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Linking Rivermead Post Concussion Symptoms Questionnaire (RPQ) and Sport Concussion Assessment Tool (SCAT) scores with item response theory
- Mary U. Simons, Lindsay D. Nelson, Michael A. McCrea, Steve Balsis, James B. Hoelzle, Brooke E. Magnus
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue 7 / August 2023
- Published online by Cambridge University Press:
- 03 November 2022, pp. 696-703
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Objective:
Despite the public health burden of traumatic brain injury (TBI) across broader society, most TBI studies have been isolated to a distinct subpopulation. The TBI research literature is fragmented further because often studies of distinct populations have used different assessment procedures and instruments. Addressing calls to harmonize the literature will require tools to link data collected from different instruments that measure the same construct, such as civilian mild traumatic brain injury (mTBI) and sports concussion symptom inventories.
Method:We used item response theory (IRT) to link scores from the Rivermead Post Concussion Symptoms Questionnaire (RPQ) and the Sport Concussion Assessment Tool (SCAT) symptom checklist, widely used instruments for assessing civilian and sport-related mTBI symptoms, respectively. The sample included data from n = 397 patients who suffered a sports-related concussion, civilian mTBI, orthopedic injury control, or non-athlete control and completed the SCAT and/or RPQ.
Results:The results of several analyses supported sufficient unidimensionality to treat the RPQ + SCAT combined item set as measuring a single construct. Fixed-parameter IRT was used to create a cross-walk table that maps RPQ total scores to SCAT symptom severity scores. Linked and observed scores were highly correlated (r = .92). Standard errors of the IRT scores were slightly higher for civilian mTBI patients and orthopedic controls, particularly for RPQ scores linked from the SCAT.
Conclusion:By linking the RPQ to the SCAT we facilitated efforts to effectively combine samples and harmonize data relating to mTBI.
Glossifungites gingrasi n. isp., a probable subaqueous insect domicile from the Cretaceous Ferron Sandstone, Utah
- M. Ryan King, Andrew D. La Croix, Terry A. Gates, Paul B. Anderson, Lindsay E. Zanno
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- Journal:
- Journal of Paleontology / Volume 95 / Issue 3 / May 2021
- Published online by Cambridge University Press:
- 25 January 2021, pp. 427-439
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A new ichnospecies, Glossifungites gingrasi n. isp., is described from multiple locations in basal sand-filled coastal plain distributary channels of the Turonian (Upper Cretaceous) Ferron Sandstone (central Utah). Glossifungites gingrasi n. isp. is attributed to the ichnogenus Glossifungites based on the presence of scratch imprints, passive fill, and a tongue-shaped structure, yet the new ichnospecies is distinct because it displays transverse bioglyphs that run perpendicular to the planiform structure, which contrasts to the axis parallel bioglyphs present in the ichnospecies G. saxicava. The transverse arrangement of ornamentation exhibited by G. gingrasi n. isp. is observed in modern subaqueous insect burrows produced by mayfly and chironomid larvae, and constitutes a way to differentiate insect-generated burrows from structures produced by crustaceans that are known to create other Glossifungites ichnospecies. Differentiating insect- from crustacean-generated burrows is significant because it provides a way to distinguish bioturbation by marine-recruited fauna from that produced by freshwater fauna in the rock record, making G. gingrasi n. isp. a valuable ichnological tool for paleoenvironmental and stratigraphic interpretation. While G. gingrasi n. isp. may represent a burrow created by a variety of filter-feeding subaqueous insects, the large size of G. gingrasi n. isp. in the Ferron Sandstone suggests that the largest specimens are probable mayfly burrows and supports the assertion that burrowing mayflies (e.g., Polymitarcyidae and Ephemeridae) adapted to domicile filter-feeding during or prior to the Turonian.
