systems, Engineering and Human Integration in Flexible and Reconfigurable Industrial Systems,Virtualization and Simulation in Computing-oriented Industry and Service.

  1. Agent paradigm and services technology for distributed Information Sources

    Directory of Open Access Journals (Sweden)

    Hakima Mellah

    2011-10-01

    Full Text Available The complexity of information is issued from interacting information sources (IS, and could be better exploited with respect to relevance of information. In distributed IS system, relevant information has a content that is in connection with other contents in information network, and is used for a certain purpose. The highlighting point of the proposed model is to contribute to information system agility according to a three-dimensional view involving the content, the use and the structure. This reflects the relevance of information complexity and effective methodologies through self organized principle to manage the complexity. This contribution is primarily focused on presenting some factors that lead and trigger for self organization in a Service Oriented Architecture (SOA and how it can be possible to integrate self organization mechanism in the same.

  2. Does psychopathology at admission predict the length of inpatient stay in psychiatry? Implications for financing psychiatric services

    Directory of Open Access Journals (Sweden)

    Herwig Uwe

    2011-07-01

    Full Text Available Abstract Background The debate on appropriate financing systems in inpatient psychiatry is ongoing. In this context, it is important to control resource use in terms of length of stay (LOS, which is the most costly factor in inpatient care and the one that can be influenced most easily. Previous studies have shown that psychiatric diagnoses provide only limited justification for explaining variation in LOS, and it has been suggested that measures such as psychopathology might be more appropriate to predict resource use. Therefore, we investigated the relationship between LOS and psychopathological syndromes or symptoms at admission as well as other characteristics such as sociodemographic and clinical variables. Methods We considered routine medical data of patients admitted to the Psychiatric University Hospital Zurich in the years 2008 and 2009. Complete data on psychopathology at hospital admission were available in 3,220 inpatient episodes. A subsample of 2,939 inpatient episodes was considered in final statistical models, including psychopathology as well as complete datasets of further measures (e.g. sociodemographic, clinical, treatment-related and psychosocial variables. We used multivariate linear as well as logistic regression analysis with forward selection procedure to determine the predictors of LOS. Results All but two syndrome scores (mania, hostility were positively related to the length of stay. Final statistical models showed that syndromes or symptoms explained about 5% of the variation in length of stay. The inclusion of syndromes or symptoms as well as basic treatment variables and other factors led to an explained variation of up to 25%. Conclusions Psychopathological syndromes and symptoms at admission and further characteristics only explained a small proportion of the length of inpatient stay. Thus, according to our sample, psychopathology might not be suitable as a primary indicator for estimating LOS and contingent

  3. Does psychopathology at admission predict the length of inpatient stay in psychiatry? Implications for financing psychiatric services

    Science.gov (United States)

    2011-01-01

    Background The debate on appropriate financing systems in inpatient psychiatry is ongoing. In this context, it is important to control resource use in terms of length of stay (LOS), which is the most costly factor in inpatient care and the one that can be influenced most easily. Previous studies have shown that psychiatric diagnoses provide only limited justification for explaining variation in LOS, and it has been suggested that measures such as psychopathology might be more appropriate to predict resource use. Therefore, we investigated the relationship between LOS and psychopathological syndromes or symptoms at admission as well as other characteristics such as sociodemographic and clinical variables. Methods We considered routine medical data of patients admitted to the Psychiatric University Hospital Zurich in the years 2008 and 2009. Complete data on psychopathology at hospital admission were available in 3,220 inpatient episodes. A subsample of 2,939 inpatient episodes was considered in final statistical models, including psychopathology as well as complete datasets of further measures (e.g. sociodemographic, clinical, treatment-related and psychosocial variables). We used multivariate linear as well as logistic regression analysis with forward selection procedure to determine the predictors of LOS. Results All but two syndrome scores (mania, hostility) were positively related to the length of stay. Final statistical models showed that syndromes or symptoms explained about 5% of the variation in length of stay. The inclusion of syndromes or symptoms as well as basic treatment variables and other factors led to an explained variation of up to 25%. Conclusions Psychopathological syndromes and symptoms at admission and further characteristics only explained a small proportion of the length of inpatient stay. Thus, according to our sample, psychopathology might not be suitable as a primary indicator for estimating LOS and contingent costs. This might be

  4. Ethics in Providing Tourism Services by Travel Agents in Serbia

    Directory of Open Access Journals (Sweden)

    Ivana Mišković

    2012-07-01

    Full Text Available This paper attempts to answer the usually neglected ethical questions of the interaction between tourism workers and participants in tourism movements and users of tourism services in general. Contact with numerous people in the work place, dynamic work with customers, continuous phone calls and stress due to constant responsibility, are just some of the conditions which tourism workers encounter on the daily basis and which sometimes make them ask themselves: Am I really able to do this job? Will their behaviour with each customer be ethical? Will they be able to hide from the customers their stress, nervousness and mental fatigue? Have all the employees in travel agencies attended the training courses in communication with customers, or does everything depend on their own decisions and home upbringing? Is it worth taking risk and putting agency`s reputation at stake? Which moral dilemmas do the tour guides encounter on the journeys? These are just some of the questions which will be put in the spotlight in this paper. The aim of this paper is to indicate the necessity to establish the codes of conduct for all professionals who are in direct contact with tourists

  5. FACTORS INFLUENCING THE QUALITY OF PROVIDED SERVICES IN THE VISION OF TRAVEL AGENTS IN SUCEAVA MUNICIPALITY

    Directory of Open Access Journals (Sweden)

    Cristian Valentin HAPENCIUC

    2015-07-01

    Full Text Available Taking into account its pragmatic meaning, the success of a travel agency frequently relies on the activity of travel agents. In the process of promoting and selling flat voyages, customer service can be directly influenced by the interaction of factors such as: offer accuracy, sales representatives quality, employee timeliness, politeness of the travel agent, maintaining eye contact etc., all of which are components of the offered product. Thereby, we conducted, within the period 5 - 15 March 2015, a research based on interviews with 26 travel agents from 20 different units, in order to determine their awareness about potential factors that may have an influence on the quality of offered services. By the instrumentality of a questionnaire, we attempted to assess the integrity and loyalty of employees, their attitude regarding the activities they carry, their dissatisfaction, negative and  positive factors influencing service quality, and their positioning to the organization and brand.

  6. Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: a retrospective database study of national health service hospitals in England

    Directory of Open Access Journals (Sweden)

    Mohammed Mohammed A

    2012-04-01

    Full Text Available Abstract Background Although acute hospitals offer a twenty-four hour seven day a week service levels of staffing are lower over the weekends and some health care processes may be less readily available over the weekend. Whilst it is thought that emergency admission to hospital on the weekend is associated with an increased risk of death, the extent to which this applies to elective admissions is less well known. We investigated the risk of death in elective and elective patients admitted over the weekend versus the weekdays. Methods Retrospective statistical analysis of routinely collected acute hospital admissions in England, involving all patient discharges from all acute hospitals in England over a year (April 2008-March 2009, using a logistic regression model which adjusted for a range of patient case-mix variables, seasonality and admission over a weekend separately for elective and emergency (but excluding zero day stay emergency admissions discharged alive admissions. Results Of the 1,535,267 elective admissions, 91.7% (1,407,705 were admitted on the weekday and 8.3% (127,562 were admitted on the weekend. The mortality following weekday admission was 0.52% (7,276/1,407,705 compared with 0.77% (986/127,562 following weekend admission. Of the 3,105,249 emergency admissions, 76.3% (2,369,316 were admitted on the weekday and 23.7% (735,933 were admitted on the weekend. The mortality following emergency weekday admission was 6.53% (154,761/2,369,316 compared to 7.06% (51,922/735,933 following weekend admission. After case-mix adjustment, weekend admissions were associated with an increased risk of death, especially in the elective setting (elective Odds Ratio: 1.32, 95% Confidence Interval 1.23 to 1.41; vs emergency Odds Ratio: 1.09, 95% Confidence Interval 1.05 to 1.13. Conclusions Weekend admission appears to be an independent risk factor for dying in hospital and this risk is more pronounced in the elective setting. Given the planned

  7. Cost-effectiveness of national mandatory screening of all admissions to English National Health Service hospitals for meticillin-resistant Staphylococcus aureus: a mathematical modelling study.

    Science.gov (United States)

    Robotham, Julie V; Deeny, Sarah R; Fuller, Chris; Hopkins, Susan; Cookson, Barry; Stone, Sheldon

    2016-03-01

    In December, 2010, National Health Service (NHS) England introduced national mandatory screening of all admissions for meticillin-resistant Staphylococcus aureus (MRSA). We aimed to assess the effectiveness and cost-effectiveness of this policy, from a regional or national health-care decision makers' perspective, compared with alternative screening strategies. We used an individual-based dynamic transmission model parameterised with national MRSA audit data to assess the effectiveness and cost-effectiveness of admission screening of patients in English NHS hospitals compared with five alternative strategies (including no screening, checklist-activated screening, and high-risk specialty-based screening), accompanied by patient isolation and decolonisation, over a 5 year time horizon. We evaluated strategies for different NHS hospital types (acute, teaching, and specialist), MRSA prevalence, and transmission potentials using probabilistic sensitivity analyses. Compared with no screening, mean cost per quality-adjusted life-year (QALY) of screening all admissions was £89,000-148,000 (range £68,000-222,000), and this strategy was consistently more costly and less effective than alternatives for all hospital types. At a £30,000/QALY willingness-to-pay threshold and current prevalence, only the no-screening strategy was cost effective. The next best strategies were, in acute and teaching hospitals, targeting of high-risk specialty admissions (30-40% chance of cost-effectiveness; mean incremental cost-effectiveness ratios [ICERs] £45,200 [range £35,300-61,400] and £48,000/QALY [£34,600-74,800], respectively) and, in specialist hospitals, screening these patients plus risk-factor-based screening of low-risk specialties (a roughly 20% chance of cost-effectiveness; mean ICER £62,600/QALY [£48,000-89,400]). As prevalence and transmission increased, targeting of high-risk specialties became the optimum strategy at the NHS willingness-to-pay threshold (£30,000/QALY

  8. A Computational Agent-Based Modeling Approach for Competitive Wireless Service Market

    KAUST Repository

    Douglas, C C

    2011-04-01

    Using an agent-based modeling method, we study market dynamism with regard to wireless cellular services that are in competition for a greater market share and profit. In the proposed model, service providers and consumers are described as agents who interact with each other and actively participate in an economically well-defined marketplace. Parameters of the model are optimized using the Levenberg-Marquardt method. The quantitative prediction capabilities of the proposed model are examined through data reproducibility using past data from the U.S. and Korean wireless service markets. Finally, we investigate a disruptive market event, namely the introduction of the iPhone into the U.S. in 2007 and the resulting changes in the modeling parameters. We predict and analyze the impacts of the introduction of the iPhone into the Korean wireless service market assuming a release date of 2Q09 based on earlier data. © 2011 IEEE.

  9. [Links between non-professional agents and the official Veterinary Services in sub-Saharan Africa].

    Science.gov (United States)

    Diop, B A; Bessin, R

    2004-04-01

    Para-professional agents known as auxiliaries, or community animal health workers, provide low-cost basic veterinary services to communities of livestock producers. A 2003 survey of 16 Sub-Saharan African countries, carried out as part of the Pan-African Programme for the Control of Epizootics, showed that in the majority of cases, the official Veterinary Services have no (or very few) links with the auxiliaries, although they are well aware of their existence and in some cases the auxiliaries have been trained by officials of the Veterinary Services. However, there are isolated cases of countries establishing more formal links, for example, recognising the status of an auxiliary, recognising auxiliaries with no definition of a status, attaching auxiliaries to Veterinary Service staff, establishing agreements for the provision of auxiliary services through livestock producer associations, harmonising auxiliary training programmes, issuing professional auxiliary cards, and setting up a consultation framework on the issue of auxiliaries. Unlike private veterinarians, agents of the official services do not generally perceive auxiliaries as competitors, and sometimes collaboration develops at this level. The authors propose several measures to improve links between the official Veterinary Services and auxiliaries, as follows: the fields of competence of auxiliaries should be defined and their curriculum harmonised, the status of auxiliaries should be recognised, a monitoring and assessment mechanism should be established at senior level in the Veterinary Services, training for livestock producers should be improved.

  10. Semantic Agent-Based Service Middleware and Simulation for Smart Cities.

    Science.gov (United States)

    Liu, Ming; Xu, Yang; Hu, Haixiao; Mohammed, Abdul-Wahid

    2016-12-21

    With the development of Machine-to-Machine (M2M) technology, a variety of embedded and mobile devices is integrated to interact via the platform of the Internet of Things, especially in the domain of smart cities. One of the primary challenges is that selecting the appropriate services or service combination for upper layer applications is hard, which is due to the absence of a unified semantical service description pattern, as well as the service selection mechanism. In this paper, we define a semantic service representation model from four key properties: Capability (C), Deployment (D), Resource (R) and IOData (IO). Based on this model, an agent-based middleware is built to support semantic service enablement. In this middleware, we present an efficient semantic service discovery and matching approach for a service combination process, which calculates the semantic similarity between services, and a heuristic algorithm to search the service candidates for a specific service request. Based on this design, we propose a simulation of virtual urban fire fighting, and the experimental results manifest the feasibility and efficiency of our design.

  11. Semantic Agent-Based Service Middleware and Simulation for Smart Cities

    Directory of Open Access Journals (Sweden)

    Ming Liu

    2016-12-01

    Full Text Available With the development of Machine-to-Machine (M2M technology, a variety of embedded and mobile devices is integrated to interact via the platform of the Internet of Things, especially in the domain of smart cities. One of the primary challenges is that selecting the appropriate services or service combination for upper layer applications is hard, which is due to the absence of a unified semantical service description pattern, as well as the service selection mechanism. In this paper, we define a semantic service representation model from four key properties: Capability (C, Deployment (D, Resource (R and IOData (IO. Based on this model, an agent-based middleware is built to support semantic service enablement. In this middleware, we present an efficient semantic service discovery and matching approach for a service combination process, which calculates the semantic similarity between services, and a heuristic algorithm to search the service candidates for a specific service request. Based on this design, we propose a simulation of virtual urban fire fighting, and the experimental results manifest the feasibility and efficiency of our design.

  12. Semantic Agent-Based Service Middleware and Simulation for Smart Cities

    Science.gov (United States)

    Liu, Ming; Xu, Yang; Hu, Haixiao; Mohammed, Abdul-Wahid

    2016-01-01

    With the development of Machine-to-Machine (M2M) technology, a variety of embedded and mobile devices is integrated to interact via the platform of the Internet of Things, especially in the domain of smart cities. One of the primary challenges is that selecting the appropriate services or service combination for upper layer applications is hard, which is due to the absence of a unified semantical service description pattern, as well as the service selection mechanism. In this paper, we define a semantic service representation model from four key properties: Capability (C), Deployment (D), Resource (R) and IOData (IO). Based on this model, an agent-based middleware is built to support semantic service enablement. In this middleware, we present an efficient semantic service discovery and matching approach for a service combination process, which calculates the semantic similarity between services, and a heuristic algorithm to search the service candidates for a specific service request. Based on this design, we propose a simulation of virtual urban fire fighting, and the experimental results manifest the feasibility and efficiency of our design. PMID:28009818

  13. Emergency department admissions are more profitable than non-emergency department admissions.

    Science.gov (United States)

    Henneman, Philip L; Lemanski, Michael; Smithline, Howard A; Tomaszewski, Andrew; Mayforth, Janice A

    2009-02-01

    We compare the contribution margin per case per hospital day of emergency department (ED) admissions with non-ED admissions in a single hospital, a 600-bed, academic, tertiary referral, Level I trauma center with an annual ED census of 100,000. This was a retrospective comparison of the contribution margin per case per day for ED and non-ED inpatient admissions for fiscal years 2003, 2004, and 2005 (October 1 through September 30). Contribution margin is defined as net revenue minus total direct costs; it is then expressed per case per hospital day. Service lines are a set of linked patient care services. Observation admissions and outpatient services are not included. Resident expenses (eg, salary and benefits) and revenue (ie, Medicare payment of indirect medical expenses and direct medical expenses) are not included. Overhead expenses are not included (eg, building maintenance, utilities, information services support, administrative services). For fiscal year 2003 through fiscal year 2005, there were 51,213 ED and 57,004 non-ED inpatient admissions. Median contribution margin per day for ED admissions was higher than for non-ED admissions: ED admissions $769 (interquartile range $265 to $1,493) and non-ED admissions $595 (interquartile range $178 to $1,274). Median contribution margin per day varied by site of admissions, by diagnosis-related group, by service line, and by insurance type. In summary, ED admissions in our institution generate a higher contribution margin per day than non-ED admissions.

  14. Lambdastation: a forwarding and admission control service to interface production network facilities with advanced research network paths

    Energy Technology Data Exchange (ETDEWEB)

    DeMar, Philip; Petravick, Don; /Fermilab

    2004-12-01

    Over the past several years, there has been a great deal of research effort and funding put into the deployment of optical-based, advanced technology wide-area networks. Fermilab and CalTech have initiated a project to enable our production network facilities to exploit these advanced research network facilities. Our objective is to forward designated data transfers across these advanced wide area networks on a per-flow basis, making use our capacious production-use storage systems connected to the local campus network. To accomplish this, we intend to develop a dynamically provisioned forwarding service that would provide alternate path forwarding onto available wide area advanced research networks. The service would dynamically reconfigure forwarding of specific flows within our local production-use network facilities, as well as provide an interface to enable applications to utilize the service. We call this service LambdaStation. If one envisions wide area optical network paths as high bandwidth data railways, then LambdaStation would functionally be the railroad terminal that regulates which flows at the local site get directed onto the high bandwidth data railways. LambdaStation is a DOE-funded SciDac research project in its very early stage of development.

  15. Personality as predictor of customer service centre agent performance in the banking industry: An exploratory study

    Directory of Open Access Journals (Sweden)

    Linda Blignaut

    2014-10-01

    Research purpose: The aim of the study was to identify personality traits, as measured by the Occupational Personality Questionnaire 32r (item response theory scored version, including the more parsimonious Big Five personality traits, that may act as job performance predictors for customer service centre (CSC agents in the banking industry. Motivation for the study: This study provides an exploratory investigation of whether specific personality traits differ amongst CSC agents in the banking industry, based on their job performance. No published research in this field could be identified. Research design, approach and method: Purposive sampling was used to collect data from the entire CSC agent base of a particular banking group (N = 89. Responses were analysed by means of quantitative techniques. Main findings and practical/managerial implications: Results indicate that parsimonious traits of personality, expressed as the Big Five personality traits, predict job performance. The importance of carefully selecting suitable job performance criteria for a specific environment, however, emerged as a critical issue in performance prediction. Contribution: The study focuses attention on the importance of CSC agents’ performance as frontline staff in the banking industry and identifying valid criteria for selecting the most suitable agents. Providing a one-contact point of service such as a CSC is a fairly new approach in the South African banking industry and this study provides an initial investigation of personality traits that may serve as job performance predictors in this environment.

  16. AN AUTOMATED END-TO-END MULTI-AGENT QOS BASED ARCHITECTURE FOR SELECTION OF GEOSPATIAL WEB SERVICES

    Directory of Open Access Journals (Sweden)

    M. Shah

    2012-07-01

    With the proliferation of web services published over the internet, multiple web services may provide similar functionality, but with different non-functional properties. Thus, Quality of Service (QoS offers a metric to differentiate the services and their service providers. In a quality-driven selection of web services, it is important to consider non-functional properties of the web service so as to satisfy the constraints or requirements of the end users. The main intent of this paper is to build an automated end-to-end multi-agent based solution to provide the best-fit web service to service requester based on QoS.

  17. 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...

  18. Utilization of psychiatric services by female military personnel changes since admission of women to all German Armed Forces military careers.

    Science.gov (United States)

    Zimmermann, Peter; Ströhle, Andreas; Langner, Franziska; Lanczik, Mario

    2010-07-01

    In 2001, women were admitted to all military careers in the German Armed Forces. This study examines whether the utilization of psychiatric services of female military personnel has changed since then. The central medical database of German military personnel for the years 2000 and 2006 was analyzed. Between 2000 and 2006, the percentage (based on the average totals of male and female military personnel) of consultations of primary care unit surgeons for psychiatric problems increased significantly for both male and female military personnel, this increase being more apparent for women than for men. Stress-related disorders showed the greatest rise. In 2006, as opposed to 2000, the total proportion of both outpatient and inpatient mental health treatment provided to female military personnel was significantly higher than for males, particularly regarding stress-related, affective and personality disorders. Gender-specific aspects should be considered more intensely in preventive and therapeutic psychiatric supply in the German Armed Forces.

  19. Agent Services for Situation Aware Control of Power Systems With Distributed Generation

    DEFF Research Database (Denmark)

    Saleem, Arshad; Heussen, Kai; Lind, Morten

    2009-01-01

    Electric Power system of Denmark exhibits some unique characteristics. An increasing part of the electricity is produced by distributed generators (DGs). Most of these DGs are connected to the network at the distribution level. At the same time the concept of vehicle to grid (V2G) is already...... in the process of realization. This situation has created an incentive in electric power industry to utilize modern information and communication technologies (ICT) for improving the distribution system automation. This paper describes our work on how significantly increased amount of distributed generation...... services. We present results from several experiments where agents offer and utilize services in order to achieve distributed and autonomous control for subgrid operation of a distribution system. Finally it is discussed how the service oriented architecture can be combined with knowledge based reasoning...

  20. Service for fault tolerance in the Ad Hoc Networks based on Multi Agent Systems

    Directory of Open Access Journals (Sweden)

    Ghalem Belalem

    2011-02-01

    Full Text Available The Ad hoc networks are distributed networks, self-organized and does not require infrastructure. In such network, mobile infrastructures are subject of disconnections. This situation may concern a voluntary or involuntary disconnection of nodes caused by the high mobility in the Ad hoc network. In these problems we are trying through this work to contribute to solving these problems in order to ensure continuous service by proposing our service for faults tolerance based on Multi Agent Systems (MAS, which predict a problem and decision making in relation to critical nodes. Our work contributes to study the prediction of voluntary and involuntary disconnections in the Ad hoc network; therefore we propose our service for faults tolerance that allows for effective distribution of information in the Network by selecting some objects of the network to be duplicates of information.

  1. 17 CFR 279.4 - Form ADV-NR, appointment of agent for service of process by non-resident general partner and non...

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form ADV-NR, appointment of agent for service of process by non-resident general partner and non-resident managing agent of an... agent for service of process by non-resident general partner and non-resident managing agent of an...

  2. Low Vocational Outcome Among People Diagnosed With Borderline Personality Disorder During First Admission to Mental Health Services in Denmark: A Nationwide 9-Year Register-Based Study.

    Science.gov (United States)

    Hastrup, Lene Halling; Kongerslev, Mickey T; Simonsen, Erik

    2018-03-05

    Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0.68; 95% CI [0.61, 0.76]) of being in work/under education after 9 years. Individuals diagnosed with BPD also showed more impairment in long-term vocational outcome than other personality disorders, and lower labor-market attachment than other psychiatric disorders except for schizophrenia, schizotypal and delusional disorders, and mental and behavioral disorders due to psychoactive substance use. Intervention programs addressing social psychiatric aspects of BPD in terms of work functioning is henceforth an important area for future research.

  3. Twitter web-service for soft agent reporting in persistent surveillance systems

    Science.gov (United States)

    Rababaah, Haroun; Shirkhodaie, Amir

    2010-04-01

    Persistent surveillance is an intricate process requiring monitoring, gathering, processing, tracking, and characterization of many spatiotemporal events occurring concurrently. Data associated with events can be readily attained by networking of hard (physical) sensors. Sensors may have homogeneous or heterogeneous (hybrid) sensing modalities with different communication bandwidth requirements. Complimentary to hard sensors are human observers or "soft sensors" that can report occurrences of evolving events via different communication devices (e.g., texting, cell phones, emails, instant messaging, etc.) to the command control center. However, networking of human observers in ad-hoc way is rather a difficult task. In this paper, we present a Twitter web-service for soft agent reporting in persistent surveillance systems (called Web-STARS). The objective of this web-service is to aggregate multi-source human observations in hybrid sensor networks rapidly. With availability of Twitter social network, such a human networking concept can not only be realized for large scale persistent surveillance systems (PSS), but also, it can be employed with proper interfaces to expedite rapid events reporting by human observers. The proposed technique is particularly suitable for large-scale persistent surveillance systems with distributed soft and hard sensor networks. The efficiency and effectiveness of the proposed technique is measured experimentally by conducting several simulated persistent surveillance scenarios. It is demonstrated that by fusion of information from hard and soft agents improves understanding of common operating picture and enhances situational awareness.

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. Lexical Profiles of Thailand University Admission Tests

    Science.gov (United States)

    Cherngchawano, Wirun; Jaturapitakkul, Natjiree

    2014-01-01

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

  7. Socio-Ecohydrologic Agents And Services: Integrating Human And Natural Components To Address Coupled System Resilience

    Science.gov (United States)

    Pavao-zuckerman, M.; Pope, A.; Chan, D.; Curl, K.; Gimblett, H. R.; Hough, M.; House-Peters, L.; Lee, R.; Scott, C. A.

    2012-12-01

    Riparian corridors in arid regions are highly valued for their relative scarcity, and because healthy riparian systems support high levels of biodiversity, can meet human demand for water and water-related resources and functions. Our team is taking a transdiciplinary social-ecological systems approach to assessing riparian corridor resilience in two watersheds (the San Pedro River in USA and Mexico, and the Rio San Miguel in Mexico) through a project funded by the NSF CNH program ("Strengthening Resilience of Arid Region Riparian Corridors"). Multiple perspectives are integrated in the project, including hydrology, ecology, institutional dynamics, and decision making (at the level of both policy and individual choice), as well as the perspectives of various stakeholder groups and individuals in the watersheds. Here we discuss initial findings that center around linking changes in ecohydrology and livelihoods related to decisions in response to climatic, ecological, and social change. The research team is implementing two approaches to integrate the disparate disciplines participating in the research (and the varied perspectives among the stakeholders in this binational riparian context): (1) ecosystem service assessment, and (2) agent based model simulation. We are developing an ecosystem service perspective that provides a bridge between ecological dynamics in the landscape and varied stakeholder perspectives on the implications of ecohydrology for well-being (economic, cultural, ecological). Services are linked on one hand to the spatial patterns of traits of individuals within species (allowing a more predictive application of ecosystem services as they vary with community change in time), and to stakeholder perspectives (facilitating integration of ecosystem services into our understanding of decision making processes) in a case study in the San Pedro River National Conservation Area. The agent- based model (ABM) approach incorporates the influence of human

  8. Agent-based organizational modelling for analysis of safety culture at an air navigation service provider

    International Nuclear Information System (INIS)

    Stroeve, Sybert H.; Sharpanskykh, Alexei; Kirwan, Barry

    2011-01-01

    Assessment of safety culture is done predominantly by questionnaire-based studies, which tend to reveal attitudes on immaterial characteristics (values, beliefs, norms). There is a need for a better understanding of the implications of the material aspects of an organization (structures, processes, etc.) for safety culture and their interactions with the immaterial characteristics. This paper presents a new agent-based organizational modelling approach for integrated and systematic evaluation of material and immaterial characteristics of socio-technical organizations in safety culture analysis. It uniquely considers both the formal organization and the value- and belief-driven behaviour of individuals in the organization. Results are presented of a model for safety occurrence reporting at an air navigation service provider. Model predictions consistent with questionnaire-based results are achieved. A sensitivity analysis provides insight in organizational factors that strongly influence safety culture indicators. The modelling approach can be used in combination with attitude-focused safety culture research, towards an integrated evaluation of material and immaterial characteristics of socio-technical organizations. By using this approach an organization is able to gain a deeper understanding of causes of diverse problems and inefficiencies both in the formal organization and in the behaviour of organizational agents, and to systematically identify and evaluate improvement options.

  9. Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study

    Directory of Open Access Journals (Sweden)

    Ukkola Anniina

    2012-09-01

    Full Text Available Abstract Background Approximately 1% of the population suffer from coeliac disease. However, the disease is heavily underdiagnosed. Unexplained symptoms may lead to incremented medical consultations and productivity losses. The aim here was to estimate the possible concealed burden of untreated coeliac disease and the effects of a gluten-free diet. Methods A nationwide cohort of 700 newly detected adult coeliac patients were prospectively evaluated. Health care service use and sickness absence from work during the year before diagnosis were compared with those in the general population; the data obtained from an earlier study. Additionally, the effect of one year on dietary treatment on the aforementioned parameters and on consumption of pharmaceutical agents was assessed. Results Untreated coeliac patients used primary health care services more frequently than the general population. On a gluten-free diet, visits to primary care decreased significantly from a mean 3.6 to 2.3. The consumption of medicines for dyspepsia (from 3.7 to 2.4 pills/month and painkillers (6.8-5.5 pills/month and the number of antibiotic courses (0.6-0.5 prescriptions/year was reduced. There were no changes in hospitalizations, outpatient visits to secondary and tertiary care, use of other medical services, or sickness absence, but the consumption of nutritional supplements increased on treatment. Conclusions Coeliac disease was associated with excessive health care service use and consumption of drugs before diagnosis. Dietary treatment resulted in a diminished burden to the health care system and lower use of on-demand medicines and antibiotic treatment. The results support an augmented diagnostic approach to reduce underdiagnosis of coeliac disease. Trial registration ClinicalTrials.gov NCT01145287

  10. Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study.

    Science.gov (United States)

    Ukkola, Anniina; Kurppa, Kalle; Collin, Pekka; Huhtala, Heini; Forma, Leena; Kekkonen, Leila; Mäki, Markku; Kaukinen, Katri

    2012-09-27

    Approximately 1% of the population suffer from coeliac disease. However, the disease is heavily underdiagnosed. Unexplained symptoms may lead to incremented medical consultations and productivity losses. The aim here was to estimate the possible concealed burden of untreated coeliac disease and the effects of a gluten-free diet. A nationwide cohort of 700 newly detected adult coeliac patients were prospectively evaluated. Health care service use and sickness absence from work during the year before diagnosis were compared with those in the general population; the data obtained from an earlier study. Additionally, the effect of one year on dietary treatment on the aforementioned parameters and on consumption of pharmaceutical agents was assessed. Untreated coeliac patients used primary health care services more frequently than the general population. On a gluten-free diet, visits to primary care decreased significantly from a mean 3.6 to 2.3. The consumption of medicines for dyspepsia (from 3.7 to 2.4 pills/month) and painkillers (6.8-5.5 pills/month) and the number of antibiotic courses (0.6-0.5 prescriptions/year) was reduced. There were no changes in hospitalizations, outpatient visits to secondary and tertiary care, use of other medical services, or sickness absence, but the consumption of nutritional supplements increased on treatment. Coeliac disease was associated with excessive health care service use and consumption of drugs before diagnosis. Dietary treatment resulted in a diminished burden to the health care system and lower use of on-demand medicines and antibiotic treatment. The results support an augmented diagnostic approach to reduce underdiagnosis of coeliac disease. ClinicalTrials.gov NCT01145287.

  11. Peadiatric social admission

    OpenAIRE

    Carter Anand, Janet

    2009-01-01

    The phenomenon of paediatric social admission describes the hospitalisation of children for medicallynon- urgent and/or social reasons. Much of the research in this field has been in relation to avoidable admissions which have been identified, studied and condoned based on strict medical criteria. Such research has tended to mask the significance of social factors and the commonplace practice of Paediatric Social Admission. This paper examines decision making from the perspective of the healt...

  12. 49 CFR 40.15 - May an employer use a service agent to meet DOT drug and alcohol testing requirements?

    Science.gov (United States)

    2010-10-01

    ... drug and alcohol testing requirements? 40.15 Section 40.15 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Employer Responsibilities § 40.15 May an employer use a service agent to meet DOT drug and alcohol testing requirements? (a...

  13. An Automated End-To Multi-Agent Qos Based Architecture for Selection of Geospatial Web Services

    Science.gov (United States)

    Shah, M.; Verma, Y.; Nandakumar, R.

    2012-07-01

    Over the past decade, Service-Oriented Architecture (SOA) and Web services have gained wide popularity and acceptance from researchers and industries all over the world. SOA makes it easy to build business applications with common services, and it provides like: reduced integration expense, better asset reuse, higher business agility, and reduction of business risk. Building of framework for acquiring useful geospatial information for potential users is a crucial problem faced by the GIS domain. Geospatial Web services solve this problem. With the help of web service technology, geospatial web services can provide useful geospatial information to potential users in a better way than traditional geographic information system (GIS). A geospatial Web service is a modular application designed to enable the discovery, access, and chaining of geospatial information and services across the web that are often both computation and data-intensive that involve diverse sources of data and complex processing functions. With the proliferation of web services published over the internet, multiple web services may provide similar functionality, but with different non-functional properties. Thus, Quality of Service (QoS) offers a metric to differentiate the services and their service providers. In a quality-driven selection of web services, it is important to consider non-functional properties of the web service so as to satisfy the constraints or requirements of the end users. The main intent of this paper is to build an automated end-to-end multi-agent based solution to provide the best-fit web service to service requester based on QoS.

