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The purpose of this study consisted of three main components: 1) to identify effective counselor characteristics in the literature; 2) to describe existing admission requirements of counseling programs; and, if a need was determined, 3) to develop a framework for a standard set of admission requirements, balanced between cognitive-behavioral characteristics and personal-emotional characteristics, to more thoroughly assess prospective master’s level counseling students. This study discusses the typical admission requirements of master's level CACREP (The Council for Accreditation of Counseling and Related Educational Programs) counseling programs and what the research indicates are characteristics of effective counselors. A literature review of effective counselor characteristics and graduate admission requirements was conducted, CACREP guidelines were examined, and admission requirements and procedures for all 129 CACREP counselor education programs were analyzed. The findings from the literature review were then compared with the data collected and analyzed from existing master’s level CACREP counseling programs to determine gaps between the literature-identified characteristics of effective counselors and current admission criteria of CACREP programs. Follow-up telephone interviews with a faculty of leadership stature from a sample of 20 CACREP counseling programs were conducted. After determining a need, information collected was used to develop a framework for a standard set of admission requirements. Results indicated that currently, a) there is no framework for a standard set of admission requirements for assessing prospective students for master’s level counseling programs that identify personal-emotional characteristics, b) there are gaps between what the literature identifies as effective counselor characteristics and what is typically assessed during admission, c) an agreement exists that the counseling profession must do a better job of gate-keeping, and d) that a framework of admission requirements is needed by counselor educators to assist in a more thorough screening and examination of personal characteristics of prospective students. Finally, e) this research established a foundation for this framework of a standard set of admission requirements that could be used by faculty to more exhaustively assess prospective master’ s level counseling students. / Ph. D.

Durante los últimos años las redes móviles celulares han experimentado un considerable crecimiento y desarrollo debido al nuevo modo en que la sociedad crea, comparte y consume información. El enorme impacto y penetración de los servicios móviles telefónicos en la sociedad actual, así como la introducción de un amplio abanico de nuevos servicios de datos y servicios multimedia, han llevado a un crecimiento espectacular del volumen de tráfico transportado por este tipo de redes. Esta tendencia se mantendrá en los próximos años ya que constantemente van apareciendo nuevas aplicaciones que demandan mayor calidad de servicio y ancho de banda. Sin embargo, lasredesmóviles celulares actualestienen fuerteslimitaciones de ancho de banda debido a la escasez de frecuencias en el espectro radioeléctrico. Así, estas nuevas necesidades establecen nuevosretos para la industria de las telecomunicaciones. Es necesario gestionar un creciente número de servicios que demandan elevadas cantidades de recursos, conjuntamente con la escasez del espectro radioeléctrico, para ofrecer servicios que satisfagan las necesidades de los usuarios de un modo eficaz y económico. Dentro de este contexto, la gestión de los recursos radio se presenta como una estrategia clave para hacer frente a las características especiales de estasredes. Concretamente, el control de admisión es un mecanismo clave para utilizar eficientemente los recursos radio disponibles, proporcionando al mismo tiempo las garantías de calidad de servicio requeridas para todoslos usuarios. El presente trabajo se centra en el diseño y evaluación de políticas de control de admisión implementadas en redes móviles celulares multiservicio que transportan diferentes servicios portadores. Además, la presente tesis es una contribución al desarrollo de modelos con los que evaluar diferentes políticas de control de admisión en el desafiante contexto introducido por las redes 4G de próxima aparición. En la primera parte de esta tesis se trata el desarrollo de políticas de control de admisión para redes utilizadas actualmente, mientras que en la segunda parte de esta tesis se proponen políticas de control de admisión novedosas con el objetivo de hacerfrente a los retos introducidos por las redes de próxima aparición, tales como las redes Long TermEvolution o las de tecnología Cognitive Radio / Bernal Mor, E. (2013). Design and evaluation of admission control policies in mobile cellular networks [Tesis doctoral]. Editorial Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/27714