UUID: http://zoobank.org/a033b22f-bf09-481a-975e-3a1b096154cc
P155: Utilization of personal mobile devices to record patient data by emergency physicians and residents
- K. E. Walker, D. Migneault, H. C. Lindsay, R. B. Abu-Laban
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 20 / Issue S1 / May 2018
- Published online by Cambridge University Press:
- 11 May 2018, p. S112
- Print publication:
- May 2018
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Introduction: The use of personal mobile devices to record patient data appears to be increasing, but remains poorly studied. We sought to determine the magnitude and purposes for which Canadian emergency physicians (EPs) and residents use their personal mobile devices (PMDs) to record patient data in the emergency department (ED). Methods: An anonymous survey was distributed to EPs and residents in the Canadian Association of Emergency Physicians (CAEP) database between 27/02/17 and 23/03/17. The survey captured demographic information and information on frequency and purpose of PMD use in the ED, whether consent was obtained, how the information was secured, and any possible implications for patient care. Participants were also asked about knowledge of, and any perceived restrictions from, current regulations regarding the use of PMDs healthcare settings. Results: The survey response rate was 23.1%. Of 415 respondents, 9 surveys were rejected for incomplete demographic data, resulting in 406 participants. A third (31.5%, 128/406, 95% CI 27.0-36.3) reported using PMDs to record patient data. Most (78.1%) reported doing so more than once a month and 7.0% reported doing so once every shift. 10.9% of participants indicated they did not obtain written or verbal consent. Reasons cited by participants for using PMDs to record patient data included a belief that doing so improves care provided by consultants (36.7%), expedites patient care (31.3%), and improves medical education (32.8%). 53.2% of participants were unaware of current regulations and 19.7% reported feeling restricted by them. Subgroup analysis suggested an increased frequency of PMD use to record patient data among younger physicians and physicians in rural settings. Conclusion: This is the first known Canadian study on the use of PMDs to record patient data in the ED. Our results suggest that this practice is common, and arises from a belief that doing so enhances patient care through better communication, efficiency, and education. Our findings also suggest current practices result in risk of both privacy and confidentiality breaches, and thus support arguments for both physician education and regulation reform.
Prospective, Head-to-Head Study of Three Computerized Neurocognitive Assessment Tools Part 2: Utility for Assessment of Mild Traumatic Brain Injury in Emergency Department Patients
- Lindsay D. Nelson, Robyn E. Furger, Peter Gikas, E. Brooke Lerner, William B. Barr, Thomas A. Hammeke, Christopher Randolph, Kevin Guskiewicz, Michael A. McCrea
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- Journal:
- Journal of the International Neuropsychological Society / Volume 23 / Issue 4 / April 2017
- Published online by Cambridge University Press:
- 27 March 2017, pp. 293-303
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Objectives: The aim of this study was to evaluate the reliability and validity of three computerized neurocognitive assessment tools (CNTs; i.e., ANAM, DANA, and ImPACT) for assessing mild traumatic brain injury (mTBI) in patients recruited through a level I trauma center emergency department (ED). Methods: mTBI (n=94) and matched trauma control (n=80) subjects recruited from a level I trauma center emergency department completed symptom and neurocognitive assessments within 72 hr of injury and at 15 and 45 days post-injury. Concussion symptoms were also assessed via phone at 8 days post-injury. Results: CNTs did not differentiate between groups at any time point (e.g., M 72-hr Cohen’s d=−.16, .02, and .00 for ANAM, DANA, and ImPACT, respectively; negative values reflect greater impairment in the mTBI group). Roughly a quarter of stability coefficients were over .70 across measures and test–retest intervals in controls. In contrast, concussion symptom score differentiated mTBI vs. control groups acutely), with this effect size diminished over time (72-hr and day 8, 15, and 45 Cohen’s d=−.78, −.60, −.49, and −.35, respectively). Conclusions: The CNTs evaluated, developed and widely used to assess sport-related concussion, did not yield significant differences between patients with mTBI versus other injuries. Symptom scores better differentiated groups than CNTs, with effect sizes weaker than those reported in sport-related concussion studies. Nonspecific injury factors, and other characteristics common in ED settings, likely affect CNT performance across trauma patients as a whole and thereby diminish the validity of CNTs for assessing mTBI in this patient population. (JINS, 2017, 23, 293–303)
Shifting Trend of Transient Ischemic Attack Admission and Prognosis in Canada
- Amy Y. X. Yu, M. Patrice Lindsay, Noreen Kamal, Jiming Fang, Shelagh B. Coutts, Michael D. Hill
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 44 / Issue 4 / July 2017
- Published online by Cambridge University Press:
- 03 October 2016, pp. 391-396
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Background: Stroke is often preceded by transient symptoms. Although global stroke rates have been shown to be declining, previous studies have reported inconsistent temporal trends of transient ischemic attacks (TIA). The objective of the current study is to report the temporal trends of TIA admissions and outcomes in Canada over the last 11 years. Methods: We conducted a complete population cohort study using a national administrative database to study the temporal trend of age- and sex-adjusted TIA admission rates in Canada from 2003 to 2013. We also determined the rates of TIA and stroke diagnoses in the emergency department in the province of Ontario during the same period. We used multivariable analyses to study discharge location after acute hospitalization as well as 90-day stroke and/or TIA readmission rates. Results: Of 425,799 admissions to an acute care hospital for all stroke and TIA, 71,443 (16.8%) were TIA. The age- and sex-standardized rates of TIA admission decreased significantly during the study period from 30.0 to 20.6 per 100,000 (p<0.0001). In Ontario, decreasing TIA admissions is mirrored by decreasing rates of TIA directly discharged from the emergency department (55.1 to 46.8 per 100,000, p = 0.002). The odds of 90-day readmission rates for stroke or TIA are also decreasing (adjusted odds ratio, 0.97; 95% confidence interval, 0.96-0.99). Conclusions: We show that TIA admission rates have declined in the past 11 years in Canada, reflecting improved vascular risk reduction and stroke care. Future studies to confirm our findings on improved stroke or TIA recurrence rates are necessary.