  14. International Workshop on Service Orientation in Holonic and Multi-Agent Manufacturing

    CERN Document Server

    Trentesaux, Damien; Thomas, André; McFarlane, Duncan

    2016-01-01

    This volume gathers the peer reviewed papers which were presented at the 5th edition of the International Workshop “Service Orientation in Holonic and Multi-agent Man-ufacturing – SOHOMA’15” organized in November 5-6, 2015 by the Institute for Manufacturing (IfM) of the University of Cambridge, UK in collaboration with the CIMR Research Centre in Computer Integrated Manufacturing and Robotics of the University Politehnica of Bucharest, Romania, the LAMIH Laboratory of Industrial and Human Automation Control, Mechanical Engineering and Computer Science of the University of Valenciennes and Hainaut-Cambrésis, France and the CRAN Re-search Centre for Automatic Control, Nancy of the University of Lorraine, France. The book is structured in seven parts, each one grouping a number of chapters de-scribing research in actual domains of the digital transformation in manufacturing and trends in future manufacturing control: (1) Applications of Intelligent Products; (2) Advances in Control of Physical Internet ...

  15. What works in 'real life' to facilitate home deaths and fewer hospital admissions for those at end of life?: results from a realist evaluation of new palliative care services in two English counties.

    Science.gov (United States)

    Wye, Lesley; Lasseter, Gemma; Percival, John; Duncan, Lorna; Simmonds, Bethany; Purdy, Sarah

    2014-01-01

    WE EVALUATED END OF LIFE CARE SERVICES IN TWO ENGLISH COUNTIES INCLUDING: coordination centres, telephone advice line, 'Discharge in Reach' nurses, a specialist community personal care team and community nurse educators. Elsewhere, we published findings detailing high family carer satisfaction and fewer hospital admissions, Accident and Emergency attendances and hospital deaths for service users compared to controls. The aim of this paper is to discuss what contributed to those outcomes. Using realist evaluation, data collection included documentation (e.g. referral databases), 15 observations of services and interviews with 43 family carers and 105 professionals. Data were analysed using framework analysis, applying realist evaluation concepts. Findings were discussed at successive team meetings and further data was collected until team consensus was reached. Services 'worked' primarily for those with cancer with 'fast track' funding who were close to death. Factors contributing to success included services staffed with experienced palliative care professionals with dedicated (and sufficient) time for difficult conversations with family carers, patients and/or clinical colleagues about death and the practicalities of caring for the dying. Using their formal and informal knowledge of the local healthcare system, they accessed community resources to support homecare and delivered excellent services. This engendered confidence and reassurance for staff, family carers and patients, possibly contributing to less hospital admissions and A&E attendances and more home deaths. With demand for 24-hour end of life care growing and care provision fragmented across health and social care boundaries, services like these that cut across organisational sectors may become more important. They offer an overview to help navigate those desiring a home death through the system.

  16. An agent-based peer-to-peer architecture for semantic discovery of manufacturing services across virtual enterprises

    Science.gov (United States)

    Zhang, Wenyu; Zhang, Shuai; Cai, Ming; Jian, Wu

    2015-04-01

    With the development of virtual enterprise (VE) paradigm, the usage of serviceoriented architecture (SOA) is increasingly being considered for facilitating the integration and utilisation of distributed manufacturing resources. However, due to the heterogeneous nature among VEs, the dynamic nature of a VE and the autonomous nature of each VE member, the lack of both sophisticated coordination mechanism in the popular centralised infrastructure and semantic expressivity in the existing SOA standards make the current centralised, syntactic service discovery method undesirable. This motivates the proposed agent-based peer-to-peer (P2P) architecture for semantic discovery of manufacturing services across VEs. Multi-agent technology provides autonomous and flexible problemsolving capabilities in dynamic and adaptive VE environments. Peer-to-peer overlay provides highly scalable coupling across decentralised VEs, each of which exhibiting as a peer composed of multiple agents dealing with manufacturing services. The proposed architecture utilises a novel, efficient, two-stage search strategy - semantic peer discovery and semantic service discovery - to handle the complex searches of manufacturing services across VEs through fast peer filtering. The operation and experimental evaluation of the prototype system are presented to validate the implementation of the proposed approach.

  17. An Admissions Officer's Credentials

    Science.gov (United States)

    Chronicle of Higher Education, 2007

    2007-01-01

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

  18. A Stunning Admission

    Science.gov (United States)

    Hu, Helen

    2012-01-01

    Few people set out to become admissions counselors, say people in the profession. But the field is requiring skills that are more demanding and varied than ever. And at a time when universities are looking especially hard at the bottom line, people in admissions need to constantly learn new things and make themselves indispensable. Counselors…

  19. Advice on Admissions Transparency

    Science.gov (United States)

    Australian Government Tertiary Education Quality and Standards Agency, 2018

    2018-01-01

    Admissions transparency means that prospective domestic undergraduate students can easily find good quality admissions information that allows them to compare courses and providers and make informed study choices. In October 2016 the Higher Education Standards Panel (HESP) made recommendations to achieve greater transparency in higher education…

  20. Vascular quality of care pilot study: how admission to a vascular surgery service affects evidence-based pharmacologic risk factor modification in patients with lower extremity peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Steenhof N

    2014-06-01

    Full Text Available Naomi Steenhof,1,2 Francesca Le Piane,1 Kori Leblanc,1–3 Naomi R Eisenberg,4 Yvonne Kwan,1 Christine Malmberg,1,6 Alexandra Papadopoulos,5,7 Graham Roche-Nagle4,7,8 1Department of Pharmacy, University Health Network, 2Leslie Dan Faculty of Pharmacy, University of Toronto, 3Centre for Innovation in Complex Care, University Health Network, 4Division of Vascular Surgery, University Health Network, 5Faculty of Nursing, University of Toronto, Toronto, ON, 6Victoria General Hospital, Vancouver Island Health Authority, Victoria, BC, 7Peter Munk Cardiac Centre, University Health Network, 8Faculty of Medicine, University of Toronto, Toronto, ON, Canada Background: Peripheral arterial disease (PAD guidelines recommend aggressive risk factor modification to improve cardiovascular outcomes. Recommended pharmacologic therapies include antiplatelets, angiotensin converting enzyme (ACE inhibitors, and HMG-CoA-reductase inhibitors (statins. Purpose: We studied the degree to which patient admission to a vascular surgery service increased the use of these therapies. Patients and methods: The authors conducted a retrospective chart review of 150 patients with PAD admitted to the vascular surgery service at a large Canadian tertiary care hospital. The use of recommended pharmacologic therapies at the time of admission and discharge were compared. A multidisciplinary clinical team established criteria by which patients were deemed ineligible to receive any of the recommended therapies. Angiotensin receptor blockers (ARBs were considered an alternative to ACE inhibitors. Results: Prior to hospital admission, 64% of patients were on antiplatelet therapy, 67% were on an ACE inhibitor or ARB, and 71% were on a statin. At the time of discharge, 91% of patients were on an antiplatelet (or not, with an acceptable reason, 77% were on an ACE inhibitor or an ARB (or not, with an acceptable reason, and 85% were on a statin (or not, with an acceptable reason. While new

  1. 26 CFR 31.3306(n)-1 - Services on American vessel whose business is conducted by general agent of Secretary of Commerce.

    Science.gov (United States)

    2010-04-01

    ... conducted by general agent of Secretary of Commerce. 31.3306(n)-1 Section 31.3306(n)-1 Internal Revenue... conducted by general agent of Secretary of Commerce. (a) Section 3306(n) and this section of the regulations... by a general agent of the Secretary of Commerce. Whether services performed by such an officer or...

  2. 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.

  3. 17 CFR 239.43 - Form F-N, appointment of agent for service of process by foreign banks and foreign insurance...

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Form F-N, appointment of agent for service of process by foreign banks and foreign insurance companies and certain of their holding... agent for service of process by foreign banks and foreign insurance companies and certain of their...

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

    Science.gov (United States)

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

    2015-06-01

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

  5. Undergraduate Admissions | NSU

    Science.gov (United States)

    . Continuing Education Financial Aid Career Development Regional Campuses International Affairs Veterans Admissions Honors College Experiential Education Study Abroad Research Opportunities Career Preparation SharkLink California Disclosure International Affairs Undergraduate Advising Career Development Libraries at

  6. Assessing the Effectiveness of Payments for Ecosystem Services: an Agent-Based Modeling Approach

    Directory of Open Access Journals (Sweden)

    Xiaodong Chen

    2014-03-01

    Full Text Available Payments for ecosystem services (PES have increasingly been implemented to protect and restore ecosystems worldwide. The effectiveness of conservation investments in PES may differ under alternative policy scenarios and may not be sustainable because of uncertainties in human responses to policies and dynamic human-nature interactions. To assess the impacts of these interactions on the effectiveness of PES programs, we developed a spatially explicit agent-based model: human and natural interactions under policies (HANIP. We used HANIP to study the effectiveness of China's Natural Forest Conservation Program (NFCP and alternative policy scenarios in a coupled human-nature system, China's Wolong Nature Reserve, where indigenous people's use of fuelwood affects forests. We estimated the effects of the current NFCP, which provides a cash payment, and an alternative payment scenario that provides an electricity payment by comparing forest dynamics under these policies to forest dynamics under a scenario in which no payment is provided. In 2007, there were 337 km² of forests in the study area of 515 km². Under the baseline projection in which no payment is provided, the forest area is expected to be 234 km² in 2030. Under the current NFCP, there are likely to be 379 km² of forests in 2030, or an increase of 145 km² of forests to the baseline projection. If the cash payment is replaced with an electricity payment, there are likely to be 435 km² of forests in 2030, or an increase of 201 km² of forests to the baseline projection. However, the effectiveness of the NFCP may be threatened by the behavior of newly formed households if they are not included in the payment scheme. In addition, the effects of socio-demographic factors on forests will also differ under different policy scenarios. Human and natural interactions under policies (HANIP and its modeling framework may also be used to assess the effectiveness of many other PES programs around

  7. [The admission to Nursing Homes and Home care services of elderly patients: analysis of the trend from 2008 to 2011 in a North Italian district].

    Science.gov (United States)

    Caporale, Loretta; Czaplejewicz, Monika; Odasmini, Bruna

    2014-01-01

    The effects of the economic crisis impact on several aspects, included the use of health and social services. To analyze the effects of the economic recession on the request of in-home and long run social-health services. Retrospective research. The databases of a In-home Nursing Service, the Social Services and the Welfare area of a Social-Health Local Service in North of Italy have been consulted, with reference to the period between 31st December 2008 to 31st December 2011. From 2008 to 2011 the users supported by the In-Home Nursing Service increased by 30.3% while a decrease in the waiting lists for public and private nursing homes was observed. The users of In-Home Assistance Service decreased by 11%, as well as recipients of In-Home Meal Service (33%). Since 2008, the number of regional economic allowance beneficiaries dramatically increased; these allowances are dispensed as a support to In-Home Nursing Service and to social frailty. Profound changes of the offer and use of long term care services is evident. The endurance of this trend could impair the In-Home Nursing Services ability to answer to health needs of citizens. Health care professionals should strengthen the educational interventions to improve the level of patients'self care.

  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 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...

  10. 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...

  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 2016

    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 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...

  14. 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...

  15. 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...

  16. Nonimmigrant Admissions: Fiscal Year 2014

    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. 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...

  18. 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...

  19. Nonimmigrant Admissions: Fiscal Year 2004

    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...

  20. Nonimmigrant Admissions: Fiscal Year 2015

    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...

  1. Maintenance service contract model for heavy equipment in mining industry using principal agent theory

    Science.gov (United States)

    Pakpahan, Eka K. A.; Iskandar, Bermawi P.

    2015-12-01

    Mining industry is characterized by a high operational revenue, and hence high availability of heavy equipment used in mining industry is a critical factor to ensure the revenue target. To maintain high avaliability of the heavy equipment, the equipment's owner hires an agent to perform maintenance action. Contract is then used to control the relationship between the two parties involved. The traditional contracts such as fixed price, cost plus or penalty based contract studied is unable to push agent's performance to exceed target, and this in turn would lead to a sub-optimal result (revenue). This research deals with designing maintenance contract compensation schemes. The scheme should induce agent to select the highest possible maintenance effort level, thereby pushing agent's performance and achieve maximum utility for both parties involved. Principal agent theory is used as a modeling approach due to its ability to simultaneously modeled owner and agent decision making process. Compensation schemes considered in this research includes fixed price, cost sharing and revenue sharing. The optimal decision is obtained using a numerical method. The results show that if both parties are risk neutral, then there are infinite combination of fixed price, cost sharing and revenue sharing produced the same optimal solution. The combination of fixed price and cost sharing contract results in the optimal solution when the agent is risk averse, while the optimal combination of fixed price and revenue sharing contract is obtained when agent is risk averse. When both parties are risk averse, the optimal compensation scheme is a combination of fixed price, cost sharing and revenue sharing.

  2. Agent-based self-service technology adoption model for air-travelers: Exploring best operational practices

    Science.gov (United States)

    Ueda, Keiichi; Kurahashi, Setsuya

    2018-02-01

    The continuous development of the service economy and an aging society with fewer children is expected to lead to a shortage of workers in the near future. In addition, the growth of the service economy would require service providers to meet various service requirements. In this regard, self-service technology (SST) is a promising alternative to securing labor in both developed and emerging countries. SST is expected to coordinate the controllable productive properties in order to optimize resources and minimize consumer stress. As services are characterized by simultaneity and inseparability, a smoother operation in cooperation with the consumer is required to provide a certain level of service. This study focuses on passenger handling in an airport departure lobby with the objective of optimizing multiple service resources comprising interpersonal service staff and self-service kiosks. Our aim is to elucidate the passenger decision- making mechanism of choosing either interpersonal service or self-service as the check-in option, and to apply it to analyze several scenarios to determine the best practice. The experimental space is studied and an agent-based model is proposed to analyze the operational efficiency via a simulation. We expand on a previous SST adoption model, which is enhanced by introducing the concept of individual traits. We focus on the decision-making of individuals who are neutral toward the service option, by tracking the actual activity of passengers and mapping their behavior into the model. A new method of validation that follows a different approach is proposed to ensure that this model approximates real-world situations. A scenario analysis is then carried out with the aim of exploring the best operational practice to minimize the stress experienced by the air travelers and to meet the business needs of the airline managers at the airport. We collected actual data from the Departure Control System of an airline to map the real-world data

  3. Agent-Based Self-Service Technology Adoption Model for Air-Travelers: Exploring Best Operational Practices

    Directory of Open Access Journals (Sweden)

    Keiichi Ueda

    2018-02-01

    Full Text Available The continuous development of the service economy and an aging society with fewer children is expected to lead to a shortage of workers in the near future. In addition, the growth of the service economy would require service providers to meet various service requirements. In this regard, self-service technology (SST is a promising alternative to securing labor in both developed and emerging countries. SST is expected to coordinate the controllable productive properties in order to optimize resources and minimize consumer stress. As services are characterized by simultaneity and inseparability, a smoother operation in cooperation with the consumer is required to provide a certain level of service. This study focuses on passenger handling in an airport departure lobby with the objective of optimizing multiple service resources comprising interpersonal service staff and self-service kiosks. Our aim is to elucidate the passenger decision-making mechanism of choosing either interpersonal service or self-service as the check-in option, and to apply it to analyze several scenarios to determine the best practice. The experimental space is studied and an agent-based model is proposed to analyze the operational efficiency via a simulation. We expand on a previous SST adoption model, which is enhanced by introducing the concept of individual traits. We focus on the decision-making of individuals who are neutral toward the service option, by tracking the actual activity of passengers and mapping their behavior into the model. A new method of validation that follows a different approach is proposed to ensure that this model approximates real-world situations. A scenario analysis is then carried out with the aim of exploring the best operational practice to minimize the stress experienced by the air travelers and to meet the business needs of the airline managers at the airport. We collected actual data from the Departure Control System of an airline to map

  4. 17 CFR 249.250 - Form F-X, for appointment of agent for service of process by issuers registering securities on...

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form F-X, for appointment of agent for service of process by issuers registering securities on Form F-8, F-9, F-10 or F-80 (§ 239.38... F-X, for appointment of agent for service of process by issuers registering securities on Form F-8...

  5. 17 CFR 269.5 - Form F-X, for appointment of agent for service of process by issuers registering securities on...

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form F-X, for appointment of agent for service of process by issuers registering securities on Form F-8, F-9, F-10 or F-80 (§§ 239... INDENTURE ACT OF 1939 § 269.5 Form F-X, for appointment of agent for service of process by issuers...

  6. Radiographic scanning agent

    International Nuclear Information System (INIS)

    Tofe, A.J.

    1976-01-01

    A stable radiographic scanning agent on a sup(99m)Tc basis has been developed. The substance contains a pertechnetate reduction agent, tin(II)-chloride, chromium(II)-chloride, or iron(II)-sulphate, as well as an organospecific carrier and ascorbic acid or a pharmacologically admissible salt or ester of ascorbic acid. (VJ) [de

  7. Characteristics of Pregnant Teen Substance Abuse Treatment Admissions

    Science.gov (United States)

    ... treatment admission (“other female teen admissions”). Note that TEDS is a census of all admissions to treatment facilities reported to the Substance Abuse and Mental Health Services Administration (SAMHSA) by State substance abuse agencies. IN BRIEF X X Between 2007 and 2010, about 57,000 ...

  8. Multi-agent agro-economic simulation of irrigation water demand with climate services for climate change adaptation

    Directory of Open Access Journals (Sweden)

    Stefano Balbi

    2013-09-01

    Full Text Available Farmers’ irrigation practices play a crucial role in the sustainability of crop production and water consumption, and in the way they deal with the current and future effects of climate change. In this study, a system dynamic multi-agent model adopting the soil water balance provided by the Food and Agriculture Organization (FAO Irrigation and Drainage Paper 56 was developed to explore how farmers’ decision making may affect future water needs and use with a focus on the role of climate services, i.e. forecasts and insurance. A climatic projection record representing the down-scaled A1B market scenario (a balance across all sources of the assessment report of the Intergovernmental Panel on Climate Change (IPCC is used to produce future daily data about relative humidity, precipitation, temperature and wind speed. Two types of meteorological services are made available: i a bi-weekly bulletin; and ii seasonal forecasts. The precision of these services was altered to represent different conditions, from perfect knowledge to poor forecasts. Using the available forecasts, farming agents take adaptation decisions concerning crop allocation and irrigation management on the basis of their own risk attitudes. Farmers’ attitudes are characterized by fuzzy classifications depending on age, relative income and crop profitability. Farming agents’ adaptation decisions directly affect the crop and irrigation parameters, which in turn affect future water needs on a territorial level. By incorporating available and future meteorological services, the model allows the farmer’s decision making-process to be explored together with the consequent future irrigation water demand for the period 2015 to 2030. The model prototype is applied to a data set of the Venice Lagoon Watershed, an area of 2038 km2 in north-east Italy, for a preliminary test of its performance and to design future development objectives.

  9. The importance of relationships in mental health care: A qualitative study of service users' experiences of psychiatric hospital admission in the UK

    Directory of Open Access Journals (Sweden)

    Slade Mike

    2008-04-01

    Full Text Available Abstract Background While a number of studies have looked at life on service users' experiences of life on psychiatric wards, no research exists that have approached these experiences from the user perspective since the introduction of community care. Methods This user-led study uses a participatory approach to develop an understanding of the processes and themes which define the user experience of hospitalisation. Nineteen service users who had all had inpatient stays in psychiatric hospitals in London were interviewed in the community. Results Relationships formed the core of service users' experiences. Three further codes, treatment, freedom and environment defined the role of hospital and its physical aspects. Themes of communication, safety, trust, coercion, and cultural competency contributed to the concept of relationships. Conclusion Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff. Barriers to positive relationships included ineffective and negative communication, a lack of trust, a lack of safety in terms of staff as ineffective in preventing violence, and as perpetrators themselves, and the use of coercion by staff. This unique perspective both acts as a source of triangulation with previous studies and highlights the importance of the therapeutic relationship in providing a safe and therapeutic milieu for the treatment of people with acute mental health problems.

  10. Failed culture change aimed at more service provision: A test of three agentic factors

    NARCIS (Netherlands)

    Jorritsma, P.Y.; Wilderom, Celeste P.M.

    2012-01-01

    Purpose – Headquarters managers of a medium-sized manufacturing company initiated a culture change in five of their dispersed wholesale units. The aim was for more external service quality. This paper aims to report the results of a test of three hypotheses, shedding light on the behavior of the

  11. An Agent-Based Model for the Development of Intelligent Mobile Services

    NARCIS (Netherlands)

    Koch, F.L.

    2009-01-01

    The next generation of mobile services must invisible, convenient, and useful. It requires new techniques to design and develop mobile computing applications, based on user-centred, environment-aware, adaptive behaviour. I propose an alternative technology for the development of intelligent mobile

  12. A new privacy preserving technique for cloud service user endorsement using multi-agents

    Directory of Open Access Journals (Sweden)

    D. Chandramohan

    2016-01-01

    Full Text Available In data analysis the present focus on storage services are leveraged to attain its crucial part while user data get compromised. In the recent years service user’s valuable information has been utilized by unauthorized users and service providers. This paper examines the privacy awareness and importance of user’s secrecy preserving in the current cloud computing era. Gradually the information kept under the cloud environment gets increased due to its elasticity and availability. However, highly sensitive information is in a serious attack from various sources. Once private information gets misused, the probability of privacy breaching increases which thereby reduces user’s trust on cloud providers. In the modern internet world, information management and maintenance is one among the most decisive tasks. Information stored in the cloud by the finance, healthcare, government sectors, etc. makes it all the more challenging since such tasks are to be handled globally. The present scenario therefore demands a new Petri-net Privacy Preserving Framework (PPPF for safeguarding user’s privacy and, providing consistent and breach-less services from the cloud. This paper illustrates the design of PPPF and mitigates the cloud provider’s trust among users. The proposed technique conveys and collaborates with Privacy Preserving Cohesion Technique (PPCT, to develop validate, promote, adapt and also increase the need for data privacy. Moreover, this paper focuses on clinching and verification of unknown user intervention into the confidential data present in storage area and ensuring the performance of the cloud services. It also acts as an information preserving guard for high secrecy data storage areas.

  13. Admissibility and hyperbolicity

    CERN Document Server

    Barreira, Luís; Valls, Claudia

    2018-01-01

    This book gives a comprehensive overview of the relationship between admissibility and hyperbolicity. Essential theories and selected developments are discussed with highlights to applications. The dedicated readership includes researchers and graduate students specializing in differential equations and dynamical systems (with emphasis on hyperbolicity) who wish to have a broad view of the topic and working knowledge of its techniques. The book may also be used as a basis for appropriate graduate courses on hyperbolicity; the pointers and references given to further research will be particularly useful. The material is divided into three parts: the core of the theory, recent developments, and applications. The first part pragmatically covers the relation between admissibility and hyperbolicity, starting with the simpler case of exponential contractions. It also considers exponential dichotomies, both for discrete and continuous time, and establishes corresponding results building on the arguments for exponent...

  14. 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.

  15. Human centred design of software agent in social network service against privacy concerns

    OpenAIRE

    Kim, Hojung

    2016-01-01

    This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London The rapid growth and influence of social network services has led many scholars to focus on privacy issues. However, the research described in this thesis was motivated by the small number of design studies that have focused on practical approaches to identifying tacit information from users’ instant non-verbal responses to privacy issues. The research therefore aimed to propose pers...

  16. 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.

  17. Nanometric agents in the service of neuroscience: Manipulation of neuronal growth and activity using nanoparticles.

    Science.gov (United States)

    Polak, Pazit; Shefi, Orit

    2015-08-01

    Nerve regeneration and recovery could provide great therapeutic benefits for individuals suffering from nerve damage post trauma or degenerative diseases. However, manipulation of nerves presents a huge challenge for neuroscientists and is not yet clinically feasible. In recent years, nanoparticles have emerged as novel effective agents for control of neuronal growth and behavior. Nanoparticles may facilitate the needed nerve manipulation abilities for therapeutic and diagnostic purposes including within the brain. This review aims at presenting the currently available literature regarding the interactions between inorganic nanoparticles and neurons. A wide range of nanoparticles are presented, including gold, iron oxide, cerium oxide, nanotubes and quantum-dots. The nanoparticles enhance neuronal differentiation and survival, direct growth and regulate electrical activity. The studies are summarized in a concise table, arranged by the function and type of nanoparticle. The latest studies present a novel interdisciplinary approach, which could be harnessed for clinical applications in nanomedicine. Nerve regeneration remains the Holy Grail for patients with neuron loss. Nonetheless, this goal has not been realized in clinical setting thus far. In this article, the authors present a comprehensive review on various nanoparticle-based approaches, in both diagnosis and therapy, which should stimulate and generate more research ideas to the advancement in this field. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The role of sourcing service agents in the competitiveness of Mexico as an international sourcing region

    Directory of Open Access Journals (Sweden)

    María del Pilar Ester Arroyo-López

    2015-01-01

    Full Text Available El objetivo de este trabajo fue el explorar y definir los servicios de abastecimiento de terceras partes mexicanas para proporcionar un mejor entendimiento en relación a cómo estos agentes contribuyen al atractivo del país como una región de producción de bajo-costo. Dada la naturaleza exploratoria del estudio, el estudio de caso fue el método cualitativo de investigación elegido. Dos compañías mexicanas asociadas a cadenas de suministro global de diferente tipo –impulsada por el producto e impulsada por el comprador- fueron seleccionadas como casos representativos. La información primaria fue recolectada a través de entrevistas personales a fondo, visitas en sitio y documentos secundarios. A partir del análisis de los dos casos se determina la estructura de gobierno en la cadena, la contribución que realizan las terceras partes a la integración de los proveedores locales a cadenas de suministro globales (CSG así como el valor que sus servicios de tercerización del abasto representa para los compradores internacionales.

  19. Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: a retrospective cohort study.

    Science.gov (United States)

    Riolfi, Mirko; Buja, Alessandra; Zanardo, Chiara; Marangon, Chiara Francesca; Manno, Pietro; Baldo, Vincenzo

    2014-05-01

    It has been demonstrated that most patients in the terminal stages of cancer would benefit from palliative home-care services. The aim of this study was to assess the effectiveness of appropriate palliative home-care services in reducing hospital admissions, and to identify factors predicting the likelihood of patients treated at home being hospitalized. Retrospective cohort study. We enrolled all 402 patients listed by the Local Health Authority No. 5, Veneto Region (North-East Italy), as dying of cancer in 2011. Of the cohort considered, 39.9% patients had been taken into care by a palliative home-care team. Irrespective of age, gender, and type of tumor, patients taken into care by the palliative home-care team were more likely to die at home, less likely to be hospitalized, and spent fewer days in hospital in the last 2 months of their life. Among the patients taken into care by the palliative home-care team, those with hematological cancers and hepatocellular carcinoma were more likely to be hospitalized, and certain symptoms (such as dyspnea and delirium) were predictive of hospitalization. Our study confirms the effectiveness of palliative home care in enabling patients to spend the final period of their lives at home. The services of a palliative home-care team reduced the consumption of hospital resources. This study also provided evidence of some types of cancer (e.g. hematological cancers and hepatocellular carcinoma) being more likely to require hospitalization, suggesting the need to reconsider the pathways of care for these diseases.

  20. How Internet of Things Influences Human Behavior Building Social Web of Services via Agent-Based Approach

    Directory of Open Access Journals (Sweden)

    Komarov Mikhail

    2016-09-01

    Full Text Available The paper discovers potential human interactions with growing amount of internet of things (IoT via proposed concept of Social Web of Services (classical social web with smart things - daily life objects connected to the internet. To investigate the impact of IoT on user behaviour patterns we modelled human-thing interactions using agent-based simulation (ABM. We have proved that under certain conditions SmartThings, connected to the IoT, are able to change patterns of Human behaviour. Results of this work predict our way of living in the era of caused by viral effects of IoT application (HCI and M2M connections, and could be used to foster business process management in the IoT era.

  1. Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department

    Directory of Open Access Journals (Sweden)

    Cholada Kittipittayakorn

    2016-01-01

    Full Text Available Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries’ healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES and agent-based simulation (ABS to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department.

  2. Using the Integration of Discrete Event and Agent-Based Simulation to Enhance Outpatient Service Quality in an Orthopedic Department.

    Science.gov (United States)

    Kittipittayakorn, Cholada; Ying, Kuo-Ching

    2016-01-01

    Many hospitals are currently paying more attention to patient satisfaction since it is an important service quality index. Many Asian countries' healthcare systems have a mixed-type registration, accepting both walk-in patients and scheduled patients. This complex registration system causes a long patient waiting time in outpatient clinics. Different approaches have been proposed to reduce the waiting time. This study uses the integration of discrete event simulation (DES) and agent-based simulation (ABS) to improve patient waiting time and is the first attempt to apply this approach to solve this key problem faced by orthopedic departments. From the data collected, patient behaviors are modeled and incorporated into a massive agent-based simulation. The proposed approach is an aid for analyzing and modifying orthopedic department processes, allows us to consider far more details, and provides more reliable results. After applying the proposed approach, the total waiting time of the orthopedic department fell from 1246.39 minutes to 847.21 minutes. Thus, using the correct simulation model significantly reduces patient waiting time in an orthopedic department.

  3. An Agent-Based Model for Addressing the Impact of a Disaster on Access to Primary Care Services.

    Science.gov (United States)

    Guclu, Hasan; Kumar, Supriya; Galloway, David; Krauland, Mary; Sood, Rishi; Bocour, Angelica; Hershey, Tina Batra; van Nostrand, Elizabeth; Potter, Margaret

    2016-06-01

    Hurricane Sandy in the Rockaways, Queens, forced residents to evacuate and primary care providers to close or curtail operations. A large deficit in primary care access was apparent in the immediate aftermath of the storm. Our objective was to build a computational model to aid responders in planning to situate primary care services in a disaster-affected area. Using an agent-based modeling platform, HAZEL, we simulated the Rockaways population, its evacuation behavior, and primary care providers' availability in the aftermath of Hurricane Sandy. Data sources for this model included post-storm and community health surveys from New York City, a survey of the Rockaways primary care providers, and research literature. The model then tested geospatially specific interventions to address storm-related access deficits. The model revealed that areas of high primary care access deficit were concentrated in the eastern part of the Rockaways. Placing mobile health clinics in the most populous census tracts reduced the access deficit significantly, whereas increasing providers' capacity by 50% reduced the deficit to a lesser degree. An agent-based model may be a useful tool to have in place so that policy makers can conduct scenario-based analyses to plan interventions optimally in the event of a disaster. (Disaster Med Public Health Preparedness. 2016;10:386-393).

  4. Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances

    Directory of Open Access Journals (Sweden)

    Agata Bielawska-Drózd

    2017-08-01

    Full Text Available Objectives: Assessment of microbial air quality and surface contamination in ambulances and administration offices as a control place without occupational exposure to biological agents; based on quantitative and qualitative analysis of bacteria, yeasts and filamentous fungi found in collected samples. Material and Methods: The sampling was done by wet cyclone technology using the Coriolis recon apparatus, imprint and swab methods, respectively. In total, 280 samples from 28 ambulances and 10 offices in Warszawa were tested. Data was analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test with α = 0.05. P value ≤ 0.05 was considered as significant. Results: The levels of air contamination were from 0 to 2.3×101 colony-forming unit (CFU/m3 for bacteria and for yeast and filamentous fungi were from 0 to 1.8×101 CFU/m3. The assessment of office space air samples has shown the following numbers of microorganisms: bacteria from 3.0×101 to 4.2×101 CFU/m3 and yeast and filamentous fungi from 0 to 1.9×101 CFU/m3. For surface contamination the mean bacterial count in ambulances has been between 1.0×101 and 1.3×102 CFU/25 cm2 and in offices – between 1.1×101 and 8.5×101 CFU/25 cm2. Mean fungal count has reached the level from 2.8×100 to 4.2×101 CFU/25 cm2 in ambulances and 1.3×101 to 5.8×101 CFU/25 cm2 in offices. The qualitative analysis has revealed the presence of Acinetobacter spp. (surfaces, coagulase – negative Staphylococci (air and surfaces, Aspergillus and Penicillium genera (air and surfaces. Conclusions: The study has revealed a satisfactory microbiological quantity of analyzed air and surface samples in both study and control environments. However, the presence of potentially pathogenic microorganisms in the air and on surfaces in ambulances may endanger the medical emergency staff and patients with infection. Disinfection and cleaning techniques therefore should be constantly developed and implemented. Int J Occup

  5. Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances.

