50 research outputs found
Head-to-head comparison of length of stay, patients' outcome and satisfaction in Switzerland before and after SwissDRG-Implementation in 2012 in 2012: an observational study in two tertiary university centers.
On 1 January 2012 Swiss Diagnosis Related Groups (DRG), a new uniform payment system for in-patients was introduced in Switzerland with the intention to replace a "cost-based" with a "case-based" reimbursement system to increase efficiency. With the introduction of the new payment system we aim to answer questions raised regarding length of stay as well as patients' outcome and satisfaction.
This is a prospective, two-centre observational cohort study with data from University Hospital Basel and the Cantonal Hospital Aarau, Switzerland, from January to June 2011 and 2012, respectively. Consecutive in-patients with the main diagnosis of either community-acquired pneumonia, exacerbation of COPD, acute heart failure or hip fracture were included. A questionnaire survey was sent out after discharge investigating changes before and after SwissDRG implementation. Our primary endpoint was LOS.
Of 1,983 eligible patients 841 returned the questionnaire and were included into the analysis (429 in 2011, 412 in 2012). The median age was 76.7 years (50.8% male). Patients in the two years were well balanced in regard to main diagnoses and co-morbidities. Mean LOS in the overall patient population was 10.0 days and comparable between the 2011 cohort and the 2012 cohort (9.7 vs 10.3; p = 0.43). Overall satisfaction with care changed only slightly after introduction of SwissDRG and remained high (89.0% vs 87.8%; p = 0.429).
Investigating the influence of the implementation of SwissDRG in 2012 regarding LOS patients' outcome and satisfaction, we found no significant changes. However, we observed some noteworthy trends, which should be monitored closely
A CURE on the Evolution of Antibiotic Resistance in <i>Escherichia coli</i> Improves Student Conceptual Understanding
We developed labs on the evolution of antibiotic resistance to assess the costs and benefits of replacing traditional laboratory exercises in an introductory biology course for majors with a course-based undergraduate research experience (CURE). To assess whether participating in the CURE imposed a cost in terms of exam performance, we implemented a quasi-experiment in which four lab sections in the same term of the same course did the CURE labs, while all other students did traditional labs. To assess whether participating in the CURE impacted other aspects of student learning, we implemented a second quasi-experiment in which all students either did traditional labs over a two-quarter sequence or did CURE labs over a two-quarter sequence. Data from the first experiment showed minimal impact on CURE students' exam scores, while data from the second experiment showed that CURE students demonstrated a better understanding of the culture of scientific research and a more expert-like understanding of evolution by natural selection. We did not find disproportionate costs or benefits for CURE students from groups that are minoritized in science, technology, engineering, and mathematics
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Recovery of release cloud from laser shock-loaded graphite and hydrocarbon targets: in search of diamonds
This work presents first insights into the dynamics of free-surface release clouds from dynamically compressed polystyrene and pyrolytic graphite at pressures up to 200 GPa, where they transform into diamond or lonsdaleite, respectively. These ejecta clouds are released into either vacuum or various types of catcher systems, and are monitored with high-speed recordings (frame rates up to 10 MHz). Molecular dynamics simulations are used to give insights to the rate of diamond preservation throughout the free expansion and the catcher impact process, highlighting the challenges of diamond retrieval. Raman spectroscopy data show graphitic signatures on a catcher plate confirming that the shock-compressed PS is transformed. First electron microscopy analyses of solid catcher plates yield an outstanding number of different spherical-like objects in the size range between ten(s) up to hundreds of nanometres, which are one type of two potential diamond candidates identified. The origin of some objects can unambiguously be assigned, while the history of others remains speculative
The relative influence of geographic and environmental factors on rare plant translocation outcomes
Conservation translocations are an established method for reducing the extinction risk of plant species through intentional movement within or outside the indigenous range. Unsuitable environmental conditions at translocation recipient sites and a lack of understanding of species–environment relationships are often identified as critical barriers to translocation success. However, previous syntheses have drawn these inferences from analyses of qualitative feedback rather than quantitative environmental data.
In this study, we use a data set of 235 translocations conducted in the US to understand the influences of geographic and environmental factors on three metrics of translocation success: population persistence, next-generation recruitment and next-generation maturity. We use random forest models to quantify the relative importance of geographic and environmental factors that characterize dissimilarity between source and recipient locations, the position of recipient sites relative to species' ranges and niche metrics derived from these ranges. We also compare the importance of these variables with more conventional predictors (e.g. founder population size).
Our results indicate that geographic and environmental variables can be as insightful as conventional variables for predicting plant translocation outcomes. The climate suitability of recipient sites, estimated using species distribution models, was the strongest relative predictor of whether a population persisted, with populations situated in more suitable climates displaying greater persistence. Next-generation recruitment and maturity were best predicted by niche metrics; species in more biotically limiting environments, including tropical regions and soils with high relative nutrient retention, as well as species with the broadest precipitation niches, were the least likely to attain these next-generation benchmarks. Synthesis and applications. Our study is one of the first to quantify the important role of spatial and climatic factors in rare plant translocation outcomes. We provide a novel geographic and environmental perspective on outcomes in plant translocations and demonstrate opportunities to improve translocation success not only by adhering to established best practice guidelines but also by integrating spatial modelling approaches into planning and management processes
Recovery of release cloud from laser shock-loaded graphite and hydrocarbon targets: in search of diamonds
This work presents first insights into the dynamics of free-surface release clouds from dynamically compressed polystyrene and pyrolytic graphite at pressures up to 200 GPa, where they transform into diamond or lonsdaleite, respectively. These ejecta clouds are released into either vacuum or various types of catcher systems, and are monitored with high-speed recordings (frame rates up to 10 MHz). Molecular dynamics simulations are used to give insights to the rate of diamond preservation throughout the free expansion and the catcher impact process, highlighting the challenges of diamond retrieval. Raman spectroscopy data show graphitic signatures on a catcher plate confirming that the shock-compressed PS is transformed. First electron microscopy analyses of solid catcher plates yield an outstanding number of different spherical-like objects in the size range between ten(s) up to hundreds of nanometres, which are one type of two potential diamond candidates identified. The origin of some objects can unambiguously be assigned, while the history of others remains speculative