1. Purpose of the Study: The purpose of this study was to develop a conceptual model for a marketing approach for administering community colleges. This model was based on Eugene McCarthy's marketing model which provides for emphasizing customer needs and developing the product, price, promotion, and place variables in relationship to customer needs and institutional resources. The concept of the model was developed as an operational tool in the form of a handbook for marketing the community college. 2. Methods and Procedures: The literature and "juries of experts" were used to develop the criteria for and content of the handbook. After the literature review two community college presidents were interviewed to determine the criteria for the handbook. Using the literature and the interview findings an outline, Preface, and one chapter were written and sent to six community college presidents for review and comments. The entire handbook was then written, using the literature, the jury members' criteria for acceptance and the researcher's knowledge of marketing. A draft of the handbook was sent to twenty-one college administrators and faculty, along with a ten-question, open ended questionnaire. The reviews of this jury were summarized for the purpose of revising the handbook. 3. Conclusions: Although there is a growing interest in the use of marketing techniques by community college administrators, most of them do not know the proper procedures to use in order to accomplish their marketing goals. There was not a handbook, book, or manual available that addressed the entire procedure for marketing the community college. The handbook which was developed during this study was judged by the reviewers to be of value to the community college administrator who is interested in using marketing techniques. / Ed. D.

With the increasing incidence and prevalence of heart failure in the United States, the burden imposed on both the patients and healthcare system is becoming increasingly difficult to manage. In 2009, the American Heart Association estimated that there were 15 million office visits and 6.5 million days spent in the hospital due to heart failure. Complex regimens requiring lifestyle alterations make it difficult for patients to adhere to provider recommendations. In an attempt to decrease this burden, the effects of home telemonitoring have been under investigation. An integrated review of the literature was conducted to summarize findings from studies investigating whether home telemonitoring increases patient adherence to prescribed therapy while reducing hospital admissions and readmissions. The search included relevant studies from 2005 to 201 0. A total of eleven studies were reviewed in this thesis. Statistically significant improvements were found in four of the five articles regarding patient adherence. Two of the articles reporting on hospital admissions indicated statistically significant reductions. while the others showed a trend towards a reduction in hospitalizations. Statistically significant decreases were found in hospital readmissions in three of five studies. While the evidence was not strong enough to support broad-scale implementation, telemonitoring can be recommended as a viable adjunct to usual care for some patients. Nurses should be at the forefront for providing patient education and assessing data provided by telemonitoring equipment. Large-scale. replicable studies are recommended to further determine the effectiveness of telemonitoring related to outcomes of heart failure patients.

The purpose of this study was to investigate the probability that race was a factor in the admissions process at Virginia Tech. The study was conducted in three parts. In the first part, logistic regression was used to develop a probability of admission model for eight demographically distinct groups for the years 1994-1998 using information that was presented to the university by all first-time freshman applicants considering grade point average (GPA), scholastic aptitude tests (SAT), high school rank (HSR), requested major (RM), gender and race. The eight demographic groups were: African American men (BM), African American women (BF), Asian American men (AM), Asian American women (AF), Hispanic American men (HM), Hispanic American women (HF), white American men (WM), and white American women (WF). The Bonferroni correction and the Wald tests were carried out to determine significance in the observed differences. Significant differences were found. The two African American groups and the white female group were found to have significantly higher probabilities of getting accepted than other groups while the two Asian groups were found to have the least probability of getting accepted. The null hypothesis that there was no difference between the groups with regard to probability of getting accepted was thus rejected. GPA was found to be the most important admission criteria followed by SAT scores. The admissions criteria were found to be important for all applicants regardless of group membership. Between group differences detected in the study was mainly the result of differences in cut-off points. The second part of the study involved evaluating the reasons that were given for rejection of admission in 1998. A stratified sample of 400 was randomly selected. The chi-square test was used to determine if there were differences between the eight groups with regard to reasons given for rejection. The frequency with which the reasons were given was also examined. It was found that there were no differences between the groups and, therefore, the null hypothesis was confirmed. GPA related reasons were the most cited for rejection followed by SAT scores. This was consistent with the finding in the first part of this study that GPA and SAT were the most important admission criteria In the third part of the study, the director of admissions and the deputy director of admissions for freshman admissions were interviewed. It was determined from them that affirmative action did not influence the university's admissions decisions but that race was "one of the many factors considered during the admissions process." Based upon the finding in the first part of this study that the two African American groups consistently had the highest probabilities of acceptance in the five years under study, it was concluded that the use of race was intended to benefit applicants from the two groups. This conclusion was further based on the information collected from the interview with the admissions officers which suggested that Affirmative action in the state of Virginia applied only to African Americans and also that there were targeted goals in the state intended to increase the number of African Americans in the state's public higher education institutions. The admissions officers could, however, not provide any references to support this information. Consultations with a professor at the university and the university's vice president for multicultural affairs suggested that there was no state mandate or requirement that public institutions in the state adopt targeted goals as a means of increasing the number of African Americans in the state's public higher education institutions. They also doubted that affirmative action could be applied to one ethnic group only. It was concluded, however, that since the admissions officers made these assertions during the interview, these perceived state requirements may have led them to deliberately seek to increase the number of African American students accepted by the university and that these deliberate efforts may have been behind the high probabilities of the acceptance of students from the two African American groups. The fact that the admissions officers may have deliberately sought to increase the number of African Americans on the campus to satisfy perceived state mandates or requirements and the finding in the first part of this study that the two African American groups consistently had the highest probabilities of getting accepted by the university in the five years under study suggested that admission to the university was not race blind. It was also concluded that since external pressure may have been the cause of the high probabilities for the African American groups, admission to the university was not entirely the prerogative of the university. / Master of Arts

