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

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

Cross-country differences in disclosure quality: a study of fair value disclosures by european real estate companies

Companies are under IAS 40 required to report fair values of investment properties on the balance sheet or to disclose them in the notes. The standard requires also that companies have to disclose the methods and significant assumptions applied in determining fair values of investment properties. However, IAS 40 does not include any illustrative examples or other guidance on how to apply the disclosure requirements. We use a sample with publicly traded companies from the real estate sector in the EU. We find that a majority of the companies use income based methods for the measurement of fair values but there are considerable cross-country variations in the level of disclosures about the assumptions used in determining fair values. More specifically, we find that Scandinavian and German origin companies disclose more than French and English origin companies. We also test whether disclosure quality is associated with enforcement quality measured with the “Rule of Law” index according to Kaufmann et al. (2010), and associated with a secrecy- versus transparency-measure based on Gray (1988). We find a positive association between disclosure and earnings quality and a negative association with secrecy.

Cross-validation of methods used for analysis of MTBE and other gasoline components in groundwater.

Head space gas chromatography with flame-ionization detection (HS-GC-FID), ancl purge and trap gas chromatography-mass spectrometry (P&T-GC-MS) have been used to determine methyl-tert-butyl ether (MTBE) and benzene, toluene, and the ylenes (BTEX) in groundwater. In the work discussed in this paper measures of quality, e.g. recovery (94-111%), precision (4.6 - 12.2%), limits of detection (0.3 - 5.7 I~g L 1 for HS and 0.001 I~g L 1 for PT), and robust-ness, for both methods were compared. In addition, for purposes of comparison, groundwater samples from areas suffering from odor problems because of fuel spillage and tank leakage were analyzed by use of both techniques. For high concentration levels there was good correlation between results from both methods.

Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross-sectional study of the PREDIMED trial

Hypertension is a major public health problem and a leading cause of death and disability in both developed and developing countries, affecting onequarter of the world"s adult population. Our aim was to evaluate whether the consumption of gazpacho, a Mediterranean vegetable-based cold soup rich in phytochemicals, is associated with lower blood pressure (BP) and/or reduced prevalence of hypertension in individuals at high cardiovascular risk. Methods and results: We selected 3995 individuals (58% women, mean age 67 y) at high cardiovascular risk (81% hypertensive) recruited into the PREDIMED study. BP, weight, and dietary and physical activity data were collected. In multivariate linear regression analyses, after adjustment, moderate and high gazpacho consumption categories were associated with reduced mean systolic BP of 1.9 mm Hg [95% confidence interval (CI): 3.4; 0.6] and 2.6 mm Hg (CI: 4.2; 1.0), respectively, and reduced diastolic BP of 1.5 mm Hg (CI: 2.3; 0.6) and 1.9 mm Hg (CI: 2.8; 1.1). By multiple-adjusted logistic regression analysis, gazpacho consumption was associated with a lower prevalence of hypertension, with OR Z 0.85 (CI: 0.73; 0.99) for each 250 g/week increase and OR Z 0.73 (CI: 0.55; 0.98) for high gazpacho consumption groups compared to the no-consumption group. Conclusions: Gazpacho consumption was inversely associated with systolic and diastolic BP and prevalence of hypertension in a cross-sectional Mediterranean population at high cardiovascular risk. The association between gazpacho intake and reduction of BP is probably due to synergy among several bioactive compounds present in the vegetable ingredients used to make the recipe.

Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross-sectional study of the PREDIMED trial

Hypertension is a major public health problem and a leading cause of death and disability in both developed and developing countries, affecting onequarter of the world"s adult population. Our aim was to evaluate whether the consumption of gazpacho, a Mediterranean vegetable-based cold soup rich in phytochemicals, is associated with lower blood pressure (BP) and/or reduced prevalence of hypertension in individuals at high cardiovascular risk. Methods and results: We selected 3995 individuals (58% women, mean age 67 y) at high cardiovascular risk (81% hypertensive) recruited into the PREDIMED study. BP, weight, and dietary and physical activity data were collected. In multivariate linear regression analyses, after adjustment, moderate and high gazpacho consumption categories were associated with reduced mean systolic BP of 1.9 mm Hg [95% confidence interval (CI): 3.4; 0.6] and 2.6 mm Hg (CI: 4.2; 1.0), respectively, and reduced diastolic BP of 1.5 mm Hg (CI: 2.3; 0.6) and 1.9 mm Hg (CI: 2.8; 1.1). By multiple-adjusted logistic regression analysis, gazpacho consumption was associated with a lower prevalence of hypertension, with OR Z 0.85 (CI: 0.73; 0.99) for each 250 g/week increase and OR Z 0.73 (CI: 0.55; 0.98) for high gazpacho consumption groups compared to the no-consumption group. Conclusions: Gazpacho consumption was inversely associated with systolic and diastolic BP and prevalence of hypertension in a cross-sectional Mediterranean population at high cardiovascular risk. The association between gazpacho intake and reduction of BP is probably due to synergy among several bioactive compounds present in the vegetable ingredients used to make the recipe.

