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  1. 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%) (p<0.001), but this is primarily attributable to a lower rate of voluntary admission among individuals born outside Ireland (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.

  2. Characteristics of delayed admission to stroke unit.

    Science.gov (United States)

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

    2006-01-01

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

  3. 28 CFR 541.47 - Admission to control unit.

    Science.gov (United States)

    2010-07-01

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

  4. [Triage in acute medical admission units.

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Folkestad, Lars; Hallas, Peter

    2010-01-01

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

  5. Admissibility, stable units and connected components

    CERN Document Server

    Xarez, J J

    2011-01-01

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

  6. Emergency department orthopedics observation unit as an alternative to admission.

    Science.gov (United States)

    Ernst, Amy A; Jones, Jaime; Weiss, Steven J; Silva, Otono

    2014-10-01

    Inclusion of select orthopedic problems in the orthopedics observation unit (OOU) may reduce hospital admissions. Our system allows OOU status for 24 hours, but the effect on admissions is unknown. Our primary hypothesis was that we could predict which OOU patients required admission based on the presence of uncontrolled pain. Data were prospectively collected for all OOU patients in this prospective observational study, including data on extremity cellulitis, fractures, and spine injuries awaiting brace placement.The primary outcome variable was admission to the hospital versus discharge home. The a priori hypotheses were that patients with more persistent or worsening pain would require admission more often and that the OOU would result in fewer patients needing a costlier inpatient admission to the hospital. An a priori power analysis showed adequate power of 80% to detect a difference between admitted and discharged patients. Data were prospectively collected from August 2011 to August 2012 for 199 consecutive OOU patients, 62% of whom were men. Diagnoses included infection (cellulitis or abscess of extremity) in 76%, fracture in 15% and other in 9% of the patients. Sixty-two patients (31%) were admitted and 7 patients (4%) made return visits for the same problem within a 30-day period. No significant relations existed between any of the independent variables and admission on bivariate analysis. Multivariable logistic regression found no significant predictors of hospital admission. Logistic regression was not performed on 30-day returns because of the low event rate (4%). An OOU prevented 138 of 199 (69%) patients from being admitted to a hospital. There were no significant predictors of which patients would require admission. Pain was not a predictor of need for admission. The lack of significant predictors is important in suggesting that without the ability to predict which patients require admission, a system using an OOU can reduce admissions by more than

  7. Outcome of mechanically ventilated patients initially denied admission to an intensive care unit and subsequently admitted.

    Science.gov (United States)

    Naser, Wasim; Schwartz, Naama; Finkelstein, Richard; Bisharat, Naiel

    2016-11-01

    The outcome of mechanically ventilated patients initially denied admission to an intensive care unit (ICU) and subsequently admitted is unclear. We compared outcomes of patients denied ICU admission and subsequently admitted, to those of patients admitted to the ICU and to patients refused ICU admission. The medical records of all the patients who were subjected to mechanical ventilation for at least 24h over a 4year period (2010-2014) were reviewed. Of 707 patients (757 admissions), 124 (18%) were initially denied ICU admission and subsequently admitted. Multivariate stepwise logistic regression analysis showed significant association with death of: age, length of stay, nursing home residency, duration of mechanical ventilation, previous admission with mechanical ventilation, cause for mechanical ventilation, rate of failed extubations, associated morbidity (previous cerebrovascular accident, dementia, chronic renal failure), and occurrence of nosocomial bacteremia. The odds for death among patients denied ICU admission and subsequently transferred to the ICU compared to patients admitted directly to the ICU was 3.6 (95% CI: 1.9-6.7) (Padmission compared to those who were initially denied and subsequently admitted were not statistically significant (OR=1.7, 95% CI: 0.8-3.8). In conclusion, patients denied ICU admission and subsequently admitted face a considerable risk of morbidity and mortality. Their odds of death are nearly three times those admitted directly to the ICU. Late admission to the ICU does not appear to provide benefit compared to patients who remain in general medicine wards.

  8. Intermediate Care Unit - defining substituyable admissions

    DEFF Research Database (Denmark)

    Nygaard, Hanne; Ekmann, Anette Addy

    Background: Elderly patients have excess risk of functional decline and development of delirium. Studies have shown that 14-27 % of hospitalizations among elderly patients are substitutable. To lower the risk of unwanted consequences of hospitalizations, we implemented an Intermediate Care Unit...... (TUE). TUE was established in collaboration between Bispebjerg Hospital and the City of Copenhagen and took in patients whose hospitalization was regarded as substitutable. TUE offered a quick diagnostic assessment by a cross sectoral team of hospital doctors and community nurses. Home care was offered...... Care Unit.' Methods: From September 17, 2012 - June 24, 2014, 969 patients were treated at TUE. We registered both demographic-, treatment- and medical data and furthermore functional related variables. We used logistic regression to test the association between a combined graded variable of EWS...

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Pharmacist-led medication review in an acute admissions unit

    DEFF Research Database (Denmark)

    Hansen, Trine Graabæk; Bonnerup, Dorthe Krogsgaard; Kjeldsen, Lene Juel

    2015-01-01

    Objectives Over the last decades, several papers have evaluated clinical pharmacy interventions in hospital settings with conflicting findings as results. Medication reviews are frequently a central component of these interventions. However, the term ‘medication review’ covers a plethora.......Methods A procedure was developed based on clinical experience and inspiration from previous studies and literature on medication review models. The procedure was developed to fit the busy workflow in acute admissions units.Results The procedure consists of five steps: (1) collection of clinical patient data, (2...... of principles and methodologies, and the practical procedure is seldom described in detail, which makes reproducing study findings difficult. The objective of this paper is to provide a detailed description of a procedure developed and used for pharmacist-led medication review in acute admissions units...

  12. Evaluation of obstetric admissions to intensive care unit of a tertiary referral center in coastal India

    Directory of Open Access Journals (Sweden)

    Poornima B Ramachandra Bhat

    2013-01-01

    Full Text Available Background and Aim: To evaluate the occurrence, indications, course, interventions, and outcome of obstetric patients admitted to the intensive care unit (ICU. Design: Retrospective study. Setting: ICU of a Medical College Hospital. Materials and Methods: The data collected were age, parity, obstetric status, primary diagnosis, interventions, and outcome of obstetric patients admitted to the ICU from Jan 2005 to June 2011. Results: Total deliveries were 16,804 in 6.5 years. Obstetric admissions to the ICU were (n = 65 which constitutes 0.39% of deliveries. Majority of the admissions were in the postpartum period (n = 46, 70.8%. The two common indications for admission were obstetric hemorrhage (n = 18, 27.7% and pregnancy related hypertension with its complications (n = 17, 26.2%. The most common intervention was artificial ventilation (n = 41, 63%. The mortality among obstetric admissions in the ICU was (33.8% (22/65. The patients appropriate for High Dependency Unit (HDU care was (32.3% (21/65. The statistical analysis was done by fractional percentage and Chi-square test. Conclusions: Hemorrhage and pregnancy-related hypertension with its complications are the two common indications for ICU admissions. The need for a HDU should be considered.

  13. Clinical Predictors of Intensive Care Unit Admission for Asthmatic Children

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    Mohammad Hasan Kargar Maher

    2015-07-01

    Full Text Available IntroductionChildren with severe asthma attack are a challenging group of patients who could be difficult to treat and leading to significant morbidity and mortality. Asthma attack severity is qualitatively estimated as mild, moderate and severe attacks and respiratory failure based on conditions such as respiration status, feeling of dyspnea, and the degree of unconsciousness. part of which are subjective rather than objective. We investigated clinical findings as predictors of severe attack and probable requirement for Pediatric Intensive Care Unit (PICU admission.Materials and MethodsIn a cross sectional and analytical study 120 patients with asthma attack were enrolled from April 2010 to April 2014 (80 admitted in the ward and 40 in pediatric intensive care unit. Predictors of PICU admission were investigated regarding to initial heart rate(HR, respiratory rate (RR, Arterial Oxygen Saturation(SaO2 and PaCo2 and clinically evident cyanosis.ResultsInitial heart rate(p-value=0.02, respiratory rate (p-value=0.03, Arterial Oxygen Saturation(p-value=0.02 and PaCo2(p-value=0.03 and clinically evident cyanosis were significantly different in two groups(Ward admitted and PICU admittedConclusion There was a significant correlation between initial vital sign and blood gas analysis suggesting usefulness of these factors as predictors of severe asthma attack and subsequent clinical course.

  14. Detection of Invalid Test Scores on Admission Tests : A Simulation Study Using Person-Fit Statistics

    NARCIS (Netherlands)

    Tendeiro, Jorge N.; Meijer, Rob R.; Albers, Casper J.

    While an admission test may strongly predict success in university or law school programs for most test takers, there may be some test takers who are mismeasured. To address this issue, a class of statistics called person-fit statistics is used to check the validity of individual test scores.

  15. Small subdural hemorrhages: is routine intensive care unit admission necessary?

    Science.gov (United States)

    Albertine, Paul; Borofsky, Samuel; Brown, Derek; Patel, Smita; Lee, Woojin; Caputy, Anthony; Taheri, M Reza

    2016-03-01

    With advancing technology, the sensitivity of computed tomography (CT) for the detection of subdural hematoma (SDH) continues to improve. In some cases, the finding is limited to one or 2 images of the CT examination. At our institution, all patients with an SDH require intensive care unit (ICU) admission, regardless of size. In this report, we tested the hypothesis that patients with a small traumatic SDH on their presenting CT examination do not require the intensive monitoring offered in the ICU and can instead be managed on a hospital unit with a lower level of monitoring. This is a retrospective study of patients evaluated and treated at a level I trauma center for acute traumatic intracranial hemorrhage between 2011 and 2014. The clinical and imaging profile of 87 patients with traumatic SDH were studied. Patients with small isolated traumatic subdural hemorrhage (tSDH) (medical stability during hospitalization, and did not require any neurosurgical intervention. It is our recommendation that patients with isolated tSDH (medical decline (4%) and neurologic decline (4%) but may still benefit from ICU observation. Patients with tSDH greater than 10 cm(3) overall demonstrated poor clinical courses and outcome and would benefit ICU monitoring.

  16. Review of Labour Statistics for the United Nations Statistical Commission

    OpenAIRE

    Catherine Barham

    2008-01-01

    Describes the Review, whose recommendations will be taken forward by UN Statistical Division and the International Labour OrganisationEarly in 2007, the Office for National Statistics was asked by United Nations Statistics Division (UNSD) to carry out a Review of Labour Statistics on behalf of the UK. The Review was carried out during 2007 and was presented at the annual UN Statistics Commission session in February 2008 in New York. The Review was very well received and recommendations in the...

  17. Correlation of admissions statistics to graduate student success in medical physics.

    Science.gov (United States)

    Burmeister, Jay; McSpadden, Erin; Rakowski, Joseph; Nalichowski, Adrian; Yudelev, Mark; Snyder, Michael

    2014-01-06

    The purpose of this work is to develop metrics for evaluation of medical physics graduate student performance, assess relationships between success and other quantifiable factors, and determine whether graduate student performance can be accurately predicted by admissions statistics. A cohort of 108 medical physics graduate students from a single institution were rated for performance after matriculation based on final scores in specific courses, first year graduate Grade Point Average (GPA), performance on the program exit exam, performance in oral review sessions, and faculty rating. Admissions statistics including matriculating program (MS vs. PhD); undergraduate degree type, GPA, and country; graduate degree; general and subject GRE scores; traditional vs. nontraditional status; and ranking by admissions committee were evaluated for potential correlation with the performance metrics. GRE verbal and quantitative scores were correlated with higher scores in the most difficult courses in the program and with the program exit exam; however, the GRE section most correlated with overall faculty rating was the analytical writing section. Students with undergraduate degrees in engineering had a higher faculty rating than those from other disciplines and faculty rating was strongly correlated with undergraduate country. Undergraduate GPA was not statistically correlated with any success metrics investigated in this study. However, the high degree of selection on GPA and quantitative GRE scores during the admissions process results in relatively narrow ranges for these quantities. As such, these results do not necessarily imply that one should not strongly consider traditional metrics, such as undergraduate GPA and quantitative GRE score, during the admissions process. They suggest that once applicants have been initially filtered by these metrics, additional selection should be performed via the other metrics shown here to be correlated with success. The parameters used

  18. Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study

    NARCIS (Netherlands)

    Zwart, J.J.; Dupuis, J.R.O.; Richters, A.; Öry, F.; Roosmalen, J. van

    2010-01-01

    Purpose: As part of a larger nationwide enquiry into severe maternal morbidity, our aim was to assess the incidence and possible risk factors of obstetric intensive care unit (ICU) admission in the Netherlands. Methods: In a 2-year nationwide prospective population-based cohort study, all ICU admiss

  19. Observational study of admission and triage decisions for patients referred to a regional intensive care unit.

    Science.gov (United States)

    Howe, D C

    2011-07-01

    The objectives of this study were to identify factors associated with decisions concerning triage and admission to the intensive care unit and to describe the outcome of patients referred to intensive care unit for admission. The study was a single-centre, prospective, observational study. It was performed in the general intensive care unit of a tertiary regional hospital, over the period of February to June 2009. The patients were non-elective, acute medical in-patients. For 100 patients referred, only 36 were admitted to the intensive care unit. The remaining 64 were declined admission: nine were declined admission because they were assessed as too sick to benefit, 41 were declined admission because they were assessed as too well to benefit and 14 were deemed to potentially benefit from intensive care unit admission but were not admitted ('triage'). Patients most likely to receive triage decisions were medical in-patients who had expressed wishes about end-of-life care, who were functionally limited with co-morbid conditions affecting their performance status. Patients referred by Resident Medical Officers were also more likely to receive a triage decision. Age, gender Aboriginal and Torres Strait Islander status, diagnostic category and reason for referral did not impact on admission or triage decisions. Bed status in intensive care unit at the time of referral affected neither admission nor triage decisions. Hospital mortality in patients deemed too well to benefit from intensive care unit was 7.3%, suggesting that all patients referred for consideration of admission to intensive care unit should be classified as 'high risk'.

  20. Low income and living alone are risk factors for admission to the intensive care unit with sepsis

    DEFF Research Database (Denmark)

    Storm, Line

    . There was no significant association between educational level and the risk of admission to the ICU with sepsis. Conclusion: Individuals either living alone or having a low income had significantly higher odds of ICU admission with sepsis. The results indicate that this patient group needs specific attention when......Background: A recent study showed significantly higher risk of bacteremia among individuals with low socioeconomic status. No studies have focused on socioeconomic status as a risk factor for intensive care unit (ICU) admission with sepsis. We hypothesize that individuals with low socioeconomic...... were matched on sex, age and area of residence (Central Region Denmark) to 9-10 controls per patient (3,869) retrieved from the background population through Statistics Denmark. Socioeconomic status was defined as highest accomplished educational level, yearly income (based on yearly tax declaration...

  1. A Molecular Biomarker to Diagnose Community-acquired Pneumonia on Intensive Care Unit Admission

    NARCIS (Netherlands)

    Scicluna, Brendon P; Klein Klouwenberg, Peter M C; van Vught, Lonneke A; Wiewel, Maryse A; Ong, David S Y; Zwinderman, Aeilko H; Franitza, Marek; Toliat, Mohammad R; Nürnberg, Peter; Hoogendijk, Arie J; Horn, Janneke; Cremer, Olaf L; Schultz, Marcus J; Bonten, Marc J; van der Poll, Tom

    2015-01-01

    Rationale: Community-acquired pneumonia (CAP) accounts for a major proportion of intensive care unit (ICU) admissions for respiratory failure and sepsis. Diagnostic uncertainty complicates case management, which may delay appropriate cause-specific treatment. Objectives: To characterize the blood

  2. Maternal super obesity and risk for intensive care unit admission in the MFMU Cesarean Registry.

    Science.gov (United States)

    Smid, Marcela C; Dotters-Katz, Sarah K; Vaught, Arthur J; Vladutiu, Catherine J; Boggess, Kim A; Stamilio, David M

    2017-08-01

    Obesity is a risk factor for intensive care unit (ICU) admission in nonpregnant populations. Less is known about maternal obesity and ICU admission risk. The objective of this study was to estimate the association between maternal obesity and ICU admission among women who delivered via cesarean section or vaginal birth after cesarean section (VBAC). This is a retrospective cohort analysis of women who delivered via VBAC or cesarean section in the Maternal-Fetal Medicine Unit (MFMU) Cesarean Registry. We defined exposure as body mass index (BMI) at delivery stratified as non-obese (BMI 18.5-29.9 kg/m(2) ), class I or II obese (BMI 30-39.9 kg/m(2) ), morbidly obese (BMI 40-49.9 kg/m(2) ), and super obese (BMI ≥ 50 kg/m(2) ). The primary outcome was ICU admission. Modified Poisson regression models estimated relative risk (RR) of ICU admission by obesity strata, after adjusting for confounders. Mediation analysis was used to estimate the proportion of ICU admission risk attributable specifically to obesity. We included 68 455 women; 40% non-obese, 46% class I or II obese, 12% morbidly obese, and 2% super obese. Super obese women were at higher risk for ICU admission compared with non-obese women (0.7 vs. 1.3%, adjusted RR 1.61; 95% CI 1.01-2.65), after adjusting for confounders. Among super obese women, medical comorbidities mediated 58% of ICU admission risk, suggesting that a significant proportion of ICU admission is driven by maternal obesity. Super obese women who deliver by cesarean section or VBAC are at increased risk of peripartum ICU admission. Obstetricians and critical care specialists should consider possible ICU admission during delivery planning. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  3. Deciding intensive care unit-admission for critically ill cancer patients

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    Thiery Guillaume

    2007-01-01

    Full Text Available Over the last 15 years, the management of critically ill cancer patients requiring intensive care unit admission has substantially changed. High mortality rates (75-85% were reported 10-20 years ago in cancer patients requiring life sustaining treatments. Because of these high mortality rates, the high costs, and the moral burden for patients and their families, ICU admission of cancer patients became controversial, or even clearly discouraged by some. As a result, the reluctance of intensivists regarding cancer patients has led to frequent refusal admission in the ICU. However, prognosis of critically ill cancer patients has been improved over the past 10 years leading to an urgent need to reappraise this reluctance. In this review, the authors sought to highlight that critical care management, including mechanical ventilation and other life sustaining therapies, may benefit to cancer patients. In addition, criteria for ICU admission are discussed, with a particular emphasis to potential benefits of early ICU-admission.

  4. Effect of advanced age and vital signs on admission from an emergency department observation unit

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    Caterino, Jeffrey M.; Hoover, Emily; Moseley, Mark G.

    2012-01-01

    Objectives The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission. Methods We conducted a prospective, observational cohort study of ED patients placed in an ED-based observation unit. Multivariable penalized maximum likelihood logistic regression was used to identify independent predictors of need for hospital admission. Age was examined continuously and at a cutoff of ≥65 years. Vital signs were examined continuously and at commonly accepted cutoffs. We additionally controlled for demographics, co-morbid conditions, laboratory values, and observation protocol. Results Three hundred patients were enrolled, 12% (n=35) ≥65 years old and 11% (n=33) requiring admission. Admission rates were 2.9% (95% confidence interval [CI], 0.07-14.9%) in older adults and 12.1% (95% CI, 8.4-16.6%) in younger adults. In multivariable analysis, age was not associated with admission (odds ratio [OR] 0.30, 95% CI 0.05-1.67). Predictors of admission included: systolic pressure ≥180 mmHg (OR 4.19, 95% CI 1.08-16.30), log Charlson co-morbidity score (OR 2.93, 95% CI 1.57-5.46), and white blood cell count ≥14,000/mm3 (OR11.35, 95% CI 3.42-37.72). Conclusions Among patients placed in an ED observation unit, age ≥65 years is not associated with need for admission. Older adults can successfully be discharged from these units. Systolic pressure≥180 mmHg was the only predictive vital sign. In determining appropriateness of patients selected for an ED observation unit, advanced age should not be an automatic disqualifying criterion. PMID:22386358

  5. [Meningococcal disease admissions in a paediatric intensive care unit].

    Science.gov (United States)

    Mação, Patrícia; Januário, Gustavo; Ferreira, Sofia; Dias, Andrea; Dionísio, Teresa; Pinto, Carla; Carvalho, Leonor

    2014-01-01

    Introdução: A infecção meningocócica tem uma elevada mortalidade e morbilidade em crianças. O tratamento agressivo do choque, a referenciação precoce, o transporte secundário especializado e a vacinação são factores com impacto potencial na redução da mortalidade. Foram objectivos caracterizar as crianças com doença invasiva meningocócica admitidas em cuidados intensivos, avaliar parâmetros de gravidade e mortalidade. Material e Métodos: Estudo observacional, cujo método de colheita de dados foi retrospectivo. Foram constituídos dois períodos, de seis anos cada, de acordo com o ano de admissão (A: 2000-2005 e B: 2006-2011) e nestes compararam-se índices de gravidade, disfunção orgânica e mortalidade. Resultados: Foram admitidas 70 crianças com doença invasiva meningocócica. Quando comparadas com as outras causas verificouse uma redução nas admissões por doença invasiva meningocócica (período A: 3,4%; período B: 1,5%; p = 0,001). A ocorrência de meningite foi de 41% no período A e de 29% no período B (p = 0,461). Tiveram púrpura rapidamente progressiva 78% no período A e 50% no período B (p = 0,0032). As crianças do período A tiveram disfunção multi-órgão (80%), coagulação intravascular disseminada (76%) e coma (22%) mais frequentemente que as crianças do período B (29%, 29%, 0%; p < 0,05). A mortalidade foi 26% no período A e 0% no período B (p = 0,006) e a mortalidade estandardizada pelo PRISM foi 1,3 e 0 no período A e B respectivamente. Discussão: A redução do número de admissões por doença menigocócica invasiva pode ser explicada pela introdução da vacina anti-meningocócica C em 2006. Pensa-se que a redução da mortalidade observada, possa ser atribuível à melhoria da estabilização inicial e ao transporte secundário. Conclusão: Nos últimos anos houve uma redução significativa no número de admissões e na mortalidade por doença invasiva meningocócica.

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

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    Kyle Richard G

    2012-03-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  8. Discrete Event Simulation of Patient Admissions to a Neurovascular Unit

    Directory of Open Access Journals (Sweden)

    S. Hahn-Goldberg

    2014-01-01

    Full Text Available Evidence exists that clinical outcomes improve for stroke patients admitted to specialized Stroke Units. The Toronto Western Hospital created a Neurovascular Unit (NVU using beds from general internal medicine, Neurology and Neurosurgery to care for patients with stroke and acute neurovascular conditions. Using patient-level data for NVU-eligible patients, a discrete event simulation was created to study changes in patient flow and length of stay pre- and post-NVU implementation. Varying patient volumes and resources were tested to determine the ideal number of beds under various conditions. In the first year of operation, the NVU admitted 507 patients, over 66% of NVU-eligible patient volumes. With the introduction of the NVU, length of stay decreased by around 8%. Scenario testing showed that the current level of 20 beds is sufficient for accommodating the current demand and would continue to be sufficient with an increase in demand of up to 20%.

  9. Low near infrared spectroscopic somatic oxygen saturation at admission is associated with need for lifesaving interventions among unplanned admissions to the pediatric intensive care unit.

    Science.gov (United States)

    Balakrishnan, Binod; Dasgupta, Mahua; Gajewski, Kim; Hoffmann, Raymond G; Simpson, Pippa M; Havens, Peter L; Hanson, Sheila J

    2017-03-03

    To investigate the association between low near infrared spectroscopy (NIRS) somatic oxygen saturation (admission and the need for lifesaving interventions (LSI) in the initial 24 h of a PICU admission. Retrospective chart review of all unplanned admissions to the pediatric intensive care unit (PICU) with NIRS somatic oxygen saturation data available within 4 h of admission, excluding admissions with a cardiac diagnosis. LSI data were collected for the first 24 h after admission. Hemodynamic parameters, laboratory values, illness severity scores and diagnoses were collected. Included PICU admissions were stratified by lowest NIRS value in the first 4 h after admission: low NIRS (admissions to the PICU of which 184 (44%) patients underwent NIRS monitoring. A higher proportion of patients who underwent somatic NIRS monitoring required LSIs compared to those without NIRS monitoring (36.4 vs 5.7% respectively, p medications were the most common LSIs. Multivariable modeling showed NIRS  2SD for age to be associated with LSIs. ROC curve analysis of the combination of NIRS 2SD for age had an area under the curve of 0.79 with 78% sensitivity and 76% specificity for association with LSI. Compared to the normal NIRS group, the low NIRS group had higher mortality (10.4 vs 0.7%, p = 0.005) and longer median hospital length of stay (2.9 vs 1.6 days, p admission is associated with need for higher number of subsequent lifesaving interventions up to 24 h after admission. Noninvasive, continuous, somatic NIRS monitoring may identify children at high risk of medical instability.

  10. Glycated hemoglobin A: A predictor of outcome in trauma admissions to intensive care unit

    Directory of Open Access Journals (Sweden)

    Karen Ruby Lionel

    2014-01-01

    Full Text Available Background and Aim: Although large studies have demonstrated the association between hyperglycemia and adverse intensive care unit (ICU outcomes, it is yet unclear which subset of patients benefit from tight sugar control in ICU. Recent evidence suggests that stress induced hyperglycemia (SIH and co-incidentally detected diabetes mellitus are different phenomena with different prognoses. Differentiating SIH from diabetic hyperglycemia is challenging in ICU settings. We followed a cohort of trauma patients admitted to a surgical intensive care unit (SICU to evaluate if initial glycated hemoglobin A (HbA 1 c level predicts the outcome of admission. Materials and Methods: A cohort of 120 consecutive admissions to SICU following trauma were recruited and admission blood sugar and HbA 1 c were measured. Outcomes were prospectively measured by blinded ICU doctors. A logistic regression model was developed to assess if HbA 1 c predicts poor outcomes in these settings. Results: Nearly 24% of the participants had HbA 1 c ≥ 6. Those with HbA 1 c ≥ 6 had 3.14 times greater risk of poor outcome at the end of hospital stay when compared to those with HbA 1 c < 6 and this risk increased to an odds ratio of 4.57 on adjusting for other significant predictors: Acute Physiology and Chronic Health Evaluation II, injury severity score, admission blood sugar and age at admission. Conclusions: Substantial proportion of trauma admissions has underlying diabetes. HbA 1 c, a measure of pre admission glycaemic status is an important predictor of ICU outcome in trauma patients.

  11. HIV/AIDS and admission to intensive care units: A comparison of ...

    African Journals Online (AJOL)

    practices related to intensive care unit (ICU) admission in India, Brazil and South Africa, .... World AIDS Day Report 2012. http://www.unaids.org/en/media/unaids/ ... South Africa. 2012 population. 199 million. 1.2 billion. 313 million. 49 million.

  12. Intensive care unit admission of obstetric cases: a single centre experience with contemporary update.

    Science.gov (United States)

    Ng, Vivian K S; Lo, T K; Tsang, H H; Lau, W L; Leung, W C

    2014-02-01

    OBJECTIVES. To review the characteristics of a series of obstetric patients admitted to the intensive care unit in a regional hospital in 2006-2010, to compare them with those of a similar series reported from the same hospital in 1989-1995 and a series reported from another regional hospital in 1998-2007. DESIGN. Retrospective case series. SETTING. A regional hospital in Hong Kong. PATIENTS. Obstetric patients admitted to the Intensive Care Unit of Kwong Wah Hospital from 1 January 2006 to 31 December 2010. RESULTS. From 2006 to 2010, there were 67 such patients admitted to the intensive care unit (0.23% of total maternities and 2.34% of total intensive care unit admission), which was a higher incidence than reported in two other local studies. As in the latter studies, the majority were admitted postpartum (n=65, 97%), with postpartum haemorrhage (n=39, 58%) being the commonest cause followed by pre-eclampsia/eclampsia (n=17, 25%). In the current study, significantly more patients had had elective caesarean sections for placenta praevia but fewer had had a hysterectomy. The duration of intensive care unit stay was shorter (mean, 1.8 days) with fewer invasive procedures performed than in the two previous studies, but maternal and neonatal mortality was similar (3% and 6%, respectively). CONCLUSION. Postpartum haemorrhage and pregnancy-induced hypertension were still the most common reasons for intensive care unit admission. There was an increasing trend of intensive care unit admissions following elective caesarean section for placenta praevia and for early aggressive intervention of pre-eclampsia. Maternal mortality remained low but had not decreased. The intensive care unit admission rate by itself might not be a helpful indicator of obstetric performance.

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

    Science.gov (United States)

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

    2010-05-01

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

  14. Consciousness levels one week after admission to a palliative care unit improve survival prediction in advanced cancer patients.

    Science.gov (United States)

    Tsai, Jaw-Shiun; Chen, Chao-Hsien; Wu, Chih-Hsun; Chiu, Tai-Yuan; Morita, Tatsuya; Chang, Chin-Hao; Hung, Shou-Hung; Lee, Ya-Ping; Chen, Ching-Yu

    2015-02-01

    Consciousness is an important factor of survival prediction in advanced cancer patients. However, effects on survival of changes over time in consciousness in advanced cancer patients have not been fully explored. This study evaluated changes in consciousness after admission to a palliative care unit and their correlation with prognosis in terminal cancer patients. This is a prospective observational study. From a palliative care unit in Taiwan, 531 cancer patients (51.8% male) were recruited. Consciousness status was assessed at admission and one week afterwards and recorded as normal or impaired. The mean age was 65.28±13.59 years, and the average survival time was 23.41±37.69 days. Patients with normal consciousness at admission (n=317) had better survival than those with impaired consciousness at admission (n=214): (17.0 days versus 6.0 days, pconsciousness at admission had a higher percentage of survival than the impaired (78.9% versus 44.3%, pconsciousness levels: (1) normal at admission and one week afterwards, (2) impaired at admission but normal one week afterwards, (3) normal at admission but impaired one week afterwards, and (4) impaired both at admission and one week afterwards. The former two groups had significantly better survival than the latter two groups: (median survival counted from day 7 after admission), 25.5, 27.0, 7.0, and 7.0 days, respectively. Consciousness levels one week after admission should be integrated into survival prediction in advanced cancer patients.

  15. Increased rates of intensive care unit admission in patients with Mycoplasma pneumoniae: a retrospective study.

    Science.gov (United States)

    Khoury, T; Sviri, S; Rmeileh, A A; Nubani, A; Abutbul, A; Hoss, S; van Heerden, P V; Bayya, A E; Hidalgo-Grass, C; Moses, A E; Nir-Paz, R

    2016-08-01

    Mycoplasma pneumoniae is a leading cause of respiratory disease. In the Intensive Care Unit (ICU) setting M. pneumoniae is not considered a common pathogen. In 2010-13 an epidemic of M. pneumoniae-associated infections was reported and we observed an increase of M. pneumoniae patients admitted to ICU. We analysed the cohort of all M. pneumoniae-positive patients' admissions during 2007 to 2012 at the Hadassah-Hebrew University Medical Centre (a 1100-bed tertiary medical centre). Mycoplasma pneumoniae diagnosis was made routinely using PCR on throat swabs and other respiratory samples. Clinical parameters were retrospectively extracted. We identified 416 M. pneumoniae-infected patients; of which 68 (16.3%) were admitted to ICU. Of these, 48% (173/416) were paediatric patients with ICU admission rate of 4.6% (8/173). In the 19- to 65-year age group ICU admission rate rose to 18% (32/171), and to 38.8% (28/72) for patients older than 65 years. The mean APACHE II score on ICU admission was 20, with a median ICU stay of 7 days, and median hospital stay of 11.5 days. Of the ICU-admitted patients, 54.4% (37/68) were mechanically ventilated upon ICU admission. In 38.2% (26/68), additional pathogens were identified mostly later as secondary pathogens. A concomitant cardiac manifestation occurred in up to 36.8% (25/68) of patients. The in-hospital mortality was 29.4% (20/68) and correlated with APACHE II score. Contrary to previous reports, a substantial proportion (16.3%) of our M. pneumoniae-infected patients required ICU admission, especially in the adult population, with significant morbidity and mortality.

  16. Patients with hematological disorders requiring admission to medical intensive care unit: Characteristics, survival and prognostic factors

    Directory of Open Access Journals (Sweden)

    Subhash H

    2003-01-01

    Full Text Available Background: This retrospective chart review assessed the characteristics and outcome of patients with hematological disorders who required admission to medical intensive care unit over a 4 year period (January 1998 to December 2001. Results: There were a total of 104 patients, 67 (64% male, 37 (36% female subjects, with a mean age of 36.3 ± 15.3 years (range 10 to 65 years. The mean duration from hospital admission to ICU transfer was 11 days. Sixty-nine (66% had malignant and 35 (34% had non-malignant conditions. Respiratory distress was the commonest reason for ICU admission 58 (56%. The other indications were hemodynamic instability 38 (36%, low sensorium 22 (21%, following cardio-pulmonary arrest 12 (11.5% and generalized tonic-clonic seizures 5 (5%. Forty-three (42% patients had absolute neutophil count (ANC less than 500, 48 (47.5% had platelet count < 20000. The mean duration of ICU stay was 4 days (range < 24 hours to 28 days. Sixty-nine (66% patients required mechanical ventilation, 61 (59% required hemodynamic support. Pneumonia or sepsis was diagnosed in 71 (68%. Twenty-five (24% survived ICU stay and 20 (19% survived to hospital discharge. ICU admission following cardio-pulmonary arrest, advanced malignancy, requirement of mechanical ventilation, vasopressor support, ANC count < 500 and platelet count < 20000 were the predictors of adverse outcome. Associated organ dysfunction further increases the mortality.

  17. 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

  18. Kidney Disease Statistics for the United States

    Science.gov (United States)

    ... High blood pressure and diabetes are the main causes of CKD. Almost half of individuals with CKD also have ... without CKD. However, rates of both overall and cause-specific admissions increased with advancing stages of CKD. Hospitalizations increased among CKD patients with the presence ...

  19. Trauma admissions to the Intensive care unit at a reference hospital in Northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Mabula Joseph B

    2011-10-01

    Full Text Available Abstract Background Major trauma has been reported to be a major cause of hospitalization and intensive care utilization worldwide and consumes a significant amount of the health care budget. The aim of this study was to describe the characteristics and treatment outcome of major trauma patients admitted into our ICU and to identify predictors of outcome. Methods Between January 2008 and December 2010, a descriptive prospective study of all trauma admissions to a multidisciplinary intensive care unit (ICU of Bugando Medical Centre in Northwestern Tanzania was conducted. Results A total of 312 cases of major trauma were admitted in the ICU, representing 37.1% of the total ICU admissions. Males outnumbered females by a ratio of 5.5:1. Their median age was 27 years. Trauma admissions were almost exclusively emergencies (95.2% and came mainly from the Accident and Emergency (60.6% and Operating room (23.4%. Road traffic crash (RTC was the most common cause of injuries affecting 70.8% of patients. Two hundred fourteen patients (68.6% required surgical intervention. The overall ICU length of stay (LOS for all trauma patients ranged from 1 to 59 days (median = 8 days. The median ICU length of hospital stay (LOS for survivors and non-survivors were 8 and 5 days respectively. (P = 0.002. Mortality rate was 32.7%. Mortality rate of trauma patients was significantly higher than that of all ICU admissions (32.7% vs. 18.8%, P = 0.0012. According to multivariate logistic regression analysis, multiple injuries, severe head injuries and burns were responsible for a longer mean ICU stay (P 16, prolonged duration of loss of consciousness, delayed ICU admission (0.028, the need for ventilatory support and finding of space occupying lesion on computed tomography scan significantly influenced mortality (P Conclusion Trauma resulting from road traffic crashes is a leading cause of intensive care utilization in our hospital. Urgent preventive measures targeting at

  20. Hypothermia at neonatal intensive care unit admission was not associated with respiratory disease or death in very preterm infants

    DEFF Research Database (Denmark)

    Jensen, C F; Ebbesen, F; Petersen, J P

    2017-01-01

    AIM: This study investigated the association between hypothermia and respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) or death in very preterm infants admitted to a Danish neonatal intensive care unit (NICU). METHODS: We studied 675 infants born at Aalborg University Hospital...... before 32 weeks and admitted to the NICU from April 1997 to December 2011. Hypothermia was defined as a core temperature of less than 36.5°C on admission. The primary outcome was severe RDS or death within the first three days of life and the secondary outcome was BPD or death before 36 postmenstrual...... weeks. The multivariable logistic regression was adjusted for early onset infection, gestational age, Apgar score, sex, treatment year and birth weight. RESULTS: Infants with hypothermia had a two-fold increase (OR) in the odds for RDS or death (2.03), but the adjusted OR was not statistically...

  1. Paediatric head injury admissions over a 10-year period in a regional neurosurgical unit.

    Science.gov (United States)

    Phang, I; Mathieson, C; Sexton, I; Forsyth, S; Brown, J; St George, E J

    2012-08-01

    Traumatic brain injury is a leading cause of death and disability in childhood. A retrospective study of all paediatric head injuries admitted to the neurosurgical unit for the West of Scotland over a 10-year period was performed to assess the impact of the National Institute for Health and Clinical Excellence head injury guidelines on the admission rate and to determine the associated risk factors, causes, severity and outcomes of these injuries. There were 564 admissions between 1998 and 2007. The median age at presentation was nine years and two months. There was no change in the admission rate, injury mechanism or severity of head injury admitted over the period studied. A relationship was observed between the Scottish Index of Multiple Deprivation Score and the incidence of head injury (P = 0.05). Alcohol was reported as a causative factor in only a small number of cases, and moderate to severe head injuries were more commonly identified as a result of road traffic accidents.

  2. 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...

  3. Acute kidney injury on admission to the intensive care unit: where to go from here?

    Science.gov (United States)

    Ostermann, Marlies

    2008-01-01

    Acute kidney injury (AKI) is a common problem, especially in critically ill patients. In Critical Care, Kolhe and colleagues report that 6.3% of 276,731 patients in 170 intensive care units (ICUs) in the UK had evidence of severe AKI within the first 24 hours of admission to ICU. ICU and hospital mortality as well as length of stay in hospital were significantly increased. In light of this serious burden on individuals and the health system in general, the following commentary discusses the current state of knowledge of AKI in ICU and calls for more attention to preventive strategies.

  4. Relationship between glycated hemoglobin, Intensive Care Unit admission blood sugar and glucose control with ICU mortality in critically ill patients

    Science.gov (United States)

    Mahmoodpoor, Ata; Hamishehkar, Hadi; Shadvar, Kamran; Beigmohammadi, Mohammadtaghi; Iranpour, Afshin; Sanaie, Sarvin

    2016-01-01

    Background and Aims: The association between hyperglycemia and mortality is believed to be influenced by the presence of diabetes mellitus (DM). In this study, we evaluated the effect of preexisting hyperglycemia on the association between acute blood glucose management and mortality in critically ill patients. The primary objective of the study was the relationship between HbA1c and mortality in critically ill patients. Secondary objectives of the study were relationship between Intensive Care Unit (ICU) admission blood glucose and glucose control during ICU stay with mortality in critically ill patients. Materials and Methods: Five hundred patients admitted to two ICUs were enrolled. Blood sugar and hemoglobin A1c (HbA1c) concentrations on ICU admission were measured. Age, sex, history of DM, comorbidities, Acute Physiology and Chronic Health Evaluation II score, sequential organ failure assessment score, hypoglycemic episodes, drug history, mortality, and development of acute kidney injury and liver failure were noted for all patients. Results: Without considering the history of diabetes, nonsurvivors had significantly higher HbA1c values compared to survivors (7.25 ± 1.87 vs. 6.05 ± 1.22, respectively, P < 0.001). Blood glucose levels in ICU admission showed a significant correlation with risk of death (P < 0.006, confidence interval [CI]: 1.004–1.02, relative risk [RR]: 1.01). Logistic regression analysis revealed that HbA1c increased the risk of death; with each increase in HbA1c level, the risk of death doubled. However, this relationship was not statistically significant (P: 0.161, CI: 0.933–1.58, RR: 1.2). Conclusions: Acute hyperglycemia significantly affects mortality in the critically ill patients; this relation is also influenced by chronic hyperglycemia. PMID:27076705

  5. Relationship between glycated hemoglobin, Intensive Care Unit admission blood sugar and glucose control with ICU mortality in critically ill patients

    Directory of Open Access Journals (Sweden)

    Ata Mahmoodpoor

    2016-01-01

    Full Text Available Background and Aims: The association between hyperglycemia and mortality is believed to be influenced by the presence of diabetes mellitus (DM. In this study, we evaluated the effect of preexisting hyperglycemia on the association between acute blood glucose management and mortality in critically ill patients. The primary objective of the study was the relationship between HbA1c and mortality in critically ill patients. Secondary objectives of the study were relationship between Intensive Care Unit (ICU admission blood glucose and glucose control during ICU stay with mortality in critically ill patients. Materials and Methods: Five hundred patients admitted to two ICUs were enrolled. Blood sugar and hemoglobin A1c (HbA1c concentrations on ICU admission were measured. Age, sex, history of DM, comorbidities, Acute Physiology and Chronic Health Evaluation II score, sequential organ failure assessment score, hypoglycemic episodes, drug history, mortality, and development of acute kidney injury and liver failure were noted for all patients. Results: Without considering the history of diabetes, nonsurvivors had significantly higher HbA1c values compared to survivors (7.25 ± 1.87 vs. 6.05 ± 1.22, respectively, P < 0.001. Blood glucose levels in ICU admission showed a significant correlation with risk of death (P < 0.006, confidence interval [CI]: 1.004–1.02, relative risk [RR]: 1.01. Logistic regression analysis revealed that HbA1c increased the risk of death; with each increase in HbA1c level, the risk of death doubled. However, this relationship was not statistically significant (P: 0.161, CI: 0.933–1.58, RR: 1.2. Conclusions: Acute hyperglycemia significantly affects mortality in the critically ill patients; this relation is also influenced by chronic hyperglycemia.

  6. Variation exists in rates of admission to intensive care units for heart failure patients across hospitals in the United States

    Science.gov (United States)

    Safavi, Kyan C.; Dharmarajan, Kumar; Kim, Nancy; Strait, Kelly M.; Li, Shu-Xia; Chen, Serene I.; Lagu, Tara; Krumholz, Harlan M.

    2013-01-01

    Background Despite increasing attention on reducing relatively costly hospital practices while maintaining the quality of care, few studies have examined how hospitals use the intensive care unit (ICU), a high-cost setting, for patients admitted with heart failure (HF). We characterized hospital patterns of ICU admission for patients with HF and determined their association with the use of ICU-level therapies and patient outcomes. Methods and Results We identified 166,224 HF discharges from 341 hospitals in the 2009–10 Premier Perspective® database. We excluded hospitals with transfers. We defined ICU as including medical ICU, coronary ICU, and surgical ICU. We calculated the percent of patients admitted directly to an ICU. We compared hospitals in the top-quartile (high ICU admission) with the remaining quartiles. The median percentage of ICU admission was 10% (Interquartile Range 6% to 16%; range 0% to 88%). In top-quartile hospitals, treatments requiring an ICU were used less often: percentage of ICU days receiving mechanical ventilation (6% top quartile versus 15% others), non-invasive positive pressure ventilation (8% versus 19%), vasopressors and/or inotropes (9% versus 16%), vasodilators (6% versus 12%), and any of these interventions (26% versus 51%). Overall HF in-hospital risk standardized mortality was similar (3.4% versus 3.5%; P = 0.2). Conclusions ICU admission rates for HF varied markedly across hospitals and lacked association with in-hospital risk-standardized mortality. Greater ICU use correlated with fewer patients receiving ICU interventions. Judicious ICU use could reduce resource consumption without diminishing patient outcomes. PMID:23355624

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

    Science.gov (United States)

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

    2015-03-01

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

  8. Predictive factors for the admission of a newborn in an intensive care unit

    Directory of Open Access Journals (Sweden)

    Carla Danielle Ribeiro Lages

    2014-04-01

    Full Text Available Analytical documentary and retrospective study aiming at determining association between predictive factors for admission of a newborn in a public Intensive Care Unit and maternal features. The study sample had 376 neonates admitted in 2009. Results showed: mothers aged between 19 and 25 years (43.4%, primary education (52.4%, living with a partner (66.2%. Prenatal care was done by 84.8% of them, and 62% presented gestational pathologies. Out of all neonates, 55.1% were male, 85.4% preterm, 83% underweight, 57.2% presented respiratory problems. The bivariate analysis showed a significant association between birth weight and growth (p = 0.04 between maternal age and Apgar in the 1st minute (p = 0.04 and maternal age and Apgar score in the 5th minute (p = 0.01. Maternal age and number of prenatal appointments influence on the admission of the neonates to the Intensive Care Unit because they are related to birth weight and Apgar scores.