Yes / The most common route to a hospital bed in an emergency is via an emergency department (ED). Many recent initiatives and interventions have the objective of reducing the number of unnecessary emergency admissions. We aimed to assess whether ED admission thresholds had changed over time taking account of the casemix of patients arriving at ED. Methods: We conducted a retrospective cross-sectional analysis of more than 20 million attendances at 47 consultant-led emergency departments in England between April 2010 and March 2015. We used mixed- effects logistic regression to estimate the odds of a patient being admitted to hospital and the impact of a range of potential explanatory variables. Models were developed and validated for four attendance subgroups : ambulance-conveyed children; walk-in children; ambulance-conveyed adults; and walk-in adults. Results: 23.8% of attendances were for children aged under 18 years, 49.7% were female and 30.0% were conveyed by ambulance. The number of ED attendances increased by 1.8% per annum between April 2010 – March 2011 (year 1) and April 2014 –March 2015 (year 5). The proportion of these attendances that were admitted to hospital changed little between year 1 (27.0%) and year 5 (27.5%). However, after adjusting for patient and attendance characteristics the odds of admission over the five year period had reduced by: 15.2% (95% CI 13.4% - 17.0%) for ambulance-conveyed children; 22.6% (95% CI 21.7%-23.5%) for walk-in children; 20.9% (95% CI 4%-21.5%) for ambulance conveyed adults; and 22.9% (95% CI 22.4%-23.5%) for walk-in adults. Conclusions: The casemix-adjusted odds of admission via ED to NHS hospitals in England have decreased since April 2010. EDs are admitting a similar proportion of patients to hospital despite increases in the complexity and acuity of presenting patients. Without these threshold changes, the number of emergency admissions would have been 11.9% higher than was the case in year 5.

Yes / Objectives The Computer-Aided Risk Score (CARS) estimates the risk of death following emergency admission to medical wards using routinely collected vital signs and blood test data. Our aim was to elicit the views of healthcare practitioners (staff) and service users and carers (SU/C) on (1) the potential value, unintended consequences and concerns associated with CARS and practitioner views on (2) the issues to consider before embedding CARS into routine practice. Setting This study was conducted in two National Health Service (NHS) hospital trusts in the North of England. Both had in-house information technology (IT) development teams, mature IT infrastructure with electronic National Early Warning Score (NEWS) and were capable of integrating NEWS with blood test results. The study focused on emergency medical and elderly admissions units. There were 60 and 39 acute medical/elderly admissions beds at the two NHS hospital trusts. Participants We conducted eight focus groups with 45 healthcare practitioners and two with 11 SU/Cs in two NHS acute hospitals. Results Staff and SU/Cs recognised the potential of CARS but were clear that the score should not replace or undermine clinical judgments. Staff recognised that CARS could enhance clinical decision-making/judgments and aid communication with patients. They wanted to understand the components of CARS and be reassured about its accuracy but were concerned about the impact on intensive care and blood tests. Conclusion Risk scores are widely used in healthcare, but their development and implementation do not usually involve input from practitioners and SU/Cs. We contributed to the development of CARS by eliciting views of staff and SU/Cs who provided important, often complex, insights to support the development and implementation of CARS to ensure successful implementation in routine clinical practice. / Health Foundation, National Institute for Health Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC)