A global view of cross-border migration

This paper evaluates the global welfare impact of observed levels of migration using a quantitativemulti-sector model of the world economy calibrated to aggregate and firm-level data.Our framework features cross-country labor productivity differences, international trade, remittances,and a heterogeneous workforce. We compare welfare under the observed levels ofmigration to a no-migration counterfactual. In the long run, natives in countries that receiveda lot of migration -such as Canada or Australia- are better o due to greater product varietyavailable in consumption and as intermediate inputs. In the short run the impact of migrationon average welfare in these countries is close to zero, while the skilled and unskilled nativestend to experience welfare changes of opposite signs. The remaining natives in countries withlarge emigration flows -such as Jamaica or El Salvador- are also better off due to migration,but for a different reason: remittances. The welfare impact of observed levels of migration issubstantial, at about 5 to 10% for the main receiving countries and about 10% in countries withlarge incoming remittances. Our results are robust to accounting for imperfect transferabilityof skills, selection into migration, and imperfect substitution between natives and immigrants.

Major variables influencing correct antibiotic prescription by primary care physicians in acute pharyngitis: a cross-sectional study

Objectives:To analyse which are the main variables that influence primary care professionals, in the prescription of antibiotics in patients with acute pharyngitis.To analyse which is the diagnosis pattern used by primary care professionals towards cutepharyngitis. To recognize the clinical and analytical criteria that primary care professionals use, to determine antibiotic treatment in acute pharyngitis.To identify the main clinical variables related with the prescription of antibiotics by primary care professionals, in acute pharyngitis treatment. Design: Cross-­‐sectional study Participants:165 primary care professionals from the Sanitary Region of Girona not attending paediatric patients and randomly selected from 29 ABS managed by two of the main health care providers: Insitut Català de la Salut (ICS) and Institut d’Assistència Sanitària (IAS) Main outcome measures: Each participant will fill out a questionnaire with personal and workplace questions, as well as about knowledge and attitude in front of the acute pharyngitis caused by group A streptococci. They will also answer 4 clinical questions about correct treatment and diagnosis of acute pharyngitis caused by group A streptococci

JXTAnonym: An anonymity layer for JXTA services messaging

With the evolution of the P2P research eld, new problems, such as those related with information security, have arisen. It is important to provide security mechanisms to P2P systems, since it has already become one of the key issues when evaluating them. However, even though many P2P systems have been adapted to provide a security baseline to their underlying applications, more advanced capabilities are becoming necessary. Speci cally, privacy preservation and anonymity are deemed essential to make the information society sustainable. Unfortunately, sometimes, it may be di cult to attain anonymity unless it is included into the system's initial design. The JXTA open protocols speci cation is a good example of this kind of scenario. This work studies how to provide anonymity to JXTA's architecture in a feasible manner and proposes an extension which allows deployed services to process two-way messaging without disclosing the endpoints'identities to third parties.

A robust audio watermarking scheme based on MPEG 1 Layer 3 Compression

This paper describes an audio watermarking scheme based on lossy compression. The main idea is taken from an image watermarking approach where the JPEG compression algorithm is used to determine where and how the mark should be placed. Similarly, in the audio scheme suggested in this paper, an MPEG 1 Layer 3 algorithm is chosen for compression to determine the position of the mark bits and, thus, the psychoacoustic masking of the MPEG 1 Layer 3compression is implicitly used. This methodology provides with a high robustness degree against compression attacks. The suggested scheme is also shown to succeed against most of the StirMark benchmark attacks for audio.

A security layer for JXTA core protocols

JXTA define un conjunto de seis protocolos básicos especialmente adecuados para una computación ad hoc, permanente, multi-hop, peer-to-peer (P2P). Estos protocolos permiten que los iguales cooperen y formen grupos autónomos de pares. Este artículo presenta un método que proporciona servicios de seguridad en los protocolos básicos: protección de datos, autenticidad, integridad y no repudio. Los mecanismos que se presentan son totalmente distribuidos y basados ¿¿en un modelo puro peer-to-peer, que no requieren el arbitraje de un tercero de confianza o una relación de confianza establecida previamente entre pares, que es uno de los principales retos en este tipo de entornos.

A two-dimensional doppler-radiometer for earth observation

Compared to synthetic aperture radars (SARs), the angular resolution of microwave radiometers is quite poor. Traditionally, it has been limited by the physical size of the antenna. However, the angular resolution can be improved by means of aperture synthesis interferometric techniques. A narrow beam is synthesized during the image formation processing of the cross-correlations measured at zero-lag between pairs of signals collected by an array of antennas. The angular resolution is then determined by the maximum antenna spacing normalized to the wavelength (baseline). The next step in improving the angular resolution is the Doppler-Radiometer, somehow related to the super-synthesis radiometers and the Radiometer-SAR. This paper presents the concept of a three-antenna Doppler-Radiometer for 2D imaging. The performance of this instrument is evaluated in terms of angular/spatial resolution and radiometric sensitivity, and an L-band illustrative example is presented.

A model of the wind direction signature in the Stokes emission vector from the ocean surface at microwave frequencies

This paper presents a model of the Stokes emission vector from the ocean surface. The ocean surface is described as an ensemble of facets with Cox and Munk's (1954) Gram-Charlier slope distribution. The study discusses the impact of different up-wind and cross-wind rms slopes, skewness, peakedness, foam cover models and atmospheric effects on the azimuthal variation of the Stokes vector, as well as the limitations of the model. Simulation results compare favorably, both in mean value and azimuthal dependence, with SSM/I data at 53° incidence angle and with JPL's WINDRAD measurements at incidence angles from 30° to 65°, and at wind speeds from 2.5 to 11 m/s.