Personality Polygenes, Positive Affect, and Life Satisfaction
- Alexander Weiss, Bart M. L. Baselmans, Edith Hofer, Jingyun Yang, Aysu Okbay, Penelope A. Lind, Mike B. Miller, Ilja M. Nolte, Wei Zhao, Saskia P. Hagenaars, Jouke-Jan Hottenga, Lindsay K. Matteson, Harold Snieder, Jessica D. Faul, Catharina A. Hartman, Patricia A. Boyle, Henning Tiemeier, Miriam A. Mosing, Alison Pattie, Gail Davies, David C. Liewald, Reinhold Schmidt, Philip L. De Jager, Andrew C. Heath, Markus Jokela, John M. Starr, Albertine J. Oldehinkel, Magnus Johannesson, David Cesarini, Albert Hofman, Sarah E. Harris, Jennifer A. Smith, Liisa Keltikangas-Järvinen, Laura Pulkki-Råback, Helena Schmidt, Jacqui Smith, William G. Iacono, Matt McGue, David A. Bennett, Nancy L. Pedersen, Patrik K. E. Magnusson, Ian J. Deary, Nicholas G. Martin, Dorret I. Boomsma, Meike Bartels, Michelle Luciano
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- Journal:
- Twin Research and Human Genetics / Volume 19 / Issue 5 / October 2016
- Published online by Cambridge University Press:
- 22 August 2016, pp. 407-417
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Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.
Prospective, Head-to-Head Study of Three Computerized Neurocognitive Assessment Tools (CNTs): Reliability and Validity for the Assessment of Sport-Related Concussion
- Lindsay D. Nelson, Ashley A. LaRoche, Adam Y. Pfaller, E. Brooke Lerner, Thomas A. Hammeke, Christopher Randolph, William B. Barr, Kevin Guskiewicz, Michael A. McCrea
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- Journal:
- Journal of the International Neuropsychological Society / Volume 22 / Issue 1 / January 2016
- Published online by Cambridge University Press:
- 30 December 2015, pp. 24-37
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Limited data exist comparing the performance of computerized neurocognitive tests (CNTs) for assessing sport-related concussion. We evaluated the reliability and validity of three CNTs—ANAM, Axon Sports/Cogstate Sport, and ImPACT—in a common sample. High school and collegiate athletes completed two CNTs each at baseline. Concussed (n=165) and matched non-injured control (n=166) subjects repeated testing within 24 hr and at 8, 15, and 45 days post-injury. Roughly a quarter of each CNT’s indices had stability coefficients (M=198 day interval) over .70. Group differences in performance were mostly moderate to large at 24 hr and small by day 8. The sensitivity of reliable change indices (RCIs) was best at 24 hr (67.8%, 60.3%, and 47.6% with one or more significant RCIs for ImPACT, Axon, and ANAM, respectively) but diminished to near the false positive rates thereafter. Across time, the CNTs’ sensitivities were highest in those athletes who became asymptomatic within 1 day before neurocognitive testing but was similar to the tests’ false positive rates when including athletes who became asymptomatic several days earlier. Test–retest reliability was similar among these three CNTs and below optimal standards for clinical use on many subtests. Analyses of group effect sizes, discrimination, and sensitivity and specificity suggested that the CNTs may add incrementally (beyond symptom scores) to the identification of clinical impairment within 24 hr of injury or within a short time period after symptom resolution but do not add significant value over symptom assessment later. The rapid clinical recovery course from concussion and modest stability probably jointly contribute to limited signal detection capabilities of neurocognitive tests outside a brief post-injury window. (JINS, 2016, 22, 24–37)
Wilderness First Aid Training as a Tool for Improving Basic Medical Knowledge in South Sudan
- Lindsay B. Katona, William S. Douglas, Sean R. Lena, Kyle G. Ratner, Daniel Crothers, Robert L. Zondervan, Charles D. Radis
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- Journal:
- Prehospital and Disaster Medicine / Volume 30 / Issue 6 / December 2015
- Published online by Cambridge University Press:
- 23 October 2015, pp. 574-578
- Print publication:
- December 2015
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Introduction
The challenges presented by traumatic injuries in low-resource communities are especially relevant in South Sudan. This study was conducted to assess whether a 3-day wilderness first aid (WFA) training course taught in South Sudan improved first aid knowledge. Stonehearth Open Learning Opportunities (SOLO) Schools designed the course to teach people with limited medical knowledge to use materials from their environment to provide life-saving care in the event of an emergency.
