The effect of hospital financial distress on immediate breast reconstruction

Hospital financial stress is a common problem. From 1995-2010 15-30% of hospitals every year were classified as financially distressed based on a negative total profit margin. However, very few studies to date have assessed the impact of hospital financial distress on quality of care indicators or patient outcomes. A comprehensive and systematic literature review was conducted to assess the state of the science on hospital financial distress and quality of care or patient outcomes. A total of three peer-reviewed articles were found that used a measure of hospital financial distress as an exposure with a quality of care indicator or health-related factor as an outcome. However, despite the limited research on this topic, the evidence suggested there was an important relationship between hospital financial distress and patient outcomes. What became clear after the systematic literature review was that not only had very few studies ever assessed the relationship between hospital financial distress and patient outcomes, but there was also limited evidence on the validity of various measures of hospital financial distress. An analysis conducted as part of this dissertation assessed the validity of profit margin, as well as two composite measures, the Financial Strength Index and the modified z-index, to see how well they predicted hospital closure. Overall, despite the added complexity of the Financial Strength Index and the modified z-index compared to profit margin, all three measures performed similarly with respect to predicting hospital closure. Finally, profit margin, as a measure of hospital financial distress was used to predict the receipt of immediate breast reconstruction. Women undergoing mastectomy at hospitals under high levels of hospital financial distress were significantly less likely to receive immediate breast reconstruction compared to women treated at hospitals under minimal to no financial distress, adjusting for important confounders. This means hospital financial distress is an important, although unwarranted, determinant of breast cancer care

Pathways to Linking Science and Policy in the Field of Global Risk

One of our current aims at the Centre for the Study of Existential Risk (CSER) is to understand the norms, values and approaches that bridge global risk with policy engagement. More specifically, to strengthen our capabilities in translation and application of our research into practical policy recommendations and proposals. Therefore, we have developed this report to help guide and enhance the policy engagement efforts of researchers at CSER and other global risk research institutions. Based on insights from academic experience, in this report readers will find: insights into academic perspectives on policy engagement; definitions of terminology; study cases, topics in demand; institutions interested in global catastrophic risks; and skills; as well as a checklist and step-by-step guidance that may inspire and help you to lead your research activities towards more impactful policy engagements. Through six cases of engagement with policy, CSER has identified a number of skills that are highly relevant to successful policy engagement: project management skills, communication skills, networking and interpersonal skills, expertise in specialist topics and familiarity with the policy research landscape, knowledge of parliamentary language and processes, knowledge of the process for drafting bills and legislation and knowledge of policy-making and how to frame policy interventions in a palatable way. Policy engagement can help you gain new skills, increase your network, and enhance the reputation of your institution and yourself. It can lead to research and funding opportunities, and enhance your future career options. This work is part of our project A Science of Global Risk which is focused on safeguarding humanity’s long-term future by being rigorous and creative; open to diverse groups; and capable of producing concrete proposals for risk management that can be implemented within the existing policy landscape

Determination and Occurrence of Phenoxyacetic Acid Herbicides and Their Transformation Products in Groundwater Using Ultra High Performance Liquid Chromatography Coupled to Tandem Mass Spectrometry

This research is funded by the National Development Plan, through the Research Stimulus Fund, administered by the Department of Agriculture, Food and Marine (RS-544) and the Teagasc Walsh Fellowship Scheme.peer-reviewedA sensitive method was developed and validated for ten phenoxyacetic acid herbicides, six of their main transformation products (TPs) and two benzonitrile TPs in groundwater. The parent compounds mecoprop, mecoprop-p, 2,4-D, dicamba, MCPA, triclopyr, fluroxypr, bromoxynil, bentazone, and 2,3,6-trichlorobenzoic acid (TBA) are included and a selection of their main TPs: phenoxyacetic acid (PAC), 2,4,5-trichloro-phenol (TCP), 4-chloro-2-methylphenol (4C2MP), 2,4-dichlorophenol (DCP), 3,5,6-trichloro-2-pyridinol (T2P), and 3,5-dibromo-4-hydroxybenzoic acid (BrAC), as well as the dichlobenil TPs 2,6-dichlorobenzamide (BAM) and 3,5-dichlorobenzoic acid (DBA) which have never before been determined in Irish groundwater. Water samples were analysed using an efficient ultra-high performance liquid chromatography (UHPLC) method in an 11.9 min separation time prior to detection by tandem mass spectrometry (MS/MS). The limit of detection (LOD) of the method ranged between 0.00008 and 0.0047 µg·L−1 for the 18 analytes. All compounds could be detected below the permitted limits of 0.1 µg·L−1 allowed in the European Union (EU) drinking water legislation [1]. The method was validated according to EU protocols laid out in SANCO/10232/2006 with recoveries ranging between 71% and 118% at the spiked concentration level of 0.06 µg·L−1. The method was successfully applied to 42 groundwater samples collected across several locations in Ireland in March 2012 to reveal that the TPs PAC and 4C2MP were detected just as often as their parent active ingredients (a.i.) in groundwater

