Background Injuries are the leading cause of death in the United States for children between the ages of 1 and 19 years. Weekend hospital admission has been associated with poor outcomes and higher mortality rates for a variety of diseases. We examined the impact of weekend versus weekday admission on in-hospital morbidity and case-fatality rates for pediatric trauma patients. Methods We performed a cross-sectional analysis on the 2016 Kids’ Inpatient Database. The study population included pediatric trauma patients under the age of 19 years which were stratified by weekend vs weekday admission. Weightings were used to produce national estimates. Multiple logistic regression analyses were performed to assess the odds of in-hospital complications and death after adjusting for a variety of potentially confounding demographic and clinical factors. Results Patients admitted on a weekend were older, more frequently male, White, and privately insured. Weekend admissions had a higher Injury Severity Score (6.7 vs 5.4, p<0.001), as well as higher rate of intensive care unit (ICU) admission (8.5% vs 7.1%, p<0.001) and in-hospital case-fatality rate (1.3% vs 1.1%, p=0.003), but lower rate of in-hospital complications (6.1% vs 6.8%, p<0.001). Unadjusted logistic regression demonstrated that weekend admission was associated with higher odds of in-hospital death as compared to weekday admission (odds ratio 1.20, 95% confidence interval [CI] 1.07 – 1.35), but in the multivariable adjusted model this was no longer statistically significant (adjusted odds ratio [aOR] 1.06, 95% CI 0.94 – 1.20). Weekend admission was associated with lower odds of in-hospital complications (aOR 0.90, 95% CI 0.86 - 0.95), but higher odds of ICU admission (aOR 1.12, 95% CI 1.06 – 1.18). Conclusions Weekend admission in pediatric trauma is associated with higher odds of ICU admission. There does not appear to be an association between weekend admission and odds of in-hospital death, however it may be associated with lower odds of in-hospital complications.

This study investigated the influence of tobacco use on postoperative narcotic requirements of female patients following pelvic surgery. The history of tobacco use was taken by telephone survey, and the amount of postoperative narcotic used was obtained from a retrospective review of the patients’ hospital charts. Postoperative narcotic use for patients who never smoked was 10.9 mg/12 hr (n = 83, S.E. = 0.5), for former smokers was 13.0 mg/12 hr (n = 33, S.E. = 0.8) and for current smokers was 13.1 mg/12 hr (n = 53, S.E. = 0.7). Patients who never smoked used significantly less narcotic than former smokers (p =.02) or current smokers (p =.007). There was no difference between current and former smokers. Patients who have smoked required more narcotic for postoperative pain control. This effect was equally strong for former as for current smokers.

Symptom control may become challenging for terminally ill patients as they near the end of life. Patients often seek hospital admission to address symptoms, such as pain, nausea, vomiting, and restlessness. Alternatively, palliative medicine focuses on the control and mitigation of symptoms, while allowing patients to maintain their quality of life, whether in an outpatient or inpatient setting. Hospice care provides, in addition to inpatient care at a hospice facility or in a hospital, the option for patients to receive symptom management at home. This option for symptom control in the outpatient setting is essential to preventing repeated and expensive hospital readmissions. This article discusses the impact of hospice care on hospital readmission rates.

Approximately 11% of patients diagnosed with a stroke or a transient ischemic attack are readmitted to the hospital, creating a cost burden of nearly $2 billion per year for Medicare beneficiaries. Because researchers and policy makers consider hospital readmission for patients with strokes or transient ischemic attack to be an indicator for the delivery of quality care, the Centers for Medicare and Medicaid Services has imposed financial penalties of up to 3% of a hospital's Medicare reimbursement in 1 year for excessive readmissions, potentially impacting the financial sustainability of various healthcare organizations. The ecological systems theory allows for the understanding of how microsystems, mesosystems, exosystems, macrosystems, and chronosystems impact the development, influence, and predictability characteristics of a specific population serviced in a healthcare setting. This quantitative study analyzed cross-sectional data from the 2016 National Hospital Ambulatory Care Survey, using cross-tabulations with chi-square followed by multiple regression analyses. Overall, this study addressed the gap in the existing literature by examining admission rates for patients with the diagnoses of strokes or TIA and the association between ancillary service use, insurance status, and provider level evaluation. The study concluded that few predictors that exist between the independent and dependent variables, with the exception of the amount of laboratory tests ordered. Maintaining the financial reasonability by avoiding penalties for stroke or transient ischemic attack unnecessary admission from value-based purchasing, the implication for social change is maintaining access to care for patients by avoiding hospital closures.