MethodsA pre-test/post-test study design was used to assess first aid knowledge of 46 community members in Kit, South Sudan, according to a protocol approved by the University of New England Institutional Review Board. The course and assessments were administered in English and translated in real-time to Acholi and Arabic, the two primary languages spoken in the Kit region. Descriptive statistics, t-test, ANOVA, and correlation analyses were conducted.
ResultsResults included a statistically significant improvement in first aid knowledge after the 3-day training course: t(38)=3.94; P<.001. Although men started with more health care knowledge: (t(37)=2.79; P=.008), men and women demonstrated equal levels of knowledge upon course completion: t(37)=1.56; P=.88.
ConclusionsThis research, which may be the first of its kind in South Sudan, provides evidence that a WFA training course in South Sudan is efficacious. These findings suggest that similar training opportunities could be used in other parts of the world to improve basic medical knowledge in communities with limited access to medical resources and varying levels of education and professional experiences.
,Katona LB ,Douglas WS ,Lena SR ,Ratner KG ,Crothers D ,Zondervan RL .Radis CD Wilderness First Aid Training as a Tool for Improving Basic Medical Knowledge in South Sudan . Prehosp Disaster Med.2015 ;30 (6 ):574 –578 .
Colostrum production in ewes: a review of regulation mechanisms and of energy supply
- G. E. Banchero, J. T. B. Milton, D. R. Lindsay, G. B. Martin, G. Quintans
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In sheep production systems based on extensive grazing, neonatal mortality often reaches 15% to 20% of lambs born, and the mortality rate can be doubled in the case of multiple births. An important contributing factor is the nutrition of the mother because it affects the amount of colostrum available at birth. Ewes carrying multiple lambs have higher energy requirements than ewes carrying a single lamb and this problem is compounded by limitations to voluntary feed intake as the gravid uterus compresses the rumen. This combination of factors means that the nutritional requirements of the ewe carrying multiple lambs can rarely be met by the supply of pasture alone. This problem can overcome by supplementation with energy during the last week of pregnancy, a treatment that increases colostrum production and also reduces colostrum viscosity, making it easier for the neonatal lamb to suck. In addition, litter size and nutrition both accelerate the decline in concentration of circulating progesterone that, in turn, triggers the onsets of both birth and lactogenesis, and thus ensures the synchrony of these two events. Furthermore, the presence of colostrum in the gut of the lamb increases its ability to recognize its mother, and thus improves mother–young bonding. Most cereal grains that are rich in energy in the form of starch, when used as supplements in late pregnancy will increase colostrum production by 90% to 185% above control (unsupplemented) values. Variation among types of cereal grain in the response they induce may be due to differences in the amount of starch digested post-ruminally. As a percentage of grain dry matter intake, the amount of starch entering the lower digestive tract is 14% for maize, 8.5% for barley and 2% for oats. Supplements of high quality protein from legumes and oleiferous seeds can also increase colostrum production but they are less effective than cereal grains. In conclusion, short-term supplementation before parturition, particularly with energy-rich concentrates, can improve colostrum production, help meet the energy and immunological requirements for new-born lambs, and improve lamb survival.