  9. Outcomes of Emergency Medical Patients Admitted to an Intermediate Care Unit With Detailed Admission Guidelines.

    Science.gov (United States)

    Simpson, Catherine E; Sahetya, Sarina K; Bradsher, Robert W; Scholten, Eric L; Bain, William; Siddique, Shazia M; Hager, David N

    2017-01-01

    An important, but not well characterized, population receiving intermediate care is that of medical patients admitted directly from the emergency department. To characterize emergency medical patients and their outcomes when admitted to an intermediate care unit with clearly defined admission guidelines. Demographic data, admitting diagnoses, illness severity, comorbid conditions, lengths of stay, and hospital mortality were characterized for all emergency medical patients admitted directly to an intermediate care unit from July through December 2012. A total of 317 unique patients were admitted (mean age, 54 [SD, 16] years). Most patients were admitted with respiratory (26.5%) or cardiac (17.0%) syndromes. The mean (SD) Acute Physiology and Chronic Health Evaluation score version II, Simplified Acute Physiology Score version II, and Charlson Comorbidity Index were 15.6 (6.5), 20.7 (11.8), and 2.7 (2.3), respectively. Severity of illness and length of stay were significantly different for patients who required intensive care within 24 hours of admission (n = 16) or later (n = 25), patients who continued with inter mediate care for more than 24 hours (n = 247), and patients who were downgraded or discharged in less than 24 hours (n = 29). Overall hospital mortality was 4.4% (14 deaths). Emergency medical patients with moderate severity of illness and comorbidity can be admitted to an intermediate level of care with relatively infrequent transfer to intensive care and relatively low mortality. ©2016 American Association of Critical-Care Nurses.

  10. THE ADMISSION OF NEWLY CREATED STATES TO THE MEMBERSHIP OF THE UNITED NATIONS: THE CASE OF REPUBLIC OF MACEDONIA

    Directory of Open Access Journals (Sweden)

    Milorad Petreski

    2017-01-01

    Full Text Available The international law which regulates the formation, functioning and legal capacity of international organizations, and also the international law in the United Nations system, are always relevant and subject to progressive development, because the international relations are in constant dynamics. Each newly created state has one major foreign policy goal during its first years of formation or after obtaining independence – admission to the membership of the United Nations. That is because the decision of admission to the membership of the UN guarantees the country’s statehood which can no longer be questioned. The country becomes part of a global community of nations – the international community. Therefore, the present paper is a qualitative research regarding the admission of new states to the international community, and the decision-making process concerning the admission of new Member States to the UN.

  11. A prospective multicentre observational study of adverse iatrogenic events and substandard care preceding intensive care unit admission (PREVENT).

    Science.gov (United States)

    Garry, D A; McKechnie, S R; Culliford, D J; Ezra, M; Garry, P S; Loveland, R C; Sharma, V V; Walden, A P; Keating, L M

    2014-02-01

    We examined the current incidence, type, severity and preventability of iatrogenic events associated with intensive care unit admission in five hospitals in England. All unplanned adult admissions to intensive care units were prospectively reviewed over a continuous six-week period. In the week before admission, 76/280 patients (27%) experienced 104 iatrogenic events. The majority of iatrogenic events were categorised as medical (37%), drug (17%) or nursing events (17%). Seventy-seven per cent of the events were considered preventable and 80% caused or contributed to admission. Eleven events were thought to have contributed to a patient's death. The mean (SD) age of patients who had an event was greater (63 (21) years) than those who had not (57 (19) years, p = 0.023), and they had a longer median (IQR [range]) intensive care stay, 4 (1-8 [0-29]) days vs 3 (1-5 [0-20]) days, respectively, p = 0.043.

  12. Ethnography of "Local Universality": Admission Practices in an Intensive Care Unit Among Guidelines, Routines, and Humour

    Directory of Open Access Journals (Sweden)

    Roberto Lusardi

    2015-04-01

    Full Text Available The article analyses the existing gap between the formal dimension of evidence-based medicine (EBM, as constituted by protocols, procedures, and guidelines, and actual professional practices in relation to a specific issue: the admission of patients to an intensive care unit (ICU. The results of a case study, carried out in the ICU of a hospital in the north of Italy between 2006 and 2007 are reported. The study was performed using ethnographic methods: participant observation, ethnographic interviews, and semi-structured interviews. Empirical data have been analysed using a grounded theory approach. The results show how three dimensions (macrosocial, organisational-interactional, and individual become intertwined with the operational guidelines that have been drafted on the basis of international evidence. The standardisation process that the guidelines presuppose results in the adoption of a variety of different local styles with respect to the approach that individual doctors take in relation to the admission of a patient to an ICU. These styles can range from strict adherence to the international criteria to a greater compliance with medical–legal, organisational, and individual needs. Furthermore, the results of the study demonstrate how relational knowledge, as a form of situated knowledge, can allow the personnel involved to activate local resources (organisational, professional, and personal in order to incorporate the formal prescriptions of EBM in professional practice. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1502261

  13. Admission clinicopathological data, length of stay, cost and mortality in an equine neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    M.N. Saulez

    2007-06-01

    Full Text Available Veterinary internists need to prognosticate patients quickly and accurately in a neonatal intensive care unit (NICU. This may depend on laboratory data collected on admission, the cost of hospitalisation, length of stay (LOS and mortality rate experienced in the NICU. Therefore, we conducted a retrospective study of 62 equine neonates admitted to a NICU of a private equine referral hospital to determine the prognostic value of venous clinicopathological data collected on admission before therapy, the cost of hospitalisation, LOS and mortality rate. The WBC count, total CO2 (TCO2 and alkaline phosphatase (ALP were significantly higher (P < 0.05 and anion gap lower in survivors compared with nonsurvivors. A logistic regression model that included WBC count, hematocrit, albumin / globulin ratio, ALP, TCO2, potassium, sodium and lactate, was able to correctly predict mortality in 84 % of cases. Only anion gap proved to be an independent predictor of neonatal mortality in this study. In the study population, the overall mortality rate was 34 % with greatest mortality rates reported in the first 48 hours and again on day 6 of hospitalisation. Amongst the various clinical diagnoses, mortality was highest in foals after forced extraction during correction of dystocia. Median cost per day was higher for nonsurvivors while total cost was higher in survivors.

  14. Lumbar puncture for suspected meningitis after intensive care unit admission is likely to change management.

    Science.gov (United States)

    Khasawneh, Faisal A; Smalligan, Roger D; Mohamad, Tammam N; Moughrabieh, Mohamad K; Soubani, Ayman O

    2011-02-01

    The aim of this study was to determine the outcome of lumbar punctures (LPs) in critically ill medical patients and how likely the results were to change case management. A retrospective review was conducted on the medical records of all 168 patients who underwent LP during their medical intensive care unit (MICU) admission at a university hospital during a 4.5-year period beginning in January 2000. Lumbar puncture was performed a mean of 2.8 days after MICU admission. The most common symptoms that prompted LP were changes in mental status and fever. Seventy-four percent of patients were on antibiotics at the time of LP, and 98% of patients had a computed tomography scan of the head performed before the procedure. Lumbar puncture confirmed meningitis in 47 (30%) patients and provided a specific bacteriologic diagnosis in 5 (3%) patients. The results of the procedure led to a change in management in 50 (30%) patients. The presence of meningeal signs and use of antibiotics at the time of the procedure were the factors that predicted change in management. Although the likelihood that LP will yield a specific bacteriologic diagnosis in critically ill patients is low, the procedure frequently provides important information that can lead to a change in case management, most commonly de-escalation of antibiotic therapy.

  15. Patterns of admissions in an acute medical unit: priorities for service development and education.

    Science.gov (United States)

    James, Natalie J; Hussain, Rumana; Moonie, Alasdair; Richardson, Donald; Waring, W Stephen

    2012-01-01

    An Acute Medical Unit has recently been established at York Hospital. The present study sought to characterise the case mix of acutely unwell medical patients to allow identification of priorities for ongoing service development and to assess educational opportunities for trainees in the region. Data were collected for 16001 admission episodes between January 2010 and April 2011 inclusive. These allowed characterisation of the case mix, and identified key priorities where clinical pathway do not yet exist, namely heart failure, urinary tract infection, and acute diarrhoea. Good educational opportunities exist for most aspects of the Acute Medicine curriculum; several weaknesses were identified, and trainees might address these by undertaking a specific period of specialty training in endocrinology and neurology.

  16. Concordance among remission and admission diagnoses at intensive care unit, Hospital Universitario San José, Popayán, 2011

    Directory of Open Access Journals (Sweden)

    Victor Daniel Montenegro

    2012-03-01

    Full Text Available There are few published studies about diagnostic concordance in hospital services. The objective of this study was to calculate the concordance among remission and admission diagnoses from Hospital Universitario San José adult intensive care unit (I.C.U. of Popayán, 2011. Methods: Descriptive and retrospective study about concordance between the main remission and admission diagnoses from patients admitted in the Hospital adult intensive care unit; 914 patients were studied from the intensive care unit database, months January to December 2011. Statistical analysis about sociodemographic variables was performed, and Kappa index according to Landis and Koch scale among remission and admission diagnoses defined as priority was calculated. Results: It was found al almost perfect level of concordance in the diagnoses pancreatitis and intoxication, a substantial level of concordance in the diagnoses acute coronary syndrome, convulsive status, gastric cancer and eclampsia, a moderate level of concordance in the diagnoses stroke, head trauma, politraumatism and cardiac failure, and a fair level of concordance in the diagnoses sepsis, pneumonia, chronic obstructive pulmonary disease (COPD, gastrointestinal bleeding, acute respiratory infection and acute respiratory distress syndrome. Conclusion: Six of the seventeen studied diagnoses presented an outstanding concordance level; this can be related to factors such as: physicians’, diagnostic ability, provenance of the patients remitted to the I.C.U. and diagnostic coding made by health staff.

  17. Airborne pollutants and lacunar stroke. A case cross-over analysis on stroke unit admissions

    Directory of Open Access Journals (Sweden)

    Nicola Murgia

    2012-06-01

    Full Text Available Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua county (Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006-08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter < 10 μm (PM10, carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a casecrossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM10 (OR 1.01, 95% CI 1.00-1.02, p<0.05 . According to the clinical classification, LACI stroke type was related to PM10 level registered on the day of admission for both genders (OR 1.01, 95% CI 1.00-1.02, p<0.05 while for TACI stroke only in men (OR: 1.04, 95% CI 1.01-1.07, p<0.05. Our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.

  18. Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions.

    Science.gov (United States)

    Corea, Francesco; Silvestrelli, Giorgio; Baccarelli, Andrea; Giua, Alessandra; Previdi, Paolo; Siliprandi, Giorgio; Murgia, Nicola

    2012-06-14

    Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD) has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006-08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter <10 µm (PM(10)), carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a case-crossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM(10) [odds ratio (OR) 1.01, 95%; confidence interval (CI) 1.00-1.02; P<0.05]. According to the clinical classification, lacunar anterior circulation syndrome stroke type was related to PM(10) level registered on the day of admission for both genders (OR: 1.01, 95%; CI: 1.00-1.02; P<0.05) while for total anterior circulation syndrome stroke only in men (OR: 1.04, 95%; CI 1.01-1.07; P<0.05).In conclusion, our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.

  19. Reduced functional measure of cardiovascular reserve predicts admission to critical care unit following kidney transplantation.

    Directory of Open Access Journals (Sweden)

    Stephen M S Ting

    Full Text Available BACKGROUND: There is currently no effective preoperative assessment for patients undergoing kidney transplantation that is able to identify those at high perioperative risk requiring admission to critical care unit (CCU. We sought to determine if functional measures of cardiovascular reserve, in particular the anaerobic threshold (VO₂AT could identify these patients. METHODS: Adult patients were assessed within 4 weeks prior to kidney transplantation in a University hospital with a 37-bed CCU, between April 2010 and June 2012. Cardiopulmonary exercise testing (CPET, echocardiography and arterial applanation tonometry were performed. RESULTS: There were 70 participants (age 41.7±14.5 years, 60% male, 91.4% living donor kidney recipients, 23.4% were desensitized. 14 patients (20% required escalation of care from the ward to CCU following transplantation. Reduced anaerobic threshold (VO₂AT was the most significant predictor, independently (OR = 0.43; 95% CI 0.27-0.68; p<0.001 and in the multivariate logistic regression analysis (adjusted OR = 0.26; 95% CI 0.12-0.59; p = 0.001. The area under the receiver-operating-characteristic curve was 0.93, based on a risk prediction model that incorporated VO₂AT, body mass index and desensitization status. Neither echocardiographic nor measures of aortic compliance were significantly associated with CCU admission. CONCLUSIONS: To our knowledge, this is the first prospective observational study to demonstrate the usefulness of CPET as a preoperative risk stratification tool for patients undergoing kidney transplantation. The study suggests that VO₂AT has the potential to predict perioperative morbidity in kidney transplant recipients.

  20. Statistical conjugated polymers comprising optoelectronically distinct units.

    Science.gov (United States)

    Hollinger, Jon; Sun, Jing; Gao, Dong; Karl, Dominik; Seferos, Dwight S

    2013-03-12

    Poly(3-heptylselenophene)-stat-poly(3-hexylthiophene) is synthesized and characterized in terms of its crystallinity and performance in an organic photovoltaic (OPV) cell. Despite the random distribution of units along the polymer main chain, the material is semi-crystalline, as demonstrated by differential scanning calorimetry and wide-angle X-ray diffraction. Thin-film absorption suggests an increased compatibility than seen with 3-hexylselenophene monomer. Optoelectronic properties are an average of the two homopolymers, and OPV performance is enhanced by a broadened absorption profile and a favorable morphology.

  1. Obstetric indications for admission to the intensive care unit of a tertiary referral center; an Iranian experience

    Directory of Open Access Journals (Sweden)

    Sousan Rasooli

    2014-04-01

    Full Text Available Objective: The aim of the present study was to evaluate the obstetric admissions to the intensive care unit (ICU in the setting of a tertiary referral hospital in an attempt to identify the risk factors influencing maternal outcome. Method: In a prospective, cross-sectional study, all parturient patients during pregnancy and up to 6 weeks postpartum admitted to the ICU of a tertiary referral hospital between 2013 and 2014 were evaluated. Demographic data, medical histories, pregnancy, and intrapartum and postpartum data were collected. Moreover, interventions and fetomaternal outcomes were noted. Results: Ninety nine obstetric patients were admitted to the ICU. Fifty seven percent of the admissions were postpartum. The main indications for admission were hypertensive disorders (37.3%, and obstetric hemorrhage (13.1%. Non-obstetric indications of ICU admission were the cardiac diseases. Conclusion: The major obstetric indications for admission in our study were hypertensive disorders of pregnancy and obstetric hemorrhage.     Keywords: Pregnancy; Intensive care unit; maternal mortality; morbidity

  2. Altering Public University Admission Standards to Preserve White Group Position in the United States: Results from a Laboratory Experiment

    Science.gov (United States)

    Samson, Frank L.

    2013-01-01

    This study identifies a theoretical mechanism that could potentially affect public university admissions standards in a context of demographic change. I explore how demographic changes at a prestigious public university in the United States affect individuals' evaluations of college applications. Responding to a line graph that randomly displays a…

  3. Trends in admission prevalence, illness severity and survival of haematological patients treated in Dutch intensive care units

    NARCIS (Netherlands)

    Vliet, M. van; Verburg, I.W.; Boogaard, M.H.W.A. van den; Keizer, N.F. de; Peek, N.; Blijlevens, N.M.A.; Pickkers, P.

    2014-01-01

    PURPOSE: To explore trends over time in admission prevalence and (risk-adjusted) mortality of critically ill haematological patients and compare these trends to those of several subgroups of patients admitted to the medical intensive care unit (medical ICU patients). METHODS: A total of 1,741 haemat

  4. New Study Shows Flu Vaccine Reduced Children's Risk of Intensive Care Unit Flu Admission by Three-Fourths

    Science.gov (United States)

    ... Health Image Library (PHIL) New Study Shows Flu Vaccine Reduced Children’s Risk of Intensive Care Unit Flu Admission by ... Media Relations (404) 639-3286 Getting a flu vaccine reduces a child's risk of flu-related intensive care hospitalization by ...

  5. Cystatin C at Admission in the Intensive Care Unit Predicts Mortality among Elderly Patients.

    Science.gov (United States)

    Dalboni, Maria Aparecida; Beraldo, Daniel de Oliveira; Quinto, Beata Marie Redublo; Blaya, Rosângela; Narciso, Roberto; Oliveira, Moacir; Monte, Júlio César Martins; Durão, Marcelino de Souza; Cendoroglo, Miguel; Pavão, Oscar Fernando; Batista, Marcelo Costa

    2013-01-01

    Introduction. Cystatin C has been used in the critical care setting to evaluate renal function. Nevertheless, it has also been found to correlate with mortality, but it is not clear whether this association is due to acute kidney injury (AKI) or to other mechanism. Objective. To evaluate whether serum cystatin C at intensive care unit (ICU) entry predicts AKI and mortality in elderly patients. Materials and Methods. It was a prospective study of ICU elderly patients without AKI at admission. We evaluated 400 patients based on normality for serum cystatin C at ICU entry, of whom 234 (58%) were selected and 45 (19%) developed AKI. Results. We observed that higher serum levels of cystatin C did not predict AKI (1.05 ± 0.48 versus 0.94 ± 0.36 mg/L; P = 0.1). However, it was an independent predictor of mortality, H.R. = 6.16 (95% CI 1.46-26.00; P = 0.01), in contrast with AKI, which was not associated with death. In the ROC curves, cystatin C also provided a moderate and significant area (0.67; P = 0.03) compared to AKI (0.47; P = 0.6) to detect death. Conclusion. We demonstrated that higher cystatin C levels are an independent predictor of mortality in ICU elderly patients and may be used as a marker of poor prognosis.

  6. The effect of gun control laws on hospital admissions for children in the United States.

    Science.gov (United States)

    Tashiro, Jun; Lane, Rebecca S; Blass, Lawrence W; Perez, Eduardo A; Sola, Juan E

    2016-10-01

    Gun control laws vary greatly between states within the United States. We hypothesized that states with strict gun laws have lower mortality and resource utilization rates from pediatric firearms-related injury admissions. Kids' Inpatient Database (1997-2012) was searched for accidental (E922), self-inflicted (E955), assault (E965), legal intervention-related (E970), or undetermined circumstance (E985) firearm injuries. Patients were younger than 20 years and admitted for their injuries. Case incidence trends were examined for the study period. Propensity score-matched analyses were performed using 38 covariates to compare outcomes between states with strict or lenient gun control laws. Overall, 38,424 cases were identified, with an overall mortality of 7%. Firearm injuries were most commonly assault (64%), followed by accidental (25%), undetermined circumstance (7%), or self-inflicted (3%). A small minority involved military-grade weapons (0.2%). Most cases occurred in lenient gun control states (48%), followed by strict (47%) and neutral (6%).On 1:1 propensity score-matched analysis, in-hospital mortality by case was higher in lenient (7.5%) versus strict (6.5%) states, p = 0.013. Lenient states had a proportionally higher rate of accidental (31%) and self-inflicted injury (4%) versus strict states (17% and 1.6%, respectively), p gun control contributes not only to worse outcomes per case, but also to a more significant and detrimental impact on public health. Epidemiologic study, level III.

  7. Trainable unit selection speech synthesis under statistical framework

    Institute of Scientific and Technical Information of China (English)

    WANG RenHua; DAI LiRong; LING ZhenHua; HU Yu

    2009-01-01

    This paper proposes a trainable unit selection speech synthesis method based on statistical modeling framework. At training stage, acoustic features are extracted from the training database and statistical models are estimated for each feature. During synthesis, the optimal candidate unit sequence is searched out from the database following the maximum likelihood criterion derived from the trained models. Finally, the waveforms of the optimal candidate units are concatenated to produce synthetic speech. Experiment results show that this method can improve the automation of system construction and naturalness of synthetic speech effectively compared with the conventional unit selection synthe-sis method. Furthermore, this paper presents a minimum unit selection error model training criterion according to the characteristics of unit selection speech synthesis and adopts discriminative training for model parameter estimation. This criterion can finally achieve the full automation of system con-struction and improve the naturalness of synthetic speech further.

  8. Prognosis of patients presenting extreme acidosis (pH <7) on admission to intensive care unit.

    Science.gov (United States)

    Allyn, Jérôme; Vandroux, David; Jabot, Julien; Brulliard, Caroline; Galliot, Richard; Tabatchnik, Xavier; Combe, Patrice; Martinet, Olivier; Allou, Nicolas

    2016-02-01

    The purpose was to determine prognosis of patients presenting extreme acidosis (pH acidosis within 24 hours of admission to a polyvalent ICU in a university hospital between January 2011 and July 2013. Multivariate analysis and survival analysis were used. Among the 2156 patients admitted, 77 patients (3.6%) presented extreme acidosis. Thirty (39%) patients suffered cardiac arrest before admission. Although the mortality rate predicted by severity score was 93.6%, death occurred in 52 cases (67.5%) in a median delay of 13 (5-27) hours. Mortality rate depended on reason for admission, varying between 22% for cases linked to diabetes mellitus and 100% for cases of mesenteric infarction (P = .002), cardiac arrest before admission (P acidosis (P = .007), high Simplified Acute Physiology Score II (P = .008), and low serum creatinine (P = .012). Patients with extreme acidosis on admission to ICU have a less severe than expected prognosis. Whereas mortality is almost 100% in cases of cardiac arrest before admission, mortality is much lower in the absence of cardiac arrest before admission, which justifies aggressive ICU therapies. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Nonimmigrant Admissions: Fiscal Year 2009

    Data.gov (United States)

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

  10. Nonimmigrant 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. Rising United States Hospital Admissions for Acute Bacterial Skin and Skin Structure Infections: Recent Trends and Economic Impact.

    Directory of Open Access Journals (Sweden)

    Keith S Kaye

    Full Text Available The number of ambulatory patients seeking treatment for skin and skin structure infections (SSSI are increasing. The objective of this study is to determine recent trends in hospital admissions and healthcare resource utilization and identify covariates associated with hospital costs and mortality for hospitalized adult patients with a primary SSSI diagnosis in the United States.We performed a retrospective cross-sectional analysis (years 2005-2011 of data from the US Healthcare Cost and Utilization Project National Inpatient Sample. Recent trends, patient characteristics, and healthcare resource utilization for patients hospitalized with a primary SSSI diagnosis were evaluated. Descriptive and bivariate analyses were conducted to assess patient and hospital characteristics.A total of 1.8% of hospital admissions for the years 2005 through 2011 were for adult patients with a SSSI primary diagnosis. SSSI-related hospital admissions significantly changed during the study period (P < .001 for trend ranging from 1.6% (in 2005 to 2.0% (in 2011. Mean hospital length of stay (LOS decreased from 5.4 days in the year 2005 to 5.0 days in the year 2011 (overall change, P < .001 with no change in hospital costs. Patients with postoperative wound infections had the longest hospital stays (adjusted mean, 5.81 days; 95% confidence interval (CI, 5.80-5.83 and highest total costs (adjusted mean, $9388; 95% CI, $9366-$9410. Year of hospital admission was strongly associated with mortality; infection type, all patient refined diagnosis related group severity of illness level, and LOS were strongly associated with hospital costs.Hospital admissions for adult patients in the United States with a SSSI primary diagnosis continue to increase. Decreasing hospital inpatient LOS and mortality rate may be due to improved early treatment. Future research should focus on identifying alternative treatment processes for patients with SSSI that could shift management from

  20. Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit

    DEFF Research Database (Denmark)

    Matzen, Lars E; Jepsen, Ditte B; Ryg, Jesper

    2012-01-01

    ABSTRACT: BACKGROUND: Functional decline is associated with increased risk of mortality in geriatric patients.Assessment of activities of daily living (ADL) with the Barthel Index (BI) at admission wasstudied as a predictor of survival in older patients admitted to an acute geriatric unit. METHODS...... to an acute geriatricunit. These data suggest that assessment of ADL may have a potential role in decisionmaking for the clinical management of frail geriatric inpatients....

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

    Directory of Open Access Journals (Sweden)

    Greer Glazer

    2016-02-01

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    Kantharuben Naidoo

    2013-03-01

    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

  3. 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.

  4. Evaluation of a flexible acute admission unit: effects on transfers to other hospitals and patient throughput times.

    Science.gov (United States)

    van der Linden, Christien; Lucas, Cees; van der Linden, Naomi; Lindeboom, Robert

    2013-07-01

    To prevent overcrowding of the emergency department, a flexible acute admission unit (FAAU) was created, consisting of 15 inpatient regular beds located in different departments. We expected the FAAU to result in fewer transfers to other hospitals and in a lower length of stay (LOS) of patients needing hospital admission. A before-and-after interventional study was performed in a level 1 trauma center in the Netherlands. Number of transfers and LOS of admitted ED patients in a 4-month period in 2008 (control period) and a 4-month period in 2009 (intervention period) were analyzed. Of 1,619 regular admission patients, 768 were admitted in the control period and 851 in the intervention period. The number of transfers decreased from 80 (10.42%) to 54 (6.35%) (P = .0037). The mean ED LOS of both the non-admitted patients and the admitted patients needing special care significantly increased (105 minutes vs 117 minutes [P = .022] and 176 minutes vs 191 minutes [P transfers of admitted patients to other hospitals. The increase in LOS for special care patients and non-admitted patients was not observed for regular, FAAU-admissible patients. Flexible bed management might be useful in preventing overcrowding. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

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

    Science.gov (United States)

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

    2011-12-01

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

  6. Obstetric admissions to the intensive care unit: a five year review

    Directory of Open Access Journals (Sweden)

    Tapan Pattnaik

    2015-12-01

    Conclusions: The need of ICU management for obstetric conditions is on rising trend. The need for ventilatory or inotropic support may predict poor outcome. An adequate adoption of safe motherhood initiative would reduce obstetric ICU admissions and thereby will also reduce the maternal mortality. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1914-1917

  7. 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…

  8. Five Years of Acute Stroke Unit Care: Comparing ASU and Non-ASU Admissions and Allied Health Involvement

    Directory of Open Access Journals (Sweden)

    Isobel J. Hubbard

    2014-01-01

    Full Text Available Background. Evidence indicates that Stroke Units decrease mortality and morbidity. An Acute Stroke Unit (ASU provides specialised, hyperacute care and thrombolysis. John Hunter Hospital, Australia, admits 500 stroke patients each year and has a 4-bed ASU. Aims. This study investigated hospital admissions over a 5-year period of all strokes patients and of all patients admitted to the 4-bed ASU and the involvement of allied health professionals. Methods. The study retrospectively audited 5-year data from all stroke patients admitted to John Hunter Hospital (n=2525 and from nonstroke patients admitted to the ASU (n=826. The study’s primary outcomes were admission rates, length of stay (days, and allied health involvement. Results. Over 5 years, 47% of stroke patients were admitted to the ASU. More male stroke patients were admitted to the ASU (chi2=5.81; P=0.016. There was a trend over time towards parity between the number of stroke and nonstroke patients admitted to the ASU. When compared to those admitted elsewhere, ASU stroke patients had a longer length of stay (z=−8.233; P=0.0000 and were more likely to receive allied healthcare. Conclusion. This is the first study to report 5 years of ASU admissions. Acute Stroke Units may benefit from a review of the healthcare provided to all stroke patients. The trends over time with respect to the utilisation of the John Hunter Hospitall’s ASU have resulted in a review of the hospitall’s Stroke Unit and allied healthcare.

  9. Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit.

    Science.gov (United States)

    Aslam, Muhammad I; Martin-Ucar, Antonio E; Nakas, Apostolos; Waller, David A

    2011-11-01

    A preoperative delay in emergency surgery for spontaneous pneumothorax is associated with a poor outcome after surgery and a prolonged hospital stay. To reduce preoperative delays, all tertiary referrals from district general hospitals to our thoracic surgery unit were processed through a 'clinical decisions unit' (CDU). Prior to the establishment of the CDU, these patients were added to a waiting list for a surgical bed. This study has reviewed the effect of this change in admission policy on the efficiency of treatment for non-elective spontaneous pneumothorax. An intergroup comparison (pre-CDU group vs. post-CDU group) was made of the following parameters: referral to transfer time, transfer to surgery time and length of inpatient stay in the referring and tertiary hospitals. There were no significant differences in gender, diagnosis, treatment in the referring hospitals, postoperative clinical outcome, or indications for or type of surgery. The total length of inpatient stay in the referring and tertiary hospitals was significantly reduced for the post-CDU group (12 vs. 15 days; P<0.001), which was attributed to the earlier transfer of patients (18 vs. 78 hours; P<0.001) hours. Allowing surgical access to a traditional medical admission unit is therefore, cost-effective and significantly improves the efficiency of non-elective pneumothorax surgery.

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

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    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. Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

    Institute of Scientific and Technical Information of China (English)

    Geoffrey C Nguyen; Justina Sam; Nitasha Anand

    2011-01-01

    AIM: To characterize the increasing incidence and geographic variation of acute diverticulitis. METHODS: Using the nationwide inpatient sample (NIS) we identified a cohort who had been admitted with diverticulitis between 1998 and 2005. We calculated age-, sex-, and region-specific rates of hospitalizations for diverticulitis over time. RESULTS: The age-adjusted hospitalization rate for diverticulitis increased from 61.8 per 100 000 to 75.5 per 100 000 between 1998 and 2005, and increased similarly in both sexes. Diverticulitis-associated admissions were male-predominant in those younger than age 45 years but were female-predominant thereafter. Admission rates increased the most among those < 45 years, while remaining unchanged for those ≥ 65 years. By 2005, the majority of hospitalized patients were < 65 years. Age-adjusted rates of diverticulitis-associated hospitalizations were lower in the West (50.4/100 000) compared to the Northeast (77.7/100 000), South (73.9/100 000), and Midwest (71.0/100 000). CONCLUSION: Diverticulitis-associated hospitalizations have steeply risen, especially in young adults. These epidemiological trends vary by geographic region and warrant further investigation into potential dietary and environmental etiologies.

  12. STUDY OF INCIDENCE, MORTALITY & CAUSES OF NEONATAL TETANUS AMONG ALL NEONATAL INTENSIVE CARE UNIT [NICU] ADMISSIONS IN TERTIARY HEALTH CARE CENTER OF SBHGMC, DHULE

    OpenAIRE

    Neeta; Neelam; Syed; Arjun

    2015-01-01

    AIM: To find out incidence & mortality due to Neonatal Tetanus and to study its causes among all the admissions in Neonatal Intensive Care Unit [NICU] of tertiary health care center of Shri Bhausaheb Hire Government Medical College, [SBHGMC] Dhule. OBJECTIVES: 1] To find out incidence of Neonatal Teta nus in all neonatal admissions. 2] To find out mortality rate among all Neonatal Tetanus cases. 3] To take detailed history to find out causes of Neonatal Tetanu...

  13. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    QuickSilver

    Statistics for 1999 showed that Helen Joseph Hospital admits on the average 53 new .... Lund C & Flisher AJ. South African Mental Health Process Indicators. .... paper) will fall well on the ears of general hospital management. Moosa and ...

  14. Cocaine-related admissions to an intensive care unit: a five-year study of incidence and outcomes.

    LENUS (Irish Health Repository)

    Galvin, S

    2010-02-01

    Cocaine misuse is increasing and it is evidently considered a relatively safe drug of abuse in Ireland. To address this perception, we reviewed the database of an 18-bed Dublin intensive care unit, covering all admissions from 2003 to 2007. We identified cocaine-related cases, measuring hospital mortality and long-term survival in early 2009. Cocaine-related admissions increased from around one annually in 2003-05 to 10 in 2007. Their median (IQR [range]) age was 25 (21-35 [17-47]) years and 78% were male. The median (IQR [range]) APACHE II score was 16 (11-27 [5-36]) and length of intensive care stay was 5 (3-9 [1-16]) days. Ten patients died during their hospital stay. A further five had died by the time of follow-up, a median of 24 months later. One was untraceable. Cocaine toxicity necessitating intensive care is increasingly common in Dublin. Hospital mortality in this series was 52%. These findings may help to inform public attitudes to cocaine.

  15. Risk factors and characterization of Plasmodium vivax-associated admissions to pediatric intensive care units in the Brazilian Amazon.

    Directory of Open Access Journals (Sweden)

    Ellen Fátima Caetano Lança

    Full Text Available BACKGROUND: Plasmodium vivax is responsible for a significant proportion of malaria cases worldwide and is increasingly reported as a cause of severe disease. The objective of this study was to characterize severe vivax disease among children hospitalized in intensive care units (ICUs in the Western Brazilian Amazon, and to identify risk factors associated with disease severity. METHODS AND FINDINGS: In this retrospective study, clinical records of 34 children, 0-14 years of age hospitalized in the 11 public pediatric and neonatal ICUs of the Manaus area, were reviewed. P. falciparum monoinfection or P. falciparum/P. vivax mixed infection was diagnosed by microscopy in 10 cases, while P. vivax monoinfection was confirmed in the remaining 24 cases. Two of the 24 patients with P. vivax monoinfection died. Respiratory distress, shock and severe anemia were the most frequent complications associated with P. vivax infection. Ninety-one children hospitalized with P. vivax monoinfections but not requiring ICU were consecutively recruited in a tertiary care hospital for infectious diseases to serve as a reference population (comparators. Male sex (p = 0.039, age less than five years (p = 0.028, parasitemia greater than 500/mm(3 (p = 0.018, and the presence of any acute (p = 0.023 or chronic (p = 0.017 co-morbidity were independently associated with ICU admission. At least one of the WHO severity criteria for malaria (formerly validated for P. falciparum was present in 23/24 (95.8% of the patients admitted to the ICU and in 17/91 (18.7% of controls, making these criteria a good predictor of ICU admission (p = 0.001. The only investigated criterion not associated with ICU admission was hyperbilirubinemia (p = 0.513]. CONCLUSIONS: Our study points to the importance of P. vivax-associated severe disease in children, causing 72.5% of the malaria admissions to pediatric ICUs. WHO severity criteria demonstrated good sensitivity in

  16. Association of Risk Factors, Mortality, and Care Costs of Adults With Acute Myeloid Leukemia With Admission to the Intensive Care Unit.

    Science.gov (United States)

    Halpern, Anna B; Culakova, Eva; Walter, Roland B; Lyman, Gary H

    2017-03-01

    Adults with acute myeloid leukemia (AML) commonly require support in the intensive care unit (ICU), but risk factors for admission to the ICU and adverse outcomes remain poorly defined. To examine risk factors, mortality, length of stay, and cost associated with admission to the ICU for patients with AML. This study extracted information from the University HealthSystem Consortium database on patients 18 years or older with AML who were hospitalized for any cause between January 1, 2004, and December 31, 2012. The University HealthSystem Consortium database contains demographic, clinical, and cost variables prospectively abstracted by certified coders from discharge summaries. Outcomes were analyzed using univariate and multivariable statistical techniques. Data analysis was performed from November 15, 2013, to August 15, 2016. Primary outcomes were admission to the ICU and inpatient mortality among patients requiring ICU care. Secondary outcomes included length of stay in the ICU, total hospitalization length of stay, and cost. Of the 43 249 patients with AML (mean [SD] age, 59.5 [16.6] years; 23 939 men and 19 310 women), 11 277 (26.1%) were admitted to the ICU. On multivariable analysis (with results reported as odds ratios [95% CIs]), independent risk factors for admission to the ICU included age younger than 80 years (1.56 [1.42-1.70]), hospitalization in the South (1.81 [1.71-1.92]), hospitalization at a low- or medium-volume hospital (1.25 [1.19-1.31]), number of comorbidities (10.64 [8.89-12.62] for 5 vs none), sepsis (4.61 [4.34-4.89]), invasive fungal infection (1.24 [1.11-1.39]), and pneumonia (1.73 [1.63-1.82]). In-hospital mortality was higher for patients requiring ICU care (4857 of 11 277 [43.1%] vs 2959 of 31 972 [9.3%]). On multivariable analysis, independent risk factors for death in patients requiring ICU care included age 60 years or older (1.16 [1.06-1.26]), nonwhite race/ethnicity (1.18 [1.07-1.30]), hospitalization on the West

  17. Effectiveness of pre-admission data and letters of recommendation to predict students who will need professional behavior intervention during clinical rotations in the United States.

    Science.gov (United States)

    Engelhard, Chalee; Leugers, Rebecca; Stephan, Jenna

    2016-01-01

    The study aimed at finding the value of letters of recommendation in predicting professional behavior problems in the clinical portion of a Doctor of Physical Therapy program learning cohorts from 2009-2014 in the United States. De-identified records of 137 Doctor of Physical Therapy graduates were examined by the descriptive statistics and comparison analysis. Thirty letters of recommendation were investigated based on grounded theory from 10 student applications with 5 randomly selected students of interest and 5 non-students of interest. Critical thinking, organizational skills, and judgement were statistically significant and quantitative differentiating characteristics. Qualitatively, significant characteristics of the student of interest included effective communication and cultural competency. Meanwhile, those of nonstudents of interest included conflicting personality descriptor, commitment to learning, balance, teamwork skills, potential future success, compatible learning skills, effective leadership skills, and emotional intelligence. Emerged significant characteristics did not consistently match common non-professional behavior issues encountered in clinic. Pre-admission data and letters of recommendation appear of limited value in predicting professional behavior performance in clinic.

  18. Effectiveness of pre-admission data and letters of recommendation to predict students who will need professional behavior intervention during clinical rotations in the United States

    Directory of Open Access Journals (Sweden)

    Chalee Engelhard

    2016-06-01

    Full Text Available The study aimed at finding the value of letters of recommendation in predicting professional behavior problems in the clinical portion of a Doctor of Physical Therapy program learning cohorts from 2009-2014 in the United States. De-identified records of 137 Doctor of Physical Therapy graduates were examined by the descriptive statistics and comparison analysis. Thirty letters of recommendation were investigated based on grounded theory from 10 student applications with 5 randomly selected students of interest and 5 non-students of interest. Critical thinking, organizational skills, and judgement were statistically significant and quantitative differentiating characteristics. Qualitatively, significant characteristics of the student of interest included effective communication and cultural competency. Meanwhile, those of nonstudents of interest included conflicting personality descriptor, commitment to learning, balance, teamwork skills, potential future success, compatible learning skills, effective leadership skills, and emotional intelligence. Emerged significant characteristics did not consistently match common non-professional behavior issues encountered in clinic. Pre-admission data and letters of recommendation appear of limited value in predicting professional behavior performance in clinic.

  19. Caregiver’s overload as a result of the admission of mental patients to a subacute unit

    Directory of Open Access Journals (Sweden)

    María Rosario Andueza Doce

    2012-11-01

    Full Text Available Objetive: Knowing the level of emotional overload which the main informal caregiver of a mentally ill person has to undergo when admitted to a subacute unit, and valuing the existence of mood disorders (anxiety or depression in the caregiver himself/herself, along with the impact for the caregiver of the patient admitted in a subacute unit. Method: A descriptive and transversal study carried out from a sample of 32 main caregivers of patients in the Unite of the Subacute in the Psyquiatric Hospital of Zaldibar, during 2010, being the measure instruments for that purpose the Zarit Scales for Caregiver Burden and the Goldberg Anxiety and Depression Scale (GADS. Results: The level of overload presented by a 53% of these caregivers is intense, coupled by a predominantly anxious mood with an average of 5.34 on the Goldberg Anxiety and Depression Scale (GADS. After admission, 69% of these caregivers reduce the overlead, and 59.5% improve in both anxiety and depression. Conclusions: The task of caring falls primarily on parents who expressed particularly fear for the future of their sons and daughters, and feel that they depend heavely on them wich generate a lot of overload.

  20. Quality of life before intensive care unit admission is a predictor of survival

    NARCIS (Netherlands)

    J.G.M. Hofhuis (Jose); P.E. Spronk (Peter); H.F. van Stel (Henk); A.J.P. Schrijvers (Augustinus); J. Bakker (Jan)

    2007-01-01

    textabstractIntroduction: Predicting whether a critically ill patient will survive intensive care treatment remains difficult. The advantages of a validated strategy to identify those patients who will not benefit from intensive care unit (ICU) treatment are evident. Providing critical care treatmen

  1. The effects of cognitive intervention on cognitive impairments after intensive care unit admission.

    Science.gov (United States)

    Zhao, Jingjing; Yao, Li; Wang, Changqing; Sun, Yun; Sun, Zhongwu

    2017-04-01

    Patients who survive critical illness commonly suffer cognitive impairments. We aimed to study the effects of cognitive intervention to treat the long-term impairments observed among different populations of intensive care unit (ICU) survivors. The results showed that the intervention significantly suppressed the deterioration of cognitive function in these patients. Medical and neurological ICU survivors were more susceptible than post-anaesthesia ICU patients to severe cognitive damage. In the former, the deterioration of impairments can be slowed by cognitive intervention. In comparison, intervention exerted significantly positive effects on the recovery of the cognitive functions of post-anaesthesia care unit patients. Furthermore, young populations were more likely than older populations to recover from acute cognitive impairments, and the impairment observed among the older population seemed to be multi-factorial and irreversible.

  2. Emotional consequences of intensive care unit delirium and delusional memories after intensive care unit admission : A systematic review

    NARCIS (Netherlands)

    Nouwen, Marinus J.; Klijn, Francina A. M.; van den Broek, Brigitte T. A.; Slooter, Arjen J. C.

    2012-01-01

    Purpose: The aim of this study was to review literature exploring the emotional consequences of delirium and delusional memories in intensive care unit patients. Methods: A systematic review was performed using PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsychINFO.

  3. The WHO near miss criteria are appropriate for admission of critically ill pregnant women to intensive care units in China

    Institute of Scientific and Technical Information of China (English)

    WANG Yong-qing; GE Qing-gang; WANG Jing; NIU Ji-hong; HUANG Chao; ZHAO Yang-yu

    2013-01-01

    Background Evaluation of the severity of the pregnant women with suitable admission to the Intensive Care Unit (ICU)is very important for obstetricians.By now there are no criteria for critically ill obstetric patients admitted to the ICU.In this article,we investigated the admission criteria of critically ill patients admitted to the ICU in order to provide a referral basis of reasonable use of the ICU.Methods A retrospective analysis of critically ill pregnant women admitted to the ICU in Perking University Third Hospital in China in the last 6 years (from January 2006 to December 2011) was performed,using acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ),Marshall and WHO near miss criteria to assess the severity of illness of patients.Results There were 101 critically ill pregnant patients admitted to the ICU.Among them,25.7% women were complicated with internal or surgical diseases,and 23.8% women were patients of postpartum hemorrhage and 23.8% women were patients of pregnancy-induced hypertension.Sixty-nine cases (68.3%) were administrated with adjunct respiration with a respirator.Sixteen cases (15.8%) required 1-2 types of vasoactive drugs.Fifty-five cases (54.5%)required a hemodynamic monitoring.Seventy-three cases (72.3%) had multiple organ dysfunctions (MODS).The average duration in ICU was (7.5±3.0) days.A total of 12.9%,23.8% and 74.3% of women were diagnosed as critically ill according to the APACHE-Ⅱ,Marshall and WHO near miss criteria,respectively.The rate was significantly different according to the three criteria (P<0.01).Conclusions The WHO near miss criteria can correctly reflect the severity of illness of pregnant women,and the WHO near miss criteria are appropriate for admission of critically ill pregnant women to ICU in China.

  4. HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil

    Directory of Open Access Journals (Sweden)

    Paulo Afonso Martins Abati

    2015-01-01

    Full Text Available OBJECTIVE To analyze the clinical and laboratory characteristics of HIV-infected individuals upon admission to a reference health care center. METHODS This cross-sectional study was conducted between 1999 and 2010 on 527 individuals with confirmed serological diagnosis of HIV infection who were enrolled in an outpatient health care service in Santarém, PA, Northern Brazil. Data were collected from medical records and included the reason for HIV testing, clinical status, and count of peripheral CD4+ T lymphocytes upon enrollment. The data were divided into three groups, according to the patient’s year of admission – P1 (1999-2002, P2 (2003-2006, and P3 (2007-2010 – for comparative analysis of the variables of interest. RESULTS In the study group, 62.0% of the patients were assigned to the P3 group. The reason for undergoing HIV testing differed between genders. In the male population, most tests were conducted because of the presence of symptoms suggesting infection. Among women, tests were the result of knowledge of the partner’s seropositive status in groups P1 and P2. Higher proportion of women undergoing testing because of symptoms of HIV/AIDS infection abolished the difference between genders in the most recent period. A higher percentage of patients enrolling at a more advanced stage of the disease was observed in P3. CONCLUSIONS Despite the increased awareness of the number of HIV/AIDS cases, these patients have identified their serological status late and were admitted to health care units with active disease. The HIV/AIDS epidemic in Pará presents specificities in its progression that indicate the complex characteristics of the epidemic in the Northern region of Brazil and across the country.

