The impact of delays to admission from the emergency department on inpatient outcomes

<p>Abstract</p> <p>Background</p> <p>We sought to determine the impact of delays to admission from the Emergency Department (ED) on inpatient length of stay (LOS), and IP cost.</p> <p>Methods</p> <p>We conducted a retrospective analysis of 13,460 adult (≥ 18 yrs) ED visits between April 1 2006 and March 30 2007 at a tertiary care teaching hospital with two ED sites in which the mode of disposition was admission to ICU, surgery or inpatient wards. We defined ED Admission Delay as ED time to decision to admit > 12 hours. The primary outcomes were IP LOS, and total IP cost.</p> <p>Results</p> <p>Approximately 11.6% (n = 1558) of admitted patients experienced admission delay. In multivariate analysis we found that admission delay was associated with 12.4% longer IP LOS (95% CI 6.6% - 18.5%) and 11.0% greater total IP cost (6.0% - 16.4%). We estimated the cumulative impact of delay on all delayed patients as an additional 2,183 inpatient days and an increase in IP cost of $2,109,173 at the study institution.</p> <p>Conclusions</p> <p>Delays to admission from the ED are associated with increased IP LOS and IP cost. Improving patient flow through the ED may reduce hospital costs and improve quality of care. There may be a business case for investments to reduce emergency department admission delays.</p

Does a lack of juveniles indicate a threat?:Understanding body size distributions in a group of long-lived vertebrates

Turtles are declining globally, and absences of juveniles during surveys are often interpreted as evidence of threats to early life stages. In Australia, for example, it is widely argued that a low number of juveniles is likely due to nest predation by introduced red foxes (Vulpes vulpes). However, small sample sizes within populations, low detectability of juveniles and turtles' long lifespans often confound the conclusion that a paucity of juveniles indicates a declining population. Because turtles have long reproductive lifespans, we might intuitively expect most turtle populations to be heavily weighted towards large individuals, but a 'typical' or 'healthy' size distribution for turtle populations has not been well established. Therefore, we collated data on 41,021 freshwater turtles from 38 species and 428 populations located in parts of Australia both with and without introduced foxes, as well as populations in the United States of America, which naturally have raccoons (Procyon lotor), foxes and other nest predators. We examined population-level body size distributions to establish a baseline for 'typical' turtle populations and test whether populations that are exposed to introduced foxes have proportionately fewer juveniles compared to both AU populations that lack introduced foxes and USA populations that are naturally exposed to nest predators. We found that most turtle populations in AU and the United States were heavily skewed towards adults and had few juveniles, regardless of the presence of foxes or other nest predators. There were, however, clear differences among population survey methods: those that target shallow areas (e.g. crawfish traps) tended to capture proportionately more juveniles, and small sample sizes (∼&lt;50) often produced inaccurate representations of size distributions. Additionally, we used a simulation to demonstrate that, given common turtle life history parameters, even stable populations should generally have low proportions of juveniles. Based on our results, we encourage caution when interpreting turtle size distributions. A small number of juveniles does not inherently suggest that a population is declining due to high egg and/or juvenile mortality, and researchers should pay careful attention to the biases in their methods and strive to capture a minimum of 50-100 turtles before drawing inferences.</p

Nutraceutyki w żywności i farmacji. Praca przeglądowa

The increase in consumer awareness about food and health has led to an increase in the demand for food containing biologically active compounds, especially antioxidants, which can help the human body fight the oxidative stress. Many unconventional or new sources of antioxidants have been discovered, which is a priority not only for food, but also for the pharmaceutical industry. It has been shown that not only raw materials, but also waste from fruit and vegetable processing contains valuable molecules, such as: proteins, essential amino acids, antioxidants, dietary fibers, natural pigments, or aromatic compounds, that can be extracted, purified and modernized in food products or pharmaceuticals with added value. This is the basis of huge potential of not only plant and biotechnology raw materials, but also food waste for the use as a source of antioxidants.

Context-specific cue use in the Eastern painted turtle (Chrysemys picta) and its effects on decision making

Abstract Many species consider both prior experiences and the context of current stimuli when making behavioural decisions. Herein, we explore the influence of prior experience and novel incoming stimuli on the decision-making in the Eastern painted turtle (Chrysemys picta). We used a free-choice Y-maze to assess the preferences of turtles wavelength and intensity of light. We then trained naïve turtles to associate one arm of a maze with a food reward, and then tested the relevance of light colour and intensity on the turtles’ decision-making regarding arm choice. Turtles avoided bright light, even when presented on the side of the maze with which they had learned to associate a food. When light intensities of both sides were the same — irrespective of intensity — turtles chose the side they had previously learned to associate with the food reward. C. picta in our study showed a weak attraction to blue light and a strong avoidance of yellow light, a response generally consistent with previous work in sea turtles. Future studies should examine the ecological and evolutionary relevance of these decisions in field-oriented tests.</jats:p

US School-Based Physical Fitness Assessments and Data Dissemination.

BackgroundLow physical fitness (PF) levels during childhood affect healthy growth and development, and increase the risk of cardiovascular diseases. Physical education standards exist for nearly all states in the United States, but evaluation of PF in youth has yet to be systematic, reproducible, and harmonized. The purpose of this project was to describe publicly available data of school-based PF testing (SB-PFT).MethodsA list of state-mandated SB-PFT programs published by SHAPE 2016 was confirmed by contacting appropriate authorities. SB-PFT data were obtained through each state's department of education.ResultsSixteen states mandate SB-PFT, with 10 states providing publicly available data; 92% to 100% of states perform the pacer/mile, curl-up, and push-up; 54.2% to 78.5% of elementary and 44% to 66.5% of high-school youth are in the "healthy fitness zone" for aerobic capacity.ConclusionsSB-PFT provided PF data in children across the United States. The variability and inconsistency in reporting and in the values, however, raises questions about the current status of SB-PFT data and its utility in assessing PF in children. The critical nature of PF assessments is highlighted in the current COVID-19 pandemic, during which physical education has been curtailed, and emerging data demonstrate worsening of the already low levels of PF in youth