Counselor education program faculties evaluate applicants to masters and doctoral level programs using criteria that the faculties hope will predict the applicant's potential for academic success and then effectiveness as a counselor, counselor educator, or researcher. Choosing admission criteria to assess this level of potential in an applicant is quite a task. Those counselor education programs that are accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) have the benefit of the admission guidelines provided by CACREP standards for accreditation. These guidelines give only basic, general direction to programs regarding their admission criteria but each individual program determines their own criteria for admission. The purpose of this study was to discover any recognizable trends in admission policy criteria, in terms of specific criteria used to evaluate and select students from the applicant pool, for CACREP accredited masters and doctoral programs. This study also sought to discover any recognizable trends in admission policy criteria, in terms of a specific number of criteria used to evaluate and select students for CACREP accredited master and doctoral counselor education programs. This qualitative study investigated 178 masters level CACREP accredited counselor education programs and 45 doctoral CACREP accredited counselor education programs. The CACREP Website provided contact names and Web address for each program. Admission criteria were pulled from the program Websites. If no criteria were present on the Website, the program contact person was contacted by phone or by email. A contact form for the masters level programs, and another for the doctoral level programs, was developed to record program criteria. A rate or return of 96% for the masters level programs and 91% for the doctoral programs was achieved. For the purposes of this study, a trend was defined as 1) any measure being required by 50% or more of the responding programs, or 2) the number of measures used by a program being equal to the mean number of measures used by all programs. The masters level program trends were for counselor education programs to use the following criteria to assess applicants: transcripts, grade point average (GPA), letters of reference, applications, Graduate Record Exam (GRE) scores, letters of intent, and interviews with faculty members. A trend was also discovered for masters level programs to use between 3 and 12 measures to assess applicants for admission with a mean score of 7.01, a median score of 7, and a mode of 7. The doctoral level program trends were for counselor education programs to use the following criteria to assess applicants: transcripts, letters of reference, letters of intent to address goals, aspirations, experiences, and purpose, GRE scores, applications, and GPA. A trend was also discovered for doctoral level programs to use between 4 and 10 measures to assess applicants for admission with a mean score of 8.097, a median score of 8, and a mode of 9. Given the high rate of return, the trends discovered can be said to reflect the admission criteria used to assess applicants for admission into CACREP accredited masters and doctoral counselor education programs in the United States. A limitation could be that the data was collected using different methods of communication in that some data was collected from Websites, some from email correspondence, and some data from phone conversations. It seemed that the Websites and the emails gave the admission criteria but the phone conversations gave an understanding of not only the criteria used but the process used in selecting students from the applicant pool.

Syftet med studien har varit att få en fördjupad kunskap kring alternativt urval genom en ökad förståelse för antagna läkarstudenters upplevda navigering genom den alternativa urvalsprocessen. Frågeställningarna har därför undersökt vilka strategier sökande använder vid antagningsintervjuerna. Och hur de två urvalskriterierna lämplighet och motivation upplevs i relation till den tidigare genomgångna antagningsprocessen samt vad läkarstudenterna menar var viktiga framgångsfaktorer för att lyckas vid intervjuerna. Tidigare forskning har visat att alternativt urval är vanligt förkommande ur en internationell kontext på det medicinska utbildningsfältet, och att studenter som har föräldrar med högskoleutbildning nyttjar utbildning på ett mer obundet sätt, där kapitaltillgångar visat sig vara viktiga i navigeringen av det svenska utbildningssystemet. Det som saknas i den tidigare forskningen är de antagna studenternas självupplevda perspektiv på alternativt urval. En kvalitativ intervjustudie har därför använts som metod för att lyfta fram dessa perspektiv. Studiens resultat har visat att de antagna läkarstudenterna har använt sig av olika strategier, en viktig sådan var att de konverterade tidigare utbildning och erfarenheter till styrkor. Lämplighet och motivation framkom