    Science.gov (United States)

    Bielawska-Drózd, Agata; Cieślik, Piotr; Wlizło-Skowronek, Bożena; Winnicka, Izabela; Kubiak, Leszek; Jaroszuk-Ściseł, Jolanta; Depczyńska, Daria; Bohacz, Justyna; Korniłłowicz-Kowalska, Teresa; Skopińska-Różewska, Ewa; Kocik, Janusz

    2017-06-19

    Assessment of microbial air quality and surface contamination in ambulances and administration offices as a control place without occupational exposure to biological agents; based on quantitative and qualitative analysis of bacteria, yeasts and filamentous fungi found in collected samples. The sampling was done by wet cyclone technology using the Coriolis recon apparatus, imprint and swab methods, respectively. In total, 280 samples from 28 ambulances and 10 offices in Warszawa were tested. Data was analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test with α = 0.05. P value ≤ 0.05 was considered as significant. The levels of air contamination were from 0 to 2.3×101 colony-forming unit (CFU)/m3 for bacteria and for yeast and filamentous fungi were from 0 to 1.8×101 CFU/m3. The assessment of office space air samples has shown the following numbers of microorganisms: bacteria from 3.0×101 to 4.2×101 CFU/m3 and yeast and filamentous fungi from 0 to 1.9×101 CFU/m3. For surface contamination the mean bacterial count in ambulances has been between 1.0×101 and 1.3×102 CFU/25 cm2 and in offices - between 1.1×101 and 8.5×101 CFU/25 cm2. Mean fungal count has reached the level from 2.8×100 to 4.2×101 CFU/25 cm2 in ambulances and 1.3×101 to 5.8×101 CFU/25 cm2 in offices. The qualitative analysis has revealed the presence of Acinetobacter spp. (surfaces), coagulase - negative Staphylococci (air and surfaces), Aspergillus and Penicillium genera (air and surfaces). The study has revealed a satisfactory microbiological quantity of analyzed air and surface samples in both study and control environments. However, the presence of potentially pathogenic microorganisms in the air and on surfaces in ambulances may endanger the medical emergency staff and patients with infection. Disinfection and cleaning techniques therefore should be constantly developed and implemented. Int J Occup Med Environ Health 2017;30(4):617-627. This work is available in Open Access

  6. Nonflexible Lie-admissible algebras

    International Nuclear Information System (INIS)

    Myung, H.C.

    1978-01-01

    We discuss the structure of Lie-admissible algebras which are defined by nonflexible identities. These algebras largely arise from the antiflexible algebras, 2-varieties and associator dependent algebras. The nonflexible Lie-admissible algebras in our discussion are in essence byproducts of the study of nonassociative algebras defined by identities of degree 3. The main purpose is to discuss the classification of simple Lie-admissible algebras of nonflexible type

  7. An Analysis of Construct Validity of Motivation As It Relates to North Carolina County Agricultural Extension Service Agents.

    Science.gov (United States)

    Calloway, Pauline Frances

    This study investigated the construct validity of the Herzberg (1964) theory of motivation as it relates to county Extension agents; and developed an inventory to measure the job satisfaction of county agents in North Carolina. The inventory was administered to 419 agents in 79 counties. Factor analysis was used to determine the number of job…

  8. Continuing Professional Education of Insurance and Risk Management Practitioners: A Comparative Case Study of Customer Service Representatives, Insurance Agents and Risk Managers

    Science.gov (United States)

    Krauss, George E.

    2009-01-01

    The purpose of this study is to understand how selected insurance practitioners learn and developed in their practices setting. The selected insurance practitioners (collectively customer service representatives, insurance agents, and risk managers) are responsible for the counseling and placement of insurance products and the implementation of…

  9. A Predictive Model for Acute Admission in Aged Population

    DEFF Research Database (Denmark)

    Mansourvar, Marjan; Andersen-Ranberg, Karen; Nøhr, Christian

    2018-01-01

    Acute hospital admission among the elderly population is very common and have a high impact on the health services and the community, as well as on the individuals. Several studies have focused on the possible risk factors, however, predicting who is at risk for acute hospitalization associated...... with disease and symptoms is still an open research question. In this study, we investigate the use of machine learning algorithms for predicting acute admission in older people based on admission data from individual citizens 70 years and older who were hospitalized in the acute medical unit of Svendborg...

  10. 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...

  11. Agent Semantic Communication Services

    National Research Council Canada - National Science Library

    Li, John; Terry, Allan

    2005-01-01

    .... In information retrieval approaches such as Google, a large number of URIs are returned that contain one or more of the search keywords, ranked by an estimate of how relevant they are to the user's query...

  12. 44 CFR 68.9 - Admissible evidence.

    Science.gov (United States)

    2010-10-01

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

  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. General Practitioners and Involuntary Admission

    DEFF Research Database (Denmark)

    Jepsen, Britta; Lomborg, Kirsten; Engberg, Marianne

    2010-01-01

    Background: In many countries, medical authorities are responsible for involuntary admissions of mentally ill patients. Nonetheless, very little is known about GPs' experiences with involuntary admission. Aim: The aim of the present study was to explore GP's experiences from participating....... 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...

  15. Designing an architectural style for dynamic medical Cross-Organizational Workflow management system: an approach based on agents and web services.

    Science.gov (United States)

    Bouzguenda, Lotfi; Turki, Manel

    2014-04-01

    This paper shows how the combined use of agent and web services technologies can help to design an architectural style for dynamic medical Cross-Organizational Workflow (COW) management system. Medical COW aims at supporting the collaboration between several autonomous and possibly heterogeneous medical processes, distributed over different organizations (Hospitals, Clinic or laboratories). Dynamic medical COW refers to occasional cooperation between these health organizations, free of structural constraints, where the medical partners involved and their number are not pre-defined. More precisely, this paper proposes a new architecture style based on agents and web services technologies to deal with two key coordination issues of dynamic COW: medical partners finding and negotiation between them. It also proposes how the proposed architecture for dynamic medical COW management system can connect to a multi-agent system coupling the Clinical Decision Support System (CDSS) with Computerized Prescriber Order Entry (CPOE). The idea is to assist the health professionals such as doctors, nurses and pharmacists with decision making tasks, as determining diagnosis or patient data analysis without stopping their clinical processes in order to act in a coherent way and to give care to the patient.

  16. Framing Pre-Service Teachers' Professional Learning Using Web2.0 Tools: Positioning Pre-Service Teachers as Agents of Cultural and Technological Change

    Science.gov (United States)

    Kidd, Warren

    2013-01-01

    This article addresses key issues in pre-service teachers' professional learning. The argument explores pre-service teachers' learning and practice, which is both informed by technology and which uses technologically enhanced practices in classrooms as learning and teaching strategies. The article is contextualized by current…

  17. Resource management in Diffserv measurement-based admission control PHR

    NARCIS (Netherlands)

    Westberg, L.; Heijenk, Geert; Karagiannis, Georgios; Oosthoek, S.; Partain, D.; Rexhepi, Vlora; Szabo, R.; Wallentin, P.; El Allali, H.

    2002-01-01

    The purpose of this draft is to present the Resource Management in Diffserv (RMD) Measurement-Based Admission Control (RIMA) Per Hop Reservation (PHR) protocol. The RIMA PHR protocol is used on a per-hop basis in a Differentiated Services (Diffserv) domain and extends the Diffserv Per Hop Behavior

  18. Evaluation of Pharmacists' Participation in Post-Admission Ward ...

    African Journals Online (AJOL)

    Objective: The study evaluates pharmacist's perception of and participation in post-admission ward rounds, at the Lagos University Teaching Hospital (LUTH). Method: All the 60 pharmacists covering various units of pharmaceutical services were administered a forty-two element structured questionnaire. Fifty (83.3%) ...

  19. Hospital admission planning to optimize major resources utilization under uncertainty

    NARCIS (Netherlands)

    Dellaert, N.P.; Jeunet, J.

    2010-01-01

    Admission policies for elective inpatient services mainly result in the management of a single resource: the operating theatre as it is commonly considered as the most critical and expensive resource in a hospital. However, other bottleneck resources may lead to surgery cancellations, such as bed

  20. SIP Controlled Admission and Preemption

    NARCIS (Netherlands)

    Babiarz, J.; Chan, K.; Karagiannis, Georgios; Eardley, P

    2006-01-01

    This framework defines a method of providing Explicit Congestion Control to real-time inelastic traffic like voice and video through the use of session admission control and preemption mechanisms. This approach uses the Pre-Congestion Notification Marking (PCN) [1] mechanism. PCN marking is deployed

  1. Open Admissions: Expanding Educational Opportunity

    Science.gov (United States)

    Benjamin, Jeanette Ann; Powell, Philip Edward

    1971-01-01

    A report on initial results of the open admissions policy (City University of New York) concludes that significant numbers of high risk students can make progress toward a degree. Program modifications are suggested as a response to the learning needs of these students. (Author/CJ)

  2. Admission to selective schools, alphabetically

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    2010-01-01

    Roč. 29, č. 6 (2010), s. 1100-1109 ISSN 0272-7757 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:MSM0021620846 Keywords : admissions to school * alphabetical order * order effects Subject RIV: AH - Economics Impact factor: 1.066, year: 2010

  3. Personal Qualities and College Admissions.

    Science.gov (United States)

    Willingham, Warren W.; Breland, Hunter M.

    The extent to which personal and academic factors are important in college admission decisions was studied in 1978, based on data on 25,000 applicants to 9 colleges (Colgate University, Williams College, Ohio Wesleyan University, Kenyon College, Kalamazoo College, Occidental College, Hartwick College, University of Richmond, and Bucknell…

  4. Admission haematological abnormalities and postoperative ...

    African Journals Online (AJOL)

    Admission haematological abnormalities and postoperative outcomes in neonates with acute surgical conditions in Alexandria, Egypt. HL Wella, SMM Farahat. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

  5. Five-year follow-up of an acute psychiatric admission cohort in Auckland, New Zealand.

    Science.gov (United States)

    Wheeler, Amanda; Moyle, Stuart; Jansen, Carol; Robinson, Elizabeth; Vanderpyl, Jane

    2011-06-10

    This paper describes a follow-up of acute psychiatric hospital contact in Auckland, New Zealand for an admission cohort in the 5-years past an index admission (published in the NZMJ in 2005). A 5-year follow-up study of hospital psychiatric service utilisation by 924 patients admitted (index admission) in Auckland during 2000. Hospital admissions within New Zealand for this population were extracted from electronic records. Relevant demographic information (gender, age and ethnicity) and clinical data (primary diagnosis at index admission and admission history) were included for each person. Descriptive analysis of inpatient data and negative binomial regression models were conducted. Of 924 patients, 38.5% had no readmissions anywhere in New Zealand in the 5-years following index discharge. 41.0% were readmitted within 12 months and 61.4% were readmitted within 5 years of index discharge. Only 5.6% experienced an admission every year for the 5-years post index admission. Readmission was least likely for those with index discharge diagnosis of depression. A history of admissions prior to index admission and Maori ethnicity were characteristics associated with higher numbers of readmission. Those who were younger, or a diagnosis of schizophrenia/schizoaffective disorder or previous admissions tended to have longer total length of stay over the 5-years. More than a third of patients had no further hospital contact and the two factors associated with readmission were a history of previous admissions and Maori ethnicity. Reliable community-based data needs to be a priority to enable exploration of community service utilisation and impact of service alternatives to hospital for acute care.

  6. 45 CFR 98.46 - Nondiscrimination in admissions on the basis of religion.

    Science.gov (United States)

    2010-10-01

    ... religion. 98.46 Section 98.46 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION... Requirements § 98.46 Nondiscrimination in admissions on the basis of religion. (a) Child care providers (other... contracts under the CCDF shall not discriminate in admissions against any child on the basis of religion. (b...

  7. 42 CFR 456.171 - Medicaid agency review of need for admission.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid agency review of need for admission. 456.171 Section 456.171 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Hospitals Medical, Psychiatric, and Social Evaluations and Admission Review § 456.171 Medicaid agency review...

  8. 42 CFR 456.372 - Medicaid agency review of need for admission.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid agency review of need for admission. 456.372 Section 456.372 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Medicaid agency review of need for admission. Medical and other professional personnel of the Medicaid...

  9. Report of a Study of Ontario Medical School Admissions Policies and Practices, 1975.

    Science.gov (United States)

    Council of Ontario Universities, Toronto.

    Presented are the results of a study of admissions policies and practices in the five Ontario schools of medicine. The study consists of a review of published information and a detailed examination of 1975 statistics from the Ontario Medical School Application Service, supplemented by a series of interviews with medical school admissions officers,…

  10. Hospital admission planning to optimize major resources utilization under uncertainty

    OpenAIRE

    Dellaert, N.P.; Jeunet, J.

    2010-01-01

    Admission policies for elective inpatient services mainly result in the management of a single resource: the operating theatre as it is commonly considered as the most critical and expensive resource in a hospital. However, other bottleneck resources may lead to surgery cancellations, such as bed capacity and nursing staff in Intensive Care (IC) units and bed occupancy in wards or medium care (MC) services. Our incentive is therefore to determine a master schedule of a given number of patient...

  11. [Influence of postcode on paediatric admissions in Seville].

    Science.gov (United States)

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

    2017-12-01

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

  12. Patient admission planning using Approximate Dynamic Programming

    NARCIS (Netherlands)

    Hulshof, P.J.H.; Mes, Martijn R.K.; Boucherie, Richardus J.; Hans, Elias W.

    2016-01-01

    Tactical planning in hospitals involves elective patient admission planning and the allocation of hospital resource capacities. We propose a method to develop a tactical resource allocation and patient admission plan that takes stochastic elements into consideration, thereby providing robust plans.

  13. Puberty menorrhagia Requiring Inpatient Admission

    Directory of Open Access Journals (Sweden)

    AH Khosla

    2010-06-01

    Full Text Available INTRODUCTION: Puberty menorrhagia is a significant health problem in adolescent age group and severe cases may require admission and blood transfusion. Aim of this study was to evaluate the causes, associated complications and management of puberty menorrhagia. METHODS: Hospital records of all patients of puberty menorrhagia requiring admission were analyzed for etiology, duration since menarche, duration of bleeding, investigation profile and management. RESULTS: There were 18 patients of puberty menorrhagia requiring hospital admission. Etiology was anovulatory bleeding in 11 patients, bleeding disorders in five which included idiopathic thrombocytopenia purpura in three and one each with Von-Willebrand disease and leukemia. Two patients had hypothyroidism as the cause. Fourteen patients presented with severe anaemia and required blood transfusion. All except one responded to oral hormonal therapy. CONCLUSIONS: Puberty menorrhagia can be associated with severe complications and requiring blood transfusion. Although most common cause is anovulation but bleeding disorder, other medical condition and other organic causes must be ruled out in any patient of Puberty menorrhagia. KEYWORDS: anovulation, bleeding disorder, puberty, menorrhagia, anaemia.

  14. 32 CFR 575.2 - Admission; general.

    Science.gov (United States)

    2010-07-01

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

  15. Testing In College Admissions: An Alternative to the Traditional Predictive Model.

    Science.gov (United States)

    Lunneborg, Clifford E.

    1982-01-01

    A decision-making or utility theory model (which deals effectively with affirmative action goals and allows standardized tests to be placed in the service of those goals) is discussed as an alternative to traditional predictive admissions. (Author/PN)

  16. 32 CFR 242.9 - Academic, intellectual, and personal requirements for admission to advanced standing.

    Science.gov (United States)

    2010-07-01

    ... aptitude and motivation for a career in medicine in the Uniformed Services will be prime considerations in making admissions decisions. Only the most promising of candidates will be accepted, as judged by...

  17. Estresse no trabalho em agentes dos centros de atendimento socioeducativo do Rio Grande do Sul Estrés en el trabajo en agentes en los centros de atención socioeducativa de Rio Grande do Sul Job stress in agents at the socio-educational service centers in the state of Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Patrícia Bitencourt Toscani Greco

    2013-03-01

    psicológicas en trabajo del agente.The study was both to understand the association of work stress, socio-demographic and labor characteristics, habits and working conditions of the Socio-educational agents in the state of Rio Grande do Sul, Brazil. It was a cross-sectional study with 381 agents of the Socio-educational Service Centers in the state of Rio Grande do Sul. The Brazilian version of the Job Stress Scale for assessment of work stress has been applied. Were classified in a situation of high strain 19.2% of the agents. The following factors were related to job stress: the need for counseling, lack of leisure time, day shift work, dissatisfaction with the workplace, the need for absence from work due to health problems and insufficient scale work. There is a need to further research working conditions and execution of Occupational Health Service acting in order to minimize the effects of psychological demands at work of a socio-educational agent.

  18. Admission Test and Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    Setareh Akhavan

    2017-07-01

    Full Text Available Background: The admission test (AT has been carried out for many years, but there are still debates about the prognostic value of the test. Therefore, we aimed to examine the value of the AT in predicting the adverse outcome in neonates. Methods: In this cross-sectional study, 425 pregnant women with normal vaginal delivery were studied between2009 and 2014at Vali-e-Asr Hospital. Based on the results, the women were divided into 2groups of normal and abnormal ATs. All the patients were followed up until the birth of their baby, when the status of mother and neonate was determined. The main outcomes of the study were cesarean rate, neonatal intensive care unit (NICU admission, fetus demise, neonatal acidosis, and Apgar score. The independent t-test, chi-square test, Fisher exact test, and logistic regression were used for statistical analysis. The data were analyzed using SPSS (version 17. Results: Of 425 pregnant women studied, 142 (33.4% had abnormal ATs with a mean age of 29 (±4.5 years. Multivariate analysis showed that an abnormal AT was able to predict the incidence of cesarean section, intrauterine growth restriction, turned cord, and Apgar<7, but it could not predict neonatal death and hypoxia. Conclusion: The AT was shown to be a useful screening test with risk factors such as oligohydramnios, bloody amniotic fluid, meconium amniotic fluid, intrauterine growth restriction, and turned cord. Additionally, the test was also able to predict NICU admission and the need for cesarean section, but it could not predict the occurrence of neonatal death.

  19. Critérios de admissão e continuidade de cuidados em centros de atenção psicossocial, Rio de Janeiro, RJ Criterios de admisión y continuidad de cuidados en centros de atención psicosocial, Rio de Janeiro, Sureste de Brasil Criteria for admission and continuity of health care in psychosocial healthcare services, City of Rio de Janeiro, Southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Maria Tavares Cavalcanti

    2009-08-01

    ón psicosocial del municipio de Rio de Janeiro (Sureste de Brasil en 2006. Fueron sorteados 15 casos encaminados entre los pacientes admitidos para tratamiento en los seis meses anteriores al inicio de la investigación. Los criterios señalados por el equipo para la admisión del paciente para tratamiento o encaminamiento fueron analizados a partir de un itinerario estructurado. El análisis de la continuidad de cuidados se basó en investigación en prontuario, informaciones del equipo y de los propios pacientes y/o familiares seis meses posteriores a la absorción o encaminamiento del paciente. RESULTADOS: Los pacientes admitidos presentaban diagnóstico de psicosis (esquizofrenia, historia de internaciones previas, funcionamiento social pobre y red de apoyo pequeño y los pacientes encaminados presentaban trastornos ansiosos y depresivos, buena adhesión al tratamiento ambulatorio, buen funcionamiento social y presencia de red social. Con relación a la continuidad de cuidados, ocho pacientes en 27 tuvieron destino desconocido. Con relación a los encaminamientos, de los 13 pacientes encaminados a ambulatorios de la red, siete permanecieron en tratamiento, dos retornaron a los CAPS y cuatro tuvieron destino desconocido. CONCLUSIONES: Los centros admiten pacientes que se encajan en la definición de un trastorno mental severo y persistente. La continuidad de cuidado fue señalada como problema, probablemente debido a la dificultad de acompañar los pacientes en la comunidad.OBJECTIVE: To analyze the criteria used by teams for admission, referral and continuity of care among patients of the Centros de Atenção Psicossocial (CAPS - Psychosocial Care Centers. METHODS: A qualitative study with participatory evaluation was conducted in three psychosocial healthcare services of the city of Rio de Janeiro, Southeastern Brazil, in 2006. A total of 15 admitted cases and 15 referred cases were selected among the patients admitted for treatment during the six months that preceded the

  20. [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

    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 at emerg......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...... for help from a senior colleague. Udgivelsesdato: 2010-May-31...

  1. Admissible invariant distributions on reductive

    CERN Document Server

    Harish-Chandra; Paul J Sally, Jr

    1999-01-01

    Harish-Chandra presented these lectures on admissible invariant distributions for p-adic groups at the Institute for Advanced Study in the early 1970s. He published a short sketch of this material as his famous "Queen's Notes". This book, which was prepared and edited by DeBacker and Sally, presents a faithful rendering of Harish-Chandra's original lecture notes. The main purpose of Harish-Chandra's lectures was to show that the character of an irreducible admissible representation of a connected reductive p-adic group G is represented by a locally summable function on G. A key ingredient in this proof is the study of the Fourier transforms of distributions on \\mathfrak g, the Lie algebra of G. In particular, Harish-Chandra shows that if the support of a G-invariant distribution on \\mathfrak g is compactly generated, then its Fourier transform has an asymptotic expansion about any semisimple point of \\mathfrak g. Harish-Chandra's remarkable theorem on the local summability of characters for p-adic groups was ...

  2. 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.

  3. Agents of change: undergraduate students' attitudes following observations of speech-language pathology service delivery: preliminary findings.

    Science.gov (United States)

    Miller, Suzanne M; Ciocci, Sandra R

    2013-01-01

    Undergraduate communication sciences and disorders students' attitudes toward speech-language pathology (SLP) clinical services to children and adults prior to and following community-based observations were examined. Participants (n=25) completed an online survey to elicit their opinions regarding their perceptions of their observation experiences. Findings revealed that after completion of community-based SLP clinical observations, 16 (64%) respondents reported a continued interest in a child-based clinical focus; 12 (48%) respondents continued to consider a clinical interest in adults, while 5 respondents (20%) changed career interests to an adult focus based on their observation experiences. Findings support the notion that observations of SLP appear to significantly influence students' career choices. Clinical observations typically occur at the junior/senior undergraduate levels; therefore, suggestions are offered for inclusion of gerontology education embedded throughout the undergraduate communication sciences and disorders curricula to foster and expand students' knowledge of aging, and to prepare our students to meet the healthcare challenges of elders in the 21st century.

  4. Biological Agents

    Science.gov (United States)

    ... E-Tools Safety and Health Topics / Biological Agents Biological Agents This page requires that javascript be enabled ... 202) 693-2300 if additional assistance is required. Biological Agents Menu Overview In Focus: Ebola Frederick A. ...

  5. An Investigation of Perspectives of Respite Admission Among People Living With Amyotrophic Lateral Sclerosis and the Hospitals That Support Them.

    Science.gov (United States)

    Nakai, Michiko; Narita, Yugo; Tomimoto, Hidekazu

    2017-07-01

    Amyotrophic lateral sclerosis is a progressive disease with rapid degeneration. Respite care is an essential service for improving the well-being of both patients with this disease and their family caregivers, but accessibility of respite services is limited. This study investigates perspectives on respite admission among people living with amyotrophic lateral sclerosis and the hospitals supporting them. We conducted semistructured interviews among 3 patients with amyotrophic lateral sclerosis and 12 family members, exploring demographic information and their awareness and experience of respite admission. We also interviewed 16 representatives from hospitals about awareness of and preparation for respite admission for patients with this disease, the role of regional networks for intractable diseases, and knowledge about communication support schemes. We found significant differences in the revised Amyotrophic Lateral Sclerosis Functional Rating Scale between patients who had and had not received respite admission. Qualitative analysis of the data indicated that respite admission was a contributory factor in continuing and stabilizing home care. Limited provision of social services and hospital care quality were barriers to respite admission. Respite admission was essential to continued home care for patients with amyotrophic lateral sclerosis. Severe-stage patients were eligible for respite admission. Its accessibility, however, was limited, especially for patients living in rural areas. Supporting hospitals had limited capacity to respond to patients' needs. Individualized care and communication were internal barriers to respite admission.

  6. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  7. Odor Classification using Agent Technology

    Directory of Open Access Journals (Sweden)

    Sigeru OMATU

    2014-03-01

    Full Text Available In order to measure and classify odors, Quartz Crystal Microbalance (QCM can be used. In the present study, seven QCM sensors and three different odors are used. The system has been developed as a virtual organization of agents using an agent platform called PANGEA (Platform for Automatic coNstruction of orGanizations of intElligent Agents. This is a platform for developing open multi-agent systems, specifically those including organizational aspects. The main reason for the use of agents is the scalability of the platform, i.e. the way in which it models the services. The system models functionalities as services inside the agents, or as Service Oriented Approach (SOA architecture compliant services using Web Services. This way the adaptation of the odor classification systems with new algorithms, tools and classification techniques is allowed.

  8. Concepts and theoretical specifications of a Coastal Vulnerability Dynamic Simulator (COVUDS): A multi-agent system for simulating coastal vulnerability towards management of coastal ecosystem services

    Science.gov (United States)

    Orencio, P. M.; Endo, A.; Taniguchi, M.

    2014-12-01

    Disaster-causing natural hazards such as floods, erosions, earthquakes or slope failures were particularly observed to be concentrated in certain geographical regions. In the Asia-pacific region, coastal ecosystems were suffering because of perennial threats driven by chronic fluctuations in climate variability (e.g., typhoons, ENSO), or by dynamically occurring events (e.g., earthquakes, tsunamis). Among the many people that were found prone to such a risky condition were the ones inhabiting near the coastal areas. Characteristically, aside from being located at the forefront of these events, the coastal communities have impacted the resource by the kind of behavioral patterns they exhibited, such as overdependence and overexploitation to achieve their wellbeing. In this paper, we introduce the development of an approach to an assessment of the coupled human- environment using a multi- agent simulation (MAS) model known as Coastal Vulnerability Dynamic Simulator (COVUDS). The COVUDS comprised a human- environmental platform consisting multi- agents with corresponding spatial- based dynamic and static variables. These variables were used to present multiple hypothetical future situations that contribute to the purpose of supporting a more rational management of the coastal ecosystem and their environmental equities. Initially, we present the theoretical and conceptual components that would lead to the development of the COVUDS. These consisted of the human population engaged in behavioral patterns affecting the conditions of coastal ecosystem services; the system of the biophysical environment and changes in patches brought by global environment and local behavioral variations; the policy factors that were important for choosing area- specific interventions; and the decision- making mechanism that integrates the first three components. To guide a future scenario-based application that will be undertaken in a coastal area in the Philippines, the components of the

  9. Confronting the categories: Equitable admissions without apartheid ...

    African Journals Online (AJOL)

    I offer a critical-race-standpoint as an alternative conceptual orientation and method for transformative admissions committed to racial redress that is socially just. I conclude that admissions criteria should encompass the lived realities of inequality and be informed by a conception of humanism as critique. This requires ...

  10. Decline in adolescent treatment admissions for methamphetamine ...

    African Journals Online (AJOL)

    Background and objectives. The purpose of this report is to describe the changing trends in adolescent treatment admissions for methamphetamine in Cape Town, and to discuss possible implications. Method. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug ...

  11. Asians in Higher Education: Conflicts over Admissions.

    Science.gov (United States)

    Hoachlander, E. Gareth; Brown, Cynthia L.

    1989-01-01

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

  12. Assessing academic potential for university admission: The ...

    African Journals Online (AJOL)

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

  13. Seasonal variations in hospital admissions for mania

    DEFF Research Database (Denmark)

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

    2016-01-01

    in summer. Higher admission rates were associated with more sunshine, more ultraviolet radiation, higher temperature and less snow but were unassociated with rainfall. We did not find a secular trend in the seasonal pattern. Finally, neither gender nor admission status impacted on the overall seasonal...

  14. Admissions 2015 Indian Institute of Science, Bangalore

    Indian Academy of Sciences (India)

    IAS Admin

    2015-02-02

    Feb 2, 2015 ... advertisement that will appear in Employment News dated 14th February 2015 and also our website: www.iisc.ernet.in/admissions. Online submission of application be made by accessing the IISc website www.iisc.ernet.in/admissions for all the programmes. IMPORTANT DATES. Website opening and ...

  15. An adaptive distributed admission approach in Bluetooth network with QoS provisions

    DEFF Research Database (Denmark)

    Son, L.T.; Schiøler, Henrik; Madsen, Ole Brun

    2002-01-01

    In this paper, a method of adaptive distributed admission with end-to-end Quality of Service (QoS) provisions for real time and non real time tra°cs in Blue-tooth networks is highlighted, its mathematic background is analyzed and a simulation with bursty tra°c sources, Interrupted Bernoulli Process...... (IBP), is carried out. The simulation results show that the performance of Bluetooth network is improved when applying the distributed admission method...

  16. [Evaluation of hospital admissions: admission guidelines implementation in a pediatric emergency department].

    Science.gov (United States)

    Katz, Manuel; Warshawsky, Sheila S; Rosen, Shirley; Barak, Nurit; Press, Joseph

    2004-10-01

    To develop and implement locally tailored pediatric admission guidelines for use in a pediatric emergency department and evaluate the appropriateness of admissions based on these guidelines. Our Study was based on the development of admission guidelines by senior physicians, using the Delphi Consensus Process, for use in the Pediatric Emergency Department (PED) at Soroka University Medical Center (Soroka). We evaluated the appropriateness of admissions to the pediatric departments of Soroka on 33 randomly selected days in 1999 and 2000 prior to guideline implementation and 30 randomly selected days in 2001, after guideline implementation. A total of 1037 files were evaluated. A rate of 12.4% inappropriate admissions to the pediatric departments was found based on locally tailored admission guidelines. There was no change in the rate of inappropriate admissions after implementation of admission guidelines in PED. Inappropriate admissions were associated with age above 3 years, hospital stay of two days or less and the season. The main reasons for evaluating an admission as inappropriate were that the admission did not comply with the guidelines and that the case could be managed in an ambulatory setting. There were distinctive differences in the characteristics of the Bedouin and Jewish populations admitted to the pediatric departments, although no difference was found in the rate of inappropriate admissions between these populations. Patient management in Soroka PED is tailored to the conditions of this medical center and to the characteristics of the population it serves. The admission guidelines developed reflect these special conditions. Lack of change in the rate of inappropriate admissions following implementation of the guidelines indicates that the guidelines reflect the physicians' approach to patient management that existed in Soroka PED prior to guideline implementation. Hospital admission guidelines have a role in the health management system; however

  17. Multi-Agent Information Classification Using Dynamic Acquaintance Lists.

    Science.gov (United States)

    Mukhopadhyay, Snehasis; Peng, Shengquan; Raje, Rajeev; Palakal, Mathew; Mostafa, Javed

    2003-01-01

    Discussion of automated information services focuses on information classification and collaborative agents, i.e. intelligent computer programs. Highlights include multi-agent systems; distributed artificial intelligence; thesauri; document representation and classification; agent modeling; acquaintances, or remote agents discovered through…

  18. A Nationwide Census of ICU Capacity and Admissions in Mongolia.

    Directory of Open Access Journals (Sweden)

    Naranpurev Mendsaikhan

    Full Text Available In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and-developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or pediatric/neonatal ICU service, the number of available ICU beds, the number of available functional mechanical ventilators, the number of patients admitted to the ICU, and the number of patients admitted to the study hospital were collected. In total, 70 ICUs with 349 ICU beds were counted in Mongolia (11.7 ICU beds/100,000 inhabitants; 1.7 ICU beds/100 hospital beds. Of these, 241 (69% were adult and 108 (31% pediatric/neonatal ICU beds. Functional mechanical ventilators were available for approximately half of the ICU beds (5.1 mechanical ventilators/100,000 inhabitants. While all provincial hospitals ran a pediatric/neonatal ICU, only dedicated pediatric hospitals in Ulaanbaatar did so. The number of adult and pediatric/neonatal ICU admissions varied between provinces. The number of adult ICU beds and adult ICU admissions per 100,000 inhabitants correlated (r = 0.5; p = 0.02, while the number of pediatric/neonatal ICU beds and pediatric/neonatal ICU admissions per 100,000 inhabitants did not (r = 0.25; p = 0.26. In conclusion, with 11.7 ICU beds per 100,000 inhabitants the ICU capacity in Mongolia is higher than in other low- and lower-middle-income countries. Substantial heterogeneities in the standardized ICU capacity and ICU admissions exist between Mongolian provinces. Functional mechanical ventilators are available for only half of the ICU beds. Pediatric/neonatal ICU beds make up one third of the national ICU capacity and appear to meet or even

  19. Agents Within our Midst

    Science.gov (United States)

    2012-03-14

    agents; and the development of bio -monitoring protocols for civilian and service personnel during a chemical attack. These efforts have resulted in greater...produced by staphylococcal bacteria that is and is classified as a CDC select agent which has the potential to be used as a biological weapon .1...NMR chemical shift perturbation titrations with Fab (fragment, antigen binding regions) domains of 20B1, 14G8, and 6D3 using deuterated (2H) SEB

  20. Marketing in Admissions: The Information System Approach.

    Science.gov (United States)

    Wofford, O. Douglas; Timmerman, Ed

    1982-01-01

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

  1. Alphabetical order effects in school admissions

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    2016-01-01

    Roč. 31, č. 4 (2016), s. 483-498 ISSN 0267-1522 Institutional support: PRVOUK-P23 Keywords : admissions * alphabetical order * order effects Subject RIV: AH - Economics Impact factor: 1.033, year: 2016

  2. Causes of Hospital Admissions in Domus

    DEFF Research Database (Denmark)

    Skov Benthien, Kirstine; Nordly, Mie; von Heymann-Horan, Annika

    2018-01-01

    CONTEXT: Avoidable hospital admissions are important negative indicators of quality of end-of-life care. Specialized palliative care (SPC) may support patients remaining at home. OBJECTIVES: Therefore, the purpose of this study was to investigate if SPC at home could prevent hospital admissions...... in patients with incurable cancer. METHODS: These are secondary results of Domus: a randomized controlled trial of accelerated transition to SPC with psychological intervention at home (Clinicaltrials.gov: NCT01885637). Participants were patients with incurable cancer and limited antineoplastic treatment...... significantly in overall potentially avoidable admissions. Both groups felt mostly safe about their place of care. CONCLUSION: The intervention did not prevent hospital admissions. Likely, any intervention effects were outweighed by increased identification of problems in the intervention group leading...

