The Effect of Health Information Technology on Hospital Quality of Care

Health Information Technology (Health IT) is designed to store patients’ records safely and clearly, to reduce input errors and missing records, and to make communications more efficiently. Concerned with the relatively lower adoption rate among the US hospitals compared to most developed countries, the Bush Administration set up the Office of National Coordinator for Health Information Technology in 2006 to mandate the Health IT implementation with $25.9 billion subsidies to eligible hospitals starting 2009. Underlying the huge subsidy is the belief that Health IT can reduce hospital cost by improving efficiency and quality, and can help reduce total health expenditure. Yet researchers from both medical field and economics field have been struggling to find evidence on such implications for years. In my dissertation I conduct empirical analysis to investigate the causal effect of Health IT on US hospitals efficiency and quality, and to examine whether such effects vary across different patient groups or hospital types. The rich study sample consists of two datasets: the 2002-2008 National Inpatient Sample (NIS) and State Inpatient Database (SID) generated by Agency for Healthcare Research and Quality (AHRQ), and the HIMSS Analytics data. The NIS is a nationally representative patient level discharge data set, which includes about 20% of the total US inpatient discharges annually. The HIMSS Analytics is a survey data set that reports about 5000 US hospitals’ Health IT adoption status and history, together with hospital characteristics. The SID comes from four states: CA, FL, NY, and WA, with almost 100% discharge information available. It also gives the benefit of linking multiple discharge records to the same initial visit record, and therefore can be used to identify readmissions to hospitals. The first chapter is a in depth literature review on the studies of Health IT and its impact on hospital outcomes. The second chapter is an empirical paper that uses nationally representative data to study how IT system affect patients\u27 Length of Stay, by adopting Finite Mixture Model method. The third chapter empirically analyzes IT\u27s impact on readmissions, and particularly for five conditions that are also of Center for Medicare and Medicaid Services (CMS) focuses in determining hospital quality. This dissertation finds empirical evidence that supports Health IT\u27s contribution. It also establishes how Finite Mixture Model method can be used in healthcare research. Results show that not all patients or hospitals are expected to receive the same degree of benefit from Health IT adoption. In fact, majority of the populations are not shown to be affected. Still, studies from this dissertation illustrate the potential of Health IT systems, as the analyses so far are only conducted in the hospital setting. On a broader sense, Health IT is supposed to support all aspects of healthcare deliveries and coordination

Análise dos principais erros de alunos chineses no uso do conjuntivo em português

Esta dissertação tem como objetivo investigar de forma aprofundada os erros mais comuns cometidos por alunos chineses em relação ao uso do conjuntivo, sendo esta uma das áreas mais difíceis para falantes não nativos. Através da realização de um inquérito com exercícios relacionados com o tema, foi analisada a capacidade dos estudantes chineses de perceber e distinguir as diferenças entre os vários usos, além da interferência da língua chinesa na aprendizagem do conjuntivo por estes alunos, a fim de propor conselhos de melhoria no ensino-aprendizagem deste tópico gramatical.The dissertation aims to investigate in depth the most common mistakes made by Chinese students in relation to the use of the conjunctive mood, because it is one of the most difficult areas for non-native speakers. Through a survey with exercises related to the theme, the ability of Chinese students to perceive and distinguish the differences between the various uses was analyzed, in addition to the interference of the Chinese language in the learning of the conjunctive by these students, in order to propose advices in the teaching-learning of this grammatical topic.Mestrado em Português Língua Estrangeira/Língua Segund

Analysis of the main errors made by chinese students in the use of the subjunctive in portuguese

Este trabalho tem como objetivo investigar os erros mais comuns cometidos por alunos chineses em relação ao uso do conjuntivo, sendo esta uma das áreas difíceis para falantes não nativos. Através da realização de um inquérito com exercícios relacionados com o tema, foi analisada a capacidade dos estudantes chineses de perceber e distinguir as diferenças entre os vários usos, além da interferência da língua chinesa na aprendizagem do conjuntivo por estes alunos, a fim de propor conselhos de melhoria no ensino-aprendizagem deste tópico gramatical.This work aims to investigate the most com-mon mistakes made by Chinese students in rela-tion to the use of the subjunctive, which is one of the most difficult areas for non-native speakers. A survey was carried out using exercises related to this topic area with the aim of testing the abi-lity of Chinese students to perceive and distin-guish the differences between the various uses. The data were then analysed, and, together with examples of the interference of the Chinese lan-guage in the learning of the subjunctive, some ways to improve the teaching-learning of this grammatical topic were suggested.publishe