Predicting soil moisture conditions for arable free draining soils in Ireland under spring cereal crop production

peer-reviewedTemporal prediction of soil moisture and evapotranspiration has a crucial role in agricultural and environmental management. A lack of Irish models for predicting evapotranspiration and soil moisture conditions for arable soils still represents a knowledge gap in this particular area of Irish agro-climatic modelling. The soil moisture deficit (SMD) crop model presented in this paper is based on the SMD hybrid model for Irish grassland (Schulte et al., 2005). Crop and site specific components (free-draining soil) have been integrated in the new model, which was calibrated and tested using soil tension measurements from two experimental sites located on a well-drained soil under spring barley cultivation in south-eastern Ireland. Calibration of the model gave an R2 of 0.71 for the relationship between predicted SMD and measured soil tension, while model testing yielded R2 values of 0.67 and 0.65 (two sites). The crop model presented here is designed to predict soil moisture conditions and effective drainage (i.e., leaching events). The model provided reasonable predictions of soil moisture conditions and effective drainage within its boundaries, i.e., free-draining land used for spring cereal production under Irish conditions. In general, the model is simple and practical due to the small number of required input parameters, and due to model outputs that have good practical applicability, such as for computing the cumulative amount of watersoluble nutrients leached from arable land under spring cereals in free-draining soils

Mustard catch crop enhances denitrification in shallow groundwater beneath a spring barley field

The study was funded by Department of Agriculture and Food through the Research Stimulus Fund Programme (Grant RSF 06383) in collaboration with the Department of Civil, Structural & Environmental Engineering, Trinity College Dublin, Ireland.peer-reviewedOver-winter green cover crops have been reported to increase dissolved organic carbon (DOC) concentrations in groundwater, which can be used as an energy source for denitrifiers. This study investigates the impact of a mustard catch crop on in situ denitrification and nitrous oxide (N2O) emissions from an aquifer overlain by arable land. Denitrification rates and N2O-N/(N2O-N + N2-N) mole fractions were measured in situ with a push–pull method in shallow groundwater under a spring barley system in experimental plots with and without a mustard cover crop. The results suggest that a mustard cover crop could substantially enhance reduction of groundwater nitrate NO3--N via denitrification without significantly increasing N2O emissions. Mean total denitrification (TDN) rates below mustard cover crop and no cover crop were 7.61 and 0.002 μg kg−1 d−1, respectively. Estimated N2O-N/(N2O-N + N2-N) ratios, being 0.001 and 1.0 below mustard cover crop and no cover crop respectively, indicate that denitrification below mustard cover crop reduces N2O to N2, unlike the plot with no cover crop. The observed enhanced denitrification under the mustard cover crop may result from the higher groundwater DOC under mustard cover crop (1.53 mg L−1) than no cover crop (0.90 mg L−1) being added by the root exudates and root masses of mustard. This study gives insights into the missing piece in agricultural nitrogen (N) balance and groundwater derived N2O emissions under arable land and thus helps minimise the uncertainty in agricultural N and N2O-N balances

Leaching of N compounds from swards used for dairying that are N based and irrigated with dirty water/slurry.

End of Project ReportA study was carried out to investigate nitrate leaching on a dairy farm in Co. Cork. The farm had a history of high nitrate-N in borehole waters and the study aimed to elucidate the causative factors for this. Physical and chemical data regarding the soils, the hydrology, and the N input/output balances were determined and collated. Results showed that nitrate-N concentrations > the EU maximum allowable concentration (MAC) of 11.3 mg/l for drinking water occurred in soil drainage from the light textured soils studied due to a large imbalance between N inputs and outputs. High fertiliser N usage, animal manure and dirty water applications, atmospheric N depositions and soil organic N mineralisation in combination produced these results . While it is recognised that nitrate leaching will vary in amount from year to year the lessons from the study are clear - light textured soils that are used for intensive dairying and which receive high inputs of N are prone to release drainage water high in nitrate.European Union Structural Funds (EAGGF

A Mixed-Methods Study Assessing Special Education Preservice Candidates\u27 Preparedness for Their First Year of Teaching

This study employed a Likert-type survey, Praxis/Pathwise written observations, as well as guided and open-ended reflections to assess the perceptions of preparedness for the first year of teaching for special education student teaching candidates. Cooperating teachers completed the survey and Praxis /Pathwise observations. University supervisors completed Praxis/Pathwise observations and responded to and analyzed guided and open-ended reflections. The survey instrument was based on the research literature and included responsibilities typically required of special educators (e.g., completing paperwork, planning, assessment, etc.). Results indicated general congruence among the three data sources, but also indicated that two cooperating teachers were reluctant to provide negative feedback, indicating to university supervisors a need to provide guidance and assurance of the value of providing less positive assessments of their student teachers’ preparedness. This ongoing research study supports efforts toward accreditation and program improvement. The methods may be generalized to other programs, even when the actual data collection instruments may differ

New people: the younger informal settlements in central Durban

The report commissioned by the Department of Local Government and National Housing covers six survey areas, the first four of which are regarded as younger informal settlements closer to the city centre (Cato Manor, Kennedy Road, Briardene and Block AK). The remaining two are formal townships (Umlazi and Clermont) which have experienced informal housing areas within them. The report was completed by the Rural-Urban Studies Unit