  3. Inappropriate Intensive Care Unit admissions: Nigerian doctors ...

    African Journals Online (AJOL)

    2015-12-04

    Dec 4, 2015 ... Background: Nonclinical factors are said to influence decisions to admit patients into the ... admissions per year did not affect possible steps in the setting of a full ICU. ... hospital management, patient's family, threat of legal.

  4. Simple measurement-based admission control for DiffServ access networks

    Science.gov (United States)

    Lakkakorpi, Jani

    2002-07-01

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

  5. 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...

  6. 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.

  7. TCP-Call Admission Control Interaction in Multiplatform Space Architectures

    Directory of Open Access Journals (Sweden)

    Roseti Cesare

    2007-01-01

    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.

  8. Coding accuracy for Parkinson's disease hospital admissions: implications for healthcare planning in the UK.

    Science.gov (United States)

    Muzerengi, S; Rick, C; Begaj, I; Ives, N; Evison, F; Woolley, R L; Clarke, C E

    2017-05-01

    Hospital Episode Statistics data are used for healthcare planning and hospital reimbursements. Reliability of these data is dependent on the accuracy of individual hospitals reporting Secondary Uses Service (SUS) which includes hospitalisation. The number and coding accuracy for Parkinson's disease hospital admissions at a tertiary centre in Birmingham was assessed. Retrospective, routine-data-based study. A retrospective electronic database search for all Parkinson's disease patients admitted to the tertiary hospital over a 4-year period (2009-2013) was performed on the SUS database using International Classification of Disease codes, and on the local inpatient electronic prescription database, Prescription and Information Communications System, using medication prescriptions. Capture-recapture methods were used to estimate the number of patients and admissions missed by both databases. From the two databases, between July 2009 and June 2013, 1068 patients with Parkinson's disease accounted for 1999 admissions. During these admissions, the Parkinson's disease was coded as a primary or secondary diagnosis. Ninety-one percent of these admissions were recorded on the SUS database. Capture-recapture methods estimated that the number of Parkinson's disease patients admitted during this period was 1127 patients (95% confidence interval: 1107-1146). A supplementary search of both SUS and Prescription and Information Communications System was undertaken using the hospital numbers of these 1068 patients. This identified another 479 admissions. SUS database under-estimated Parkinson's disease admissions by 27% during the study period. The accuracy of disease coding is critical for healthcare policy planning and must be improved. If the under-reporting of Parkinson's disease admissions on the SUS database is repeated nationally, expenditure on Parkinson's disease admissions in England is under-estimated by approximately £61 million per year. Copyright © 2016 The Royal

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

    Science.gov (United States)

    Larrobla, Cristina; Botega, Neury José

    2006-12-01

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

  10. [Alkylating agents].

    Science.gov (United States)

    Pourquier, Philippe

    2011-11-01

    With the approval of mechlorethamine by the FDA in 1949 for the treatment of hematologic malignancies, alkylating agents are the oldest class of anticancer agents. Even though their clinical use is far beyond the use of new targeted therapies, they still occupy a major place in specific indications and sometimes represent the unique option for the treatment of refractory diseases. Here, we are reviewing the major classes of alkylating agents and their mechanism of action, with a particular emphasis for the new generations of alkylating agents. As for most of the chemotherapeutic agents used in the clinic, these compounds are derived from natural sources. With a complex but original mechanism of action, they represent new interesting alternatives for the clinicians, especially for tumors that are resistant to conventional DNA damaging agents. We also briefly describe the different strategies that have been or are currently developed to potentiate the use of classical alkylating agents, especially the inhibition of pathways that are involved in the repair of DNA lesions induced by these agents. In this line, the development of PARP inhibitors is a striking example of the recent regain of interest towards the "old" alkylating agents.

  11. 32 CFR 776.66 - Bar admission and disciplinary matters.

    Science.gov (United States)

    2010-07-01

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

  12. The Pattern of Surgical Admissions in University of Nigeria Teaching ...

    African Journals Online (AJOL)

    The digestive system and genitourinary systems were the most commonly affected systems. Emergency admission accounted for 18.1% of all surgical admissions while elective admissions accounted for the rest. Conclusion: More detailed research on the pattern of admissions is important in planning and should be carried ...

  13. Contributing factors in self-poisoning leading to hospital admission in adolescents in northern Finland.

    Science.gov (United States)

    Liisanantti, Janne Henrik; Ala-Kokko, Tero Ilmari; Dunder, Teija Sinikka; Ebeling, Hanna Elina

    2010-07-01

    To evaluate the frequencies of different agents used in self-poisonings and acute factors contributing to intoxication of patients aged 12-18 years in northern Finland. Retrospective medical record review of all hospitalized patients during the period from January 1, 1991 to December 31, 2006. Cause of the admission, contributing factors, readmissions within one year. There were 309 admissions during the period, 54% were females. The leading cause of admission was alcohol, in 222 cases (71.8%). Hospitalizations related to alcohol consumption were associated with accidental poisoning in recreational use. There were no acute contributing factors in the majority of all patients. Over one-third of all intoxications were intentional self-harm, although previously diagnosed psychiatric diseases were rare. It is crucial to recognize adolescent psychiatric disorders in time and consult child and adolescent psychiatrist in case of poisoning.

  14. Utilization of emergency medical transports and hospital admissions among persons with behavioral health conditions.

    Science.gov (United States)

    Cuddeback, Gary; Patterson, P Daniel; Moore, Charity Galena; Brice, Jane H

    2010-04-01

    Emergency medical services transport and emergency department misuse among persons with behavioral health conditions is a concern. Administrative data were used to examine medical transports and hospital admissions among persons with behavioral health conditions. Data on 70,126 medical transports to emergency departments in three southeastern counties were analyzed. Compared with general medical transports, fewer behavioral health transports resulted in a hospital admission. Among behavioral health transports, persons with schizophrenia were 2.62 times more likely than those with substance use disorders to be admitted, and persons with mood disorders were 4.36 times more likely than those with substance use disorders to be admitted. Also, among behavioral health transports, rural transports were less likely than more urban transports to result in a hospital admission. More training of emergency medical services personnel and more behavioral health crisis resources, especially targeting rural areas and substance use disorders, are needed.

  15. The impact of migration on deaths and hospital admissions from work-related injuries in Australia.

    Science.gov (United States)

    Reid, Alison; Peters, Susan; Felipe, Nieves; Lenguerrand, Erik; Harding, Seeromanie

    2016-02-01

    The shift from an industrial to a service-based economy has seen a decline in work-related injuries (WRIs) and mortality. How this relates to migrant workers, who traditionally held high-risk jobs is unknown. This study examined deaths and hospital admissions from WRI, among foreign and Australian-born workers. Tabulated population data from the 1991 to 2011 censuses, national deaths 1991-2002 and hospital admission for 2001-10. Direct age standardised mortality and hospital admission rates (DSRs) and rate ratios (RRs) were derived to examine differences in work-related mortality/hospital admissions by gender, country of birth, employment skill level and years of residence in Australia. DSRs and RRs were generally lower or no different between Australian and foreign-born workers. Among men, mortality DSRs were lower for nine of 16 country of birth groups, and hospital admissions DSRs for 14 groups. An exception was New Zealand-born men, with 9% (95%CI 9-13) excess mortality and 24% (95%CI 22-26) excess hospital admissions. Four decades ago, foreign-born workers were generally at higher risk of WRI than Australian-born. This pattern has reversed. The local-born comprise 75% of the population and a pro-active approach to health and safety regulation could achieve large benefits. © 2015 Public Health Association of Australia.

  16. Discerning applicants’ interests in rural medicine: a textual analysis of admission essays

    Directory of Open Access Journals (Sweden)

    Carol L. Elam

    2015-03-01

    Full Text Available Background: Despite efforts to construct targeted medical school admission processes using applicant-level correlates of future practice location, accurately gauging applicants’ interests in rural medicine remains an imperfect science. This study explores the usefulness of textual analysis to identify rural-oriented themes and values underlying applicants’ open-ended responses to admission essays. Methods: The study population consisted of 75 applicants to the Rural Physician Leadership Program (RPLP at the University of Kentucky College of Medicine. Using WordStat, a proprietary text analysis program, applicants’ American Medical College Application Service personal statement and an admission essay written at the time of interview were searched for predefined keywords and phrases reflecting rural medical values. From these text searches, derived scores were then examined relative to interviewers’ subjective ratings of applicants’ overall acceptability for admission to the RPLP program and likelihood of practicing in a rural area. Results: The two interviewer-assigned ratings of likelihood of rural practice and overall acceptability were significantly related. A statistically significant relationship was also found between the rural medical values scores and estimated likelihood of rural practice. However, there was no association between rural medical values scores and subjective ratings of applicant acceptability. Conclusions: That applicants’ rural values in admission essays were not related to interviewers’ overall acceptability ratings indicates that other factors played a role in the interviewers’ assessments of applicants’ acceptability for admission.

  17. Discerning applicants' interests in rural medicine: a textual analysis of admission essays.

    Science.gov (United States)

    Elam, Carol L; Weaver, Anthony D; Whittler, Elmer T; Stratton, Terry D; Asher, Linda M; Scott, Kimberly L; Wilson, Emery A

    2015-01-01

    Despite efforts to construct targeted medical school admission processes using applicant-level correlates of future practice location, accurately gauging applicants' interests in rural medicine remains an imperfect science. This study explores the usefulness of textual analysis to identify rural-oriented themes and values underlying applicants' open-ended responses to admission essays. The study population consisted of 75 applicants to the Rural Physician Leadership Program (RPLP) at the University of Kentucky College of Medicine. Using WordStat, a proprietary text analysis program, applicants' American Medical College Application Service personal statement and an admission essay written at the time of interview were searched for predefined keywords and phrases reflecting rural medical values. From these text searches, derived scores were then examined relative to interviewers' subjective ratings of applicants' overall acceptability for admission to the RPLP program and likelihood of practicing in a rural area. The two interviewer-assigned ratings of likelihood of rural practice and overall acceptability were significantly related. A statistically significant relationship was also found between the rural medical values scores and estimated likelihood of rural practice. However, there was no association between rural medical values scores and subjective ratings of applicant acceptability. That applicants' rural values in admission essays were not related to interviewers' overall acceptability ratings indicates that other factors played a role in the interviewers' assessments of applicants' acceptability for admission.

  18. Admission to Banking Public Service in Brazil: Constitutional Compliance?

    Directory of Open Access Journals (Sweden)

    Raquel Maria Azevedo Pereira Farias

    2016-10-01

    Full Text Available Concerning public banking institutions, many tenders take place, however “reservation register” retain people in the expectation of being hired, which may not happen. Another institute that compromises the hiring of those is the outsourcing process that is formally constituted, but whose aim is the hiring of cheap and skilled labor not to shoulder the high costs of a public worker. Economic growth, globalization, the informal market, increase banks’ profits at the expenses of people who dedicate their lives to succeed in a public tender while there are those who submit themselves to the precarious work conditions of the outsourcing.

  19. Impact of Admission Control Methods to the Traffic Management

    Directory of Open Access Journals (Sweden)

    Filip Chamraz

    2015-01-01

    Full Text Available The paper deals with Admission control methods (AC in IMS networks (IP multimedia subsystem as one of the elements that help ensure QoS (Quality of service. In the paper we are trying to choose the best AC method for selected IMS network node to allow access to the greatest number of users. Of the large number of methods that were tested and considered good we chose two. The paper compares Gaussian approximation method and one of the measurement based method, specifically „Measured Sum“. Both methods estimate effective bandwidth to allow access for the greatest number of users/devices and allow them access to prepaid services or multimedia content.

  20. Admission levels of serum Gc-globulin

    DEFF Research Database (Denmark)

    Schiødt, F V; Bondesen, S; Petersen, I

    1996-01-01

    Gc-globulin scavenges actin released from necrotic hepatocytes to the extracellular space. In 77 patients with fulminant hepatic failure (FHF) (excluding patients treated with liver transplantation), admission levels of serum Gc-globulin and degree of complexing with monomeric actin (complex ratio...... in the same range as the KCH criteria. An advantage of Gc-globulin is that it gives an estimate of the outcome already on admission. Acute liver transplantation should be considered in FHF patients with Gc-globulin less than 100 mg/L....

  1. Admission Control Techniques for UMTS System

    Directory of Open Access Journals (Sweden)

    P. Kejik

    2010-09-01

    Full Text Available Universal mobile telecommunications system (UMTS is one of the 3rd generation (3G cell phone technologies. The capacity of UMTS is interference limited. Radio resources management (RRM functions are therefore 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. An own UMTS simulation program and several versions of proposed admission control algorithms are presented in this paper. These algorithms are based on fuzzy logic and genetic algorithms. The performance of algorithms is verified via simulations.

  2. Ethnic group variations in alcohol-related hospital admissions in England: does place matter?

    Science.gov (United States)

    Barry, Eleanor; Laverty, Anthony A; Majeed, Azeem; Millett, Christopher

    2015-01-01

    The health burden of alcohol use is socially and geographically patterned in many countries. Less is known about variations in this burden between ethnic groups and whether this differs across place of residence. National cross-sectional study using hospital admission data in England. Alcohol-related admission rates, where an alcohol-related condition was either the primary diagnosis (considered as the reason for admission) or a comorbidity, were calculated using ethnic group specific rates for English regions. In 2010/11 there were a total of 264,870 alcohol-related admissions in England. Admission rates were higher in the North of England than elsewhere (e.g. for primary diagnosis 161 per 100,000 population in the North vs. 62 per 100,000 in the South). These patterns were not uniform across ethnic groups however. For example, admission rates for alcohol-related comorbidity were four times higher among White Irish in London compared with those in the South of England (306 to 76 per 100,000) and four times higher in Indians living in the Midlands compared with those in the South of England (128 to 29 per 100,000). These patterns were similar for admissions with a comorbid alcohol-related condition. Geographical location may be an important determinant of within and between ethnic group variations in alcohol-related hospital admissions in England. While a number of factors were not examined here, this descriptive analysis suggests that this heterogeneity should be taken into account when planning interventions and services for the prevention and management of alcohol misuse.

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

    Science.gov (United States)

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

    2012-06-10

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

  4. Admissions Standards and the Use of Key Marketing Techniques by United States' Colleges and Universities.

    Science.gov (United States)

    Goldgehn, Leslie A.

    1989-01-01

    A survey of admissions deans and directors investigated the use and perceived effectiveness of 15 well-known marketing techniques: advertising, advertising research, a marketing plan, market positioning, market segmentation, marketing audit, marketing research, pricing, program and service accessibility, program development, publicity, target…

  5. Preventive Psychiatric Admission for Patients With Borderline Personality Disorder: A Pilot Study

    NARCIS (Netherlands)

    Koekkoek, B.W.; Snoek, R. van der; Oosterwijk, K.; Meijel, B.K.G. van

    2010-01-01

    PURPOSE. The purpose of this study was to establish the preliminary effects of preventive psychiatric admission of patients with severe borderline personality disorder (BPD) on the rate of agreement over treatment, patient service use, and patient views on the intervention. DESIGN AND METHODS. A

  6. The impact of migration on deaths and hospital admissions from work-related injuries in Australia

    NARCIS (Netherlands)

    Reid, Alison; Peters, Susan; Felipe, Nieves; Lenguerrand, Erik; Harding, Seeromanie

    Objective: The shift from an industrial to a service-based economy has seen a decline in work-related injuries (WRIs) and mortality. How this relates to migrant workers, who traditionally held high-risk jobs is unknown. This study examined deaths and hospital admissions from WRI, among foreign and

  7. A retrospective audit of paediatric surgical admission in a sub-urban ...

    African Journals Online (AJOL)

    Conclusions: Childhood injuries, congenital anomalies and infections are important paediatric health problems. Key words: Children, Admission, Injuries, Congenital malformation, Pattern, Surgical care, Infection. Résumé Introductions: Les données sur l'utilisation du service de la chirurgie pediatrique et le problème des ...

  8. Speaking in Tongues: Can International Graduate Students Read International Graduate Admissions Materials?

    Science.gov (United States)

    Taylor, Zachary W.

    2017-01-01

    A recent Educational Testing Services report (2016) found that international graduate students with a TOEFL score of 80--the minimum average TOEFL score for graduate admission in the United States--usually possess reading subscores of 20, equating to a 12th-grade reading comprehension level. However, one public flagship university's international…

  9. Institutional Planning: What Role for Directors of Student Admissions and Financial Aid?

    Science.gov (United States)

    Haines, John R.

    1976-01-01

    According to the director of Higher Education Management Services for the New York State Education Department, the offices of admissions and student financial aid have long been excluded from the institutional planning process. In an era of projected enrollment declines and increased competition, these offices need to assume a critical new role.…

  10. QoS-Guaranteed Admission Control for OFDMA-based Systems

    DEFF Research Database (Denmark)

    Ramkumar, Venkata; Anggorojati, Bayu; Lucian, Stefan P. Andrei

    2010-01-01

    This paper proposes a novel admission control (AC) algorithm for guaranteed quality of service (QoS) to all users. The proposed solution provides better utilization of system capacity using adaptive modulation (AM). A scheduler based on a per user priority function is also given in this paper. Th...

  11. Increasing Short-Stay Unplanned Hospital Admissions among Children in England; Time Trends Analysis ’97–‘06

    Science.gov (United States)

    Saxena, Sonia; Bottle, Alex; Gilbert, Ruth; Sharland, Mike

    2009-01-01

    Background Timely care by general practitioners in the community keeps children out of hospital and provides better continuity of care. Yet in the UK, access to primary care has diminished since 2004 when changes in general practitioners' contracts enabled them to ‘opt out’ of providing out-of-hours care and since then unplanned pediatric hospital admission rates have escalated, particularly through emergency departments. We hypothesised that any increase in isolated short stay admissions for childhood illness might reflect failure to manage these cases in the community over a 10 year period spanning these changes. Methods and Findings We conducted a population based time trends study of major causes of hospital admission in children 2 days. By 2006, 67.3% of all unplanned admissions were isolated short stays <2 days. The increases in admission rates were greater for common non-infectious than infectious causes of admissions. Conclusions Short stay unplanned hospital admission rates in young children in England have increased substantially in recent years and are not accounted for by reductions in length of in-hospital stay. The majority are isolated short stay admissions for minor illness episodes that could be better managed by primary care in the community and may be evidence of a failure of primary care services. PMID:19829695

  12. Alphabetical order effects in school admissions

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    2016-01-01

    Roč. 31, č. 4 (2016), s. 483-498 ISSN 0267-1522 R&D Projects: GA ČR(CZ) GBP402/12/G130 Institutional support: RVO:67985998 Keywords : admissions * alphabetical order * order effects Subject RIV: AH - Economics Impact factor: 1.033, year: 2016

  13. Admission predictability of children with acute asthma

    Directory of Open Access Journals (Sweden)

    Maan Alherbish

    2018-01-01

    CONCLUSIONS: Decision of admission could be made to many children with moderate-to-severe acute asthma at the 2nd h of ED stay based on their total PAS. OS and RR should be part of any scoring system to evaluate acute asthma in children.

  14. 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.

  15. Test-Based Admission to Selective Universities:

    DEFF Research Database (Denmark)

    Thomsen, Jens-Peter

    2016-01-01

    This article examines whether the existence of a secondary higher education admission system honouring more qualitative and extra-curricular merits has reduced the social class gap in access to highly sought-after university programmes in Denmark. I use administrative data to examine differences...

  16. 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…

  17. Tricyclic antidepressant overdose necessitating ICU admission ...

    African Journals Online (AJOL)

    Tricyclic antidepressant (TCA) overdose necessitating intensive care unit (ICU) admission remains a significant problem in the Western Cape. In this retrospective study, we reviewed the course of life-threatening TCA overdose in our centre to identify potential prognostic indicators. TCA levels >1 000 ng/ml were associated ...

  18. 28 CFR 54.220 - Admissions.

    Science.gov (United States)

    2010-07-01

    ... Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN...) Admissions to educational institutions prior to June 24, 1973, are not covered by these Title IX regulations... §§ 54.300 through 54.310, each administratively separate unit shall be deemed to be an educational...

  19. 43 CFR 4.1141 - Admissions.

    Science.gov (United States)

    2010-10-01

    ... readily obtainable by him is insufficient to enable him to admit or deny. (d) The party who has requested... pending action only and is not an admission by him for any other purpose nor may it be used against him in...

  20. Perceptions of veterinary admissions committee members of ...

    African Journals Online (AJOL)

    Veterinary admission committees are asked to create and implement a fair, reliable, and valid system to select the candidates most likely to succeed in veterinary school from a large pool of applicants. Although numerous studies have explored grade point average (GPA) as a predictive value of later academic success, ...

  1. Artificial agents learning human fairness

    NARCIS (Netherlands)

    Jong, de S.; Tuyls, K.P.; Verbeeck, K.; Padgham, xx; Parkes, xx

    2008-01-01

    Recent advances in technology allow multi-agent systems to be deployed in cooperation with or as a service for humans. Typically, those systems are designed assuming individually rational agents, according to the principles of classical game theory. However, research in the field of behavioral

  2. 75 FR 6397 - AMC USA, Inc. v. International First Service S.A. a/k/a IFS S.A, its Agents, Affiliated, Related...

    Science.gov (United States)

    2010-02-09

    ... Service USA, Inc. a/k/a IFS USA, Inc. d/b/a Global Wine Logistics USA Inc. a/k/a GWL USA, Inc., and Global... Wine Logistics USA Inc. a/k/a GWL USA, Inc. (``GWL USA''); Anita McNeil; International First Service... FEDERAL MARITIME COMMISSION [Docket No. 10-01] AMC USA, Inc. v. International First Service S.A. a...

  3. Building Agents to Serve Customers

    OpenAIRE

    Barbuceanu, Mihai; Fox, Mark S.; Hong, Lei; Lallement, Yannick; Zhang, Zhongdong

    2004-01-01

    AI agents combining natural language interaction, task planning, and business ontologies can help companies provide better-quality and more costeffective customer service. Our customer-service agents use natural language to interact with customers, enabling customers to state their intentions directly instead of searching for the places on the Web site that may address their concern. We use planning methods to search systematically for the solution to the customer's problem, ensuring that a r...

  4. Chemical Agents

    Science.gov (United States)

    ... CR) see Riot Control Agents Digitalis Distilled mustard (HD) see Sulfur mustard E Ethylene glycol F Fentanyls and other opioids H Hydrazine Hydrofluoric acid (hydrogen fluoride) Hydrogen chloride Hydrogen cyanide (AC) Hydrogen ...

  5. 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 Louison

    2017-01-01

    The aim of this study was to evaluate the predictive validity of a two-step admissions procedure that included a cognitive ability test followed by multiple mini-interviews (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...

  6. 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.

  7. Admission Systems and Student Mobility: A Proposal for an EU-Wide Registry for University Admission

    Directory of Open Access Journals (Sweden)

    Cecile Hoareau McGrath

    2016-07-01

    Full Text Available Europe’s higher education systems are struggling to respond to the established mass demand for higher education, especially given the proportional decline in available resources per student and, more generally the demand for an ever longer education and reduction of the population of working age due to demographic decline. In addition, growing student mobility puts pressure on admission systems to set up relevant procedures for applicants who wish to enter a country. Admission systems to higher education constitute one key element in the mitigation of these challenges. Admissions can regulate student flows, and play a key role in guaranteeing the acquisition of skills in higher education by matching student profiles to their desired courses of study. This article puts European admission systems in perspective. The issue of regulation of student mobility is topical, given the broader and salient discussion on migration flows in Europe. The article uses international comparisons with systems such as the US, Australia and Japan, to provide a critical overview of the role of admission systems in an often overlooked but yet fundamental part of the European Higher Education Area, namely student mobility. The paper also argues for the creation of an information-sharing EU registry on admissions practices for mobile students.

  8. Psychiatric admissions fall following the Christchurch earthquakes: an audit of inpatient data.

    Science.gov (United States)

    Beaglehole, Ben; Bell, Caroline; Beveridge, John; Frampton, Chris

    2015-04-01

    Following the devastating earthquake in Christchurch, New Zealand, there was the widespread perception that the demand for inpatient mental health services would increase. However, our clinical observation was to the contrary, with substantial reductions in inpatient utilisation being noted. We therefore examined psychiatric bed occupancy and admission data to improve understanding of the impact of the disaster on mental health services. We audited acute psychiatric bed occupancy and admission rates prior to and following a major earthquake. After the earthquake, total bed occupancy reduced from an average of 93% to 79%. Daily admissions also reduced by 20.2% for the 30 days following the earthquake. All diagnostic groups, with the exception of the 'Schizophrenia, schizotypal and delusional disorders' category, contributed to the reduction. No rebound to increased occupancy or admissions was seen over the study period. The study confirmed our clinical observation that demand for acute inpatient psychiatric services were markedly reduced after the February 2011 earthquake. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  9. Medication reconciliation errors in a tertiary care hospital in Saudi Arabia: admission discrepancies and risk factors

    Directory of Open Access Journals (Sweden)

    Mazhar F

    2017-03-01

    Full Text Available Background: Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. Objective: The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission. Each medication error was rated for its potential to cause patient harm during hospitalization. A secondary objective was to determine risk factors associated with medication reconciliation errors. Methods: This was a prospective, single-center pilot study conducted in the internal medicine and surgical wards of a tertiary care teaching hospital in the Eastern province of Saudi Arabia. A clinical pharmacist took the best possible medication history of patients admitted to medical and surgical services and compared with the medication orders at hospital admission; any identified discrepancies were noted and analyzed for reconciliation errors. Multivariate logistic regression was performed to determine the risk factors related to reconciliation errors. Results: A total of 328 patients (138 in surgical and 198 in medical were included in the study. For the 1419 medications recorded, 1091 discrepancies were discovered out of which 491 (41.6% were reconciliation errors. The errors affected 177 patients (54%. The incidence of reconciliation errors in the medical patient group was 25.1% and 32.0% in the surgical group (p<0.001. In both groups, the most frequent reconciliation error was the omission (43.5% and 51.2%. Lipid-lowering (12.4% and antihypertensive agents were most commonly involved. If undetected, 43.6% of order errors were rated as potentially requiring increased monitoring or intervention to preclude harm; 17

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

    Science.gov (United States)

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

    2016-10-14

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

  11. Out-of-office hours' elective surgical intensive care admissions and their associated complications.

    Science.gov (United States)

    Morgan, David J R; Ho, Kwok Ming; Ong, Yang Jian; Kolybaba, Marlene L

    2017-11-01

    The 'weekend' effect is a controversial theory that links reduced staffing levels, staffing seniority and supportive services at hospitals during 'out-of-office hours' time periods with worsening patient outcomes. It is uncertain whether admitting elective surgery patients to intensive care units (ICU) during 'out-of-office hours' time periods mitigates this affect through higher staffing ratios and seniority. Over a 3-year period in Western Australia's largest private hospital, this retrospective nested-cohort study compared all elective surgical patients admitted to the ICU based on whether their admission occurred 'in-office hours' (Monday-Friday 08.00-18.00 hours) or 'out-of-office hours' (all other times). The main outcomes were surgical complications using the Dindo-Clavien classification and length-of-stay data. Of the total 4363 ICU admissions, 3584 ICU admissions were planned following elective surgery resulting in 2515 (70.2%) in-office hours and 1069 (29.8%) out-of-office hours elective ICU surgical admissions. Out-of-office hours ICU admissions following elective surgery were associated with an increased risk of infection (P = 0.029), blood transfusion (P = 0.020), total parental nutrition (P office hours ICU admissions were also associated with an increased hospital length-of-stay, with (1.74 days longer, P office hours ICU admissions following elective surgery is common and associated with serious post-operative complications culminating in significantly longer hospital length-of-stays and greater transfers with important patient and health economic implications. © 2017 Royal Australasian College of Surgeons.

  12. Patterns of admission to acute psychiatric in-patient facilities: a national survey in Italy.

    Science.gov (United States)

    Preti, A; Rucci, P; Santone, G; Picardi, A; Miglio, R; Bracco, R; Norcio, B; de Girolamo, G

    2009-03-01

    A proper understanding of patterns of care represents a crucial step in improving clinical decision making and enhancing service provision. Only a few studies, however, have explored global patterns of psychiatric admissions nationwide, and none have been undertaken in Italy. Sociodemographic, clinical and treatment-related information was collected for 1577 patients admitted to 130 public and 36 private in-patient facilities in Italy during an index period in the year 2004. All patients were also rated using the 24-item Brief Psychiatric Rating Scale (BPRS) and the Personal and Social Performance (PSP) rating scales. Non-affective psychoses (36%) were the most common diagnoses and accounted to a large extent for compulsory admissions. Private facilities were more likely to admit patients with organic mental disorders and substance abuse/dependence and less likely to admit patients with non-affective psychoses. Overall, 77.8% of patients had been receiving treatment by a mental health professional in the month prior to admission. In 54% of cases, the admission was solicited by patients' family members. The main factors preceding admission were impairment in work or social functioning, social withdrawal, and conflict with family members. Agitation, delusions and/or hallucinations, and the presence of multiple problems were associated with compulsory admissions, whereas depressive and anxiety symptoms were associated with voluntary admissions. In a mixed, public-private psychiatric care system, like the Italian one, public and private facilities admit patients with widely different clinical characteristics and needs. Family support represents an important resource for most patients, and interventions specifically addressed to relieving family burden are warranted.

  13. Medición de la Calidad del Servicio para Agentes de Suscripción en Revistas Digitales a través del Modelo Servqual (Measuring the Quality of Service for Subscription Agents in eJournals through Model Servqual

    Directory of Open Access Journals (Sweden)

    Salvador Enrique Vazquez Moctezuma

    2015-07-01

    Full Text Available Resumen Las bibliotecas, hospitales, bancos y centros de investigación compran revistas académicas en formato digital con editores e intermediarios para proveerlas a los usuarios que las necesitan. Los administradores con frecuencia califican los servicios que ofertan hacia sus usuarios, pero se olvidan en evaluar a los agentes de suscripción, los cuales a su vez repercuten en el servicio que se brinda a los usuarios finales. Por otra parte, los agentes requieren conocer la percepción que tienen sus clientes/bibliotecas al utilizar sus servicios con el fin de rediseñar, incrementar o eliminar alguno de estos, sin embargo tratar de medir la calidad de un servicio es complejo, puesto que son acciones donde los resultados pueden verse o sentirse, pero la actividad en sí misma es intangible. El presente estudio tiene como propósito esencial, realizar un acercamiento para determinar las percepciones y expectativas que tienen 31 administradores de cinco países de Latinoamérica, que contrataron el servicio de gestión de accesos a través de agencias de suscripción y de la cual son los principales verificadores de accesos a revistas electrónicas. También se mencionan los servicios que ofrece el agente de suscripciones así como se describe el modelo Servqual. Con respecto a la metodología se aplicó un cuestionario con escala Likert. De forma general, se encontró que las expectativas de los clientes superan sus percepciones. Abstract Libraries, hospitals, banks and research centers buy academic journals in digital format with publishers and intermediaries to provide them to the users who need them. Administrators often qualify the services they offer to their users, but forget to rate subscription agents, which in turn affect the service to end users is provided. Moreover, agents need to know the perception your customers / libraries to use their services in order to redesign, increase or remove any of these, however try to measure the

  14. Admission Hyperglycemia and Clinical Outcome in Cerebral Venous Thrombosis

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; Hiltunen, Sini; Tatlisumak, Turgut; Peters, Guusje M.; Silvis, Suzanne M.; Haapaniemi, Elena; Kruyt, Nyika D.; Putaala, Jukka; Coutinho, Jonathan M.

    2016-01-01

    Background and Purpose-Admission hyperglycemia is associated with poor clinical outcome in ischemic and hemorrhagic stroke. Admission hyperglycemia has not been investigated in patients with cerebral venous thrombosis. Methods-Consecutive adult patients with cerebral venous thrombosis were included

  15. 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.

  16. Challenges and potential improvements in the admission process of patients with spinal cord injury in a specialized rehabilitation clinic - an interview based qualitative study of an interdisciplinary team.

    Science.gov (United States)

    Röthlisberger, Fabian; Boes, Stefan; Rubinelli, Sara; Schmitt, Klaus; Scheel-Sailer, Anke

    2017-06-26

    The admission process of patients to a hospital is the starting point for inpatient services. In order to optimize the quality of the health services provision, one needs a good understanding of the patient admission workflow in a clinic. The aim of this study was to identify challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic from the perspective of an interdisciplinary team of health professionals. Semi-structured interviews with eight health professionals (medical doctors, physical therapists, occupational therapists, nurses) at the Swiss Paraplegic Centre (acute and rehabilitation clinic) were conducted based on a maximum variety purposive sampling strategy. The interviews were analyzed using a thematic analysis approach. The interviewees described the challenges and potential improvements in this admission process, focusing on five themes. First, the characteristics of the patient with his/her health condition and personality and his/her family influence different areas in the admission process. Improvements in the exchange of information between the hospital and the patient could speed up and simplify the admission process. In addition, challenges and potential improvements were found concerning the rehabilitation planning, the organization of the admission process and the interdisciplinary work. This study identified five themes of challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic. When planning adaptations of process steps in one of the areas, awareness of effects in other fields is necessary. Improved pre-admission information would be a first important step to optimize the admission process. A common IT-system providing an interdisciplinary overview and possibilities for interdisciplinary exchange would support the management of the admission process. Managers of other hospitals can supplement

  17. Custody, care and country of origin: demographic and diagnostic admission statistics at an inner-city adult psychiatry unit.

