Madeline McDowell Breckinridge; a leader in the new South,

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Contemporary Cuban Culture: Notes on Alternative Thinking, Lecture by Madeline Cámara Betancourt

This flyer promotes the event "Contemporary Cuban Culture: Notes on Alternative Thinking Lecture by Madeline Cámara Betancourt ". Credit for image on flyer: Baruj Salinas, Punta Cana VI, 1999.

Contemporary Cuban Culture: Notes on Alternative Thinking, Lecture by Madeline Cámara Betancourt

Dr. Madeline Camara Betancourt gives a lecture that considers several key cultural, political, and literary events as "crossroads" that have generated alternative thoughts in the quest for a Cuban identity after 1959.

President Madeline McWhinney at Women's bank press conference

General note: Title and date provided by Bettye Lane.

Propuesta de herramientas administrativas que contribuyan a mejorar el desempeño organizacional de la Panadería Valeria departamento de San Miguel

El presente trabajo tiene como finalidad elaborar herramientas administrativas que contribuyan a mejorar el desempeño organizacional de la Panadería Valeria en la ciudad de San Miguel así como determinar una planeación que logre la eficiente toma de decisiones; diseñar una organización que permita la coordinación y ordenamiento de las operaciones de La Panadería Valeria; definir una dirección que proporcione una mejor ejecución y coordinación de los recursos humanos en La Panadería Valeria y establecer un control interno para el Área de Recursos Humanos que les permita garantizar el logro de los objetivos. Por lo que la implementación de herramientas administrativas permitirá analizar los cambios de las variables internas como externas ya que estás ayudaran a mejorar el desarrollo de la organización mediante la utilización de planes, y diferentes tipos de sistemas con el propósito de ofrecer un instrumento administrativo que permita facilitar la toma de decisiones en la planificación y en el control así como también mejorar la situación de la empresa.

Using Trauma Injury Severity Score (TRISS) variables to predict length of hospital stay following trauma in New Zealand

Aim – To develop and assess the predictive capabilities of a statistical model that relates routinely collected Trauma Injury Severity Score (TRISS) variables to length of hospital stay (LOS) in survivors of traumatic injury. Method – Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until discharge from Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Cubic-root transformed LOS was analysed using two-level mixed-effects regression models. Results – 1498 eligible patients were identified, 1446 (97%) injured from a blunt mechanism and 52 (3%) from a penetrating mechanism. For blunt mechanism trauma, 1096 (76%) were male, average age was 37 years (range: 15-94 years), and LOS and TRISS score information was available for 1362 patients. Spearman’s correlation and the median absolute prediction error between LOS and the original TRISS model was ρ=0.31 and 10.8 days, respectively, and between LOS and the final multivariable two-level mixed-effects regression model was ρ=0.38 and 6.0 days, respectively. Insufficient data were available for the analysis of penetrating mechanism models. Conclusions – Neither the original TRISS model nor the refined model has sufficient ability to accurately or reliably predict LOS. Additional predictor variables for LOS and other indicators for morbidity need to be considered.

Contemporary New Zealand coefficients for the Trauma Injury Severity Score: TRISS(NZ)

Aims – To develop local contemporary coefficients for the Trauma Injury Severity Score in New Zealand, TRISS(NZ), and to evaluate their performance at predicting survival against the original TRISS coefficients. Methods – Retrospective cohort study of adults who sustained a serious traumatic injury, and who survived until presentation at Auckland City, Middlemore, Waikato, or North Shore Hospitals between 2002 and 2006. Coefficients were estimated using ordinary and multilevel mixed-effects logistic regression models. Results – 1735 eligible patients were identified, 1672 (96%) injured from a blunt mechanism and 63 (4%) from a penetrating mechanism. For blunt mechanism trauma, 1250 (75%) were male and average age was 38 years (range: 15-94 years). TRISS information was available for 1565 patients of whom 204 (13%) died. Area under the Receiver Operating Characteristic (ROC) curves was 0.901 (95%CI: 0.879-0.923) for the TRISS(NZ) model and 0.890 (95% CI: 0.866-0.913) for TRISS (P<0.001). Insufficient data were available to determine coefficients for penetrating mechanism TRISS(NZ) models. Conclusions – Both TRISS models accurately predicted survival for blunt mechanism trauma. However, TRISS(NZ) coefficients were statistically superior to TRISS coefficients. A strong case exists for replacing TRISS coefficients in the New Zealand benchmarking software with these updated TRISS(NZ) estimates.