Exploring race/ethnicity as a risk factor for mortality in newborns following congenital heart surgery at a center of excellence

The purpose of this study was to determine if race/ethnicity was a significant risk factor for hospital mortality in children following congenital heart surgery in a contemporary sample of newborns with congenital heart disease. Unlike previous studies that utilized administrative databases, this study utilized clinical data collected at the point of care to examine racial/ethnic outcome differences in the context of the patients' clinical condition and their overall perioperative experience. A retrospective cohort design was used. The study sample consisted of 316 newborns (<31 days of age) who underwent congenital heart surgery between January 2007 through December 2009. A multivariate logistic regression model was used to determine the impact of race/ethnicity, insurance status, presence of a spatial anomaly, prenatal diagnosis, postoperative sepsis, cardiac arrest, respiratory failure, unplanned reoperation, and total length of stay in the intensive care unit on outcomes following congenital heart surgery in newborns. The study findings showed that the strongest predictors of hospital mortality following congenital heart surgery in this cohort were postoperative cardiac arrest, postoperative respiratory failure, having a spatial anomaly, and total ICU LOS. Race/ethnicity and insurance status were not significant risk factors. The institution where this study was conducted is designated as a center of excellence for congenital heart disease. These centers have state-of-the-art facilities, extensive experience in caring for children with congenital heart disease, and superior outcomes. This study suggests that optimal care delivery for newborns requiring congenital heart surgery at a center of excellence portends exceptional outcomes and this benefit is conferred upon the entire patient population despite the race/ethnicity of the patients. From a public health and health services view, this study also contributes to the overall body of knowledge on racial/ethnic disparities in children with congenital heart defects and puts forward the possibility of a relationship between quality of care and racial/ethnic disparities. Further study is required to examine the impact of race/ethnicity on the long-term outcomes of these children as they encounter the disparate components of the health care delivery system. There is also opportunity to study the role of race/ethnicity on the hospital morbidity in these patients considering current expectations for hospital survival are very high, and much of the current focus for quality improvement rests in minimizing the development of patient morbidities.^

Campus of Excellence: The Power of Diversity in Engineering Education

This paper presents the results of a strategy to modernise the Spanish University system through the establishment of an International Campus of Excellence (CEI). The current, ambitious but realistic, project is a joint initiative of a number of institutions located in the Moncloa Campus, amongst them the Complutense and the Technical Universities, as well as CIEMAT, CSIC and INIA. The aim of the project is to transform the Moncloa Campus into an international point of reference with regard to research, education and innovation. This paper describes the project and presents the qualitative and quantitative results.

INFOBIOMED: European Network of Excellence on Biomedical Informatics to support individualised healthcare

INFOBIOMED is an European Network of Excellence (NoE) funded by the Information Society Directorate-General of the European Commission (EC). A consortium of European organizations from ten different countries is involved within the network. Four pilots, all related to linking clinical and genomic information, are being carried out. From an informatics perspective, various challenges, related to data integration and mining, are included.

The exaptive excellence of spandrels as a term and prototype

In 1979, Lewontin and I borrowed the architectural term “spandrel” (using the pendentives of San Marco in Venice as an example) to designate the class of forms and spaces that arise as necessary byproducts of another decision in design, and not as adaptations for direct utility in themselves. This proposal has generated a large literature featuring two critiques: (i) the terminological claim that the spandrels of San Marco are not true spandrels at all and (ii) the conceptual claim that they are adaptations and not byproducts. The features of the San Marco pendentives that we explicitly defined as spandrel-properties—their necessary number (four) and shape (roughly triangular)—are inevitable architectural byproducts, whatever the structural attributes of the pendentives themselves. The term spandrel may be extended from its particular architectural use for two-dimensional byproducts to the generality of “spaces left over,” a definition that properly includes the San Marco pendentives. Evolutionary biology needs such an explicit term for features arising as byproducts, rather than adaptations, whatever their subsequent exaptive utility. The concept of biological spandrels—including the examples here given of masculinized genitalia in female hyenas, exaptive use of an umbilicus as a brooding chamber by snails, the shoulder hump of the giant Irish deer, and several key features of human mentality—anchors the critique of overreliance upon adaptive scenarios in evolutionary explanation. Causes of historical origin must always be separated from current utilities; their conflation has seriously hampered the evolutionary analysis of form in the history of life.

Communicating excellence in innovation

The innovation–performance relationship is well studied in the literature, but the effect of innovation-based public recognitions is underresearched. This article finds a positive effect, whose magnitude is contingent upon the firm’s growth, experience, and its service–manufacturer character.

Le Royaume de Bosnie, dans son entier, dédié a son Excellence Monseignr. le feld Maréchal Comte de Khewenhüller Colonel d'un Régiment de Dragon Vice Roy d'Esclavonie, du Duché de Syrmie et Gouverneur de la Forteresse d'Essegg etc

le très humble et très obéissant serviteur Étienne Briffaut.

Towards a Definition of Excellence in Sport Coaching

In this paper,we propose different definitions of coaching excellence based on two principles. First,the application of coaching skill,as in any other domain of excellence,is context-dependent. Second, excellent coaches are knowledgeable and constantly assemble mental models that enable them to meet their athletes' needs and to effectively manage the central duties of coaching - organization, training, and competition. Four categories of coaches and corresponding definitions are proposed based on the characteristics of athletes and the developmentally-appropriate sport contexts: 1) participation coaches for children, 2) participation coaches for teens and adults, 3) performance coaches for young adolescents, 4) performance coaches for older adolescents and adults.

Rapport sur la création de colonies cotonnières nationales : présenté à son excellence le ministre de l'agriculture, docteur Damián M. Torino /

Mode of access: Internet.

Guidelines for a K-12 traffic safety education curriculum. Volume II: curriculum content and instructional approach. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Minority ownership of small business: instructional handbook.

"Produced by the Office of Education in cooperation with the Dept. of Commerce, the Dept. o Housing and Urban Development, and the Office of Economic Opportunity."

National assessment of educational progress, 1985-86 : mathematics achievement and classroom instructional activities /

Item 455-G-9

An instructional delivery system for manpower management /

Mode of access: Internet.

Excellence in design, a new potential on the American campus: the 1966 awards program,

Includes five addresses and a list of the awards.

National Excellence Awards for the city summit, the United States of America.

Shipping list no.: 96-0259-P.