    Science.gov (United States)

    Kelly, Brendan D; Emechebe, Afam; Anamdi, Chike; Duffy, Richard; Murphy, Niamh; Rock, Catherine

    2015-01-01

    Involuntary detention is a feature of psychiatric care in many countries. We previously reported an involuntary admission rate of 67.7 per 100,000 population per year in inner-city Dublin (January 2008-December 2010), which was higher than Ireland's national rate (38.5). We also found that the proportion of admissions that was involuntary was higher among individuals born outside Ireland (33.9%) compared to those from Ireland (12.0%), apparently owing to increased diagnoses of schizophrenia in the former group. In the present study (January 2011-June 2013) we again found that the proportion of admissions that was involuntary was higher among individuals from outside Ireland (32.5%) compared to individuals from Ireland (9.9%) (pIreland (206.1 voluntary admissions per 100,000 population per year; deprivation-adjusted rate: 158.5) compared to individuals from Ireland (775.1; deprivation-adjusted rate: 596.2). Overall, admission rates in our deprived, inner-city catchment area remain higher than national rates and this may be attributable to differential effects of Ireland's recent economic problems on different areas within Ireland. The relatively low rate of voluntary admission among individuals born outside Ireland may be attributable to different patterns of help-seeking which mental health services in Ireland need to take into account in future service-planning. Other jurisdictions could also usefully focus attention not just on rates on involuntary admission among individuals born elsewhere, but also rates of voluntary admission which may provide useful insights for service-planning and delivery. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 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\\'.

  19. Patients’ Admissions in Intensive Care Units: A Clustering Overview

    Directory of Open Access Journals (Sweden)

    Ana Ribeiro

    2017-02-01

    Full Text Available Intensive care is a critical area of medicine having a multidisciplinary nature requiring all types of healthcare professionals. Given the critical environment of intensive care units (ICUs, the need to use information technologies, like decision support systems, to improve healthcare services and ICU management is evident. It is proven that unplanned and prolonged admission to the ICU is not only prejudicial to a patient's health, but also such a situation implies a readjustment of ICU resources, including beds, doctors, nurses, financial resources, among others. By discovering the common characteristics of the admitted patients, it is possible to improve these outcomes. In this study clustering techniques were applied to data collected from admitted patients in an intensive care unit. The best results presented a silhouette of 1, with a distance to centroids of 6.2 × 10−17 and a Davies–Bouldin index of −0.652.

  20. Cross-Layer Admission Control Policy for CDMA Beamforming Systems

    Directory of Open Access Journals (Sweden)

    Sheng Wei

    2007-01-01

    Full Text Available A novel admission control (AC policy is proposed for the uplink of a cellular CDMA beamforming system. An approximated power control feasibility condition (PCFC, required by a cross-layer AC policy, is derived. This approximation, however, increases outage probability in the physical layer. A truncated automatic retransmission request (ARQ scheme is then employed to mitigate the outage problem. In this paper, we investigate the joint design of an AC policy and an ARQ-based outage mitigation algorithm in a cross-layer context. This paper provides a framework for joint AC design among physical, data-link, and network layers. This enables multiple quality-of-service (QoS requirements to be more flexibly used to optimize system performance. Numerical examples show that by appropriately choosing ARQ parameters, the proposed AC policy can achieve a significant performance gain in terms of reduced outage probability and increased system throughput, while simultaneously guaranteeing all the QoS requirements.

  1. 49 CFR 1114.3 - Admissibility of business records.

    Science.gov (United States)

    2010-10-01

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

  2. 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…

  3. 78 FR 62415 - Refugee Admissions for Fiscal Year 2014

    Science.gov (United States)

    2013-10-21

    ... October 2, 2013 Refugee Admissions for Fiscal Year 2014 Memorandum for the Secretary of State In... authorize the following actions: The admission of up to 70,000 refugees to the United States during fiscal... with Federal refugee resettlement assistance under the Amerasian immigrant admissions program, as...

  4. Scheduling admissions and reducing variation in bed demand

    NARCIS (Netherlands)

    Bekker, R.; Out, P.

    2011-01-01

    Variability in admissions and lengths of stay inherently leads to variability in bed occupancy. The aim of this paper is to analyse the impact of these sources of variability on the required amount of capacity and to determine admission quota for scheduled admissions to regulate the occupancy

  5. Epidemiological factors in admissions for diarrhoea in 6 - 60-month ...

    African Journals Online (AJOL)

    Objectives. To describe the diarrhoea admissions and the influencing factors in 6 - 60-month-old children at Morogoro Regional Hospital. Design. A retrospective descriptive study of the type of diarrhoea, patient age, home address, nutritional status, diagnosed infection, month of admission, admission duration and outcome ...

  6. Pattern of non-communicable diseases among medical admissions ...

    African Journals Online (AJOL)

    Medical admissions due to non-communicable diseases were carefully selected and analyzed. There were 1853 cases of various non-communicable diseases out of a total medical admission of 3294 constituting 56.2% of total medical admissions. Diseases of the cardiovascular, endocrine and renal systems were the most ...

  7. Rethinking Student Services: Assessing and Improving Service Quality.

    Science.gov (United States)

    Zammuto, Raymond F.; And Others

    1996-01-01

    A study investigated the quality of services in four student enrollment services administrative sub-units (recruiting, admissions, records and registration, financial aid) at a public comprehensive university, using student and staff evaluations and program evaluations. Specific changes needed to improve service delivery are identified and…

  8. Agent-based enterprise integration

    Energy Technology Data Exchange (ETDEWEB)

    N. M. Berry; C. M. Pancerella

    1998-12-01

    The authors are developing and deploying software agents in an enterprise information architecture such that the agents manage enterprise resources and facilitate user interaction with these resources. The enterprise agents are built on top of a robust software architecture for data exchange and tool integration across heterogeneous hardware and software. The resulting distributed multi-agent system serves as a method of enhancing enterprises in the following ways: providing users with knowledge about enterprise resources and applications; accessing the dynamically changing enterprise; locating enterprise applications and services; and improving search capabilities for applications and data. Furthermore, agents can access non-agents (i.e., databases and tools) through the enterprise framework. The ultimate target of the effort is the user; they are attempting to increase user productivity in the enterprise. This paper describes their design and early implementation and discusses the planned future work.

  9. Exploring unplanned ICU admissions: a systematic review.

    Science.gov (United States)

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

    Adverse events are unintended patient injuries or complications that arise from healthcare management resulting in death, disability or prolonged hospital stay. Adverse events that require critical care are a considerable financial burden to the healthcare system. Medical record review seems to be a reliable method for detecting adverse events. To synthesize the best available evidence regarding the estimates of the incidence and preventability of adverse events that necessitate intensive care admission; to determine the type and consequences (patient harm, mortality, length of ICU stay and direct medical costs) of these adverse events. MEDLINE (from 1966 to present), EMBASE (from 1974 to present) and CENTRAL (version 1-2010) were searched for studies reporting on unplanned admissions to intensive care units (ICUs). Databases of reports, conference proceedings, grey literature, ongoing research, relevant patient safety organizations and two journals were searched for additional studies. Reference lists of retrieved papers were searched and authors were contacted in an attempt to find any further published or unpublished work. Only quantitative studies that used chart review for the detection of adverse events requiring intensive care admission were considered for eligibility. Studies that were published in the English, Dutch, German, French or Spanish language were included. Two reviewers independently extracted data and assessed the methodological quality of the included studies. 28 studies in the English language and one study in French were included. Of these, two were considered duplicate publications and therefore 27 studies were reviewed. Meta-analysis of the data was not appropriate due to statistical heterogeneity between studies; therefore, results are presented in a descriptive way. Studies were categorized according to the population and the providers of care. 1) The majority of the included studies investigated unplanned intensive care admissions after

  10. An audit of intensive care unit admission in a pediatric cardio-thoracic population in Enugu, Nigeria

    Directory of Open Access Journals (Sweden)

    Azike Jerome

    2010-08-01

    Full Text Available BACKGROUND: The study aimed to perform an audit of intensive care unit admissions in the paediatric cardio-thoracic population in Enugu, Nigeria and examine the challenges and outcome in this high risk group. Ways of improvement based on this study are suggested. METHODS: The hospital records of consecutive postoperative pediatric cardiothoracic admissions to the multidisciplinary and cardiothoracic intensive care units of the University of Nigeria Teaching Hospital (UNTH Enugu, Nigeria to determine their Intensive Care Unit management and outcome over a 2 year span - June 2002 to June 2004 were retrospectively reviewed. Data collected included patient demographics, diagnosis, duration of stay in the intensive care unit, therapeutic interventions and outcome. RESULTS: There were a total of thirty consecutive postoperative paediatric admissions to the intensive care unit over the 2 year study period. The average age of the patients was 5.1 years with a range of 2 weeks to 13 years. Twelve patients had cardiac surgery with cardiopulmonary bypass (CPB, three patients had colon transplant, four patients had pericardiotomy/pericardicectomy, and five patients had diagnostic/therapeutic bronchoscopy. The remaining patients had the following surgeries, thoracotomy for repair of diaphragmatic hernia/decortications, delayed primary repair of esophageal atresia and gastrostomy. Two patients had excision of a cervical teratoma and cystic hygroma. The average duration of stay in the intensive care unit was 6.2 days. Ten patients (33% received pressor agents for organ support. Five patients (17% had mechanical ventilation, while twenty-five patients (83% received oxygen therapy via intranasal cannula or endotracheal tube. Seven patients (23% received blood transfusion in the ICU. There was a 66% survival rate with ten deaths. CONCLUSION: Paediatric cardio-thoracic services in Nigeria suffer from the problems of inadequate funding and manpower flight to better

  11. 21 CFR 181.28 - Release agents.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Release agents. 181.28 Section 181.28 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN... Release agents. Substances classified as release agents, when migrating from food-packaging material shall...

  12. Effectiveness of screening hospital admissions to detect asymptomatic carriers of Clostridium difficile: a modeling evaluation.

    Science.gov (United States)

    Lanzas, Cristina; Dubberke, Erik R

    2014-08-01

    Both asymptomatic and symptomatic Clostridium difficile carriers contribute to new colonizations and infections within a hospital, but current control strategies focus only on preventing transmission from symptomatic carriers. Our objective was to evaluate the potential effectiveness of methods targeting asymptomatic carriers to control C. difficile colonization and infection (CDI) rates in a hospital ward: screening patients at admission to detect asymptomatic C. difficile carriers and placing positive patients into contact precautions. We developed an agent-based transmission model for C. difficile that incorporates screening and contact precautions for asymptomatic carriers in a hospital ward. We simulated scenarios that vary according to screening test characteristics, colonization prevalence, and type of strain present at admission. In our baseline scenario, on average, 42% of CDI cases were community-onset cases. Within the hospital-onset (HO) cases, approximately half were patients admitted as asymptomatic carriers who became symptomatic in the ward. On average, testing for asymptomatic carriers reduced the number of new colonizations and HO-CDI cases by 40%-50% and 10%-25%, respectively, compared with the baseline scenario. Test sensitivity, turnaround time, colonization prevalence at admission, and strain type had significant effects on testing efficacy. Testing for asymptomatic carriers at admission may reduce both the number of new colonizations and HO-CDI cases. Additional reductions could be achieved by preventing disease in patients who are admitted as asymptomatic carriers and developed CDI during the hospital stay.

  13. Virtual Web Services

    OpenAIRE

    Rykowski, Jarogniew

    2007-01-01

    In this paper we propose an application of software agents to provide Virtual Web Services. A Virtual Web Service is a linked collection of several real and/or virtual Web Services, and public and private agents, accessed by the user in the same way as a single real Web Service. A Virtual Web Service allows unrestricted comparison, information merging, pipelining, etc., of data coming from different sources and in different forms. Detailed architecture and functionality of a single Virtual We...

  14. An Agent-Based Model for Analyzing Control Policies and the Dynamic Service-Time Performance of a Capacity-Constrained Air Traffic Management Facility

    Science.gov (United States)

    Conway, Sheila R.

    2006-01-01

    Simple agent-based models may be useful for investigating air traffic control strategies as a precursory screening for more costly, higher fidelity simulation. Of concern is the ability of the models to capture the essence of the system and provide insight into system behavior in a timely manner and without breaking the bank. The method is put to the test with the development of a model to address situations where capacity is overburdened and potential for propagation of the resultant delay though later flights is possible via flight dependencies. The resultant model includes primitive representations of principal air traffic system attributes, namely system capacity, demand, airline schedules and strategy, and aircraft capability. It affords a venue to explore their interdependence in a time-dependent, dynamic system simulation. The scope of the research question and the carefully-chosen modeling fidelity did allow for the development of an agent-based model in short order. The model predicted non-linear behavior given certain initial conditions and system control strategies. Additionally, a combination of the model and dimensionless techniques borrowed from fluid systems was demonstrated that can predict the system s dynamic behavior across a wide range of parametric settings.

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

    Science.gov (United States)

    Röding, Karin

    2005-08-01

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

  16. [Biological agents].

    Science.gov (United States)

    Amano, Koichi

    2009-03-01

    There are two types of biological agents for the treatment of rheumatoid arthritis (RA); monoclonal antibodies and recombinant proteins. Among the latter, etanercept, a recombinant fusion protein of soluble TNF receptor and IgG was approved in 2005 in Japan. The post-marketing surveillance of 13,894 RA patients revealed the efficacy and safety profiles of etanercept in the Japanese population, as well as overseas studies. Abatacept, a recombinant fusion protein of CTLA4 and IgG, is another biological agent for RA. Two clinical trials disclosed the efficacy of abatacept for difficult-to-treat patients: the AIM for MTX-resistant cases and the ATTAIN for patients who are resistant to anti-TNF. The ATTEST trial suggested abatacept might have more acceptable safety profile than infliximab. These biologics are also promising for the treatment of RA for not only relieving clinical symptoms and signs but retarding structural damage.

  17. Predominant diagnoses, gender, and admission duration in an adult psychiatric inpatient hospital in United Kingdom

    Directory of Open Access Journals (Sweden)

    Carlo Lazzari

    2017-12-01

    Full Text Available Introduction: The study objective was to epidemiologically analyse patients presenting at an adult and mixed-gender psychiatric inpatient unit in Essex, Kingswood Centre, UK, to report the predominant diagnoses, gender, and admission duration. Method and material: Meta-analysis and descriptive statistics analysed the year 2016 discharge data on Excel® for 162 patients. ICD-10 codes classified their mental illnesses. Results: Meta-analysis evidenced statistically significant heterogeneity in numbers admissions (I2=95%; p≤0.001, length (I2=78%; p≤0.001, and gender (I2=76%; p≤0.001. The prevailing diagnosis was borderline personality disorder (BPD (rate, 95% CI=0.46 [0.38-0.54]. The longest admission was for schizoaffective disorder (mean duration, 95% CI=53 [22.65-83.34], p=0.001. Gender presented a prevalence of male over female admissions for schizophrenia (OR, 95% CI=0.14 [0.05-0.35], p≤0.001 and BPD with prevalence of female over male admissions (OR, 95% CI=2.79 [1.35-5.76], p=0.05. Conclusion: Female patients with BPD were the most represented category in non-forensic psychiatric inpatient wards in the population studied. Male patients with schizophrenia represented the other gender highly represented. The longest admission was recorded for schizoaffective disorder due to the complexity to treat both mood and psychotic symptoms. It is likely that women with BPD will be the future recipients of psychiatric inpatient and outpatient healthcare services.

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

    Science.gov (United States)

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

    2014-01-01

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

  19. Effect of reclassification of cannabis on hospital admissions for cannabis psychosis: a time series analysis.

    Science.gov (United States)

    Hamilton, Ian; Lloyd, Charlie; Hewitt, Catherine; Godfrey, Christine

    2014-01-01

    The UK Misuse of Drugs Act (1971) divided controlled drugs into three groups A, B and C, with descending criminal sanctions attached to each class. Cannabis was originally assigned by the Act to Group B but in 2004, it was transferred to the lowest risk group, Group C. Then in 2009, on the basis of increasing concerns about a link between high strength cannabis and schizophrenia, it was moved back to Group B. The aim of this study is to test the assumption that changes in classification lead to changes in levels of psychosis. In particular, it explores whether the two changes in 2004 and 2009 were associated with changes in the numbers of people admitted for cannabis psychosis. An interrupted time series was used to investigate the relationship between the two changes in cannabis classification and their impact on hospital admissions for cannabis psychosis. Reflecting the two policy changes, two interruptions to the time series were made. Hospital Episode Statistics admissions data was analysed covering the period 1999 through to 2010. There was a significantly increasing trend in cannabis psychosis admissions from 1999 to 2004. However, following the reclassification of cannabis from B to C in 2004, there was a significant change in the trend such that cannabis psychosis admissions declined to 2009. Following the second reclassification of cannabis back to class B in 2009, there was a significant change to increasing admissions. This study shows a statistical association between the reclassification of cannabis and hospital admissions for cannabis psychosis in the opposite direction to that predicted by the presumed relationship between the two. However, the reasons for this statistical association are unclear. It is unlikely to be due to changes in cannabis use over this period. Other possible explanations include changes in policing and systemic changes in mental health services unrelated to classification decisions. Copyright © 2013 Elsevier B.V. All rights

  20. Reasons for hospital admissions among youth and young adults with cerebral palsy.

    Science.gov (United States)

    Young, Nancy L; McCormick, Anna M; Gilbert, Tom; Ayling-Campos, Anne; Burke, Tricia; Fehlings, Darcy; Wedge, John

    2011-01-01

    To identify the most common reasons for acute care hospital admissions among youth (age range, 13-17.9y) and young adults (age range, 23-32.9y) with cerebral palsy (CP). We completed a secondary analysis of data from the Canadian Institute for Health Information (CIHI) to determine the most frequently observed reasons for admissions and the associated lengths of stay (LOS). Participants were identified from 6 children's treatment centers in Ontario, Canada. Health records data from youth with CP (n=587) and young adults with CP (n=477) contributed to this study. Not applicable. The most common reasons for hospital admission, relative frequencies of admissions for each reason, and mean LOS were reported. The analysis of CIHI records identified epilepsy and pneumonia as the top 2 reasons for admissions in both age groups. Both age groups were commonly admitted because of infections other than pneumonia and urinary tract infections (UTIs), gastrointestinal (GI) problems such as malabsorption, and mental illness. The reasons that were unique to youth included orthopedic and joint-related issues, other respiratory problems, and scoliosis. In young adults, mental illness was the third most common reason for admission, followed by lower GI or constipation problems, malnutrition or dehydration, upper GI problems, fractures, and UTIs. This article provides important clinical information that can be used in the training of physicians and health care providers, and to guide future planning of ambulatory care services to support the clinical management of persons with CP over their lifespan. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Hospital Preparations for Viral Hemorrhagic Fever Patients and Experience Gained from Admission of an Ebola Patient.

    Science.gov (United States)

    Haverkort, J J Mark; Minderhoud, A L C Ben; Wind, Jelte D D; Leenen, Luke P H; Hoepelman, Andy I M; Ellerbroek, Pauline M

    2016-02-01

    The Major Incident Hospital of the University Medical Centre of Utrecht has a longstanding history of preparing for the management of highly pathogenic and infectious organisms. An assessment of the hospital's preparations for an outbreak of viral hemorrhagic fever and its experience during admission of a patient with Ebola virus disease showed that the use of the buddy system, frequent training, and information sessions for staff and their relatives greatly increased the sense of safety and motivation among staff. Differing procedures among ambulance services limited the number of services used for transporting patients. Waste management was the greatest concern, and destruction of waste had to be outsourced. The admission of an Ebola patient proceeded without incident but led to considerable demands on staff. The maximum time allowed for wearing personal protective equipment was 45 minutes to ensure safety, and an additional 20 minutes was needed for recovery.

  2. A distributed admission approach based on marking mechanism over Bluetooth best-effort network

    DEFF Research Database (Denmark)

    Son, L.T.; Schiøler, Henrik; Madsen, Ole Brun

    2002-01-01

    The end-to-end Quality of Service delivered in Bluetooth networks depends on a large number of parameters at different levels, e.g. link capacity, packet delays, etc, which are requested in certain patterns and controlled by various algorithms. In this paper, a method of adaptive distributed...... admission with end-to-end Quality of Service (QoS) provisions based marking information for real time and non real time traffics in Bluetooth networks is highlighted, its mathematical background is analyzed and a simulation with bursty traffic sources, Interrupted Bernoulli Process (IBP), is carried out....... The simulation results show that the performance of Bluetooth network is improved when applying the distributed admission method....

  3. 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…

  4. Trading Agents

    CERN Document Server

    Wellman, Michael

    2011-01-01

    Automated trading in electronic markets is one of the most common and consequential applications of autonomous software agents. Design of effective trading strategies requires thorough understanding of how market mechanisms operate, and appreciation of strategic issues that commonly manifest in trading scenarios. Drawing on research in auction theory and artificial intelligence, this book presents core principles of strategic reasoning that apply to market situations. The author illustrates trading strategy choices through examples of concrete market environments, such as eBay, as well as abst

  5. SECOND BUYING AGENT

    CERN Multimedia

    SPL - SERVICES ACHATS

    2000-01-01

    Last year the buying agent LOGITRADE started operations on the CERN site, processing purchasing requests for well-defined families of products up to a certain value. It was planned from the outset that a second buying agent would be brought in to handle the remaining product families. So, according to that plan, the company CHARLES KENDALL will be commencing operations at CERN on 8 May 2000 in Building 73, 1st floor, offices 31 and 35 (phone and fax numbers to be announced).Each buying agent will have its own specific list of product families and will handle purchasing requests up to 10'000 CHF.Whenever possible they will provide the requested supplies at a price (including the cost of their own services) which must be equivalent to or lower than the price mentioned on the purchasing request, changing the supplier if necessary. If a lower price cannot be obtained, agents will provide the necessary administrative support free of charge.To ensure that all orders are processed in the best possible conditions, us...

  6. 39 CFR 2.2 - Agent for receipt of process.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Agent for receipt of process. 2.2 Section 2.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE GENERAL AND TECHNICAL PROVISIONS (ARTICLE II) § 2.2 Agent for receipt of process. The General Counsel of the Postal...

  7. Qualitative exploration of stakeholders' perspectives of involuntary admission under the Mental Health Act 2001 in Ireland.

    Science.gov (United States)

    Smyth, Siobhán; Casey, Dympna; Cooney, Adeline; Higgins, Agnes; McGuinness, David; Bainbridge, Emma; Keys, Mary; Georgieva, Irina; Brosnan, Liz; Beecher, Claire; Hallahan, Brian; McDonald, Colm; Murphy, Kathy

    2017-12-01

    There is international interest in, and continued concern about, the potential long-term impact of involuntary admission to psychiatric institutions, and the effect this coercive action has on a person's well-being and human rights. Involuntary detention in hospital remains a controversial process that involves stakeholders with competing concerns and who often describe negative experiences of the process, which can have long-lasting effects on the therapeutic relationship with service users. The aim of the present study was to explore the perspectives of key stakeholders involved in the involuntary admission and detention of people under the Mental Health Act 2001 in Ireland. Focus groups were used to collect data. Stakeholders interviewed were service users, relatives, general practitioners, psychiatrists, mental health nurses, solicitors, tribunal members, and police. Data were analysed using a general inductive approach. Three key categories emerged: (i) getting help; (ii) detention under the Act; and (iii) experiences of the tribunal process. This research highlights gaps in information and uncertainty about the involuntary admission process for stakeholders, but particularly for service users who are most affected by inadequate processes and supports. Mental health law has traditionally focussed on narrower areas of detention and treatment, but human rights law requires a greater refocussing on supporting service users to ensure a truly voluntary approach to care. The recent human rights treaty, the UN Convention on the Rights of Persons with Disabilities, is to guarantee a broad range of fundamental rights, such as liberty and integrity, which can be affected by coercive processes of involuntary admission and treatment. © 2016 Australian College of Mental Health Nurses Inc.

  8. A participação dos agentes indígenas de saúde nos serviços de atenção à saúde: a experiência em Santa Catarina, Brasil Participation by indians health agents in health services: the experience in Santa Catarina State, Brazil

    Directory of Open Access Journals (Sweden)

    Esther Jean Langdon

    2006-12-01

    Full Text Available Este trabalho analisa a formação e o papel do agente indígena de saúde (AIS nas Terras Indígenas (T.I. Xapecó e Laklãnõ, Santa Catarina, Brasil, frente à Política Nacional de Atenção à Saúde dos Povos Indígenas. O papel do AIS na atenção básica de saúde é definido com base na mediação entre os saberes e práticas de atenção à saúde tradicionais e biomédicos, inserido no conceito de atenção diferenciada. Em ambas as T.I. foi constatada uma grande rotatividade de AIS, bem como a falta e/ou a inadequação de cursos de capacitação. Observaram-se ainda dificuldades dos AIS para entender a justificativa das atividades delegadas a eles, agravadas pela ambigüidade de seu papel frente à comunidade e por problemas na comunicação com os outros profissionais de saúde. Considerando os pressupostos da Política Nacional, esta pesquisa indicou que a articulação entre as práticas indígenas de auto-atenção e os serviços biomédicos é precária, necessitando de um aprofundamento nas discussões, com a efetiva participação de todos os atores envolvidos na atenção à saúde.This study analyzes the role and training of indian health agents as defined by the National Policy for Health Care of Indians Peoples on two Indian reservations in Santa Catarina, Brazil. The health agent's role in primary care is based on mediation between traditional health practices and biomedicine, subsumed in the concept of differentiated care. On both reservations, a large turnover of indigenous health agents and lack of adequate training were observed. The indigenous health agents expressed difficulty in understanding the reasons for their activities, role ambiguity vis-à-vis the community, and communications problems with other health professionals. Considering the national policy guidelines, this study indicates that the provision of differentiated care is precarious and that a dialogue is necessary, with actual participation by all

  9. A review of one year of British Armed Forces mental health hospital admissions.

    Science.gov (United States)

    Finnegan, A; Finnegan, S; Gamble, D

    2007-03-01

    The paper provides a review of one year of military Mental Health (MH) hospital admissions. This includes an exploration into demographic trends, differences in clinical opinion and how information gained is used to improve the service and ensure appropriate, cost effective care in the optimum environment. The sample group is entitled military MH hospital admissions from 1 April 2005 to 31 March 2006. Data was collected on questionnaires with SPSS used for the management and analysis of the quantitative data, with the information exposed to descriptive and inferential statistical analysis. There were 344 admissions. The paper contains a detailed review of a number of variables. Depression was the most common diagnosis resulting in 112 (33%) hospital admissions and Post Traumatic Stress Disorder accounted for 23 (7%). There were statistically significant differences that may be attributable to gender with more women admitted with depression and more men with alcohol related disorders. The average length of stay was 21 days, with 48% of patients discharged within 3 weeks. 45% of all returns included significant events reporting that highlighted written evidence of good and poor practice. This study is part of an extensive monitoring programme of military MH hospital admissions. Depression is the most common MH problem leading to hospital admission. The results indicate that Service-personnel have access to a highly responsive service that provides brief assessment and treatment within a safe therapeutic environment. 45% of returns included significant event information that resulted in policy changes, leading to improved patient care and a better interface with the NHS. Bench-marking, both internally between military Departments of Community Mental Health and externally have improved visibility and self awareness leading to better GP induction programmes, PHC educational seminars and the establishment of MH web-pages. The Armed Forces need an effective MH service

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

    LENUS (Irish Health Repository)

    Galvin, Mairead

    2012-10-08

    apparently unintentional discrepancies, a mean of 3.3 per patient. In total, 227 (50 %) interventions were accepted and discrepancies resolved. At 48-hours under half (46 %) of patients remained affected by an unintentional unresolved discrepancy (60 % related to omissions). Verbally communicated discrepancies were more likely to be resolved than those not communicated verbally (Chi-square (1) = 30.029 p < 0.05). Under half of unintentional unresolved discrepancies (46 %) had the potential to cause minor harm compared to 70 % of the resolved unintentional discrepancies. None had the potential to result in severe harm. Conclusion Clinical pharmacists contribute positively to admission medication reconciliation and should be engaged to deliver this service in Ireland.

  11. The Economics of an Admissions Holding Unit.

    Science.gov (United States)

    Schreyer, Kraftin E; Martin, Richard

    2017-06-01

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

  12. Quality of life before surgical ICU admission.

    Science.gov (United States)

    Abelha, Fernando J; Santos, Cristina C; Barros, Henrique

    2007-11-12

    Examining the quality of life (QOL) of patients before ICU admission will allow outcome variables to be compared and analyzed in relation to it. The objective of this study was to analyze QOL of patients before admission to a surgical ICU and to study its relationship to outcome and to the baseline characteristics of the patients. All adult patients consecutively admitted to the surgical ICU between November 2004 and April 2005, who underwent non-cardiac surgery, were enrolled in this observational and prospective study. The following patient characteristics were recorded: age, gender, body mass index, ASA physical status, type and magnitude of surgical procedure, length of stay (LOS), in ICU and in hospital, mortality, Simplified Acute Physiology Score II (SAPS), history of co-morbidities and quality of life survey score (QOLSS). The relationships between QOLSS and ICU variables and outcome were evaluated. The relationship between the total QOLSS and each variable or outcome was assessed by multiple linear regression. One hundred eighty seven patients completed the study. The preadmission QOLSS of the patients studied was 4.43 +/- 4.90; 28% of patients had a normal quality of life (0 points), 38% had between 1 and 5 points (considered mild deterioration), 21% had between 6 and 10 points (moderate deterioration), 10% had between 11 and 15 points (considered major deterioration) and 3% had more than 15 points (severe limitation of quality of life). A worse preadmission QOLSS was associated with higher SAPS II scores, with older patients (age> 65 years) and with ASA physical status (ASA III/IV). Total QOLSS was significantly worse in elderly patients and in patients with co-morbidities and in patients more severely ill at ICU admission. Patients who died in the ICU and in hospital had worse QOLSS scores compared to those who survived. However, no statistical differences in QOLSS were found in relation to longer ICU stays (ICU LOS). Preadmission QOL correlates with

  13. Quality of life before surgical ICU admission

    Directory of Open Access Journals (Sweden)

    Barros Henrique

    2007-11-01

    Full Text Available Abstract Background: Examining the quality of life (QOL of patients before ICU admission will allow outcome variables to be compared and analyzed in relation to it. The objective of this study was to analyze QOL of patients before admission to a surgical ICU and to study its relationship to outcome and to the baseline characteristics of the patients. Methods: All adult patients consecutively admitted to the surgical ICU between November 2004 and April 2005, who underwent non-cardiac surgery, were enrolled in this observational and prospective study. The following patient characteristics were recorded: age, gender, body mass index, ASA physical status, type and magnitude of surgical procedure, length of stay (LOS, in ICU and in hospital, mortality, Simplified Acute Physiology Score II (SAPS, history of co-morbidities and quality of life survey score (QOLSS. The relationships between QOLSS and ICU variables and outcome were evaluated. The relationship between the total QOLSS and each variable or outcome was assessed by multiple linear regression. Results: One hundred eighty seven patients completed the study. The preadmission QOLSS of the patients studied was 4.43 ± 4.90; 28% of patients had a normal quality of life (0 points, 38% had between 1 and 5 points (considered mild deterioration, 21% had between 6 and 10 points (moderate deterioration, 10% had between 11 and 15 points (considered major deterioration and 3% had more than 15 points (severe limitation of quality of life. A worse preadmission QOLSS was associated with higher SAPS II scores, with older patients (age> 65 years and with ASA physical status (ASA III/IV. Total QOLSS was significantly worse in elderly patients and in patients with co-morbidities and in patients more severely ill at ICU admission. Patients who died in the ICU and in hospital had worse QOLSS scores compared to those who survived. However, no statistical differences in QOLSS were found in relation to longer ICU stays

  14. The Economics of an Admissions Holding Unit

    Directory of Open Access Journals (Sweden)

    Kraftin E. Schreyer

    2017-05-01

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

  15. Structure preserving transformations for Newtonian Lie-admissible equations

    International Nuclear Information System (INIS)

    Cantrijn, F.

    1979-01-01

    Recently, a new formulation of non-conservative mechanics has been presented in terms of Hamilton-admissible equations which constitute a generalization of the conventional Hamilton equations. The algebraic structure entering the Hamilton-admissible description of a non-conservative system is that of a Lie-admissible algebra. The corresponding geometrical treatment is related to the existence of a so-called symplectic-admissible form. The transformation theory for Hamilton-admissible systems is currently investigated. The purpose of this paper is to describe one aspect of this theory by identifying the class of transformations which preserve the structure of Hamilton-admissible equations. Necessary and sufficient conditions are established for a transformation to be structure preserving. Some particular cases are discussed and an example is worked out

  16. Construction of a Composite Hospital Admission Index Using the Aggregated Weights of Criteria

    International Nuclear Information System (INIS)

    Nor Hasliza Mat Desa; Abdul Aziz Jemain; Maznah Mat Kasim

    2015-01-01

    The issue of age difference in hospital admission should be given special attention since it affects the structure of hospital care and treatments. Patients of different age groups should be given different priority in service provision. Due to crucial time and limited resources, health care managers need to make wise decisions in identifying priorities in age of admission. This paper aimed to propose a construction of a daily composite hospital admission index (CHAI) as an indicator that captures relevant information about the overall performance of hospital admission over time. It involves five different age groups of total patients admitted to seven major public hospitals in the Klang Valley, Malaysia for respiratory and cardiovascular diseases for a period of three years, 2008 - 2010. The criteria weights were predetermined by aggregating the subjective weight based on rank ordered centroid (ROC) method and objective weight based on entropy - kernel method. The highest and lowest scores of CHAI were marked, while the groups of patients were prioritized according to the criteria weight ranking orders. (author)

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

    Science.gov (United States)

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

    2013-05-01

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

  18. Admission criteria and diversity in medical school

    DEFF Research Database (Denmark)

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

    2013-01-01

    on other attributes. To explore the social mix of the two tracks, we obtained information on social indices associated with educational attainment in Denmark (ethnic origin, father’s education, mother’s education, parenthood, parents live together, parent on benefit). Result: Selection strategy (grade......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...... 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...

