An investigation of biases in Patient Safety Indicator score distribution among hospital cohorts

Denman Research Forum- 2nd Place, Health Professions-ClinicalThe Centers for Medicare and Medicaid Services (CMS) have implemented a hospital reimbursement system that incentivizes payment proportional to the quality of care delivered and performance on certain metrics. One such metric is the Agency for Healthcare Research and Quality’s Patient Safety Indicator 90 (PSI-90). It is composed of eight individual indicators designed to flag adverse patient events that are potentially preventable, such as post-operative wound dehiscence and accidental lacerations. CMS publicly reports four of these individual PSI scores (6, 12, 14 and 15) in addition to the composite PSI-90. Previous studies question the PSIs’ validity beyond screening purposes and furthermore question the underlying administrative data’s ability to accurately and reliably flag such events. This study looks to analyze biases in PSI score distribution for hospitals depending on teaching status, differences in patient demographics and lastly, interactions between teaching status and patient demographic factors and their ability to account for differences in PSI rates. Significant differences were found between teaching and non-teaching hospitals for PSIs 6, 12, 15 and 90 (p<0.01). Inpatient volume and patient severity (p<0.01) were found to be significantly different between teaching status cohorts. Lastly, significant differences in PSI scores were found between patient severity quartiles for PSI 6, 15 and 90 (p<0.05) and between socio-economic quartiles for PSI 6, 12, 15 and 90 (p<0.05); but interaction between patient severity and teaching status was only significant for PSI 90 (p<0.05) and between socioeconomic and teaching statuses for PSI 6 (p<0.05). These results indicate current PSI score distributions may be biased against teaching hospitals for 4 out of 5 PSI measures. Further studies will involve assessing the adequacy of risk-adjustment methodology for PSI metrics. Until then, use of PSI metrics to determine federal reimbursement can lead to bias against teaching hospitals.A three-year embargo was granted for this item.Academic Major: Health Information Management and System

How Astronomers Use Spectra to Learn About the Sun and Other Stars

This booklet allows students to learn how astronomers get information about the Sun and other stars. Educational levels: High school, Undergraduate lower division

A Study of Media Portrayal of Schizophrenics to Understand How Stigma Associated with Schizophrenia may be Reversed

The news media are one of the most influential sources of information regarding mental illness. Media coverage on schizophrenia, one of the most stigmatized mental illnesses, tends to be negative, focusing on high risks of violence, failure, and unpredictability. Such perceptions may cause a detrimental impact on the mentally ill and cause them to internalize a stigmatizing stereotype and hinder the public’s understanding of mental illness. I studied how media portrayal in newspaper coverage of schizophrenics has evolved to discover how nonfiction media representation has affected people’s perceptions and attitudes towards schizophrenics and to propose an implementable solution to reduce stigma by utilizing the media. I explored scholarly sources that analyzed the changes in reporting of schizophrenia in high-circulation newspapers in different countries and how renaming schizophrenia in Japan reduced the associated stigma. I also investigated successful solutions that have been implemented in other countries that have helped decease the stigma associated with schizophrenia. Currently in other countries, destigmatization efforts are mostly directed at providing more accurate information. An appeal for the government to provide opportunities to discuss and reflect on media contents may also be successful in decreasing the association between mental illness and violent crime. It is imperative that the US creates and implement solutions that may decrease mental health stigma and also discover other possible solutions. This will not only help the predicaments of those suffering from mental illness, but may also educate the public on such mental health problems as to prevent further misinformation.https://scholarscompass.vcu.edu/uresposters/1256/thumbnail.jp

Empower(ed) Families: Supportive Treatment for Caregiver Burnout for Parents of Adolescents with Eating Disorders

Graduate Theoretical Proposa

CAFS in action

For those few readers who do not know, CAFS is a system developed by ICL to search through data at speeds of several million characters per second. Its full name is Content Addressable File Store Information Search Processor, CAFS-ISP or CAFS for short. It is an intelligent hardware-based searching engine, currently available with both ICL's 2966 family of computers and the recently announced Series 39, operating within the VME environment. It uses content addressing techniques to perform fast searches of data or text stored on discs: almost all fields are equally accessible as search keys. Software in the mainframe generates a search task; the CAFS hardware performs the search, and returns the hit records to the mainframe. Because special hardware is used, the searching process is very much more efficient than searching performed by any software method. Various software interfaces are available which allow CAFS to be used in many different situations. CAFS can be used with existing systems without significant change. It can be used to make online enquiries of mainframe files or databases or directly from user written high level language programs. These interfaces are outlined in the body of the report

