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Occupancy Rate (occupancy + rate)
Selected AbstractsGrowth potential of adult hepatocytes in mammals: Highly replicative small hepatocytes with liver progenitor-like traitsDEVELOPMENT GROWTH & DIFFERENTIATION, Issue 2 2007Katsutoshi Yoshizato The liver is one of the few organs that is capable of completely regenerating itself without using a stem cell population. When damaged, growth factors and cytokines are released, stimulating terminally differentiated adult hepatocytes and making them re-enter the cell cycle. We have been developing a series of studies on the growth potential of rat and human hepatocytes to identify a population of hepatocytes that is responsible for the regeneration of the injured liver. For this purpose, we established an appropriate culture method for hepatocytes by which growth and differentiation capacities are practically examined under various experimental conditions. This in vitro assay system allows us to identify small hepatocytes that are prominently replicative compared to large hepatocytes. Non-parenchymal cells play critical roles in the proliferation of small hepatocytes. These hepatocytes are present in both rat and human liver and are located in portal regions there. Phenotypic features were examined at morphological and gene/protein levels in detail, which showed the phenotypic plasticity in vitro. Mammalian liver includes a population of small hepatocytes in normal adults with a minute occupancy rate. We speculate that small hepatocytes play a role in regenerating the injured liver and in compensating for apoptotic hepatocytes in the physiological turnover of hepatocytes. [source] Doing Better to Do Good: The Impact of Strategic Adaptation on Nursing Home PerformanceHEALTH SERVICES RESEARCH, Issue 3p1 2007Jacqueline S. Zinn Objective. To test the hypothesis that a greater commitment to strategic adaptation, as exhibited by more extensive implementation of a subacute/rehabilitation care strategy in nursing homes, will be associated with superior performance. Data Sources. Online Survey, Certification, and Reporting (OSCAR) data from 1997 to 2004, and the area resource file (ARF). Study Design. The extent of strategic adaptation was measured by an aggregate weighted implementation score. Nursing home performance was measured by occupancy rate and two measures of payer mix. We conducted multivariate regression analyses using a cross-sectional time series generalized estimating equation (GEE) model to examine the effect of nursing home strategic implementation on each of the three performance measures, controlling for market and organizational characteristics that could influence nursing home performance. Data Collection/Abstraction Methods. OSCAR data was merged with relevant ARF data. Principal Findings. The results of our analysis provide strong support for the hypothesis. Conclusions. From a theoretical perspective, our findings confirm that organizations that adjust strategies and structures to better fit environmental demands achieve superior performance. From a managerial perspective, these results support the importance of proactive strategic leadership in the nursing home industry. [source] Perceived adverse patient outcomes correlated to nurses' workload in medical and surgical wards of selected hospitals in KuwaitJOURNAL OF CLINICAL NURSING, Issue 4 2009Fatimah Al-Kandari Aim., This study was carried out to identify the perceived adverse patient outcomes as related to nurses' workload. It also assessed nurses' perception of variables contributing to the workload and adverse patient outcomes. Background., Several studies have been published on adverse patient outcomes in which a correlation was found between nurses' workload and some adverse patient outcomes. Design., A cross-sectional survey was conducted between registered nurses (n = 780) working in medical and surgical wards of five general governmental hospitals in Kuwait. Data collection instruments., Data were collected using a self-administered questionnaire consisting of three sections to elicit information about the sample characteristics, perception of workload and perceived adverse patient outcomes during the last shift and last working week. Results., The three major perceived adverse outcomes reported by the nurses while on duty during their last shift were: complaints from patients and families (2%), patients received a late dose or missed a dose of medication (1·8%) and occurrences of pressure ulcer (1·5%). Similarly, the reported adverse outcomes over the past week were complaints from patients and families (5%), patients received a late dose or missed a dose of medication (5·3%) and discovery of a urinary tract infection (3·7%). Increases in nurse-patient load, bed occupancy rate, unstable patients' condition, extra ordinary life support efforts and non-nursing tasks; all correlated positively with perceived adverse