  19. Admissibility of appeals in atomic energy law

    International Nuclear Information System (INIS)

    Rengeling, H.W.

    1981-01-01

    Using two decisions made by the Federal Court of Administration on the Whyl reactor on July 17, 1980, and on the Stade reactor on December 22, 1980, which he considers as having at least an orientation effect, the author examines the admissibility of appeals filed according to the Atomic Energy Law. For substantiating the appeal, he discusses rules of law that protect third parties and the complainant's obligation to substantiate the appeal. In view of the preclusion of objectives, he differentiates between 'forfeiture' preclusion and 'validity' preclusion. In his view, the above-mentioned decisions produce effects that are to the benefit of the constitutional state and the necessary further development of economy and technology. (HSCH) [de

  20. Recurrent Admissions for Diabetic Foot Complications

    Directory of Open Access Journals (Sweden)

    Ang CL

    2013-07-01

    Full Text Available Diabetic foot complications are a significant source of morbidity and mortality. Patients who undergo recurrent admissions for the same diabetic foot problems represent a difficult subgroup to treat. From July 2007 to June 2008, there were 38 such patients who were admitted recurrently. Eighteen patients (47% were re-admitted because of previous refusal of surgical treatment. Eighteen patients (47% received treatment as necessary but were still readmitted for recurrent infection at the same wound site. Assessment of patients’ compliance to outpatient treatment was found to be generally lacking. As a significant proportion were re-admitted because of previous refusal of surgery, a trained counselor may be suitable in counselling patients for debridement or amputation surgery.

  1. Distribution and drivers of costs in type 2 diabetes mellitus treated with oral hypoglycemic agents: a retrospective claims data analysis.

    Science.gov (United States)

    Bron, Morgan; Guerin, Annie; Latremouille-Viau, Dominick; Ionescu-Ittu, Raluca; Viswanathan, Prabhakar; Lopez, Claudia; Wu, Eric Q

    2014-09-01

    To describe the distribution of costs and to identify the drivers of high costs among adult patients with type 2 diabetes mellitus (T2DM) receiving oral hypoglycemic agents. T2DM patients using oral hypoglycemic agents and having HbA1c test data were identified from the Truven MarketScan databases of Commercial and Medicare Supplemental insurance claims (2004-2010). All-cause and diabetes-related annual direct healthcare costs were measured and reported by cost components. The 25% most costly patients in the study sample were defined as high-cost patients. Drivers of high costs were identified in multivariate logistic regressions. Total 1-year all-cause costs for the 4104 study patients were $55,599,311 (mean cost per patient = $13,548). Diabetes-related costs accounted for 33.8% of all-cause costs (mean cost per patient = $4583). Medical service costs accounted for the majority of all-cause and diabetes-related total costs (63.7% and 59.5%, respectively), with a minority of patients incurring >80% of these costs (23.5% and 14.7%, respectively). Within the medical claims, inpatient admission for diabetes-complications was the strongest cost driver for both all-cause (OR = 13.5, 95% CI = 8.1-23.6) and diabetes-related costs (OR = 9.7, 95% CI = 6.3-15.1), with macrovascular complications accounting for most inpatient admissions. Other cost drivers included heavier hypoglycemic agent use, diabetes complications, and chronic diseases. The study reports a conservative estimate for the relative share of diabetes-related costs relative to total cost. The findings of this study apply mainly to T2DM patients under 65 years of age. Among the T2DM patients receiving oral hypoglycemic agents, 23.5% of patients incurred 80% of the all-cause healthcare costs, with these costs being driven by inpatient admissions, complications of diabetes, and chronic diseases. Interventions targeting inpatient admissions and/or complications of diabetes may contribute to the decrease of the

  2. Radioprotective Agents

    Directory of Open Access Journals (Sweden)

    Ilker Kelle

    2008-01-01

    Full Text Available Since1949, a great deal of research has been carried out on the radioprotective activity of various chemical substances. Thiol compounds, compounds which contain –SH radical, different classes of pharmacological agents and other compounds such as vitamine C and WR-2721 have been shown to reduce mortality when administered prior to exposure to a lethal dose of radiation. Recently, honey bee venom as well as that of its components melittin and histamine have shown to be valuable in reduction of radiation-induced damage and also provide prophylactic alternative treatment for serious side effects related with radiotherapy. It has been suggested that the radioprotective activity of bee venom components is related with the stimulation of the hematopoetic system.

  3. Security Framework for Agent-Based Cloud Computing

    Directory of Open Access Journals (Sweden)

    K Venkateshwaran

    2015-06-01

    Full Text Available Agent can play a key role in bringing suitable cloud services to the customer based on their requirements. In agent based cloud computing, agent does negotiation, coordination, cooperation and collaboration on behalf of the customer to make the decisions in efficient manner. However the agent based cloud computing have some security issues like (a. addition of malicious agent in the cloud environment which could demolish the process by attacking other agents, (b. denial of service by creating flooding attacks on other involved agents. (c. Some of the exceptions in the agent interaction protocol such as Not-Understood and Cancel_Meta protocol can be misused and may lead to terminating the connection of all the other agents participating in the negotiating services. Also, this paper proposes algorithms to solve these issues to ensure that there will be no intervention of any malicious activities during the agent interaction.

  4. The Family Physician's Perceived Role in Preventing and Guiding Hospital Admissions at the End of Life: A Focus Group Study

    NARCIS (Netherlands)

    Reyniers, T.; Houttekier, D.; Pasman, H.R.; Stichele, R.V.; Cohen, J.; Deliens, L.

    2014-01-01

    CONCLUSIONS Family physicians face many different and complex roles and difficulties in preventing and guiding hospital admissions at the end of life. Enhancing the family physician’s role as a gatekeeper to hospital services, offering the physicians more end-of-life care training, and developing or

  5. The Validity of Graduate Management Admission Test Scores: A Summary of Studies Conducted from 1997 to 2004

    Science.gov (United States)

    Talento-Miller, Eileen; Rudner, Lawrence M.

    2008-01-01

    The validity of Graduate Management Admission Test (GMAT) scores is examined by summarizing 273 studies conducted between 1997 and 2004. Each of the studies was conducted through the Validity Study Service of the test sponsor and contained identical variables and statistical methods. Validity coefficients from each of the studies were corrected…

  6. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data.

    Science.gov (United States)

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-06-01

    likely to have been admitted via a GP (vs an A and E department). This furthers evidence suggesting that access to general practice is related to use of emergency hospital services in England. The relative merits of the two admission routes remain unclear. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Woodhams Victoria

    2012-06-01

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

  9. Trends in substance use admissions among older adults.

    Science.gov (United States)

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

    2017-08-22

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

  10. Temperature effects on hospital admissions for kidney morbidity in Taiwan

    International Nuclear Information System (INIS)

    Lin, Yu-Kai; Wang, Yu-Chun; Ho, Tsung-Jung; Lu, Chensheng

    2013-01-01

    Objective: This study aimed to associate hospital admissions of kidney diseases with extreme temperature and prolonged heat/cold events in 7 regions of Taiwan. Methods: Age-specific ( 10 , O 3 , and NO 2 ) and potential confounders. Results: We observed a V or J-shape association between daily average temperatures and the RR estimates for hospital admissions of kidney diseases in Taiwan. The lowest risk for hospital admissions of kidney diseases was found at around 25 °C, and risk increased as temperatures deviated from 25 °C. The pooled cumulative 8-day RR for all ages of population of the 7 study areas were 1.10 (95% confidence interval (CI): 1.01, 1.19) at 18 °C and 1.45 (95% CI: 1.27, 1.64) at 30 °C. High temperature has more profound influence on hospital admission of kidney diseases than low temperature. Temperature risks for hospital admissions were similar between younger (< 65 years) and elderly (65 + years) population. This study observed no significant effects of prolonged heat extremes on hospital admissions of kidney diseases. Conclusions: The heat effect for kidney morbidities leading to hospital admission was more significant than that of the cold temperature. This study did not find the age-dependent relative risks for temperature associating with hospital admissions of kidney diseases. - Highlights: ► V or J-shaped association was observed between daily temperatures and hospital admissions for renal diseases in Taiwan. ► The pooled relative risks accounting for 8 days of lag for the 7 study areas were 1.1 at 18 °C and 1.46 at 30 °C. ► There is no difference of the relative risk estimates for hospital admissions between younger and elderly population. ► We found significant protective effects of hospital admissions for prolonged cold extremes, but not for heat extremes

  11. Effect of post-discharge follow-up care on re-admissions among US veterans with congestive heart failure: a rural-urban comparison.

    Science.gov (United States)

    Muus, Kyle J; Knudson, Alana; Klug, Marilyn G; Gokun, Jane; Sarrazin, Mary; Kaboli, Peter

    2010-01-01

    Hospital re-admissions for patients with congestive heart failure (CHF) are relatively common and costly occurrences within the US health infrastructure, including the Veterans Affairs (VA) healthcare system. Little is known about CHF re-admissions among rural veteran patients, including the effects of socio-demographics and follow-up outpatient visits on these re-admissions. To examine socio-demographics of US veterans with CHF who had 30 day potentially preventable re-admissions and compare the effect of 30 day VA post-discharge service use on these re-admissions for rural- and urban-dwelling veterans. The 2005-2007 VA data were analyzed to examine patient characteristics and hospital admissions for 36 566 veterans with CHF. The CHF patients who were and were not re-admitted to a VA hospital within 30 days of discharge were identified. Logistic regression was used to examine and compare the effect of VA post-acute service use on re-admissions between rural- and urban-dwelling veterans. Re-admitted veterans tended to be older (p=.002), had disability status (p=.024) and had longer hospital stays (precovery and good health among hospitalized veterans with CHF, regardless of their rural or urban residence. Older, rural veterans with CHF are in need of special attention for VA discharge planning and follow up with primary care providers.

  12. Hospital admissions for dental treatment among children with cleft lip and/or palate born between 1997 and 2003: an analysis of Hospital Episode Statistics in England.

    Science.gov (United States)

    Fitzsimons, Kate J; Copley, Lynn P; Smallridge, Jacqueline A; Clark, Victoria J; van der Meulen, Jan H; Deacon, Scott A

    2014-05-01

    Children with clefts have an increased tendency for dental anomalies and caries. To determine the pattern of hospital admissions for dental treatment during primary dentition among children with clefts. Cohort study based on Hospital Episode Statistics, an administrative database of all admissions to National Health Service hospitals in England. Patients born alive between 1997 and 2003 who had both a cleft diagnosis and cleft repair were included. The number of hospital admissions for surgical removal of teeth, simple extraction of teeth, and restoration of teeth before the age of seven was examined. Eight hundred and fifty-eight hospital admissions for dental treatment among 6551 children (dental treatment. The presence of additional anomalies, having a more severe cleft type, and living in relatively deprived areas increased the risk of hospital admission. Factors increasing the risk of hospital admission among cleft children should be taken into account when planning services. Efforts to reduce the number of hospital admissions should be focused on disease prevention, particularly among those most at risk of caries. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Comparison of Communication Models for Mobile Agents

    Directory of Open Access Journals (Sweden)

    Xining Li

    2003-04-01

    Full Text Available An agent is a self-contained process being acting on behalf of a user. A Mobile Agent is an agent roaming the internet to access data and services, and carry out its assigned task remotely. This paper will focus on the communication models for Mobile Agents. Generally speaking, communication models concern with problems of how to name Mobile Agents, how to establish communication relationships, how to trace moving agents, and how to guarantee reliable communication. Some existing MA systems are purely based on RPC-style communication, whereas some adopts asynchronous message passing, or event registration/handling. Different communication concepts suitable for Mobile Agents are well discussed in [1]. However, we will investigate these concepts and existing models from a different point view: how to track down agents and deliver messages in a dynamic, changing world.

  14. Continuum deformation of multi-agent systems

    CERN Document Server

    Rastgoftar, Hossein

    2016-01-01

    This monograph presents new algorithms for formation control of multi-agent systems (MAS) based on principles of continuum mechanics. Beginning with an overview of traditional methods, the author then introduces an innovative new approach whereby agents of an MAS are considered as particles in a continuum evolving in ℝn whose desired configuration is required to satisfy an admissible deformation function. The necessary theory and its validation on a mobile-agent-based swarm test bed are considered for two primary tasks: homogeneous transformation of the MAS and deployment of a random distribution of agents on a desired configuration. The framework for this model is based on homogeneous transformations for the evolution of an MAS under no inter-agent communication, local inter-agent communication, and intelligent perception by agents. Different communication protocols for MAS evolution, the robustness of tracking of a desired motion by an MAS evolving in ℝn, and the effect of communication delays in an MAS...

  15. A Secure Protocol Based on a Sedentary Agent for Mobile Agent Environments

    OpenAIRE

    Abdelmorhit E. Rhazi; Samuel Pierre; Hanifa Boucheneb

    2007-01-01

    The main challenge when deploying mobile agent environments pertains to security issues concerning mobile agents and their executive platform. This paper proposes a secure protocol which protects mobile agents against attacks from malicious hosts in these environments. Protection is based on the perfect cooperation of a sedentary agent running inside a trusted third host. Results show that the protocol detects several attacks, such as denial of service, incorrect execution and re-execution of...

  16. Regional Comparison of Enteral Nutrition-Related Admission Policies in Skilled Nursing Facilities.

    Science.gov (United States)

    Burgermaster, Marissa; Slattery, Eoin; Islam, Nafeesa; Ippolito, Paul R; Seres, David S

    2016-06-01

    Nursing home admission policies are one driver of increased and earlier gastrostomy placement, a procedure that is not always medically or ethically indicated among patients needing short-term nutrition support. This important clinical decision should be based upon patient prognosis, goals, and needs. We compared nursing home enteral nutrition-related admission policies in New York City and other regions of the United States. We also explored motivations for these policies. We conducted a telephone survey with skilled nursing facility administrators in New York City and a random sample of facilities throughout the United States about enteral nutrition-related admission policies. Survey data were matched with publically available data about facility characteristics from the Centers for Medicare and Medicaid Services. The relationship between facility location and admission policies was described with regression models. Reasons for these policies were thematically analyzed. New York City nursing homes were significantly less likely to admit patients with nasogastric feeding tubes than were nursing homes nationwide, after we controlled for facility characteristics (odds ratio = 0.111; 95% CI, 0.032-0.344). Reasons for refusing nasogastric tubes fell into 5 categories: safety, capacity, policy, perception of appropriate level of care, and patient quality of life. Our findings indicate that enteral nutrition-related admission policies vary greatly between nursing homes in New York City and nationwide. Many administrators cited safety and policy as factors guiding their institutional policies and practices, despite a lack of evidence. This gap in research, practice, and policy has implications for quality and cost of care, length of hospital stay, and patient morbidity and mortality. © 2016 American Society for Parenteral and Enteral Nutrition.

  17. Review of road traffic accident admissions in a Nigerian tertiary ...

    African Journals Online (AJOL)

    Background: Road traffic accident remains a leading cause of trauma and admissions to the accidents and emergency units of most hospitals. The aim of this study was to determine the pattern and epidemiological characteristics of trauma admissions to the Obafemi Awolowo University Teaching Hospital. Methods: This ...

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

    Science.gov (United States)

    Spafford, Marlee M.

    2000-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  20. Increase in childhood asthma admissions in an urbanising population

    African Journals Online (AJOL)

    Objective. In South Africa, rapid urbanisation has increased the risk of childhood asthma. This report reviews the pattern of asthma admissions to the Paediatric Department of Ga-Rankuwa Hospital, South Africa, from 1986 to 1996. Design. Inpatient admission data were reviewed for 1986- 1996. A detailed analysis of the ...

  1. Patient mix optimisation in hospital admission planning: a case study

    NARCIS (Netherlands)

    Adan, I.J.B.F.; Vissers, J.M.H.

    2002-01-01

    Admissions planning decides on the number of patients admitted for a specialty each day, but also on the mix of patients admitted. Within a specialty different categories of patients can be distinguished on behalf of their requirement of resources. The type of resources required for an admission may

  2. Patient mix optimisation in hospital admission planning : a case study

    NARCIS (Netherlands)

    Adan, I.J.B.F.; Vissers, J.M.H.

    2001-01-01

    Admissions planning decides on the number of patients admitted for a specialty each day, but also on the mix of patients admitted. Within a specialty different categories of patients can be distinguished on behalf of their requirement of resources. The type of resources required for an admission may

  3. Preterm Admissions in a Special Care Baby Unit: The Nnewi ...

    African Journals Online (AJOL)

    A review of all preterm admissions into the Special Care Bay Unit of the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, over a period of 29 months (May 1998 October 2000) was carried out. Out of a total of 699 neonatal admissions, 133 (19 percent) were preterms with gestational ages ranging from 24 to ...

  4. An information model of a centralized admission campaign in ...

    African Journals Online (AJOL)

    The aim of the work is to structure individual application environments of the information model of a centralized admission campaign in higher education institutions in Russia by modifying the corresponding structure of the Federal information system supporting state final examination and admission procedures. , The ...

  5. 19 CFR 210.31 - Requests for admission.

    Science.gov (United States)

    2010-04-01

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

  6. 4 CFR 25.3 - Admission to the GAO building.

    Science.gov (United States)

    2010-01-01

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

  7. Teacher Education Admission Criteria as Measure of Preparedness for Teaching

    Science.gov (United States)

    Casey, Catherine; Childs, Ruth

    2011-01-01

    This study investigated the relationship between commonly used admission criteria, found in a one-year, post Bachelor's degree, initial, teacher education program, and the preparedness of teacher candidates in mathematics for independent teaching. The admission criteria used in this study were grade point average (GPA) and a written profile. The…

  8. Increase in hospital admissions for acute childhood asthma in Cape ...

    African Journals Online (AJOL)

    To determine whether hospital admissions for acute childhood asthma were rising in Cape Town in line with the experience of other countries, Red Cross War Memorial Children's Hospital's records for the period 1978 - 1990 were analysed. These were compared with total admissions for non-surgical causes and lower ...

  9. Hospital admission interviews are time-consuming with several interruptions

    DEFF Research Database (Denmark)

    Ghazanfar, Misbah N; Honoré, Per Gustaf Hartvig; Nielsen, Trine R H

    2012-01-01

    The admission interview is an important procedure to reduce medication errors. Studies indicate that physicians do not spend much time on the interview and that the major obstacles are lack of time and heavy workload. The aim of this study was to measure the time physicians spend on admission...... interviews and to describe factors that affect time consumption....

  10. Social Factors Determine the Emergency Medical Admission Workload

    Directory of Open Access Journals (Sweden)

    Seán Cournane

    2017-06-01

    Full Text Available We related social factors with the annual rate of emergency medical admissions using census small area statistics. All emergency medical admissions (70,543 episodes in 33,343 patients within the catchment area of St. James’s Hospital, Dublin, were examined between 2002 and 2016. Deprivation Index, Single-Parent status, Educational level and Unemployment rates were regressed against admission rates. High deprivation areas had an approximately fourfold (Incidence Rate Ratio (IRR 4.0 (3.96, 4.12 increase in annual admission rate incidence/1000 population from Quintile 1(Q1, from 9.2/1000 (95% Confidence Interval (CI: 9.0, 9.4 to Q5 37.3 (37.0, 37.5. Single-Parent families comprised 40.6% of households (95% CI: 32.4, 49.7; small areas with more Single Parents had a higher admission rate-IRR (Q1 vs. for Q5 of 2.92 (95% CI: 2.83, 3.01. The admission incidence rate was higher for Single-Parent status (IRR 1.50 (95% CI: 1.46, 1.52 where the educational completion level was limited to primary level (Incidence Rate Ratio 1.45 (95% CI: 1.43, 1.47. Small areas with higher educational quintiles predicted lower Admission Rates (IRR 0.85 (95% CI: 0.84, 0.86. Social factors strongly predict the annual incidence rate of emergency medical admissions.

  11. 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…

  12. The Use of Tests in Admissions to Higher Education.

    Science.gov (United States)

    Fruen, Mary

    1978-01-01

    There are both strengths and weaknesses of using standardized test scores as a criterion for admission to institutions of higher education. The relative importance of scores is dependent on the institution's degree of selectivity. In general, decision processes and admissions criteria are not well defined. Advantages of test scores include: use of…

  13. A Review of Neonatal Admissions in Osogbo, Southwestern Nigeria ...

    African Journals Online (AJOL)

    A retrospective analysis of the records of all neonatal admissions into the Special Baby care unit (SCBU) of LAUTECH Teaching Hospital, Osogbo between January 2006 and December 2007 was undertaken. There were 605 admissions (371 males and 234 females) with 308 (50.9%) being admitted in 2006 and 297 ...

  14. A Survey of International Practice in University Admissions Testing

    Science.gov (United States)

    Edwards, Daniel; Coates, Hamish; Friedman, Tim

    2012-01-01

    This paper explores how admissions tests are used in different higher education systems around the world. This is a relatively new area of research, despite the fact that admissions processes are a key component of university practices and given the ever increasing globalisation of higher education. This paper shows that aptitude and achievement…

  15. 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…

  16. 28 CFR 541.47 - Admission to control unit.

    Science.gov (United States)

    2010-07-01

    ... 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 unit. Staff shall provide an inmate admitted to a control unit with: (a) Notice of the projected duration of...

  17. Admitted or Denied: Multilingual Writers Negotiate Admissions Essays

    Science.gov (United States)

    Wight, Shauna

    2017-01-01

    This article presents data from a collection of yearlong case studies on resident multilingual writers' college admissions essays. The focal student in this piece revealed the challenges that such writers face in presenting themselves to college admissions officers. Exploring these cultural and linguistic conflicts, this analysis uses Goffman's…

  18. OPTIMAL PRICE OF ADMISSION BANTIMURUNG NATURAL PARK, SOUTH SULAWESI

    Directory of Open Access Journals (Sweden)

    Wahyudi Isnan

    2016-12-01

    Full Text Available The number of visitors to the Bantimurung natural park fluctuated allegedly due to the increase of the price of admission ticket. The aim of the study is to analyze optimal price of admission ticket and willingness of visitors to pay admission ticket to the Park. The study was conducted in Bantimurung natural park, South Sulawsi, from January to April 2013.117 number of samples was taken by using convenience sampling method. Analysis of optimal prices and the willingness of visitors to pay for ecotourism to the Park were conducted by creating tourism demand function, which then simulated the price of admission, into the equation function of tourist demand. The results showed that the optimal price of the admission ticket was at the price of Rp75,000. At the optimal price of admission ticket of Rp75,000 the Park would earn revenues of Rp18,230,700,000. An average value of the visitor willingness to pay was Rp118,032, with price of admission ticket was Rp75,000, then, the average visitor will get consumer surplus of Rp43,032. If the management of Bantimurung natural park desiring to increase the total revenue, then the price of admission ticket can be increased to be Rp75,000.

  19. Effectiveness of Student Admission Essays in Identifying Attrition.

    Science.gov (United States)

    Sadler, Judith

    2003-01-01

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

  20. 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…

  1. Open Admissions: A Bibliography for Research and Application.

    Science.gov (United States)

    Shrier, Irene; Lavin, David E.

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

  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. The Power Trading Agent Competition

    NARCIS (Netherlands)

    Ketter, W.; Collins, J.; Reddy, P.; Flath, C.; De Weerdt, M.M.

    2011-01-01

    This is the specification for the Power Trading Agent Competition for 2012 (Power TAC 2012). Power TAC is a competitive simulation that models a “liberalized” retail electrical energy market, where competing business entities or “brokers” offer energy services to customers through tariff contracts,

  4. The Power Trading Agent Competition

    NARCIS (Netherlands)

    W. Ketter (Wolfgang); J. Collins (John); P. Reddy (Prashant); C. Flath (Christoph); M.M. de Weerdt (Mathijs)

    2011-01-01

    textabstractThis is the specification for the Power Trading Agent Competition for 2012 (Power TAC 2012). Power TAC is a competitive simulation that models a “liberalized” retail electrical energy market, where competing business entities or “brokers” offer energy services to customers through tariff

  5. Avoiding inappropriate paediatric admission: facilitating General Practitioner referral to Community Children’s Nursing Teams

    Directory of Open Access Journals (Sweden)

    Kyle Richard G

    2013-01-01

    Full Text Available Abstract Background Children’s emergency admissions in England are increasing. Community Children’s Nursing Teams (CCNTs have developed services to manage acutely ill children at home to reduce demand for unscheduled care. Referral between General Practitioners (GPs and CCNTs may reduce avoidable admissions and minimise the psychosocial and financial impact of hospitalisation on children, families and the NHS. However, facilitators of GP referral to CCNTs are not known. The aim of this study was to identify facilitators of GP referral to CCNTs. Methods Semi-structured interviews with 39 health professionals were conducted between June 2009 and February 2010 in three Primary Care Trusts served by CCNTs in North West England. Interviewees included GPs, Community Children’s Nurses (CCNs, consultant paediatricians, commissioners, and service managers. Qualitative data were analysed thematically using the Framework approach in NVivo 8. Results Five facilitators were identified: 1 CCN/CCNT visibility; 2 clear clinical governance procedures; 3 financial and organisational investment in the role of CCNTs in acute care pathways; 4 access and out of hours availability; 5 facilitative financial frameworks. Conclusion GPs required confidence in CCNs’ competence to safely manage acutely ill children at home and secure rapid referral if a child’s condition deteriorated. Incremental approaches to developing GP referral to CCNTs underpinned by clear clinical governance protocols are likely to be most effective in building GP confidence and avoiding inappropriate admission.

  6. Forecasting peak asthma admissions in London: an application of quantile regression models

    Science.gov (United States)

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

    2013-07-01

    Asthma is a chronic condition of great public health concern globally. The associated morbidity, mortality and healthcare utilisation place an enormous burden on healthcare infrastructure and services. This study demonstrates a multistage quantile regression approach to predicting excess demand for health care services in the form of asthma daily admissions in London, using retrospective data from the Hospital Episode Statistics, weather and air quality. Trivariate quantile regression models (QRM) of asthma daily admissions were fitted to a 14-day range of lags of environmental factors, accounting for seasonality in a hold-in sample of the data. Representative lags were pooled to form multivariate predictive models, selected through a systematic backward stepwise reduction approach. Models were cross-validated using a hold-out sample of the data, and their respective root mean square error measures, sensitivity, specificity and predictive values compared. Two of the predictive models were able to detect extreme number of daily asthma admissions at sensitivity levels of 76 % and 62 %, as well as specificities of 66 % and 76 %. Their positive predictive values were slightly higher for the hold-out sample (29 % and 28 %) than for the hold-in model development sample (16 % and 18 %). QRMs can be used in multistage to select suitable variables to forecast extreme asthma events. The associations between asthma and environmental factors, including temperature, ozone and carbon monoxide can be exploited in predicting future events using QRMs.

  7. Holistic Admissions in Nursing: We Can Do This.

    Science.gov (United States)

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

    2016-01-01

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

  8. Holistic Admissions in Nursing: We Can Do This

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2012-09-05

    ). 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge. Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention). The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement.

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

    Directory of Open Access Journals (Sweden)

    Lay Barbara

    2012-09-01

    compared with standard care procedures (control group. 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge. Discussion Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention. The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement. Trial registration Current Controlled Trials ISRCTN63162737.

  11. Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study.

    Science.gov (United States)

    Aldridge, Cassie; Bion, Julian; Boyal, Amunpreet; Chen, Yen-Fu; Clancy, Mike; Evans, Tim; Girling, Alan; Lord, Joanne; Mannion, Russell; Rees, Peter; Roseveare, Chris; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Temple, Mark; Watson, Sam; Lilford, Richard

    2016-07-09

    Increased mortality rates associated with weekend hospital admission (the so-called weekend effect) have been attributed to suboptimum staffing levels of specialist consultants. However, evidence for a causal association is elusive, and the magnitude of the weekend specialist deficit remains unquantified. This uncertainty could hamper efforts by national health systems to introduce 7 day health services. We aimed to examine preliminary associations between specialist intensity and weekend admission mortality across the English National Health Service. Eligible hospital trusts were those in England receiving unselected emergency admissions. On Sunday June 15 and Wednesday June 18, 2014, we undertook a point prevalence survey of hospital specialists (consultants) to obtain data relating to the care of patients admitted as emergencies. We defined specialist intensity at each trust as the self-reported estimated number of specialist hours per ten emergency admissions between 0800 h and 2000 h on Sunday and Wednesday. With use of data for all adult emergency admissions for financial year 2013-14, we compared weekend to weekday admission risk of mortality with the Sunday to Wednesday specialist intensity ratio within each trust. We stratified trusts by size quintile. 127 of 141 eligible acute hospital trusts agreed to participate; 115 (91%) trusts contributed data to the point prevalence survey. Of 34,350 clinicians surveyed, 15,537 (45%) responded. Substantially fewer specialists were present providing care to emergency admissions on Sunday (1667 [11%]) than on Wednesday (6105 [42%]). Specialists present on Sunday spent 40% more time caring for emergency patients than did those present on Wednesday (mean 5·74 h [SD 3·39] vs 3·97 h [3·31]); however, the median specialist intensity on Sunday was only 48% (IQR 40-58) of that on Wednesday. The Sunday to Wednesday intensity ratio was less than 0·7 in 104 (90%) of the contributing trusts. Mortality risk among patients

  12. Body pushing, prescription drugs and hospital admission.

    Science.gov (United States)

    Byard, Roger W; Kenneally, Michaela

    2017-09-01

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

  13. A Reinforcement Learning Approach to Call Admission Control in HAPS Communication System

    Directory of Open Access Journals (Sweden)

    Ni Shu Yan

    2017-01-01

    Full Text Available The large changing of link capacity and number of users caused by the movement of both platform and users in communication system based on high altitude platform station (HAPS will resulting in high dropping rate of handover and reduce resource utilization. In order to solve these problems, this paper proposes an adaptive call admission control strategy based on reinforcement learning approach. The goal of this strategy is to maximize long-term gains of system, with the introduction of cross-layer interaction and the service downgraded. In order to access different traffics adaptively, the access utility of handover traffics and new call traffics is designed in different state of communication system. Numerical simulation result shows that the proposed call admission control strategy can enhance bandwidth resource utilization and the performances of handover traffics.

  14. Paid family leave's effect on hospital admissions for pediatric abusive head trauma.

    Science.gov (United States)

    Klevens, Joanne; Luo, Feijun; Xu, Likang; Peterson, Cora; Latzman, Natasha E

    2016-12-01

    Paediatric abusive head trauma (AHT) is a leading cause of fatal child maltreatment among young children. Current prevention efforts have not been consistently effective. Policies such as paid parental leave could potentially prevent AHT, given its impacts on risk factors for child maltreatment. To explore associations between California's 2004 paid family leave (PFL) policy and hospital admissions for AHT, we used difference-in-difference analyses of 1995-2011 US state-level data before and after the policy in California and seven comparison states. Compared with seven states with no PFL policies, California's 2004 PFL showed a significant decrease in AHT admissions in both <1 and <2-year-olds. Analyses using additional data years and comparators could yield different results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. 社会中介参与村级会计委托代理服务的演化博弈分析%Analysis of Social Intermediaries Involved in Village-Level Accounting Principal-Agent Services

    Institute of Scientific and Technical Information of China (English)

    傅黎瑛; 杨银川

    2014-01-01

    我国村级会计委托代理制存在两种现实模式:一是以浙江省为代表并在全国范围内普遍推广的“村账镇代理”模式,另有广东佛山市推行的由会计师事务所代理村会计核算的“村账所代理”模式。本文运用演化博弈论原理,对社会中介参与村级会计委托代理的可行性、优势及其运行模式作出分析,提出“村账所代理”即由社会中介(如会计师事务所)代理村级会计更符合我国农村财务管理的现实和发展趋势。%In China, the village accounting principal-agent system has two modes: one is the “village accounting by township agent” mode that is a representative practice in Zhejiang Province and is promoted widely in the whole country ;the other is the“village accounting by firm agent” mode that is adopted by Foshan City , Guangdong Province , in which village ac-counting services are provided by accounting firms . This article , using principles of evolutionary game theory , analyzes the feasibility and advantages of the participation of social intermediaries in the village-level accounting principal-agent operation , and proposes that the “village accounting by firm agent” mode with social intermediaries ( such as accounting firms ) is more in line with the reality and trend of financial management in rural China .

