The Impact of Admissions for the Management of End-stage renal disease on hospital bed occupancy

BACKGROUND:

End-stage renal disease (ESRD) is increasingly prevalent but the inpatient costs associated with this condition are poorly defined due to limitations with data extraction and failure to differentiate between hospitalisation for renal and non-renal disease reasons. The impact of admissions primarily for the management of ESRD on hospital bed utilisation was assessed over a 5-year period in a large teaching hospital.

METHODS:

All admission episodes were reviewed and the ESRD group was identified by a primary International Classification of Diseases code for ESRD or a non-specific primary renal failure code with a secondary code for ESRD. The frequency and duration of hospitalisation and contribution to bed day occupancy of this group with ESRD was determined.

RESULTS:

There were 70,808 patients responsible for a total of 116,915 admissions and 919,212 bed days over the study period. Of these, 988 (1.4%) patients were admitted for the management of ESRD, accounting for 2,387 (2.0%) of admissions and utilisation of 23,011 (2.5%) bed days. After adjustment for age and gender, those admitted for ESRD management were significantly more likely to have a prolonged admission exceeding 30 days (odds ratio 1.46, 95% confidence interval 1.23-1.72, p < 0.001). When the admission was an emergency rather than an elective event, the patient was 4.6 times more likely to be hospitalised for over 30 days.

CONCLUSIONS:

Persons admitted for ESRD management are hospitalised more frequently and for longer than the overall inpatient population, occupying a substantial number of bed days.

Age and palaeoenvironmental significance of an inter-tidal peat bed at Ballywoolen, Bann estuary, Co. Londonderry.

A recently exposed inter-tidal peat bed at Ballywoolen, Bann estuary, Co. Londonderry, has yielded new information about mid-Holocene coastal environmental change in the northeast of Ireland. Pollen analytical data and wood detritus demonstrate that peat accumulation occurred in a terrestrial environment that was free from marine influence. Radiocarbon dates suggest that the peat accumulated rapidly during a period of low relative sea level subsequent to the maximum of Holocene relative sea-level rise along the north coast of Northern Ireland. The absence of marine/brackish indicator taxa at the site suggests that the tidal range was somewhat less than that at present and/or that the channel of the river was located some distance east of its present alignment. The dates indicate that the low stand lasted for at least ~0.2 ka and possibly for ~1.1 ka. Stable, woodland-dominated landscapes are indicated at both this site and neighbouring ones around ~6.4-5.3 cal ka BP. There is no evidence for large-scale aeolian sand movement or human impact on the landscape during the period of peat accumulation.

Isolation of monocytes from human peripheral blood using immuno-affinity expanded-bed adsorption

A novel technique for the separation of monocytes from human peripheral blood preparations has been developed. The technique is based on the use of expanded-bed adsorption and a solid perfluorocarbon derivatized with avidin or streptavidin for the indirect positive or negative capture of cells labeled with biotinylated monoclonal antibodies. The perfluorocarbon support was prepared and characterized and the contactor design and operating conditions, that enable cells to be selectively isolated, were investigated. Experiments consisted of applying an immunolabeled pulse of 1 x 10(8) peripheral blood mononuclear cells (PBMCs), isolated by density gradient centrifugation, directly onto a refrigerated expanded bed. The major cell types remaining were T-lymphocytes, B-lymphocytes, and monocytes. Monocytes could be positively adsorbed, following labeling with anti-CD14 mAb, with a clearance of up to 89% and a depletion factor of 7.6. They could also be

Trends in reported sun bed use, sunburn, and sun care knowledge and attitudes in a UK region: results of a survey of the Northern Ireland population

Background Sunburn and sun bed use increase risk of malignant melanoma, the incidence of which continues to rise.

Fluidised bed characterisation using Raman spectroscopy: Applications to pharmaceutical processing

This study investigates a model system for potential pharmaceutical materials in fluidised bed processes. In particular, this study proposes a novel use of Raman spectroscopy, which allows in situ measurement of the composition of the material within the fluidised bed in three spatial dimensions and as a function of time. This is achieved by recording Raman spectra from specific volumes of space. The work shows that Raman spectroscopy can be used to provide 3D maps of the concentration and chemical structure of the particles in a fluidised bed within a relatively short (120 s) time window. At the most basic level the technique measures particle density via the intensity of the Raman spectra, however this could be used. More importantly the data are also rich in spectroscopic information on the chemical structure of the fluidised particles which is useful either for monitoring a given granulation process or more generally for the analysis of the dynamics of the airflow if the data were incorporated into an appropriate model. The technique has the potential to give detailed in situ information on how the structure and composition of the granules/powders within the fluidised bed (dryer or granulator) vary with the position and evolve with time. (c) 2007 Elsevier Ltd. All rights reserved.