It has been evidenced by the increased amount of contacts being made in Counseling Services of Utah State University that students have been very much concerned about whether or not they should be in college. The discussion concerning which college to attend has been heard often among high school graduates, and for many, Utah State University has been a first choice. An increased drop-out rate among students has been found in the past few years. This study has been accomplished to determine which of the entering students at Utah State have been sufficiently prepared to enter into a course of study on a full time basis. The many drop-outs have been an indication that many have not been prepared for collegiate work at this institution. If this has been the case, it is properly in order that some studying and reviewing be done in connection with the entrance requirements of the University.

Background: Groote Schuur Hospital (GSH) Division of Dermatology receives many referrals from local clinics and hospitals. Some of these patients are admitted to the dermatology wards for diagnosis and/or management. It is important to look at the spectrum and outcome of these patients who are admitted to dermatology wards at the hospital, to inform policy. Objectives: To characterise the spectrum of dermatological conditions requiring admission, to determine the outcome and to describe the factors that may influence the outcome of dermatological conditions in patients admitted to the dermatology wards at Groote Schuur Hospital in South Africa. Methods: This research employed descriptive retrospective analysis to describe the dermatology inpatients who were admitted to dermatology wards at Groote Schuur Hospital over the period January 2017 to December 2017. Results: There were a total of 120 admissions to Groote Schuur Hospital Dermatology wards in 2017. Of these, 89 (74.1%) were new admissions and 31 (25.8%) re-admissions. The most frequent diagnosis was drug reaction (27.5%), followed by psoriasis (23.3%), eczema (17.5%), and bullous disease (10%). Less common indications for admission were infections, lupus erythematosus, scabies, ulcers, pyoderma gangrenosum and cutaneous small-vessel vasculitis. The outcome of the admission was usually favorable. Conclusions: The most common diagnoses on admission were drug reactions, psoriasis, eczema, and bullous diseases. The generally favorable outcomes would support the future use of inpatient care for people with severe skin disorders.

Schools of business within the Florida State University system have state-mandated common prerequisites that students are required to complete prior to formal admission into baccalaureate business programs. As such, the common prerequisites serve as minimum admission requirements for schools of business in the state of Florida. This study sought to determine the ability of these discipline specific admission criteria to predict academic performance in upper-level business coursework. This study looked at existing data for 860 students in the College of Business Administration at the University of Central Florida. Findings of the study demonstrate that there is a positive and moderate to strong correlation between the final grade earned in each individual course within the common prerequisites and the cumulative academic performance in upper-level business coursework. The strength of the correlation varied among the individual prerequisites, however, each individual prerequisite was positively correlated. Regression findings also demonstrate that the common prerequisites may, with certain student populations such as native students and students pursuing quantitative business majors, be a rather effective predictor of program performance. Most problematic of the findings was that the predictive ability was not equivalent across different student populations. This suggests that as admission criteria or screening mechanisms designed to select students most likely to be successful in the program, the state-mandated common prerequisites were not effective for all student populations. Findings of this study have implications for schools of business, as well as other disciplines, as they evaluate the common prerequisites required by their institution or consider best practices and policies to improve student retention, graduation, and other outcomes.

The researcher developed this study based on the Hardgrave, et al. (1993)statement that for a doctoral student, it was "more than just standardized scores, previous academic performance, and past work experience ultimately affects whether the candidate will be successful in the program" (p. 261). This study examined both the subjective and quantifiable aspects of application materials to a physics doctoral program to explore potential relationships between the credentials presented in the application and the ultimate success of the admitted students. The researcher developed questions with the goals of addressing the problem of attrition in doctoral programs and gaining a better of understanding the information provided in students' application packets. The researcher defined success as either enrolled four years after admission or attainment of the degree. This study examined the records of a population of students admitted to a physics doctoral program from the fall of 1997 to the fall of 2003 to determine their level of success as of August 2006. An exploratory analysis of the data provided answers to each of the research questions as well as an extensive understanding of the students admitted into the program during this time. This study examined both admission credentials and constructs identified by past researchers. An evaluation of the data gathered in this research revealed no relationships between these and student success as previously defined. In 1974, Willingham stated simply, "the best way to improve selection of graduate students will be to develop improved criteria for success" (p. 278). To this end, recommendations emerged regarding the decision-making process and suggestions for future research. This study was not developed to prove or disprove past research findings that predicted success from admissions information; rather, the researcher developed this study to explore each of the credentials that a student presents with his or her application packet, and to tell the story about the nuances of these credentials as they related to student success in a physics doctoral program.

