Telephone Follow-Up to Reduce the Readmission Rate in Gynecologic Oncology Surgery Patients

Unplanned hospital readmissions are commonly viewed as a marker of poor quality care and result in increased costs for both healthcare institutions and patients. Factors associated with readmission for gynecological oncology patients can be related to the radical surgical interventions required for the management of their disease, as well as complex comorbidity profiles, surgical complexity, cancer stage, and perioperative complications. The purpose of this study was to explore and examine the impact of nursing-led telephone follow up on the reduction of the readmission rate in gynecologic oncology abdominal surgery patients following initial discharge post-operatively. A cross-sectional research study was used to examine the relationship between the use of post discharge follow-up calls (intervention group versus control group) and 30-day readmission (yes/no) using chi-squared test for all categorical variables, and two sample t-tests for continuous variables. Variables were compared between the experimental and control groups given the potential association with the outcome of interest (readmission), including age, body mass index (BMI), comorbidities, tobacco use, performance status using the Eastern Cooperative Oncology Group (ECOG) status, length of surgery, estimated blood loss, perioperative blood transfusion, formation of ostomy, and length of hospital stay of one day or greater than one day duration. There were no significant differences found between the control group and experimental groups and each variable. There are future implications of this study surrounding the profound importance of the involvement of nursing staff in improvement in discharge teaching, transitions of care, and the patient experience. Evidenced-based practices are needed to improve the health and safety of the patients we care for

Combination and QCD analysis of charm production cross section measurements in deep-inelastic ep scattering at HERA

Measurements of open charm production cross sections in deep-inelastic ep scattering at HERA from the H1 and ZEUS Collaborations are combined. Reduced cross sections sigma(c (c) over bar)(red) for charm production are obtained in the kinematic range of photon virtuality 2.5 LT = Q(2) LT = 2000 GeV2 and Bjorken scaling variable 3 . 10(-5) LT = x LT = 5 . 10(-2). The combination method accounts for the correlations of the systematic uncertainties among the different data sets. The combined charm data together with the combined inclusive deep-inelastic scattering cross sections from HERA are used as input for a detailed NLO QCD analysis to study the influence of different heavy flavour schemes on the parton distribution functions. The optimal values of the charm mass as a parameter in these different schemes are obtained. The implications on the NLO predictions for W-+/- and Z production cross sections at the LHC are investigated. Using the fixed flavour number scheme, the running mass of the charm quark is determined

Realizing the business benefits of enterprise IT

The development and implementation of IT/IS systems inherently requires a deep understanding of user requirements. However, experience shows that a key barrier to the success of an IT/IS system, is the manner by which it is adopted by end users. As such, this viewpoint article presents an overview of those typical enterprise IT user traits as experience by the author. These traits are placed in the context of the steps that need to be taken in terms of a lifecycle approach to business systems implementation. Thus, the paper describes those drivers which inhibit the adoption of enterprise IT/IS projects from a user expectation point of view. By outlining key benefits of such systems, the author presents a 6-stage approach to benefits realisation, known as the acronym, ASSIST. By applying such an approach, the management of business process change and delivery of IT/IS should be more achievable, by addressing the specific needs and expectations of different types of users, as identified in the text of the article. In doing so, the definition of those key IT/IS benefits as outlined in the ASSIST phase approach described is therefore a useful addition to existing project management and business analysis tools and techniques, that can be utilised by enterprise IT system delivery managers as well as Senior IT/IS managemen

The complex Grothendieck for 2x2 matrices

We show that the complex Grothendieck constant for 2x2 matrices is 1

Ecological Consequences of Lost Anadromous Forage Fish in Freshwater Ecosystems

Beginning in the early 1600s, dam construction in New England obstructed anadromous fish access to spawning grounds during migration. As a result, anadromous forage fish populations have declined, which has impacted freshwater, marine, and terrestrial ecosystems. To determine the impacts of dams on anadromous forage fish and freshwater ecosystems, I used historical and current data to estimate population changes in alewives (Alosa pseudoharengus) from 1600-1900. A significant reduction in spawning habitat occurred in New England as a result of 1,642 dams constructed between 1600 and 1900, resulting in 14.8% and 16.6% lake and stream habitat remaining by 1900, respectively. In eight New England watersheds, this translates to an estimated cumulative annual loss of 30 B juvenile alewives available as freshwater forage and 538 M year 1, 2 and 3 alewives available as marine forage. The cumulative annual lost number of adult return spawners was conservatively 17 M fish, or 3,642 metric tons. Lost marine-derived nutrients from adult return spawners were 11 T phosphorus, 64 T nitrogen, and 410 T carbon. A comparison of predator fish growth and condition in alewife and non-alewife lakes showed that white perch (Morone Americana) and yellow perch (Perca flavescens) have higher condition in early summer in lakes with alewives. Predator growth rates (length-at-age) were significantly higher in early life stages (ages 1 and 2) when alewives were present, but significantly lower in late life stages (ages 3 and older). Results indicate a greater maximum length obtained by mature fish when alewives are absent, and an earlier age and length at maturity when alewives are present. These results indicate significant ecosystem impacts of lost anadromous forage fish, with bottom-up trophic effects across multiple time scales and biological processes. An ecosystem-based management approach should be used by inland and marine aquatic managers, and ecosystem connectivity and trophic interactions should be considered when managing migratory fish and prioritizing restoration goals

Measurement of beauty photoproduction near threshold using di-electron events with the H1 detector at HERA

The cross section for ep -> eb (b) over barX in photoproduction is measured with the H1 detector at the ep-collider HERA. The decay channel b (b) over bar -> eeX' is selected by identifying the semi-electronic decays of the b-quarks. The total production cross section is measured in the kinematic range given by the photon virtuality Q(2) down to the threshold. The results are compared to next-to-leading-order QCD predictions

Determination of the Integrated Luminosity at HERA using Elastic QED Compton Events

24 pages, 3 tables, 7 figures, submitted to EPJC - See paper for full list of authorsA measurement of the integrated luminosity at the ep collider HERA is presented, exploiting the elastic QED Compton process ep \rightarrow ep. The electron and the photon are detected in the backward calorimeter of the H1 experiment. The integrated luminosity of the data recorded in 2003 to 2007 is determined with a precision of 2.3%. The measurement is found to be compatible with the corresponding result obtained using the Bethe-Heitler process

Measurement of the Azimuthal Correlation between the most Forward Jet and the Scattered Positron in Deep-Inelastic Scattering at HERA

Deep-inelastic positron-proton scattering events at low photon virtuality Q^2 with a forward jet, produced at small angles with respect to the proton beam, are measured with the H1 detector at HERA. A subsample of events with an additional jet in the central region is also studied. For both samples differential cross sections and normalised distributions are measured as a function of the azimuthal angle difference, Delta phi, between the forward jet and the scattered positron. The sensitivity to QCD evolution mechanisms is tested by comparing the data to predictions of Monte Carlo generators based on different evolution approaches as well as to next-to-leading order calculations