  5. Limitation of life-sustaining treatment in severe trauma in the elderly after admission to an intensive care unit.

    Science.gov (United States)

    Peñasco, Y; González-Castro, A; Rodríguez Borregán, J C; Ortiz-Lasa, M; Jáuregui Solórzano, R; Sánchez Arguiano, M J; Escudero Acha, P

    2017-05-18

    To analyze the factors associated to limitation of life-sustaining treatment (LLST) measures in elderly patients admitted to an intensive care unit (ICU) due to trauma. A retrospective, descriptive, observational study was carried out. ICU. A total of 149 patients aged 65 years or older admitted to the ICU due to trauma. Hospital mortality, the decision to limit life-sustaining treatment and the factors associated to these measures were analyzed. None. The mean patient age was 76.3±6.36 years. The average APACHE II and ISS scores were 15.9±7.4 and 19.6±11.4 points, respectively. LLST were used in 37 patients (24.8%). Factors associated to the use of these measures were patient age (OR 1.16; 95% CI 1.08 to 1.25], APACHE II score (OR 1.11; 95% CI 1.05-1.67), ISS score (OR 1.03; 95% CI 1.01 to 1.06), admission due to neurological impairment (OR 19.17; 95% CI 2.33 to 157.83) and traumatic brain injury (OR 2.89; 95% CI 1.05 to 7.96). LLST is frequently established in elderly patients admitted to the ICU due to trauma, and is associated to hospital mortality. Factors associated with the use of these measures are patient age, higher APACHE II and ISS scores, admission due to neurological impairment, and the presence of head injuries. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  6. Hyperglycemia at admission and during hospital stay are independent risk factors for mortality in high risk cardiac patients admitted to an intensive cardiac care unit

    NARCIS (Netherlands)

    J.A. Lipton (Jonathan); R. Barendse (Rj); R.T. van Domburg (Ron); A.F.L. Schinkel (Arend); H. Boersma (Eric); M.L. Simoons (Maarten); K.M. Akkerhuis (Martijn)

    2013-01-01

    textabstractAims: Hyperglycemia is associated with increased mortality in cardiac patients. However, the predictive value of admission- and average glucose levels in patients admitted to an intensive cardiac care unit (ICCU) has not been described. Methods: Observational study of patients admitted t

  7. Intensive Care Unit Admission after Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Is It Necessary?

    Directory of Open Access Journals (Sweden)

    Horacio N. López-Basave

    2014-01-01

    Full Text Available Introduction. Cytoreductive surgery (CS with hyperthermic intraperitoneal chemotherapy (HIPEC is a new approach for peritoneal carcinomatosis. However, high rates of complications are associated with CS and HIPEC due to treatment complexity; that is why some patients need stabilization and surveillance for complications in the intensive care unit. Objective. This study analyzed that ICU stay is necessary after HIPEC. Methods. 39 patients with peritoneal carcinomatosis were treated according to strict selection criteria with CS and HIPEC, with closed technique, and the chemotherapy administered were cisplatin 25 mg/m2/L and mitomycin C 3.3 mg/m2/L for 90-minutes at 40.5°C. Results. 26 (67% of the 39 patients were transferred to the ICU. Major postoperative complications were seen in 14/26 patients (53%. The mean time on surgical procedures was 7.06 hours (range 5−9 hours. The mean blood loss was 939 ml (range 100–3700 ml. The mean time stay in the ICU was 2.7 days. Conclusion. CS with HIPEC for the treatment of PC results in low mortality and high morbidity. Therefore, ICU stay directly following HIPEC should not be standardized, but should preferably be based on the extent or resections performed and individual patient characteristics and risk factors. Late complications were comparable to those reported after large abdominal surgery without HIPEC.

  8. Comparison of reasons of admission of young, age 18-30 years old in Intensive Care Unit to young adult, age 31-40 years old due to road accident

    Directory of Open Access Journals (Sweden)

    Vaios Douloudis

    2010-10-01

    Full Text Available During recent years, it has been noticed a remarkable increase in frequency of admission of young individuals in Intensive Care Units (ICU due to road accidents. The aim of the present study was to compare the reasons of admission of young individuals 18-30 years old to young adults 31-40 years old in ICU due to road accident. Method and material: The sample studied consisted of individuals 18-40 years old that were hospitalized in ICU due to road accident. Data were collected by the completion of a specially designed clinical protocol for the needs of the research. For the analysis of data the statistical package SPSS 13 was used and the x2 method. Results: 81,2% of the sample-studied were men and 18,8% women. Regarding nationality, 80,1 % were Greek and 19,9% foreigner. 34,6% of the participants were unemployed, 21,2% were working in private sector, 20,1% were free-lancers and 16,2% students. 46,3% of individuals were admitted in ICU after transfer of another hospital. In 69,7% of the participants age 18-30 years old and 74,5% of 31-40 years old road took place accident at night and 77,3% 18-30 years old and 77,0% of 31-40 years old road accident took place on the way to entertainment. The statistical analysis of data showed that : road accidents were the main reason for admission in ICU of young individuals of age 18-30 years old with statistically significant difference compared to those 31-40 years old, p<0,001. Brain injuries as well as admission of motorcycle drivers were more frequent in individuals of age 18-30 years old with statistically significant difference compared to those 31-40 years old, p=0,018 and p=0,041, respectively. On the contrary, admission of car-drivers and those who had consumed alcohol were more frequent in individuals of age 31-40 years old with statistically significant difference compared to group 18-30 years old, p=0,041 and , p<0,001, respectively. Conclusions: More often admitted in ICU motorcycle drivers of

  9. Short- and Long-Term Validity of High School GPA for Admission to Colleges outside the United States

    Science.gov (United States)

    Al-Hattami, Abdulghani

    2014-01-01

    High school GPA is the only admission criterion that is currently used by many colleges in Yemen to select their potential students. Its predictive validity was investigated to ensure the accuracy of the admission decisions in these colleges. The relationship between students' persistence in the 4 years of college and high school GPA was studied…

  10. How to reduce avoidable admissions due to acute diabetes complications?: Interrelation between primary and specialized attention in a diabetes unit

    Directory of Open Access Journals (Sweden)

    N. V. García-Talavera Espín

    2012-12-01

    Full Text Available Introduction: Type 2 Diabetes Mellitus is a serious health problem. In the year 2030 it will affect 366 million people around the world. Objective: Evaluate the effectiveness of a mixed intervention and reducing the amount and seriousness of acute complications in diabetics from our Health Area. Materials and method: Protocols of action as well as information documents were produced. Diabetes Unit coordinated educational activities in the different support levels of the Area VII of Murcia. Information talks were provided for the people in charge of the Diabetes Unit in every Care Center and Service of the Health Area. Personalized training was provided for patients treated in the differet Care levels. The study comprised three stages. Information leaflets were spread and talks offered to the patient regarding in house handling of hypo and hyper glycemia. Results: A reduction of 39% of the emergencies due to acute non complicated diabetes was achieved, as well as a reduction of 47.6% of hospital admissions. There was a reduction of 67.8% of the amount of total hospital stays for the group of patients under 35 years who were admitted into the hospital due to type 1 or 2 diabetes mellitus that didn't show any complications (GRD295. Conclusions: There was a reduction of more than thirty percent in the emergencies due to acute decompensations in the disease and a significant reduction in the avoidable hospital stays in the young adult, thus improving the patients' life quality and reducing the social cost of the diabetic patient.

  11. Medicaid Fraud Control Units (MFCU) Annual Spending and Performance Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicaid Fraud Control Units (MFCU or Unit) investigate and prosecute Medicaid fraud as well as patient abuse and neglect in health care facilities. OIG certifies,...

  12. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study.

    Science.gov (United States)

    Lombardi, Natália Fracaro; Mendes, Antonio Eduardo Matoso; Lucchetta, Rosa Camila; Reis, Wálleri Christini Torelli; Fávero, Maria Luiza Drechsel; Correr, Cassyano Januário

    2016-08-15

    this observational study aimed to describe the discrepancies identified during medication reconciliation on patient admission to cardiology units in a large hospital. the medication history of patients was collected within 48 hours after admission, and intentional and unintentional discrepancies were classified as omission, duplication, dose, frequency, timing, and route of drug administration. most of the patients evaluated were women (58.0%) with a mean age of 59 years, and 75.5% of the patients had a Charlson comorbidity index score between 1 and 3. Of the 117 discrepancies found, 50.4% were unintentional. Of these, 61.0% involved omission, 18.6% involved dosage, 18.6% involved timing, and 1.7% involved the route of drug administration. this study revealed a high prevalence of discrepancies, most of which were related to omissions, and 50% were unintentional. These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences. este estudo observacional teve como objetivo descrever discrepâncias encontradas na realização de conciliação medicamentosa de pacientes admitidos em unidades de cardiologia de um hospital de grande porte. a história de medicação dos pacientes foi coletada dentro de 48h após a admissão, e as discrepâncias, identificadas como intencionais ou não intencionais, foram classificadas como de: omissão, duplicidade, dose, frequência, intervalo e via. a maioria dos pacientes incluídos pertençia ao sexo feminino (58,0%), com idade média de 59 anos, e com índice de comorbidades de Charlson entre 1 e 3 (75,5% dos casos). Das 117 discrepâncias encontradas, 50,4% foram não intencionais. Dessas, 61,0% foram de omissão, 18,6% de dose, 18,6% de intervalo e 1,7% de via de administração. o estudo mostra a alta prevalência de discrepâncias, principalmente de omissão, sendo quase metade não intencionais. Esse dado remete ao número de medicamentos que n

  13. FASTSUBS: An Efficient Admissible Algorithm for Finding the Most Likely Lexical Substitutes Using a Statistical Language Model

    CERN Document Server

    Yuret, Deniz

    2012-01-01

    Lexical substitutes have found use in the context of word sense disambiguation, unsupervised part-of-speech induction, paraphrasing, machine translation, and text simplification. Using a statistical language model to find the most likely substitutes in a given context is a successful approach, but the cost of a naive algorithm is proportional to the vocabulary size. This paper presents the Fastsubs algorithm which can efficiently and correctly identify the most likely lexical substitutes for a given context based on a statistical language model without going through most of the vocabulary. The efficiency of Fastsubs makes large scale experiments based on lexical substitutes feasible. For example, it is possible to compute the top 10 substitutes for each one of the 1,173,766 tokens in Penn Treebank in about 6 hours on a typical workstation. The same task would take about 6 days with the naive algorithm. An implementation of the algorithm and a dataset with the top 100 substitutes of each token in the WSJ secti...

  14. Lack of utility of a decision support system to mitigate delays in admission from the operating room to the postanesthesia care unit.

    Science.gov (United States)

    Ehrenfeld, Jesse M; Dexter, Franklin; Rothman, Brian S; Minton, Betty Sue; Johnson, Diane; Sandberg, Warren S; Epstein, Richard H

    2013-12-01

    When the phase I postanesthesia care unit (PACU) is at capacity, completed cases need to be held in the operating room (OR), causing a "PACU delay." Statistical methods based on historical data can optimize PACU staffing to achieve the least possible labor cost at a given service level. A decision support process to alert PACU charge nurses that the PACU is at or near maximum census might be effective in lessening the incidence of delays and reducing over-utilized OR time, but only if alerts are timely (i.e., neither too late nor too early to act upon) and the PACU slot can be cleared quickly. We evaluated the maximum potential benefit of such a system, using assumptions deliberately biased toward showing utility. We extracted 3 years of electronic PACU data from a tertiary care medical center. At this hospital, PACU admissions were limited by neither inadequate PACU staffing nor insufficient PACU beds. We developed a model decision support system that simulated alerts to the PACU charge nurse. PACU census levels were reconstructed from the data at a 1-minute level of resolution and used to evaluate if subsequent delays would have been prevented by such alerts. The model assumed there was always a patient ready for discharge and an available hospital bed. The time from each alert until the maximum census was exceeded ("alert lead time") was determined. Alerts were judged to have utility if the alert lead time fell between various intervals from 15 or 30 minutes to 60, 75, or 90 minutes after triggering. In addition, utility for reducing over-utilized OR time was assessed using the model by determining if 2 patients arrived from 5 to 15 minutes of each other when the PACU census was at 1 patient less than the maximum census. At most, 23% of alerts arrived 30 to 60 minutes prior to the admission that resulted in the PACU exceeding the specified maximum capacity. When the notification window was extended to 15 to 90 minutes, the maximum utility was system to mitigate

  15. Factors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians

    Science.gov (United States)

    Ramos, João Gabriel Rosa; Passos, Rogerio da Hora; Baptista, Paulo Benigno Pena; Forte, Daniel Neves

    2017-01-01

    Objective To evaluate the factors potentially associated with the decision of admission to the intensive care unit in Brazil. Methods An electronic survey of Brazilian physicians working in intensive care units. Fourteen variables that were potentially associated with the decision of admission to the intensive care unit were rated as important (from 1 to 5) by the respondents and were later grouped as "patient-related," "scarcity-related" and "administrative-related" factors. The workplace and physician characteristics were evaluated for correlation with the factor ratings. Results During the study period, 125 physicians completed the survey. The scores on patient-related factors were rated higher on their potential to affect decisions than scarcity-related or administrative-related factors, with a mean ± SD of 3.42 ± 0.7, 2.75 ± 0.7 and 2.87 ± 0.7, respectively (p < 0.001). The patient's underlying illness prognosis was rated by 64.5% of the physicians as always or frequently affecting decisions, followed by acute illness prognosis (57%), number of intensive care unit beds available (56%) and patient's wishes (53%). After controlling for confounders, receiving specific training on intensive care unit triage was associated with higher ratings of the patient-related factors and scarcity-related factors, while working in a public intensive care unit (as opposed to a private intensive care unit) was associated with higher ratings of the scarcity-related factors. Conclusions Patient-related factors were more frequently rated as potentially affecting intensive care unit admission decisions than scarcity-related or administrative-related factors. Physician and workplace characteristics were associated with different factor ratings.

  16. The Eldicus prospective, observational study of triage decision making in European intensive care units: Part I-European Intensive Care Admission Triage Scores (EICATS)

    DEFF Research Database (Denmark)

    Sprung, Charles L; Baras, Mario; Iapichino, Gaetano

    2012-01-01

    care unit admission. INTERVENTIONS:: Admission or rejection to an intensive care unit. MEASUREMENTS AND MAIN RESULTS:: Clinical, laboratory, and physiological variables and data from severity scores were collected. Separate scores for accepted and rejected patients with 28-day mortality end point were...... built. Values for variables were grouped into categories determined by the locally weighted least squares graphical method applied to the logit of the mortality and by univariate logistic regressions for reducing candidates for the score. Multivariate logistic regression was used to construct the final...... score. Cutoff values for 99.5% specificity were determined. Of 6796 patients, 5602 were admitted and 1194 rejected. The initial refusal score included age, diagnosis, systolic blood pressure, pulse, respirations, creatinine, bilirubin, PaO2, bicarbonate, albumin, use of vasopressors, Glasgow Coma Scale...

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

    Science.gov (United States)

    Sullivan, Paul

    2017-01-01

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

  18. Time from accident to admission to a burn intensive care unit: how long does it actually take? A 25-year retrospective data analysis from a german burn center.

    Science.gov (United States)

    Schiefer, J L; Alischahi, A; Perbix, W; Grigutsch, D; Graeff, I; Zinser, M; Demir, E; Fuchs, P C; Schulz, A

    2016-03-31

    Severe burn injuries often require specialized treatment at a burn center. It is known that prompt admission to an intensive care unit is essential for achieving good outcome. Nevertheless, very little is known about the duration of time before a patient is admitted to a specialized center after a burn injury in Germany, and whether the situation has improved over time. We retrospectively analyzed time from burn injury to admission to the burn intensive care unit in the Cologne-Merheim Medical Center - one of Germany's specialized burn centers - over the last 25 years. Moreover, we analyzed the data based on differences according to time of injury and day of the week, as well as severity of the burn injury. There was no weekend effect with regard to transfer time; instead transfer time was particularly short on a Monday or on Sundays. Furthermore, patients with severe burn injuries of 40-89% total body surface area (TBSA) showed the least differences in transfer time. Interestingly, the youngest and the oldest patients arrived at the burn intensive care unit (BICU) the fastest. This study should help elucidate published knowledge regarding transfer time from the scene of the accident to admission to a BICU in Germany.

  19. Shocking Admission

    Science.gov (United States)

    Hoover, Eric; Millman, Sierra

    2007-01-01

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

  20. USA by Numbers: A Statistical Portrait of the United States.

    Science.gov (United States)

    Weber, Susan, Ed.

    This book presents demographic data about a variety of U.S. public policies, social problems, and environmental issues. The issues and problems that the statistics illustrate (such as overflowing garbage dumps, homelessness, child poverty, and smog and water pollution) are connected with, and the consequences of, the expanding U.S. population. The…

  1. Serious neck injuries in U19 rugby union players: an audit of admissions to spinal injury units in Great Britain and Ireland.

    Science.gov (United States)

    MacLean, James G B; Hutchison, James D

    2012-06-01

    To obtain data regarding admissions of U19 rugby players to spinal injury units in Great Britain and Ireland and to compare this with a recent peak in presentation in Scotland. To assess the current state of data collection and subsequent analysis of serious neck injuries. To analyse the mechanism of injury in this group of at-risk players. Retrospective case series. Spinal injury units in Great Britain and Ireland. Annual frequency of serious neck injuries. Analysis of injury types, neurological deficit and mechanism of injury. 36 Injuries were recorded. 10 Of these occurred in Scotland since 1996 of which six have occurred in the past 4 years. This compared with 14 in Ireland over the same period. 12 Cases were traced in England and Wales since 2000; records were not available before this date. No prospective collation of data is performed by the home unions and inconsistency of data collection exists. The mean age was 16.2 years. 16 Of the 36 admissions had complete neurological loss, 9 had incomplete neurological injury and 11 had cervical column injury without spinal cord damage. The mechanism of injury was tackle in 17 (47%), scrum in 13 (36%), two each due to the maul and collision, and one each due to a kick and a ruck. Some degree of spinal cord injury occurred in 92% of scrum injuries (61% complete) and 53% of tackle injuries (29% complete). U19 rugby players continue to sustain serious neck injuries necessitating admission to spinal injury units with a low but persistent frequency. The recent rate of admission in Scotland is disproportionately high when the respective estimated playing populations are considered. While more injuries were sustained in the tackle, spinal cord injury was significantly more common in neck injury sustained in the scrum (pscrum engagement and the tackle can be made safer.

  2. Admissions Testing & Institutional Admissions Processes

    Science.gov (United States)

    Hossler, Don; Kalsbeek, David

    2009-01-01

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

  3. Assessment of risk factors related to healthcare-associated methicillin-resistant Staphylococcus aureus infection at patient admission to an intensive care unit in Japan

    Directory of Open Access Journals (Sweden)

    Ogura Hiroshi

    2011-11-01

    Full Text Available Abstract Background Healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA infection in intensive care unit (ICU patients prolongs ICU stay and causes high mortality. Predicting HA-MRSA infection on admission can strengthen precautions against MRSA transmission. This study aimed to clarify the risk factors for HA-MRSA infection in an ICU from data obtained within 24 hours of patient ICU admission. Methods We prospectively studied HA-MRSA infection in 474 consecutive patients admitted for more than 2 days to our medical, surgical, and trauma ICU in a tertiary referral hospital in Japan. Data obtained from patients within 24 hours of ICU admission on 11 prognostic variables possibly related to outcome were evaluated to predict infection risk in the early phase of ICU stay. Stepwise multivariate logistic regression analysis was used to identify independent risk factors for HA-MRSA infection. Results Thirty patients (6.3% had MRSA infection, and 444 patients (93.7% were infection-free. Intubation, existence of open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission, were detected as independent prognostic indicators. Patients with intubation or open wound comprised 96.7% of MRSA-infected patients but only 57.4% of all patients admitted. Conclusions Four prognostic variables were found to be risk factors for HA-MRSA infection in ICU: intubation, open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission. Preemptive infection control in patients with these risk factors might effectively decrease HA-MRSA infection.

  4. Ethical problems in intensive care unit admission and discharge decisions: a qualitative study among physicians and nurses in the Netherlands

    NARCIS (Netherlands)

    Oerlemans, A.J.; Sluisveld, N. van; Leeuwen, E.S. van; Wollersheim, H.C.; Dekkers, W.J.M.; Zegers, M.

    2015-01-01

    BACKGROUND: There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about res

  5. Perfil das admissões em uma unidade de terapia intensiva obstétrica de uma maternidade brasileira Admission profile in an obstetrics intensive care unit in a maternity hospital of Brazil

    Directory of Open Access Journals (Sweden)

    Melania Maria Ramos de Amorim

    2006-05-01

    Full Text Available OBJETIVOS: descrever a experiência de três anos com terapia intensiva em obstetrícia em Unidade de Terapia Intensiva em setor que permite que obstetras continuem conduzindo as pacientes obstétricas criticamente enfermas. MÉTODOS: estudo avaliando 933 pacientes atendidas na UTI obstétrica do Instituto Materno Infantil Prof. Fernando Figueira (IMIP de setembro de 2002 a fevereiro de 2005. As variáveis foram idade, paridade, diagnóstico de admissão, época da admissão, diagnósticos e complicações durante o internamento, procedimentos invasivos empregados e resultado final. RESULTADOS: as três principais causas de internamento foram hipertensão (87%, hemorragia obstétrica (4,9% e infecção (2,1%. A idade média foi 25 anos e 65% dos partos, cesarianas. Anemia foi achado freqüente (58,4%. Outros diagnósticos: insuficiência renal, doença tromboembólica, cardiopatia, edema agudo de pulmão, sepse, choque hemorrágico. Das 814 pacientes admitidas com hipertensão associada à gestação, 65% tinham pré-eclâmpsia grave, 16% pré-eclâmpsia leve e 11% eclâmpsia. Síndrome HELLP ocorreu em 46%. Ventilação mecânica foi necessária em 3,6% e hemotransfusão em 17%. A duração média do internamento foi cinco dias (1-41. A taxa de óbito foi 2,4%. CONCLUSÕES: a taxa de morte foi relativamente baixa, sugerindo que uma UTI conduzida por obstetras pode ser uma estratégia factível para reduzir a mortalidade materna.OBJECTIVES: to describe a three-year experience with obstetric Intensive Care Units (ICU, a unit allowing obstetricians to continue to care for critically ill obstetrics patients. METHODS: the study evaluated all admissions (933 to the Obstetric ICU, in the Instituto Materno Infantil Prof. Fernando Figueira (IMIP, from September 2002 to February 2005. Age, parity, diagnosis, admission time, diagnosis during ICU stay, associated complications, invasive procedures utilized, and final outcome were analyzed. RESULTS

  6. Association of Bystander Interventions and Hospital Length of Stay and Admission to Intensive Care Unit in Out-of-Hospital Cardiac Arrest Survivors

    DEFF Research Database (Denmark)

    Riddersholm, Signe; Sørensen, Kristian Dahl Kragholm; Mortensen, Rikke Nørmark

    2017-01-01

    BACKGROUND: The impact of bystander interventions on post-arrest hospital course is sparsely studied. We examined the association between bystander interventions and length of hospital stay and admission to intensive care unit (ICU) in one-day survivors after OHCA. METHODS: This cohort study linked...... data of 4641 one-day OHCA survivors from 2001 to 2014 to data on hospital length of stay and ICU admission. We examined associations between bystander efforts and outcomes using regression, adjusted for age, sex, comorbidities, calendar year and witnessed status. We divided bystander efforts into three...... categories: 1. No bystander interventions; 2.Bystander CPR only; 3. Bystander defibrillation with or without bystander CPR. RESULTS: For patients surviving to hospital discharge, hospital length of stay was 20days for patients without bystander interventions, compared to 16 for bystander CPR, and 13...

  7. Changes in Perceptions of Opioids Before and After Admission to Palliative Care Units in Japan: Results of a Nationwide Bereaved Family Member Survey.

    Science.gov (United States)

    Kinoshita, Satomi; Miyashita, Mitsunori; Morita, Tatsuya; Sato, Kazuki; Miyazaki, Tamana; Shoji, Ayaka; Chiba, Yurika; Tsuneto, Satoru; Shima, Yasuo

    2016-06-01

    This study aimed to clarify perspectives of bereaved family members regarding opioids and compare perceptions before admission and after bereavement. A cross-sectional questionnaire survey for bereaved family members in 100 inpatient palliative care units was administered. Participants were 297 bereaved family members of patients who used opioids. Many bereaved family members had misconceptions of opioids before admission. There was improvement after bereavement, but understanding remained low. Respondents less than 65 years old showed significantly greater decreases in misconceptions regarding opioids compared to older generations, after bereavement. Bereaved family members who were misinformed about opioids by physicians were significantly more likely to have misconceptions about opioids. Educational interventions for physicians are needed to ensure that they offer correct information to the general population.

  8. Modeling, dependence, classification, united statistical science, many cultures

    CERN Document Server

    Parzen, Emanuel

    2012-01-01

    Breiman (2001) proposed to statisticians awareness of two cultures: 1. Parametric modeling culture, pioneered by R.A.Fisher and Jerzy Neyman; 2. Algorithmic predictive culture, pioneered by machine learning research. Parzen (2001), as a part of discussing Breiman (2001), proposed that researchers be aware of many cultures, including the focus of our research: 3. Nonparametric, quantile based, information theoretic modeling. Our research seeks to unify statistical problem solving in terms of comparison density, copula density, measure of dependence, correlation, information, new measures (called LP score comoments) that apply to long tailed distributions with out finite second order moments. A very important goal is to unify methods for discrete and continuous random variables. We are actively developing these ideas, which have a history of many decades, since Parzen (1979, 1983) and Eubank et al. (1987). Our research extends these methods to modern high dimensional data modeling.

  9. Harnessing graphics processing units for improved neuroimaging statistics.

    Science.gov (United States)

    Eklund, Anders; Villani, Mattias; Laconte, Stephen M

    2013-09-01

    Simple models and algorithms based on restrictive assumptions are often used in the field of neuroimaging for studies involving functional magnetic resonance imaging, voxel based morphometry, and diffusion tensor imaging. Nonparametric statistical methods or flexible Bayesian models can be applied rather easily to yield more trustworthy results. The spatial normalization step required for multisubject studies can also be improved by taking advantage of more robust algorithms for image registration. A common drawback of algorithms based on weaker assumptions, however, is the increase in computational complexity. In this short overview, we will therefore present some examples of how inexpensive PC graphics hardware, normally used for demanding computer games, can be used to enable practical use of more realistic models and accurate algorithms, such that the outcome of neuroimaging studies really can be trusted.

  10. Statistics of lower tropospheric inversions over the continental United States

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Y.H.; Zhang, S.D.; Yi, F. [Wuhan Univ., Hubei (China). School of Electronic Information; Ministry of Education, Wuhan, Hubei (China). Key Lab. of Geospace Environment and Geodesy; State Observatory for Atmospheric Remote Sensing, Wuhan (China); Chen, Z.Y. [Chinese Academy of Sciences, Beijing (China). Inst. of Atmospheric Sciences

    2011-07-01

    The basic structure parameters of lower tropospheric inversions (LTIs) have been derived from 10 years (1998-2007) of high vertical resolution ({proportional_to}50 m) radiosonde observations over 56 United States stations. Seasonal and longitudinal variability of these parameters are presented and the formation mechanisms of LTI are also discussed. It is found that LTI seems to be a common feature over the continental United States. The LTI occurrence rates (defined as the fraction of measurements with LTI, which is calculated from the number of LTI cases divided by the number of measurements of the whole 10 years) at these 56 stations vary from 3.7% to 14.5%; the averaged base heights of LTI have a range of 3-5 km above mean sea level (a.m.s.l.); the averaged thicknesses and temperature jump ranges from 420-465m and 1.9-2.2 K, respectively. These parameters have an obvious seasonal variation. In winter, all the occurrence rates, thicknesses and temperature jumps of LTI have much larger values than those in summer. LTI occurrence rate shows an obvious west-east increasing trend in all 4 seasons. Detailed analyses reveal that dynamical instability induced by strong zonal wind shear is responsible for LTI in winter, spring and autumn; the frontal system tends to generate LTI in summer. Since the higher occurrence rate, larger temperature jump and larger thickness of LTI occur in winter, we believe strong zonal wind shear plays a more important role in the formation of LTI. (orig.)

  11. Statistics of lower tropospheric inversions over the continental United States

    Directory of Open Access Journals (Sweden)

    Y. H. Zhang

    2011-02-01

    Full Text Available The basic structure parameters of lower tropospheric inversions (LTIs have been derived from 10 years (1998–2007 of high vertical resolution (~50 m radiosonde observations over 56 United States stations. Seasonal and longitudinal variability of these parameters are presented and the formation mechanisms of LTI are also discussed. It is found that LTI seems to be a common feature over the continental United States. The LTI occurrence rates (defined as the fraction of measurements with LTI, which is calculated from the number of LTI cases divided by the number of measurements of the whole 10 years at these 56 stations vary from 3.7% to 14.5%; the averaged base heights of LTI have a range of 3–5 km above mean sea level (a.m.s.l.; the averaged thicknesses and temperature jump ranges from 420–465 m and 1.9–2.2 K, respectively. These parameters have an obvious seasonal variation. In winter, all the occurrence rates, thicknesses and temperature jumps of LTI have much larger values than those in summer. LTI occurrence rate shows an obvious west-east increasing trend in all 4 seasons. Detailed analyses reveal that dynamical instability induced by strong zonal wind shear is responsible for LTI in winter, spring and autumn; the frontal system tends to generate LTI in summer. Since the higher occurrence rate, larger temperature jump and larger thickness of LTI occur in winter, we believe strong zonal wind shear plays a more important role in the formation of LTI.

  12. Association of bystander interventions and hospital length of stay and admission to intensive care unit in out-of-hospital cardiac arrest survivors.

    Science.gov (United States)

    Riddersholm, Signe; Kragholm, Kristian; Mortensen, Rikke Nørmark; Pape, Marianne; Hansen, Carolina Malta; Lippert, Freddy K; Torp-Pedersen, Christian; Christiansen, Christian F; Rasmussen, Bodil Steen

    2017-10-01

    The impact of bystander interventions on post-arrest hospital course is sparsely studied. We examined the association between bystander interventions and length of hospital stay and admission to intensive care unit (ICU) in one-day survivors after OHCA. This cohort study linked data of 4641 one-day OHCA survivors from 2001 to 2014 to data on hospital length of stay and ICU admission. We examined associations between bystander efforts and outcomes using regression, adjusted for age, sex, comorbidities, calendar year and witnessed status. We divided bystander efforts into three categories: 1. No bystander interventions; 2.Bystander CPR only; 3. Bystander defibrillation with or without bystander CPR. For patients surviving to hospital discharge, hospital length of stay was 20days for patients without bystander interventions, compared to 16 for bystander CPR, and 13 for bystander defibrillation. 82% of patients without bystander interventions were admitted to ICU compared to 77.2% for bystander CPR, and 61.2% for bystander defibrillation. In-hospital mortality was 60% in the first category compared to 40.5% and 21.7% in the two latter categories. In regression models, bystander CPR and bystander defibrillation were associated with a reduction of length of hospital stay of 21% (Estimate: 0.79 [95% CI: 0.72-0.86]) and 32% (Estimate: 0.68 [95% CI: 0.59-0.78]), respectively. Both bystander CPR (OR: 0.94 [95% CI: 0.91-0.97]) and bystander defibrillation (OR: 0.81 [0.76-0.85]), were associated with lower risk of ICU admission. Bystander interventions were associated with reduced hospital length of stay and ICU admission, suggesting that these efforts improve recovery in OHCA survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Labor Statistics for the United States - Annual Averages for 2000 and 2001 - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set portrays labor statistics annual averages for the years 2000 and 2001, shown by county, for the United States and Puerto Rico. The data set was created...

  14. Labor Statistics for the United States - Annual Averages for 2005 to 2009 - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set portrays labor statistics annual averages for the years 2005 to 2009, shown by county, for the United States and Puerto Rico. The data set was created...

  15. Labor Statistics for the United States - Annual Averages for 2002 to 2004 - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set portrays labor statistics annual averages for the years 2002 to 2004, shown by county, for the United States and Puerto Rico. The data set was created...

  16. Long-Term Impact of Acute, Critical Illness and Admission to an Intensive Care Unit. Perspectives of Patients and Partners

    DEFF Research Database (Denmark)

    Ågård, Anne Sophie

    2013-01-01

    spouse to caregiver and back again in a dynamic process involving committing to caregiving, acquiring caregiving skills, negotiating level of caregiving, and leaving the caregiver role. Spouses' wide-ranging support to the patient was constituted by five dimensions: observing, assisting, coa......-ching, advocating, and managing. The spouses often required comprehensive sick leave related to problems that arose because of the patients’ critical illness and hospital admission. As a couple, patients and caregivers sought to regain partnership balances. The study identified three types of couples...

  17. Social and Economic Statistics in the United Kingdom: A Review of Information Sources.

    Science.gov (United States)

    Tanenbaum, Eric; Nunez, Alfonso

    1982-01-01

    A new system is needed to monitor socioeconomic statistical data for the United Kingdom (UK). The current state of UK socioeconomic statistics, an assessment of methods used to communicate available information, and the resource requirements of a successful monitoring service are discussed. (AM)

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

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

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

  19. Effect of a Multi-Diagnosis Observation Unit on Emergency Department Length of Stay and Inpatient Admission Rate at Two Canadian Hospitals.

    Science.gov (United States)

    Cheng, Amy H Y; Barclay, Neil G; Abu-Laban, Riyad B

    2016-12-01

    Observation units (OUs) have been shown to reduce emergency department (ED) lengths of stay (LOS) and admissions. Most published studies have been on OUs managing single complaints. Our aim was to determine whether an OU reduces ED LOS and hospital admission rates for adults with a variety of presenting complaints. We comparatively evaluated two hospitals in British Columbia, Canada (hereafter ED A and ED B) using a pre-post design. Data were extracted from administrative databases. The post-OU cohort included all adults presenting 6 months after OU implementation. The pre-OU cohort included all adults presenting in the same 6-month period 1 year before OU implementation. There were 109,625 patient visits during the study period. Of the 56,832 visits during the post-OU period (27,512 to ED A and 29,318 to ED B), 1.9% were managed in the OU in ED A and 1.4% in ED B. Implementation was associated with an increase in the median ED LOS at ED A (179.0 min pre vs. 192.0 min post [+13.0 min]; p < 0.001; mean difference -12.5 min, 95% confidence interval [CI] -15.2 to -9.9 min), but no change at ED B (182.0 min pre vs. 182.0 min post; p = 0.55; mean difference +2.0 min, 95% CI -0.7 to +4.7 min). Implementation significantly decreased the hospital admission rate for ED A (17.8% pre to 17.0% post [-0.8%], 95% CI -0.18% to 0.15%; p < 0.05) and did not significantly change the hospital admission rate at ED B (18.9% pre to 18.3% post [-0.6%], 95% CI -1.19% to -0.09%; p = 0.09). A multi-diagnosis OU can reduce hospital admission rate in a site-specific manner. In contrast to previous studies, we did not find that an OU reduced ED LOS. Further research is needed to determine whether OUs can reduce ED overcrowding. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Déficit de base à admissão na unidade de terapia intensiva: um indicador de mortalidade precoce Base deficit at intensive care unit admission: an early mortality indicator

    Directory of Open Access Journals (Sweden)

    Iara Serra Azul Machado Bezerra

    2007-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O déficit de base é considerado um indicador de lesão tissular, choque e reanimação. O objetivo deste estudo foi estabelecer uma associação entre o déficit de base na admissão dos pacientes internados em unidade de terapia intensiva (UTI e seu prognóstico. MÉTODO: Estudo retrospectivo com análise de 110 pacientes admitidos consecutivamente na UTI, durante o período de 01 de junho a 31 de dezembro de 2006. RESULTADOS: Houve predomínio do sexo feminino, com idade média de 54,2 ± 18,7 anos. O tempo médio de permanência foi 6,5 ± 7,4 dias e o APACHE médio foi de 21 ± 8,1 pontos. A razão de mortalidade padronizada foi 0,715. A mortalidade dos pacientes com déficit de base superior a 6 mEq/L foi maior (38,9% que a daqueles com déficit menor (ou excesso (20,6%; p BACKGROUND AND OBJECTIVES: Base deficit is considered an indicator of tissue injury, shock and resuscitation. The objective of this study was to establish an association between base deficit obtained on the admission of patients in intensive care unit (ICU and their prognosis. METHODS: A retrospective study with analysis of 110 patients admitted consecutively in the ICU, during the period of June to December 2006. RESULTS: There was a predominance of women, with age mean 54.2 ± 18.7 years old. Length of stay in ICU was 6.5 ± 7.4 days and the mean APACHE II score was 21 ± 8.1 points. The standardized mortality ratio was 0.715. Mortality was higher in patients with base deficit > 6 mEq/L (38.9% than in those with base deficit 6 mEq/L is a marker of significant mortality.

  1. Admission to a dedicated cardiac intensive care unit is associated with decreased resource use for infants with prenatally diagnosed congenital heart disease.

    Science.gov (United States)

    Johnson, Joyce T; Tani, Lloyd Y; Puchalski, Michael D; Bardsley, Tyler R; Byrne, Janice L B; Minich, L LuAnn; Pinto, Nelangi M

    2014-12-01

    Many factors in the delivery and perinatal care of infants with a prenatal diagnosis of congenital heart disease (CHD) have an impact on outcome and costs. This study sought to determine the modifiable factors in perinatal management that have an impact on postnatal resource use for infants with CHD. The medical records of infants with prenatally diagnosed CHD (August 2006-December 2011) who underwent cardiac surgery before discharge were reviewed. The exclusion criteria ruled out prematurity and intervention or transplantation evaluation before surgery. Clinical characteristics, outcomes, and cost data were collected. Multivariate linear regression models were used to determine the impact of perinatal decisions on hospitalization cost and surrogates of resource use after adjustment for demographic and other risk factors. For the 126 patients who met the study criteria, the median hospital stay was 22 days (range 4-122 days), and the median inflation-adjusted total hospital cost was $107,357 (range $9,746-602,320). The initial admission to the neonatal versus the cardiac intensive care unit (NICU vs. CICU) was independently associated with a 19 % longer hospital stay, a 26 % longer ICU stay, and 47 % more mechanical ventilation days after adjustment for Risk Adjustment for Congenital Heart Surgery, version 1 score, gestation age, genetic abnormality, birth weight, mode of delivery, and postsurgical complications. Weekend versus weekday delivery was not associated with hospital cost or length of hospital stay. For term infants with prenatally diagnosed CHD undergoing surgery before discharge, preoperative admission to the NICU (vs. the CICU) resulted in a longer hospital stay and greater intensive care use. Prenatal planning for infants with CHD should consider the initial place of admission as a modifiable factor for potential lowering of resource use.

  2. Why routine intensive care unit admission after elective open infrarenal Abdominal Aortic Aneurysm repair is no longer an evidence based practice.

    LENUS (Irish Health Repository)

    Ryan, David

    2012-01-31

    BACKGROUND: Elective open infrarenal Abdominal Aortic Aneurysm (AAA) repair is major surgery performed on high-risk patients. Routine ICU admission postoperatively is the current accepted standard of care. Few of these patients actually require a level of care that cannot be provided just as effectively in a surgical high dependency unit (HDU). Our aim was to determine, \\'can high risk patients that will require ICU admission postoperatively be reliably identified preoperatively?\\'. METHODS: A retrospective analysis of all elective open infrarenal AAA repairs in our institution over a 3-year period was performed. The Estimation of Physiological Ability and Surgical Stress (E-PASS) model was used as our risk stratification tool for predicting post-operative morbidity. Renal function was also considered as a predictor of outcome, independent of the E-PASS. RESULTS: 80% (n = 16) were admitted to ICU. Only 30% (n = 6) of the total study population necessitated intensive care. There were 9 complications in 7 patients in our study. The E-PASS comprehensive risk score (CRS)\\/Surgical stress score (SSS) were found to be significantly associated with the presence of a complication (p = 0.009)\\/(p = 0.032) respectively. Serum creatinine (p = 0.013) was similarly significantly associated with the presence of a complication. CONCLUSIONS: The E-PASS model possessing increasing external validity is an effective risk stratification tool in safely deciding the appropriate level of post-operative care for elective infrarenal AAA repairs.

  3. Influenza in hospitalized children in Ireland in the pandemic period and the 2010/2011 season: risk factors for paediatric intensive-care-unit admission.

    LENUS (Irish Health Repository)

    Rebolledo, J

    2013-11-11

    SUMMARY Influenza causes significant morbidity and mortality in children. This study\\'s objectives were to describe influenza A(H1N1)pdm09 during the pandemic, to compare it with circulating influenza in 2010\\/2011, and to identify risk factors for severe influenza defined as requiring admission to a paediatric intensive care unit (PICU). Children hospitalized with influenza during the pandemic were older, and more likely to have received antiviral therapy than children hospitalized during the 2010\\/2011 season. In 2010\\/2011, only one child admitted to a PICU with underlying medical conditions had been vaccinated. The risk of severe illness in the pandemic was higher in females and those with underlying conditions. In 2010\\/2011, infection with influenza A(H1N1)pdm09 compared to other influenza viruses was a significant risk factor for severe disease. An incremental relationship was found between the number of underlying conditions and PICU admission. These findings highlight the importance of improving low vaccination uptake and increasing the use of antivirals in vulnerable children.

  4. Admission of hematopoietic cell transplantation patients to the intensive care unit at the Pontificia Universidad Católica de Chile Hospital.

    Science.gov (United States)

    Escobar, Karen; Rojas, Patricio; Ernst, Daniel; Bertin, Pablo; Nervi, Bruno; Jara, Veronica; Garcia, Maria Jose; Ocqueteau, Mauricio; Sarmiento, Mauricio; Ramirez, Pablo

    2015-01-01

    Patients undergoing hematopoietic cell transplantation (HCT) can have complications that require management in the intensive care unit (ICU). We conducted a retrospective study of patients undergoing HCT between 2007 and 2011 with admission to the ICU. We analyzed 97 patients, with an average age of 37 (range, 15 to 68). The main indications for HCT were hematologic malignancies (84%, n = 82). Ninety percent (n = 87) received myeloablative conditioning. Thirty-one percent were admitted (autologous transplant recipients 15%, allogeneic transplant recipients 34%, and umbilical cord blood [UCB] transplant recipients 48%) with an average length of stay of 19 days (range, 1 to 73 days). The average time between transplantation and transfer was 15 days. The main causes of admission were acute respiratory failure (63%) and septic shock (20%). ICU mortality was 20% for autologous transplantations and 64% for allogeneic transplantations (adult donor and UCB combined). On average, patients died 108 days after the transplantation (range, 4 to 320 days). One-year overall survival, comparing patients entering the ICU with those never admitted, was 16% versus 82% (P < .0001) for allogeneic transplantations (adult donor and UCB combined) and 80% versus 89% (P = not significant) for autologous transplantations. Acute graft-versus-host disease was significantly associated with death in ICU after UCB HCT. ICU support is satisfactory in about one half of patients admitted, characterized by a short and medium term prognosis not as unfavorable as has been previously reported.

  5. The ED-inpatient dashboard: Uniting emergency and inpatient clinicians to improve the efficiency and quality of care for patients requiring emergency admission to hospital.

    Science.gov (United States)

    Staib, Andrew; Sullivan, Clair; Jones, Matt; Griffin, Bronwyn; Bell, Anthony; Scott, Ian

    2017-06-01

    Patients who require emergency admission to hospital require complex care that can be fragmented, occurring in the ED, across the ED-inpatient interface (EDii) and subsequently, in their destination inpatient ward. Our hospital had poor process efficiency with slow transit times for patients requiring emergency care. ED clinicians alone were able to improve the processes and length of stay for the patients discharged directly from the ED. However, improving the efficiency of care for patients requiring emergency admission to true inpatient wards required collaboration with reluctant inpatient clinicians. The inpatient teams were uninterested in improving time-based measures of care in isolation, but they were motivated by improving patient outcomes. We developed a dashboard showing process measures such as 4 h rule compliance rate coupled with clinically important outcome measures such as inpatient mortality. The EDii dashboard helped unite both ED and inpatient teams in clinical redesign to improve both efficiencies of care and patient outcomes. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  6. Incidence, Risk Factors, and Attributable Mortality of Secondary Infections in the Intensive Care Unit After Admission for Sepsis

    NARCIS (Netherlands)

    van Vught, Lonneke A; Klein Klouwenberg, Peter M C; Spitoni, Cristian; Scicluna, Brendon P; Wiewel, Maryse A; Horn, Janneke; Schultz, Marcus J; Nürnberg, Peter; Bonten, Marc J M; Cremer, Olaf L; van der Poll, Tom

    2016-01-01

    Importance: Sepsis is considered to induce immune suppression, leading to increased susceptibility to secondary infections with associated late mortality. Objective: To determine the clinical and host genomic characteristics, incidence, and attributable mortality of intensive care unit

  7. Incidence, Risk Factors, and Attributable Mortality of Secondary Infections in the Intensive Care Unit After Admission for Sepsis

    NARCIS (Netherlands)

    van Vught, Lonneke A; Klein Klouwenberg, Peter M C|info:eu-repo/dai/nl/33706864X; Spitoni, Cristian; Scicluna, Brendon P; Wiewel, Maryse A; Horn, Janneke; Schultz, Marcus J; Nürnberg, Peter; Bonten, Marc J M|info:eu-repo/dai/nl/123144337; Cremer, Olaf L|info:eu-repo/dai/nl/304815683; van der Poll, Tom

    2016-01-01

    Importance: Sepsis is considered to induce immune suppression, leading to increased susceptibility to secondary infections with associated late mortality. Objective: To determine the clinical and host genomic characteristics, incidence, and attributable mortality of intensive care unit (ICU)-acquire

  8. Managing acute medical admissions: a survey of acute medical services and medical assessment and planning units in New Zealand.