patient outcomes. Conclusion., This study sheds light on an important issue affecting patient safety and quality of care as perceived by the nurses themselves as caregivers. Relevance to clinical practice., Nurses' perception of variables contributing to adverse patient outcomes and their workload could significantly affect the provided nursing care and nursing care recipients. The findings could help in policy formulation and planning strategies to decrease adverse patient outcomes in many countries with a health care structure similar to that of Kuwait. [source] Effect of floating nest platforms on the breeding performance of Black TernsJOURNAL OF FIELD ORNITHOLOGY, Issue 2 2006David A. Shealer ABSTRACT In 2003 and 2004, we placed 41 floating nest platforms on Grassy Lake in southeastern Wisconsin (USA) to test the hypothesis that reproductive success of Black Terns (Chlidonias niger) is limited by the quality of suitable nesting habitat. Extreme differences in water levels between these 2 yr provided a natural experiment to evaluate the effectiveness of the nest platforms during a drought year (2003) when natural nesting substrate was abundant, and a flood year (2004) when natural substrate was limited during the peak nesting period. Terns nested on 27 of 41 (66%) of the platforms in 2003 and 26 of 41 (63%) in 2004. No difference in the occupancy rate of platforms and natural nests was evident in 2003, but the pattern of clutch initiations early in the season in 2004 indicated that platforms were preferred over natural substrates. In 2003, nest survival rates did not differ between nests placed on platforms and those placed on natural substrates, but platform nests had significantly higher hatching success and nest survival rates in 2004. Both the Kaplan-Meier and Apparent Nest Success methods of calculating nest survival provided similar estimates. In both years, eggs laid on platforms were significantly larger than those laid on natural substrates, suggesting that platforms were occupied by high-quality birds. Our study indicates that floating nest platforms can be an effective management tool to enhance nesting habitat for Black Terns and other aquatic birds that construct floating nests, primarily because platforms provide nest sites when natural sites are not available due to flooding. Nest platforms also may be useful for addressing questions concerning habitat selection and parental quality. SINOPSIS De 2003-2004 colocamos 41 plataformas flotantes para poner aprueba la hipótesis que el éxito reproductivo de la gaviota Chlidonias níger, esta limitado por la calidad y lo apropiado del hábitat de anidamiento. El estudio se llevó a cabo en el Grassy Lake, Wisconsin. Extremos (bajos y altos) en los niveles de agua, causados por sequía (2203) y fuertes lluvias (2004) proveyeron el escenario adecuado para evaluar la efectividad de las plataformas. Las gaviotas anidaron en 27 (66%) de las 41 plataformas en el 2003 y en 26 (63%) de las 41 en el 2004. No se encontraron diferencias en la tasa de uso de las plataformas y áreas naturales en el 2003, pero el inicio de las camadas temprano en la temporada durante el 2004, dieron a indicar que las plataformas fueron preferidas a los lugares naturales. Durante el 2003, no hubo diferencia en la tasa de supervivencia de nidos en plataformas y o en áreas naturales. Sin embargo, durante el 2004 el éxito de eclosionamiento, de los nidos y la supervivencia fue mas alto en las plataformas. Tanto el método Kaplan-Meier como el "Aparente Éxito de Anidamiento", utilizados para calcular la supervivencia de los nidos, ofrecieron resultados similares. En ambos años el tamaño de los huevos fue mayor en las plataformas que en áreas naturales, lo que implica que las primeras fueron utilizadas por aves sumamente vigorosas o de alta calidad. El estudio indica que las plataformas flotantes pueden ser una herramienta de manejo adecuada para mejorar el hábitat de anidamiento de la gaviota estudiada, al igual que otras aves que construyen nidos flotantes. Las plataformas proveen de lugares de anidamientos cuando no hay disponible lugares naturales debido a inundaciones. Las plataformas de anidamiento muy bien pudieran proveer de información útil con respecto a la selección de hábitat y la calidad del cuidado parental. [source] The Effects of Case-Mix Reimbursement on Ohio Medicaid Nursing Home CostsPOLICY STUDIES JOURNAL, Issue 3 2002Sunday E. Ubokudom This article examines empirically the effects of the Ohio case-mix reimbursement system on nursing home costs. The results show that case-mix is the single most important factor affecting both direct-care (nursing staff) and total per diem costs. Although other factors, such as bedsize, occupancy rate, ownership status, county per capita income, and the demand for nursing home care, also affeet costs; they have far smaller effects on costs than case-mix. Further, the results show that the cost differentials