som viktiga begrepp där förmedlingen av hur och varför var centrala i navigeringen. Framgångsfaktorer som lyftes fram i relation till antagningsprocessen var uppväxtmiljö, att lyckas förmedla sin person och skapa en relation till intervjuarna. Resultatet har analyserats med hjälp av ett bourdieuskt perspektiv där intervjupersonernas kapitaltillgångar, strategier och förhållningssätt till det medicinska fältet och rådande doxa varit centrala punkter. Studiens resultat har bidragit till ny kunskap och insyn i en annars tämligen outforskad värld kring det alternativa urvalet, genom de antagna läkarstudenternas perspektiv. Studien har också pekat på vikten av mer specifik studie- och yrkesvägledning för att fler med olika bakgrund ska kunna få de redskap som krävs för att navigera sig genom antagningsprocessen. / The aim of the study was to gain a deeper knowledge about alternative admission through a better understanding of admitted medical students’ navigation throughout the admission process. It has therefore been explored which strategies applicants use during the admission interviews. And how the two selection criteria aptitude and motivation are perceived in relation to the previously experienced admission process, as well as what medical students point out as important factors to succeed with the interviews. Previous research has shown that alternative admission is commonly used internationally in the medical field of education, and that students who have parents with higher level of education use education in a more unbound way where capital assets have shown to be important in the navigation of the Swedish educational system. What is less known in earlier research is the selfperceived perspective of the admitted students in relation to alternative admission. A qualitative interview study has therefore been conducted. The study result showed that the admitted medical students used different strategies – a critical one being the converting of previous education and experiences to strengths. Aptitude and motivation also emerged as important terms where the mediation of how and why was fundamental in the navigation. The success factors that were raised in relation to the admission process were the upbringing environment, achieving to mediate one’s personality, and to create a relation with the interviewer. The results were analysed with a Bourdieuan perspective where the interviewee’s capital assets, strategies and attitudes toward the medical field of education and existing doxa emerged as key points. The study results have contributed with new knowledge and insight in the so far unexplored field that is alternative admission, from the medical students’ perspective. The results also indicate the importance of more specific study and career guidance, which could lead to that more students with adverse backgrounds learn which tools that are helpful while navigating through the alternative admission process.

Contexte: L’utilisation efficiente des ressources en soins intensifs représente un défi potentiellement surmontable dans un contexte de régionalisation des services. Conséquemment, il importe de convenir de critères homogènes et transparents permettant de trier et de transporter les patients là où ils peuvent recevoir les soins nécessaires à leur condition. Objectif: L’objectif principal de cette étude est d’identifier et d’évaluer les publications définissant les critères utilisés pour prioriser ou refuser une admission aux soins intensifs. Méthodes: Nous avons entrepris une revue systématique en accord avec les lignes directrices PRISMA. Nous avons identifié tous les articles pertinents publiés jusqu’au 8 novembre 2016 au moyen des bases de données PubMed, Embase, Medline, EBM Reviews, CINAHL Complete, les bases de données recensant la littérature grise ainsi qu’en effectuant une revue manuelle d’articles supplémentaires. Nous avons ensuite évalué la qualité des articles retenus selon une échelle d’appréciation que nous avons développée. Finalement, nous avons extrait puis évalué chaque critère individuel en plus de les regrouper par thème. Résultats: L’étude nous a permis d’identifier 5818 abrégés. Nous avons révisé 416 articles exhaustivement pour en retenir 129 qui correspondent aux critères d’inclusion. Il s’agit d’articles de recherche originale (34%), de lignes directrices (26 %) ou de revues de la littérature (21 %). Nous avons extrait 200 critères de triage et de transport au sein des 129 articles. Ceux-ci proviennent surtout des États-Unis (43 %) et privilégient un mécanisme d’exclusion (71 %) plutôt que de priorisation (17 %) des clientèles. Peu d’articles abordent les critères de transport (4 %). Nous avons classifié les critères selon qu’ils soient reliés à l’un ou l’autre des quatre thèmes qui ont émergé de notre analyse : au patient; à la condition clinique; au médecin qui évalue le cas; ou au contexte. Le critère le plus fréquemment cité est celui de la préférence du patient