The Perspective from the Private Sector: The Institute for Tourism Development at the Rochester Institute of Technology

This article explores the development and organizational structure for a tourism center within a privately endowed university. The success of this undertaking has been directly related to the foresight of the administration and the cooperation among the faculty. Another important component of the success of this center has been private industry and their readiness to provide input, an well as dollars

The «Mal de la Madre» and the Failure of Maternal Influence in <i>Celestina</i>

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Randomized controlled trial of a clinical decision support system for painful polyneuropathy

IntroductionDespite the existence of guidelines, painful neuropathy is often inappropriately treated. We sought to determine the effectiveness of a clinical decision support system on guideline‐recommended medication use.MethodsWe randomized neurology providers, stratified by subspecialty, to a best practice alert (BPA) linked to a Smartset or a BPA alone when seeing patients with neuropathy. The primary outcome was the proportion of patients with uncontrolled nerve pain prescribed a guideline‐recommended medication. Generalized estimating equations were used to assess effectiveness.ResultsSeventy‐five neurology providers (intervention 38, control 37) treated 2697 patients with neuropathy (intervention 1026, control 671). Providers did not acknowledge the BPA in 1928 (71.5%) visits. Only four of eight intervention arm neurologists who treated patients with uncontrolled nerve pain opened the Smartset. The intervention was not associated with guideline‐recommended medication use (odds ratio 0.52, 0.18‐1.48; intervention 52%, control 54.8%).DiscussionOur intervention did not improve prescribing practices for painful neuropathy. Physicians typically ignored the BPAs/Smartset; therefore, future studies should mandate their use or employ alternate strategies.See editorial on pages 552–553 in this issue.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154934/1/mus26774.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154934/2/mus26774_am.pd

Electrodiagnostic tests are unlikely to change management in those with a known cause of typical distal symmetric polyneuropathy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138297/1/mus25713_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138297/2/mus25713.pd

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Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106672/1/ana24034.pd

Choosing Wisely: Highest‐cost tests in outpatient neurology

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98329/1/ana23865.pd

Accessing Young Black Stroke Survivors for Secondary Prevention

ABSTRACT Background- Stroke rates and risk factors may be increasing in young adults aged 18-64, especially black individuals. We sought to identify whether young high risk stroke survivors could be found at community health centers. Methods- This was a cross-sectional analysis of the National Ambulatory Medical Care Survey from 2006-2011. We used chi-square analyses, t-tests, and proportions to compare and describe stroke survivor visits at community health centers and private offices. Results- Young stroke survivor visits comprise 48% of stroke survivor visits at community health centers compared to 31% of stroke survivor visits at the private office setting. Among young stroke survivors cared for at community health centers, 47% were black individuals compared to 14% at a private office setting. The prevalence of hypertension and cigarette smoking was higher in young stroke survivors at the community health center. Conclusions- The community health center is a setting to access young black stroke survivors. Stroke prevention and preparedness interventions should be considered at community health centers

Price Discovery and the Accuracy of Consolidated Data Feeds in the U.S. Equity Markets

Both the scientific community and the popular press have paid much attention to the speed of the Securities Information Processor, the data feed consolidating all trades and quotes across the US stock market. Rather than the speed of the Securities Information Processor, or SIP, we focus here on its accuracy. Relying on Trade and Quote data, we provide various measures of SIP latency relative to high-speed data feeds between exchanges, known as direct feeds. We use first differences to highlight not only the divergence between the direct feeds and the SIP, but also the fundamental inaccuracy of the SIP. We find that as many as 60 percent or more of trades are reported out of sequence for stocks with high trade volume, therefore skewing simple measures such as returns. While not yet definitive, this analysis supports our preliminary conclusion that the underlying infrastructure of the SIP is currently unable to keep pace with the trading activity in today's stock market.Comment: 18 pages, 20 figures, 2 table

Preliminary Experience with Digital Subtraction Angiography in Cardiac Evaluation

iVe report our initial experience using digital subtraction angiography (DSA) techniques for cardiac evaluation. DSA of the heart may be performed with intravenous or right atrial injection of contrast medium (IVDSA) and with left ventricular or aortic root contrast injection (lADSA). The right ventricle and the atria are best demonstrated by IVDSA, while the left ventricle and coronary arteries are best demonstrated by lADSA. The advantages and disadvantages of DSA ofthe bean are discussed. Present equipment limitations restrict the routine use of cardiac DSA, but these should be overcome with advances in technology