Contributors
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- By Tod C. Aeby, Melanie D. Altizer, Ronan A. Bakker, Meghann E. Batten, Anita K. Blanchard, Brian Bond, Megan A. Brady, Saweda A. Bright, Ellen L. Brock, Amy Brown, Ashley Carroll, Jori S. Carter, Frances Casey, Weldon Chafe, David Chelmow, Jessica M. Ciaburri, Stephen A. Cohen, Adrianne M. Colton, PonJola Coney, Jennifer A. Cross, Julie Zemaitis DeCesare, Layson L. Denney, Megan L. Evans, Nicole S. Fanning, Tanaz R. Ferzandi, Katie P. Friday, Nancy D. Gaba, Rajiv B. Gala, Andrew Galffy, Adrienne L. Gentry, Edward J. Gill, Philippe Girerd, Meredith Gray, Amy Hempel, Audra Jolyn Hill, Chris J. Hong, Kathryn A. Houston, Patricia S. Huguelet, Warner K. Huh, Jordan Hylton, Christine R. Isaacs, Alison F. Jacoby, Isaiah M. Johnson, Nicole W. Karjane, Emily E. Landers, Susan M. Lanni, Eduardo Lara-Torre, Lee A. Learman, Nikola Alexander Letham, Rachel K. Love, Richard Scott Lucidi, Elisabeth McGaw, Kimberly Woods McMorrow, Christopher A. Manipula, Kirk J. Matthews, Michelle Meglin, Megan Metcalf, Sarah H. Milton, Gaby Moawad, Christopher Morosky, Lindsay H. Morrell, Elizabeth L. Munter, Erin L. Murata, Amanda B. Murchison, Nguyet A. Nguyen, Nan G. O’Connell, Tony Ogburn, K. Nathan Parthasarathy, Thomas C. Peng, Ashley Peterson, Sarah Peterson, John G. Pierce, Amber Price, Heidi J. Purcell, Ronald M. Ramus, Nicole Calloway Rankins, Fidelma B. Rigby, Amanda H. Ritter, Barbara L. Robinson, Danielle Roncari, Lisa Rubinsak, Jennifer Salcedo, Mary T. Sale, Peter F. Schnatz, John W. Seeds, Kathryn Shaia, Karen Shelton, Megan M. Shine, Haller J. Smith, Roger P. Smith, Nancy A. Sokkary, Reni A. Soon, Aparna Sridhar, Lilja Stefansson, Laurie S. Swaim, Chemen M. Tate, Hong-Thao Thieu, Meredith S. Thomas, L. Chesney Thompson, Tiffany Tonismae, Angela M. Tran, Breanna Walker, Alan G. Waxman, C. Nathan Webb, Valerie L. Williams, Sarah B. Wilson, Elizabeth M. Yoselevsky, Amy E. Young
- Edited by David Chelmow, Virginia Commonwealth University, Christine R. Isaacs, Virginia Commonwealth University, Ashley Carroll, Virginia Commonwealth University
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- Book:
- Acute Care and Emergency Gynecology
- Published online:
- 05 November 2014
- Print publication:
- 30 October 2014, pp ix-xiv
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A Marine Reservoir Correction for the Houtman-Abrolhos Archipelago, East Indian Ocean, Western Australia
- Peter Squire, Renaud Joannes-Boyau, Anja M Scheffers, Luke D Nothdurft, Quan Hua, Lindsay B Collins, Sander R Scheffers, Jian-xin Zhao
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- Journal:
- Radiocarbon / Volume 55 / Issue 1 / 2013
- Published online by Cambridge University Press:
- 19 January 2016, pp. 103-114
- Print publication:
- 2013
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High-precision analysis using accelerator mass spectrometry (AMS) was performed upon known-age Holocene and modern, pre-bomb coral samples to generate a marine reservoir age correction value (ΔR) for the Houtman-Abrolhos Archipelago (28.7°S, 113.8°E) off the Western Australian coast. The mean ΔR value calculated for the Abrolhos Islands, 54 ± 30 yr (1 σ) agrees well with regional ΔR values for Leeuwin Current source waters (N-NW Australia-Java) of 60 ± 38 yr. The Abrolhos Islands show little variation with ΔR values of the northwestern and north Australian coast, underlining the dominance of the more equilibrated western Pacific-derived waters of the Leeuwin Current over local upwelling. The Abrolhos Islands ΔR values have remained stable over the last 2896 cal yr BP, being also attributed to the Leeuwin Current and the El Niño Southern Oscillation (ENSO) signal during this period. Expected future trends will be a strengthening of the teleconnection of the Abrolhos Islands to the climatic patterns of the equatorial Pacific via enhanced ENSO and global warming activity strengthening the Leeuwin Current. The possible effect upon the trend of future ΔR values may be to maintain similar values and an increase in stability. However, warming trends of global climate change may cause increasing dissimilarity of ΔR values due to the effects of increasing heat stress upon lower-latitude coral communities.
Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria
- Nimalie D. Stone, Muhammad S. Ashraf, Jennifer Calder, Christopher J. Crnich, Kent Crossley, Paul J. Drinka, Carolyn V. Gould, Manisha Juthani-Mehta, Ebbing Lautenbach, Mark Loeb, Taranisia MacCannell, Preeti N. Malani, Lona Mody, Joseph M. Mylotte, Lindsay E. Nicolle, Mary-Claire Roghmann, Steven J. Schweon, Andrew E. Simor, Philip W. Smith, Kurt B. Stevenson, Suzanne F. Bradley, Society for Healthcare Epidemiology Long-Term Care Special Interest Group
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 33 / Issue 10 / October 2012
- Published online by Cambridge University Press:
- 02 January 2015, pp. 965-977
- Print publication:
- October 2012
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Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections.
Infect Control Hosp Epidemiol 2012;33(10):965-977
Healthcare-Associated Infection and Hospital Readmission
- Carley B. Emerson, Lindsay M. Eyzaguirre, Jennifer S. Albrecht, Angela C. Comer, Anthony D. Harris, Jon P. Furuno
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 33 / Issue 6 / June 2012
- Published online by Cambridge University Press:
- 02 January 2015, pp. 539-544
- Print publication:
- June 2012
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Objective.
Hospital readmissions are a current target of initiatives to reduce healthcare costs. This study quantified the association between having a clinical culture positive for 1 of 3 prevalent hospital-associated organisms and time to hospital readmission.
Design.Retrospective cohort study.
Patients and Setting.Adults admitted to an academic, tertiary care referral center from January 1, 2001, through December 31, 2008.
Methods.The primary exposure of interest was a clinical culture positive for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), or Clostridium difficile obtained more than 48 hours after hospital admission during the index hospital stay. The primary outcome of interest was time to readmission to the index facility. Multivariable Cox proportional hazards models were used to model the adjusted association between positive clinical culture result and time to readmission and to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results.Among 136,513 index admissions, the prevalence of hospital-associated positive clinical culture result for 1 of the 3 organisms of interest was 3%, and 35% of patients were readmitted to the index facility within 1 year after discharge. Patients with a positive clinical culture obtained more than 48 hours after hospital admission had an increased hazard of readmission (HR, 1.40; 95% CI, 1.33–1.46) after adjusting for age, sex, index admission length of stay, intensive care unit stay, Charlson comorbidity index, and year of hospital admission.
Conclusions.Patients with healthcare-associated infections may be at increased risk of hospital readmission. These findings may be used to impact health outcomes after discharge from the hospital and to encourage better infection prevention efforts.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Contributors
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- By Joanne R. Adler, David A. Alexander, Laurence Alison, Catherine C. Ayoub, Peter Banister, Anthony R. Beech, Amanda Biggs, Julian Boon, Adrian Bowers, Neil Brewer, Eric Broekaert, Paula Brough, Jennifer M. Brown, Kevin Browne, Elizabeth A. Campbell, David Canter, Michael Carlin, Shihning Chou, Martin A. Conway, Claire Cooke, David Cooke, Ilse Derluyn, Robert J. Edelmann, Vincent Egan, Tom Ellis, Marie Eyre, David P. Farrington, Seena Fazel, Daniel B. Fishman, Victoria Follette, Katarina Fritzon, Elizabeth Gilchrist, Nathan D. Gillard, Renée Gobeil, Agnieszka Golec de Zavala, Jane Goodman-Delahunty, Lynsey Gozna, Don Grubin, Gisli H. Gudjonsson, Helinä Häkkänen-Nyholm, Guy Hall, Nathan Hall, Roisin Hall, Sean Hammond, Leigh Harkins, Grant T. Harris, Camilla Herbert, Robert D. Hoge, Todd E. Hogue, Clive