  16. Management of thallium poisoning in patients with delayed hospital admission.

    Science.gov (United States)

    Sun, Tong-Wen; Xu, Qing-Yan; Zhang, Xiao-Juan; Wu, Qiong; Liu, Zhang-Suo; Kan, Quan-Cheng; Sun, Cheng-Ye; Wang, Lexin

    2012-01-01

    To describe the clinical features and management of thallium poisoning in patients with delayed hospital admission. Fourteen patients (median age 36 years) were admitted 9-19 days after ingesting food poisoned with thallium. Clinical and laboratory data, including blood and urine thallium concentrations, were collected. Patients were treated with oral Prussian blue, a chelating agent sodium dimercaptosulfonate, and hemodialysis. All patients experienced a triad of symptoms of acute gastrointestinal upset, painful combined polyneuropathy, and hair loss after consuming poisoned food. Fatigue and skin pigmentation were observed in all patients. Abnormal liver function tests were found in 6 (42.9%) and delirium and coma were identified in 4 (28.6%). Two weeks after the poisoning, the blood and urine thallium concentration ranged from 219.0 to 1414.4 μg/L (median: 535.3) and 956.5 to 11285.0 μg/L (median: 7460.0), respectively. One patient (7.1%) with a previous history of pulmonary fibrosis died of respiratory failure in hospital. Symptoms were improved and blood or urine thallium levels were normalized in the remaining 13 patients before discharge. After a 6.5 ± 1-month follow-up, 1 patient (7.1%) developed deep venous thrombosis in the left lower limb. In another patient (7.1%), numbness in the lower limbs remained. Acute thallium poisoning is commonly manifested by gastrointestinal upset, painful polyneuropathy, and significant hair loss. Treatment strategies included Prussian blue and hemodialysis, which were associated with a good outcome in this case series.

  17. A qualitative examination of inappropriate hospital admissions and lengths of stay

    Directory of Open Access Journals (Sweden)

    Hammond Christina L

    2009-03-01

    Full Text Available Abstract Background Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions. We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group. Methods Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach. Results The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS, including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations. Conclusion Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.

  18. Utilizing Chinese Admission Records for MACE Prediction of Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Danqing Hu

    2016-09-01

    Full Text Available Background: Clinical major adverse cardiovascular event (MACE prediction of acute coronary syndrome (ACS is important for a number of applications including physician decision support, quality of care assessment, and efficient healthcare service delivery on ACS patients. Admission records, as typical media to contain clinical information of patients at the early stage of their hospitalizations, provide significant potential to be explored for MACE prediction in a proactive manner. Methods: We propose a hybrid approach for MACE prediction by utilizing a large volume of admission records. Firstly, both a rule-based medical language processing method and a machine learning method (i.e., Conditional Random Fields (CRFs are developed to extract essential patient features from unstructured admission records. After that, state-of-the-art supervised machine learning algorithms are applied to construct MACE prediction models from data. Results: We comparatively evaluate the performance of the proposed approach on a real clinical dataset consisting of 2930 ACS patient samples collected from a Chinese hospital. Our best model achieved 72% AUC in MACE prediction. In comparison of the performance between our models and two well-known ACS risk score tools, i.e., GRACE and TIMI, our learned models obtain better performances with a significant margin. Conclusions: Experimental results reveal that our approach can obtain competitive performance in MACE prediction. The comparison of classifiers indicates the proposed approach has a competitive generality with datasets extracted by different feature extraction methods. Furthermore, our MACE prediction model obtained a significant improvement by comparison with both GRACE and TIMI. It indicates that using admission records can effectively provide MACE prediction service for ACS patients at the early stage of their hospitalizations.

  19. Temperature effects on hospital admissions for kidney morbidity in Taiwan

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yu-Kai [Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (United States); Wang, Yu-Chun [Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan (China); Research Center for Environmental Risk Management, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan (China); Ho, Tsung-Jung [The Division of Chinese Medicine, China Medical University Beigang Hospital, Taiwan (China); School Of Chinese Medicine, College of Chinese Medicine, China Medical University, 91 Xueshi Road, Taichung City 404, Taiwan (China); Lu, Chensheng, E-mail: cslu@hsph.harvard.edu [Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (United States)

    2013-01-15

    Objective: This study aimed to associate hospital admissions of kidney diseases with extreme temperature and prolonged heat/cold events in 7 regions of Taiwan. Methods: Age-specific (< 65 years, 65 + years and all ages) hospital admission records of nephritis, nephrotic syndrome, or nephrosis, in the form of electronic insurance reimbursement claims, were retrieved from Taiwan's National Health Insurance Research Database during the period of 2000–2008. The area–age-specific relative risk (RR) accounting for 8 days of lag for temperature on hospital admissions of kidney diseases were estimated using distributed lag non-linear models with the Poisson distribution controlling for extreme temperature events, levels of air pollutants (PM{sub 10}, O{sub 3}, and NO{sub 2}) and potential confounders. Results: We observed a V or J-shape association between daily average temperatures and the RR estimates for hospital admissions of kidney diseases in Taiwan. The lowest risk for hospital admissions of kidney diseases was found at around 25 °C, and risk increased as temperatures deviated from 25 °C. The pooled cumulative 8-day RR for all ages of population of the 7 study areas were 1.10 (95% confidence interval (CI): 1.01, 1.19) at 18 °C and 1.45 (95% CI: 1.27, 1.64) at 30 °C. High temperature has more profound influence on hospital admission of kidney diseases than low temperature. Temperature risks for hospital admissions were similar between younger (< 65 years) and elderly (65 + years) population. This study observed no significant effects of prolonged heat extremes on hospital admissions of kidney diseases. Conclusions: The heat effect for kidney morbidities leading to hospital admission was more significant than that of the cold temperature. This study did not find the age-dependent relative risks for temperature associating with hospital admissions of kidney diseases. - Highlights: ► V or J-shaped association was observed between daily temperatures and

  20. Pharmacist-led admission medication reconciliation before and after the implementation of an electronic medication management system.

    Science.gov (United States)

    Sardaneh, Arwa A; Burke, Rosemary; Ritchie, Angus; McLachlan, Andrew J; Lehnbom, Elin C

    2017-05-01

    -risk medication (44%, p=0.007). Implementing an electronic medication management system facilitates the medication reconciliation process leading to more high risk patients receiving this service on admission to hospital and in a more timely manner. The impact of electronic medication reconciliation on patient safety and clinical outcomes remains unknown. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. [Estimating emergency hospital admissions to gauge short-term effects of air pollution: evaluation of health data quality].

    Science.gov (United States)

    Bois de Fer, Béatrice; Host, Sabine; Chardon, Benoît; Chatignoux, Edouard; Beaujouan, Laure; Brun-Ney, Dominique; Grémy, Isabelle

    2009-01-01

    The study of the short-term effects and health impact of air pollution is carrier out by the ERPURS regional surveillance program which utilizes hospitalization data obtained from the French hospital information system (PMSI) to determine these links. This system does not permit the distinction between emergency hospital admissions from scheduled ones, which cannot be related to short term changes in air pollution levels. This study examines how scheduled admissions affect the quality of the health indicators used to estimate air pollution effects. This indicator is compared to three new emergency hospitalisation indicators reconstructed based on data from the public hospitals in Paris, partly from the PMSI data and partly with data from an on-line emergency network that regroups all of the computerized emergency services. According to the pathology, scheduled admissions present a difficulty which affects the capacity to highlight the weakest risks with any precision.

  2. Improving Disability Awareness among Extension Agents

    Science.gov (United States)

    Mahadevan, Lakshmi; Peterson, Rick L.; Grenwelge, Cheryl

    2014-01-01

    Increasing prevalence rates and legislative mandates imply that educators, parents, and Extension agents will need better tools and resources to meet the needs of special populations. The Texas A&M AgriLife Extension Service addresses this issue by using e-learning tools. Extension agents can take advantage of these courses to gain critical…

  3. Solar radiation is inversely associated with inflammatory bowel disease admissions.

    Science.gov (United States)

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

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

  4. Exponentiation and deformations of Lie-admissible algebras

    International Nuclear Information System (INIS)

    Myung, H.C.

    1982-01-01

    The exponential function is defined for a finite-dimensional real power-associative algebra with unit element. The application of the exponential function is focused on the power-associative (p,q)-mutation of a real or complex associative algebra. Explicit formulas are computed for the (p,q)-mutation of the real envelope of the spin 1 algebra and the Lie algebra so(3) of the rotation group, in light of earlier investigations of the spin 1/2. A slight variant of the mutated exponential is interpreted as a continuous function of the Lie algebra into some isotope of the corresponding linear Lie group. The second part of this paper is concerned with the representation and deformation of a Lie-admissible algebra. The second cohomology group of a Lie-admissible algebra is introduced as a generalization of those of associative and Lie algebras in the Hochschild and Chevalley-Eilenberg theory. Some elementary theory of algebraic deformation of Lie-admissible algebras is discussed in view of generalization of that of associative and Lie algebras. Lie-admissible deformations are also suggested by the representation of Lie-admissible algebras. Some explicit examples of Lie-admissible deformation are given in terms of the (p,q)-mutation of associative deformation of an associative algebra. Finally, we discuss Lie-admissible deformations of order one

  5. Risk factors for readmission in schizophrenia patients following involuntary admission.

    Directory of Open Access Journals (Sweden)

    Yu-Yuan Hung

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

  6. Risk factors for readmission in schizophrenia patients following involuntary admission.

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

  8. GRACE score predicts heart failure admission following acute coronary syndrome.

    Science.gov (United States)

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

    2015-04-01

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

  9. Universal screening for alcohol misuse in acute medical admissions is feasible and identifies patients at high risk of liver disease.

    Science.gov (United States)

    Westwood, Greta; Meredith, Paul; Atkins, Susan; Greengross, Peter; Schmidt, Paul E; Aspinall, Richard J

    2017-09-01

    Many people who die from alcohol related liver disease (ARLD) have a history of recurrent admissions to hospital, representing potential missed opportunities for intervention. Universal screening for alcohol misuse has been advocated but it is not known if this is achievable or effective at detecting individuals at high risk of ARLD. We systematically screened all admissions to the Acute Medical Unit (AMU) of a large acute hospital using an electronic data capture system in real time. Patients at an increasing risk of alcohol harm were referred for either brief intervention (BI) or further assessment by an Alcohol Specialist Nursing Service (ASNS). Additional data were recorded on admission diagnoses, alcohol unit consumption, previous attendances, previous admissions, length of stay and mortality. Between July 2011 and March 2014, there were 53,165 admissions and 48,211 (90.68%) completed screening. Of these, 1,122 (2.3%) were classified as "increasing", and 1,921 (4.0%) as "high" risk of alcohol harm. High risk patients had more hospital admissions in the three previous years (average 4.74) than the low (3.00) and increasing (2.92) risk groups (prisk patients also had more frequent emergency department (ED) attendances (7.68) than the lower (2.64) and increasing (3.81) groups (prisk group were seen by the ASNS and 1,135 (81.2%) had an Alcohol Use Disorders Identification Test (AUDIT) score over 20 with 527 (37.8%) recording the maximum value of 40. Compared to the other groups, high risk patients had a distinct profile of admissions with the most common diagnoses being mental health disorders, gastro-intestinal bleeding, poisoning and liver disease. Universal screening of admissions for alcohol misuse is feasible and identifies a cohort with frequent ED attendances, recurrent admissions and an elevated risk of ARLD. An additional group of patients at an increasing risk of alcohol harm can be identified in a range of common presentations. These patients can be

  10. Interacting agents in finance

    NARCIS (Netherlands)

    Hommes, C.; Durlauf, S.N.; Blume, L.E.

    2008-01-01

    Interacting agents in finance represent a behavioural, agent-based approach in which financial markets are viewed as complex adaptive systems consisting of many boundedly rational agents interacting through simple heterogeneous investment strategies, constantly adapting their behaviour in response

  11. Riot Control Agents

    Science.gov (United States)

    ... Submit What's this? Submit Button Facts About Riot Control Agents Interim document Recommend on Facebook Tweet Share Compartir What riot control agents are Riot control agents (sometimes referred to ...

  12. Factors present on admission associated with increased mortality in ...

    African Journals Online (AJOL)

    among low-, middle- and high-income countries, with demand exceed- ... The admission of children to an intensive care unit (ICU) necessitates the selection of children ..... severity of multiple organ dysfunction syndrome in critically ill children.

  13. The effects of Montessori education: Evidence from admission lotteries

    NARCIS (Netherlands)

    Ruijs, N.

    2017-01-01

    This study investigates the causal effects of Montessori secondary education by exploiting admission lotteries in Dutch Montessori schools. Results from 308 to 625 students indicate that Montessori education provides an alternative way to attain similar outcomes. Montessori students obtain their

  14. Prognostic value of admission plasma glucose in non-diabetic ...

    African Journals Online (AJOL)

    Prognostic value of admission plasma glucose in non-diabetic Nigerians with stroke. ... International Journal of Medicine and Health Development ... Outcome was measured using the Modified Rankin scale based on the last score of each ...

  15. Factors present on admission associated with increased mortality in ...

    African Journals Online (AJOL)

    centile has been shown to be an independent risk factor for mortality ... score quantifying organ dysfunction on admission or throughout the .... model. The Wald χ2 test was used to determine significance using a 5% significance level.

  16. Secondary School Admissions Policies in Eastern Africa: Some Regional Issues

    Science.gov (United States)

    Gould, W. T. S.

    1974-01-01

    This discussion considers some regional issues implicit in current procedures regulating admission to secondary education in four countries of Eastern Africa and places these procedures in their general political context. (Author)

  17. Urological Emergency Admissions to a Community Hospital: A Review

    Science.gov (United States)

    Atkins, Sam O.

    1983-01-01

    A one-year study was conducted on the impact of emergency admissions to the 125-bed Southwest Community Hospital in Atlanta, Georgia. During the study in 1979, 70 urological emergency room admissions were made, of which 44 (62.8 percent) were males and 26 (37.2 percent) were females. In comparison, 93 admissions were made directly from the private office. The study considered the timeliness of diagnosis and treatment, surgical procedures performed, impact on urological emergency room nursing and medical personnel, physician response to notification, cost containment, and implied legal ramifications and organization structure. Thus, an immediate close scrutiny of urological emergency admission at the nonuniversity affiliated Southwest Community Hospital was permitted. PMID:6876189

  18. Mina Shaughnessy and Open Admissions at New York's City College.

    Science.gov (United States)

    Reeves, LaVona L.

    2002-01-01

    Discusses basic writing pioneer Mina Shaughnessy, who advocated for a humanistic approach to writing instruction for disadvantaged students, within the context of the City University of New York's policy of open admissions. (EV)

  19. 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

  20. Pattern of admission and outcome of patients admitted into the ...

    African Journals Online (AJOL)

    2015-02-26

    Feb 26, 2015 ... Objective: The objective was to determine the pattern of admission and outcome of patients .... Referred to Europe (London) .... In: A Concise Textbook. ... Khush KK, Rapaport E, Waters D. The history of the coronary care unit.

  1. Admission to a psychiatric unit and changes in tobacco smoking.

    Science.gov (United States)

    Ker, Suzy; Owens, David

    2008-05-06

    Smoking and withdrawal from smoking complicates the assessment and treatment of mental illness. We aimed to establish whether psychiatric inpatients smoke different amounts after admission than beforehand and, if so, to find out why. Forty-three inpatients on a working age adult psychiatry ward completed self-report questionnaires about smoking habits. Those who smoked a different amount after admission had a follow-up interview to find out why they thought this had occurred. The interview incorporated qualitative and quantitative aspects which were analysed accordingly.Fifty-six percent of participants were smokers before admission, rising to 70% afterwards. Of the smokers, 17% smoked less after admission, and 63% smoked more. The average number of cigarettes smoked per person per day increased from five to thirteen. The main reasons for smoking more were boredom, stress and the wish to socialise.

  2. Seasonal variation in admission for heart failure, hypertension and ...

    African Journals Online (AJOL)

    Seasonal variation in admission for heart failure, hypertension and stroke. ... Background: Seasonal variation in hospitalization for cardiovascular disease has been ... hypertension and hypertension – related stroke (Cerebrovascular accident) ...

  3. Identification of medication discrepancies during hospital admission in Jordan: Prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Lana Salameh

    2018-01-01

    unintentional discrepancies at the time of hospital admission was alarmingly high. Majority of these discrepancies were associated with a potential harm to the patients. These findings support the necessity for implementing the medication reconciliation service in the country, engaging healthcare providers in the process of identification and resolution of medication discrepancies. Keywords: Discrepancies, Hospital, Admission, Jordan, Prevalence, Risk factors

  4. Academic Achievement, Perceived Stress, Admission Data, and Sociodemographic Background Among Therapy Students in Israel.

    Science.gov (United States)

    Jacob, Tamar; Einstein, Ofira

    2017-01-01

    Academic achievement (AA) is of great importance in the academic world. The aims of this study were to: 1) identify contributors to AA of physical therapy (PT) students; 2) evaluate students' perceived stress (PS); and 3) identify contributors to PS. A cross-sectional study involving three undergraduate PT classes in a single academic year was performed 1 week prior to final examinations. Current grade point average (GPA) and admission data were collected from administrative records. Additional data, collected using an online questionnaire, included the Perceived Stress Scale 10 (PSS), Scale for Assessing Academic Stress (SAAS), and selected sociodemographic variables. Regression analysis identified contributors to AA and to PS. Records of 153 students and questionnaires of 118 students were included in the study. Combined grades from psychometric tests and matriculation exams at admission, low PS, absence due to military reserve service during the academic year, and participation in the second and third years of the PT program accounted for a modest variance (31.1% ) in students' GPA. The low contribution of admission criteria to GPA suggests that there is no justification for raising the level of the present criteria.

  5. Brief report: Correlates of inpatient psychiatric admission in children and adolescents with eating disorders.

    Science.gov (United States)

    Hamilton, Matthew J; Watson, Hunna J; Egan, Sarah J; Hoiles, Kimberley J; Harper, Emily; McCormack, Julie; Shu, Chloe; Forbes, David A

    2015-06-01

    To examine the prevalence and importance of psychological, behavioural, and situational correlates of impending psychiatric inpatient admissions in children and adolescents with eating disorders. The sample consisted of 285 patients (8-17 years, M = 14.4, SD = 1.49) with DSM-5 eating disorders assessed between 2006 and 2013 from the Helping to Outline Pediatric Eating Disorders (HOPE) Project. The sample was split into two groups, those with (n = 38) and without (n = 247) impending psychiatric admission; Discriminant function analysis was used to examine correlates. The prevalence of impending psychiatric admission was 13.3%. Suicidal ideation provided the greatest discriminating power, followed by eating pathology, depressive symptoms, anxiety, multiple methods of weight control, binge eating, and family functioning. Earlier recognition of comorbid symptoms in eating disorders in the community may reduce the number of young people with eating disorders who present needing critical psychiatric care. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  6. Social Welfare Centers Protect Outpatients with Mood Disorders from Risk of Hospital Admission.

    Directory of Open Access Journals (Sweden)

    Kyu-Tae Han

    Full Text Available South Korea faces difficulties in the management of mental disorders, and those difficulties are expected to gradually worsen. Therefore, we analyzed the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders.We used data from the National Health Insurance Service National Sample Cohort 2002-2013, which included all medical claims filed for the 50,160 patients who were newly diagnosed with a mood disorder among the 1,025,340 individuals in a nationally representative sample. We performed a logistic regression analysis using generalized estimating equation (GEE models to examine the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders (ICD-10: F3.There was a 3.9% admission rate among a total of 99,533 person-years. Outpatients who lived in regions with more social welfare centers were less likely to be admitted to a hospital (per increase of five social welfare centers per 100,000 people; OR: 0.958; 95% CI: 0.919-0.999. Social welfare centers had an especially strong protective effect on patients with relatively mild mood disorders and those who were vulnerable to medical expenditures.Considering the protective role of social welfare centers in managing patients with mood disorders, health-policy makers need to consider strategies for activating mental healthcare.

  7. Analysis of National Trends in Admissions for Pulmonary Embolism.

    Science.gov (United States)

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

    2016-07-01

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

  8. Visa refusal following compulsory hospital admission under the Mental Health Act 1983 (England and Wales): fact or fiction?

    Science.gov (United States)

    Ashmore, R

    2015-08-01

    Historically, compulsory hospital admission led to discrimination for service users. For example, until recently detention under the Mental Health Act 1983 (England and Wales) would disqualify a person from being a Member of Parliament. There is a belief among mental health professionals that compulsory hospital admission will result in service users being refused a tourist visa. However, there is a paucity of literature on this topic, particularly from an international perspective. Based on the information reviewed in this study, there is no evidence to support this belief. Of 262 travel destinations, 96 (36.6%) require British citizens to obtain a tourist visa. Six (2.3%) destinations require applicants to declare a mental health condition in order to obtain a tourist visa. None of these destinations ask applicants to declare a history of compulsory hospital admission. However, the possibility exists that anyone declaring a mental health problem may be asked to provide further information about their condition before a visa is granted. Mental health nurses require education to ensure that their knowledge of mental health legislation is up to date. This education should include information on the potential consequences of compulsory hospital admission for the service user's social life following discharge. Service users and their families should be provided with written information on the potential social impact of detention along with a list of organizations that can provide advice on specific issues. This study sought to establish whether a history of compulsory hospital admission prevented a person from obtaining a tourist visa. A visa application form and/or other relevant information were obtained for 262 travel destinations visited by British citizens. Ninety-six (36.6%) destinations require British citizens to obtain a tourist visa. All visas are issued subject to travellers meeting a number of conditions, for example being in possession of travel insurance

  9. 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).......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)....

  10. Towards a structure theory for Lie-admissible algebras

    International Nuclear Information System (INIS)

    Wene, G.P.

    1981-01-01

    The concepts of radical and decomposition of algebras are presented. Following a discussion of the theory for associative algebras, examples are presented that illuminate the difficulties encountered in choosing a structure theory for nonassociative algebras. Suitable restrictions, based upon observed phenomenon, are given that reduce the class of Lie-admissible algebras to a manageable size. The concepts developed in the first part of the paper are then reexamined in the context of this smaller class of Lie-admissible algebras

  11. 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).

  12. Massless representations and admissibility condition for higher spin superalgebras

    Energy Technology Data Exchange (ETDEWEB)

    Konstein, S E; Vasiliev, M A

    1989-01-16

    Massless particle representations of various infinite-dimensional higher spin superalgebras proposed previously are constructed. We analyse which of higher spin superalgebras obey the requirement (the admissibility condition) of possessing massless unitary representations with the same spectra of spins as predicted by the structure of gauge fields originating from these superalgebras. It is argued that those higher spin superalgebras, which obey the admissibility condition, can serve as rigid supersymmetries in nontrivial consistent gauge theories of massless fields of all spins.

  13. Admissions and Readmissions Related to Adverse Events, 2007-2014

    Science.gov (United States)

    2015-12-01

    DRG is a classification system primarily used for billing purposes. It uses the principle and secondary diagnoses to assign clinical conditions to...This study assessed adverse events as they relate to readmissions in the Military Health System (MHS). Among 142,579 admissions with an adverse event...The following study retrospectively assessed admissions and readmissions for adverse events in the Military Health System (MHS) by quantifying

  14. HIV/AIDS and admission to intensive care units: A comparison of India, Brazil and South Africa

    Directory of Open Access Journals (Sweden)

    Kantharuben Naidoo

    2013-02-01

    Full Text Available In resource-constrained settings and in the context of HIV-infected patients requiring intensive care, value-laden decisions by critical care specialists are often made in the absence of explicit policies and guidelines. These are often based on individual practitioners’ knowledge and experience, which may be subject to bias. We reviewed published information on legislation and practices related to intensive care unit (ICU admission in India, Brazil and South Africa, to assess access to critical care services in the context of HIV. Each of these countries has legal instruments in place to provide their citizens with health services, but they differ in their provision of ICU care for HIV-infected persons. In Brazil, some ICUs have no admission criteria, and this decision vests solely on the ‘availability, and the knowledge and the experience’ of the most experienced ICU specialist at the institution. India has few regulatory mechanisms to ensure ICU care for critically ill patients including HIV-infected persons. SA has made concerted efforts towards non-discriminatory criteria for ICU admissions and, despite the shortage of ICU beds, HIV-infected patients have relatively greater access to this level of care than in other developing countries in Africa, such as Botswana. Policymakers and clinicians should devise explicit policy frameworks to govern ICU admissions in the context of HIV status. S Afr J HIV Med 2013;14(1:15-16. DOI:10.7196/SAJHIVMED.887

  15. Trend of urban-rural disparities in hospital admissions and medical expenditure in China from 2003 to 2011.

    Science.gov (United States)

    Fu, Rong; Wang, Yupeng; Bao, Han; Wang, Zhiqiang; Li, Yongquan; Su, Shaofei; Liu, Meina

    2014-01-01

    To assess the trend of urban-rural disparities in hospital admissions and medical expenditure between 2003 and 2011 in the context of Chinese health-care system reform. The data were from three different national surveys: the Third National Health Services Survey in 2003, the Fourth National Health Services Survey in 2008 and the national health-care reform phased assessment survey in 2011. There were 151421, 143380 and 48356 respondents aged 15 years or older in 2003, 2008 and 2011, respectively. The health insurance coverage expanded considerably from 27.7% in 2003 to 96.4% in 2011 among respondents aged 15 years or older. Hospitalization rate increased rapidly from 4.1% in 2003 to 9.6% in 2011. Urban respondents had higher hospital admissions than rural respondents, and the RR (95% CI) of hospitalization was 1.23 (1.17-1.30), 1.06 (1.02-1.10) and 1.16 (1.10-1.23) in 2003, 2008 and 2011, respectively. The urban-rural disparity in hospital admissions significantly narrowed over time. Urban respondents had a higher admission rate if insured and a lower admission if not insured than their rural counterparts. Of the six medical expenditure measures, the disparities in reimbursement rate and the proportion of hospitalization direct cost to the total consumer spending significantly narrowed. The health insurance coverage has been continually expanding and health service utilization has been substantially improved. Urban-rural disparities have been narrowed but still exist. Therefore, policy-makers should focus on increasing investment and reimbursement levels, developing a uniform standard health insurance system for urban and rural residents and improving the medical assistance system.

  16. Fixed and growth mindsets in physics graduate admissions

    Directory of Open Access Journals (Sweden)

    Rachel E. Scherr

    2017-11-01

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

  17. Promoting Inclusive Holistic Graduate Admissions in Educational Leadership Preparation Programs

    Directory of Open Access Journals (Sweden)

    Christa Boske

    2018-04-01

    Full Text Available Aspiring and practicing school leaders often identify graduate degrees as playing a significant role in achieving educational access and engaging in building, district-wide, regional, state, and national decision-making regarding practice and policy impacting marginalized populations in K–12 U.S. schools. The rationale behind initiating discourse on graduate student involvement grows out of current policy and reform initiatives requiring increased accountability for improved student performance, especially for children from predetermined “subgroups” due to race, class, native language, and ability (i.e., emotional, social, cognitive, and physical. The call for more deliberate involvement in understanding graduate admissions also arises in regard to student attrition and retention concerns. Faculty often play an under-examined role as gatekeepers throughout the admissions process. The way in which they understand graduate requirements, holistic evaluation, and merit affords opportunities to positively address significant implications for racial equity and diversity in graduate education. To understand faculty reliance upon graduate admissions criteria that undermine espoused university strategic plans, college-level diversity goals, and programmatic decision-making, four professors across the U.S. explore graduate admissions processes and the significance of implementing holistic admissions criteria. We present a holistic graduate admissions conceptual model for school leadership preparation programs to consider when increasing equity and access for minoritized candidates.

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

    Science.gov (United States)

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

    2013-09-01

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

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

    Science.gov (United States)

    Taha, Haytham; abdulhay, dana; Luqman, Neama; Ellahham, Samer

    2016-01-01

    Sheikh Khalifa Medical City (SKMC) in Abu Dhabi is the main tertiary care referral hospital in the United Arab Emirates (UAE) with 560 bed capacity that is fully occupied most of the time. SKMC senior management has made a commitment to make quality and patient safety a top priority. Our governing body Abu Dhabi Health Services Company has identified medication reconciliation as a critical patient safety measure and key performance indicator (KPI). The medication reconciliation electronic form a computerized decision support tool was introduced to improve medication reconciliation compliance on transition of care at admission, transfer and discharge of patients both in the inpatient and outpatient settings. In order to improve medication reconciliation compliance a multidisciplinary task force team was formed and led this quality improvement project. The purpose of this publication is to indicate the quality improvement interventions implemented to enhance compliance with admission medication reconciliation and the outcomes of those interventions. We chose to conduct the pilot study in general medicine as it is the busiest department in the hospital, with an average of 390 patients admitted per month during the study period. The study period was from April 2014 till October 2015 and a total of 8576 patients were evaluated. The lessons learned were disseminated throughout the hospital. Our aim was to improve admission medication reconciliation compliance using the electronic form in order to ensure patient safety and reduce preventable harm in terms of medication errors. Admission medication reconciliation compliance improved in general medicine from 40% to above 85%, and this improvement was sustained for the last four months of the study period. PMID:27822371

  20. Is 30-Day Mortality after Admission for Heart Failure an Appropriate Metric for Quality?

    Science.gov (United States)

    Faillace, Robert T; Yost, Gregory W; Chugh, Yashasvi; Adams, Jeffrey; Verma, Beni R; Said, Zaid; Sayed, Ibrahim Ismail; Honushefsky, Ashley; Doddamani, Sanjay; Berger, Peter B

    2018-02-01

    The Centers for Medicare and Medicaid Services (CMS) model for publicly reporting national 30-day-risk-adjusted mortality rates for patients admitted with heart failure fails to include clinical variables known to impact total mortality or take into consideration the culture of end-of-life care. We sought to determine if those variables were related to the 30-day mortality of heart failure patients at Geisinger Medical Center. Electronic records were searched for patients with a diagnosis of heart failure who died from any cause during hospitalization or within 30 days of admission. There were 646 heart-failure-related admissions among 530 patients (1.2 admissions/patient). Sixty-seven of the 530 (13%) patients died: 35 (52%) died during their hospitalization and 32 (48%) died after discharge but within 30 days of admission; of these, 27 (40%) had been transferred in for higher-acuity care. Fifty-one (76%) died from heart failure, and 16 (24%) from other causes. Fifty-five (82%) patients were classified as American Heart Association Stage D, 58 (87%) as New York Heart Association Class IV, and 30 (45%) had right-ventricular systolic dysfunction. None of the 32 patients who died after discharge met recommendations for beta-blockers. Criteria for prescribing angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor blockers were not met by 33 of the 34 patients (97%) with heart failure with reduced ejection fraction not on one of those drugs. Fifty-seven patients (85%) had a do-not-resuscitate (DNR) status. A majority of heart failure-related mortality was among patients who opted for a DNR status with end-stage heart failure, limiting the appropriateness of administering evidence-based therapies. No care gaps were identified that contributed to mortality at our institution. The CMS 30-day model fails to take important variables into consideration. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Seizure-related hospital admissions, readmissions and costs: Comparisons with asthma and diabetes in South Australia.

    Science.gov (United States)

    Bellon, Michelle L; Barton, Christopher; McCaffrey, Nikki; Parker, Denise; Hutchinson, Claire

    2017-08-01

    Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions; bronchitis/asthma; and diabetes. Additional data included length of hospital stay and type of admission. Demographic data were analysed to identify whether social determinants influence admission, and a macro costing approach was then applied to calculate the financial costs to the Health Care System. The rate of total seizure hospitalizations was 649 per 100,000; lower than bronchitis/asthma (751/100,000), yet higher than diabetes (500/100,000). The highest proportions of subsequent separations were recorded by children with seizures regardless of complexity (47% +CSCC; 17% -CSCC) compared with asthma (11% +CSCC; 14% -CSCC) or diabetes (14% +CSCC; 13% -CSCC), and by adults with seizures with catastrophic or severe complications/comorbidity (25%), compared with diabetes (22%) or asthma (14%). The mean cost per separation in both children and adults was highest for diabetes (AU$4438/$7656), followed by seizures (AU$2408/$5691) and asthma (AU$2084/$3295). Following the lead of well-developed and resourced health promotion initiatives in asthma and diabetes, appropriate primary care, community education and seizure management services (including seizure clinics) should be targeted in an effort to reduce seizure related hospitalisations which may be avoidable

  2. 7 CFR 17.4 - Agents of the participant or importer.

    Science.gov (United States)

    2010-01-01

    ... competitive advantage. A shipping agent may not take any action which would give a competitive advantage to... a purchasing agent or shipping agent, or employ the services of any other agent, broker, consultant... services for commodities provided under any title of the Act, section 416(b) of the Agricultural Act of...

  3. A time-based admission control mechanism for IEEE 802.11 ad Hoc networks

    OpenAIRE

    Costa, Luís Henrique M. K.; Cerveira, Carlos Rodrigo

    2006-01-01

    This paper presents a time-based admission control mechanism (TAC) for IEEE 802.11 ad hoc networks. The proposed mechanism was adapted to the QoS AODV routing protocol, which takes the quality of service requirements of the data flow into account in the route discovery process. TAC-AODV estimates the idle time of the physical medium based on the frames listened. The incoming traffic is admitted according to the offered load as well as the intra-flow interference, calculated based on the numbe...