suivi de l’évaluation du médecin. Conclusion: Une revue systématique a permis de générer une liste de 200 critères utilisés pour prioriser ou exclure certains types de patients dans un état critique. Malgré les limites de notre étude, celle-ci peut permettre aux cliniciens et aux preneurs de décision de concevoir des politiques de triage et d’admission au niveau local, régional ou national. De plus, l’étude identifie des champs de recherche potentiels où le développement de critères spécifiques et mesurables pourrait contribuer au développement de lignes directrices diminuant la variabilité dans les pratiques et améliorant le processus d’admission aux soins intensifs. / Context: Intensive care bed unavailability negatively affects patients' outcomes. Strategies that reduce inefficient use of resources and reduce unavailability may increase quality and accessibility of critical care. As advocacy for regionalization of critical care resources increases, there is a need for agreed triage and transport criteria. However, outside of the trauma population, such agreed criteria and recommendations are lacking. Objective: We aimed to identify and appraise articles defining criteria used to prioritize or withhold a critical care admission. Methods: We undertook a systematic review according to PRISMA guidelines. Relevant articles were identified through searches of PubMed, Embase, Medline, EBM Reviews, CINAHL Complete from inception until November 8th, 2016. We also undertook searches through gray literature as well as a manual review of references. We then assessed the quality of identified articles through an appraisal scale we developed. Finally, we extracted and evaluated all criteria within the articles and grouped them by theme. Results: A total of 5818 abstracts were identified. After screening, we reviewed 416 articles in full and 129 articles met study criteria. These articles were mainly original research (34%), guidelines (26%) and reviews (21%). Amongst them, we identified 200 unique triage and transport criteria. Most articles were published in the United States (43%) and highlighted exclusion criteria (71%) rather than a prioritization mechanism (17%). Very few articles pertained to transport of critically ill patients (4%). We classified criteria as they related to one of four emerging themes: patient, condition, physician and context. The most commonly found triage criteria was patient preference followed by physician’s assessment that the patient was too well to benefit from ICU admission. Conclusion: A systematic review aimed at identifying triage and transport criteria used to prioritize or exclude certain patient populations under different settings helped to generate a list of 200 criteria classified within 4 themes. Despite its limitations, this study may help clinicians and decision makers devise local, regional or national ICU triage criteria. It also identifies gaps in knowledge where future clinical research yielding specific and measurable criteria tailored to clearly defined patient populations may help to decrease ICU triage variability.

In a stroke-certified 500-bed acute care hospital, the 30-day readmission rates for patients discharged to rehabilitation centers or skilled nursing facilities were higher than the rates for patients discharged to home. A review of data by the stroke team showed 44 patients readmitted within 30 days of initial stroke discharge between October 2016 and January 2017. The rate of re-admission for those discharged home was 41% (18 patients), whereas the rate for those discharged to acute inpatient rehabilitation, long-term acute care, or skilled nursing facilities was 59% (26 patients). The practice-focused question for this project assessed whether using a re-admission risk-assessment tool and implementing interventions during the initial acute-care admission, would help to identify and improve risk for 30-day re-admissions for patients diagnosed with stroke. The goal of this research project was to adopt, test, and recommend the implementation of a readmission risk assessment tool to enable discharge planners to identify stroke patients at risk for readmission and implement interventions to help reduce this risk. Lewin’s theory of change was used to inform the project. A stroke re-admission risk-assessment tool in use at a similar hospital was adopted and tested for 1 week on the hospital’s 28-bed stroke unit by nurse case managers. The test was conducted among 5 patients with confirmed diagnosis of stroke. A re-admission data review was performed 30 days after their discharge, which showed no readmissions for the 5 patients involved in the trial. The tool helped to improve case manager awareness of increased risk for readmissions, guide interventions, and improve patient transition and outcomes. The implications of this project for positive change include the potential to improve risk for patients with stroke in the acute-care facility.