Yes / Objectives There are no established mortality risk equations specifically for emergency medical patients who are admitted to a general hospital ward. Such risk equations may be useful in supporting the clinical decision-making process. We aim to develop and externally validate a computer-aided risk of mortality (CARM) score by combining the first electronically recorded vital signs and blood test results for emergency medical admissions. Design Logistic regression model development and external validation study. Setting Two acute hospitals (Northern Lincolnshire and Goole NHS Foundation Trust Hospital (NH)—model development data; York Hospital (YH)—external validation data). Participants Adult (aged ≥16 years) medical admissions discharged over a 24-month period with electronic National Early Warning Score(s) and blood test results recorded on admission. Results The risk of in-hospital mortality following emergency medical admission was 5.7% (NH: 1766/30 996) and 6.5% (YH: 1703/26 247). The C-statistic for the CARM score in NH was 0.87 (95% CI 0.86 to 0.88) and was similar in an external hospital setting YH (0.86, 95% CI 0.85 to 0.87) and the calibration slope included 1 (0.97, 95% CI 0.94 to 1.00). Conclusions We have developed a novel, externally validated CARM score with good performance characteristics for estimating the risk of in-hospital mortality following an emergency medical admission using the patient’s first, electronically recorded, vital signs and blood test results. Since the CARM score places no additional data collection burden on clinicians and is readily automated, it may now be carefully introduced and evaluated in hospitals with sufficient informatics infrastructure. / The Health Foundation, National Institute for Health Research (NIHR) Yorkshire and Humberside Patient Safety Translational Research Centre

Yes / Objectives: To compare the performance of a validated automatic computer-aided risk of mortality (CARM) score versus medical judgement in predicting the risk of in-hospital mortality for patients following emergency medical admission. Design: A prospective study. Setting: Consecutive emergency medical admissions in York hospital. Participants: Elderly medical admissions in one ward were assigned a risk of death at the first post-take ward round by consultant staff over a 2-week period. The consultant medical staff used the same variables to assign a risk of death to the patient as the CARM (age, sex, National Early Warning Score and blood test results) but also had access to the clinical history, examination findings and any immediately available investigations such as ECGs. The performance of the CARM versus consultant medical judgement was compared using the c-statistic and the positive predictive value (PPV). Results: The in-hospital mortality was 31.8% (130/409). For patients with complete blood test results, the c-statistic for CARM was 0.75 (95% CI: 0.69 to 0.81) versus 0.72 (95% CI: 0.66 to 0.78) for medical judgements (p=0.28). For patients with at least one missing blood test result, the c-statistics were similar (medical judgements 0.70 (95% CI: 0.60 to 0.81) vs CARM 0.70 (95% CI: 0.59 to 0.80)). At a 10% mortality risk, the PPV for CARM was higher than medical judgements in patients with complete blood test results, 62.0% (95% CI: 51.2 to 71.9) versus 49.2% (95% CI: 39.8 to 58.5) but not when blood test results were missing, 50.0% (95% CI: 24.7 to 75.3) versus 53.3% (95% CI: 34.3 to 71.7). Conclusions: CARM is comparable with medical judgements in discriminating in-hospital mortality following emergency admission to an elderly care ward. CARM may have a promising role in supporting medical judgements in determining the patient's risk of death in hospital. Further evaluation of CARM in routine practice is required. / Supported by the Health Foundation, National Institute for Health Research (NIHR) Yorkshire and Humberside Patient Safety Translational Research Centre (NIHR YHPSTRC).