Characterizing Average Properties of Southern California Ground Motion Amplitudes and Envelopes

We examine ground motion envelopes of horizontal and vertical acceleration, velocity, and filtered displacement recorded within 200 km from southern California earthquakes in the magnitude range 2 5 range typically considered for strong motion attenuation relationships

Investigating ultrasound–light interaction in scattering media

Significance: Ultrasound-assisted optical imaging techniques, such as ultrasound-modulated optical tomography, allow for imaging deep inside scattering media. In these modalities, a fraction of the photons passing through the ultrasound beam is modulated. The efficiency by which the photons are converted is typically referred to as the ultrasound modulation’s “tagging efficiency.” Interestingly, this efficiency has been defined in varied and discrepant fashion throughout the scientific literature. Aim: The aim of this study is the ultrasound tagging efficiency in a manner consistent with its definition and experimentally verify the contributive (or noncontributive) relationship between the mechanisms involved in the ultrasound optical modulation process. Approach: We adopt a general description of the tagging efficiency as the fraction of photons traversing an ultrasound beam that is frequency shifted (inclusion of all frequency-shifted components). We then systematically studied the impact of ultrasound pressure and frequency on the tagging efficiency through a balanced detection measurement system that measured the power of each order of the ultrasound tagged light, as well as the power of the unmodulated light component. Results: Through our experiments, we showed that the tagging efficiency can reach 70% in a scattering phantom with a scattering anisotropy of 0.9 and a scattering coefficient of 4  mm⁻¹ for a 1-MHz ultrasound with a relatively low (and biomedically acceptable) peak pressure of 0.47 MPa. Furthermore, we experimentally confirmed that the two ultrasound-induced light modulation mechanisms, particle displacement and refractive index change, act in opposition to each other. Conclusion: Tagging efficiency was quantified via simulation and experiments. These findings reveal avenues of investigation that may help improve ultrasound-assisted optical imaging techniques

Exploiting CAFS-ISP

In the summer of 1982, the ICLCUA CAFS Special Interest Group defined three subject areas for working party activity. These were: 1) interfaces with compilers and databases, 2) end-user language facilities and display methods, and 3) text-handling and office automation. The CAFS SIG convened one working party to address the first subject with the following terms of reference: 1) review facilities and map requirements onto them, 2) "Database or CAFS" or "Database on CAFS", 3) training needs for users to bridge to new techniques, and 4) repair specifications to cover gaps in software. The working party interpreted the topic broadly as the data processing professional's, rather than the end-user's, view of and relationship with CAFS. This report is the result of the working party's activities. The report content for good reasons exceeds the terms of reference in their strictest sense. For example, we examine QUERYMASTER, which is deemed to be an end-user tool by ICL, from both the DP and end-user perspectives. First, this is the only interface to CAFS in the current SV201. Secondly, it is necessary for the DP department to understand the end-user's interface to CAFS. Thirdly, the other subjects have not yet been addressed by other active working parties

Projet interordres sur les applications pédagogiques de la conception universelle de l’apprentissage : rapport final

Ont collaboré: Dominique Alarie, Marie Blain, Yves Carignan, Nathalie Giguère, Thomas Henderson, Carole Lavallée, Catherine Loiselle, Dolores Otero, Hélène Trifiro, Stéphanie Tremblay, Paul Turcotte, Florence Lebeau, Brigitte Auclair, Véronique Besançon, Jean-René Corbeil, Antoine Coulombe, Johanne Morin, Cédric Lamathe, Florence Lebeau, Paul Turcotte, Steve Vezeau

Real-time Performance of the Virtual Seismologist Earthquake Early Warning Algorithm in Southern California

The Virtual Seismologist (VS) method is a Bayesian approach to regional network-based earthquake early warning (EEW) that estimates earthquake magnitude, location, and the distribution of peak ground motion using observed ground motion amplitudes, predefined prior information, and appropriate attenuation relationships (Cua 2005; Cua and Heaton 2007). The application of Bayes's theorem in earthquake early warning (Cua 2005) states that the most probable source estimate at any given time is a combination of contributions from prior information (possibilities include network topology or station health status, regional hazard maps, earthquake forecasts, the Gutenberg-Richter magnitude-frequency relationship) and a likelihood function, which takes into account observations from the ongoing earthquake. Prior information can be considered relatively static over the timescale of a given earthquake rupture. The changes in the source estimates and predicted peak ground motion distribution, which are updated each second, are due to changes in the likelihood function as additional arrival and amplitude data become available. The potential use of prior information differentiates the VS approach from other regional, network-based EEW algorithms, such as ElarmS (Allen and Kanamori 2003)