R. Hollin, Lorraine Hope, Miranda A. H. Horvath, Kevin Howells, Carol A. Ireland, Jane L. Ireland, Mark Kebbell, Michael King, Bruce D. Kirkcaldy, Heidi La Bash, Cara Laney, William R. Lindsay, Elizabeth F. Loftus, L. E. Marshall, W. L. Marshall, James McGuire, Neil McKeganey, T. M. McMillan, Mary McMurran, Joav Merrick, Becky Milne, Joanne M. Nadkarni, Claire Nee, M. D. O’Brien, William O’Donohue, Darragh O’Neill, Jane Palmer, Adria Pearson, Derek Perkins, Devon L. L. Polaschek, Louise E. Porter, Charlotte C. Powell, Graham E. Powell, Martine Powell, Christine Puckering, Ethel Quayle, Vernon L. Quinsey, Marnie E. Rice, Randall Richardson-Vejlgaard, Richard Rogers, Louis B Schlesinger, Carolyn Semmler, G. A. Serran, Ralph C. Serin, John L. Taylor, Max Taylor, Brian Thomas-Peter, Paul A. Tiffin, Graham Towl, Rosie Travers, Arlene Vetere, Graham Wagstaff, Helen Wakeling, Fiona Warren, Brandon C. Welsh, David Wexler, Margaret Wilson, Dan Yarmey, Susan Young
- Edited by Jennifer M. Brown, London School of Economics and Political Science, Elizabeth A. Campbell, University of Glasgow
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- The Cambridge Handbook of Forensic Psychology
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- 06 July 2010
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- 29 April 2010, pp xix-xxiii
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A pre-partum lift in ewe nutrition from a high-energy lick or maize or by grazing Lotus uliginosus pasture, increases colostrum production and lamb survival
- G. E. Banchero, G. Quintans, D. R. Lindsay, J. T. B. Milton
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This experiment tested the hypothesis that a lift in the nutrition of ewes, before lambing, to increase colostrum production would enhance lamb survival. In all, 261 mature Corriedale ewes, each with a single fetus from a synchronised mating, grazed native pasture to day 130 after mating; at which point they were weighed, condition scored and allocated to graze either native pasture or a pasture dominant with Lotus uliginosus. Five days later (14 days before the expected start of lambing) the ewes were allocated to one of four treatments and fed: (i) native pasture alone, (ii) native pasture plus a commercial high-energy lick, (iii) L. uliginosus pasture alone or (iv) L. uliginosus pasture plus whole maize. The weight, viscosity and concentration of components and immunoglobulin G in the colostrum that had accumulated at parturition, were measured for 10 ewes in each treatment. The lambs that survived to 20 days of age from the 221 ewes that were not milked, were recorded. The ewes supplemented with the lick or maize grain and those that grazed the L. uliginosus pasture alone accumulated two to three times more colostrum at birth than the ewes that grazed native pasture alone (396, 635 and 662 g v. 206 g; P < 0.01). The colostrum from the ewes that grazed only native pasture was more viscous (lower score) than that from the ewes supplemented with the lick or maize grain or the ewes that grazed the L. uliginosus pasture alone (scores of 4.1 v. 6.2, 6.5 and 6.4, P < 0.001) and, not surprisingly, the concentration of lactose in the colostrum of the ewes fed only native pasture was also much lower (1.1% v. 3.0%, 2.8% and 2.6%; P < 0.001)he survival of lambs from the ewes fed only native pasture was less than that of the lambs from ewes fed native pasture plus the commercial lick (81.8% v. 95.5%; P < 0.05) or the L. uliginosus pasture alone (92.4%, P < 0.05), and also tended to be lower than that for lambs born to ewes fed L. uliginosus pasture plus maize (91.8%, P = 0.08). The concentration of glucose in the blood of the lambs from the ewes that grazed only native pasture was lower than that of the other lambs (42.1 v. 60.2 ng/ml, P = 0.012). We conclude that the marked increase in colostrum production associated with the lift in ewe nutrition, just prior to lambing, enhanced lamb survival.