論過士行《鳥人》話劇中的文化迷惘主題

過士行，1952年出生於北京，成長於傳統的圍棋世家。1979年從北京日報新聞班畢業以後，過士行成為《北京晚報》的見習記者，在責戲劇報導期間對於話劇產生濃厚興趣。過士行從1986年莎士比亞戲劇節中獲得啟發，並在話劇導演林兆華的鼓勵下開始走上創作的道路。1993年由林兆華導演的《鳥人》在北京人民藝術劇院上演，是過士行第一部面世的戲劇作品卻引起轟動。此後，過士行持續創作出聚焦於市井人物的戲劇作品，也擔任多部電視劇與電影的編劇。過士行擅於運用獨特的角度審視當代人的精神和生活狀態，揭露人在現代社會中的矛盾。 前人學者對於《鳥人》的劇本在人物形象、藝術風格、美學特徵方面都有深刻的研究，而在其主題意藴方面，則著重分析鳥人養鳥的悖論，強調人被自己的愛好所禁錮，人與鳥互為隱喻的關係。然而作品中除去鳥人與鳥之外，過士行運用不少筆墨於知識分子，而從知識分子的視角則能更深入理解鳥人的困境心理。本文將鳥人放在全球化時代背景下討論他們精神困境的原因。第一章簡述前人學者對《鳥人》的研究成果，論述將「知識分子」的角度及其所代表的西方文明引入來探尋鳥人的文化迷惘的正當性。第二章詳細解讀鳥人痴迷養鳥文化的行為，總結鳥人的異化中所體現出來的本土特徵。第三章則在第二章的基礎上分析鳥人的本土特質與全球化時代的矛盾，分析出鳥人入魔般養鳥行為的背後成因，並在解析知識分子與鳥人矛盾的符號化意義的同時引入「文明衝突論」來理解鳥人群體的痴迷與迷惘心裡

Development of a general component-based connection element for structural fire engineering analysis

This paper reports on the development of general-purpose component-based connection finite element intended to model the performance of steel-to-steel joints in fire. The element is generally consistent with Eurocode principles. The development began with the creation of an assembled component-based finite element to represent the flush endplate connection type, in the main using temperature-dependent connection component characteristics which had previously been developed at the University of Sheffield for behaviour up to very high distortions and ultimate fracture, as well as for force reversal.  In subsequent work, components for the reverse-channel have been characterized and validated against both numerical modelling and high-temperature testing. The element has been incorporated into the nonlinear global structural analysis program Vulcan, developed at the University of Sheffield

An analytical and numerical prediction for ductility demand on steel beam-to-column connections in fire

In this paper a simplified analytical method to assess the ductility demand on connections according to fire resistance requirements is developed on the basis of fundamental structural mechanics principles. An objective is to enable the development of a viable method to allow engineers to take the ductility of connections into account in design practice. Numerical finite element simulations of the single beam model were also performed to validate the simplified analytical model and reveal the important parameters that can influence the ductility demand within the connections. Using both analytical and numerical methods, the principal factors which influence the ductility demand of a connection, such as the span of the connected beam and the required connection strength, are also assessed. It is shown that: 1. The compressive ductility of connections is helpful in reducing the push-out of perimeter columns and the possibility of local buckling of beams. 2. Provision of high tensile deformation capacity allows large deflection in the beam, substantially reduces catenary forces on the connections, and consequently reduces the risk of structural collapse in fire. 3. The ductility demand of the connection is closely related to its stiffness and strength, as well as to the slenderness and load ratio of the connected beam

Bis[bis­(1-ethyl­benzimidazol-2-ylmeth­yl) ether]cobalt(II) dipicrate dimethyl­formamide disolvate

In the title complex, [Co(C20H22N4O)2](C6H2N3O7)2·2C3H7NO, the CoII ion is coordinated by two sets of two N atoms and an O atom from two independent tridendate ligands in a distorted octa­hedral coordination environment. There are significant differences between chemically equivalent coordination bond lengths. The crystal structure is stabilized by weak inter­molecular C—H⋯O hydrogen bonds and weak π–π stacking inter­actions [centroid–centroid distance 3.495 (1) Å]. In one of the anions one nitro group is rotationally disordered about the C—N bond with refined occupancies of 0.524 (8) and 0.476 (8)

Bis[1,3-bis­(1-benzyl-1H-benzimidazol-2-yl)-2-oxapropane]zinc(II) dipicrate dimethyl­formamide disolvate

In the title compound, [Zn(C30H26N4O)2](C6H2N3O7)2·2C3H7NO, the ZnII ion is coordinated in a distorted octa­hedral environment involving four equatorial N atoms and two O atoms in axial sites. The dihedral angles between the benzimidazole ring system and the phenyl rings in each of the benzyl­benzimidazole units are 78.56 (12), 81.68 (11), 75.76 (10) and 85.78 (9)°. In the crystal structure, there are weak but significant inter­molecular π–π stacking inter­actions with centroid–centroid distances of 3.685 (1) and 3.978 (1) Å