Plusieurs recherches traitent de l’importance de la promotion de la diversité et l’équité pour les cohortes de médecine. D’autres recherches font état de la diversité des étudiants de médecine par rapport à la diversité de la population desservie. À cet intérêt, la plupart de ces études témoignent que « la profession médicale présente un problème d’iniquité » (Tricco et al., 2021, p. 664). Dans le cadre de la reddition de compte, le secteur médical, avec ses différents détenteurs d’enjeux, doit diriger ses services afin de répondre aux différents besoins locaux et régionaux de la société (Boelen et Heck, 1995). Cependant, en absence d’une diversité suffisante, le secteur médical ne peut vraisemblablement pas remplir son devoir de donner des soins optimaux à tout le monde (Cohen et al., 2002). Il faut noter qu’assurer une diversité optimale des cohortes de médecine implique de promouvoir la diversité des professionnels de santé. À cet intérêt, les facultés de médecine doivent être socialement responsables et doivent attacher une grande importance à la sélection des candidats afin de former de futurs médecins compétents, représentatifs de la société qu’ils desservent et en mesure de répondre aux besoins de celle-ci (Gough, 2004). Ainsi, les facultés de médecine sont engagées à promouvoir la diversité et l’équité parmi leurs cohortes de médecine. À cet intérêt, plusieurs recherches canadiennes ont trouvé que les caractéristiques sociodémographiques des étudiants de médecine diffèrent de celles de la population (Khan et al., 2020; Pitre et al., 2020). Au Québec, peu d’études ont exploré cette problématique. Dans ce contexte, nous avons mené notre recherche afin de comprendre le processus d’admission aux facultés de médecine franco-québécoises tout en tenant compte des caractéristiques sociodémographiques et de la performance des candidats et des étudiants admis en 2019. En premier lieu, nous avons brossé le profil sociodémographique des candidats et des étudiants de médecine par rapport au profil sociodémographique de la population québécoise. En second lieu, nous avons exploré le lien entre la performance des candidats et des candidats admis (pour la cote R, le Casper et les MEMFI) avec leurs caractéristiques sociodémographiques. Enfin, nous avons mené des études de simulation afin d’explorer l’effet potentiel de la variation des pondérations des résultats de la cote R, du Casper et des MEMFI sur la composition démographique des cohortes de médecine. Cette recherche utilise une base de données des candidats qui sont passés par la deuxième phase d’admission de 2019 et qui ont répondu au questionnaire sur les caractéristiques sociodémographiques. À l’aide d’analyses descriptives, d’analyses de variance univariées, des tests T et de la simulation, nous avons essayé de répondre à nos intérêts de recherches déjà mentionnées. Les résultats de cette étude montrent que les caractéristiques sociodémographiques des candidats et des candidats admis des facultés de médecine franco-québécoises, en général, diffèrent des caractéristiques sociodémographiques de la population québécoise. En effet, la majorité des étudiants sont des femmes et la grande majorité des étudiants sont favorisés ou ont tendance à la favorisation matérielle et sociale ; ayant des parents qui ont fréquenté l’université et qui ont un revenu annuel supérieur à 100 000 $. En ce qui concerne la diversité ethnoculturelle, les candidats noirs, latino-américains et autochtones sont sous-représentés dans notre bassin d’étudiants admis en 2019. D’autre part, nos analyses de simulation ont permis de reconnaitre le potentiel de chaque outil d’évaluation à promouvoir ou à limiter la diversité des cohortes simulées. En effet, dans le sous-groupe étudié, la cote R favorisera les chances d’admission des hommes et des candidats matériellement et socialement défavorisés. En contrepartie, les MEMFI favoriseront les chances des candidats matériellement et socialement favorisés et pourraient défavoriser les chances des candidats asiatiques par rapport aux autres. D’autre part, nous avons montré que la procédure d’admission de 2019 n’a pas favorisé des candidats sur la base de leurs caractéristiques sociodémographiques. À travers ces résultats, nous avons constaté que notre recherche confirme les résultats d’études antérieures rapportés dans la littérature médicale. / Many research works seek to highlight the importance of promoting diversity and equity for medicine cohorts. Other works promote the diversity of medical students in relation to the diversity of the population. In this regard, most of these studies claimed that " the medical profession suffers from an inequity problem " (Tricco et al., 2021, p. 664). In terms of accountability, the medical sector, including its various stakeholders, must direct its services to meet the local and regional needs of society (Boelen et Heck, 1995). However, with lack of diversity, the medical sector is unlikely to fulfill its duty to provide optimal care for everyone (Cohen et al., 2002). Indeed, ensuring optimal diversity of medical cohorts enforces promoting the diversity of health professionals. Given the importance of health professionals, medical schools must be socially accountable and must give significant importance to the process of student selection in order to ensure diversity within doctors and health professionals (Gough, 2004). Thus, medical schools are committed to promoting diversity and equity among their medical cohorts. In this regard, several Canadian studies have found that socio-demographic characteristics of medical students differ from those of the general population (Khan et al., 2020; Pitre et al., 2020). In Quebec, few studies have explored this subject. In this context, we conducted our study to understand the process of admission to French medical