  4. Traffic Management by Using Admission Control Methods in Multiple Node IMS Network

    Directory of Open Access Journals (Sweden)

    Filip Chamraz

    2016-01-01

    Full Text Available The paper deals with Admission Control methods (AC as a possible solution for traffic management in IMS networks (IP Multimedia Subsystem - from the point of view of an efficient redistribution of the available network resources and keeping the parameters of Quality of Service (QoS. The paper specifically aims at the selection of the most appropriate method for the specific type of traffic and traffic management concept using AC methods on multiple nodes. The potential benefit and disadvantage of the used solution is evaluated.

  5. Agent review phase one report.

    Energy Technology Data Exchange (ETDEWEB)

    Zubelewicz, Alex Tadeusz; Davis, Christopher Edward; Bauer, Travis LaDell

    2009-12-01

    This report summarizes the findings for phase one of the agent review and discusses the review methods and results. The phase one review identified a short list of agent systems that would prove most useful in the service architecture of an information management, analysis, and retrieval system. Reviewers evaluated open-source and commercial multi-agent systems and scored them based upon viability, uniqueness, ease of development, ease of deployment, and ease of integration with other products. Based on these criteria, reviewers identified the ten most appropriate systems. The report also mentions several systems that reviewers deemed noteworthy for the ideas they implement, even if those systems are not the best choices for information management purposes.

  6. Reasoning about emotional agents

    OpenAIRE

    Meyer, J.-J.

    2004-01-01

    In this paper we discuss the role of emotions in artificial agent design, and the use of logic in reasoning about the emotional or affective states an agent can reside in. We do so by extending the KARO framework for reasoning about rational agents appropriately. In particular we formalize in this framework how emotions are related to the action monitoring capabilities of an agent.

  7. On the use of Disease Staging for clinical management: analysis of untimely admissions in the Abruzzo Region, Italy

    Directory of Open Access Journals (Sweden)

    Lamberto Manzoli

    2004-12-01

    Full Text Available

    Background and aims. The process of decentralization which recently occurred within the Italian National Health Service has transferred substantial responsibility and authority for health care administration to the individual regions. The project is aimed at developing regional benchmarks that can be used as a part of an ongoing system for analysis of resource use and quality of care in the Abruzzo Region of Italy.

    Methods. All 286 924 hospital admissions for the year 2001 in the region were analysed. Three diseases were chosen for in-depth review: diabetes mellitus; cholecystitis/cholelithiasis; and bacterial pneumonia. There were a total of 9391 admissions for these diagnoses. Severity, length of hospital stay and hospital mortality were analysed using Disease Staging methodology. In addition, the timeliness of hospitalisation was assessed by grouping admissions in three categories: premature or medically unnecessary, timely and late.

    Results. The rate of medically unnecessary admissions for diabetes mellitus was 72% throughout the region, and the percentage of late hospitalisations for cholelithiasis/cholecystitis was 43%. For both diseases, there were significant variations across Local Health Units in the proportion of late and early admissions. The rate of timely hospitalisations for bacterial pneumonia was higher than 86%.

    Conclusion. The analysis of discharge abstract data using Disease Staging revealed that in the Abruzzo region there are problems of inappropriate hospital admission, both early and late, for all diseases examined excepted bacterial pneumonia.

    Data confirmed the validity of Disease Staging to compare the performance of diverse hospitals in terms of length of stay and in-hospital mortality.

  8. Predicting respiratory hospital admissions in young people with cerebral palsy.

    Science.gov (United States)

    Blackmore, Amanda Marie; Bear, Natasha; Blair, Eve; Langdon, Katherine; Moshovis, Lisa; Steer, Kellie; Wilson, Andrew C

    2018-03-19

    To determine the early predictors of respiratory hospital admissions in young people with cerebral palsy (CP). A 3-year prospective cohort study using linked data. Children and young people with CP, aged 1 to 26 years. Self-reported and carer-reported respiratory symptoms were linked to respiratory hospital admissions (as defined by the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes) during the following 3 years. 482 participants (including 289 males) were recruited. They were aged 1 to 26 years (mean 10 years, 10 months; SD 5 years, 11 months) at the commencement of the study, and represented all Gross Motor Function Classification Scale (GMFCS) levels. During the 3-year period, 55 (11.4%) participants had a total of 186 respiratory hospital admissions, and spent a total of 1475 days in hospital. Statistically significant risk factors for subsequent respiratory hospital admissions over 3 years in univariate analyses were GMFCS level V, at least one respiratory hospital admission in the year preceding the survey, oropharyngeal dysphagia, seizures, frequent respiratory symptoms, gastro-oesophageal reflux disease, at least two courses of antibiotics in the year preceding the survey, mealtime respiratory symptoms and nightly snoring. Most risk factors for respiratory hospital admissions are potentially modifiable. Early identification of oropharyngeal dysphagia and the management of seizures may help prevent serious respiratory illness. One respiratory hospital admission should trigger further evaluation and management to prevent subsequent respiratory illness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. The Fall and Rise of the Travel Agent

    Directory of Open Access Journals (Sweden)

    Steve Jermanok

    2014-02-01

    Full Text Available In the age of online travel agencies, there are questions of whether personal travel agents remain relevant. This article argues that travel agents have never been more necessary because the proliferation of options is overwhelming for many consumers. Travel agents are also much more personal than their online counterparts, providing services that cannot be found online.

  10. The Fall and Rise of the Travel Agent

    OpenAIRE

    Steve Jermanok

    2014-01-01

    In the age of online travel agencies, there are questions of whether personal travel agents remain relevant. This article argues that travel agents have never been more necessary because the proliferation of options is overwhelming for many consumers. Travel agents are also much more personal than their online counterparts, providing services that cannot be found online.

  11. 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".

  12. Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

    Directory of Open Access Journals (Sweden)

    Jensen Gunnar

    2011-01-01

    Full Text Available Abstract Background Several countries have established or are planning acute psychiatric in-patient services that accept around-the-clock emergency admission of adolescents. Our aim was to investigate the characteristics and clinical outcomes of a cohort of patients at four Norwegian units. Methods We used a prospective pre-post observational design. Four units implemented a clinician-rated outcome measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA, which measures mental health problems and their severity. We collected also data about the diagnoses, suicidal problems, family situations, and the involvement of the Child Protection Service. Predictions of outcome (change in HoNOSCA total score were analysed with a regression model. Results The sample comprised 192 adolescents admitted during one year (response rate 87%. Mean age was 15.7 years (range 10-18 and 70% were girls. Fifty-eight per cent had suicidal problems at intake and the mean intake HoNOSCA total score was 18.5 (SD 6.4. The largest groups of main diagnostic conditions were affective (28% and externalizing (26% disorders. Diagnoses and other patient characteristics at intake did not differ between units. Clinical psychiatric disorders and developmental disorders were associated with severity (on HoNOSCA at intake but not with outcome. Of adolescents ≥ 16 years, 33% were compulsorily admitted. Median length of stay was 8.5 days and 75% of patients stayed less than a month. Compulsory admissions and length of stay varied between units. Mean change (improvement in the HoNOSCA total score was 5.1 (SD 6.2, with considerable variation between units. Mean discharge score was close to the often-reported outpatient level, and self-injury and emotional symptoms were the most reduced symptoms during the stay. In a regression model, unit, high HoNOSCA total score at intake, or involvement of the Child Protection Service predicted improvement during admission

  13. Establishment of a local psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1981-01-01

    of senile psychoses. The total increase amounts to 2.4 times the admission rates of psychiatric cases to the General Hospital and 4.4 times the admission rates to the Psychiatric Hospital in Nykøbing in the last years prior to the start of the local service. The outpatient department has grown steadily...... patients were referred to the local General Hospital and about half of the patients in each diagnostic group were sent on the Psychiatric Hospital in Nykøbing on Zealand, Denmark. Since the establishment of the department, admissions have increased in all diagnostic groups, especially in the group...

  14. Establishment of a local psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1981-01-01

    patients were referred to the local General Hospital and about half of the patients in each diagnostic group were sent on the Psychiatric Hospital in Nykøbing on Zealand, Denmark. Since the establishment of the department, admissions have increased in all diagnostic groups, especially in the group...... of senile psychoses. The total increase amounts to 2.4 times the admission rates of psychiatric cases to the General Hospital and 4.4 times the admission rates to the Psychiatric Hospital in Nykøbing in the last years prior to the start of the local service. The outpatient department has grown steadily...

  15. Inpatient dermatology: Characteristics of patients and admissions in a tertiary level hospital in Eastern India

    Directory of Open Access Journals (Sweden)

    Arpita Sen

    2016-01-01

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

  16. International trends in admissions and drug sales for asthma.

    Science.gov (United States)

    Gupta, R; Anderson, H R; Strachan, D P; Maier, W; Watson, L

    2006-02-01

    To test whether national patterns of asthma drug use, particularly inhaled corticosteroids (ICS), are related to the rate of acute severe asthma exacerbations. The relation of international trends in hospital admissions for asthma with asthma drug sales was examined using country-specific regressions over the period 1990-1999. Pooled estimates of the regression coefficients were calculated using random effects models. Data on asthma admissions and asthma drug sales (including the sub-category ICS) were obtained from 11 countries. There was a negative relationship between falling admissions and rising sales of respiratory drugs and ICS in 9 of these 11 countries. A pooled estimate of the change in asthma admission rate per 10,000 associated with a unit increase in sales rate was -6.3 (95% CI -10.4 - -2.3) for all asthma drugs and -11.2 (95% CI -19.7 - -2.8) for ICS. At the national level, there is good evidence that over the last decade, increased sales of asthma drugs, and ICS in particular, were associated with a decline in rates of hospital admission for asthma. This is consistent with a beneficial effect of increasing use of asthma drugs, but other explanations such as decreasing prevalence could also be responsible.

  17. 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.

  18. Chemical warfare agents.

    Science.gov (United States)

    Kuca, Kamil; Pohanka, Miroslav

    2010-01-01

    Chemical warfare agents are compounds of different chemical structures. Simple molecules such as chlorine as well as complex structures such as ricin belong to this group. Nerve agents, vesicants, incapacitating agents, blood agents, lung-damaging agents, riot-control agents and several toxins are among chemical warfare agents. Although the use of these compounds is strictly prohibited, the possible misuse by terrorist groups is a reality nowadays. Owing to this fact, knowledge of the basic properties of these substances is of a high importance. This chapter briefly introduces the separate groups of chemical warfare agents together with their members and the potential therapy that should be applied in case someone is intoxicated by these agents.

  19. 78 FR 75471 - Section 3504 Agent Employment Tax Liability

    Science.gov (United States)

    2013-12-12

    ... 3504 Agent Employment Tax Liability AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final... home care services, which are subject to taxes under the Federal Unemployment Tax Act. The final... the agent and employer are liable for the employment taxes and penalties associated with the employer...

  20. 42 CFR 60.36 - Consequence of using an agent.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Consequence of using an agent. 60.36 Section 60.36 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE LOAN PROGRAM The Lender and Holder § 60.36 Consequence of using an agent. The delegation of...

  1. Transformation of admission interview to documentation for nursing practice

    DEFF Research Database (Denmark)

    Højskov, Ida E; Glasdam, Stinne

    2014-01-01

    's preconception of how to live a good life, with or without disease. Often, the patient tended to become an object in the nurse's report. It is concluded that in practice, the applied documentation system, VIPS, comes to act as the framework for what is important to the nurse to document rather than a tool......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...

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

    Science.gov (United States)

    Nirenberg, Michael

    2016-05-01

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

  3. 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...... compensated unemployment and both types of disease specific hospital admission was associated statistically significant in the cross-sectional analysis. With regard to circulatory disease, the cohort approach suggests that social welfare compensated unemployment might lead to hospital admission due...... 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...

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

    Science.gov (United States)

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

    2016-03-15

    To elucidate the association between antiplatelet use in patients with non-haemorrhagic moyamoya disease before hospital admission and good functional status on admission in Japan. Retrospective, multicentre, non-randomised, observational study. Nationwide registry data in Japan. A total of 1925 patients with non-haemorrhagic moyamoya disease admitted between 1 April 2012 and 31 March 2014 in Japan. We performed propensity score-matched analysis to examine the association between prehospital antiplatelet use and no significant disability on hospital admission, as defined by a modified Rankin Scale score of 0 or 1. Propensity-matched patients who received prehospital antiplatelet drugs were associated with a good outcome on hospital admission (OR adjusted for all covariates, 3.82; 95% CI 1.22 to 11.99) compared with those who did not receive antiplatelet drugs prior to hospital admission. Prehospital antiplatelet use was significantly associated with good functional status on hospital admission among patients with non-haemorrhagic moyamoya disease in Japan. Our results suggest that prehospital antiplatelet use should be considered when evaluating outcomes of patients with non-haemorrhagic moyamoya disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Core personal competencies important to entering students' success in medical school: what are they and how could they be assessed early in the admission process?

    Science.gov (United States)

    Koenig, Thomas W; Parrish, Samuel K; Terregino, Carol A; Williams, Joy P; Dunleavy, Dana M; Volsch, Joseph M

    2013-05-01

    Assessing applicants' personal competencies in the admission process has proven difficult because there is not an agreed-on set of personal competencies for entering medical students. In addition, there are questions about the measurement properties and costs of currently available assessment tools. The Association of American Medical College's Innovation Lab Working Group (ILWG) and Admissions Initiative therefore engaged in a multistep, multiyear process to identify personal competencies important to entering students' success in medical school as well as ways to measure them early in the admission process. To identify core personal competencies, they conducted literature reviews, surveyed U.S and Canadian medical school admission officers, and solicited input from the admission community. To identify tools with the potential to provide data in time for pre-interview screening, they reviewed the higher education and employment literature and evaluated tools' psychometric properties, group differences, risk of coaching/faking, likely applicant and admission officer reactions, costs, and scalability. This process resulted in a list of nine core personal competencies rated by stakeholders as very or extremely important for entering medical students: ethical responsibility to self and others; reliability and dependability; service orientation; social skills; capacity for improvement; resilience and adaptability; cultural competence; oral communication; and teamwork. The ILWG's research suggests that some tools hold promise for assessing personal competencies, but the authors caution that none are perfect for all situations. They recommend that multiple tools be used to evaluate information about applicants' personal competencies in deciding whom to interview.

  6. Variability of intensive care admission decisions for the very elderly.

    Directory of Open Access Journals (Sweden)

    Ariane Boumendil

    Full Text Available Although increasing numbers of very elderly patients are requiring intensive care, few large sample studies have investigated ICU admission of very elderly patients. Data on pre triage by physicians from other specialities is limited. This observational cohort study aims at examining inter-hospital variability of ICU admission rates and its association with patients' outcomes. All patients over 80 years possibly qualifying for ICU admission who presented to the emergency departments (ED of 15 hospitals in the Paris (France area during a one-year period were prospectively included in the study. Main outcome measures were ICU eligibility, as assessed by the ED and ICU physicians; in-hospital mortality; and vital and functional status 6 months after the ED visit. 2646 patients (median age 86; interquartile range 83-91 were included in the study. 94% of participants completed follow-up (n = 2495. 12.4% (n = 329 of participants were deemed eligible for ICU admission by ED physicians and intensivists. The overall in-hospital and 6-month mortality rates were respectively 27.2% (n = 717 and 50.7% (n = 1264. At six months, 57.5% (n = 1433 of patients had died or had a functional deterioration. Rates of patients deemed eligible for ICU admission ranged from 5.6% to 38.8% across the participating centers, and this variability persisted after adjustment for patients' characteristics. Despite this variability, we found no association between level of ICU eligibility and either in-hospital death or six-month death or functional deterioration. In France, the likelihood that a very elderly person will be admitted to an ICU varies widely from one hospital to another. Influence of intensive care admission on patients' outcome remains unclear.ClinicalTrials.gov NCT00912600.

  7. Web Services Integration on the Fly

    National Research Council Canada - National Science Library

    Leong, Hoe W

    2008-01-01

    .... Given data, software agents and supporting software infrastructure, web services integration on the fly means that human coding is not required to integrate web services into a Web Service Architecture...

  8. The family physician's perceived role in preventing and guiding hospital admissions at the end of life: a focus group study.

    Science.gov (United States)

    Reyniers, Thijs; Houttekier, Dirk; Pasman, H Roeline; Stichele, Robert Vander; Cohen, Joachim; Deliens, Luc

    2014-01-01

    Family physicians play a pivotal role in providing end-of-life care and in enabling terminally ill patients to die in familiar surroundings. The purpose of this study was to explore the family physicians' perceptions of their role and the difficulties they have in preventing and guiding hospital admissions at the end of life. Five focus groups were held with family physicians (N= 39) in Belgium. Discussions were transcribed verbatim and analyzed using a constant comparative approach. Five key roles in preventing and guiding hospital admissions at the end of life were identified: as a care planner, anticipating future scenarios; as an initiator of decisions in acute situations, mostly in an advisory manner; as a provider of end-of-life care, in which competency and attitude is considered important; as a provider of support, particularly by being available during acute situations; and as a decision maker, taking overall responsibility. Family physicians face many different and complex roles and difficulties in preventing and guiding hospital admissions at the end of life. Enhancing the family physician's role as a gatekeeper to hospital services, offering the physicians more end-of-life care training, and developing or expanding initiatives to support them could contribute to a lower proportion of hospital admissions at the end of life. © 2014 Annals of Family Medicine, Inc.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK

    Science.gov (United States)

    Fishpool, SJC; Tomkinson, A

    2012-01-01

    INTRODUCTION Epistaxis is the one of the most common otorhinolaryngology emergencies. This study examined the age and sex distribution of all patients admitted with epistaxis to National Health Service (NHS) hospitals in Wales, UK, over a period of 18 years and 9 months. METHODS The Patient Episode Database for Wales was examined for all patient admissions with a diagnosis of epistaxis between April 1991 and December 2009. The age and sex of these patients was recorded and the proportion of the underlying population affected was calculated by comparing admission rates to the population data derived from the 1991 and 2001 national population censuses for Wales. RESULTS A total of 26,725 patients were admitted to NHS hospitals in Wales with epistaxis over the period studied. The proportion of the population admitted with epistaxis increased from the age of 40 onwards. For all ages except patients in the 10–14 years group, a higher proportion of the male population was admitted with epistaxis than the comparable female population. This discrepancy was most pronounced between the ages of 15 and 49 years, with the female-to-male ratio of hospital admissions with epistaxis being 0.55. These ages (15 and 49 years) approximate the average age of menarche and menopause respectively in the UK. CONCLUSIONS Women of menstrual age have fewer hospital admissions with epistaxis. This may be due to oestrogens providing protection to the nasal vasculature (as they do to other areas of the vascular tree). PMID:23131225

  11. THE ADMISSION OF ALBANIA IN THE LEAGUE OF NATIONS

    Directory of Open Access Journals (Sweden)

    Deona Cali Kalaja

    2016-01-01

    Full Text Available This paper aims to focus on the questions of how important was the admission of Albania to the League of Nations as well as what was the reason of the change of attitude of the Great Powers and neighbors against Albanian candidature. In the paper is scrutinized the situation of Albania before membership in the League of Nations as well as the reasons that led it before this international body. The topic is interesting as the scrutiny of this moment of Albanian history in international relations helps to understand the events that followed in 1920s and how contributed this admission on the issue of borders and on international recognition.

  12. SARP: a value-based approach to hospice admissions triage.

    Science.gov (United States)

    MacDonald, D

    1995-01-01

    As hospices become established and case referrals increase, many programs are faced with the necessity of instituting waiting lists. Prioritizing cases for order of admission requires a triage method that is rational, fair, and consistent. This article describes the SARP method of hospice admissions triage, which evaluates prospective cases according to seniority, acuity, risk, and political significance. SARP's essential features, operative assumptions, advantages, and limitations are discussed, as well as the core hospice values which underlie its use. The article concludes with a call for trial and evaluation of SARP in other hospice settings.

  13. Introducing ALAS: A Novel Agent-Oriented Programming Language

    Science.gov (United States)

    Mitrović, Dejan; Ivanović, Mirjana; Vidaković, Milan

    2011-09-01

    Agent-oriented programming languages represent a family of programming languages that provide developers with high-level abstractions and constructs necessary for implementing and using agent-related concepts. In this paper a novel agent-oriented programming language for rapid and efficient development of reactive agents, named ALAS, is presented. The simple, but powerful set of language constructs is designed to support the execution of agents in heterogenous environments, and to enable easy employment of advanced agent features, such as mobility and web service integration.

  14. Radiopharmaceutical scanning agents

    International Nuclear Information System (INIS)

    1976-01-01

    This invention is directed to dispersions useful in preparing radiopharmaceutical scanning agents, to technetium labelled dispersions, to methods for preparing such dispersions and to their use as scanning agents

  15. Taskable Reactive Agent Communities

    National Research Council Canada - National Science Library

    Myers, Karen

    2002-01-01

    The focus of Taskable Reactive Agent Communities (TRAC) project was to develop mixed-initiative technology to enable humans to supervise and manage teams of agents as they perform tasks in dynamic environments...

  16. Analysis of the burns profile and the admission rate of severely burned adult patient to the National Burn Center of Chile after the 2010 earthquake.

    Science.gov (United States)

    Albornoz, Claudia; Villegas, Jorge; Sylvester, Marilu; Peña, Veronica; Bravo, Iside

    2011-06-01

    Chile is located in the Ring of Fire, in South America. An earthquake 8.8° affected 80% of the population in February 27th, 2010. This study was conducted to assess any change in burns profile caused by the earthquake. This was an ecologic study. We compared the 4 months following the earthquake in 2009 and 2010. age, TBSA, deep TBSA, agent, specific mortality rate and rate of admissions to the National burn Center of Chile. Mann-Whitney test and a Poisson regression were performed. Age, agent, TBSA and deep TBSA percentages did not show any difference. Mortality rate was lower in 2010 (0.52 versus 1.22 per 1,000,000 habitants) but no meaningful difference was found (Poisson regression p = 0.06). Admission rate was lower in 2010, 4.6 versus 5.6 per 1,000,000 habitants, but no differences were found (p = 0.26). There was not any admissions directly related to the earthquake. As we do not have incidence registries in Chile, we propose to use the rate of admission to the National Burn Reference Center as an incidence estimator. There was not any significant difference in the burn profile, probably because of the time of the earthquake (3 am). We conclude the earthquake did not affect the way the Chilean people get burned. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  17. Usefulness of admission gamma-glutamyltransferase level for predicting new-onset heart failure in patients with acute coronary syndrome with left ventricular systolic dysfunction.

    Science.gov (United States)

    Sarıkaya, Savaş; Aydın, Gülay; Yücel, Hasan; Kaya, Hakkı; Yıldırımlı, Kutay; Başaran, Ahmet; Zorlu, Ali; Sahin, Safak; Akyol, Lütfü; Bulut, Musa

    2014-04-01

    Our aim was to determine whether there is a relationship between admission gamma-glutamyltransferase (GGT) and subsequent heart failure hospitalizations in patients with acute coronary syndrome. We selected 123 patients with newly diagnosed acute coronary syndrome of ejection fraction (EF) 49 IU/L on admission, presence of hypertension and hyperlipidemia, left ventricular ejection fraction (LVEF), right ventricular dysfunction, moderate-to-severe mitral regurgitation, alanine aminotransferase level, and antiplatelet agent usage were found to have prognostic significance in univariate Cox proportional hazards analysis. In multivariate Cox proportional-hazards model, increased GGT >49 IU/L on admission (hazard ratio [HR] 2.663, p=0.047), presence of hypertension (HR 4.107, p=0.007), and LVEF (HR 0.911, p=0.002) were found to be independent factors to predict new-onset heart failure requiring hospitalization. Hospitalization in heart failure was associated with increased admission GGT levels. Increased admission GGT level in acute coronary syndrome with heart failure should be monitored closely and treated aggressively.

  18. Association Between Changes in CMS Reimbursement Policy and Drug Labels for Erythrocyte-Stimulating Agents With Outcomes for Older Patients Undergoing Hemodialysis Covered by Fee-for-Service Medicare.

    Science.gov (United States)

    Wang, Cunlin; Kane, Robert; Levenson, Mark; Kelman, Jeffrey; Wernecke, Michael; Lee, Joo-Yeon; Kozlowski, Steven; Dekmezian, Carmen; Zhang, Zhiwei; Thompson, Aliza; Smith, Kimberly; Wu, Yu-Te; Wei, Yuqin; Chillarige, Yoganand; Ryan, Qin; Worrall, Chris; MaCurdy, Thomas E; Graham, David J

    2016-12-01

    In 2011, the US Centers for Medicare & Medicaid Services (CMS) changed its reimbursement policy for hemodialysis to a bundled comprehensive payment system that included the cost of erythrocyte-stimulating agents (ESAs). Also in 2011, the US Food and Drug Administration revised the drug label for ESAs, recommending more conservative dosing in patients with chronic kidney disease. In response to concerns that these measures could have adverse effects on patient care and outcomes, the CMS and the FDA initiated a collaboration to assess the effect. To assess the effects of the changes in reimbursement policy and the ESA drug label on patients who underwent incident hemodialysis. For this retrospective cohort study, patients 66 years or older who had undergone incident hemodialysis, and were enrolled in Medicare parts A, B, or D for at least 12 months prior to hemodialysis initiation between January 1, 2008, and December 31, 2013, were recruited from hemodialysis centers across the United States. Patients were divided into 2 cohorts based on their date of hemodialysis initiation and followed: January 1, 2008, to December 31, 2009, for the prepolicy cohort and July 1, 2011, to June 30, 2013, for the postpolicy cohort, with the exclusion of January 1, 2010, to June 30, 2011, as a transition period. Changes in CMS reimbursement policy for dialysis and the FDA label for ESAs. Major adverse cardiovascular events (MACEs), including acute myocardial infarction (AMI), stroke, and all-cause mortality; hospitalized congestive heart failure (H-CHF); venous thromboembolism; and red blood cell transfusions. Secondary outcomes included evaluating effects on black and other patient subgroups. Baseline characteristics of the 69 718 incident hemodialysis patients were similar between cohorts. Compared with the prepolicy period, the risk of MACE, death, H-CHF, and venous thromboembolism were similar in the postpolicy period, and the risk of stroke decreased (hazard ratio [HR], 0.77; 95

  19. What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study.

    Science.gov (United States)

    Sefton, G; McGrath, C; Tume, L; Lane, S; Lisboa, P J G; Carrol, E D

    2015-04-01

    The ideology underpinning Paediatric Early Warning systems (PEWs) is that earlier recognition of deteriorating in-patients would improve clinical outcomes. To explore how the introduction of PEWs at a tertiary children's hospital affects emergency admissions to the Paediatric Intensive Care Unit (PICU) and the impact on service delivery. To compare 'in-house' emergency admissions to PICU with 'external' admissions transferred from District General Hospitals (without PEWs). A before-and-after observational study August 2005-July 2006 (pre), August 2006-July 2007 (post) implementation of PEWs at the tertiary children's hospital. The median Paediatric Index of Mortality (PIM2) reduced; 0.44 vs 0.60 (pemergency admissions to PICU. A 39% reduction in emergency admission total beds days reduced cancellation of major elective surgical cases and refusal of external PICU referrals. Following introduction of PEWs at a tertiary children's hospital PIM2 was reduced, patients required less PICU interventions and had a shorter length of stay. PICU service delivery improved. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Users, Bystanders and Agents

    DEFF Research Database (Denmark)

    Krummheuer, Antonia Lina

    2015-01-01

    Human-agent interaction (HAI), especially in the field of embodied conversational agents (ECA), is mainly construed as dyadic communication between a human user and a virtual agent. This is despite the fact that many application scenarios for future ECAs involve the presence of others. This paper...

  1. Asymptotically Optimal Agents

    OpenAIRE

    Lattimore, Tor; Hutter, Marcus

    2011-01-01

    Artificial general intelligence aims to create agents capable of learning to solve arbitrary interesting problems. We define two versions of asymptotic optimality and prove that no agent can satisfy the strong version while in some cases, depending on discounting, there does exist a non-computable weak asymptotically optimal agent.

  2. Reasoning about emotional agents

    NARCIS (Netherlands)

    Meyer, J.-J.

    In this paper we discuss the role of emotions in artificial agent design, and the use of logic in reasoning about the emotional or affective states an agent can reside in. We do so by extending the KARO framework for reasoning about rational agents appropriately. In particular we formalize in

  3. Admission Blood Pressure of Stroke Patients and Its Relationship to ...

    African Journals Online (AJOL)

    Background: High blood pressure is often said to be associated with poor outcome in stroke. However, there remains some uncertainly about the relationship of blood pressure to mortality in stroke. Objective: This study seeks to determine the influence of admission blood pressure on early mortality of stroke patients at the ...

  4. admission patterns and outcomes of paediatric patients admitted at ...

    African Journals Online (AJOL)

    OBJECTIVE To determine patterns of admissions due to diarrhea and their outcomes of paediatric patients at Muhimbili National Hospital (MNH). METHODOLOGY A hospital-based prospective study including all children admitted to the Diarrhea Unit during the study period. Data was collected using content analysis ...

  5. 40 CFR 85.1505 - Final admission of certified vehicles.

    Science.gov (United States)

    2010-07-01

    ... PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Importation of Motor Vehicles and Motor... vehicle or engine from the previous test (e.g., adjusting the RPM, timing, air-to-fuel ratio, etc.) other... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Final admission of certified vehicles...

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

    NARCIS (Netherlands)

    Zonderland, Maartje Elisabeth; Boucherie, Richardus J.; Carter, Michael W.; Stanford, David A.

    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

  7. 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

  8. Risk Factors for Maternal Deaths in Unplanned Obstetric Admissions ...

    African Journals Online (AJOL)

    ... (37.5%), and respiratory distress (12.5%). There were 12 deaths (48%). Organ dysfunction on admission, massive blood loss and late presentation were the risk factors for mortality. The high maternal mortality was mainly due to limited supply of blood products and inadequate prenatal care resulting in disease severity.

  9. Pattern of surgical admissions to Tikur Anbessa Hospital, Addis ...

    African Journals Online (AJOL)

    developing countries is mainly performed on acute and curable conditions('). ... 550. 2. Gastric outlet obstruction (PUD). 265. 3. Appendicitis. 258. 4. Intestinal obstruction. 229. 5. Oesophageal carcinoma. 114. 6. Abdominal trauma. 102. 7. Other GI diseases ... managing special referred cases, the majority of admission were ...

  10. Trends in admissions, morbidity and outcomes at Red Cross War ...

    African Journals Online (AJOL)

    Child health in South Africa (SA) has faced significant challenges in the recent past, largely as a result .... or LRTI remained the top two reasons for hospitalisation, but they ..... Owing to the diverse objectives of this study, all results are not generalisable to .... Gender disparity in paediatric hospital admissions. Ann Acad Med ...

  11. Employee Turnover in Christian College/University Admissions

    Science.gov (United States)

    Dougherty, Kevin D.; Andrews, Megan

    2007-01-01

    Few campus offices bear the weight of organizational health and vitality more directly than college and university admissions offices. This is particularly true for Christian colleges and universities where annual operating budgets depend largely on student tuition dollars. The purpose of the research reported in this paper was to explore rates…

  12. An $\\mathcal{H}_\\infty$ calculus of admissible operators

    NARCIS (Netherlands)

    Zwart, Heiko J.

    Given a Hilbert space and the generator A of a strongly continuous, exponentially stable, semigroup on this Hilbert space. For any $g(-s) \\in H_{\\infty}$ we show that there exists an infinite-time admissible output operator $g(A)$. If $g$ is rational, then this operator is bounded, and equals the

  13. 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…

  14. Pattern and outcome of diabetic admissions at a federal medical ...

    African Journals Online (AJOL)

    Background: Prevalence of diabetes mellitus (DM) is increasing worldwide, with the major increases expected to occur in developing countries. It has been observed that the pattern of hospital admissions can be used to determine the effectiveness of outpatient care of DM. Objective:This study was aimed to examine ...

  15. 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...

  16. One year audit of surgical admissions at Gondar university medical ...

    African Journals Online (AJOL)

    Background: The new University of Gondar enrolled surgeons for post graduate training in November 2003. A new surgical curriculum was designed in partnership with the Leicester Gondar Link. Admissions to the Department of Surgery over twelve months were subject to audit. The objectives of the audit study were to ...

  17. On orbits and admissible subalgebras for the PR groups

    International Nuclear Information System (INIS)

    Lebedenko, V.M.

    1977-01-01

    The PR-groups (Lie groups with commutation relations of [Hsub(i),Hsub(0)] = rsub(ij)Hsub(i) (i< j)-type) are investigated within the Kirillov orbit method. Orbits for all the PR-groups are constructed in a general form. For some classes of PR-groups orbits and admissible subalgebras are obtained in an explicit form

  18. admission patterns and outcomes of paediatric patients admitted at ...

    African Journals Online (AJOL)

    National Hospital (MNH). The sample population included all children admitted to the Diarrhea Unit and sample size was made up of all admissions in Diarrhea Unit of MNH from 18th February to 8th March, 2008. Data was collected using a content analytic checklist which was designed to cover all necessary information.

  19. Continuous admission to primary school and mental health problems

    NARCIS (Netherlands)

    S.A. Reijneveld (Sijmen); C.H. Wiefferink (Carin); E. Brugman (Emily); F.C. Verhulst (Frank); S.P. Verloove-Vanhorick; A.D.C. Paulussen (Aimée)

    2006-01-01

    textabstractBackground: 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

  20. 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