396 Characterizing inpatient hospitalizations for hidradenitis suppurativa and assessing the impact of outpatient dermatology care on hospitalizations

Introduction: Hidradenitis suppurativa (HS) is associated with a significant disease burden. The use of high-cost settings care are common among HS patients. Objective: To explore factors that may influence hospital admissions and readmissions among HS patients. Methods: Using ICD-9/10 codes (705.83 and L73.2), we extracted the medical records of adult HS patients who visited the Henry Ford Health System (HFHS) ED between 2010 and 2020. Results: Of the 100 HS patients, 52 (52%) were admitted to an inpatient service. Hypertension (OR:2.55,95% CI:1.11-5.83, p value=0.027), diabetes mellitus (OR:2.42, 95%CI:1.05-5.61, p value =0.039), cellulitis (OR: 19.28, 95%CI:4.23-87.96 p\u3c0.001), sepsis (OR:10.25, 95%CI:1.34-89.24, p value=0.025), and depression (OR:3.32, 95%CI:1.10-10.04, p value =0.002) were significant predictors of admission. Chronic kidney disease (OR:3.05, 95% CI:1.00-9.23,p value=0.049), congestive heart failure (OR:4.06, 95%CI:1.19-13.80, p value =0.025), coronary artery disease (OR:15.20, 95%CI:2.80-82.65, p value=0.002), chronic obstructive pulmonary disease (OR:8.94, 95%: 1.51-52.86, p value =0.003), cellulitis (OR:4.62, 95%CI:1.66-12.88, p=0.003), sepsis (OR:3.75, 95%CI:1.02-13.82,p value =0.047), and depression (OR:4.50, 95%CI:1.54-13.18, p value=0.006) were positively associated with readmission. Those who received outpatient dermatology care had a lower risk of being admitted (n=87, 28.7% vs n=13,100%, p \u3c0.001) and readmitted (n=10, 11.5% vs n=5, 38.5%, p value =0.0108). Discussion: In this study, we demonstrate that certain comorbidities, that are common among HS patients, are significant determinants of admission to an inpatient service. Furthermore, the increase access to outpatient dermatology care significantly reduces the likelihood of HS patients being admitted and readmitted. Conclusion: The findings of this study illuminate the pivotal role of dermatologists in improving patients’ health outcomes while minimizing the avoidable use of high-cost settings care

Impacts of terrain attributes on economics and the environment: costs of reducing potential nitrogen pollution in wheat production

The economic cost of achieving desired environmental outcomes from uniform and variable rate fertilizer application technologies depends both on market forces and agronomic properties. Using spatial econometric methods, we analyze the impact of nitrogen fertilizer supply by terrain attribute on the yield and protein content of hard red spring wheat grown in EasternWashington as well as the impact on residual nitrogen.We find significant association with all three. The economic impact of nitrogen restrictions depends critically on both prices and level of the restriction. Uniform application of nitrogen was found to economically outperform variable rate application, but variable rate application provided positive environmental benefits due to less residual nitrogen

A principled approach to the measurement of situation awareness in commercial aviation

The issue of how to support situation awareness among crews of modern commercial aircraft is becoming especially important with the introduction of automation in the form of sophisticated flight management computers and expert systems designed to assist the crew. In this paper, cognitive theories are discussed that have relevance for the definition and measurement of situation awareness. These theories suggest that comprehension of the flow of events is an active process that is limited by the modularity of attention and memory constraints, but can be enhanced by expert knowledge and strategies. Three implications of this perspective for assessing and improving situation awareness are considered: (1) Scenario variations are proposed that tax awareness by placing demands on attention; (2) Experimental tasks and probes are described for assessing the cognitive processes that underlie situation awareness; and (3) The use of computer-based human performance models to augment the measures of situation awareness derived from performance data is explored. Finally, two potential example applications of the proposed assessment techniques are described, one concerning spatial awareness using wide field of view displays and the other emphasizing fault management in aircraft systems

‘Problem people’ and ‘problem places’ : territorial stigmatisation and ‘The Leys’, Oxford

This study examines the concept of territorial stigmatisation and both the extent to which a specific community has experienced this process and the impact it has had on them. The thesis critically examines the ways in which policy, academic and other forms of representation have worked to socially construct social housing estates and those who live there as, predominantly, ‘problematic’. The study also explores how officially produced data – in the form of the Indices of Multiple Deprivation and the 2011 Census also work to construct this area as one of deficit. The study employs semi-structured, qualitative interviews with a diverse sample of twenty residents of a large, peripheral housing estate in Oxford that has experienced territorial stigmatisation over a number of decades. The study presents an analysis of the rich data drawn from these interviews which examines the views and experiences of these residents and how they account for this stigmatisation, how it impacts on their lives and their community and the extent to which they present alternative and oppositional readings of where they live. The thesis demonstrates that the stigmatising narratives of the Leys are problematic because of the responsibility they seem to place on the residents for their own exclusion and deprivation. However, the thesis also demonstrates that while this estate has experienced long-term territorial stigmatisation, residents’ responses to this experience are more complex, nuanced and reflective than some literature suggests

Inclusive Scholarship: Developing Black Studies in the United States

Brings together four reports commissioned between 1982 and 2000 that examine the history of African American Studies, its impact, and its institutionalization. Reviews Ford's grantmaking to African American Studies programs from 1982 to 2007