Contributors
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- By Jennifer Alvarez, Ananda B. Amstadter, Metin Başoğlu, David M. Benedek, Charles C. Benight, George A. Bonanno, Evelyn J. Bromet, Richard A. Bryant, Barbara Lopes Cardozo, M. L. Somchai Chakkraband, Claude Chemtob, Roman Cieslak, Lauren M. Conoscenti, Joan M. Cook, Judith Cukor, Carla Kmett Danielson, JoAnn Difede, Charles DiMaggio, Anja J.E. Dirkzwager, Cristiane S. Duarte, Jon D. Elhai, Diane L. Elmore, Yael L.E. Errera, Julian D. Ford, Carol S. Fullerton, Sandro Galea, Freya Goodhew, Neil Greenberg, Lindsay Greene, Linda Grievink, Michael J. Gruber, Sumati Gupta, Johan M. Havenaar, Alesia O. Hawkins, Clare Henn-Haase, Kimberly Eaton Hoagwood, Christina W. Hoven, Sabra S. Inslicht, Krzysztof Kaniasty, Ronald C. Kessler, Rachel Kimerling, Richard V. King, Rolf J. Kleber, Jessica Mass Levitt, Brett T. Litz, Maria Livanou, Katelyn P. Mack, Paula Madrid, Shira Maguen, Paul Maguire, Donald J. Mandell, Charles R. Marmar, Andrea R. Maxwell, Shannon E. McCaslin, Alexander C. McFarlane, Thomas J. Metzler, Summer Nelson, Yuval Neria, Elana Newman, Thomas C. Neylan, Fran H. Norris, Carol S. North, Lawrence A. Palinkas, Benjaporn Panyayong, Maria Petukhova, Betty Pfefferbaum, Marleen Radigan, Beverley Raphael, James Rodriguez, G. James Rubin, Kenneth J. Ruggiero, Ebru Şalcıoğlu, Nancy A. Sampson, Arieh Y. Shalev, Bruce Shapiro, Laura M. Stough, Prawate Tantipiwatanaskul, Warunee Thienkrua, Phebe Tucker, J. Blake Turner, Robert J. Ursano, Bellis van den Berg, Peter G. van der Velden, Frits van Griensven, Miranda Van Hooff, Edward Waldrep, Philip S. Wang, Simon Wessely, Leslie H. Wind, C. Joris Yzermans, Heidi M. Zinzow
- Edited by Yuval Neria, Columbia University, New York, Sandro Galea, University of Michigan, Ann Arbor, Fran H. Norris
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- Mental Health and Disasters
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- 07 May 2010
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- 20 July 2009, pp xi-xvi
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Estimation of pituitary secretion rate during the reproductive cycle of sheep
- K. S. Lindsay, I. R. Fleet, D. E. Walters, R. B. Heap
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- The Journal of Agricultural Science / Volume 114 / Issue 2 / April 1990
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- 27 March 2009, pp. 213-218
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A technique has been developed for the measurement of pituitary hormone secretion rates in conscious sheep. The technique involves the continuous and simultaneous sampling of blood from the carotid artery and jugular vein and the measurement of cephalic blood flow by an indicator dilution technique. Veno-arterial differences in hormone concentrations multiplied by cephalic blood flow gave average secretion rates which were measured after single or repeated large doses of luteinizing hormone releasing hormone (LHRH) and thyrotrophin-releasing hormone (TRH) at various times in the reproductive cycle.
Oxidation and metabolism of linoleic acid in fed and fasted sheep
- D. B. Lindsay, W. M. F. Leat
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- The Journal of Agricultural Science / Volume 89 / Issue 1 / August 1977
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- 27 March 2009, pp. 215-221
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Using continuous infusion techniques the entry rate of linoleic acid and its contribution to carbon dioxide production has been studied in fed and fasted sheep. The entry rate of linoleic acid in fasted sheep (0·052 mg/min/kg) was considerably less than that of stearic acid (0·432 mg/min/kg), and the percentage of total carbon dioxide production derived from the oxidation of linoleic acid (0·4%) was also markedly less than that from stearic acid (10·13%).
On starvation there was a preferential mobilization of palmitic, stearic and oleic acids relative to linoleic acid.
The infused 14C-labelled linoleic acid was initially incorporated into plasma phospholipids, with maximal radioactivity at about 1 day post-infusion, and subsequently into plasma cholesteryl esters with a maximum at 2 days post-infusion. The incorporation of 14C-labelled stearic acid into plasma phospholipids was only 25–30% that of linoleic acid, with negligible incorporation into cholesteryl esters.
Possible explanations for ruminant animals being able to exist on a very low intake of linoleic acid are discussed. In essence, there is a discrimination against the use of linoleic acid as an energy source, but the mechanisms involved do not appear to be unique to ruminant animals.
The metabolic changes which occur in sheep transferred to lush spring pastures II. Changes in the acid-base balance of the whole animal
- E. F. Annison, D. Lewis, D. B. Lindsay
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- The Journal of Agricultural Science / Volume 53 / Issue 1 / August 1959
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- 27 March 2009, pp. 42-45
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1. Acid-base changes were observed in the blood of some sheep after turning them out to lush spring grass.
2. These changes were observed in animals previously fed a diet of hay plus concentrates. No changes were found in animals previously fed hay alone.
3. Reasons are given for believing the acidosis observed was a consequence of feeding on lush pasture, and not a consequence of the exercise and excitement involved in rounding up sheep for sampling.