Downsizing of acute inpatient beds associated with private finance initiative: Scotland's case study

OBJECTIVES: To evaluate whether the projected 24% reduction in acute bed numbers in Lothian hospitals, which formed part of the private finance initiative (PFI) plans for the replacement Royal Infirmary of Edinburgh, is being compensated for by improvements in efficiency and greater use of community facilities, and to ascertain whether there is an independent PFI effect by comparing clinical activity and performance in acute specialties in Lothian hospitals with other NHS hospitals in Scotland. DESIGN: Comparison of projected and actual trends in acute bed capacity and inpatient and day case admissions in the first five years (1995-6 to 2000-1) of Lothian Health Board's integrated healthcare plan. Population study of trends in bed rate, hospital activity, length of stay, and throughput in Lothian hospitals compared with the rest of Scotland from 1990-1 to 2000-1. MAIN OUTCOME MEASURES: Staffed bed rates, admission rates, mean lengths of stay, occupancy, and throughput in four adult acute specialty groups in 1990-1, 1995-6, and 2000-1. RESULTS: By 2000-1, rates for inpatient admission in all acute, medical, surgical, and intensive therapy specialties in Lothian hospitals were respectively 20%, 6%, 28%, and 38% below those in the rest of Scotland. Day case rates in all acute and acute surgical specialties were 13% and 33% lower. The proportion of delayed discharges in staffed acute and post-acute NHS beds in Lothian hospitals exceeded the Scottish average (15% and 12% respectively; P<0.001). CONCLUSION: The planning targets and increase in clinical activity in acute specialties in Lothian hospitals associated with PFI had not been achieved by 2000-1. The effect on clinical activity has been a steeper decline in the number of acute beds and rates of admission in Lothian hospitals compared with the rest of Scotland between 1995-6 and 2000-1

Nonlinear H ∞ optimal control scheme for an underwater vehicle with regional function formulation

A conventional region control technique cannot meet the demands for an accurate tracking performance in view of its inability to accommodate highly nonlinear system dynamics, imprecise hydrodynamic coefficients, and external disturbances. In this paper, a robust technique is presented for an Autonomous Underwater Vehicle (AUV) with region tracking function. Within this control scheme, nonlinear H∞ and region based control schemes are used. A Lyapunov-like function is presented for stability analysis of the proposed control law. Numerical simulations are presented to demonstrate the performance of the proposed tracking control of the AUV. It is shown that the proposed control law is robust against parameter uncertainties, external disturbances, and nonlinearities and it leads to uniform ultimate boundedness of the region tracking error

Bargaining Towards Equality: The Effects of Implicit Bias Training on Plea-Bargaining

This comment focuses on the racial discrimination that currently exists in the process of plea-bargaining. The author suggests an approach aimed to mend the widespread racial discrimination. Particularly, the author details why mandatory implicit bias trainings for prosecutors would benefit defendants. Implicit bias trainings would benefit the criminal justice system as a whole because they would bring awareness to the issue and give prosecutors the knowledge they need to act justly in the plea-bargaining process

La naissance tardive d’une intervention psychosociale en infertilité

Au Québec, tous les aspects de la vie reproductive sont activement débattus. Cet article propose quelques réflexions sur les bases d'une approche différente du problème de l'infertilité, incluant des dimensions subjectives, évolutives et interactives, et sur la place que pourrait prendre l'intervention psychosociale auprès des personnes qui vivent cette situation. L'auteure conclut sur l'intérêt de développer une approche d'intervention féministe sur cette question

Nutrition Knowledge and Attitudes Among Clemson University Student-Athletes

ABSTRACT Participants in this study were 95 Clemson University student-athletes who were currently on the varsity men\u27s and women\u27s soccer, tennis, track and field, and swimming and diving who completed a survey on nutrition knowledge and attitudes. The mean total point score on the survey was 17.48 + 1.71. The mean score on knowledge questions on the survey was 11.59 + 3.14 or 46.3%. Females had a slightly higher mean score (12.3+ 3.03 or 49.2%) than males (10.9 + 3.13 or 43.6%) on the knowledge questions. The mean score on attitude questions was 5.89+ 1.67 or 58.9%. Females had a slightly higher mean score (6.19 + 1.53 or 61.9%) than the males (5.60 + 1.76 or 56%) on the attitude questions. A multiple regression analysis for impact of sport, gender, class rank, previous nutrition course, and eating situation on total score on the survey gave an overall R2 of 0.174 (F= 3.75, p= 0.004). There was no significant unique effect of class rank (p = 0.084), sport (p= 0.079), and eating situation (p= 0.079) for this model. The unique effect of gender (p= 0.003) and taking a nutrition course (p= 0.036) were statistically significant. Even though the proposed model was statistically significant, it did not adequately predict performance on the survey. The model predicted that females were to score 2.5 points higher on the survey than males and that those who reported taking a nutrition course in the past were to score 1.7 points lower than those who had not taken a nutrition course. This most likely reflects the relatively small number who reported having taken a nutrition course. Additional studies should include additional attitude questions and further define the role of nutrition education on knowledge and attitudes of student-athletes

Restoring Power to the Powerless: The Need to Reform California\u27s Mandatory Mediation for Victims of Domestic Violence

In California, the intersection of mandatory mediation with domestic violence poses significant dangers on two levels. On a societal level, California\u27s requirement that victims of domestic violence mediate with their abusers has placed a hurdle in the battered women\u27s movement by reprivatizing domestic violence, impeding the progress that is driven by public discourse and scrutiny. On an individual level, mandatory mediation leaves victims in a disadvantageous position, fending for themselves at a bargaining table that fails to promote the safety and welfare of victims and their children

Making a salary schedule for Quincy

Thesis (Ed.M.)--Boston University, 1945. This item was digitized by the Internet Archive