Used water and nutrients: recovery perspectives in a 'panta rhei' context

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Impact of sucrose and palm sugar blend as sweetener on the quality attributes of dark chocolate

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Acrylamide in levensmiddelen: toch nog een weg af te leggen...

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Temperature regulates methane production through the function centralization of microbial community in anaerobic digestion

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Electrochemical stability of ionic liquids: general influences and degradation mechanisms

The stability of ionic liquids is of paramount importance in selecting the appropriate ionic liquid for a well-defined application. This Review provides an overview of stability issues, both chemical and electrochemical, and the underlying degradation mechanisms that are known. The influence of various functionalities on the stability of the ionic liquid, influencing both the cationic as the anionic parts of the ionic liquid, still requires several careful studies.

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The Impact of Emergency Department Census on the Decision to Admit

Abstract

Objective

We evaluated the effect of Emergency Department (ED) census on disposition decisions made by ED physicians.

Methods

We performed a retrospective analysis using 18 months of all adult patient encounters seen in the main ED at an academic tertiary care center. Patient census information was calculated at the time of physician assignment for each individual patient, and included the number of patients in the waiting room (waiting room census) and number of patients being managed by the patient's attending (physician load census). A multiple logistic regression model was created to assess the association between these census variables and the disposition decision, controlling for potential confounders including ESI acuity, patient demographics, arrival hour, arrival mode, and chief complaint.

Results

49,487 patient visits were included in this analysis, of which 37% were admitted to the hospital. Both census measures were significantly associated with increased chance of admission; the OR (odds ratio) per patient increase for waiting room census was 1.011, (95% CI: 1.001-1.020), and the OR for physician load census was 1.010, (95% CI: 1.002-1.019). To put this in practical terms, this translated to a modeled rise from 35.3% to 40.1% when shifting from an empty waiting room and zero patient load to a 12-patient wait and 16-patient load for a given physician.

Conclusion

Waiting room census and physician load census at time of physician assignment were positively associated with the likelihood that a patient would be admitted, controlling for potential confounders. Our data suggests that disposition decisions in the ED are influenced not only by objective measures of a patient's disease state, but also by workflow related concerns.

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Shared Decision Making in the Emergency Department among patients with Limited Health Literacy: Beyond Slower and Louder

Abstract

Health literacy is "the degree to which individuals can obtain, process and understand the basic health information needed to make appropriate health decisions and access health services needed to prevent or treat illness." The prevalence of limited health literacy (LHL) among adult ED patients is as high as 88%. Numeracy, or the "ability to understand and use numbers in daily life," is a continuum of skills that ranges from basic recognition and computation of numbers to understanding and use of high level skills such as probability, risk, and randomization.

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