    Science.gov (United States)

    Providence, C; Gommans, J; Burns, A

    2012-01-01

    To determine the current provision of acute medical services, including the development of medical assessment and planning units (MAPUs), by district health boards (DHBs) throughout New Zealand (NZ). A questionnaire-based survey about organisation of acute medical services and establishment of MAPUs was sent to all 21 DHBs in NZ. All 21 DHBs responded. Seven DHBs serving 42% of the population have established MAPUs since 2003 and a further six have plans to do so over the next 3 years, potentially expanding service to 73% of the NZ population. All seven current MAPUs are in close proximity to and accept patients directly from emergency departments. Each MAPU has a documented target length of stay, four units have referral protocols, five provide guidelines for management of common medical emergencies and five routinely audit unit performance. Five MAPUs have cardiac monitored beds and isolation rooms. Rapid access is available to computed tomography scanning (six units), ultrasound (five) and echocardiography (four). Two units have no nominated physician leadership and two lack dedicated therapy resources. General physicians are involved in provision of acute medical services in 20 of 21 DHBs. Medical assessment and planning units have become an important component of acute medical service provision in NZ. The established units largely comply with Australasian recommendations, although important deficiencies exist. Training of physicians must combine the needs of acute medical patients and clinical roles of physicians within MAPUs with local DHB requirements for services to be most effective. © 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians.

  9. The impact of chronic obstructive pulmonary disease on intensive care unit admission and 30-day mortality in patients undergoing colorectal cancer surgery

    DEFF Research Database (Denmark)

    Platon, Anna Maria; Erichsen, Rune; Christiansen, Christian Fynbo;

    2014-01-01

    all patients undergoing CRC surgery in the period 2005-2011, identified through medical databases. We categorised the patients according to the history of COPD. We assessed the rate of complications within 30 days. We computed 30-day mortality among patients with/without COPD using the Kaplan......-Meier method. We used Cox regression to compute HRs for death, controlling for age, gender, type of admission, cancer stage, hospital volume, alcohol-related diseases, obesity and Charlson comorbidity score. RESULTS: We identified 18 302 CRC surgery patients. Of these, 7.9% had a prior diagnosis of COPD. Among...... patients with COPD, 16.1% were admitted postoperatively to the intensive care unit, 1.9% were treated with mechanical ventilation, and 3.6% were treated with non-invasive ventilation. In patients without COPD, the corresponding proportions were 9.7%, 1.1% and 1.1%. The reoperation rate was 10.6% among...

  10. Accident statistics for fixed offshore units on the UK Continental Shelf 1980-2001

    Energy Technology Data Exchange (ETDEWEB)

    Funnemark, E. [Det Norske Veritas Industry AS, (Norway); Young, E. [Health and Safety Executive, (United Kingdom)

    2003-07-01

    Comprehensive statistics for the accidents and incidents on fixed units engaged in oil and gas exploration/exploitation on the UK continental shelf between 1980 and 2001 have been assembled from other databases. The data includes nature of the incident, type of unit involved, geographical area and time period. The results cover a total of 5,563 events which are described as accidents, hazardous situations or near misses.

  11. Statistics

    CERN Document Server

    Hayslett, H T

    1991-01-01

    Statistics covers the basic principles of Statistics. The book starts by tackling the importance and the two kinds of statistics; the presentation of sample data; the definition, illustration and explanation of several measures of location; and the measures of variation. The text then discusses elementary probability, the normal distribution and the normal approximation to the binomial. Testing of statistical hypotheses and tests of hypotheses about the theoretical proportion of successes in a binomial population and about the theoretical mean of a normal population are explained. The text the

  12. The Admission and Academic Placement of Students from: Bahrain, Oman, Qatar, United Arab Emirates, Yemen Arab Republic.

    Science.gov (United States)

    Johnson, J. K., Ed.

    Information is provided on the educational systems of Bahrain, Oman, Qatar, the United Arab Emirates, and the Yemen Arab Republic in order to assist U.S. colleges and universities as they work with international student agencies and representatives from these countries. For each country, placement recommendations are offered, along with notes to…

  13. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Directory of Open Access Journals (Sweden)

    Chitra Mehta

    2016-01-01

    Full Text Available Background: Timely decision making in Intensive Care Unit (ICU is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643 and morbidity (P = 0.000, AUC = 0.763, comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045. Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.

  14. Timber resource statistics for the Willow block, Susitna River Basin multiresource inventory unit, Alaska, 1978.

    Science.gov (United States)

    Theodore S. Setzer; Bert R. Mead; Gary L. Carroll

    1984-01-01

    A multiresource inventory of the Willow block, Susitna River basin inventory unit, was conducted in 1978. Statistics on forest area, timber volumes, and growth and mortality from this inventory are presented. Timberland area is estimated at 230,200 acres and net growing stock volume, mostly birch, at 231.9 million cubic feet. Net annual growth of growing stock is...

  15. Timber resource statistics for the Upper Susitna block, Susitna River basin multiresource inventory unit, Alaska, 1980.

    Science.gov (United States)

    Bert R. Mead; Theodore S. Setzer; Gary L. Carroll

    1985-01-01

    A multiresource inventory of the Upper Susitna block, Susitna River basin inventory unit, was conducted in 1980. Statistics on forest area, timber volumes, and annual growth from this inventory are presented. Timberland area is estimated at 112,130 acres, and net growing stock volume, mostly hardwood, is 84.6 million cubic feet. Net annual growth of growing stock is...

  16. Timber resource statistics for the Beluga block, Susitna River basin multiresource inventory unit, Alaska, 1980.

    Science.gov (United States)

    Gary L. Carroll; Theodore S. Setzer; Bert R. Mead

    1985-01-01

    A multiresource inventory of the Beluga block, Susitna River basin inventory unit, was conducted in 1980. Statistics on forest area, timber volumes, and growth and mortality from this inventory are presented. Timberland area is estimated at 131,740 acres and net growing stock volume, mostly hardwood, is 99.4 million cubic feet. Net annual growth of growing stock is...

  17. Timber resource statistics for the Talkeetna block, Susitna River basin multiresource inventory unit, Alaska, 1979.

    Science.gov (United States)

    Theodore S. Setzer; Gary L. Carroll; Bert R. Mead

    1984-01-01

    A multiresource inventory of the Talkeetna block, Susitna River basin inventory unit, was conducted in 1979. Statistics on forest area, timber volumes, and growth and mortality from this inventory are presented. Timberland area is estimated at 562,105 acres and net growing stock volume, mostly hardwood, at 574.7 million cubic feet. Net annual growth of growing stock is...

  18. Orthognathic Surgery Patients (Maxillary Impaction and Setback plus Mandibular Advancement plus Genioplasty) Need More Intensive Care Unit (ICU) Admission after Surgery

    Science.gov (United States)

    Eftekharian, Hamidreza; Zamiri, Barbad; Ahzan, Shamseddin; Talebi, Mohamad; Zarei, Kamal

    2015-01-01

    Statement of the Problem: Due to shortage of ICU beds in hospitals, knowing what kind of orthognathic surgery patients more need ICU care after surgery would be important for surgeons and hospitals to prevent unnecessary ICU bed reservation. Purpose: The aim of the present study was to determine what kinds of orthognathic surgery patients would benefit more from ICU care after surgery. Materials and Method: 210 patients who were admitted to Chamran Hospital, Shiraz, for bimaxillary orthognathic surgery (2008-2013) were reviewed based on whether they had been admitted to ICU or maxillofacial surgery ward. Operation time, sex, intraoperative Estimated Blood Loss (EBL), postoperative complications, ICU admission, and unwanted complications resulting from staying in ICU were assessed. Results: Of 210 patients undergoing bimaxillary orthognathic surgery, 59 patients (28.1%) were postoperatively admitted to the ICU and 151 in the maxillofacial ward (71.9%). There was not statistically significant difference in age and sex between the two groups (p> 0.05). The groups were significantly different in terms of operation time (p< 0.001). Blood loss For ICU admitted patients was 600.00±293.621mL and for those who were hospitalized in the ward was 350.00±298.397 mL. Statistically significant differences were found between the two groups (p< 0.001). Moreover, there was a direct linear correlation between operation time and intraoperative estimated blood loss and this relationship was statistically significant (r=0.42, p< 0.001). Patients with maxillary impaction and setback plus mandibular advancement plus genioplasty were among the most ICU admitted patients (44%), while these patients were only 20% of all patients who were admitted to the ward. As a final point, the result illustrated that patients who were admitted to the ICU experienced more complication such as bleeding, postoperative nausea, and pain (p< 0.001). Conclusion: Orthognathic surgery patients (maxillary

  19. Orthognathic Surgery Patients (Maxillary Impaction and Setback Plus Mandibular Advancement Plus Genioplasty Need More Intensive Care Unit (ICU Admission after Surgery

    Directory of Open Access Journals (Sweden)

    Hamidreza Eftekharian

    2015-03-01

    Full Text Available Statement of the Problem: Due to shortage of ICU beds in hospitals, knowing what kind of orthognathic surgery patients more need ICU care after surgery would be important for surgeons and hospitals to prevent unnecessary ICU bed reservation. Purpose: The aim of the present study was to determine what kinds of orthognathic surgery patients would benefit more from ICU care after surgery. Materials and Method: 210 patients who were admitted to Chamran Hospital, Shiraz, for bimaxillary orthognathic surgery (2008-2013 were reviewed based on whether they had been admitted to ICU or maxillofacial surgery ward. Operation time, sex, intraoperative Estimated Blood Loss (EBL, postoperative complications, ICU admission, and unwanted complications resulting from staying in ICU were assessed. Results: Of 210 patients undergoing bimaxillary orthognathic surgery, 59 patients (28.1% were postoperatively admitted to the ICU and 151 in the maxillofacial ward (71.9%. There was not statistically significant difference in age and sex between the two groups (p> 0.05. The groups were significantly different in terms of operation time (p< 0.001. Blood loss For ICU admitted patients was 600.00±293.621mL and for those who were hospitalized in the ward was 350.00±298.397 mL. Statistically significant differences were found between the two groups (p< 0.001. Moreover, there was a direct linear correlation between operation time and intraoperative estimated blood loss and this relationship was statistically significant (r=0.42, p< 0.001. Patients with maxillary impaction and setback plus mandibular advancement plus genioplasty were among the most ICU admitted patients (44%, while these patients were only 20% of all patients who were admitted to the ward. As a final point, the result illustrated that patients who were admitted to the ICU experienced more complication such as bleeding, postoperative nausea, and pain (p< 0.001. Conclusion: Orthognathic surgery patients

  20. Statistics

    Science.gov (United States)

    Links to sources of cancer-related statistics, including the Surveillance, Epidemiology and End Results (SEER) Program, SEER-Medicare datasets, cancer survivor prevalence data, and the Cancer Trends Progress Report.

  1. External validation of the simple clinical score and the HOTEL score, two scores for predicting short-term mortality after admission to an acute medical unit.

    Science.gov (United States)

    Stræde, Mia; Brabrand, Mikkel

    2014-01-01

    Clinical scores can be of aid to predict early mortality after admission to a medical admission unit. A developed scoring system needs to be externally validated to minimise the risk of the discriminatory power and calibration to be falsely elevated. We performed the present study with the objective of validating the Simple Clinical Score (SCS) and the HOTEL score, two existing risk stratification systems that predict mortality for medical patients based solely on clinical information, but not only vital signs. Pre-planned prospective observational cohort study. Danish 460-bed regional teaching hospital. We included 3046 consecutive patients from 2 October 2008 until 19 February 2009. 26 (0.9%) died within one calendar day and 196 (6.4%) died within 30 days. We calculated SCS for 1080 patients. We found an AUROC of 0.960 (95% confidence interval [CI], 0.932 to 0.988) for 24-hours mortality and 0.826 (95% CI, 0.774-0.879) for 30-day mortality, and goodness-of-fit test, χ(2) = 2.68 (10 degrees of freedom), P = 0.998 and χ(2) = 4.00, P = 0.947, respectively. We included 1470 patients when calculating the HOTEL score. Discriminatory power (AUROC) was 0.931 (95% CI, 0.901-0.962) for 24-hours mortality and goodness-of-fit test, χ(2) = 5.56 (10 degrees of freedom), P = 0.234. We find that both the SCS and HOTEL scores showed an excellent to outstanding ability in identifying patients at high risk of dying with good or acceptable precision.

  2. An audit of obstetric admissions to intensive care unit in a medical college hospital of central India: lessons in preventing maternal morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Manisha Jain

    2015-02-01

    Full Text Available Background: The spectrum of causes leading to maternal morbidity and mortality may be well reflected in the clinical profile of obstetric patients admitted to the Intensive Care Unit (ICU. An audit of these patients may help in devising intervention strategies and implementing preventive measures. This is expected to contribute to the ongoing concerted multipronged efforts towards reducing maternal mortality as a step towards the millennium development goals. The aim was to study the clinical and demographic profile of antenatal and postpartum women requiring admission to the ICU, the interventions required in these women and the final outcome. The overall goal is to identify the contributing factors towards maternal morbidity and mortality. Methods: A retrospective analysis of hospital records of all antenatal, post-abortal and postpartum women admitted to the ICU at People's hospital, Bhopal over a period of 3 years (June 2011 to May 2014. Results: A total of 157 records were identified and analyzed: 22 (14% antenatal, seven (4% post-abortion, 114 (73% postpartum, and 14(9% post-laparotomy women. The mean age was 25 years (Range 18-38 years; SD 4.49, two thirds being from rural areas. Majority (78% had no earlier visit. The gestational age at admission to ICU ranged from 6-43 weeks (Mean 31 weeks; SD 9.06. One third (24% of patients had severe anemia, 18 patients needed ventilation, 25 required inotropic support, 4 required dialysis and 17 underwent surgical intervention. Blood or blood component therapy was needed in 60% cases with total blood units transfused being 225. The average duration of stay in intensive care unit was 79 hours. Analyzing as organ-system dysfunctions: Cardiovascular dysfunction (22%, hematological (20%, hepatic (16%, neurological (11%, septicemia (11%, renal (9%. There were 19 maternal deaths. Conclusions: Maternal anemia and consequences still contribute significantly to maternal morbidity. Non-utilization of

  3. CUSUM Statistics for Large Item Banks: Computation of Standard Errors. Law School Admission Council Computerized Testing Report. LSAC Research Report Series.

    Science.gov (United States)

    Glas, C. A. W.

    In a previous study (1998), how to evaluate whether adaptive testing data used for online calibration sufficiently fit the item response model used by C. Glas was studied. Three approaches were suggested, based on a Lagrange multiplier (LM) statistic, a Wald statistic, and a cumulative sum (CUMSUM) statistic respectively. For all these methods,…

  4. Towards a best practice of modeling unit of measure and related statistical metadata

    CERN Document Server

    Grossmann, Wilfried

    2011-01-01

    Data and metadata exchange between organizations requires a common language for describing structure and content of statistical data and metadata. The SDMX consortium develops content oriented guidelines (COG) recommending harmonized cross-domain concepts and terminology to increase the efficiency of (meta-) data exchange. A recent challenge is a recommended code list for the unit of measure. Based on examples from SDMX sponsor organizations this paper analyses the diversity of ""unit of measure"" as used in practice, including potential breakdowns and interdependencies of the respective meta-

  5. A hybrid statistical-dynamical framework for meteorological drought prediction: Application to the southwestern United States

    Science.gov (United States)

    Madadgar, Shahrbanou; AghaKouchak, Amir; Shukla, Shraddhanand; Wood, Andrew W.; Cheng, Linyin; Hsu, Kou-Lin; Svoboda, Mark

    2016-07-01

    Improving water management in water stressed-regions requires reliable seasonal precipitation predication, which remains a grand challenge. Numerous statistical and dynamical model simulations have been developed for predicting precipitation. However, both types of models offer limited seasonal predictability. This study outlines a hybrid statistical-dynamical modeling framework for predicting seasonal precipitation. The dynamical component relies on the physically based North American Multi-Model Ensemble (NMME) model simulations (99 ensemble members). The statistical component relies on a multivariate Bayesian-based model that relates precipitation to atmosphere-ocean teleconnections (also known as an analog-year statistical model). Here the Pacific Decadal Oscillation (PDO), Multivariate ENSO Index (MEI), and Atlantic Multidecadal Oscillation (AMO) are used in the statistical component. The dynamical and statistical predictions are linked using the so-called Expert Advice algorithm, which offers an ensemble response (as an alternative to the ensemble mean). The latter part leads to the best precipitation prediction based on contributing statistical and dynamical ensembles. It combines the strength of physically based dynamical simulations and the capability of an analog-year model. An application of the framework in the southwestern United States, which has suffered from major droughts over the past decade, improves seasonal precipitation predictions (3-5 month lead time) by 5-60% relative to the NMME simulations. Overall, the hybrid framework performs better in predicting negative precipitation anomalies (10-60% improvement over NMME) than positive precipitation anomalies (5-25% improvement over NMME). The results indicate that the framework would likely improve our ability to predict droughts such as the 2012-2014 event in the western United States that resulted in significant socioeconomic impacts.

  6. Trends in admissions, morbidity and outcomes at Red Cross War Memorial Children’s Hospital, Cape Town, 2004 - 2013

    Directory of Open Access Journals (Sweden)

    Y Isaacs-Long

    2017-03-01

    Full Text Available Background. Routinely collected patient information has the potential to yield valuable information about health systems and population health, but there have been few comprehensive analyses of paediatric admissions at South African (SA hospitals. Objectives. To investigate trends in hospitalisation and outcomes at Red Cross War Memorial Children’s Hospital (RCWMCH, a major referral hospital for children in the Western Cape and SA. Methods. Using routinely collected observational health data from the hospital informatics system, we investigated admissions between 2004 and 2013. Clinical classification software was used to group International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10 codes to rank causes during 2008 - 2013, when ICD-10 codes were widely available. Analyses examined trends in medical and surgical admissions over time. Results. There were 215 536 admissions over 10 years of 129 733 patients. Admissions increased by 9.3%, with increases in the general medical wards (5%, medical specialty wards (74%, the burns unit (73%, and the intensive care unit (16%. In contrast, admissions decreased in the trauma unit (21% and short-stay medical wards (1%. In-hospital mortality decreased by 54% (p-trend <0.001 over 10 years. Diarrhoea and lower-respiratory tract illness were the most common causes for medical admissions, although admissions and deaths due to these conditions decreased between 2008 and 2013, which coincided with the national introduction of related vaccines. Similarly, tuberculosis admissions and deaths decreased over this period. These trends could be owing to a concurrent decrease in HIV comorbidity (p-trend <0.001. Trauma was the most common reason for surgical admission. Conclusion. Paediatric in-hospital mortality decreased consistently over a decade, despite an overall increase in admissions. Pneumonia and diarrhoea admissions decreased markedly over a 6-year period, but

  7. Statistical Comparisons of watershed scale response to climate change in selected basins across the United States

    Science.gov (United States)

    Risley, John; Moradkhani, Hamid; Hay, Lauren; Markstrom, Steve

    2011-01-01

    In an earlier global climate-change study, air temperature and precipitation data for the entire twenty-first century simulated from five general circulation models were used as input to precalibrated watershed models for 14 selected basins across the United States. Simulated daily streamflow and energy output from the watershed models were used to compute a range of statistics. With a side-by-side comparison of the statistical analyses for the 14 basins, regional climatic and hydrologic trends over the twenty-first century could be qualitatively identified. Low-flow statistics (95% exceedance, 7-day mean annual minimum, and summer mean monthly streamflow) decreased for almost all basins. Annual maximum daily streamflow also decreased in all the basins, except for all four basins in California and the Pacific Northwest. An analysis of the supply of available energy and water for the basins indicated that ratios of evaporation to precipitation and potential evapotranspiration to precipitation for most of the basins will increase. Probability density functions (PDFs) were developed to assess the uncertainty and multimodality in the impact of climate change on mean annual streamflow variability. Kolmogorov?Smirnov tests showed significant differences between the beginning and ending twenty-first-century PDFs for most of the basins, with the exception of four basins that are located in the western United States. Almost none of the basin PDFs were normally distributed, and two basins in the upper Midwest had PDFs that were extremely dispersed and skewed.

  8. Who should be admitted to the intensive care unit? The outcome of intensive care unit admission in stage IIIB-IV lung cancer patients.

    Science.gov (United States)

    Kim, Yu Jung; Kim, Mi-Jung; Cho, Young-Jae; Park, Jong Sun; Kim, Jin Won; Chang, Hyun; Lee, Jeong-Ok; Lee, Keun-Wook; Kim, Jee Hyun; Yoon, Ho Il; Bang, Soo-Mee; Lee, Jae Ho; Lee, Choon-Taek; Lee, Jong Seok

    2014-03-01

    Critical care for advanced lung cancer patients is still controversial, and the appropriate method for the selection of patients who may benefit from intensive care unit (ICU) care is not clearly defined. We retrospectively reviewed the medical records of stage IIIB-IV lung cancer patients admitted to the medical ICU of a university hospital in Korea between 2003 and 2011. Of 95 patients, 64 (67%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS)≥2, and 79 (84%) had non-small-cell lung cancer. In total, 28 patients (30%) were newly diagnosed or were receiving first-line treatment, and 22 (23%) were refractory or bedridden. Mechanical ventilation was required in 85 patients (90%), and ICU mortality and hospital mortality were 57 and 78%, respectively. According to a multivariate analysis, a PaO2/FiO2 ratiocare. Oncologists should try to discuss palliative care and end-of-life issues in advance to avoid futile care.

  9. Statistically-Estimated Tree Composition for the Northeastern United States at Euro-American Settlement.

    Directory of Open Access Journals (Sweden)

    Christopher J Paciorek

    Full Text Available We present a gridded 8 km-resolution data product of the estimated composition of tree taxa at the time of Euro-American settlement of the northeastern United States and the statistical methodology used to produce the product from trees recorded by land surveyors. Composition is defined as the proportion of stems larger than approximately 20 cm diameter at breast height for 22 tree taxa, generally at the genus level. The data come from settlement-era public survey records that are transcribed and then aggregated spatially, giving count data. The domain is divided into two regions, eastern (Maine to Ohio and midwestern (Indiana to Minnesota. Public Land Survey point data in the midwestern region (ca. 0.8-km resolution are aggregated to a regular 8 km grid, while data in the eastern region, from Town Proprietor Surveys, are aggregated at the township level in irregularly-shaped local administrative units. The product is based on a Bayesian statistical model fit to the count data that estimates composition on the 8 km grid across the entire domain. The statistical model is designed to handle data from both the regular grid and the irregularly-shaped townships and allows us to estimate composition at locations with no data and to smooth over noise caused by limited counts in locations with data. Critically, the model also allows us to quantify uncertainty in our composition estimates, making the product suitable for applications employing data assimilation. We expect this data product to be useful for understanding the state of vegetation in the northeastern United States prior to large-scale Euro-American settlement. In addition to specific regional questions, the data product can also serve as a baseline against which to investigate how forests and ecosystems change after intensive settlement. The data product is being made available at the NIS data portal as version 1.0.

  10. Theoretical approaches to the steady-state statistical physics of interacting dissipative units

    Science.gov (United States)

    Bertin, Eric

    2017-02-01

    The aim of this review is to provide a concise overview of some of the generic approaches that have been developed to deal with the statistical description of large systems of interacting dissipative ‘units’. The latter notion includes, e.g. inelastic grains, active or self-propelled particles, bubbles in a foam, low-dimensional dynamical systems like driven oscillators, or even spatially extended modes like Fourier modes of the velocity field in a fluid. We first review methods based on the statistical properties of a single unit, starting with elementary mean-field approximations, either static or dynamic, that describe a unit embedded in a ‘self-consistent’ environment. We then discuss how this basic mean-field approach can be extended to account for spatial dependences, in the form of space-dependent mean-field Fokker-Planck equations, for example. We also briefly review the use of kinetic theory in the framework of the Boltzmann equation, which is an appropriate description for dilute systems. We then turn to descriptions in terms of the full N-body distribution, starting from exact solutions of one-dimensional models, using a matrix-product ansatz method when correlations are present. Since exactly solvable models are scarce, we also present some approximation methods which can be used to determine the N-body distribution in a large system of dissipative units. These methods include the Edwards approach for dense granular matter and the approximate treatment of multiparticle Langevin equations with colored noise, which models systems of self-propelled particles. Throughout this review, emphasis is put on methodological aspects of the statistical modeling and on formal similarities between different physical problems, rather than on the specific behavior of a given system.

  11. Availability of Pre-Admission Information to Prospective Graduate Students in Speech-Language Pathology

    Science.gov (United States)

    Tekieli Koay, Mary Ellen; Lass, Norman J.; Parrill, Madaline; Naeser, Danielle; Babin, Kelly; Bayer, Olivia; Cook, Megan; Elmore, Madeline; Frye, Rachel; Kerwood, Samantha

    2016-01-01

    An extensive Internet search was conducted to obtain pre-admission information and acceptance statistics from 260 graduate programmes in speech-language pathology accredited by the American Speech-Language-Hearing Association (ASHA) in the United States. ASHA is the national professional, scientific and credentialing association for members and…

  12. Structural characterization and condition for measurement statistics preservation of a unital quantum operation

    Science.gov (United States)

    Lee, Kai-Yan; Fung, Chi-Hang Fred; Chau, H. F.

    2013-05-01

    We investigate the necessary and sufficient condition for a convex cone of positive semidefinite operators to be fixed by a unital quantum operation ϕ acting on finite-dimensional quantum states. By reducing this problem to the problem of simultaneous diagonalization of the Kraus operators associated with ϕ, we can completely characterize the kinds of quantum states that are fixed by ϕ. Our work has several applications. It gives a simple proof of the structural characterization of a unital quantum operation that acts on finite-dimensional quantum states—a result not explicitly mentioned in earlier studies. It also provides a necessary and sufficient condition for determining what kind of measurement statistics is preserved by a unital quantum operation. Finally, our result clarifies and extends the work of Størmer by giving a proof of a reduction theorem on the unassisted and entanglement-assisted classical capacities, coherent information, and minimal output Renyi entropy of a unital channel acting on a finite-dimensional quantum state.

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

    Science.gov (United States)

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

    2017-01-04

    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. Publicado por Elsevier España, S.L.U.

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Cirurgia bariátrica: existe necessidade de internação em unidade de terapia intensiva? Bariatric surgery: is admission to the intensive care unit necessary?

    Directory of Open Access Journals (Sweden)

    Saulo Maia D'Avila Melo

    2009-06-01

    Full Text Available OBJETIVOS: Determinar o local de internação no pós-operatório de cirurgia bariátrica primária e verificar as complicações clínicas-cirúrgicas que justificassem internação em unidade de terapia intensiva, inclusive morte. MÉTODOS: Estudo transversal, prospectivo, aberto, sendo avaliados 120 pacientes submetidos à cirurgia bariátrica primária por vídeolaparoscopia no período de maio de 2007 a abril de 2008 em um hospital terciário. Utilizou-se o índice de Aldrete e Kroulik para liberação da sala de recuperação pós-anestésica e definição do local de encaminhamento no pós-operatório. RESULTADOS: Entre os 120 pacientes, havia 83 mulheres e 37 homens, com média de idade 35,4 ± 10,5 anos (18 a 66 anos, índice de massa corpórea médio 45,6 ± 10,5. O tempo entre admissão hospitalar e inicio da cirurgia foi de 140,7 ± 81,8 minutos, o tempo cirúrgico 105,0 ± 28,6 minutos, o tempo de permanência na sala de recuperação pós-anestésica foi 125,0 ± 38,0 minutos e tempo de internação hospitalar 47,7 ± 12,4 horas, com 100% dos pacientes deambulando em 24 horas. O índice de Aldrete e Kroulik da sala de recuperação pós-anestésica alcançou pontuação de 10 com 120 minutos em todos os pacientes, com sobrevida de 100%. CONCLUSÃO: Com o uso do índice Aldrete e Kroulik na sala de recuperação pós-anestésica de bypass gástrico por videolaparoscopia em cirurgia bariátrica primária, nenhum paciente foi internado em unidade de terapia intensiva e nenhuma complicação maior foi observada.OBJECTIVE: The purpose of this study was to determine the place of stay at postoperative and to verify medical-surgical complications that would justify admission to the intensive care unit, including death. METHODS: Cross-over, prospective, open study that evaluated 120 patients who were submitted to primary bariatric surgery by video laparoscopy from May 2007 to April 2008 in a tertiary hospital. The Aldrete Kroulik index was

  16. In-Situ Statistical Analysis of Autotune Simulation Data using Graphical Processing Units

    Energy Technology Data Exchange (ETDEWEB)

    Ranjan, Niloo [ORNL; Sanyal, Jibonananda [ORNL; New, Joshua Ryan [ORNL

    2013-08-01

    Developing accurate building energy simulation models to assist energy efficiency at speed and scale is one of the research goals of the Whole-Building and Community Integration group, which is a part of Building Technologies Research and Integration Center (BTRIC) at Oak Ridge National Laboratory (ORNL). The aim of the Autotune project is to speed up the automated calibration of building energy models to match measured utility or sensor data. The workflow of this project takes input parameters and runs EnergyPlus simulations on Oak Ridge Leadership Computing Facility s (OLCF) computing resources such as Titan, the world s second fastest supercomputer. Multiple simulations run in parallel on nodes having 16 processors each and a Graphics Processing Unit (GPU). Each node produces a 5.7 GB output file comprising 256 files from 64 simulations. Four types of output data covering monthly, daily, hourly, and 15-minute time steps for each annual simulation is produced. A total of 270TB+ of data has been produced. In this project, the simulation data is statistically analyzed in-situ using GPUs while annual simulations are being computed on the traditional processors. Titan, with its recent addition of 18,688 Compute Unified Device Architecture (CUDA) capable NVIDIA GPUs, has greatly extended its capability for massively parallel data processing. CUDA is used along with C/MPI to calculate statistical metrics such as sum, mean, variance, and standard deviation leveraging GPU acceleration. The workflow developed in this project produces statistical summaries of the data which reduces by multiple orders of magnitude the time and amount of data that needs to be stored. These statistical capabilities are anticipated to be useful for sensitivity analysis of EnergyPlus simulations.

  17. Effect of the timing of admission upon patient prognosis in the Intensive Care Unit: On-hours versus off-hours.

    Science.gov (United States)

    Abella, A; Hermosa, C; Enciso, V; Torrejón, I; Molina, R; Díaz, M; Mozo, T; Gordo, F; Salinas, I

    2016-01-01

    To assess the repercussion of the timing of admission to the ICU upon patient prognosis. A prospective, observational, non-interventional cohort study was carried out. A second level hospital with 210 operational beds and a general ICU with 8 operational beds. The study comprised all patients admitted to the ICU during 3 years (January 2010 to December 2012), excluding those subjects admitted from the operating room after scheduled surgery. The patients were divided into 2 groups according to the timing of admission (on-hours or off-hours). Non-interventional study. An analysis was made of demographic variables (age, sex), origin (emergency room, hospital ward, operating room), comorbidities and SAPS 3 as severity score upon admission, length of stay in the ICU and hospital ward, and ICU and hospital mortality. A total of 504 patients were included in the on-hours group, versus 602 in the off-hours group. Multivariate analysis showed the factors independently associated to hospital mortality to be SAPS 3 (OR 1.10; 95% CI 1.08-1.12), and off-hours admission (OR 2.00; 95% CI 1.20-3.33). In a subgroup analysis of the off-hours group, the admission of patients on weekends or non-working days compared to daily night shifts was found to be independently associated to hospital mortality (OR 2.30; 95% CI 1.23-4.30). Admission to the ICU in off-hours is independently associated to patient mortality, which is also higher in patients admitted on weekends and non-working days compared to the daily night shifts. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  18. Revised Definitions for Statistical Units – Methodology, Application and User Needs. The Main Conceptual Issues of the “Units Discussion” of the Years 2009–2014

    Directory of Open Access Journals (Sweden)

    Roland Sturm

    2015-09-01

    Full Text Available In the years 2009 to 2014 in the European Statistical System (ESS modified definitions for basic statistical units have been proposed and discussed. The author took part in this discussion as regular participant in the ESS “Working Group Business Registers and Statistical Units”, as participant in the ESSnet “Profiling of large and complex multinational enterprise groups” (2009–2013 and as member of the Eurostat task force “Statistical Units” which worked from 2013 to 2015 on the main issues...

  19. Statistical Verification of Hydraulic Units in a Heterogeneous Reservoir of the Liaohe Oilfield

    Institute of Scientific and Technical Information of China (English)

    Wei Zhou; Shuxian Liang; Desheng Ma; Zhonghua Tang

    2014-01-01

    The Liaohe Oil Field has passed peak production and correct discrimination of hy-draulic units (HU) has vital significance for forecasting remaining oil distribution in a petroleum reservoir, enhancing the recovery ratio and adjusting development plans. A unified multi-parameter cluster analysis and fuzzy quality synthetic evaluations have been used for the identification of res-ervoir hydraulic units. This paper analyzes three predictions within Block Shen-95: intersection of multiple well-logs, independent mulitple well-logs and mutually exclusive multiple well-logs. HU has been delineated to conveniently compute permeability and serve as the basis of a structural model for enhanced simulation study. HU has been defined by the flow zone indicator concept using a modified Kozeny-Carmen equation. The Bayesian method was used to predict HU at uncored wells by constructing a probability database and then integrating established HU and well-log responses at cored wells. HU has then been inferred from the database using well-log responses. Estimated permeability from predicted HU gave an overall improved permeability match when compared with traditional statistical methods. The method proved most favourable when using mutually exclusive multiple well-logs, most significant by integrating reservoir performance with HU distribution and indicating that reasonable prediction had been obtained at uncored wells using this mutually exclu-sive approach. The distribution pattern was revealed by interwell HU correlation using modified depositional cycles as a framework, an integration step that qualitatively examines prediction accu-racy. Detailed analysis has been carried out to determine and verify the characteristics of each kind of flow unit, providing a detailed geological basis for control of the oil field.

  20. Atrial Fibrillation on Intensive Care Unit Admission Independently Increases the Risk of Weaning Failure in Nonheart Failure Mechanically Ventilated Patients in a Medical Intensive Care Unit: A Retrospective Case-Control Study.

    Science.gov (United States)

    Tseng, Yen-Han; Ko, Hsin-Kuo; Tseng, Yen-Chiang; Lin, Yi-Hsuan; Kou, Yu Ru

    2016-05-01

    Atrial fibrillation (AF) is one of the most frequent arrhythmias in clinical practice. Previous studies have reported the influence of AF on patients with heart failure (HF). The effect of AF on the non-HF critically ill patients in a medical intensive care unit (ICU) remains largely unclear. The study aimed to investigate the impact of AF presenting on ICU admission on the weaning outcome of non-HF mechanically ventilated patients in a medical ICU.A retrospective observational case-control study was conducted over a 1-year period in a medical ICU at Taipei Veterans General Hospital, a tertiary medical center in north Taiwan. Non-HF mechanically ventilated patients who were successful in their spontaneous breathing trial and underwent ventilator discontinuation were enrolled. The primary outcome measure was the ventilator status after the first episode of ventilator discontinuation.A total of 285 non-HF patients enrolled were divided into AF (n = 62) and non-AF (n = 223) groups. Compared with the non-AF patients, the AF patients were significantly associated with old age (P = 0.002), a higher rate of acute respiratory distress syndrome causing respiratory failure (P = 0.015), a higher percentage of sepsis before liberation from mechanical ventilation (MV) (P = 0.004), and a higher serum level of blood urea nitrogen on the day of liberation from MV (P = 0.003). Multivariate logistic regression analysis demonstrated that AF independently increased the risk of weaning failure [adjusted odds ratio (AOR), 3.268; 95% confidence interval (CI), 1.254-8.517; P = 0.015]. Furthermore, the AF patients were found to be independently associated with a high rate of ventilator dependence (log rank test, P = 0.026), prolonged total ventilator use (AOR, 1.979; 95% CI, 1.032-3.794; P = 0.040), increased length of ICU stay (AOR, 2.256; 95% CI, 1.049-4.849; P = 0.037), increased length of hospital stay (AOR, 2.921; 95% CI, 1.363-6.260; P = 0

  1. Statistics of Petroleum Exploration in the World Outside the United States and Canada Through 2001

    Science.gov (United States)

    Attanasi, E.D.; Freeman, P.A.; Glovier, Jennifer A.

    2007-01-01

    Future oil and gas supplies depend, in part, on the reserves that are expected to be added through exploration and new discoveries. This Circular presents a summary of the statistics and an analysis of petroleum exploration in the world outside the United States and Canada (the study area) through 2001. It updates U.S. Geological Survey Circular 1096 (by E.D. Attanasi and D.H. Root, 1993) and expands coverage of the statistics to areas where drilling and discovery data have recently become available. These new areas include China, the formerly Communist countries of Eastern Europe, and the countries that once were part of the former Soviet Union in Europe and Asia. Data are presented by country but are organized by petroleum provinces delineated by the U.S. Geological Survey World Energy Assessment Team (USGS Digital Data Series DDS?60, published in 2000). The data and analysis are presented in maps and graphs, providing a visual summary of the exploration maturity of an area. The maps show the delineated prospective areas and explored areas through 2001; explored areas have a drilling density that would rule out the occurrence of undetected large petroleum accumulations. Graphs summarize the exploration yields in terms of cumulative recoverable discovered oil and gas by delineated prospective area. From 1992 through 2001 in areas outside the United States and Canada, the delineated prospective area expanded at a rate of about 50,000 square miles per year while the explored area grew at the rate of about 11,000 square miles per year. The delineated prospective area established by 1970 contains about 75 percent of the oil discovered to date in the study area. This area is slightly less than 40 percent of the delineated prospective area established through 2001. Maps and graphs show the extension of the delineated prospective area to deepwater areas offshore of Brazil and West Africa. From 1991 through 2000, offshore discoveries accounted for 59 percent of the oil

  2. The Correlation Between Candida Colonization of Distinct Body Sites and Invasive Candidiasis in Emergency Intensive Care Units: Statistical and Molecular Biological Analysis.

    Science.gov (United States)

    Li, Zhen; Jiang, Cen; Dong, Danfeng; Zhang, Lihua; Tian, Yuan; Ni, Qi; Mao, Enqiang; Peng, Yibing

    2016-08-01

    Both statistical and molecular biological methods were used to evaluate the association between Candida colonization of different body sites and invasive candidiasis (IC) and analyse the potential infection sources of IC. Candida surveillance cultures from the urine, sputum, rectum and skin were performed on patients admitted to an emergency intensive care units (EICU) of a tertiary care hospital in Shanghai, China, from February 2014 to January 2015. Specimens were collected once a week at admission and thereafter. The patients' clinical data were collected, and Candida isolates were genotyped using polymorphic microsatellite markers. A total of 111 patients were enrolled. Patients with positive urine (23.3 vs. 2.5 %, p = 0.001) and rectal swab (13.6 vs. 0 %, p = 0.010) cultures were more likely to develop IC. However, the risk for IC was not significantly different among patients with and without respiratory (10.0 vs. 5.8 %, p = 0.503) and skin (33.3 vs. 6.5 %, p = 0.056) colonization. Gene microevolution frequently occurred at rectal swab and urine sites, and IC with possible source of infection was caused by rectal isolates (2/7), urine isolates (4/7) and sputum isolate (1/7).The colonization of gut and urinary tract maybe more relevant indicators of IC, which should be taken into consideration when selecting practical body sites for Candida surveillance cultures.

  3. The Eldicus prospective, observational study of triage decision making in European intensive care units : Part I-European Intensive Care Admission Triage Scores

    NARCIS (Netherlands)

    Sprung, Charles L.; Baras, Mario; Iapichino, Gaetano; Kesecioglu, Jozef; Lippert, Anne; Hargreaves, Chris; Pezzi, Angelo; Pirracchio, Romain; Edbrooke, David L.; Pesenti, Antonio; Bakker, Jan; Gurman, Gabriel; Cohen, Simon L.; Wiis, Joergen; Payen, Didier; Artigas, Antonio

    2012-01-01

    Objective: Life and death triage decisions are made daily by intensive care unit physicians. Scoring systems have been developed for prognosticating intensive care unit mortality but none for intensive care unit triage. The objective of this study was to develop an intensive care unit triage decisio

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    with the highest in-hospital mortality were 'dyspnoea' (11.5 %) and 'altered level of consciousness' (10.6 %). More than half of the patients had a Tcomplaint more urgent than Tvitals, the opposite was true in just 6 % of the patients. CONCLUSION: The HAPT system is valid in terms of predicting in......, scored and categorized at admission, that are most strongly associated with the outcome measures. METHODS: The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT) and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category...

  5. Forensic human identification in the United States and Canada: a review of the law, admissible techniques, and the legal implications of their application in forensic cases.

    Science.gov (United States)

    Holobinko, Anastasia

    2012-10-10

    Forensic human identification techniques are successful if they lead to positive personal identification. However, the strongest personal identification is of no use in the prosecution--or vindication--of an accused if the associated evidence and testimony is ruled inadmissible in a court of law. This review examines the U.S. and Canadian legal rulings regarding the admissibility of expert evidence and testimony, and subsequently explores four established methods of human identification (i.e., DNA profiling, forensic anthropology, forensic radiography, forensic odontology) and one complementary technique useful in determining identity, and the legal implications of their application in forensic cases. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Caracterização das internações de dependentes químicos em Unidade de Internação Psiquiátrica do Hospital Geral Characterization of admission of chemical-dependents in a Psychiatric Admission Unit of the General Hospital

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Pereira de Sousa

    2010-05-01

    Full Text Available A Unidade de Internação Psiquiátrica do Hospital Geral (UIPHG é uma proposta articulada ao movimento da reforma psiquiátrica. O objetivo deste estudo foi avaliar os determinantes das internações de dependentes químicos na UIPHG Dr. Estevam, em Sobral (CE. Este estudo foi do tipo documental com abordagem quantitativa, envolvendo 203 clientes que foram internados na UIPHG no período de outubro de 2005 a abril de 2006. Os dados foram coletados por meio de um roteiro adaptado a partir do documento usado no momento da internação. Observou-se predomínio de pacientes do sexo masculino (95,1%, com idade entre 30 e 40 anos (62,5% e solteiros (59,1%. Em 76,3% dos casos, o diagnóstico da internação foi síndrome de abstinência do álcool. Após alta hospitalar, 70% desses clientes foram encaminhados ao CAPS-AD. Esses resultados demonstram quão imprescindíveis são os serviços de saúde mental que enfoquem a problemática do alcoolismo.The Psychiatric Admission Unit of the General Hospital (UIPHG is integrated to the psychiatric reform movement. The aim of this study was to evaluate chemical-dependent's admission causes at the UIPHG Dr. Estevam in the city of Sobral, Ceará State. It was a documental study with a quantitative approach involving 203 patients who were admitted at the UIPGH Dr. Estevam from October 2005 to April 2006. Data were collected from a document filled during admission process in the hospital. 95.1% of the sample was represented by men, age range of 30-40 years (62.5% and single (59.1%. The alcohol withdrawal syndrome was the main admission cause (76.3%. After leaving the hospital, 70% of the sample was conducted to aftercare at CAPS-AD. These results provide preliminary evidence for the need of mental health services emphasizing alcohol dependence problem.

  7. A President Views Admissions.

    Science.gov (United States)

    Morris, John S.

    1983-01-01

    Discusses the changing role of admissions officers which corresponds to the declining student enrollment rate. Looks at changes in higher education over the past 15 years, and considers such issues as marketing, consumerism, and integrity as they relate to college admissions. (WAS)

  8. Flow-units verification, using statistical zonation and application of Stratigraphic Modified Lorenz Plot in Tabnak

    Directory of Open Access Journals (Sweden)

    Seyed Kourosh Mahjour

    2016-06-01

    Full Text Available The relationship between two main reservoir parameters being porosity and permeability, in the carbonate rocks is very complex and obscure. To get a better understanding on flow behavior, the relationship of porosity and permeability of reservoir units, reservoir zonation and flow units were defined. The significance of dividing the sedimentary intervals into flow units reflects groups of rocks that have similar geologic, physical properties and depositional environment that affect fluid flow. Variations in rock properties result from depositional, diagenetic and post-depositional changes. A flow unit is a volume of a reservoir rock that is continuous laterally and vertically and has similar averages of those rock properties that affect fluid flow. Different methods exist for the zonation of reservoirs based on petrophysical data and well logs; among them are: Permeability–Porosity cross plot, Pickett and Soder and Gill methods. In this study, the flow units are determined in Tabnak gas field in South of Iran based on Testerman Zonation Technique and Stratigraphic Modified Lorenz Plot (SMLP methods. For determining these units, conflation of petrophysical data and comparing porosity and permeability of cores are done for verification three wells. By comparing flow-units derived from two methods, it was realized that in permeable zones they have a relatively valid correlation.

  9. The impact of chronic obstructive pulmonary disease on intensive care unit admission and 30-day mortality in patients undergoing colorectal cancer surgery: a Danish population-based cohort study.