schools in Quebec while considering the socio-demographic characteristics and performance of applicants and admitted students in 2019. First, we outlined the socio-demographic profile of applicants and medical students in relation to the socio-demographic profile of Quebec’s population. Second, we explored the link between the performance of candidates and admitted candidates (for the R score, the Casper and the MEMFI) and their socio-demographic characteristics. Finally, we performed various simulation scenarios to explore the potential effect of varying the weights of the R-score, Casper, and MEMFI scores on the demographic composition of medical cohorts. This study is based on a database of applicants who went through the second phase of admission in 2019 and answered the socio-demographic characteristics survey. Furthermore, the research interest is demonstrated using descriptive statistics, univariate analysis, Student’s T-tests and simulation. The results of this study demonstrate that, in general, the socio-demographic characteristics of candidates and students from French medical schools in Quebec differ from the socio-demographic characteristics of the Quebec population. Indeed, we found out that most of the students are women, have high socioeconomic status; have parents who attended university and have an annual parental income of more than $100,000. In terms of ethnocultural diversity, Black, Latino, and Indigenous candidates are underrepresented in our pool of admitted students in 2019. On the other hand, our simulation analyses revealed the potential for each assessment tool to promote or limit the diversity of the simulated cohorts. Indeed, the R-score would favour the chances of admission of men and materially and socially disadvantaged candidates in the studied subgroup. On the other hand, the MEMFI would favour the chances of materially and socially advantaged candidates and could disadvantage the chances of Asian candidates compared to others. Furthermore, we have demonstrated that admission procedure in 2019 did not favour candidates based on their socio-demographic characteristics. Through these results, we found that our research affirms the results of previous studies reported in the medical literature.

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Bakgrund: Vid psykisk sjukdom kan behov av heldygnsvård uppstå för att den enskilde personen inte skall utgöra någon fara för sig eller för tredje part. Vården kan vara av nytta trots att personen i fråga inte ger medgivande till vård, vilket medför ett etiskt dilemma för vårdpersonalen. Syfte: Att belysa patienters upplevelse av att vårdas enligt tvångslagstiftning vid en psykiatrisk avdelning. Metod: En litteraturstudie har genomförts som omfattar 11 kvalitativa vetenskapliga artiklar. Resultat: Resultatet visar att patienterna antingen upplevde att inläggningen varit till nytta eller till skada och att flertalet patienter upplevde en bristande autonomi och en känsla av minskat människovärde. Slutsats: Slutsatsen är att patienternas syn på inläggningen beror på dennes upplevelse av bevarad autonomi och möjlighet till delaktighet. Personal som har ett förhållningssätt som främjar detta, främjar också att patienten upplever den tvångslagstiftade vården som nödvändig. Detta förtydligar vikten av att i vården arbeta personcenterat och med ett förhållningssätt som främjar patientens autonomi och delaktighet. / Background: When a person is mentally ill, they might need hospitalisation against their ill, to protect them from themselves or to third parties. The care may be beneficial even though the person does not give consent to treatment, resulting in an ethical dilemma for caregivers. Aim: To elucidate patients' experiences of being cared for under a compulsory admission at a psychiatric ward. Method: A literature review has been carried out covering 11 qualitative research articles. Results: The results show that patients either feel that the admission was beneficial or detrimental, and that most patients experience a lack of autonomy and a sense of diminished human dignity. Conclusion: It is concluded that patients' views on the admission depends on his or hers experience of preserved autonomy and the opportunity to participate. Staff who have an attitude that promotes this, also encourages the patient to experience the compulsory care as necessary. This clarifies the importance of working personcentered with an approach that promotes patient autonomy and participation.

Energy consumption is increasingly affecting battery life and cooling for real- time systems. Dynamic Voltage and frequency Scaling (DVS) has been shown to substantially reduce the energy consumption of uniprocessor real-time systems. It is worthwhile to extend the efficient DVS scheduling algorithms to distributed system with dependent tasks. The dissertation describes how to extend several effective uniprocessor DVS schedul- ing algorithms to distributed system with dependent task set. Task assignment and deadline assignment heuristics are proposed and compared with existing heuristics concerning energy-conserving performance. An admission test and a deadline com- putation algorithm are presented in the dissertation for dynamic task set to accept the arriving task in a DVS scheduled real-time system. Simulations show that an effective distributed DVS scheduling is capable of saving as much as 89% of energy that would be consumed without using DVS scheduling. It is also shown that task assignment and deadline assignment affect the energy- conserving performance of DVS scheduling algorithms. For some aggressive DVS scheduling algorithms, however, the effect of task assignment is negligible. The ad- mission test accept over 80% of tasks that can be accepted by a non-DVS scheduler to a DVS scheduled real-time system.