An experimental scale model study was conducted to investigate the onset of fluidelastic instability in a tube array subjected to axisymmetric jet flow. A tube array was constructed using aluminum tubes with 44.45 mm outer diameter, $D$, which were arranged in a square pattern with 88 mm pitch, $P$. The pitch to diameter ratio, $P/D$, was approximately 2.0. The tubes were flexibly mounted using threaded rod and tuned to a first mode natural frequency, $f_n$, of 9 Hz. Auxiliary damping devices were added to each tube, and tuned, to achieve a damping ratio, $\zeta$, of 1 % of critical. The mass damping parameter, $m(2 \pi \zeta)/(\rho D^{2})$, of the tube array was 27.9. The tube array was tested under uniform flow conditions in McMaster University's 2 ft wind tunnel to establish the critical reduced velocity, $V_{cr}/(f_n D)$, of 30.0 at the onset of fluidelastic instability. The uniform flow test established a basis for comparing the results with the existing literature and evaluating the validity of the proposed partial admission calculation. The tube array was also tested in open air using an axisymmetric jet, with two different physical arrangements, the first with the jet aimed between tubes and perpendicular to the tube spans and the second with the jet aimed at a tube face and perpendicular to the tube spans. In each case the jet flow velocity was incrementally increased to characterize the onset of fluidelastic instability. To characterize the flow dispersion through the tube array a series of velocity profile measurements were also collected. The measured velocity profiles were used to estimate the spanwise function of transverse average gap velocity, $\bar{V}(x)$, which was used to predict the equivalent critical uniform gap flow velocity, $V_{cr}$, using the concept of partial admission. The predicted $V_{cr}$ values showed reasonable agreement with the experimental results. However, the prediction method did indicate instabilities in tube rows where instability was not actually observed. A simplified prediction approach was developed which was based on using a predicted three dimensional velocity profile, $V(x,y)$, at the $z$ location of the first row tube gap, under the assumption of free field conditions, to calculate an estimate of the spanwise function of transverse average gap velocity, $\bar{V}(x)$. Although the predictions of $V_{cr}$ agreed reasonably well with the experimental results, first row instabilities were not observed in any of axisymmetric jet flow experiments. Therefore, this method can be used to estimate the the critical uniform gap velocity, $V_{cr}$, but not the spatial location of the instability. Based on the results of the experiments and calculations, adoption of the modified partial admission formula is recommended and possible avenues for further investigation and verification are suggested. / Thesis / Master of Applied Science (MASc)

Purpose: Academic programs are faced with the important task of selecting health professional students who not only possess necessary cognitive abilities to perform their future job, but also have valuable personal/professional characteristics to draw upon in the provision of quality patient care. There is therefore "widespread agreement that it is desirable to broaden the scope of assessment beyond academic achievement" (Eva, Reiter, Trinh, Wasi, Rosenfeld, Norman, 2009, p.768) in candidate selection. The Child Life Studies Program at McMaster University used a 4-station multiple mini-interview (MMI) as part of the admission selection process. This study sought to determine the feasibility, degree of acceptability and reliability of this 4-station MMI design, and if there were any predictors of candidate's performance on the MMI. Methods: A group of 35 applicants in 2014, and 40 applicants in 2015 screened through admission procedures participated in a 4-station MMI. Each station was 15 minutes in length with 5 minutes for scoring each candidate. Anonymous stakeholder surveys were used in 2015 to assess participant and interviewer's perceptions and acceptability of the MMI in applicant selection. Generalizability coefficients were calculated to determine reliability. In addition, candidate's experience in healthcare, professional work experience, experience with children with disabilities, and previous child life course work (or lack thereof) were analyzed through independent t-tests to report any relationship with candidate's performance on the MMI. A one-way ANOVA was also completed to report any relationship between candidate's undergraduate degree type and his/her MMI performance. Results: The 4-station MMI was found to be feasible for a small program with a marked increase found in the number of candidates interviewed in a shorter period of time. It was also found to be highly acceptable among candidates and faculty. However, this studies' findings did not show statistically significant differences in MMI performance based on identified predictors, or undergraduate degree type. The reliability of the 4-station design in 2014 was G=0.718, however, was only G=0.089 in 2015, far lower than expected based on the prior year’s G Coefficient. The potential pitfalls in running a small program MMI are discussed with specific suggestions and modifications provided to enhance reliability of candidate selections across professions. / Thesis / Master of Science (MSc)