between for-profit and nonprofit facilities are largely explained by differences in cost response to case-mix and, to a lesser extent, by differences in cost response to bedsize, Medicaid utilization, county per capita income, demand for nursing home beds, and occupancy rate. The for-profit facilities in this study cost significantly less than their nonprofit counterparts. [source] MS analysis of rheumatoid arthritic synovial tissue identifies specific citrullination sites on fibrinogenPROTEOMICS - CLINICAL APPLICATIONS, Issue 5 2010Monika Hermansson Abstract Purpose: Citrullination is a post-translational modification of arginine residues to citrulline catalyzed by peptidyl arginine deiminases. Induced expression of citrullinated proteins are frequently detected in various inflammatory states including arthritis; however, direct detection of citrullination in arthritic samples has not been successfully performed in the past. Experimental design: Citrullination of human fibrinogen, a candidate autoantigen in arthritis, was studied. Accurate identification of citrullinated fibrinogen peptides from rheumatoid arthritis synovial tissue specimens was performed using accurate mass and retention time analysis. Results: A peptide with the sequence ESSSHHPGIAEFPSRGK corresponding to amino acids 559,575 of fibrinogen ,-chain was identified to be citrullinated with an occupancy rate between 1.4 and 2.5%. Citrullination of the peptide KREEAPSLRPAPPPISGGGYRARPAK corresponding to amino acids 52,77 of the fibrinogen ,-chain was identified with an occupancy rate of 1.2%. Conclusions and clinical relevance: We report a proof of principle study for the identification of citrullinated proteins and within them, identification of citrullination sites and quantification of their occupancies in synovial tissue from rheumatoid arthritis patients using high-resolution MS. Detailed studies on which molecules are citrullinated in arthritis can provide information about their role in immune regulation and serve as novel biomarkers and potentially even as therapeutic targets. [source] Characterizing Waiting Room Time, Treatment Time, and Boarding Time in the Emergency Department Using Quantile RegressionACADEMIC EMERGENCY MEDICINE, Issue 8 2010Ru Ding MS ACADEMIC EMERGENCY MEDICINE 2010; 17:813,823 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, The objective was to characterize service completion times by patient, clinical, temporal, and crowding factors for different phases of emergency care using quantile regression (QR). Methods:, A retrospective cohort study was conducted on 1-year visit data from four academic emergency departments (EDs; N = 48,896,58,316). From each ED's clinical information system, the authors extracted electronic service information (date and time of registration; bed placement, initial contact with physician, disposition decision, ED discharge, and disposition status; inpatient medicine bed occupancy rate); patient demographics (age, sex, insurance status, and mode of arrival); and clinical characteristics (acuity level and chief complaint) and then used the service information to calculate patients' waiting room time, treatment time, and boarding time, as well as the ED occupancy rate. The 10th, 50th, and 90th percentiles of each phase of care were estimated as a function of patient, clinical, temporal, and crowding factors using multivariate QR. Accuracy of models was assessed by comparing observed and predicted service completion times and the proportion of observations that fell below the predicted 10th, 50th, and 90th percentiles. Results:, At the 90th percentile, patients experienced long waiting room times (105,222 minutes), treatment times (393,616 minutes), and boarding times (381,1,228 minutes) across the EDs. We observed a strong interaction effect between acuity level and temporal factors (i.e., time of day and day of week) on waiting room time at all four sites. Acuity level 3 patients waited the longest across the four sites, and their waiting room times were most influenced by temporal factors compared to other acuity level patients. Acuity level and chief complaint were important predictors of all phases of care, and there was a significant interaction effect between acuity and chief complaint. Patients with a psychiatric problem experienced the longest treatment times, regardless of acuity level. Patients who presented with an injury did not wait as long for an ED or inpatient bed. Temporal factors were strong predictors of service completion time, particularly waiting room time. Mode of arrival was the only patient characteristic that substantially affected waiting room time and treatment time. Patients who arrived by ambulance had shorter wait times but longer treatment times compared to those who did not arrive by ambulance. There was close agreement between observed and predicted service completion times at the 10th, 50th, and 90th percentile distributions