Understanding how individuals weigh the quality of life associated with complications and treatments is important in assessing economic value diabetes care may provide insight into treatment adherence. We quantify patients' utilities (a measure preference) for full array diabetes-related treatments.We conducted interviews a multiethnic sample 701 adult patients living who were attending Chicago area clinics. elicited (ratings on 0-1 scale, where 0 represents death 1 perfect health)...

Chinese translation Background: Strains on the capacities of intensive care units (ICUs) may influence quality ICU-to-floor transitions. Objective: To determine how 3 metrics ICU capacity strain (ICU census, new admissions, and average acuity) measured days patient discharges length stay (LOS) post–ICU discharge outcomes. Design: Retrospective cohort study from 2001 to 2008. Setting: 155 ICUs in United States. Patients: 200 730 adults discharged hospital floors. Measurements: Associations...

The incidence of intensive care unit (ICU) readmissions across the United States is unknown.To determine ICU in hospitals, and describe distribution time between discharges readmissions.This retrospective cohort study used 196,202 patients 156 medical surgical ICUs 106 community academic hospitals participating Project IMPACT from April 1, 2001, to December 31, 2007. We mixed-effects logistic regression, adjusting for patient hospital characteristics, how readmission rates differed types,...

Objective. To estimate the incremental cost‐effectiveness of improving diabetes care with Health Disparities Collaborative (HDC), a national collaborative quality improvement (QI) program conducted in community health centers (HCs). Data Sources/Study Setting. regarding impact Diabetes HDC came from serial cross‐sectional follow‐up study (1998, 2000, 2002) 17 Midwestern HCs. inputs for simulation model latest clinical trials and epidemiological studies. Study Design. We societal analysis,...

Observational studies of anesthetic neurotoxicity may be biased because children requiring anesthesia commonly have medical conditions associated with neurobehavioral problems. This study takes advantage a natural experiment appendicitis to determine whether and surgery in childhood were specifically subsequent outcomes.

Background: Intensive care unit (ICU) readmission rates are commonly viewed as indicators of ICU quality. However, definitions readmissions vary, and it is unknown which, if any, associated with Objective: Empirically derive the optimal interval between discharge for purposes considering an quality indicator. Research Design: Retrospective cohort study. Subjects: A total 214,692 patients discharged from 157 US ICUs participating in Project IMPACT database, 2001–2008. Measures: We graphically...

This paper reports on an empirical study of defense mechanisms in 60 psychiatric inpatients. Eight defenses--compensation, denial, displacement, intellectualization, projection, reaction formation, regression, and repression--were studied the context a two-stage model suicidal violent behavior. The results showed that use regression as differentiated from nonsuicidal patients, displacement nonviolent patients. Repression tended to turn aggression inward, projection denial turned outward.

To evaluate ethnic differences in medication concerns (e.g., side effects and costs) that may contribute to the adoption of adherence type 2 diabetes treatments.

To compare outcomes and costs between major teaching nonteaching hospitals on a national scale by closely matching patient procedures characteristics.Teaching have been shown to often better quality than hospitals, but cost value associated with remains unclear.A study of Medicare patients at 340 (resident-to-bed ratios ≥ 0.25) matched controls from 2444 < 0.05).We studied 86,751 pairs admitted for general surgery (GS), 214,302 orthopedic surgery, 52,025 vascular surgery.In GS, mortality was...

Sugammadex was initially approved for reversal of neuromuscular blockade in adults the United States 2015. Limited data suggest sugammadex is widely used pediatric anesthesia practice however factors influencing use are not known. We explore patient, surgical, and institutional associated with decision to versus neostigmine or no reversal, 2 mg/kg vs 4 dosing.

ABSTRACT Background Videolaryngoscopy (VL) and apneic oxygenation are highly recommended increasingly used in pediatric anesthesia practice; yet, availability, use clinical settings (e.g., neonates, airway emergencies, out‐of‐operating‐room tracheal intubation), the association of VL availability with how anesthesiologists define difficult intubation have not been explored. Method An electronic survey was distributed to members several international societies examine practice patterns...

Objectives: Over 1.5 million adolescents undergo surgery each year in the United States. While is performed to improve pain and physical functioning, there may be temporary disability an increased reliance on caregivers during recovery. Caregivers not accustomed providing this level of care for used greater independence struggle. We sought better understand dyadic experience at‐home adolescent patients after nonemergency surgery. Methods: conducted semi‐structured interviews with aged...

Objective This study aimed to evaluate the relationship between group exercise membership, social network characteristics, and general state anxiety in a sample of college students. Participants: 490 undergraduates from private university southern US participated study. Methods: An egocentric analysis was conducted test whether demographic variables, leisure-time physical activity, flourishing scores, variables were related anxiety. Results: Regression analyses (R2 = .174, F 7.650, p <...

Objective: Good quality indicators should have face validity, relevance to patients, and be able measured reliably. Beyond these general requirements, good also certain statistical properties, including sufficient variability identify poor performers, relative insensitivity severity adjustment, the ability capture what providers do rather than patients' characteristics. We assessed performance of candidate ICU on criteria. Indicators included readmission, mortality, several length stay...

To assess whether patient perceptions of treatments for diabetes mellitus differ according to clinical criteria such as limited life expectancy and functional decline (i.e., vulnerability).Cross-sectional survey.Clinics affiliated with two Chicago-area hospitals.Patients aged 65 older living type 2 (N=332).Utilities (quantitative measures preference on a scale from 0 1, representing state equivalent death 1 in perfect health) were assessed nine hypothetical treatment states using time...

The Health Disparities Collaboratives are the largest national quality improvement (QI) initiatives in community health centers. This article identifies incentives and assistance personnel believe necessary to sustain QI. In 2004, 1006 survey respondents (response rate 67%) at 165 centers cited lack of resources, time, staff burnout as common barriers. Release time was most desired personal incentive. highest funding priorities were direct patient care services (44% ranked no. 1), data entry...

Growing pressures to ration intensive care unit beds and services pose novel challenges clinicians. Whereas the question of how allocate scarce resources has received much attention, whether disclose these decisions patients surrogates not been explored.We explore considerations professionalism, dual agency, patients' surrogates' preferences, beneficence, healthcare efficiency efficacy influence propriety disclosing rationing in unit.There are compelling conceptual reasons support a policy...

Sugammadex is a neuromuscular blockade (NMB) reversal agent introduced in the United States 2016, which allows of deep NMB, not possible with neostigmine. Few data describe associated practice changes, if any, NMB medication use that may have resulted from its availability. We hypothesized after institutional introduction, agents increased. Furthermore, as typically used when airway has been secured an endotracheal tube (ETT), we speculated ETT also increased over same time period result sugammadex