    Science.gov (United States)

    Platon, Anna Maria; Erichsen, Rune; Christiansen, Christian Fynbo; Andersen, Lea Kjær; Sværke, Claus; Montomoli, Jonathan; Sørensen, Henrik Toft

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) may increase the risk of postoperative complications and thus mortality after colorectal cancer (CRC) surgery, but the evidence is sparse. We conducted this nationwide population-based cohort study in Denmark, including all patients undergoing CRC surgery in the period 2005-2011, identified through medical databases. We categorised the patients according to the history of COPD. We assessed the rate of complications within 30 days. We computed 30-day mortality among patients with/without COPD using the Kaplan-Meier method. We used Cox regression to compute HRs for death, controlling for age, gender, type of admission, cancer stage, hospital volume, alcohol-related diseases, obesity and Charlson comorbidity score. We identified 18 302 CRC surgery patients. Of these, 7.9% had a prior diagnosis of COPD. Among patients with COPD, 16.1% were admitted postoperatively to the intensive care unit, 1.9% were treated with mechanical ventilation, and 3.6% were treated with non-invasive ventilation. In patients without COPD, the corresponding proportions were 9.7%, 1.1% and 1.1%. The reoperation rate was 10.6% among patients with COPD and 8% among patients with cancer without COPD. 30-day mortality was 13% (95% CI 11.4% to 14.9%) among patients with COPD and 5.3% (95% CI 5.0% to 5.7%) among patients without COPD, corresponding to an adjusted HR of 1.7 (95% CI 1.5 to 2.0). COPD is a strong predictor for intensive care unit admission and mortality after CRC surgery.

  10. Beyond Transitional Probability Computations: Extracting Word-Like Units when Only Statistical Information Is Available

    Science.gov (United States)

    Perruchet, Pierre; Poulin-Charronnat, Benedicte

    2012-01-01

    Endress and Mehler (2009) reported that when adult subjects are exposed to an unsegmented artificial language composed from trisyllabic words such as ABX, YBC, and AZC, they are unable to distinguish between these words and what they coined as the "phantom-word" ABC in a subsequent test. This suggests that statistical learning generates knowledge…

  11. Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance

    NARCIS (Netherlands)

    Peeters, Babette; Jansen, Nicolaas J. G.; Bollen, Casper W.; van Vught, Adrianus J.; van der Heide, Douwe; Albers, Marcel J. I. J.

    2010-01-01

    To compare risk-adjusted mortality of children non-electively admitted during off-hours with risk-adjusted mortality of children admitted during office hours to two pediatric intensive care units (PICUs) without 24-h in-house attendance of senior staff. Prospective observational study, performed bet

  12. United States Air Force Statistical Digest, Fiscal Year 1992/1993 Estimate

    Science.gov (United States)

    1993-01-01

    affairs; general science , space and technology; energy; natural resources and environment; agriculture; commerce and housing credit; transportation...Gen S B Croker Director (Test & Evaluation) Mr C G Jones Director (Space & Strategic InitiatiVe Programs) Maj Gen 0 G Hard .: Director ( SCience ...Brig Gen F D Walker 459th Military Airlift Wing Vacant 514th Military Airlift Wing (Associate) Col J D Copenhaver DIRECT REPORTING UNITS AF District of

  13. Admissible and Restrained Revision

    CERN Document Server

    Booth, R; 10.1613/jair.1874

    2011-01-01

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

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

    Science.gov (United States)

    Michaelson, Martin

    1999-01-01

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

  15. Between Certainty and Uncertainty Statistics and Probability in Five Units with Notes on Historical Origins and Illustrative Numerical Examples

    CERN Document Server

    Laudański, Ludomir M

    2013-01-01

    „Between Certainty & Uncertainty” is a one-of–a-kind short course on statistics for students, engineers  and researchers.  It is a fascinating introduction to statistics and probability with notes on historical origins and 80 illustrative numerical examples organized in the five units:   ·         Chapter 1  Descriptive Statistics:  Compressing small samples, basic averages - mean and variance, their main properties including God’s proof; linear transformations and z-scored statistics .   ·         Chapter 2 Grouped data: Udny Yule’s concept of qualitative and quantitative variables. Grouping these two kinds of data. Graphical tools. Combinatorial rules and qualitative variables.  Designing frequency histogram. Direct and coded evaluation of quantitative data. Significance of percentiles.   ·         Chapter 3 Regression and correlation: Geometrical distance and equivalent distances in two orthogonal directions  as a prerequisite to the concept of two regressi...

  16. Leveraging spatial statistics in the development of an historical narrative for water resources in the Northeast United States

    Science.gov (United States)

    Hoover, J. H.; Brideau, J. M.; Voigt, B. G.; Vorosmarty, C. J.

    2010-12-01

    The complexity of water resource issues in the Northeast United States is engendered by multiple causal factors and interdependent relationships. Here, we present research that utilized spatial statistics to identify coincident areas of statistically high values (spatial autocorrelation) for biophysical variables such as nutrient loading, population growth, water withdrawals and others in the Northeast United States. The goals of this project were to identify sub-regions in the Northeastern United States that were spatially autocorrelated for multiple variables, and to relate these hotspots to social movements in an historical context. The data employed in this research were point (e.g., wastewater treatment plant location) and county level information for socioeconomic, hydrologic, and water usage variables. We used Local Indicators of Spatial Association, a spatial statistic, to identify county clusters of positive spatial autocorrelation for the region. These clusters were simultaneously overlaid onto a single map to identify areas of positive spatial autocorrelation among multiple variables. Preliminary spatial analysis results suggest that, between 1970 and 2000, positive spatial autocorrelation occurred among nutrient loads, wastewater treatment plant construction, population growth, and dam construction in the Chesapeake Bay area. The New York/New Jersey corridor also showed positive spatial autocorrelation among groundwater withdrawals, thermoelectric power generation, population growth, and wastewater treatment plant construction. Additionally, evaluation of these spatial clusters within their historical context suggests a regional linkage between surface water pollution, environmental regulation, and wastewater treatment plant construction. The results of this project indicate that spatial autocorrelation metrics can be employed in the creation of an historical narrative to more comprehensively understand the interplay between regional socioeconomic

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

    Science.gov (United States)

    Harasym, P. H.; And Others

    1995-01-01

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

  18. 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…

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

    Science.gov (United States)

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

    2005-01-01

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

  20. Involuntary admission and treatment

    Directory of Open Access Journals (Sweden)

    Anirudh Kala

    2015-01-01

    Full Text Available Provisions for involuntary admission proposed in the Mental Health Care Bill, which is currently before the parliament, are discussed. Concerns about feasibility and cost-effectiveness of the postadmission judicial review, which is a novel feature in the Indian context, are put forward.

  1. The Admissions Equity Struggle

    Science.gov (United States)

    Freedman, Eric

    2012-01-01

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

  2. United States Air Force Statistical Digest, Fiscal Year 1978. Thirty-Third Edition

    Science.gov (United States)

    1979-05-31

    MEXICO ~ ~o PAR!’ I •.--.UNCLASSIFIED PART I AIR fORCE UNITS AND CAPABILITIES INTRODUCTION...34 1 2!:.- 2 ft6 .IE,...c: .l ali 8𔃻 111.2en ft 80 68 15.3 ~"’ ~ TOTAL lEe 2it3 127.0 !i-e -e 0-21 1 1U75 11077 󈧑.3 2 120󈧗 lUJO ’:!.6 3 11J26 11692...8,293 Arkansa~. 9,1% ~lew Jlamp~hir.. 3,~74 Arizona 16,829 ’I\\’f~".or Jersey. 5,138 Ne’l’ Mexico . 13,976 raliforni a. 53,191 New York. 9,413

  3. Histoplasmosis Statistics

    Science.gov (United States)

    ... Foodborne, Waterborne, and Environmental Diseases Mycotic Diseases Branch Histoplasmosis Statistics Recommend on Facebook Tweet Share Compartir How common is histoplasmosis? In the United States, an estimated 60% to ...

  4. Patient Admission Preferences and Perceptions

    Science.gov (United States)

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

    2015-01-01

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

  5. 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

    The association between unemployment and hospital admission is known, but the causal relationship is still under discussion. The aim of the present analysis is to compare results of a cross-sectional and a cohort approach considering overall hospital admission and hospital admission due to cancer...... 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...

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

    Science.gov (United States)

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

    1997-12-01

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

  7. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Science.gov (United States)

    Mehta, Chitra; Dara, Babita; Mehta, Yatin; Tariq, Ali M.; Joby, George V.; Singh, Manish K.

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643) and morbidity (P = 0.000, AUC = 0.763), comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045). Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study. PMID:27052066

  8. Six temperature and precipitation regimes of the contiguous United States between 1895 and 2010: a statistical inference study

    Science.gov (United States)

    Shen, Samuel S. P.; Wied, Olaf; Weithmann, Alexander; Regele, Tobias; Bailey, Barbara A.; Lawrimore, Jay H.

    2016-07-01

    This paper describes six different temporal climate regimes of the contiguous United States (CONUS) according to interdecadal variations of surface air temperature (SAT) and precipitation using the United States Historical Climatology Network (USHCN) monthly data (Tmax, Tmin, Tmean, and precipitation) from 1895 to 2010. Our analysis is based on the probability distribution, mean, standard deviation, skewness, kurtosis, Kolmogorov-Smirnov (KS) test, and Welch's t test. The relevant statistical parameters are computed from gridded monthly SAT and precipitation data. SAT variations lead to classification of four regimes: 1895-1930 (cool), 1931-1960 (warm), 1961-1985 (cool), and 1986-2010 (warm), while precipitation variations lead to a classification of two regimes: 1895-1975 (dry) and 1976-2010 (wet). The KS test shows that any two regimes of the above six are statistically significantly different from each other due to clear shifts of the probability density functions. Extremes of SAT and precipitation identify the ten hottest, coldest, driest, and wettest years. Welch's t test is used to discern significant differences among these extremes. The spatial patterns of the six climate regimes and some years of extreme climate are analyzed. Although the recent two decades are the warmest among the other decades since 1895 and many hottest years measured by CONUS Tmin and Tmean are in these two decades, the hottest year according to the CONUS Tmax anomalies is 1934 (1.37 °C), which is very close to the second Tmax hottest year 2006 (1.35 °C).

  9. Colonização orofaríngea de crianças à admissão em uma unidade de cuidados intensivos Colonización de la orofaringe de niños admitidos en una unidad de cuidados intensivos pediátricos Children's oropharyngeal colonization upon admission at a pediatric intensive care unit

    Directory of Open Access Journals (Sweden)

    Denise Miyuki Kusahara

    2007-12-01

    ón microbiológico de la colonización orofaríngea de los niños en la admisión a la UCIP, con todo se verificó que los niños portadores de microorganismos patógenos presentaron tiempo de internamiento hospitalario mayor (p=0,020 que aquellos colonizados solamente por especies de la flora normal.Objectives: This study aimed to identify the microbiological oropharyngeal colonization pattern in children admitted at a Pediatric Intensive Care Unit (PICU and to verify the influence of children's and implemented therapies' characteristics before admission at the UCIP on this pattern. Prospective study realized at a PICU of a university hospital. METHODS: Samples of oropharyngeal secretion were obtained in the first 24 hours of the children's admission. Variables related to the children's and the therapies' characteristics were investigated. RESULTS: The majority of the children had normal nutritional state, admitted in the hospital in emergencies situations, with chronic diseases and without alterations in the clinical conditions of the oral cavity. CONCLUSION: The children who were colonized by pathogenic microorganisms presented a longer hospital stay (p=0,020 than those with cultures with normal flora species. The investigated characteristics of the children did not exert any significant influence the microbiological oropharyngeal colonization pattern.

  10. Affirmative action policy in medical school admissions.

    Science.gov (United States)

    Frazer, Ricardo A

    2005-02-01

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

  11. 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.

  12. Impacto da internação em unidade de terapia intensiva pediátrica: avaliação por meio de escalas de desempenho cognitivo e global The impact of admission to a pediatric intensive care unit assessed by means of global and cognitive performance scales

    Directory of Open Access Journals (Sweden)

    Patrícia T. Alievi

    2007-12-01

    Full Text Available OBJETIVO: Avaliar o impacto da internação sobre os desempenhos cognitivo e global em crianças admitidas na unidade de tratamento intensivo (UTI pediátrica do Hospital de Clínicas de Porto Alegre. MÉTODOS: Estudo longitudinal, observacional de amostra seqüencial de crianças gravemente doentes. Foram utilizados os indicadores Pediatric Index of Mortality (PIM, para gravidade e risco de morte na admissão, Pediatric Cerebral Performance Category (PCPC, para morbidade cognitiva, e Pediatric Overall Performance Category (POPC, para morbidade global, na admissão e na alta. Para morbidade relacionada à UTI, foi utilizada a diferença entre as classificações de alta e de admissão (escores delta. Foi empregado o teste de Kruskal-Wallis. RESULTADOS: Foram avaliados 443 pacientes, sendo 54% do sexo masculino, com mediana de idade de 12 meses (IQ 4-45, e mediana de permanência na UTI de 4,24 dias (IQ 2,4-8. A taxa de mortalidade foi de 6,3%. A mediana do PIM foi de 2,36% (IQ 1-7. Na admissão, 46% dos pacientes tinham algum grau de morbidade cognitiva e 66% de morbidade global. Na alta, 60% de morbidade cognitiva e 86% de morbidade global. Na avaliação de morbidade relacionada à UTI, 25% dos pacientes mostraram variação na área cognitiva, enquanto que 41% mostraram variação global na alta em comparação à admissão. CONCLUSÕES: Ainda que influenciado por elevado grau de morbidade na admissão, o impacto da internação na UTI foi mais importante no domínio global do que no cognitivo. Da mesma forma, tanto o risco de morte na admissão quanto o tempo de permanência tiveram efeito significativo na morbidade dos pacientes gravemente doentes.OBJECTIVE: To assess the impact of admission to the pediatric intensive care unit (ICU at the Hospital de Clínicas de Porto Alegre, RS, Brazil on children's cognitive and global performance. METHODS: An observational, longitudinal study of a sequential sample of critically ill children. The

  13. Analysis of the medication reconciliation process conducted at hospital admission

    Directory of Open Access Journals (Sweden)

    María Beatriz Contreras Rey

    2016-07-01

    Full Text Available Objective: To analyze the outcomes of a medication reconciliation process at admission in the hospital setting. To assess the role of the Pharmacist in detecting reconciliation errors and preventing any adverse events entailed. Method: A retrospective study was conducted to analyze the medication reconciliation activity during the previous six months. The study included those patients for whom an apparently not justified discrepancy was detected at admission, after comparing the hospital medication prescribed with the home treatment stated in their clinical hospital records. Those patients for whom the physician ordered the introduction of home medication without any specification were also considered. In order to conduct the reconciliation process, the Pharmacist prepared the best pharmacotherapeutical history possible, reviewing all available information about the medication the patient could be taking before admission, and completing the process with a clinical interview. The discrepancies requiring clarification were reported to the physician. It was considered that the reconciliation proposal had been accepted if the relevant modification was made in the next visit of the physician, or within 24-48 hours maximum; this case was then labeled as a reconciliation error. For the descriptive analysis, the Statistics® SPSS program, version 17.0, was used. Outcomes: 494 medications were reconciled in 220 patients, with a mean of 2.25 medications per patient. More than half of patients (59.5% had some discrepancy that required clarification; the most frequent was the omission of a medication that the patient was taking before admission (86.2%, followed by an unjustified modification in dosing or way of administration (5.9%. In total, 312 discrepancies required clarification; out of these, 93 (29.8% were accepted and considered as reconciliation errors, 126 (40% were not accepted, and in 93 cases (29,8% acceptance was not relevant due to a change in

  14. Polymer micelles with hydrophobic core and ionic amphiphilic corona. 1. Statistical distribution of charged and nonpolar units in corona.

    Science.gov (United States)

    Lysenko, Evgeny A; Kulebyakina, Alevtina I; Chelushkin, Pavel S; Rumyantsev, Artem M; Kramarenko, Elena Yu; Zezin, Alexander B

    2012-12-11

    Polymer micelles with hydrophobic polystyrene (PS) core and ionic amphiphilic corona from charged N-ethyl-4-vinylpyridinium bromide (EVP) and uncharged 4-vinylpyridine (4VP) units spontaneously self-assembled from PS-block-poly(4VP-stat-EVP) macromolecules in mixed dimethylformamide/methanol/water solvent. The fraction of statistically distributed EVP units in corona-forming block is β = [EVP]/([EVP]+[4VP]) = 0.3-1. Micelles were transferred into water via dialysis technique, and pH was adjusted to 9, where 4VP is insoluble. Structural characteristics of micelles were investigated both experimentally and theoretically as a function of corona composition β. Methods of dynamic and static light scattering, electrophoretic mobility measurements, sedimentation velocity, transmission electron microscopy, and UV spectrophotometry were applied. All micelles possessed spherical morphology. The aggregation number, structure, and electrophoretic mobility of micelles changed in a jumplike manner near β ~ 0.6-0.75. Below and above this region, micelle characteristics were constant or insignificantly changed upon β. Theoretical dependencies for micelle aggregation number, corona dimensions, and fraction of small counterions outside corona versus β were derived via minimization the micelle free energy, taking into account surface, volume, electrostatic, and elastic contributions of chain units and translational entropy of mobile counterions. Theoretical estimations also point onto a sharp structural transition at a certain corona composition. The abrupt reorganization of micelle structure at β ~ 0.6-0.75 entails dramatic changes in micelle dispersion stability in the presence of NaCl or in the presence of oppositely charged polymeric (sodium polymethacrylate) or amphiphilic (sodium dodecyl sulfate) complexing agents.

  15. Influence of 2000-2050 climate change on particulate matter in the United States: results from a new statistical model

    Science.gov (United States)

    Shen, Lu; Mickley, Loretta J.; Murray, Lee T.

    2017-03-01

    We use a statistical model to investigate the effect of 2000-2050 climate change on fine particulate matter (PM2. 5) air quality across the contiguous United States. By applying observed relationships of PM2. 5 and meteorology to the IPCC Coupled Model Intercomparision Project Phase 5 (CMIP5) archives, we bypass some of the uncertainties inherent in chemistry-climate models. Our approach uses both the relationships between PM2. 5 and local meteorology as well as the synoptic circulation patterns, defined as the singular value decomposition (SVD) pattern of the spatial correlations between PM2. 5 and meteorological variables in the surrounding region. Using an ensemble of 19 global climate models (GCMs) under the RCP4.5 scenario, we project an increase of 0.4-1.4 µg m-3 in annual mean PM2. 5 in the eastern US and a decrease of 0.3-1.2 µg m-3 in the Intermountain West by the 2050s, assuming present-day anthropogenic sources of PM2. 5. Mean summertime PM2. 5 increases as much as 2-3 µg m-3 in the eastern United States due to faster oxidation rates and greater mass of organic aerosols from biogenic emissions. Mean wintertime PM2. 5 decreases by 0.3-3 µg m-3 over most regions in the United States, likely due to the volatilization of ammonium nitrate. Our approach provides an efficient method to calculate the potential climate penalty on air quality across a range of models and scenarios. We find that current atmospheric chemistry models may underestimate or even fail to capture the strongly positive sensitivity of monthly mean PM2. 5 to temperature in the eastern United States in summer, and they may underestimate future changes in PM2. 5 in a warmer climate. In GEOS-Chem, the underestimate in monthly mean PM2. 5-temperature relationship in the east in summer is likely caused by overly strong negative sensitivity of monthly mean low cloud fraction to temperature in the assimilated meteorology ( ˜ -0.04 K-1) compared to the weak sensitivity implied by satellite

  16. The Interview In Excellent Nursing Before Admission To The Intensive Care Unit%患儿入监护室前访视在优质护理中应用

    Institute of Scientific and Technical Information of China (English)

    李志敏

    2014-01-01

    Objective:To make sure the Interview and application effect in Excellent Nursing.Methods:visiting 654 cases of congenital heart disease in children before admission to the intensive care unit (ICU).Comparing with no visiting 654 cases in feedback form、family breaking, number of conflicts with the staff.Results:the children and their parents after interview improved significantly in feedback form、family breaking、number of conflicts with the staff, significant difference between the two groups (P<0.05).Conclusion:the interview before ICU is an important aspect of high nursing quality, reflecting humanization and individuation, which is suitable for application in clinical nursing.%目的:探讨患儿入监护室前访视在优质护理中应用及效果。方法:对654例先心病患儿进行了入室前访视。反馈表意见、家属私闯监护室、由此引发与医护人员冲突次数与未访视654例比较。结果:访视后患儿家属反馈表满意度、私闯监护室。由此引发与医护人员冲突次数明显改善,两组比较有显著性差异(P<0.05)。结论:患儿入室前访视是监护室体现优质护理的一个重要方面,是人性化与个体化服务理念在监护室中的体现,适合应用于临床护理中。

  17. Predicting the risk for hospital-onset Clostridium difficile infection (HO-CDI) at the time of inpatient admission: HO-CDI risk score.

    Science.gov (United States)

    Tabak, Ying P; Johannes, Richard S; Sun, Xiaowu; Nunez, Carlos M; McDonald, L Clifford

    2015-06-01

    To predict the likelihood of hospital-onset Clostridium difficile infection (HO-CDI) based on patient clinical presentations at admission Retrospective data analysis Six US acute care hospitals Adult inpatients We used clinical data collected at the time of admission in electronic health record (EHR) systems to develop and validate a HO-CDI predictive model. The outcome measure was HO-CDI cases identified by a nonduplicate positive C. difficile toxin assay result with stool specimens collected >48 hours after inpatient admission. We fit a logistic regression model to predict the risk of HO-CDI. We validated the model using 1,000 bootstrap simulations. Among 78,080 adult admissions, 323 HO-CDI cases were identified (ie, a rate of 4.1 per 1,000 admissions). The logistic regression model yielded 14 independent predictors, including hospital community onset CDI pressure, patient age ≥65, previous healthcare exposures, CDI in previous admission, admission to the intensive care unit, albumin ≤3 g/dL, creatinine >2.0 mg/dL, bands >32%, platelets ≤150 or >420 109/L, and white blood cell count >11,000 mm3. The model had a c-statistic of 0.78 (95% confidence interval [CI], 0.76-0.81) with good calibration. Among 79% of patients with risk scores of 0-7, 19 HO-CDIs occurred per 10,000 admissions; for patients with risk scores >20, 623 HO-CDIs occurred per 10,000 admissions (Prisk identification tool for HO-CDI preventive interventions and outcome comparisons.

  18. Community Essay: Toward greater ecological intelligence in the United States: ten statements with statistics and commentary regarding ecolabels

    Directory of Open Access Journals (Sweden)

    Christopher Wedding

    2010-06-01

    Full Text Available Those of us whose careers and personal lives focus on environmental issues do not want to admit any deficiency in ecological intelligence. Unfortunately, we have to face facts, and that includes me, which is part of the reason for writing this essay. Insufficient ecological intelligence results partly because of the phenomenon of information overload, but it is also due to the absence of systems, policies, or sometimes even intentions to make certain pieces of information open and public. Ecolabels are one way to remedy these problems. My own experience with the United States Green Building Council’s green building rating system (Leadership in Energy and Environmental Design and its success as a tool for transforming the building sector has demonstrated that these labeling programs can create massive market change. This essay aims 1 to pull together in one place a wide variety of statistics related to ecological intelligence, 2 to distill ten statements worth consideration regarding ecolabels, and 3 to advance a discussion on the trends, potential, and limitations of ecolabels in order to make doing the right thing by the environment and our health, for both individuals and organizations, much easier than it is now.

  19. Case mix, outcome and activity for patients with severe acute kidney injury during the first 24 hours after admission to an adult, general critical care unit: application of predictive models from a secondary analysis of the ICNARC Case Mix Programme database.

    Science.gov (United States)

    Kolhe, Nitin V; Stevens, Paul E; Crowe, Alex V; Lipkin, Graham W; Harrison, David A

    2008-01-01

    This study pools data from the UK Intensive Care National Audit and Research Center (ICNARC) Case Mix Programme (CMP) to evaluate the case mix, outcome and activity for 17,326 patients with severe acute kidney injury (AKI) occurring during the first 24 hours of admission to intensive care units (ICU). Severe AKI admissions (defined as serum creatinine >/=300 mumol/l and/or urea >/=40 mmol/l during the first 24 hours) were extracted from the ICNARC CMP database of 276,326 admissions to UK ICUs from 1995 to 2004. Subgroups of oliguric and nonoliguric AKI were identified by daily urine output. Data on surgical status, survival and length of stay were also collected. Severity of illness scores and mortality prediction models were compared (UK Acute Physiology and Chronic Health Evaluation [APACHE] II, Stuivenberg Hospital Acute Renal Failure [SHARF] T0, SHARF II0 and the Mehta model). Severe AKI occurred in 17,326 out of 276,731 admissions (6.3%). The source of admission was nonsurgical in 83.7%. Sepsis was present in 47.3% and AKI was nonoliguric in 63.9% of cases. Admission to ICU with severe AKI accounted for 9.3% of all ICU bed-days. Oliguric AKI was associated with longer length of stay for survivors and shorter length of stay for nonsurvivors compared with nonoliguric AKI. Oliguric AKI was associated with significantly greater ICU and hospital mortality (55.8% and 77.3%, respectively) compared with nonoliguric AKI (33.4% and 49.3%, respectively). Surgery during the 1 week before admission or during the first week in the CMP unit was associated with decreased odds of mortality. UK APACHE II and the Mehta scores under-predicted the number of deaths, whereas SHARF T0 and SHARF II0 over-predicted the number of deaths. Severe AKI accounts for over 9% of all bed-days in adult, general ICUs, representing a considerable drain on resources. Although nonoliguric AKI continues to confer a survival benefit, overall survival from AKI in the ICU and survival to leave hospital

  20. Admission criteria and diversity in medical school

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...... 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......-based or attribute-based) had no statistically significant effect on the social diversity of medical students admitted to USD. Discussion: It may be a myth that attribute-based admission widens access and increases social diversity. To the contrary, there is evidence that combining grade-based with attribute...

  1. 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...

  2. 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...

  3. Optimal Admission to Higher Education

    Science.gov (United States)

    Albaek, Karsten

    2017-01-01

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

  4. Pharmacist- versus physician-initiated admission medication reconciliation: impact on adverse drug events.

    Science.gov (United States)

    Mergenhagen, Kari A; Blum, Sharon S; Kugler, Anne; Livote, Elayne E; Nebeker, Jonathan R; Ott, Michael C; Signor, Daniel; Sung, Soojin; Yeh, Jessica; Boockvar, Kenneth S

    2012-08-01

    Medication reconciliation (MR) has proven to be a problematic task for many hospitals to accomplish. It is important to know the clinical impact of physician- versus pharmacist-initiated MR in the resource-limited hospital environment. This quasi-experimental study took place from December 2005 to February 2006 at an urban US Veterans Affairs hospital. MR was implemented on 2 similar general medical units: one received physician-initiated MR and the other received pharmacist-initiated MR. Adverse drug events (ADEs) and a 72-hour medication-prescribing risk score were ascertained by research pharmacists for all admitted patients by structured record review. Multivariable models were tested for intervention effect, accounting for quasi-experimental design and clustered observations, and were adjusted for patient and encounter covariates. Pharmacists completed the MR process in 102 admissions and physicians completed the process in 116 admissions. In completing the MR process, pharmacists documented statistically more admission medication changes than physicians (3.6 vs 0.8; P pharmacist-initiated MR compared with a physician-initiated MR were 1.04 with a 95% CI of 0.53 to 2.0. The adjusted odds of an ADE caused by an admission prescribing change that was a prescribing error with pharmacist-initiated MR compared with a physician-initiated MR were 0.38 with a confidence interval of 0.14 to 1.05. No difference was observed in 72-hour prescribing risk score (coefficient = 0.10; 95% CI, -0.54 to 0.75). MR performed by pharmacists versus physicians was more comprehensive and was followed by lower odds of ADEs from admission prescribing errors but with similar odds of all types of ADEs. Further research is warranted to examine how MR tasks may be optimally divided among clinicians and the mechanisms by which MR affects the likelihood of subsequent ADEs. Published by EM Inc USA.

  5. Forecasting paediatric malaria admissions on the Kenya Coast using rainfall.

    Science.gov (United States)

    Karuri, Stella Wanjugu; Snow, Robert W

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Barbui Corrado

    2006-08-01

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

  7. Admissibility of logical inference rules

    CERN Document Server

    Rybakov, VV

    1997-01-01

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

  8. General Practitioners and Involuntary Admission

    DEFF Research Database (Denmark)

    Jepsen, Britta; Lomborg, Kirsten; Engberg, Marianne

    2010-01-01

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

  9. Influence of ICU-bed availability on ICU admission decisions.

    Science.gov (United States)

    Robert, René; Coudroy, Rémi; Ragot, Stéphanie; Lesieur, Olivier; Runge, Isabelle; Souday, Vincent; Desachy, Arnaud; Gouello, Jean-Paul; Hira, Michel; Hamrouni, Mouldi; Reignier, Jean

    2015-12-01

    The potential influence of bed availability on triage to intensive care unit (ICU) admission is among the factors that may influence the ideal ratio of ICU beds to population: thus, high bed availability (HBA) may result in the admission of patients too well or too sick to benefit, whereas bed scarcity may result in refusal of patients likely to benefit from ICU admission. Characteristics and outcomes of patient admitted in four ICUs with usual HBA, defined by admission refusal rate less than 11 % because of bed unavailability, were compared to patients admitted in six ICUs with usual low bed availability (LBA), i.e., an admission refusal rate higher than 10 % during a 90-day period. Over the 90 days, the mean number of days with no bed available was 30 ± 16 in HBA units versus 48 ± 21 in LBA units (p Bed availability affected triage decisions. Units with HBA trend to admit patients too sick or too well to benefit.

  10. Statistical methods

    CERN Document Server

    Szulc, Stefan

    1965-01-01

    Statistical Methods provides a discussion of the principles of the organization and technique of research, with emphasis on its application to the problems in social statistics. This book discusses branch statistics, which aims to develop practical ways of collecting and processing numerical data and to adapt general statistical methods to the objectives in a given field.Organized into five parts encompassing 22 chapters, this book begins with an overview of how to organize the collection of such information on individual units, primarily as accomplished by government agencies. This text then

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

    Science.gov (United States)

    Harwood, Rowan H; Goldberg, Sarah E; Whittamore, Kathy H; Russell, Catherine; Gladman, John Rf; Jones, Rob G; Porock, Davina; Lewis, Sarah A; Bradshaw, Lucy E; Elliot, Rachel A

    2011-05-13

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

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

    Directory of Open Access Journals (Sweden)

    Gladman John RF

    2011-05-01

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

  13. No evidence of purported lunar effect on hospital admission rates or birth rates.

    Science.gov (United States)

    Margot, Jean-Luc

    2015-01-01

    Studies indicate that a fraction of nursing professionals believe in a "lunar effect"-a purported correlation between the phases of the Earth's moon and human affairs, such as birth rates, blood loss, or fertility. This article addresses some of the methodological errors and cognitive biases that can explain the human tendency of perceiving a lunar effect where there is none. This article reviews basic standards of evidence and, using an example from the published literature, illustrates how disregarding these standards can lead to erroneous conclusions. Román, Soriano, Fuentes, Gálvez, and Fernández (2004) suggested that the number of hospital admissions related to gastrointestinal bleeding was somehow influenced by the phases of the Earth's moon. Specifically, the authors claimed that the rate of hospital admissions to their bleeding unit is higher during the full moon than at other times. Their report contains a number of methodological and statistical flaws that invalidate their conclusions. Reanalysis of their data with proper procedures shows no evidence that the full moon influences the rate of hospital admissions, a result that is consistent with numerous peer-reviewed studies and meta-analyses. A review of the literature shows that birth rates are also uncorrelated to lunar phases. Data collection and analysis shortcomings, as well as powerful cognitive biases, can lead to erroneous conclusions about the purported lunar effect on human affairs. Adherence to basic standards of evidence can help assess the validity of questionable beliefs.

  14. Prognosis of Allogeneic Haematopoietic Stem Cell Recipients Admitted to the Intensive Care Unit

    DEFF Research Database (Denmark)

    Lindgaard, Sidsel Christy; Nielsen, Jonas; Lindmark, Anders

    2016-01-01

    BACKGROUND: Allogeneic haematopoietic stem cell transplantation (HSCT) is a procedure with inherent complications and intensive care may be necessary. We evaluated the short- and long-term outcomes of the HSCT recipients requiring admission to the intensive care unit (ICU). METHODS: We...... ventilation had a statistically significant effect on in-ICU (p = 0.02), 6-month (p = 0.049) and 1-year (p = 0.014) mortality. Renal replacement therapy also had a statistically significant effect on in-hospital (p = 0.038) and 6-month (p = 0.026) mortality. Short ICU admissions, i.e. ... to the ICU was confirmed in our study. Mechanical ventilation, renal replacement therapy and an ICU admission of ≥10 days were each risk factors for mortality in the first year after ICU admission....

  15. A national survey of admission practices for late preterm infants in England

    Science.gov (United States)

    2014-01-01

    Background Infants born at 34+0 to 36+6 weeks gestation are defined as ‘late preterm’ infants. It is not clear whether these babies can be managed on the postnatal ward (PNW) or routinely need to be admitted to the neonatal unit after birth. Aim To conduct a national survey of admission practice for late preterm and low birth weight infants directly to the PNW after birth in England. Methods All neonatal units were identified from the Standardised Electronic Neonatal Database (SEND). Individual units were contacted and data collected on their admission practice. Results All 180 neonatal units in England responded. 49, 84 and 47 Units were Special Care Units (SCUs), Local Neonatal Units (LNUs) and Neonatal Intensive Care Units (NICUs) respectively. 161 units (89%) had written guidelines in relation to direct PNW admission for late preterm infants. The mean gestational age of infants admitted directly to the PNW was significantly lower in LNUs compared to SCUs and NICUs compared to LNUs. Mean birth weight limit for direct PNW admission was significantly lower in NICUs compared to SCUs. 72 units had PNW nursery nurses. There was no significant difference in gestational age or birth weight limit for direct PNW admission in the presence of PNW nursery nurses. Conclusions Admission practices of late preterm infants directly to the PNW varies according to designation of neonatal unit in England. Further studies are needed to establish the factors influencing these differences. PMID:24939510

  16. The admission index in the dental school admissions process.

    Science.gov (United States)

    Staat, R H; Yancey, J M

    1982-08-01

    Preprofessional students' grade point averages (GPAs) and aptitude test scores have been moderately successful in predicting student performance in dental school. The authors attempted to improve the predictability of the school's admission process by combining several preprofessional academic averages and selected nongraded personal attributes into a single Admission Index (AI) score. A Pearson r of 0.67 was found for the relationship between the AI and first-year dental school GPA for University of Louisville dental students accepted into the class of 1984. The correlation coefficient generated from the AI and first-year dental school GPA was markedly superior to those generated by any single predictor. The authors propose that the AI is of value not only for its use in the admission process, but also in the development of an interceptive student monitoring program for the less-qualified student.

  17. Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution Internação breve em unidade de emergência psiquiátrica pode prevenir permanência prolongada em instituições psiquiátricas

    Directory of Open Access Journals (Sweden)

    Régis Eric Maia Barros

    2010-06-01

    Full Text Available OBJECTIVE: Characterize and compare acute psychiatric admissions to the psychiatric wards of a general hospital (22 beds, a psychiatric hospital (80 and of an emergency psychiatry unit (6. METHOD: Survey of the ratios and shares of the demographic, diagnostic and hospitalization variables involved in all acute admissions registered in a catchment area in Brazil between 1998 and 2004. RESULTS: From the 11,208 admissions, 47.8% of the patients were admitted to a psychiatric hospital and 14.1% to a general hospital. The emergency psychiatry unit accounted for 38.1% of all admissions during the period, with a higher variability in occupancy rate and bed turnover during the years. Around 80% of the hospital stays lasted less than 20 days and in almost half of these cases, patients were discharged in 2 days. Although the total number of admissions remained stable during the years, in 2004, a 30% increase was seen compared to 2003. In 2004, bed turnover and occupancy rate at the emergency psychiatry unit increased. CONCLUSION: The increase in the number of psychiatric admissions in 2004 could be attributed to a lack of new community-based services available in the area beginning in 1998. Changes in the health care network did affect the emergency psychiatric service and the limitations of the community-based network could influence the rate of psychiatric admissions.OBJETIVO: Caracterizar e comparar internações psiquiátricas agudas em alas psiquiátricas no hospital geral (22 leitos, hospital psiquiátrico (80 e emergência psiquiátrica (6. MÉTODO: Foram analisadas todas as internações agudas entre 1998 e 2004 na região do estudo, com razões e proporções de variáveis demográficas, diagnósticas e das hospitalizações. RESULTADOS: Das 11.208 internações, 47,8% foram no hospital psiquiátrico e 14,1% no hospital geral. A emergência psiquiátrica realizou 38,1% das internações no período, com grande variabilidade da taxa de ocupa

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

    Science.gov (United States)

    O'Neill, Kathleen A.; And Others

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

  19. 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.

  20. Probabilistic Anonymity and Admissible Schedulers

    CERN Document Server

    Garcia, Flavio D; Sokolova, Ana

    2007-01-01

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

  1. 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....

  2. Hospital mortality is associated with ICU admission time

    NARCIS (Netherlands)

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

    2010-01-01

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

  3. 8 CFR 1101.1 - Presumption of lawful admission.

    Science.gov (United States)

    2010-01-01

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

  4. Coupling Admissions and Curricular Data to Predict Medical Student Outcomes

    Science.gov (United States)

    Sesate, Diana B.; Milem, Jeffrey F.; McIntosh, Kadian L.; Bryan, W. Patrick

    2017-01-01

    The relative impact of admissions factors and curricular measures on the first medical licensing exam (United States Medical Licensing Exam [USMLE] Step 1) scores is examined. The inclusion of first-year and second-year curricular measures nearly doubled the variance explained in Step 1 scores from the amount explained by the combination of…

  5. 78 FR 62415 - Refugee Admissions for Fiscal Year 2014

    Science.gov (United States)

    2013-10-21

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

  6. The Declining Significance of Race in College Admissions Decisions

    Science.gov (United States)

    Grodsky, Eric; Kalogrides, Demetra

    2008-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  8. Admissions Plan Goes beyond Numbers

    Science.gov (United States)

    Hoover, Eric

    2007-01-01

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

  9. College Admissions: Beyond Conventional Testing

    Science.gov (United States)

    Sternberg, Robert J.

    2012-01-01

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

  10. Optimal Admission to Higher Education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    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....

  11. Forecasting paediatric malaria admissions on the Kenya Coast using rainfall

    Directory of Open Access Journals (Sweden)

    Stella Wanjugu Karuri

    2016-02-01

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

  12. Admission Hyperglycemia in Head Injured Patients

    Directory of Open Access Journals (Sweden)

    Yousefzadeh Chabok Sh

    2009-04-01

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

  13. Amphetamine availability and admissions for psychosis in New South Wales, 2001-2009.

    Science.gov (United States)

    Sara, Grant; Burgess, Philip; Malhi, Gin; Whiteford, Harvey

    2011-04-01

    Clinicians have raised concerns about the impact of amphetamines on demand for mental health services. However, evidence for this link is limited. This study explores whether changes in the availability of amphetamines in NSW in the last decade have been associated with variations in admission to mental health units for amphetamine related conditions and for psychoses more generally. The study examined admissions from community settings to NSW acute mental health units from 2000 to 2009. Quarterly rates of hospital admission with primary or comorbid diagnoses of stimulant use disorders, stimulant-induced psychoses and non-drug-related psychoses were compared to quarterly rates of criminal incidents of amphetamine possession and use, which provide an indirect measure of the community availability of amphetamines. Analysis was confounded by increases in mental health beds over the period. Linear regression predicted admission rates on the basis of amphetamine availability, adjusting for changing mental health bed numbers. Amphetamine availability and admissions for psychoses increased steadily from 2000 to a peak in early 2007, but have declined since. Regression models including both amphetamine availability and bed numbers predicted 34% of variation in stimulant use disorders admission rates and 50% of variation in stimulant induced psychoses admission rates. There was no significant effect of amphetamine availability on admissions for schizophrenia and other non-drug-induced psychoses after controlling for changing bed numbers. Increased amphetamine availability appears to have been one factor increasing demand for mental health admission in NSW over the last decade. However, there appears to have been a recent downward trend in both amphetamine availability and amphetamine-related admissions. Policies which reduce the community availability of amphetamines may result in reduced admissions for amphetamine-related mental health conditions, including amphetamine

  14. Allocation and Admission Policies for Service Streams

    CERN Document Server

    Mazzucco, Michele; Fisher, Mike; McKee, Paul

    2011-01-01

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

  15. Toward a Sociology of Law School Admissions.

    Science.gov (United States)

    Erlanger, Howard S.

    1984-01-01

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

  16. Why Do Students Repeat Admissions Tests?

    Science.gov (United States)

    Jones, Martha S.

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

  17. Seasonal variations in hospital admissions for mania

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  18. Admissibility of Linear Systems in Banach Spaces

    Institute of Scientific and Technical Information of China (English)

    GUO Fa-ming

    2005-01-01

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

  19. Estimation and scaling of hydrostratigraphic units: application of unsupervised machine learning and multivariate statistical techniques to hydrogeophysical data

    Science.gov (United States)

    Friedel, Michael J.

    2016-08-01

    Numerical models provide a way to evaluate groundwater systems, but determining the hydrostratigraphic units (HSUs) used in constructing these models remains subjective, nonunique, and uncertain. A three-step machine-learning approach is proposed in which fusion, estimation, and clustering operations are performed on different data sets to arrive at HSUs at different scales. In step one, data fusion is performed by training a self-organizing map (SOM) with sparse borehole hydrogeologic (lithology, hydraulic conductivity, aqueous field parameters, dissolved constituents) and geophysical (gamma, spontaneous potential, and resistivity) measurements. Estimation is handled by iterative least-squares minimization of the SOM quantization and topographical errors. Application of the Davies-Bouldin criteria to k-means clustering of SOM nodes is used to determine the number and location of discontinuous borehole HSUs with low lateral density (based on borehole spacing at 100 s m) and high vertical density (based on cm-scale logging). In step two, a scaling network is trained using the estimated borehole HSUs, airborne electromagnetic measurements, and numerically inverted resistivity profiles. In step three, independent airborne electromagnetic measurements are applied to the scaling network, and the estimation performed to arrive at a set of continuous HSUs with high lateral density (based on sounding locations at meter (m) spacing) and medium vertical density (based on m-layer modeled structure). Performance metrics are used to evaluate each step of the approach. Efficacy of the proposed approach is demonstrated to map local-to-regional scale HSUs using hydrogeophysical data collected at a heterogeneous surficial aquifer in northwestern Nebraska, USA.

  20. Estimation and scaling of hydrostratigraphic units: application of unsupervised machine learning and multivariate statistical techniques to hydrogeophysical data

    Science.gov (United States)

    Friedel, Michael J.

    2016-12-01

    Numerical models provide a way to evaluate groundwater systems, but determining the hydrostratigraphic units (HSUs) used in constructing these models remains subjective, nonunique, and uncertain. A three-step machine-learning approach is proposed in which fusion, estimation, and clustering operations are performed on different data sets to arrive at HSUs at different scales. In step one, data fusion is performed by training a self-organizing map (SOM) with sparse borehole hydrogeologic (lithology, hydraulic conductivity, aqueous field parameters, dissolved constituents) and geophysical (gamma, spontaneous potential, and resistivity) measurements. Estimation is handled by iterative least-squares minimization of the SOM quantization and topographical errors. Application of the Davies-Bouldin criteria to k-means clustering of SOM nodes is used to determine the number and location of discontinuous borehole HSUs with low lateral density (based on borehole spacing at 100 s m) and high vertical density (based on cm-scale logging). In step two, a scaling network is trained using the estimated borehole HSUs, airborne electromagnetic measurements, and numerically inverted resistivity profiles. In step three, independent airborne electromagnetic measurements are applied to the scaling network, and the estimation performed to arrive at a set of continuous HSUs with high lateral density (based on sounding locations at meter (m) spacing) and medium vertical density (based on m-layer modeled structure). Performance metrics are used to evaluate each step of the approach. Efficacy of the proposed approach is demonstrated to map local-to-regional scale HSUs using hydrogeophysical data collected at a heterogeneous surficial aquifer in northwestern Nebraska, USA.

