Determinants of preventable readmissions in the United States: a systematic review

<p>Abstract</p> <p>Background</p> <p>Hospital readmissions are a leading topic of healthcare policy and practice reform because they are common, costly, and potentially avoidable events. Hospitals face the prospect of reduced or eliminated reimbursement for an increasing number of preventable readmissions under nationwide cost savings and quality improvement efforts. To meet the current changes and future expectations, organizations are looking for potential strategies to reduce readmissions. We undertook a systematic review of the literature to determine what factors are associated with preventable readmissions.</p> <p>Methods</p> <p>We conducted a review of the English language medicine, health, and health services research literature (2000 to 2009) for research studies dealing with unplanned, avoidable, preventable, or early readmissions. Each of these modifying terms was included in keyword searches of readmissions or rehospitalizations in Medline, ISI, CINAHL, The Cochrane Library, ProQuest Health Management, and PAIS International. Results were limited to US adult populations.</p> <p>Results</p> <p>The review included 37 studies with significant variation in index conditions, readmitting conditions, timeframe, and terminology. Studies of cardiovascular-related readmissions were most common, followed by all cause readmissions, other surgical procedures, and other specific-conditions. Patient-level indicators of general ill health or complexity were the commonly identified risk factors. While more than one study demonstrated preventable readmissions vary by hospital, identification of many specific organizational level characteristics was lacking.</p> <p>Conclusions</p> <p>The current literature on preventable readmissions in the US contains evidence from a variety of patient populations, geographical locations, healthcare settings, study designs, clinical and theoretical perspectives, and conditions. However, definitional variations, clear gaps, and methodological challenges limit translation of this literature into guidance for the operation and management of healthcare organizations. We recommend that those organizations that propose to reward reductions in preventable readmissions invest in additional research across multiple hospitals in order to fill this serious gap in knowledge of great potential value to payers, providers, and patients.</p

Effects of Atmospheric Rivers

This book is intended to summarize the state of the science of atmospheric rivers (ARs) and itsapplication to practical decision-making and broader policy topics. It is the first book on thesubject and is intended to be a learning resource for professionals, students, and indeed anyonenew to the field, as well as a reference source for all.We first envisioned the book during the heady days of 2013 when the Center for WesternWeather and Water Extremes was being planned and established. However, right from the start,we recognized that the effort required would exceed that of any single or couple of authors, andthat the book would surely benefit from a broad range of perspectives and knowledge from avariety of leaders of atmospheric-river science from around the world. Consequently, the firststep toward this book was to organize workshops addressing various aspects of AR science thatwe were able to co-opt, in part, for recruitment of, and discussions among, possible contributingauthors. This led to the diverse authorship team that ultimately wrote this book, as well asour engagement of an experienced publication and book editing team. Among the strategiesagreed to by the contributing authors, one key decision was that the book would focus mostlyon results that have already been published and would emphasize figures and references fromthose formal publications. Where vital, new information has been developed and incorporated.Each chapter was led by a few expert lead authors recruited by the four of us, and those chapterleads recruited contributions from other experts on the chapter topic. Each chapter wasreviewed by other specialists who were not part of its authorship team, generally including onehighly technical expert and one reviewer intended to represent members of a broader audience.This helped ensure the accuracy of interpretations as well as high standards and accessibilityof presentation. We, the editors of the book, reviewed all chapters at various stages of compositionand layout.Given currently high levels of interest in ARs in the scientific community as well as by thepublic, we hope that the book will be a useful starting place for many readers. Writing a bookabout a topic that is as new and that is advancing as quickly as AR science is today (in 2018)poses many difficult challenges but, with the help of the large team of expert authors who havecontributed, we believe that, with this book, we are providing a firm foundation for futureexpansion and advances in this important field.Fil: Dettinger, Michael D.. United States Geological Survey; Estados UnidosFil: Lavers, David A.. No especifíca;Fil: Compo, Gilbert P.. State University of Colorado at Boulder; Estados UnidosFil: Gorodetskaya, Irina V.. Universidade de Aveiro; PortugalFil: Neff, William. State University of Colorado at Boulder; Estados UnidosFil: Neiman, Paul J.. National Oceanic And Atmospheric Administration; Estados UnidosFil: Ramos, Alexandre M.. Universidade Nova de Lisboa; PortugalFil: Rutz, Jonathan J.. National Weather Service; Estados UnidosFil: Viale, Maximiliano. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Wade, Andrew J.. University of Reading; Reino UnidoFil: White, Allen B.. National Oceanic And Atmospheric Administration; Estados Unido

Phytoplasma diseases of medicinal crops

Phytoplasma diseases of medicinal plants occur worldwide and are of great concern. So far 19 different phytoplasma ribosomal groups encompassing various subgroups have been reported. The subgroup 16SrI-B phytoplasmas are the prevalent agents mainly detected in Europe, North America and Asia. Phytoplasma diseases of medicinal plants severely reduce yield and quality of crops along with the longevity of the plants. Changes in the composition of secondary metabolites are induced, while the levels of valuable phytochemicals are greatly affected. In contrast, an accumulation of pharmaceutically important compounds such as vinblastine and vincristine is reported in periwinkle upon phytoplasma infections. Important phytoplasma diseases of several medicinal plants with special reference to their impact on active biological constituents and secondary metabolites are reviewed. General information on geographic distribution, diagnostics, genetic diversity, natural transmission and management aspects of phytoplasmas infecting medicinal plants are also discussed