across the four EDs. Conclusions:, Service completion times varied significantly across the four academic EDs. QR proved to be a useful method for estimating the service completion experience of not only typical ED patients, but also the experience of those who waited much shorter or longer. Building accurate models of ED service completion times is a critical first step needed to identify barriers to patient flow, begin the process of reengineering the system to reduce variability, and improve the timeliness of care provided. [source] Emergency Department Patient Flow: The Influence of Hospital Census Variables on Emergency Department Length of StayACADEMIC EMERGENCY MEDICINE, Issue 7 2009Ray Lucas MD Abstract Objectives:, The objective was to evaluate the association between hospital census variables and emergency department (ED) length of stay (LOS). This may give insights into future strategies to relieve ED crowding. Methods:, This multicenter cohort study captured ED LOS and disposition for all ED patients in five hospitals during five 1-week study periods. A stepwise multiple regression analysis was used to examine associations between ED LOS and various hospital census parameters. Results:, Data were analyzed on 27,325 patients on 161 study days. A significant positive relationship was demonstrated between median ED LOS and intensive care unit (ICU) census, cardiac telemetry census, and the percentage of ED patients admitted each day. There was no relationship in this cohort between ED LOS and ED volume, total hospital occupancy rate, or the number of scheduled cardiac or surgical procedures. Conclusions:, In multiple hospital settings, ED LOS is correlated with the number of admissions and census of the higher acuity nursing units, more so than the number of ED patients each day, particularly in larger hospitals with busier EDs. Streamlining ED admissions and improving availability of inpatient critical care beds may reduce ED LOS. [source] Breeding performance, age effects and territory occupancy in a Bonelli's Eagle Hieraaetus fasciatus populationIBIS, Issue 2 2008JOSÉ A. MARTÍNEZ Bonelli's Eagle Hieraaetus fasciatus is one of the most endangered birds of prey in Europe. Despite mounting interest and research, several questions regarding the conservation implications of territory occupancy and site-dependent population regulation remain insufficiently explored for this species. Here, we report on a 12-year study of the territorial structure of a Bonelli's Eagle population in southeastern Spain. No signals of population decline were found in the breeding population, as mean annual productivity was stable and the presence of mixed-age pairs in the population decreased with the years. However, the average proportion of subadults occupying territories was larger than that observed in other Spanish populations. Contrary to the predictions of a despotic distribution model, we found no significant relationship between occupancy rates and breeding parameters. Our results showed significant variations in productivity attributable to differences in the quality of individuals (i.e. mixed versus adult pairs), but no variability among territories per se (i.e. caused by habitat heterogeneity). Moreover, coexistence with intraguild species did not have any significant effect on productivity, although the proximity of Eagle Owls Bubo bubo affected the occupation rate of territories. Finally, our population does not appear to experience site-dependent population regulation, as a positive relation between mean annual productivity and density was found. The threat posed by changes in land use in the study area leads us to suggest that strict protection of current territories is necessary to ensure population persistence, and we suggest that a significant population increase is only likely if new or deserted territories become available. [source] Driven to Tiers: Socioeconomic and Racial Disparities in the Quality of Nursing Home CareTHE MILBANK QUARTERLY, Issue 2 2004VINCENT MOR Nursing home care is currently a two-tiered system. The lower tier consists of facilities housing mainly Medicaid residents and, as a result, has very limited resources. The nearly 15 percent of U.S. nonhospital-based nursing homes that serve predominantly Medicaid residents have fewer nurses, lower occupancy rates, and more health-related deficiencies. They are more likely to be terminated from the Medicaid/Medicare program, are disproportionately located in the poorest counties, and are more likely to serve African-American residents than are other facilities. The public reporting of quality indicators, intended to improve quality through market mechanisms, may result in driving poor homes out of business and will disproportionately affect nonwhite residents living in poor communities. This article recommends a proactive policy stance to mitigate these consequences of quality competition. [source] | |||||||||||||