  1. Hospital Transfers of Skilled Nursing Facility (SNF) Patients Within 48 Hours and 30 Days After SNF Admission.

    Science.gov (United States)

    Ouslander, Joseph G; Naharci, Ilkin; Engstrom, Gabriella; Shutes, Jill; Wolf, David G; Rojido, Maria; Tappen, Ruth; Newman, David

    2016-09-01

    Close to 1 in 5 patients admitted to a skilled nursing facility (SNF) are readmitted to the acute hospital within 30 days, and a substantial percentage are readmitted within 2 days of the SNF admission. These rapid returns to the hospital may provide insights for improving care transitions between the acute hospital and the SNF. To describe the characteristics of SNF to hospital transfers that occur within 48 hours and 30 days of SNF admission based on root cause analyses (RCAs) performed by SNF staff, and identify potential areas of focus for improving transitions between hospitals and SNFs. Trained staff from SNFs enrolled in a randomized, controlled clinical trial of the INTERACT (Interventions to Reduce Acute Care Transfers) quality improvement program performed retrospective RCAs on hospital transfers during a 12-month implementation period. SNFs from across the United States. 64 of 88 SNFs randomized to the intervention group submitted RCAs. SNFs were implementing the INTERACT quality improvement program. Data were abstracted from the INTERACT Quality Improvement (QI) tool, a structured, retrospective RCA on hospital transfers. Among 4658 transfers for which data on the time between SNF admission and hospital transfer were available, 353 (8%) occurred within 48 hours of SNF admission, 524 (11%) 3 to 6 days after SNF admission, 1450 (31%) 7 to 29 days after SNF admission, and 2331 (50%) occurred 30 days or longer after admission. Comparisons between transfers that occurred within 48 hours and within 30 days of SNF admission to transfers that occurred 30 days or longer after SNF admission revealed several statistically significant differences between patient risk factors for transfer, symptoms and signs precipitating the transfers, and other characteristics of the transfers. Hospitalization in the last 30 days and year was significantly more common among those with rapid returns to the hospital. Shortness of breath was significantly more common

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

    Directory of Open Access Journals (Sweden)

    Gunther Stephen

    2013-01-01

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

  3. Alcohol Facts and Statistics

    Science.gov (United States)

    ... Standard Drink? Drinking Levels Defined Alcohol Facts and Statistics Print version Alcohol Use in the United States: ... 1245, 2004. PMID: 15010446 11 National Center for Statistics and Analysis. 2014 Crash Data Key Findings (Traffic ...

  4. Neuroendocrine Tumor: Statistics

    Science.gov (United States)

    ... Tumor > Neuroendocrine Tumor: Statistics Request Permissions Neuroendocrine Tumor: Statistics Approved by the Cancer.Net Editorial Board , 11/ ... the United States are diagnosed with Merkel cell skin cancer each year. Almost all people diagnosed with the ...

  5. Data to support statistical modeling of instream nutrient load based on watershed attributes, southeastern United States, 2002

    Science.gov (United States)

    Hoos, Anne B.; Terziotti, Silvia; McMahon, Gerard; Savvas, Katerina; Tighe, Kirsten C.; Alkons-Wolinsky, Ruth

    2008-01-01

    This report presents and describes the digital datasets that characterize nutrient source inputs, environmental characteristics, and instream nutrient loads for the purpose of calibrating and applying a nutrient water-quality model for the southeastern United States for 2002. The model area includes all of the river basins draining to the south Atlantic and the eastern Gulf of Mexico, as well as the Tennessee River basin (referred to collectively as the SAGT area). The water-quality model SPARROW (SPAtially-Referenced Regression On Watershed attributes), developed by the U.S. Geological Survey, uses a regression equation to describe the relation between watershed attributes (predictors) and measured instream loads (response). Watershed attributes that are considered to describe nutrient input conditions and are tested in the SPARROW model for the SAGT area as source variables include atmospheric deposition, fertilizer application to farmland, manure from livestock production, permitted wastewater discharge, and land cover. Watershed and channel attributes that are considered to affect rates of nutrient transport from land to water and are tested in the SAGT SPARROW model as nutrient-transport variables include characteristics of soil, landform, climate, reach time of travel, and reservoir hydraulic loading. Datasets with estimates of each of these attributes for each individual reach or catchment in the reach-catchment network are presented in this report, along with descriptions of methods used to produce them. Measurements of nutrient water quality at stream monitoring sites from a combination of monitoring programs were used to develop observations of the response variable - mean annual nitrogen or phosphorus load - in the SPARROW regression equation. Instream load of nitrogen and phosphorus was estimated using bias-corrected log-linear regression models using the program Fluxmaster, which provides temporally detrended estimates of long-term mean load well

  6. Plague Maps and Statistics

    Science.gov (United States)

    ... and Statistics Recommend on Facebook Tweet Share Compartir Plague in the United States Plague was first introduced ... per year in the United States: 1900-2012. Plague Worldwide Plague epidemics have occurred in Africa, Asia, ...

  7. CDC WONDER: Cancer Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The United States Cancer Statistics (USCS) online databases in WONDER provide cancer incidence and mortality data for the United States for the years since 1999, by...

  8. A prediction model of optimum statistical unit of relief%地形起伏度最佳分析区域预测模型

    Institute of Scientific and Technical Information of China (English)

    张锦明; 游雄

    2013-01-01

    在中国区域内随机选取的78个实验区域的DEM数据作为实验对象,分别进行系列分析区域尺度的地形起伏度计算,建立了基于微观地形特征因子的地形起伏度最佳分析区域预测模型.实验结果表明:相同区域、不同尺度的DEM数据提取的地形起伏度存在差异,DEM尺度相差较小时,地形起伏度的差异也较小;地形起伏度和实验区域的平均高程、区域高程差、平均坡度和平均坡度变化率等地形特征因子存在强相关关系;当置信水平为0.05时,预测模型拟合参数的准确率达到95%以上,证明预测模型可以有效地确定最佳分析区域的取值范围.%In this paper,we uses Digital Elevation Model(DEM) with three different scales in 78 study areas to calculate multiscale relief,and tries to ascertain the evaluation model of relief and to calculate the optimum statistical unit.The experiment result shows that the relief of the same experimental area with different scale exists a certain extent of difference,the smaller difference of the scale,the smaller difference of the relief.There is a strong relationship between the relief and the terrain factors of the experimental area such as the average elevation,the elevation difference,the average slope and the average slope variability.Based on this,we build the prediction model of the relief.We use the prediction model to estimate the scale of optimum statistical unit and the accuracy of the prediction model to fitted parameter is above 95%.The experimental results show that the model can effectively determine the optimum statistical unit of relief.

  9. No Evidence of Purported Lunar Effect on Hospital Admission Rates or Birth Rates

    Science.gov (United States)

    Margot, Jean-Luc

    2015-01-01

    Background Studies indicate that a fraction of nursing professionals believe in a “lunar effect”—a purported correlation between the phases of the Earth’s moon and human affairs, such as birth rates, blood loss, or fertility. Purpose This article addresses some of the methodological errors and cognitive biases that can explain the human tendency of perceiving a lunar effect where there is none. Approach This article reviews basic standards of evidence and, using an example from the published literature, illustrates how disregarding these standards can lead to erroneous conclusions. Findings Román, Soriano, Fuentes, Gálvez, and Fernández (2004) suggested that the number of hospital admissions related to gastrointestinal bleeding was somehow influenced by the phases of the Earth’s moon. Specifically, the authors claimed that the rate of hospital admissions to their bleeding unit is higher during the full moon than at other times. Their report contains a number of methodological and statistical flaws that invalidate their conclusions. Reanalysis of their data with proper procedures shows no evidence that the full moon influences the rate of hospital admissions, a result that is consistent with numerous peer-reviewed studies and meta-analyses. A review of the literature shows that birth rates are also uncorrelated to lunar phases. Conclusions Data collection and analysis shortcomings, as well as powerful cognitive biases, can lead to erroneous conclusions about the purported lunar effect on human affairs. Adherence to basic standards of evidence can help assess the validity of questionable beliefs. PMID:25756232

  10. National surveillance of pandemic influenza A(H1N1) infection-related admissions to intensive care units during the 2009-10 winter peak in Denmark: two complementary approaches

    DEFF Research Database (Denmark)

    Gubbels, S; Perner, A; Valentiner-Branth, Palle

    2010-01-01

    Surveillance of 2009 pandemic influenza A(H1N1) in Denmark was enhanced during the 2009–10 winter season with a system monitoring the burden of the pandemic on intensive care units (ICUs), in order to inform policymakers and detect shortages in ICUs in a timely manner. Between week 46 of 2009...

  11. Study of The Correlation Between World Patenting Trends and The University Admission Rate in Russia Based on Open Data

    OpenAIRE

    Balk Igor; Tishchenko Elena; Ivashchenko Natalia

    2016-01-01

    This paper discusses use of the open PCT patent data and university admission rate to study world technological trends and correlation between industry trends and the student admission rate for government sponsored University programs in Russia. OECD open statistical database and Lomonosov Moscow State University open admission data is used as a data source in this study. ICT and biotechnology industries used as a sample industries to study this correlations.

  12. A Poisson Cluster Stochastic Rainfall Generator That Accounts for the Interannual Variability of Rainfall Statistics: Validation at Various Geographic Locations across the United States

    Directory of Open Access Journals (Sweden)

    Dongkyun Kim

    2014-01-01

    Full Text Available A novel approach for a Poisson cluster stochastic rainfall generator was validated in its ability to reproduce important rainfall and watershed response characteristics at 104 locations in the United States. The suggested novel approach, The Hybrid Model (THM, as compared to the traditional Poisson cluster rainfall modeling approaches, has an additional capability to account for the interannual variability of rainfall statistics. THM and a traditional approach of Poisson cluster rainfall model (modified Bartlett-Lewis rectangular pulse model were compared in their ability to reproduce the characteristics of extreme rainfall and watershed response variables such as runoff and peak flow. The results of the comparison indicate that THM generally outperforms the traditional approach in reproducing the distributions of peak rainfall, peak flow, and runoff volume. In addition, THM significantly outperformed the traditional approach in reproducing extreme rainfall by 2.3% to 66% and extreme flow values by 32% to 71%.

  13. Microwave noise temperature and attenuation of clouds - Statistics of these effects at various sites in the United States, Alaska, and Hawaii

    Science.gov (United States)

    Slobin, S. D.

    1982-01-01

    The microwave attenuation and noise temperature effects of clouds can result in serious degradation of telecommunications link performance, especially for low-noise systems presently used in deep-space communications. Although cloud effects are generally less than rain effects, the frequent presence of clouds will cause some amount of link degradation a large portion of the time. This paper presents a general review of cloud types and their water particle densities, attenuation and noise temperature calculations, and basic link signal-to-noise ratio calculations. Tabular results of calculations for 12 different cloud models are presented for frequencies in the range 10-50 GHz. Curves of average-year attenuation and noise temperature statistics at frequencies ranging from 10 to 90 GHz, calculated from actual surface and radiosonde observations, are given for 15 climatologically distinct regions in the contiguous United States, Alaska, and Hawaii. Nonuniform sky cover is considered in these calculations.

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

    Science.gov (United States)

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

    2004-12-01

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

  15. Assessment of Communications-related Admissions Criteria in a Three-year Pharmacy Program.

    Science.gov (United States)

    Parmar, Jayesh R; Tejada, Frederick R; Lang, Lynn A; Purnell, Miriam; Acedera, Lisa; Ngonga, Ferdinand

    2015-08-25

    To determine if there is a correlation between TOEFL and other admissions criteria that assess communications skills (ie, PCAT variables: verbal, reading, essay, and composite), interview, and observational scores and to evaluate TOEFL and these admissions criteria as predictors of academic performance. Statistical analyses included two sample t tests, multiple regression and Pearson's correlations for parametric variables, and Mann-Whitney U for nonparametric variables, which were conducted on the retrospective data of 162 students, 57 of whom were foreign-born. The multiple regression model of the other admissions criteria on TOEFL was significant. There was no significant correlation between TOEFL scores and academic performance. However, significant correlations were found between the other admissions criteria and academic performance. Since TOEFL is not a significant predictor of either communication skills or academic success of foreign-born PharmD students in the program, it may be eliminated as an admissions criterion.

  16. 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.

  17. Typhoid fever acquired in the United States, 1999–2010: epidemiology, microbiology, and use of a space–time scan statistic for outbreak detection

    Science.gov (United States)

    IMANISHI, M.; NEWTON, A. E.; VIEIRA, A. R.; GONZALEZ-AVILES, G.; KENDALL SCOTT, M. E.; MANIKONDA, K.; MAXWELL, T. N.; HALPIN, J. L.; FREEMAN, M. M.; MEDALLA, F.; AYERS, T. L.; DERADO, G.; MAHON, B. E.; MINTZ, E. D.

    2016-01-01

    SUMMARY Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space–time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space–time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space–time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection. PMID:25427666

  18. Typhoid fever acquired in the United States, 1999-2010: epidemiology, microbiology, and use of a space-time scan statistic for outbreak detection.

    Science.gov (United States)

    Imanishi, M; Newton, A E; Vieira, A R; Gonzalez-Aviles, G; Kendall Scott, M E; Manikonda, K; Maxwell, T N; Halpin, J L; Freeman, M M; Medalla, F; Ayers, T L; Derado, G; Mahon, B E; Mintz, E D

    2015-08-01

    Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space-time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space-time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space-time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection.

  19. Covariate adjusted weighted normal spatial scan statistics with applications to study geographic clustering of obesity and lung cancer mortality in the United States.

    Science.gov (United States)

    Huang, Lan; Tiwari, Ram C; Pickle, Linda W; Zou, Zhaohui

    2010-10-15

    In the field of cluster detection, a weighted normal model-based scan statistic was recently developed to analyze regional continuous data and to evaluate the clustering pattern of pre-defined cells (such as state, county, tract, school, hospital) that include many individuals. The continuous measures of interest are, for example, the survival rate, mortality rate, length of physical activity, or the obesity measure, namely, body mass index, at the cell level with an uncertainty measure for each cell. In this paper, we extend the method to search for clusters of the cells after adjusting for single/multiple categorical/continuous covariates. We apply the proposed method to 1999-2003 obesity data in the United States (US) collected by CDC's Behavioral Risk Factor Surveillance System with adjustment for age and race, and to 1999-2003 lung cancer age-adjusted mortality data by gender in the United States from the Surveillance Epidemiology and End Results (SEER Program) with adjustment for smoking and income.

  20. Identifying the Drivers and Occurrence of Historical and Future Extreme Air-quality Events in the United States Using Advanced Statistical Techniques

    Science.gov (United States)

    Porter, W. C.; Heald, C. L.; Cooley, D. S.; Russell, B. T.

    2013-12-01

    Episodes of air-quality extremes are known to be heavily influenced by meteorological conditions, but traditional statistical analysis techniques focused on means and standard deviations may not capture important relationships at the tails of these two respective distributions. Using quantile regression (QR) and extreme value theory (EVT), methodologies specifically developed to examine the behavior of heavy-tailed phenomena, we analyze extremes in the multi-decadal record of ozone (O3) and fine particulate matter (PM2.5) in the United States. We investigate observations from the Air Quality System (AQS) and Interagency Monitoring of Protected Visual Environments (IMPROVE) networks for connections to meteorological drivers, as provided by the National Center for Environmental Prediction (NCEP) North American Regional Reanalysis (NARR) product. Through regional characterization by quantile behavior and EVT modeling of the meteorological covariates most responsible for extreme levels of O3 and PM2.5, we estimate pollutant exceedance frequencies and uncertainties in the United States under current and projected future climates, highlighting those meteorological covariates and interactions whose influence on air-quality extremes differs most significantly from the behavior of the bulk of the distribution. As current policy may be influenced by air-quality projections, we then compare these estimated frequencies to those produced by NCAR's Community Earth System Model (CESM) identifying regions, covariates, and species whose extreme behavior may not be adequately captured by current models.

  1. [Information Concerning Mean Test Scores for the Graduate Management Admission Test (GMAT), Graduate Record Examinations (GRE), Law School Admission Test (LSAT), Preliminary Scholastic Aptitude Test (PSAT), and Scholastic Aptitude Test (SAT) for the National Commission on Excellence in Education.

    Science.gov (United States)

    Solomon, Robert J.

    Data are provided to the National Commission on Excellence in Education on the Graduate Management Admission Test (GMAT), Graduate Record Examinations (GRE), Law School Admission Test (LSAT), Preliminary Scholastic Aptitude Test (PSAT), and Scholastic Aptitude Test (SAT). Statistics are provided on the following: yearly GMAT mean scores 1965-1966…

  2. Statistics; Tilastot

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    For the year 1997 and 1998, part of the figures shown in the tables of the Energy Review are preliminary or estimated. The annual statistics of the Energy Review appear in more detail from the publication Energiatilastot - Energy Statistics issued annually includes also historical time series over a longer period (see e.g. Energiatilastot 1997, Statistics Finland, Helsinki 1998, ISSN 0784-3165). The inside of the Review`s back cover shows the energy units and the conversion coefficients used for them. Explanatory notes to the statistical tables can be found after tables and figures. The figures presents: Changes in the volume of GNP and energy consumption, Changes in the volume of GNP and electricity, Coal consumption, Natural gas consumption, Peat consumption, Domestic oil deliveries, Import prices of oil, Consumer prices of principal oil products, Fuel prices for heat production, Fuel prices for electricity production, Carbon dioxide emissions, Total energy consumption by source and CO{sub 2}-emissions, Electricity supply, Energy imports by country of origin in January-September 1998, Energy exports by recipient country in January-September 1998, Consumer prices of liquid fuels, Consumer prices of hard coal, Natural gas and indigenous fuels, Average electricity price by type of consumer, Price of district heating by type of consumer, Excise taxes, Value added taxes and fiscal charges and fees included in consumer prices of some energy sources, Energy taxes and precautionary stock fees, pollution fees on oil products

  3. Statistics; Tilastot

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    For the year 1997 and 1998, part of the figures shown in the tables of the Energy Review are preliminary or estimated. The annual statistics of the Energy Review appear in more detail from the publication Energiatilastot - Energy Statistics issued annually includes also historical time series over a longer period (see e.g. Energiatilastot 1996, Statistics Finland, Helsinki 1997, ISSN 0784-3165). The inside of the Review`s back cover shows the energy units and the conversion coefficients used for them. Explanatory notes to the statistical tables can be found after tables and figures. The figures presents: Changes in the volume of GNP and energy consumption, Changes in the volume of GNP and electricity, Coal consumption, Natural gas consumption, Peat consumption, Domestic oil deliveries, Import prices of oil, Consumer prices of principal oil products, Fuel prices for heat production, Fuel prices for electricity production, Carbon dioxide emissions, Total energy consumption by source and CO{sub 2}-emissions, Electricity supply, Energy imports by country of origin in January-June 1998, Energy exports by recipient country in January-June 1998, Consumer prices of liquid fuels, Consumer prices of hard coal, Natural gas and indigenous fuels, Average electricity price by type of consumer, Price of district heating by type of consumer, Excise taxes, Value added taxes and fiscal charges and fees included in consumer prices of some energy sources, Energy taxes and precautionary stock fees, pollution fees on oil products

  4. A doença oncológica não deve ser um fator limitante para admissão na UTI de pacientes submetidos a cirurgias de alto risco Cancer disease should not be a limitative factor for admission of high risk surgical patients to an intensive care unit

    Directory of Open Access Journals (Sweden)

    Cristina P. Amendola

    2006-09-01

    study. 43 were oncologic and 76 were non-oncologic. 52.9% were female. Mean age was 65.1 ± 14.1 years. Mean APACHE II score was 16.5 ± 5.8 and MODS median was 3 (2-6. Median length of surgery was 5 (3.3-7 hours and ICU and hospital mortality were 10.9% and 25.2%, respectively. Oncologic patients had greater length of hospital stay and length of stay before surgery. These results were statistically significant. Hospital mortality of oncologic patients was not greater than non-oncologic patients (22.4% versus 30.2%, p = 0.32. CONCLUSIONS: In this series, oncologic patients submitted to high risk surgery had the same mortality rate as non-onconlogic patients with similar disease severity.

  5. Variations in admission practices for adolescents with anorexia nervosa: a North American sample.

    Science.gov (United States)

    Schwartz, Beth I; Mansbach, Jonathan M; Marion, Jenna G; Katzman, Debra K; Forman, Sara F

    2008-11-01

    The purpose of this study was to assess the variability in admission practices and medical inpatient care for adolescent patients with anorexia nervosa (AN). Participants consisted of members of the 2001-2003 Eating Disorder Special Interest Group from the Society for Adolescent Medicine who completed a structured telephone interview about their admission practices and patterns of inpatient care for teens with AN. Questions focused on admission threshold for heart rate (HR), percentage of ideal body weight (% IBW), and refeeding protocols. Case vignettes were used. Of 95 eligible practitioners, 51 (53%) agreed to participate. Participants represented 25 American states, one Canadian province, and 45 different adolescent programs. The majority of physicians reported they would hospitalize an AN patient with HR practices based on number of years in practice, gender of physician, or practice setting. Regional differences in admission practices were noted, with physicians in the western United States less likely to admit patients with HR >or=40 beats per minute (p = .018). Physicians described 28 different methods of advancing a diet during an admission. Only 37% of physicians were aware of a standardized refeeding protocol in their institution. This study indicates variability in admission criteria and refeeding practices and shows evidence of geographic variations of admission standards. These data provide a baseline for outcome trials investigating medical admissions for adolescents with AN.

  6. Assessment and statistical modeling of the relationship between remotely sensed aerosol optical depth and PM2.5 in the eastern United States.

    Science.gov (United States)

    Paciorek, Christopher J; Liu, Yang

    2012-05-01

    Research in scientific, public health, and policy disciplines relating to the environment increasingly makes use of high-dimensional remote sensing and the output of numerical models in conjunction with traditional observations. Given the public health and resultant public policy implications of the potential health effects of particulate matter (PM*) air pollution, specifically fine PM with an aerodynamic diameter contributing a second likelihood to a Bayesian statistical model, as well as a data source on which we could directly regress. Previous consideration of satellite AOD has largely focused on the National Aeronautics and Space Administration (NASA) moderate resolution imaging spectroradiometer (MODIS) and multiangle imaging spectroradiometer (MISR) instruments. One contribution of our work is more extensive consideration of AOD derived from the Geostationary Operational Environmental Satellite East Aerosol/Smoke Product (GOES GASP) AOD and its relationship with PM2.5. In addition to empirically assessing the spatiotemporal relationship between GASP AOD and PM2.5, we considered new statistical techniques to screen anomalous GOES reflectance measurements and account for background surface reflectance. In our statistical work, we developed a new model structure that allowed for more flexible modeling of the proxy discrepancy than previous statistical efforts have had, with a computationally efficient implementation. We also suggested a diagnostic for assessing the scales of the spatial relationship between the proxy and the spatial process of interest (e.g., PM2.5). In brief, we had little success in improving predictions in our eastern-United States domain for use in epidemiologic applications. We found positive correlations of AOD with PM2.5 over time, but less correlation for long-term averages over space, unless we used calibration that adjusted for large-scale discrepancy between AOD and PM2.5 (see sections 3, 4, and 5). Statistical models that combined

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  8. Assessing the need for hospital admission by the Cape Triage discriminator presentations and the simple clinical score.

    LENUS (Irish Health Repository)

    Emmanuel, Andrew

    2010-11-01

    There is uncertainty about how to assess unselected acutely ill medical patients at the time of their admission to hospital. This study examined the use of the Simple Clinical Score (SCS) and the medically relevant Cape Triage discriminator clinical presentations to determine the need for admission to an acute medical unit.

  9. The Effectiveness of Traditional Admissions Criteria in Predicting College and Graduate Success for American and International Students

    Science.gov (United States)

    Fu, Yanfei

    2012-01-01

    This study examines the effectiveness of traditional admissions criteria, including prior GPA, SAT, GRE, and TOEFL in predicting undergraduate and graduate academic success for American and international students at a large public university in the southwestern United States. Included are the admissions and enrollment data for 25,017 undergraduate…

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

    Science.gov (United States)

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

    2013-11-01

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

  11. A statistical analysis of dam removals in the United States of America%美国拆坝统计分析

    Institute of Scientific and Technical Information of China (English)

    李翠; 王晓玥

    2015-01-01

    The information found from researches regarding 1 093 removed dams across the United States from 1921 to 2013 is summarized. This paper analyzes information by the number, size, material and age of the removed dams and three primary dam removal purposes including environmental restora-tion, safety concerns, and economic considerations. The statistical results show that the dam removal phenomenon has existed for years and up to now the removed dams in the United States are small, low-head, aging and deteriorating dams. Dams that contribute a lot to the nation's economy are not removed at all, instead they get constant maintenance. Dams still form an integral part that makes great contribu-tion to the collective economy and social welfare.%对美国1921~2013年共计1 093座水坝拆除进行了信息统计,从拆坝数量、大坝规模、筑坝材料、坝龄等方面系统分析了美国拆坝现状,并从生态、经济、安全方面分析拆坝的主要原因.统计结果表明水坝拆除现象在美国一直存在,且至今为止美国所拆除的主要为小型水坝、旧坝、病险坝.对美国经济发展有重要影响的水坝不仅未被拆除,还不断得到维护,水坝在美国的经济和社会发展中仍贡献着重要力量.

  12. Unethical Admissions: Academic Integrity in Question.

    Science.gov (United States)

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

    2016-11-28

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

  13. The ageing society and emergency hospital admissions.

    Science.gov (United States)

    Wittenberg, Raphael; Sharpin, Luke; McCormick, Barry; Hurst, Jeremy

    2017-08-01

    There is strong policy interest, in England as elsewhere, in slowing the growth in emergency hospital admissions, which for older people increased by 3.3% annually between 2001/2 and 2012/3. Resource constrains have increased the importance of understanding rising emergency admissions, which in policy discourse is often explained by population aging. This study examines how far the rise in emergency admissions of people over 65 was due to population ageing, how far to the changing likelihood of entering hospital at each age, and how far to other factors which might be more amenable to policy measures. It shows that: admission rates rose with age from age 40 upward but each successive birth cohort experienced lower emergency admission rates after standardising for age and other effects. This downward cohort effect largely offset the consequences of an older and larger population aged over 65. Other factors which could explain increasing admissions, such as new technologies or rising expectations, appear more important than the changing size and age structure of the population as drivers of rising emergency admissions in old age. These findings suggest that stemming the rate of increase in emergency admissions of older people may be feasible, if challenging, despite population ageing. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Parental Involvement in Admissions and Financial Aid.

    Science.gov (United States)

    Lange, Douglas K.; Stone, Michael E.

    2001-01-01

    Admissions and financial aid offices are the initial point of interaction for many parents of college students. Highlights several recent trends in higher education, including the expanding use of technology and a growing consumerism, and how these forces reshape the work of admissions and financial aid professionals. (Contains 21 references.)…

  15. Admission to Law School: New Measures

    Science.gov (United States)

    Shultz, Marjorie M.; Zedeck, Sheldon

    2012-01-01

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

  16. A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Last Bob F

    2009-10-01

    Full Text Available Abstract Aim To study the prevalence of posttraumatic stress disorder (PTSD, anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems. Methods This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115, anxiety and depression (n = 128 questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems. Results Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD. Conclusion A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being.

  17. National surveillance of pandemic influenza A(H1N1) infection-related admissions to intensive care units during the 2009-10 winter peak in Denmark: two complementary approaches

    DEFF Research Database (Denmark)

    Gubbels, S; Perner, A; Valentiner-Branth, Palle

    2010-01-01

    Surveillance of 2009 pandemic influenza A(H1N1) in Denmark was enhanced during the 2009–10 winter season with a system monitoring the burden of the pandemic on intensive care units (ICUs), in order to inform policymakers and detect shortages in ICUs in a timely manner. Between week 46 of 2009...... and week 11 of 2010, all 36 relevant Danish ICUs reported in two ways: aggregate data were reported online and case-based data on paper. Cases to be reported were defined as patients admitted to an ICU with laboratory-confirmed 2009 pandemic influenza A(H1N1) infection or clinically suspected illness after......, of whom 53 were laboratory confirmed. The proportion of beds used for influenza patients did not exceed 4.5% of the national capacity. Hospitals with cases used a median of 11% of bed capacity (range: 3–40%). Of the patients for whom information was available, 15 of 48 patients developed renal...

  18. A Logical Characterization of Iterated Admissibility

    CERN Document Server

    Halpern, Joseph Y

    2009-01-01

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

  19. A combined dynamical and statistical downscaling technique to reduce biases in climate projections: an example for winter precipitation and snowpack in the western United States

    Science.gov (United States)

    Li, R.; Wang, S.-Y.; Gillies, R. R.

    2016-04-01

    Large biases associated with climate projections are problematic when it comes to their regional application in the assessment of water resources and ecosystems. Here, we demonstrate a method that can reduce systematic biases in regional climate projections. The global and regional climate models employed to demonstrate the technique are the Community Climate System Model (CCSM) and the Weather Research and Forecasting (WRF) model. The method first utilized a statistical regression technique and a global reanalysis dataset to correct biases in the CCSM-simulated variables (e.g., temperature, geopotential height, specific humidity, and winds) that are subsequently used to drive the WRF model. The WRF simulations were conducted for the western United States and were driven with (a) global reanalysis, (b) original CCSM, and (c) bias-corrected CCSM data. The bias-corrected CCSM data led to a more realistic regional climate simulation of precipitation and associated atmospheric dynamics, as well as snow water equivalent (SWE), in comparison to the original CCSM-driven WRF simulation. Since most climate applications rely on existing global model output as the forcing data (i.e., they cannot re-run or change the global model), which often contain large biases, this method provides an effective and economical tool to reduce biases in regional climate downscaling simulations of water resource variables.

  20. Injury Statistics

    Science.gov (United States)

    ... Certification Import Safety International Recall Guidance Civil and Criminal Penalties Federal Court Orders & Decisions Research & Statistics Research & Statistics Technical Reports Injury Statistics NEISS Injury ...

  1. Cosmic Statistics of Statistics

    OpenAIRE

    Szapudi, I.; Colombi, S.; Bernardeau, F.

    1999-01-01

    The errors on statistics measured in finite galaxy catalogs are exhaustively investigated. The theory of errors on factorial moments by Szapudi & Colombi (1996) is applied to cumulants via a series expansion method. All results are subsequently extended to the weakly non-linear regime. Together with previous investigations this yields an analytic theory of the errors for moments and connected moments of counts in cells from highly nonlinear to weakly nonlinear scales. The final analytic formu...

  2. Inappropriate hospital admissions: patient participation in research.

    Science.gov (United States)

    Glasby, J; Littlechild, R

    Although political interest in reducing the number of inappropriate hospital admissions is mounting, methods for researching the rate of inappropriate admissions have several major limitations. Whereas traditional studies have tended to be predominantly subjective, more recent studies using clinical review instruments also have a number of limitations. Chief among these is the failure to consider the potential input of the individual patient. To illustrate some of the possible benefits of patient participation, this article cites findings from a study in Birmingham, which sought to involve individual older people in a research study into emergency hospital admissions.

  3. A COMBINED ADMISSION CONTROL ALGORITHM WITH DA PROTOCOL FOR SATELLITE ATM NETWORKS

    Institute of Scientific and Technical Information of China (English)

    Lu Rong; Cao Zhigang

    2006-01-01

    Admission control is an important strategy for Quality of Service (QoS) provisioning in Asynchronous Transfer Mode (ATM) networks. Based on a control-theory model of resources on-Demand Allocation (DA) protocol, the paper studies the effect of the protocol on the statistical characteristics of network traffic,and proposes a combined connection admission control algorithm with the DA protocol to achieve full utilization of link resources in satellite communication systems. The proposed algorithm is based on the cross-layer-design approach. Theoretical analysis and system simulation results show that the proposed algorithm can admit more connections within certain admission thresholds than one that does not take into account the DA protocol. Thus, the proposed algorithm can increase admission ratio of traffic sources for satellite ATM networks and improve satellite link utilization.

  4. Correlation of admissions criteria with academic performance in dental students.

    Science.gov (United States)

    Curtis, Donald A; Lind, Samuel L; Plesh, Octavia; Finzen, Frederick C

    2007-10-01

    Our purpose was to compare admissions criteria as predictors of dental school performance in underachieving and normally tracking dental students. Underachieving dental students were identified by selecting ten students with the lowest class grade point average following the first year of dental school from five classes, resulting in a pool of fifty students. Normally tracking students served as a control and were randomly selected from students who had completed their first year of dental school not in the underachieving group. Admission measures of college grade point average (GPA), science grade point average (SGPA), academic average (AA), Perceptual Ability Test (PAT), college rigor, and academic load in college were evaluated with descriptive statistics, correlation, and regression analysis with first-year and graduating GPA as the dependent variables. Admissions criteria were generally weak predictors of first-year and graduating GPA. However, first-year dental school GPA was a strong predictor (R(2)=0.77) of graduating GPA for normally tracking students and a moderate predictor (R(2)=0.58) for underachieving students. Students who completed the first year of dental school having a low GPA tended to graduate with a low GPA. Therefore, remediation and monitoring would be important during the dental school experience for these students.

  5. The full moon and admission to emergency rooms

    Directory of Open Access Journals (Sweden)

    Zargar Moosa

    2004-05-01

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

  6. The full moon and admission to emergency rooms.

    Science.gov (United States)

    Zargar, Moosa; Khaji, Ali; Kaviani, Ahmad; Karbakhsh, Mojgan; Yunesian, Masud; Abdollahi, Morteza

    2004-05-01

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

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

    Science.gov (United States)

    Senanayake, H; Dias, T; Jayawardena, A

    2013-12-01

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

  8. Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study

    Science.gov (United States)

    Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling; Andersen, Per Kragh; Giacco, Domenico; Nordentoft, Merete

    2016-01-01

    Introduction Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled hospital admission on the use of coercion and of healthcare services. Design and methods We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare the use of coercive measures and of healthcare services, the use of medications and suicidal behaviour. Descriptive statistics will be used to investigate hospitalisations, global assessment of functioning (GAF) and patient satisfaction with treatment. To minimise selection bias, we will match individuals using patient-controlled hospital admission and controls with a 1:5 ratio via a propensity score based on the following factors: sex, age group, primary diagnosis, substance abuse as secondary diagnosis, coercion, number of psychiatric bed days, psychiatric history, urbanity and suicidal behaviour. Additionally, a historical control study will be undertaken in which patients serve as their own control group prior to index date. Ethics and dissemination The study has been approved by The Danish Health and Medicines Authority (j.nr.: 3-3013-934/1/) and by The Danish Data Protection Agency (j.nr.: 2012-58-0004). The study was categorised as a register study by The Danish Health Research Ethics Committee and therefore no further approval was needed (j.nr.: H-2-2014-FSP70

  9. First Nations Pneumonia Admissions: Different Patients or Different Attitudes?

    Directory of Open Access Journals (Sweden)

    NR Anthonisen

    2004-01-01

    Full Text Available In this issue of the Canadian Respiratory Journal, Marrie et al (pages 336-342 present a database study of hospital admissions among First Nation Aboriginals (FNAs in Alberta that is fascinating, at least to me. They captured all hospital admissions for "status" FNAs from 1997 to 1999, along with data on where and how long they were hospitalized, the severity of the pneumonia, the number of comorbidities present, whether they were readmitted and the costs involved. They compared these finding with a group of age- and sex-matched non-FNAs who were also hospitalized for pneumonia. There are, of course, weaknesses in the study that commonly occur in most exercises using administrative databases. Pneumonia is a hospital record diagnosis (there is no information about chest x-rays, sputum cultures, etc. Pneumonia severity assessment relies on information regarding hospital transfers, intensive care unit admissions and events such as shock, artificial ventilation and death (there is no information available to apply an accepted grading system (1. Further, "status" FNAs were probably not entirely representative of FNAs in general; indeed, some nonstatus FNAs may well have been included in the control group. However, I strongly doubt that these or similar objections are substantial enough to greatly influence the findings of Marrie et al.

  10. Every seventh acute medical admission is preventable

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  11. The Parent Role in College Admission.

    Science.gov (United States)

    Krugman, Mary K.

    1990-01-01

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

  12. Test-Based Admission to Selective Universities:

    DEFF Research Database (Denmark)

    Thomsen, Jens-Peter

    2016-01-01

    not favour first-generation students; further, the system serves as an access route for low-achieving children from the privileged professional classes. Drawing mainly on theories in the social closure tradition, I argue that children with highly educated parents will be favoured when qualitative merits......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...... in the social gradient in the primary admission system, admitting students on the basis of their high school grade point average, and in the secondary admission system, admitting university students based on more qualitative assessments. I find that the secondary higher education admission system does...

  13. Admissible Strategies in Semimartingale Portfolio Selection

    CERN Document Server

    Biagini, Sara

    2009-01-01

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

  14. Call Admission Control in Mobile Cellular Networks

    CERN Document Server

    Ghosh, Sanchita

    2013-01-01

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

  15. 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

    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......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...... 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...

  16. Drug related hospital admissions. Results from an intervention program

    DEFF Research Database (Denmark)

    Hallas, J.; Harvald, B.; Worm, J.

    1994-01-01

    Farmakologi, drug education, hospital admission, adverse drug reactions, drug utilisation, intervention......Farmakologi, drug education, hospital admission, adverse drug reactions, drug utilisation, intervention...

  17. Every seventh acute medical admission is preventable

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  18. Every seventh acute medical admission is preventable

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  19. Ehrlichiosis: Statistics and Epidemiology

    Science.gov (United States)

    ... a tick Diseases transmitted by ticks Statistics and Epidemiology Recommend on Facebook Tweet Share Compartir On this ... Holman RC, McQuiston JH, Krebs JW, Swerdlow DL. Epidemiology of human ehrlichiosis and anaplasmosis in the United ...

  20. An audit of unplanned postoperative intensive care unit admissions ...

    African Journals Online (AJOL)

    2009-07-23

    Jul 23, 2009 ... operating theatres and ICU resource management,1 including quality ... Department of Anaesthesia, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu,. Nigeria .... more a global indicator of the safety of surgical care.

  1. The most frequent nursing diagnoses in a gynecological admission unit

    OpenAIRE

    Maria Helena Baena de Moraes Lopes; Édina Tavares de Lima Montagnoli; Celi Aparecida Thiago Maia

    1999-01-01

    Nosso objetivo foi identificar os diagnósticos de enfermagem mais freqüentes numa unidade de internação ginecológica. A partir do histórico de enfermagem e do prontuário de 30 pacientes foram levantadas retrospectivamente as características definidoras e, com estas, os diagnósticos de enfermagem, segundo a taxionomia I revisada da NANDA. Os cinco diagnósticos de enfermagem mais freqüentes foram: risco para infecção (30 casos); risco para dor (24 casos); comportamento para elevar nível de saúd...

  2. ADMISSIONS FOR CERVICAL LYMPHADENITIS IN A GENERAL PAEDIATRICS UNIT

    Directory of Open Access Journals (Sweden)

    David Lito

    2016-09-01

    Conclusion: Aetiology identification for CL can be challenging. Although the majority of children with CL can be managed in an outpatient setting, there are cases that require in-hospital diagnostic investigation or intensive care. Since Portugal presents a medium incidence of tuberculosis, clinicians should maintain a high -level of suspicion for the emergence of multiresistant M. tuberculosis.

  3. Variation in outcomes in Veterans Affairs intensive care units with a computerized severity measure.

    Science.gov (United States)

    Render, Marta L; Kim, H Myra; Deddens, James; Sivaganesin, Siva; Welsh, Deborah E; Bickel, Karen; Freyberg, Ron; Timmons, Stephen; Johnston, Joseph; Connors, Alfred F; Wagner, Douglas; Hofer, Timothy P

    2005-05-01

    To quantify the variability in risk-adjusted mortality and length of stay of Veterans Affairs intensive care units using a computer-based severity of illness measure. Retrospective cohort study. A stratified random sample of 34 intensive care units in 17 Veterans Affairs hospitals. A consecutive sample of 29,377 first intensive care unit admissions from February 1996 through July 1997. Standardized mortality ratio (observed/expected deaths) and observed minus expected length of stay (OMELOS) with 95% confidence intervals were estimated for each unit using a hierarchical logistic (standardized mortality ratio) or linear (OMELOS) regression model with Markov Chain Monte Carlo simulation. We adjusted for patient characteristics including age, admission diagnosis, comorbid disease, physiology at admission (from laboratory data), and transfer status. Mortality across the intensive care units for the 12,088 surgical and 17,289 medical cases averaged 11% (range, 2-30%). Length of stay in the intensive care units averaged 4.0 days (range, mean unit length of stay 3.0-5.9). Standardized mortality ratio of the intensive care units varied from 0.62 to 1.27; the standardized mortality ratio and 95% confidence interval were units and >1.0 for seven intensive care units. OMELOS of the intensive care units ranged from -0.89 to 1.34 days. In a random slope hierarchical model, variation in standardized mortality ratio among intensive care units was similar across the range of severity, whereas variation in length of stay increased with severity. Standardized mortality ratio was not associated with OMELOS (Pearson's r = .13). We identified intensive care units whose indicators for mortality and length of stay differ substantially using a conservative statistical approach with a severity adjustment model based on data available in computerized clinical databases. Computerized risk adjustment employing routinely available data may facilitate research on the utility of intensive care

  4. Spreading a Medical Home Redesign: Effects on Emergency Department Use and Hospital Admissions

    Science.gov (United States)

    Reid, Robert J.; Johnson, Eric A.; Hsu, Clarissa; Ehrlich, Kelly; Coleman, Katie; Trescott, Claire; Erikson, Michael; Ross, Tyler R.; Liss, David T.; Cromp, DeAnn; Fishman, Paul A.

    2013-01-01

    PURPOSE The patient-centered medical home (PCMH) is being rapidly deployed in many settings to strengthen US primary care, improve quality, and control costs; however, evidence supporting this transformation is still lacking. We describe the Group Health experience in attempting to replicate the effects on health care use seen in a PCMH prototype clinic via a systemwide spread using Lean as the change strategy. METHODS We used an interrupted time series analysis with a patient-month unit of analysis over a 4-year period that included baseline, implementation, and stabilization periods for 412,943 patients. To account for secular trends across these periods, we compared changes in use of face-to-face primary care visits, emergency department visits, and inpatient admissions with those of a nonequivalent comparison group of patients served by community network practices. RESULTS After accounting for secular trends among network patients, patients empaneled to the PCMH clinics had 5.1% and 6.7% declines in primary care office visits in early and later stabilization years, respectively, after the implementation year. This trend was accompanied by a 123% increase in the use of secure electronic message threads and a 20% increase in telephone encounters. Declines were also seen in emergency department visits at 1 and 2 years (13.7% and 18.5%) compared with what would be expected based on secular trends in network practices. No statistically significant changes were found for hospital admissions. CONCLUSIONS The Group Health experience shows it is possible to reduce emergency department use with PCMH transformation across a diverse set of clinics using a clear change strategy (Lean) and sufficient resources and supports. PMID:23690382

  5. Safety of Outpatient Total Ankle Arthroplasty vs Traditional Inpatient Admission or Overnight Observation.

    Science.gov (United States)

    Mulligan, Ryan P; Parekh, Selene G

    2017-08-01

    Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control. The medical records of patients who underwent TAA with 1 fellowship-trained orthopedic foot and ankle surgeon were reviewed. Outcome measures included operative complications, adverse medical events, readmission or emergency room visit for any reason, or reoperation within 90 days following surgery; surgeon's office contact before first postoperative visit regarding pain or other issues; visual analog scale pain score at the first postoperative visit; and need for narcotic refill. Outcomes were assessed by admission status: outpatient, overnight observation, or inpatient admission. Standard statistical analysis was used, and P rate was seen among groups ( P = .01) but not rate of readmission or reoperation. Of 16 patients, 5 (31%) who were admitted for 2 or more nights following surgery had a complication, as opposed to 3 of 65 (5%) who were outpatient or admitted overnight ( P = .01). There were no differences in frequency of postoperative phone calls, narcotic refills, or visual analog scale pain scores at the first postoperative visit. There were no adverse medical events. With proper instruction, TAA was performed safely in the outpatient setting. As health care policy continues to evolve in the United States, safe and efficient practices will remain a priority. Level III, retrospective comparative study.

  6. Changes in NHS organization of care and management of hospital admissions with COPD exacerbations between the national COPD audits of 2003 and 2008.

    Science.gov (United States)

    George, P M; Stone, R A; Buckingham, R J; Pursey, N A; Lowe, D; Roberts, C M

    2011-10-01

    The 2003 UK Chronic Obstructive Pulmonary Disease (COPD) audit revealed wide variability between hospital units in care delivered. To assess whether processes of care, patient outcomes and organization of care have improved since 2003. A UK national audit was performed in 2008 to survey the organization and delivery of clinical care provided to patients admitted to hospital with COPD. All UK acute hospital Trusts (units) were invited to participate. Each unit completed cross-sectional resource and organization questionnaires and a prospective clinical audit comprising up to 60 consecutively admitted cases of COPD exacerbation. Comparison between 2003 and 2008 includes aggregated statistics for units participating in both audit rounds. A total of 192 units participated in both audit rounds (6197 admissions in 2003 and 8170 in 2008). In 2008, patients were older and of a poorer functional class. Overall mortality was unchanged but adjusting for age and performance status, inpatient mortality (P = 0.05) and 90-day mortality (P = 0.001) were both reduced in 2008. More patients were discharged under a respiratory specialist (P < 0.01), treated with non-invasive ventilation if acidotic (P < 0.001) and accepted onto early discharge schemes (P < 0.01) while median length of stay fell from 6 to 5 days (P < 0.001). Within these mean data, however, there remains considerable inter-unit variation in organization, resources and outcomes. Overall improvements in resources and organization are accompanied by reduced mortality, shorter admissions and greater access to specialist services. There remains, however, considerable variation in the quality of secondary care provided between units.

  7. Admission cell free DNA levels predict 28-day mortality in patients with severe sepsis in intensive care.

    Directory of Open Access Journals (Sweden)

    Avital Avriel

    Full Text Available The aim of the current study is to assess the mortality prediction accuracy of circulating cell-free DNA (CFD level at admission measured by a new simplified method.CFD levels were measured by a direct fluorescence assay in severe sepsis patients on intensive care unit (ICU admission. In-hospital and/or twenty eight day all-cause mortality was the primary outcome.Out of 108 patients with median APACHE II of 20, 32.4% have died in hospital/or at 28-day. CFD levels were higher in decedents: median 3469.0 vs. 1659 ng/ml, p<0.001. In multivariable model APACHE II score and CFD (quartiles were significantly associated with the mortality: odds ratio of 1.05, p = 0.049 and 2.57, p<0.001 per quartile respectively. C-statistics for the models was 0.79 for CFD and 0.68 for APACHE II. Integrated discrimination improvement (IDI analyses showed that CFD and CFD+APACHE II score models had better discriminatory ability than APACHE II score alone.CFD level assessed by a new, simple fluorometric-assay is an accurate predictor of acute mortality among ICU patients with severe sepsis. Comparison of CFD to APACHE II score and Procalcitonin (PCT, suggests that CFD has the potential to improve clinical decision making.

  8. Handbook of Spatial Statistics

    CERN Document Server

    Gelfand, Alan E

    2010-01-01

    Offers an introduction detailing the evolution of the field of spatial statistics. This title focuses on the three main branches of spatial statistics: continuous spatial variation (point referenced data); discrete spatial variation, including lattice and areal unit data; and, spatial point patterns.

  9. 45 CFR 84.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Admissions and recruitment. 84.42 Section 84.42... Education § 84.42 Admissions and recruitment. (a) General. Qualified handicapped persons may not, on the basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment by...

  10. 34 CFR 104.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Admissions and recruitment. 104.42 Section 104.42... ASSISTANCE Postsecondary Education § 104.42 Admissions and recruitment. (a) General. Qualified handicapped... admission or recruitment by a recipient to which this subpart applies. (b) Admissions. In administering its...

  11. 15 CFR 8b.20 - Admission and recruitment.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Admission and recruitment. 8b.20... Secondary Education § 8b.20 Admission and recruitment. (a) General. Qualified handicapped may not, on the basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment by...

  12. 22 CFR 217.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Admissions and recruitment. 217.42 Section 217... Admissions and recruitment. (a) General. Qualified handicapped persons may not, on the basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment by a recipient to which...

  13. 45 CFR 605.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Admissions and recruitment. 605.42 Section 605.42... Postsecondary Education § 605.42 Admissions and recruitment. (a) General. Qualified handicapped persons may not... recruitment by a recipient to which this subpart applies. (b) Admissions. In administering its admission...

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

    Science.gov (United States)

    British Columbia Council on Admissions and Transfer, 2008

    2008-01-01

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

  15. National Center for Health Statistics

    Science.gov (United States)

    ... United States National Health Statistics Reports National Vital Statistics Reports News and Events NCHS Pressroom Inside NCHS Blog Events and Announcements Growth Charts Where to Write for Vital Records NCHS For You General Pubilc ...

  16. Brain Aneurysm Statistics and Facts

    Science.gov (United States)

    ... Facts A- A A+ Brain Aneurysm Statistics and Facts An estimated 6 million people in the United ... Brain Warning Signs/ Symptoms Brain Aneurysm Statistics and Facts Seeking Medical Attention Risk Factors Aneurysm Complications Types ...

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

    Science.gov (United States)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  19. Hospital Admission Patterns in Children with CAH: Admission Rates and Adrenal Crises Decline with Age

    Directory of Open Access Journals (Sweden)

    R. Louise Rushworth

    2016-01-01

    Full Text Available Objective. To examine patterns of hospitalisation for acute medical conditions in children with congenital adrenal hyperplasia (CAH. Design. A retrospective study of hospitalisation using administrative data. Setting. All hospitals in NSW, Australia. Patients. All patients admitted with CAH and a random sample of admissions in patients aged 0 to 18 years without adrenal insufficiency (AI. Main Outcome Measures. Admissions and comorbidities by age and sex. Results. Of 573 admissions for medical problems in CAH children, 286 (49.9% were in males, and 236 (41.2% had a principal diagnosis of CAH or had an adrenal crisis (AC. 37 (6.5% ACs were recorded. An infection was found in 43.5% (n=249 of the CAH patient admissions and 51.7% (n=1613 of the non-AI group, p<0.001. Children aged up to one year had the highest number of admissions (n=149 and six ACs (four in males. There were 21 ACs recorded for children aged 1–5 years. Older CAH children had fewer admissions and fewer ACs. No in-hospital deaths were recorded. Conclusions. Admission for medical problems in CAH children declines with age. An AC was recorded in 6.5% of the admissions, with the majority of ACs occurring in the 1 to 5 years age group and there were no deaths.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  2. Recent Trends in Characteristics of Graduate Management Admission Test Takers. GMAC Occasional Papers.

    Science.gov (United States)

    Hudis, Paula M.; Stolzenberg, Ross M.

    Statistical trends in the characteristics of registrants for the Graduate Management Admission Test (GMAT) are presented. Areas of focus are: registrations (registration volumes have increased dramatically over time); worldwide age distribution (the percentage of older test registrants has increased); world distribution (there has been a…

  3. Algebraic Statistics

    OpenAIRE

    Norén, Patrik

    2013-01-01

    Algebraic statistics brings together ideas from algebraic geometry, commutative algebra, and combinatorics to address problems in statistics and its applications. Computer algebra provides powerful tools for the study of algorithms and software. However, these tools are rarely prepared to address statistical challenges and therefore new algebraic results need often be developed. This way of interplay between algebra and statistics fertilizes both disciplines. Algebraic statistics is a relativ...

  4. Impact of team-versus ward-aligned clinical pharmacy on unintentional medication discrepancies at admission.

    Science.gov (United States)

    Byrne, Sharon M; Grimes, Tamasine C; Jago-Byrne, Marie-Claire; Galvin, Mairéad

    2017-02-01

    Background Medication reconciliation at admission to hospital reduces the prevalence of medication errors. Strategies are needed to ensure timely and efficient delivery of this service. Objective To investigate the effect of aligning clinical pharmacy services with consultant teams, by pharmacists attending post-admission ward rounds, in comparison to a ward-based service, on prevalence of unintentional unresolved discrepancies 48 h into admission. Setting A 243-bed public university teaching hospital in Ireland. Method A prospective, uncontrolled before-after observational study. A gold standard preadmission medication list was completed for each patient and compared with the patient's admission medication prescription and discrepancies were noted. Unresolved discrepancies were examined at 48 h after admission to determine if they were intentional or unintentional. Main outcome measured Number of patients with one or more unintentional, unresolved discrepancy 48 h into admission. Results Data were collected for 140 patients, of whom 73.5% were over 65 years of age. There were no differences between before (ward-aligned) and after (team-aligned) groups regarding age, number of medications or comorbidities. There was a statistically significant reduction in the prevalence of unintentional, unresolved discrepancy(s) per patient (67.3 vs. 27.3%, p medication (13.7 vs. 4.1%, p medications and comorbidities (adjusted odds ratio 4.9, 95% confidence interval 2.3-10.6). Conclusion A consultant team-based clinical pharmacy service contributed positively to medication reconciliation at admission, reducing the prevalence of unintentional, unresolved discrepancy(s) present 48 h after admission.

  5. On the use of statistics and kriging to the monitoring of hydro generating units at Hydro-Quebec; Application de la statistique et du krigeage a la surveillance de groupes hydroelectriques a Hydro-Quebec

    Energy Technology Data Exchange (ETDEWEB)

    Leonard, F.

    1996-12-31

    Optimizing the preventing monitoring of a water current power generator requires a good statistical representation. But the unit working rate is always one of the three most interesting ones, which results in poor statistical data for any other working rate. Kriging has been used, in a simplified and efficient way that takes into account for each state the preceding state and the following one (dual kriging). In addition, a novel approach for computing the standard deviation of a distribution is described, as well as a method for estimating the bias on the interpolation used to calculate the latter`s range of validity. (D.L.) 32 refs.

  6. Environmental Monitoring, Water Quality - WATER_QUALITY_STATISTICS_EPA_IN: Water Quality Monitoring and Data Summaries Indiana, Derived from EPA BASINS (United States Environmental Protection Agency, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — WATER_QUALITY_STATISTICS_EPA_IN is a point shapefile developed by the USEPA BASINS 3.0 program and edited by Bernardin, Lochmueller and Associates. Points represent...

  7. Air pollution and hospital admissions for asthma in a tropical city: Kaohsiung, Taiwan

    Energy Technology Data Exchange (ETDEWEB)

    Shang-Shyue Tsai; Meng-Hsuan Cheng; Hui-Fen Chiu; Trong-Neng Wu; Chun-Yuh Yang [I-Shou University, Kaohsiung (Taiwan). Department of Health Care Administration

    2006-07-15

    This study was undertaken to determine whether there is an association between air pollutants levels and hospital admissions for asthma in Kaohsiung, Taiwan. Hospital admissions for asthma and ambient air pollution data for Kaohsiung were obtained for the period from 1996 through 2003. The relative risk of hospital admission was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant models, on warm days ({>=}25{sup o}C) statistically significant positive associations were found in all pollutants except sulfur dioxide. On cool days ({<=} 25{sup o}C) all pollutants were significantly associated with asthma admissions. For the two pollutant models, CO and O{sub 3} were significant in combination with each of the other four pollutants on warm days. On cool days NO{sub 2} remained statistically significant in all the two-pollutant models. This study provides evidence that higher levels of ambient pollutants increase the risk of hospital admissions for asthma.

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

    Directory of Open Access Journals (Sweden)

    Panagiotis Kasteridis

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

  9. Drug use before hospital admission in Zimbabwe.

    Science.gov (United States)

    Taylor, H G; Stein, C M; Jongeling, G

    1988-01-01

    Drug use before hospital admission was studied prospectively in 284 consecutive patients admitted to general medical wards in Zimbabwe. Drugs were used by 84% of patients. Self-medication was used by 143 (50%) patients, aspirin (54%) and chloroquine (17%) being the most commonly used drugs. Traditional medicines were used by 55 (19%) patients. Drugs dispensed from orthodox medical sources were taken by 128 (45%) patients. Analgesics (22%), antibiotics (18%), and chloroquine (13%) were the commonest drugs dispensed. Urine screening tests were performed and were positive for aspirin in 37% of cases, chloroquine (33%), and antibiotics (20%). Adverse drug reactions requiring hospital admission occurred in 14 patients (10 orthodox medicines, 4 traditional medicines). Drug use before hospital admission, which is often poorly documented, is a source of potential drug toxicity and may obscure a diagnosis of infective illness.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Leo D. Westbury

    2016-04-01

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

  12. A comparison of inpatient admissions in 2012 from two European countries

    Directory of Open Access Journals (Sweden)

    Victoria Tittle

    2014-11-01

    Full Text Available Introduction: This study compares the trends of HIV inpatient admissions between a London tertiary HIV centre (United Kingdom and four infectious disease wards in Italy (IT to recognize common patterns across Europe. Methods: Data regarding HIV inpatient admissions was collected by using discharge diagnostic codes from 1 January to 31 December 2012, including patient demographics, combined antiretroviral therapy (cART history, CD4, viral load (VL and mortality rates. Discharge diagnoses were categorized according to the International Classification of Disease (ICD 9 and 10 system. All ICD categories that reach a 3% threshold of total admissions were analyzed. Results: A total of 731 admissions (257 in Italy and 474 in the United Kingdom for 521 patients (1.5 mean admission per patient. Female admissions were higher in Italy at 22.6% (n=58 compared to 14.9% (n=47 in the United Kingdom. Median age of patients was 47 years old. There was an undetectable VL in 65.8% (n=169 of admissions in Italy and 67.1% (n=319 in the United Kingdom (p=0.385; 86.4% (n=222 and 82.4% (n=389 of admissions were on cART, respectively. Mean CD4 was 302 in Italy compared to 368 in the United Kingdom (p=0.003. Average length of admission was 16 days with a 10.2% (n=21 mortality rate in Italy compared to 8 days with 2.8% (n=9 mortality in the United Kingdom (p<0.001. HCV co-infection was present in 64.6% (n=166 in Italy and 13.5% (n=64 in the United Kingdom and commonest mode of transmission was needle use in Italy (67.3%, n=173 and men who have sex with men in the UK cohort (59.9%, n=284. The cause of inpatient admissions according to ICD codes can be seen in following Figure 1. Conclusions: Significant differences in the duration of inpatient admission and mortality rates can be observed between these two cohorts which is secondary to the impact of Hepatitis C co-infection in Italy. However increases in the number of Hepatitis C co-infection patients amongst MSM in London

  13. Increased admissions for diabetes mellitus after burn.

    Science.gov (United States)

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

    2016-12-01

    Currently, limited long-term data on hyperglycaemia and insulin sensitivity in burn patients are available and the data that do exist are primarily related to paediatric severe burns. The aim of this study was to assess if burn is associated with increased post-burn admissions for diabetes mellitus. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalized for a first burn (n=30,997) in 1980-2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's birth registrations and electoral roll (n=123,399). Crude admission rates and summed length of stay for diabetes mellitus were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for socio-demographic factors and pre-existing health status, the burn cohort had 2.21 times (95% Confidence Interval (CI): 1.36-1.56) as many admissions and almost three times the number of days in hospital with a diabetes mellitus diagnosis (IRR, 95% CI: 2.94, 2.12-4.09) than the uninjured cohort. Admission rates were significantly elevated for those burned during childhood (diabetes mellitus in the burn cohort provide evidence that burns have longer term effects on blood glucose and insulin regulation after wound healing. The first five years after burn discharge appears to be a critical period with significantly elevated incident admissions for diabetes mellitus during this time. Results would suggest prolonged clinical management after discharge and or wound healing to minimise post-burn admissions for diabetes mellitus is required. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  14. Bernoulli measure of complex admissible kneading sequences

    CERN Document Server

    Bruin, Henk

    2012-01-01

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

  15. Modeling admissible behavior using event signals.

    Science.gov (United States)

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

    2004-06-01

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

  16. Entropy Production and Admissibility of Shocks

    Institute of Scientific and Technical Information of China (English)

    Tai-Ping Liu; Tommaso Ruggeri

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Laura-Maria Peltonen

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

    To identify factors influencing triage decisions and investigate whether admission to the intensive care unit (ICU) could reduce mortality compared with treatment on the ward. A multicentre cohort study in 11 university hospitals from seven countries, evaluating triage decisions and outcomes of pati

  19. S. aureus colonization at ICU admission as a risk factor for developing S. aureus ICU pneumonia

    NARCIS (Netherlands)

    Paling, Fleur P; Wolkewitz, Martin; Bode, Lonneke G M; Klein Klouwenberg, Peter M C; Ong, David S Y; Depuydt, Pieter; de Bus, Liesbet; Sifakis, Frangiscos; Bonten, Marc J M; Kluijtmans, Jan

    OBJECTIVE: To quantify the incidence of intensive care unit (ICU) acquired pneumonia caused by Staphylococcus aureus (S. aureus) and its association with S. aureus colonization at ICU admission. METHODS: This was a post-hoc analysis of two cohort studies in critically ill patients. The primary

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

    Science.gov (United States)

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

    2015-01-01

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

  1. The Statistical Analysis of Stock Market of Second Board of the United States for the Recent Years%对近几年美国创业资本市场的统计分析

    Institute of Scientific and Technical Information of China (English)

    胡海峰

    2004-01-01

    The second board stock market of the United States is now the largest and most developed one in theworld after 50-year development. It provides American technical innovation enterprises with necessarycapital and management supports, plays a very important role in promoting high-tech industries. Thepaper tries to statistically analyse the characteristics of the second board market and the effects andimpacts on macro-economy.

  2. Observational, longitudinal study of delirium in consecutive unselected acute medical admissions: age-specific rates and associated factors, mortality and re-admission

    Science.gov (United States)

    Pendlebury, ST; Lovett, NG; Smith, SC; Dutta, N; Bendon, C; Lloyd-Lavery, A; Mehta, Z; Rothwell, PM

    2015-01-01

    Objectives We aimed to determine age-specific rates of delirium and associated factors in acute medicine, and the impact of delirium on mortality and re-admission on long-term follow-up. Design Observational study. Consecutive patients over two 8-week periods (2010, 2012) were screened for delirium on admission, using the confusion assessment method (CAM), and reviewed daily thereafter. Delirium diagnosis was made using the Diagnostic and Statistical Manual Fourth Edition (DSM IV) criteria. For patients aged ≥65 years, potentially important covariables identified in previous studies were collected with follow-up for death and re-admission until January 2014. Participants 503 consecutive patients (age median=72, range 16–99 years, 236 (48%) male). Setting Acute general medicine. Results Delirium occurred in 101/503 (20%) (71 on admission, 30 during admission, 17 both), with risk increasing from 3% (6/195) at patients aged >65 years, after adjustment for age, delirium was associated with previous falls (OR=2.47, 95% CI 1.45 to 4.22, p=0.001), prior dementia (2.08, 1.10 to 3.93, p=0.024), dependency (2.58, 1.48 to 4.48, p=0.001), low cognitive score (5.00, 2.50 to 9.99, pPatients with delirium were more likely to fall (OR=4.55, 1.47 to 14.05, p=0.008), be incontinent of urine (3.76, 2.15 to 6.58, pdelirium was associated with stay >7 days (2.82, 1.68 to 4.75, pPatients with delirium had fewer re-admissions within 30-days (OR=0.32, 95% CI 0.09 to 1.1, p=0.07) and in total (median, IQR total re-admissions=0, 0–1 vs 1, 0–2, p=0.01). Conclusions Delirium affected a fifth of acute medical admissions and a third of those aged ≥75 years, and was associated with increased mortality, institutionalisation and dependency, but not with increased risk of re-admission on follow-up. PMID:26576806

  3. Bayesian statistics

    OpenAIRE

    新家, 健精

    2013-01-01

    © 2012 Springer Science+Business Media, LLC. All rights reserved. Article Outline: Glossary Definition of the Subject and Introduction The Bayesian Statistical Paradigm Three Examples Comparison with the Frequentist Statistical Paradigm Future Directions Bibliography

  4. Mathematical statistics

    CERN Document Server

    Pestman, Wiebe R

    2009-01-01

    This textbook provides a broad and solid introduction to mathematical statistics, including the classical subjects hypothesis testing, normal regression analysis, and normal analysis of variance. In addition, non-parametric statistics and vectorial statistics are considered, as well as applications of stochastic analysis in modern statistics, e.g., Kolmogorov-Smirnov testing, smoothing techniques, robustness and density estimation. For students with some elementary mathematical background. With many exercises. Prerequisites from measure theory and linear algebra are presented.

  5. 32 CFR 242.5 - Admission procedures.

    Science.gov (United States)

    2010-07-01

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

  6. Foundation Schools and Admissions: The Local Dimension.

    Science.gov (United States)

    Wise, Christine; Anderson, Lesley; Bush, Tony

    2001-01-01

    In 1988, the Labour Government abolished Grant Maintained schools and introduced three new categories of school: community, voluntary, and foundation. Reports findings of a study that gathered the perceptions of heads, governors, and senior staff about admission issues in 11 foundation schools after their first full term. (26 references)…

  7. 7 CFR 15a.16 - Admission.

    Science.gov (United States)

    2010-01-01

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

  8. 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…

  9. The National Center Test for University Admissions

    Science.gov (United States)

    Watanabe, Yoshinori

    2013-01-01

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

  10. Reporting Subscores from College Admission Tests

    Science.gov (United States)

    Lyren, Per-Erik

    2009-01-01

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

  11. 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.

  12. Hospital admissions before and after shipyard closure.

    Science.gov (United States)

    Bartley, M; Fagin, L

    1990-03-01

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

  13. 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…

  14. Biennial Survey of Education in the United States, 1932-1934. Bulletin, 1935, No. 2. Chapter IV: Statistics of Higher Education, 1933-34

    Science.gov (United States)

    Foster, Emery M.; Badger, Henry G.; Carr, Margaret J. S.; Choate, Blanche K.; Farr, Maude; Smith, Rose M.; Kelly, Frederick J.; Greenleaf, Walter J.

    1937-01-01

    The publication each 2 years by the Office of Education of a statistical report dealing with the institutions of higher education leads an occasional reader to a misconception of the Federal Government's relation to higher education. There is no national system of higher education in this country. Except for the 69 land-grant colleges and…

  15. Trends in Contraceptive Practice: United States, 1965-76. Vital & Health Statistics. Data from the National Survey of Family Growth, Series 23, No. 10.

    Science.gov (United States)

    Mosher, William D.

    This report presents findings based on interviews with three nationally representative samples of currently married women between the ages of 15 and 44 years, as documented in 1965 National Fertility Study and the 1973 and 1976 National Surveys of Family Growth. Statistics from these surveys are presented on the contraceptive practice of…

  16. The Development of Statistical Literacy Skills in the Eighth Grade: Exploring the TIMSS Data to Evaluate Student Achievement and Teacher Characteristics in the United States

    Science.gov (United States)

    Mills, Jamie D.; Holloway, Charles E.

    2013-01-01

    This study investigated the relationship between student achievement in statistics and factors at the student and teacher/classroom levels using the US 8th-grade Data and Chance content domain from the Trends in International Mathematics and Science Study, 2007 (TIMSS, 2007). Using variables that have been linked to mathematics and statistics…

  17. Clinical audit indicators of outcome following admission to hospital with acute exacerbation of chronic obstructive pulmonary disease

    OpenAIRE

    2002-01-01

    Background: The 1997 BTS/RCP national audit of acute chronic obstructive pulmonary disease (COPD) in terms of process of care has previously been reported. This paper describes from the same cases the outcomes of death, readmission rates within 3 months of initial admission, and length of stay. Identification of the main pre-admission predictors of outcome may be used to control for confounding factors in population characteristics when comparing performance between units.

  18. Harmonic statistics

    Science.gov (United States)

    Eliazar, Iddo

    2017-05-01

    The exponential, the normal, and the Poisson statistical laws are of major importance due to their universality. Harmonic statistics are as universal as the three aforementioned laws, but yet they fall short in their 'public relations' for the following reason: the full scope of harmonic statistics cannot be described in terms of a statistical law. In this paper we describe harmonic statistics, in their full scope, via an object termed harmonic Poisson process: a Poisson process, over the positive half-line, with a harmonic intensity. The paper reviews the harmonic Poisson process, investigates its properties, and presents the connections of this object to an assortment of topics: uniform statistics, scale invariance, random multiplicative perturbations, Pareto and inverse-Pareto statistics, exponential growth and exponential decay, power-law renormalization, convergence and domains of attraction, the Langevin equation, diffusions, Benford's law, and 1/f noise.

  19. 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.

  20. Diagnósticos de enfermagem mais freqüentes em uma unidade de internação de ginecologia Diagnósticos de enfermería mas frecuentes en una unidad de hospitalización en ginecología The most frequent nursing diagnoses in a gynecological admission unit

    Directory of Open Access Journals (Sweden)

    Maria Helena Baena de Moraes Lopes

    1999-12-01

    Full Text Available Nosso objetivo foi identificar os diagnósticos de enfermagem mais freqüentes numa unidade de internação ginecológica. A partir do histórico de enfermagem e do prontuário de 30 pacientes foram levantadas retrospectivamente as características definidoras e, com estas, os diagnósticos de enfermagem, segundo a taxionomia I revisada da NANDA. Os cinco diagnósticos de enfermagem mais freqüentes foram: risco para infecção (30 casos; risco para dor (24 casos; comportamento para elevar nível de saúde (11 casos; medo (10 casos e incontinência por pressão (5 casos.Nuestro objetivo fue identificar los diagnósticos de enfermería mas frecuentes en una unidad de internación ginecológica. Partiendo de los datos de las notas de enfermería en las historias clínicas de 30 pacientes, fueron retrospectivamente vistas las características definitorias y los diagnósticos de enfermería según la Taxonomía I revisada de la NANDA. Los cinco diagnósticos mas frecuentes fueron: riesgo para infección (30 casos; riesgo para dolor (24 casos; comportamiento para engrandecer los niveles de salud (11 casos; temor (10 casos e incontinencia por presión (5 casos.Our objective was to identify the most frequent nursing diagnoses in a gynecological admission unit. The defining characteristics were surveyed from the data reported in the nursing case history and the patient files of 30 patients. The nursing diagnoses were found according to the revised NANDA Taxionomy I. The five most frequent nursing diagnoses were: risk for infection (30 cases; risk for pain (24 cases; health-seeking behaviors (11cases; fear (10 cases and stress incontinence (5 cases.

  1. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    OpenAIRE

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac d...

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

    DEFF Research Database (Denmark)

    Knudsen, N V; Møller, M H

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  4. Influence of social deprivation, overcrowding and family structure on emergency medical admission rates.

    Science.gov (United States)

    Conway, R; Byrne, D; O'Riordan, D; Cournane, S; Coveney, S; Silke, B

    2016-10-01

    Patients from deprived backgrounds have a higher in-patient mortality following emergency medical admission. To evaluate the influence of Deprivation Index, overcrowding and family structure on hospital admission rates. Retrospective cohort study. All emergency medical admissions from 2002 to 2013 were evaluated. Based on address, each patient was allocated to an electoral division, whose small area population statistics were available from census data. Patients were categorized by quintile of Deprivation Index, overcrowding and family structure, and these were evaluated against hospital admission rate, calculated as rate/1000 population. Univariate and multivariable risk estimates (Odds Ratios or Incidence Rate Ratios) were calculated, using logistic or zero truncated Poisson regression as appropriate. There were 66 861 admissions in 36 214 patients over the 12-year study period. Deprivation Index quintile independently predicted the admission rate, with rates of Q1 12.0 (95% CI 11.8-12.2), Q2 19.5 (95% CI 19.3-19.6), Q3 33.7 (95% CI 33.3-34.0), Q4 31.4 (95% CI 31.2-31.6) and Q5 38.1 (95% CI 37.7-38.5). Similarly the proportions of families with children families with children ≥15-years old was also predictive but quintile of overcrowding was only predictive in the univarate model. Deprivation Index and family structure strongly predict emergency medical hospital admission rates. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Pre-admission statin use and in-hospital severity of 2009 pandemic influenza A(H1N1 disease.

    Directory of Open Access Journals (Sweden)

    Stephen J Brett

    Full Text Available BACKGROUND: Statins are drugs that are used to lower plasma cholesterol levels. Recently, contradictory claims have been made about possible additional effects of statins on progression of a variety of inflammatory disorders, including infections. We therefore examined the clinical course of patients admitted to hospital with 2009 pandemic influenza A(H1N1, who were or weren't taking statins at time of admission. METHODS: A retrospective case-control study was performed using the United Kingdom Influenza Clinical Information Network (FLU-CIN database, containing detailed information on 1,520 patients admitted to participating hospitals with confirmed 2009 pandemic influenza A(H1N1 infection between April 2009 and January 2010. We confined our analysis to those aged over 34 years. Univariate analysis was used to calculate unadjusted odds ratios (OR and 95 percent confidence intervals (95%CI for factors affecting progression to severe outcome (high dependency or intensive care unit level support or death (cases; two multivariable logistic regression models were then established for age and sex, and for age, sex, obesity and "indication for statin" (e.g., heart disease or hypercholesterolaemia. RESULTS: We found no statistically significant association between pre-admission statin use and severity of outcome after adjustment for age and sex [adjusted OR: 0.81 (95% CI: 0.46-1.38; n = 571]. After adjustment for age, sex, obesity and indication for statin, the association between pre-admission statin use and severe outcome was not statistically significant; point estimates are compatible with a small but clinically significant protective effect of statin use [adjusted OR: 0.72 (95% CI: 0.38-1.33]. CONCLUSIONS: In this group of patients hospitalized with pandemic influenza, a significant beneficial effect of pre-admission statin use on the in-hospital course of illness was not identified. Although the database from which these observations are

  6. Factors Associated with ICU Admission following Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Andrea Bellone

    2016-01-01

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

  7. Drop-out and admission cancel rate among the students in a selected medical college.

    Science.gov (United States)

    Wahed, F; Latif, S A; Mahamud, M M; Nessa, A; Hossain, M A; Sultana, S Z; Hossain, M B

    2011-04-01

    A record based descriptive type of study was carried out among the under-graduate students of Mymensingh Medical College from the session 1966-67 to 2006-07. The academic years were divided into four decades and admission was followed into three categories such as retained, cancellation and drop-out. Total number of the students was 5892. Among them 3848(65.30%) were male and 2044(34.69%) were female. Out of 5892 students drop-out was 282(4.78%) and admission cancel was 304(5.15%). It was also found that drop-out in male was 232(6.02%) and in female was 50(2.44%) and admission cancel in male was 266(5.87%) and in female was 78(3.81%). The difference was found statistically significant (pdrop-out and admission cancel rate is decreasing from the very beginning to till now. It was also observed that all drop-out and admission cancellation were in first & second year students. There was no continuation of their class roll numbers in third year registration.

  8. Statistical physics

    CERN Document Server

    Sadovskii, Michael V

    2012-01-01

    This volume provides a compact presentation of modern statistical physics at an advanced level. Beginning with questions on the foundations of statistical mechanics all important aspects of statistical physics are included, such as applications to ideal gases, the theory of quantum liquids and superconductivity and the modern theory of critical phenomena. Beyond that attention is given to new approaches, such as quantum field theory methods and non-equilibrium problems.

  9. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care.

    Science.gov (United States)

    Crary, Michael A; Humphrey, Jamie L; Carnaby-Mann, Giselle; Sambandam, Raam; Miller, Leslie; Silliman, Scott

    2013-03-01

    Dysphagia may predispose stroke patients toward undernutrition and hydration. These comorbidities increase patient risks for reduced functional outcome and short-term mortality. Despite this impact, available information on relationships among dysphagia, nutrition, and hydration status in acute stroke is limited and conflicted. This study evaluated nutrition and hydration status in ischemic stroke patients with versus without clinically significant dysphagia at admission and at discharge from acute care. Sixty-seven patients admitted to the stroke unit in a tertiary-care hospital provided data for this study. On the day of hospital admission and upon discharge or at 7 days post admission, serum biochemical measures were obtained for nutrition (prealbumin) and hydration status (BUN/Cr). Clinical evaluation for dysphagia, nutrition status, and stroke severity were completed an average of 1.4 days following hospital admission. Dysphagia was identified in 37 % of the cohort. At admission 32 % of patients demonstrated malnutrition based on prealbumin levels and 53 % demonstrated evidence of dehydration based on BUN/Cr levels. No differences in nutrition status were attributed to dysphagia. Patients with dysphagia demonstrated significantly higher BUN/Cr levels (greater dehydration) than patients without dysphagia at admission and at discharge. Dehydration at both admission and discharge was associated with dysphagia, clinical nutrition status, and stroke severity. Results of this study support prior results indicating that dysphagia is not associated with poor nutrition status during the first week post stroke. Dehydration status is associated with dysphagia during this period. The results have implications for future confirmatory research and for clinical management of dysphagia in the acute stroke period.

  10. 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

    2017-06-12

    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.

  11. Unreliable patient identification warrants ABO typing at admission to check existing records before transfusion.

    Science.gov (United States)

    Ferrera-Tourenc, V; Lassale, B; Chiaroni, J; Dettori, I

    2015-06-01

    This study describes patient identification errors leading to transfusional near-misses in blood issued by the Alps Mediterranean French Blood Establishment (EFSAM) to Marseille Public Hospitals (APHM) over an 18-month period. The EFSAM consolidates 14 blood banks in southeast France. It supplies 149 hospitals and maintains a centralized database on ABO types used at all area hospitals. As an added precaution against incompatible transfusion, the APHM requires ABO testing at each admission regardless of whether the patient has an ABO record. The study goal was to determine if admission testing was warranted. Discrepancies between ABO type determined by admission testing and records in the centralized database were investigated. The root cause for each discrepancy was classified as specimen collection or patient admission error. Causes of patient admission events were further subclassified as namesake (name similarity) or impersonation (identity fraud). The incidence of ABO discrepancies was 1:2334 including a 1:3329 incidence of patient admission events. Impersonation was the main cause of identity events accounting for 90.3% of cases. The APHM's ABO control policy prevented 19 incompatible transfusions. In relation to the 48,593 packed red cell units transfused, this would have corresponded to a risk of 1:2526. Collecting and storing ABO typing results in a centralized database is an essential public health tool. It allows crosschecking of current test results with past records and avoids redundant testing. However, as patient identification remains unreliable, ABO typing at each admission is still warranted to prevent transfusion errors. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Admission to intensive care can be reliably predicted using only clinical judgment

    DEFF Research Database (Denmark)

    Brabrand, M.

    2015-01-01

    staffwere able to identify patients in need of critical care using only clinical judgment and to compare this with the National Early Warning Score (NEWS). Methods This was a prospective cohort study of all adult patients with a first-time admission to a medical admission unit at a 450-bed regional teaching......Introduction Not all patients in need of critical care arrive in clinical distress and some deteriorate after arrival. Identifying these patients early in their clinical course could potentially improve outcome. The present study was performed with the aim of assessing whether nursing and physician...... hospital over a 3-month period in 2010. All subspecialties of internal medicine are present as well as a level 2 ICU. Upon first contact with the patient after arrival, nursing staffand physicians were asked to report their estimation of the probability of ICU admission (0 to 100%). Survival status...

  13. Involuntary psychiatric admissions: A retrospective study of 460 cases

    Directory of Open Access Journals (Sweden)

    P. Zeppegno

    2005-09-01

    Full Text Available Introduction: We collected the data relating to involuntary hospital treatment (IHT in the University Psychiatric Ward at Novara Hospital between 1991 and 2002, and compared them with those relating to Piedmont and the whole of Italy. Methods: The data were collected from the ward medical records. Results: IHT was much more frequent among young male schizophrenics living with their families of origin. Most of the subjects were not working at the time of admission. There was a statistically significant correlation between male gender and the risk of being admitted for a period of less than 12 days. The risk of being admitted for more than 12 days significantly correlated with the province of birth and residence, as well as with a diagnosis of schizophrenic psychosis. Conclusions: Schizophrenia is the diagnosis that is most frequently associated with IHT.

  14. Statistical optics

    CERN Document Server

    Goodman, Joseph W

    2015-01-01

    This book discusses statistical methods that are useful for treating problems in modern optics, and the application of these methods to solving a variety of such problems This book covers a variety of statistical problems in optics, including both theory and applications.  The text covers the necessary background in statistics, statistical properties of light waves of various types, the theory of partial coherence and its applications, imaging with partially coherent light, atmospheric degradations of images, and noise limitations in the detection of light. New topics have been introduced i

  15. Statistical distributions

    CERN Document Server

    Forbes, Catherine; Hastings, Nicholas; Peacock, Brian J.

    2010-01-01

    A new edition of the trusted guide on commonly used statistical distributions Fully updated to reflect the latest developments on the topic, Statistical Distributions, Fourth Edition continues to serve as an authoritative guide on the application of statistical methods to research across various disciplines. The book provides a concise presentation of popular statistical distributions along with the necessary knowledge for their successful use in data modeling and analysis. Following a basic introduction, forty popular distributions are outlined in individual chapters that are complete with re

  16. Harmonic statistics

    Energy Technology Data Exchange (ETDEWEB)

    Eliazar, Iddo, E-mail: eliazar@post.tau.ac.il

    2017-05-15

    The exponential, the normal, and the Poisson statistical laws are of major importance due to their universality. Harmonic statistics are as universal as the three aforementioned laws, but yet they fall short in their ‘public relations’ for the following reason: the full scope of harmonic statistics cannot be described in terms of a statistical law. In this paper we describe harmonic statistics, in their full scope, via an object termed harmonic Poisson process: a Poisson process, over the positive half-line, with a harmonic intensity. The paper reviews the harmonic Poisson process, investigates its properties, and presents the connections of this object to an assortment of topics: uniform statistics, scale invariance, random multiplicative perturbations, Pareto and inverse-Pareto statistics, exponential growth and exponential decay, power-law renormalization, convergence and domains of attraction, the Langevin equation, diffusions, Benford’s law, and 1/f noise. - Highlights: • Harmonic statistics are described and reviewed in detail. • Connections to various statistical laws are established. • Connections to perturbation, renormalization and dynamics are established.

  17. How to reduce avoidable admissions due to acute diabetes complications?: Interrelation between primary and specialized attention in a diabetes unit ¿Cómo reducir los ingresos evitables por complicaciones agudas de la diabetes?: Interrelación entre atención primaria y especializada en una unidad de diabetes

    Directory of Open Access Journals (Sweden)

    N. V. García-Talavera Espín

    2012-12-01

    Full Text Available Introduction: Type 2 Diabetes Mellitus is a serious health problem. In the year 2030 it will affect 366 million people around the world. Objective: Evaluate the effectiveness of a mixed intervention and reducing the amount and seriousness of acute complications in diabetics from our Health Area. Materials and method: Protocols of action as well as information documents were produced. Diabetes Unit coordinated educational activities in the different support levels of the Area VII of Murcia. Information talks were provided for the people in charge of the Diabetes Unit in every Care Center and Service of the Health Area. Personalized training was provided for patients treated in the differet Care levels. The study comprised three stages. Information leaflets were spread and talks offered to the patient regarding in house handling of hypo and hyper glycemia. Results: A reduction of 39% of the emergencies due to acute non complicated diabetes was achieved, as well as a reduction of 47.6% of hospital admissions. There was a reduction of 67.8% of the amount of total hospital stays for the group of patients under 35 years who were admitted into the hospital due to type 1 or 2 diabetes mellitus that didn't show any complications (GRD295. Conclusions: There was a reduction of more than thirty percent in the emergencies due to acute decompensations in the disease and a significant reduction in the avoidable hospital stays in the young adult, thus improving the patients' life quality and reducing the social cost of the diabetic patient.Introducción: La diabetes mellitus tipo 2 es un problema de salud grave. En el año 2030 afectará a 366 millones de personas en todo el mundo. Objetivo: Evaluar la eficacia de una intervención mixta y reducir la cantidad y gravedad de las complicaciones agudas de la diabetes en nuestra Área de Salud. Material y método: Se diseñaron protocolos de actuación y documentos de información. La Unidad de Diabetes coordin

  18. 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...

  19. 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...

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

    Data.gov (United States)

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

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

  2. 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...

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

    Data.gov (United States)

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

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

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

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

  19. 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...

  20. Pattern and Outcome of Gynaecological Admissions at a Nigerian ...

    African Journals Online (AJOL)

    Pattern and Outcome of Gynaecological Admissions at a Nigerian Tertiary Care Centre. ... Abortion accounted for 15.6% of total gynaecological admissions and was ... This was followed by infections, 43.5% with post abortal sepsis contributing ...

  1. Effect Of Admission Hyperglycaemia On Short-Term Outcome In ...

    African Journals Online (AJOL)

    Effect Of Admission Hyperglycaemia On Short-Term Outcome In Adult ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL ... Admission hyperglycaemia is a significant predictor of short-term case fatality but ...

  2. 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.

  3. Lie Admissible Non-Associative Algebras

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  4. Scan Statistics

    CERN Document Server

    Glaz, Joseph

    2009-01-01

    Suitable for graduate students and researchers in applied probability and statistics, as well as for scientists in biology, computer science, pharmaceutical science and medicine, this title brings together a collection of chapters illustrating the depth and diversity of theory, methods and applications in the area of scan statistics.

  5. Statistical Diversions

    Science.gov (United States)

    Petocz, Peter; Sowey, Eric

    2008-01-01

    In this article, the authors focus on hypothesis testing--that peculiarly statistical way of deciding things. Statistical methods for testing hypotheses were developed in the 1920s and 1930s by some of the most famous statisticians, in particular Ronald Fisher, Jerzy Neyman and Egon Pearson, who laid the foundations of almost all modern methods of…

  6. Practical Statistics

    CERN Document Server

    Lyons, L

    2016-01-01

    Accelerators and detectors are expensive, both in terms of money and human effort. It is thus important to invest effort in performing a good statistical anal- ysis of the data, in order to extract the best information from it. This series of five lectures deals with practical aspects of statistical issues that arise in typical High Energy Physics analyses.

  7. 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.

  8. 45 CFR 1170.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Admissions and recruitment. 1170.42 Section 1170... FEDERALLY ASSISTED PROGRAMS OR ACTIVITIES Postsecondary Education § 1170.42 Admissions and recruitment. (a... subjected to discrimination in admission or recruitment by a recipient to which this subpart applies. (b...

  9. 38 CFR 18.442 - Admissions and recruitment.

    Science.gov (United States)

    2010-07-01

    ... recruitment. 18.442 Section 18.442 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... Postsecondary Education § 18.442 Admissions and recruitment. (a) General. Qualified handicapped persons may not... recruitment by a recipient. (b) Admission. In administering its admission policies, a recipient; (1) May not...

  10. 7 CFR 15b.30 - Admissions and recruitment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Admissions and recruitment. 15b.30 Section 15b.30... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 15b.30 Admissions and recruitment... be subjected to discrimination in admission or recruitment by a recipient to which this subpart...

  11. 22 CFR 142.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Admissions and recruitment. 142.42 Section 142... and recruitment. (a) General. Qualified handicapped persons may not, on the basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment by a recipient to which...

  12. Equity of Access. New Approaches to Minority Admissions

    Science.gov (United States)

    Bingham, Rebecca Saady

    1978-01-01

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

  13. 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…

  14. Reclaiming the Educational Role of Chief Admission Officers.

    Science.gov (United States)

    McDonough, Patricia; Robertson, Larry

    1995-01-01

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

  15. Book Trade Research and Statistics. Prices of U.S. and Foreign Published Materials; Book Title Output and Average Prices: 2001 Final and 2002 Preliminary Figures; Book Sales Statistics, 2002: AAP Preliminary Estimates; U.S. Book Exports and Imports:2002; Number of Book Outlets in the United States and Canada; Review Media Statistics.

    Science.gov (United States)

    Sullivan, Sharon G.; Grabois, Andrew; Greco, Albert N.

    2003-01-01

    Includes six reports related to book trade statistics, including prices of U.S. and foreign materials; book title output and average prices; book sales statistics; book exports and imports; book outlets in the U.S. and Canada; and numbers of books and other media reviewed by major reviewing publications. (LRW)

  16. Removal of Cu(II) ions by biosorption onto powdered waste sludge (PWS) prior to biological treatment in an activated sludge unit: a statistical design approach.

    Science.gov (United States)

    Pamukoglu, M Yunus; Kargi, Fikret

    2009-04-01

    Biological treatment of synthetic wastewater containing Cu(II) ions was realized in an activated sludge unit with pre-adsorption of Cu(II) onto powdered waste sludge (PWS). Box-Behnken experimental design method was used to investigate Cu(II), chemical oxygen demand (COD) and toxicity removal performance of the activated sludge unit under different operating conditions. The independent variables were the solids retention time (SRT, 5-30 d), hydraulic residence time (HRT, 5-25 h), feed Cu(II) concentration (0-50 mg L(-1)) and PWS loading rate (0-4 g h(-1)) while percent Cu(II), COD, toxicity (TOX) removals and the sludge volume index (SVI) were the objective functions. The data were correlated with a quadratic response function (R2=0.99). Cu(II), COD and toxicity removals increased with increasing PWS loading rate and SRT while decreasing with the increasing feed Cu(II) concentration and HRT. Optimum conditions resulting in maximum Cu(II), COD, toxicity removals and SVI values were found to be SRT of 30 d, HRT 15 h, PWS loading rate 3 g h(-1) and feed Cu(II) concentration of less than 30 mg L(-1).

  17. A model to create an efficient and equitable admission policy for patients arriving to the cardiothoracic ICU.

    Science.gov (United States)

    Yang, Muer; Fry, Michael J; Raikhelkar, Jayashree; Chin, Cynthia; Anyanwu, Anelechi; Brand, Jordan; Scurlock, Corey

    2013-02-01

    To develop queuing and simulation-based models to understand the relationship between ICU bed availability and operating room schedule to maximize the use of critical care resources and minimize case cancellation while providing equity to patients and surgeons. Retrospective analysis of 6-month unit admission data from a cohort of cardiothoracic surgical patients, to create queuing and simulation-based models of ICU bed flow. Three different admission policies (current admission policy, shortest-processing-time policy, and a dynamic policy) were then analyzed using simulation models, representing 10 yr worth of potential admissions. Important output data consisted of the "average waiting time," a proxy for unit efficiency, and the "maximum waiting time," a surrogate for patient equity. A cardiothoracic surgical ICU in a tertiary center in New York, NY. Six hundred thirty consecutive cardiothoracic surgical patients admitted to the cardiothoracic surgical ICU. None. Although the shortest-processing-time admission policy performs best in terms of unit efficiency (0.4612 days), it did so at expense of patient equity prolonging surgical waiting time by as much as 21 days. The current policy gives the greatest equity but causes inefficiency in unit bed-flow (0.5033 days). The dynamic policy performs at a level (0.4997 days) 8.3% below that of the shortest-processing-time in average waiting time; however, it balances this with greater patient equity (maximum waiting time could be shortened by 4 days compared to the current policy). Queuing theory and computer simulation can be used to model case flow through a cardiothoracic operating room and ICU. A dynamic admission policy that looks at current waiting time and expected ICU length of stay allows for increased equity between patients with only minimum losses of efficiency. This dynamic admission policy would seem to be a superior in maximizing case-flow. These results may be generalized to other surgical ICUs.

  18. Introductory statistics

    CERN Document Server

    Ross, Sheldon M

    2005-01-01

    In this revised text, master expositor Sheldon Ross has produced a unique work in introductory statistics. The text's main merits are the clarity of presentation, contemporary examples and applications from diverse areas, and an explanation of intuition and ideas behind the statistical methods. To quote from the preface, ""It is only when a student develops a feel or intuition for statistics that she or he is really on the path toward making sense of data."" Ross achieves this goal through a coherent mix of mathematical analysis, intuitive discussions and examples.* Ross's clear writin

  19. Introductory statistics

    CERN Document Server

    Ross, Sheldon M

    2010-01-01

    In this 3rd edition revised text, master expositor Sheldon Ross has produced a unique work in introductory statistics. The text's main merits are the clarity of presentation, contemporary examples and applications from diverse areas, and an explanation of intuition and ideas behind the statistical methods. Concepts are motivated, illustrated and explained in a way that attempts to increase one's intuition. To quote from the preface, ""It is only when a student develops a feel or intuition for statistics that she or he is really on the path toward making sense of data."" Ross achieves this

  20. Statistics Clinic

    Science.gov (United States)

    Feiveson, Alan H.; Foy, Millennia; Ploutz-Snyder, Robert; Fiedler, James

    2014-01-01

    Do you have elevated p-values? Is the data analysis process getting you down? Do you experience anxiety when you need to respond to criticism of statistical methods in your manuscript? You may be suffering from Insufficient Statistical Support Syndrome (ISSS). For symptomatic relief of ISSS, come for a free consultation with JSC biostatisticians at our help desk during the poster sessions at the HRP Investigators Workshop. Get answers to common questions about sample size, missing data, multiple testing, when to trust the results of your analyses and more. Side effects may include sudden loss of statistics anxiety, improved interpretation of your data, and increased confidence in your results.

  1. Statistical physics

    CERN Document Server

    Wannier, Gregory H

    2010-01-01

    Until recently, the field of statistical physics was traditionally taught as three separate subjects: thermodynamics, statistical mechanics, and kinetic theory. This text, a forerunner in its field and now a classic, was the first to recognize the outdated reasons for their separation and to combine the essentials of the three subjects into one unified presentation of thermal physics. It has been widely adopted in graduate and advanced undergraduate courses, and is recommended throughout the field as an indispensable aid to the independent study and research of statistical physics.Designed for

  2. Semiconductor statistics

    CERN Document Server

    Blakemore, J S

    1962-01-01

    Semiconductor Statistics presents statistics aimed at complementing existing books on the relationships between carrier densities and transport effects. The book is divided into two parts. Part I provides introductory material on the electron theory of solids, and then discusses carrier statistics for semiconductors in thermal equilibrium. Of course a solid cannot be in true thermodynamic equilibrium if any electrical current is passed; but when currents are reasonably small the distribution function is but little perturbed, and the carrier distribution for such a """"quasi-equilibrium"""" co

  3. Properties and outcomes of spinal rehabilitation units in four countries

    DEFF Research Database (Denmark)

    Fromovich-Amit, Y; Biering-Sørensen, F; Baskov, V

    2009-01-01

    for rehabilitation (TAR), length of stay in rehabilitation (LOS), SCIM and spinal cord ability realization measurement index (SCI-ARMI) scores, SCIM gain, SCI-ARMI gain and rehabilitation efficiency (RE). RESULTS: Differences were found between the units in rehabilitation objectives, facilities and special equipment......OBJECTIVE: Compare rehabilitation after spinal cord lesions (SCL) in different countries. DESIGN: Multicenter comparative study. SETTING: Four spinal rehabilitation units, in Denmark, Russia, Lithuania and Israel. SUBJECTS: 199 SCL patients. INTERVENTIONS: Information was collected about unit...... properties, rehabilitation objectives, American Spinal Injury Association (ASIA) scale and spinal cord independence measure (SCIM) assessments, and patient data. chi (2)-test, t-test, ANOVA and ANCOVA were used for statistical analysis. MAIN OUTCOME MEASURES: Time from lesion onset to admission...

  4. SEER Statistics

    Science.gov (United States)

    The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute works to provide information on cancer statistics in an effort to reduce the burden of cancer among the U.S. population.

  5. Cancer Statistics

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  6. CMS Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Center for Strategic Planning produces an annual CMS Statistics reference booklet that provides a quick reference for summary information about health...

  7. Reversible Statistics

    DEFF Research Database (Denmark)

    Tryggestad, Kjell

    2004-01-01

    The study aims is to describe how the inclusion and exclusion of materials and calculative devices construct the boundaries and distinctions between statistical facts and artifacts in economics. My methodological approach is inspired by John Graunt's (1667) Political arithmetic and more recent work...... within constructivism and the field of Science and Technology Studies (STS). The result of this approach is here termed reversible statistics, reconstructing the findings of a statistical study within economics in three different ways. It is argued that all three accounts are quite normal, albeit...... in different ways. The presence and absence of diverse materials, both natural and political, is what distinguishes them from each other. Arguments are presented for a more symmetric relation between the scientific statistical text and the reader. I will argue that a more symmetric relation can be achieved...

  8. Image Statistics

    Energy Technology Data Exchange (ETDEWEB)

    Wendelberger, Laura Jean [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-08-08

    In large datasets, it is time consuming or even impossible to pick out interesting images. Our proposed solution is to find statistics to quantify the information in each image and use those to identify and pick out images of interest.

  9. Accident Statistics

    Data.gov (United States)

    Department of Homeland Security — Accident statistics available on the Coast Guard’s website by state, year, and one variable to obtain tables and/or graphs. Data from reports has been loaded for...

  10. Multiparametric statistics

    CERN Document Server

    Serdobolskii, Vadim Ivanovich

    2007-01-01

    This monograph presents mathematical theory of statistical models described by the essentially large number of unknown parameters, comparable with sample size but can also be much larger. In this meaning, the proposed theory can be called "essentially multiparametric". It is developed on the basis of the Kolmogorov asymptotic approach in which sample size increases along with the number of unknown parameters.This theory opens a way for solution of central problems of multivariate statistics, which up until now have not been solved. Traditional statistical methods based on the idea of an infinite sampling often break down in the solution of real problems, and, dependent on data, can be inefficient, unstable and even not applicable. In this situation, practical statisticians are forced to use various heuristic methods in the hope the will find a satisfactory solution.Mathematical theory developed in this book presents a regular technique for implementing new, more efficient versions of statistical procedures. ...

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

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-02-01

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

  12. Homeschoolers Entering Community Colleges: Perceptions of Admission Officers

    Science.gov (United States)

    Sorey, Kellie; Duggan, Molly H.

    2008-01-01

    An estimated 1.1 million students were homeschooled in the United States in spring 2003, according to the U.S. Department of Education's National Center for Education Statistics (2006). This figure represents a sizeable increase from the homeschooling rate of 1.7 percent--or 850,000 students--in 1999. With the popularity of homeschooling…

  13. Trichomoniasis Statistics

    Science.gov (United States)

    ... Transmitted Diseases - Trichomoniasis (October 19, 2016) Figure 52. Trichomonas vaginalis and Other Vaginal Infections Among Women — Initial ... States (February 13, 2013) Prevalence The prevalence of Trichomonas vaginalis infection in the United States is estimated to ...

  14. A qualitative study of determinants of patient behaviour leading to an infection related hospital admission.

    Science.gov (United States)

    Tonna, A P; Weidmann, A E; Laing, R B; Tonna, I; Macartney, G M; Paudyal, V; Stewart, D

    2017-03-01

    Objectives To describe and understand the determinants of patients' behaviours surrounding admission to hospital for an acute infective episode Method Patients admitted to the infection or acute medicine admission units of a major Scottish teaching hospital and commenced on antibiotic therapy after admission were included. Semi-structured face-to-face interviews were conducted using a pre-piloted interview schedule guide that focused on gathering information about patient behaviours and experiences prior to admission to hospital with an acute infection. Interviews were audio-recorded, transcribed verbatim and analysed using the Framework Approach. Emerging themes were matched to the Theoretical Domains Framework of behavioural determinants. Results Twenty-one patients consented to participate and 18 transcripts were suitable for analysis. The most common infections were those of the skin, soft tissue and respiratory tract. From the patients' perspectives, behavioural determinants that appeared to impact their admission to hospital were principally their knowledge, beliefs of consequences, the environmental context and resources (mainly out-of-hours services), social influences and their own emotions. Determinants such as knowledge of the signs and symptoms, beliefs of consequences and environmental context were facilitators of health seeking behaviours. The main barriers were a lack of awareness of consequences of infection potentially leading to delayed admission impacting infection severity, stay in secondary care and resource utilisation. Conclusions This study has shown that any initial patient-centred intervention that is proposed to change patient behaviour needs to be based on behavioural determinants emerging in this research. The intervention may include aspects such as patient education on resources available out-of-hours and ways to access the healthcare system, education on recognising signs of infection leading to prompter treatment and positive

  15. Role Playing Approach vs. Traditional Method about Neonatal Admission Skills among Midwifery Students

    Directory of Open Access Journals (Sweden)

    Shahla Mohamadiriz

    2015-10-01

    Full Text Available Introduction Since, employing new education approach is necessary for enhancing medical students` skills, so the aim of this study was to determine the effectiveness of role –play approach compared the traditional method about neonatal admission skills in delivery room among midwifery students. Materials and Methods This was an experimental study in 2013-2014 in Isfahan-Iran. After baseline testing, 30 midwifery students were trained using role-playing method for neonatal admission skills (n=15, case group and using a traditional method (n=15, control group. Participants were tested after intervention in final term. The collected data was analyzed using SPSS version 13 and descriptive and analysis such as independent t-test and paired test. The significant level was considered less than 0.05. Results Before intervention, the findings did not show any significant difference between skill scores of  two groups (role-play and traditional method; while a statistically significant difference was observed in after intervention between the scores of two groups (P=0.003. After intervention, Paired t- test showed a statistically significant difference in skills scores in two groups respectively (P=0.024, P=0.010. Conclusion Role-play teaching technique can be increased neonatal admission management skills levels in midwifery students. So, the conduction of this educational model is recommended as an effective learning in neonatal admission management. The role playing approach leads to comparable practical neonatal admission management-performance compared to traditional method. Therefore, this approach could be useful in special educational settings especial midwifery and neonatal wards.

  16. Risk Factors for Hospital Admission with RSV Bronchiolitis in England: A Population-Based Birth Cohort Study

    Science.gov (United States)

    Murray, Joanna; Bottle, Alex; Sharland, Mike; Modi, Neena; Aylin, Paul; Majeed, Azeem; Saxena, Sonia

    2014-01-01

    Objective To examine the timing and duration of RSV bronchiolitis hospital admission among term and preterm infants in England and to identify risk factors for bronchiolitis admission. Design A population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics database. Setting 71 hospitals across England. Participants We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life. Results In our cohort there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95%CI 23.7–24.8), of which 15% (1050/7189) were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4–50.2)). The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61–209 days). The median length of stay was 1 day (IQR = 0–3). The relative risk (RR) of a bronchiolitis admission was higher among infants with known risk factors for severe RSV infection, including those born preterm (RR = 1.9, 95% CI 1.8–2.0) compared with infants born at term. Other conditions also significantly increased risk of bronchiolitis admission, including Down's syndrome (RR = 2.5, 95% CI 1.7–3.7) and cerebral palsy (RR = 2.4, 95% CI 1.5–4.0). Conclusions Most (85%) of the infants who are admitted to hospital with bronchiolitis in England are born at term, with no known predisposing risk factors for severe RSV infection, although risk of admission is higher in known risk groups. The early age of bronchiolitis admissions has important implications for the potential impact and timing of future active and passive immunisations. More research is needed to explain why babies born with Down's syndrome and cerebral palsy are also at higher risk of hospital admission with RSV bronchiolitis. PMID:24586581

  17. Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study.

    Directory of Open Access Journals (Sweden)

    Joanna Murray

    Full Text Available OBJECTIVE: To examine the timing and duration of RSV bronchiolitis hospital admission among term and preterm infants in England and to identify risk factors for bronchiolitis admission. DESIGN: A population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics database. SETTING: 71 hospitals across England. PARTICIPANTS: We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life. RESULTS: In our cohort there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95%CI 23.7-24.8, of which 15% (1050/7189 were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4-50.2. The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61-209 days. The median length of stay was 1 day (IQR = 0-3. The relative risk (RR of a bronchiolitis admission was higher among infants with known risk factors for severe RSV infection, including those born preterm (RR = 1.9, 95% CI 1.8-2.0 compared with infants born at term. Other conditions also significantly increased risk of bronchiolitis admission, including Down's syndrome (RR = 2.5, 95% CI 1.7-3.7 and cerebral palsy (RR = 2.4, 95% CI 1.5-4.0. CONCLUSIONS: Most (85% of the infants who are admitted to hospital with bronchiolitis in England are born at term, with no known predisposing risk factors for severe RSV infection, although risk of admission is higher in known risk groups. The early age of bronchiolitis admissions has important implications for the potential impact and timing of future active and passive immunisations. More research is needed to explain why babies born with Down's syndrome and cerebral palsy are also at higher risk of hospital admission with RSV bronchiolitis.

  18. Statistical mechanics

    CERN Document Server

    Jana, Madhusudan

    2015-01-01

    Statistical mechanics is self sufficient, written in a lucid manner, keeping in mind the exam system of the universities. Need of study this subject and its relation to Thermodynamics is discussed in detail. Starting from Liouville theorem gradually, the Statistical Mechanics is developed thoroughly. All three types of Statistical distribution functions are derived separately with their periphery of applications and limitations. Non-interacting ideal Bose gas and Fermi gas are discussed thoroughly. Properties of Liquid He-II and the corresponding models have been depicted. White dwarfs and condensed matter physics, transport phenomenon - thermal and electrical conductivity, Hall effect, Magneto resistance, viscosity, diffusion, etc. are discussed. Basic understanding of Ising model is given to explain the phase transition. The book ends with a detailed coverage to the method of ensembles (namely Microcanonical, canonical and grand canonical) and their applications. Various numerical and conceptual problems ar...

  19. Statistical mechanics

    CERN Document Server

    Schwabl, Franz

    2006-01-01

    The completely revised new edition of the classical book on Statistical Mechanics covers the basic concepts of equilibrium and non-equilibrium statistical physics. In addition to a deductive approach to equilibrium statistics and thermodynamics based on a single hypothesis - the form of the microcanonical density matrix - this book treats the most important elements of non-equilibrium phenomena. Intermediate calculations are presented in complete detail. Problems at the end of each chapter help students to consolidate their understanding of the material. Beyond the fundamentals, this text demonstrates the breadth of the field and its great variety of applications. Modern areas such as renormalization group theory, percolation, stochastic equations of motion and their applications to critical dynamics, kinetic theories, as well as fundamental considerations of irreversibility, are discussed. The text will be useful for advanced students of physics and other natural sciences; a basic knowledge of quantum mechan...

  20. Statistical inference

    CERN Document Server

    Rohatgi, Vijay K

    2003-01-01

    Unified treatment of probability and statistics examines and analyzes the relationship between the two fields, exploring inferential issues. Numerous problems, examples, and diagrams--some with solutions--plus clear-cut, highlighted summaries of results. Advanced undergraduate to graduate level. Contents: 1. Introduction. 2. Probability Model. 3. Probability Distributions. 4. Introduction to Statistical Inference. 5. More on Mathematical Expectation. 6. Some Discrete Models. 7. Some Continuous Models. 8. Functions of Random Variables and Random Vectors. 9. Large-Sample Theory. 10. General Meth

  1. Statistical Physics

    CERN Document Server

    Mandl, Franz

    1988-01-01

    The Manchester Physics Series General Editors: D. J. Sandiford; F. Mandl; A. C. Phillips Department of Physics and Astronomy, University of Manchester Properties of Matter B. H. Flowers and E. Mendoza Optics Second Edition F. G. Smith and J. H. Thomson Statistical Physics Second Edition E. Mandl Electromagnetism Second Edition I. S. Grant and W. R. Phillips Statistics R. J. Barlow Solid State Physics Second Edition J. R. Hook and H. E. Hall Quantum Mechanics F. Mandl Particle Physics Second Edition B. R. Martin and G. Shaw The Physics of Stars Second Edition A. C. Phillips Computing for Scient

  2. AP statistics

    CERN Document Server

    Levine-Wissing, Robin

    2012-01-01

    All Access for the AP® Statistics Exam Book + Web + Mobile Everything you need to prepare for the Advanced Placement® exam, in a study system built around you! There are many different ways to prepare for an Advanced Placement® exam. What's best for you depends on how much time you have to study and how comfortable you are with the subject matter. To score your highest, you need a system that can be customized to fit you: your schedule, your learning style, and your current level of knowledge. This book, and the online tools that come with it, will help you personalize your AP® Statistics prep

  3. Statistical methods

    CERN Document Server

    Freund, Rudolf J; Wilson, William J

    2010-01-01

    Statistical Methods, 3e provides students with a working introduction to statistical methods offering a wide range of applications that emphasize the quantitative skills useful across many academic disciplines. This text takes a classic approach emphasizing concepts and techniques for working out problems and intepreting results. The book includes research projects, real-world case studies, numerous examples and data exercises organized by level of difficulty. This text requires that a student be familiar with algebra. New to this edition: NEW expansion of exercises a

  4. Statistical mechanics

    CERN Document Server

    Davidson, Norman

    2003-01-01

    Clear and readable, this fine text assists students in achieving a grasp of the techniques and limitations of statistical mechanics. The treatment follows a logical progression from elementary to advanced theories, with careful attention to detail and mathematical development, and is sufficiently rigorous for introductory or intermediate graduate courses.Beginning with a study of the statistical mechanics of ideal gases and other systems of non-interacting particles, the text develops the theory in detail and applies it to the study of chemical equilibrium and the calculation of the thermody

  5. Accounting providing of statistical analysis of intangible assets renewal under marketing strategy

    Directory of Open Access Journals (Sweden)

    I.R. Polishchuk

    2016-12-01

    Full Text Available The article analyzes the content of the Regulations on accounting policies of the surveyed enterprises in terms of the operations concerning the amortization of intangible assets on the following criteria: assessment on admission, determination of useful life, the period of depreciation, residual value, depreciation method, reflection in the financial statements, a unit of account, revaluation, formation of fair value. The characteristic of factors affecting the accounting policies and determining the mechanism for evaluating the completeness and timeliness of intangible assets renewal is showed. The algorithm for selecting the method of intangible assets amortization is proposed. The knowledge base of statistical analysis of timeliness and completeness of intangible assets renewal in terms of the developed internal reporting is expanded. The statistical indicators to assess the effectiveness of the amortization policy for intangible assets are proposed. The marketing strategies depending on the condition and amount of intangible assets in relation to increasing marketing potential for continuity of economic activity are described.

  6. Vitamin D deficiency at pediatric intensive care admission

    Directory of Open Access Journals (Sweden)

    Corsino Rey

    2014-04-01

    Full Text Available OBJECTIVE:to assess whether 25hydroxivitaminD or 25(OHvitD deficiency has a high prevalence at pediatric intensive care unit (PICU admission, and whether it is associated with increased prediction of mortality risk scores.METHOD:prospective observational study comparing 25(OHvitD levels measured in 156 patients during the 12 hours after critical care admission with the 25(OHvitD levels of 289 healthy children. 25(OHvitD levels were also compared between PICU patients with pediatric risk of mortality III (PRISM III or pediatric index of mortality 2 (PIM 2 > p75 [(group A; n = 33 vs. the others (group B; n = 123]. Vitamin D deficiency was defined as < 20 ng/mL levels.RESULTS:median (p25-p75 25(OHvitD level was 26.0 ng/mL (19.2-35.8 in PICU patients vs. 30.5 ng/mL (23.2-38.6 in healthy children (p = 0.007. The prevalence of 25(OHvitD < 20 ng/mL was 29.5% (95% CI: 22.0-37.0 vs. 15.6% (95% CI: 12.2-20.0 (p = 0.01. Pediatric intensive care patients presented an odds ratio (OR for hypovitaminosis D of 2.26 (CI 95%: 1.41-3.61. 25(OHvitD levels were 25.4 ng/mL (CI 95%: 15.5-36.0 in group A vs. 26.6 ng/mL (CI 95%: 19.3-35.5 in group B (p = 0.800.CONCLUSIONS:hypovitaminosis D incidence was high in PICU patients. Hypovitaminosis D was not associated with higher prediction of risk mortality scores.

  7. Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward

    Science.gov (United States)

    Wilson, Rachel

    2015-01-01

    Cardiology wards are generally high turnover units, which may receive primary PCI, high-risk NSTEMI patients, and other general cardiac admissions from a large geographical area. Many centres also provide national specialist services for rarer cardiac conditions for which admissions may be lengthy. Cardiac patients have significant risk factors for venous thromboembolism (VTE) as immobility may be due to systolic dysfunction, attachment to continuous monitoring and predisposition to chest pain, or cardiac syncope. It is recommended by NICE that an initial VTE risk assessment is undertaken at the time of patient admission, with reassessment within 24 hours. For this purpose a risk assessment tool is featured on the front of many Trust drug charts. It is noted that this risk assessment is electronic in other trusts. We undertook an audit into the drug chart documentation of VTE risk assessment on the cardiology ward and the Coronary Care Unit (CCU) at The Royal Free Hospital. It was evident that documentation of VTE risk assessment was poor. The audit interventions were; a teaching presentation to the cardiology department, an educational poster, several update emails to the department and the identification of a ‘VTE risk assessment champion’ to audit ongoing compliance. Following these measures the second audit round demonstrated that documentation of initial risk assessment was slightly improved, but significant improvement was seen in documentation of risk assessment at 24 hours post admission. Results from a third audit cycle indicated that the improvement in initial VTE risk assessment was sustained, and that there was a significant sustained improvement in risk assessment at 24 hours (p <0.05). Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor

  8. 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…

  9. 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…

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

    OpenAIRE

    2016-01-01

    Background: Malnutrition has been linked to poor outcomes after elective joint arthroplasty, but the risk of unplanned postoperative intensive care unit (ICU) admission in malnourished arthroplasty patients is unknown. Methods: 1098 patients were followed as part of a prospective risk stratification program at a tertiary, high-volume arthroplasty center. Chronic malnutrition was defined as preoperative albumin Results: The overall incidence of malnutrition was 16.9% (primary and revision arth...

  11. Statistical Mechancis

    CERN Document Server

    Gallavotti, Giovanni

    2011-01-01

    C. Cercignani: A sketch of the theory of the Boltzmann equation.- O.E. Lanford: Qualitative and statistical theory of dissipative systems.- E.H. Lieb: many particle Coulomb systems.- B. Tirozzi: Report on renormalization group.- A. Wehrl: Basic properties of entropy in quantum mechanics.

  12. Impact of urban atmospheric environment on hospital admissions in the elderly

    Directory of Open Access Journals (Sweden)

    Edelci Nunes da Silva

    2012-08-01

    Full Text Available OBJECTIVE: To analyze the impact of intra-urban atmospheric conditions on circulatory and respiratory diseases in elder adults. METHODS: Cross-sectional study based on data from 33,212 hospital admissions in adults over 60 years in the city of São Paulo, southeastern Brazil, from 2003 to 2007. The association between atmospheric variables from Congonhas airport and bioclimatic index, Physiological Equivalent Temperature, was analyzed according to the district's socioenvironmental profile. Descriptive statistical analysis and regression models were used. RESULTS: There was an increase in hospital admissions due to circulatory diseases as average and lowest temperatures decreased. The likelihood of being admitted to the hospital increased by 12% with 1ºC decrease in the bioclimatic index and with 1ºC increase in the highest temperatures in the group with lower socioenvironmental conditions. The risk of admission due to respiratory diseases increased with inadequate air quality in districts with higher socioenvironmental conditions. CONCLUSIONS: The associations between morbidity and climate variables and the comfort index varied in different groups and diseases. Lower and higher temperatures increased the risk of hospital admission in the elderly. Districts with lower socioenvironmental conditions showed greater adverse health impacts.

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

    Directory of Open Access Journals (Sweden)

    Ortiga Berta

    2012-06-01

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

  14. 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…

  15. 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…

  16. Analysis of factors influencing admission to intensive care following convulsive status epilepticus in children.

    LENUS (Irish Health Repository)

    Tirupathi, Sandya

    2012-02-01

    OBJECTIVES: To identify clinical features and therapeutic decisions that influence admission to the Intensive Care unit (ICU) in children presenting with convulsive status epilepticus (CSE). METHODS: We evaluated 47 admissions with status epilepticus to a tertiary paediatric hospital A&E over a three year period (2003-2006). Following initial management 23 episodes required admission to ICU and 24 were managed on a paediatric ward. We compared clinical, demographic data and compliance with our CSE protocol between the ICU and ward groups. RESULTS: Median age at presentation in the ICU group was 17 months (range 3 months-11 years) compared to 46 months in the ward group (range 3 months-10 years). Fifty per cent of patients in both groups had a previous history of seizures. Median duration of pre-hospital seizure activity was 30 min in both groups. More than two doses of benzodiazepines were given as first line medication in 62% of the ICU group and 33% of the ward group. Among children admitted to ICU with CSE, 26% had been managed according to the CSE protocol, compared to 66% of children who were admitted to a hospital ward. Febrile seizures were the most common aetiology in both groups. CONCLUSION: Younger age at presentation, administration of more than two doses of benzodiazepines and deviation from the CSE protocol appear to be factors which influence admission of children to ICU. Recognition of pre-hospital administration of benzodiazepines and adherence to therapeutic guidelines may reduce the need for ventilatory support in this group.

  17. Tobacco Stained Fingers and Its Association with Death and Hospital Admission: A Retrospective Cohort Study

    Science.gov (United States)

    John, Gregor; Genné, Daniel

    2015-01-01

    Background Among smokers, the presence of tobacco stains on fingers has recently been associated with a high prevalence of tobacco related conditions and alcohol abuse. Objective we aimed to explore tobacco stains as a marker of death and hospital readmission. Method Seventy-three smokers presenting tobacco-tar staining on their fingers and 70 control smokers were followed during a median of 5.5 years in a retrospective cohort study. We used the Kaplan-Meier survival analysis and the log-rank test to compare mortality and hospital readmission rates among smokers with and smokers without tobacco stains. Multivariable Cox models were used to adjust for confounding factors: age, gender, pack-year unit smoked, cancer, harmful alcohol use and diabetes. The number of hospital admissions was compared through a negative binomial regression and adjusted for the follow-up time, diabetes, and alcohol use. Results Forty-three patients with tobacco-stained fingers died compared to 26 control smokers (HR 1.6; 95%CI: 1.0 to 2.7; p 0.048). The association was not statistically significant after adjustment. Patients with tobacco-stained fingers needed a readmission earlier than smokers without stains (HR 2.1; 95%CI: 1.4 to 3.1; p<0.001), and more often (incidence rate ratio (IRR) 1.6; 95%CI: 1.1 to 2.1). Associations between stains and the first hospital readmission (HR 1.6; 95%CI: 1.0 to 2.5), and number of readmissions (IRR 1.5; 95%CI: 1.1 to 2.1) persisted after adjustment for confounding factors. Conclusions Compared to other smokers, those presenting tobacco-stained fingers have a high unadjusted mortality rate and need early and frequent hospital readmission even when controlling for confounders. PMID:26375287

  18. Preferential Treatment in College Admissions and Student Incentives

    OpenAIRE

    Pastine, Tuvana; Pastine, Ivan

    2011-01-01

    This paper examines student incentives when faced with a college admissions policy which pursues student body diversity. The effect of a diversify-conscious admissions policy critically depends on the design of the policy. If the admissions policy fails to incentivize students from a disadvantaged socioeconomic background it may lead to a deterioration in the intergroup score gap while failing to improve student body diversity in equilibrium.

  19. Student incentives and preferential treatment in college admissions

    OpenAIRE

    2012-01-01

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

  20. Experimental statistics

    CERN Document Server

    Natrella, Mary Gibbons

    2005-01-01

    Formulated to assist scientists and engineers engaged in army ordnance research and development programs, this well-known and highly regarded handbook is a ready reference for advanced undergraduate and graduate students as well as for professionals seeking engineering information and quantitative data for designing, developing, constructing, and testing equipment. Topics include characterizing and comparing the measured performance of a material, product, or process; general considerations in planning experiments; statistical techniques for analyzing extreme-value data; use of transformations

  1. Cost-effectiveness of same-admission versus interval cholecystectomy after mild gallstone pancreatitis in the PONCHO trial.

    Science.gov (United States)

    da Costa, D W; Dijksman, L M; Bouwense, S A; Schepers, N J; Besselink, M G; van Santvoort, H C; Boerma, D; Gooszen, H G; Dijkgraaf, M G W

    2016-11-01

    Same-admission cholecystectomy is indicated after gallstone pancreatitis to reduce the risk of recurrent disease or other gallstone-related complications, but its impact on overall costs is unclear. This study analysed the cost-effectiveness of same-admission versus interval cholecystectomy after mild gallstone pancreatitis. In a multicentre RCT (Pancreatitis of biliary Origin: optimal timiNg of CHOlecystectomy; PONCHO) patients with mild gallstone pancreatitis were randomized before discharge to either cholecystectomy within 72 h (same-admission cholecystectomy) or cholecystectomy after 25-30 days (interval cholecystectomy). Healthcare use of all patients was recorded prospectively using clinical report forms. Unit costs of resources used were determined, and patients completed multiple Health and Labour Questionnaires to record pancreatitis-related absence from work. Cost-effectiveness analyses were performed from societal and healthcare perspectives, with the costs per readmission prevented as primary outcome with a time horizon of 6 months. All 264 trial participants were included in the present analysis, 128 randomized to same-admission cholecystectomy and 136 to interval cholecystectomy. Same-admission cholecystectomy reduced the risk of acute readmission for recurrent gallstone-related complications from 16·9 to 4·7 per cent (P = 0·002). Mean total costs from a societal perspective were €234 (95 per cent c.i. -1249 to 738) less per patient in the same-admission cholecystectomy group. Same-admission cholecystectomy was superior to interval cholecystectomy, with a societal incremental cost-effectiveness ratio of -€1918 to prevent one readmission for gallstone-related complications. In mild biliary pancreatitis, same-admission cholecystectomy was more effective and less costly than interval cholecystectomy. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  2. Arc Statistics

    CERN Document Server

    Meneghetti, M; Dahle, H; Limousin, M

    2013-01-01

    The existence of an arc statistics problem was at the center of a strong debate in the last fifteen years. With the aim to clarify if the optical depth for giant gravitational arcs by galaxy clusters in the so called concordance model is compatible with observations, several studies were carried out which helped to significantly improve our knowledge of strong lensing clusters, unveiling their extremely complex internal structure. In particular, the abundance and the frequency of strong lensing events like gravitational arcs turned out to be a potentially very powerful tool to trace the structure formation. However, given the limited size of observational and theoretical data-sets, the power of arc statistics as a cosmological tool has been only minimally exploited so far. On the other hand, the last years were characterized by significant advancements in the field, and several cluster surveys that are ongoing or planned for the near future seem to have the potential to make arc statistics a competitive cosmo...

  3. Namibia's exceptional admission to the ILO.

    Science.gov (United States)

    Fromont, M

    1998-01-01

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

  4. Superconformal minimal models and admissible Jack polynomials

    CERN Document Server

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

    2016-01-01

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

  5. Weight Representations of Admissible Affine Vertex Algebras

    Science.gov (United States)

    Arakawa, Tomoyuki; Futorny, Vyacheslav; Ramirez, Luis Enrique

    2017-08-01

    For an admissible affine vertex algebra {V_k{(\\mathfrak{g})}} of type A, we describe a new family of relaxed highest weight representations of {V_k{(\\mathfrak{g})}}. They are simple quotients of representations of the affine Kac-Moody algebra {\\widehat{\\mathfrak{g}}} induced from the following {\\mathfrak{g}}-modules: (1) generic Gelfand-Tsetlin modules in the principal nilpotent orbit, in particular all such modules induced from {\\mathfrak{sl}_2}; (2) all Gelfand-Tsetlin modules in the principal nilpotent orbit that are induced from {\\mathfrak{sl}_3}; (3) all simple Gelfand-Tsetlin modules over {\\mathfrak{sl}_3}. This in particular gives the classification of all simple positive energy weight representations of {V_k{(\\mathfrak{g})}} with finite dimensional weight spaces for {\\mathfrak{g}=\\mathfrak{sl}_3}.

  6. 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.

  7. Hospital Transfers of Skilled Nursing Facility (SNF) Patients within 48 Hours and 30 Days after SNF Admission

    Science.gov (United States)

    Ouslander, Joseph G.; Naharci, Ilkin; Engstrom, Gabriella; Shutes, Jill; Wolf, David G.; Rojido, Maria; Tappen, Ruth; Newman, David

    2016-01-01

    Background Close to one in 5 patients admitted to a skilled nursing facility (SNF) are readmitted to the acute hospital within 30 days, and a substantial percentage are readmitted within two days of the SNF admission. These rapid returns to the hospital may provide insights for improving care transitions between the acute hospital and the SNF. Objectives To describe the characteristics of SNF to hospital transfers that occur within 48 hours and 30 days of SNF admission based on root cause analyses (RCAs) performed by SNF staff, and identify potential areas of focus for improving transitions between hospitals and SNFs. Design Trained staff from SNFs enrolled in a randomized, controlled clinical trial of the INTERACT (Interventions to Reduce Acute Care Transfers) quality improvement program performed retrospective RCAs on hospital transfers during a 12-month implementation period. Setting SNFs from across the U.S. Participants 64 of 88 SNFs randomized to the intervention group submitted RCAs. Interventions SNFs were implementing the INTERACT quality improvement program. Measures Data were abstracted from the INTERACT Quality Improvement (QI) tool, a structured, retrospective RCA on hospital transfers. Results Among 4,658 transfers for which data on the time between SNF admission and hospital transfer were available, 353 (8%) occurred within 48 hours of SNF admission; 524 (11%) 3–6 days after SNF admission; 1,450 (31%) (7 – 29 days after SNF admission; and 2,331 (50%) occurred 30 days or longer after admission. Comparisons between transfers that occurred within 48 hours and within 30 days of SNF admission to transfers that occurred 30 days or longer after SNF admission revealed several statistically significant differences between patient risk factors for transfer, symptoms and signs precipitating the transfers, and other characteristics of the transfers. Hospitalization in the last 30 days and year was significantly more common among those with rapid returns to

  8. Basic HIV/AIDS Statistics

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Statistics Center . How many people are diagnosed with HIV each year in the United States? In 2015, ...

  9. Effects of short-term exposure to air pollution on hospital admissions of young children for acute lower respiratory infections in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Le, Truong Giang; Ngo, Long; Mehta, Sumi; Do, Van Dzung; Thach, T Q; Vu, Xuan Dan; Nguyen, Dinh Tuan; Cohen, Aaron

    2012-06-01

    hospitals. Daily citywide 24-hour average concentrations of particulate matter (PM) air quality monitoring network. Daily meteorologic information including temperature and relative humidity were collected from KTTV NB, the Southern Regional Hydro-Meteorological Center. An individual-level indicator of socioeconomic position (SEP) was based on the degree to which the patient was exempt from payment according to hospital financial records. A group-level indicator of SEP was based on estimates of poverty prevalence in the districts of HCMC in 2004, obtained from a poverty mapping project of the Institute of Economic Research in HCMC, in collaboration with the General Statistics Office of Vietnam and the World Bank. Poverty prevalence was defined using the poverty line set by the People's Committee of HCMC of 6 million Vietnamese dong (VND) annual income. Quartiles of district-level poverty prevalence were created based on poverty prevalence estimates for each district. Analyses were conducted using both time-series and case-crossover approaches. In the absence of measurement error, confounding, and other sources of bias, the two approaches were expected to provide estimates that differed only with regard to precision. For the time-series analyses, the unit of observation was daily counts of hospital admissions for ALRI. Poisson regression with smoothing functions for meteorologic variables and variables for seasonal and long-term trends was used. Case-crossover analyses were conducted using time-stratified selection of controls. Control days were every 7th day from the date of admission within the same month as admission. Large seasonal differences were observed in pollutant levels and hospital admission patterns during the investigation period for HCMC. Of the 15,717 ALRI admissions occurring within the study period, 60% occurred in the rainy season (May through October), with a peak in these admissions during July and August of each year. Average daily concentrations for PM

  10. Formulating Recruitment and Retention Policies at the University of Delaware: From Affirmative Action to Diversity in Financial Aid and Admissions

    Science.gov (United States)

    Burton, Johnie A., Jr.

    2010-01-01

    In 2003, the United States Supreme Court decided on two cases that involved affirmative action policies for admission to the University of Michigan at Ann Arbor Law School and the College of Literature, Science and the Arts. Those cases, "Gratz v. Bollinger" (2003) and "Grutter v. Bollinger" (2003) had implications for the…

  11. 8 CFR 212.2 - Consent to reapply for admission after deportation, removal or departure at Government expense.

    Science.gov (United States)

    2010-01-01

    ..., removal or departure at Government expense. (a) Evidence. Any alien who has been deported or removed from... who has been deported or removed from the United States and is applying for a visa, admission to the... alien deported, or removed 2 or more times, or at any time after deportation or removal in the case...

  12. Depth statistics

    OpenAIRE

    2012-01-01

    In 1975 John Tukey proposed a multivariate median which is the 'deepest' point in a given data cloud in R^d. Later, in measuring the depth of an arbitrary point z with respect to the data, David Donoho and Miriam Gasko considered hyperplanes through z and determined its 'depth' by the smallest portion of data that are separated by such a hyperplane. Since then, these ideas has proved extremely fruitful. A rich statistical methodology has developed that is based on data depth and, more general...

  13. Statistical mechanics

    CERN Document Server

    Sheffield, Scott

    2009-01-01

    In recent years, statistical mechanics has been increasingly recognized as a central domain of mathematics. Major developments include the Schramm-Loewner evolution, which describes two-dimensional phase transitions, random matrix theory, renormalization group theory and the fluctuations of random surfaces described by dimers. The lectures contained in this volume present an introduction to recent mathematical progress in these fields. They are designed for graduate students in mathematics with a strong background in analysis and probability. This book will be of particular interest to graduate students and researchers interested in modern aspects of probability, conformal field theory, percolation, random matrices and stochastic differential equations.

  14. 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.

  15. Using Lean Management to Reduce Emergency Department Length of Stay for Medicine Admissions.

    Science.gov (United States)

    Allaudeen, Nazima; Vashi, Anita; Breckenridge, Julia S; Haji-Sheikhi, Farnoosh; Wagner, Sarah; Posley, Keith A; Asch, Steven M

    The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored. To evaluate a Lean-based initiative to reduce ED LOS for medicine admissions. Prospective quality improvement initiative performed at a single university-affiliated Department of Veterans Affairs (VA) medical center from February 2013 to February 2016. We performed a Lean-based multidisciplinary initiative beginning with a rapid process improvement workshop to evaluate current processes, identify root causes of delays, and develop countermeasures. Frontline staff developed standard work for each phase of the ED stay. Units developed a daily management system to reinforce, evaluate, and refine standard work. The primary outcome was the change in ED LOS for medicine admissions pre- and postintervention. ED LOS at the intervention site was compared with other similar VA facilities as controls over the same time period using a difference-in-differences approach. ED LOS for medicine admissions reduced 26.4%, from 8.7 to 6.4 hours. Difference-in-differences analysis showed that ED LOS for combined medicine and surgical admissions decreased from 6.7 to 6.0 hours (-0.7 hours, P = .003) at the intervention site compared with no change (5.6 hours, P = .2) at the control sites. We utilized Lean management to significantly reduce ED LOS for medicine admissions. Specifically, the development and management of standard work were key to sustaining these results.

  16. Mortality associated with timing of admission to and discharge from ICU: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Laupland Kevin B

    2011-11-01

    Full Text Available Abstract Background Although the association between mortality and admission to intensive care units (ICU in the "after hours" (weekends and nights has been the topic of extensive investigation, the timing of discharge from ICU and outcome has been less well investigated. The objective of this study was to assess effect of timing of admission to and discharge from ICUs and subsequent risk for death. Methods Adults (≥18 years admitted to French ICUs participating in Outcomerea between January 2006 and November 2010 were included. Results Among the 7,380 patients included, 61% (4,481 were male, the median age was 62 (IQR, 49-75 years, and the median SAPS II score was 40 (IQR, 28-56. Admissions to ICU occurred during weekends (Saturday and Sunday in 1,708 (23% cases, during the night (18:00-07:59 in 3,855 (52%, and on nights and/or weekends in 4,659 (63% cases. Among 5,992 survivors to ICU discharge, 903 (15% were discharged on weekends, 659 (11% at night, and 1,434 (24% on nights and/or weekends. After controlling for a number of co-variates using logistic regression analysis, admission during the after hours was not associated with an increased risk for death. However, patients discharged from ICU on nights were at higher adjusted risk (odds ratio, 1.54; 95% confidence interval, 1.12-2.11 for death. Conclusions In this study, ICU discharge at night but not admission was associated with a significant increased risk for death. Further studies are needed to examine whether minimizing night time discharges from ICU may improve outcome.

  17. Contribution of ED admissions to inpatient hospital revenue.

    Science.gov (United States)

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

    2002-01-01

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

  18. Comparison of Risks Factors for Unplanned ICU Transfer after ED Admission in Patients with Infections and Those without Infections

    Directory of Open Access Journals (Sweden)

    Jeffrey Che-Hung Tsai

    2014-01-01

    Full Text Available Background. The objectives of this study were to compare the risk factors for unplanned intensive care unit (ICU transfer after emergency department (ED admission in patients with infections and those without infections and to explore the feasibility of using risk stratification tools for sepsis to derive a prediction system for such unplanned transfer. Methods. The ICU transfer group included 313 patients, while the control group included 736 patients randomly selected from those who were not transferred to the ICU. Candidate variables were analyzed for association with unplanned ICU transfer in the 1049 study patients. Results. Twenty-four variables were associated with unplanned ICU transfer. Sixteen (66.7% of these variables displayed association in patients with infections and those without infections. These common risk factors included specific comorbidities, physiological responses, organ dysfunctions, and other serious symptoms and signs. Several common risk factors were statistically independent. Conclusions. The risk factors for unplanned ICU transfer in patients with infections were comparable to those in patients without infections. The risk factors for unplanned ICU transfer included variables from multiple dimensions that could be organized according to the PIRO (predisposition, insult/infection, physiological response, and organ dysfunction model, providing the basis for the development of a predictive system.

  19. The role of socioeconomic status in SAT-grade relationships and in college admissions decisions.

    Science.gov (United States)

    Sackett, Paul R; Kuncel, Nathan R; Beatty, Adam S; Rigdon, Jana L; Shen, Winny; Kiger, Thomas B

    2012-09-01

    This article examines the role of socioeconomic status (SES) in the relationships among college admissions-test scores, secondary school grades, and subsequent academic performance. Scores on the SAT (a test widely used in the admissions process in the United States), secondary school grades, college grades, and SES measures from 143,606 students at 110 colleges and universities were examined, and results of these analyses were compared with results obtained using a 41-school data set including scores from the prior version of the SAT and using University of California data from prior research on the role of SES. In all the data sets, the SAT showed incremental validity over secondary school grades in predicting subsequent academic performance, and this incremental relationship was not substantially affected by controlling for SES. The SES of enrolled students was very similar to that of specific schools' applicant pools, which suggests that the barrier to college for low-SES students in the United States is a lower rate of entering the college admissions process, rather than exclusion on the part of colleges.

  20. Factors influencing nursing care in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Raj John

    2006-01-01

    Full Text Available Context: The total time spent in nursing care depends on the type of patient and the patient′s condition. We analysed factors that influenced the time spent in nursing a patient. Aims : To analyse the factors in a patient′s condition that influenced time spent in nursing a patient. Materials and Methods: This study was performed in the Surgical Intensive Care Unit of a tertiary referral centre, over a period of one month. The total time spent on a patient in nursing care for the first 24 hours of admission, was recorded. This time was divided into time for routine nursing care, time for interventions, time for monitoring and time for administering medications. Statistical analysis used: A backward stepwise linear regression analysis using the age, sex, diagnosis, type of admission and ventilatory status as variables, was done. Results: Patients admitted after elective surgery required less time (852.4 ± 234.1 minutes, than those admitted after either emergency surgery (1069.5 ± 187.3 minutes, or directly from the ward or the emergency room (1253.7 ± 42.1 minutes. Patients who were ventilated required more time (1111.5 ± 132.5 minutes, than those brought on a T-piece (732.2 ± 134.8 minutes or extubated (639.5 ± 155.6 minutes. The regression analysis showed that only the type of admission and the ventilatory status significantly affected the time. Conclusions : This study showed that the type of admission and ventilatory status significantly influenced the time spent in nursing care. This will help optimal utilization of nursing resources.