Age at Death Used to Assess the Effect of Interhospital Transfer of Newborns

PEDIATRICS ◽  
1984 ◽  
Vol 73 (6) ◽  
pp. 854-861 ◽  
Author(s):  
Nigel Paneth ◽  
John L. Kiely ◽  
Mervyn Susser
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Mortality ◽  
Low Birth Weight Infants ◽  
Levels Of Care ◽  
Transport Services ◽  
Interhospital Transfer ◽  
Level 3 ◽  
Level 1 ◽  
Level 2

In New York City, newborn units classified as level 1 (no intensive care) frequently transfer low-birth-weight infants to units classified as level 3 (complete intensive care), but level 2 units (those with intermediate levels of care) transfer rarely. As deaths occurring in the first hours of life are unlikely to be affected by infant transport services, early (first four hours), late (four hours to 28 days), and overall neonatal death rates were separately examined at each of the three levels of care for singleton live-births weighing 501 to 2,250 g. As previously reported, overall neonatal mortality (adjusted for birth weight, gestational age, sex, and race) for births at level 1 units (163.0/1,000) and level 2 units (168.1/1,000) was similar, and rates for births at level 3 (128.0/1,000) were significantly lower. Mortality up to four hours, and from four hours to 28 days, however, differed between level 1 and level 2 units. Among early deaths, the mortality for level 1 births was 68.0/1,000, significantly higher than both the rate for level 2 births (46.0/1,000) and for level 3 births (40.6/1,000). Between four hours and 28 days, mortality relative to level 3 improved for level 1 births, but worsened for level 2 births. For infants with birth weight <1,251 g, for whom transport rates from level 1 units are highest, mortality in level 1 births was higher than in level 2 births only until 18 hours of life; thereafter, level 2 mortality was higher. These results could not be explained by any of eight additional variables examined in a multivariate model, nor by live birth/fetal death misclassification. Early deaths constituted 30% of neonatal mortality in this population. Thus, infant transport cannot replace maternal selection for place of delivery. However, the excess mortality after four hours seen at level 2 units might be avoided by more frequent referral of sick infants to level 3 services.

Newborn Intensive Care and Neonatal Mortality in Low-Birth-Weight Infants

1982 ◽  
Vol 307 (3) ◽  
pp. 149-155 ◽  
Author(s):  
Nigel Paneth ◽  
John L. Kiely ◽  
Sylvan Wallenstein ◽  
Michele Marcus ◽  
Jean Pakter ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Low Birth Weight Infants ◽  
Newborn Intensive Care

Favorable Results of Neonatal Intensive Care for Very Low-Birth-Weight Infants

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 621-625
Author(s):  
Ronald S. Cohen ◽  
David K. Stevenson ◽  
Natalie Malachowski ◽  
Ronald L. Ariagno ◽  
Keith J. Kimble ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Very Low Birth Weight ◽  
Ventilatory Support ◽  
University Hospital ◽  
High Risk Infant ◽  
Low Birth Weight Infants

From 1961 to 1976, 229 infants with birth weights ranging from 751 to 1,000 gm were admitted to the Stanford University Hospital Intensive Care Nursery. The overall neonatal mortality for these infants was 63% (144/229), and there were ten late deaths. Before 1967, no infant in this group who required mechanical ventilation survived; therafter, 30% (34/114) of the ventilated patients survived. Of the 75 long-term survivors 60 participated in a high-risk infant follow-up program; these included 23 infants who had received mechanical ventilation. The mean birth weight of these infants was 928 ± 67 (SD) gm. Seventeen children (28%) had significant morbidity: seven (12%) with severe handicaps and ten (17%) with moderate handicaps. During this same period, seven infants weighing less than 750 gm at birth were also observed. The three infants who had not required ventilatory support thrived; the other four infants had required respirators and were significantly handicapped. More recently, neonatal mortality for infants with birth weights from 751 to 1,000 gm has improved: for 1977 to 1980, it was 28% (33/118). Furthermore, neonatal mortality for ventilated infants in this weight group was 27% (26/95). These data indicate an improved prognosis for very low-birth-weight infants, even with ventilatory support.

Survival and Morbidity of Our Smallest Babies: Is There a Limit to Neonatal Care?

PEDIATRICS ◽  
1984 ◽  
Vol 73 (3) ◽  
pp. 415-416
Author(s):  
RONALD S. COHEN ◽  
DAVID K. STEVENSON ◽  
RONALD L. ARIAGNO ◽  
PHILIP SUNSHINE
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Very Low Birth Weight ◽  
University Hospital ◽  
Low Birth Weight Infants ◽  
Hospital Intensive Care Unit ◽  
Improved Outcome

To the Editor.— We recently reported an improved outcome for infants with birth weight in the 751-to 1,000-g range; the prognosis for infants weighing 750 g or less at birth was equivocal.1 Since the publication of this report, further interesting data on the very low-birth-weight infants cared for in the Stanford University Hospital Intensive Care Unit have become available. We would like to add these data to those already published. In the original paper,1 we reported a 28% neonatal mortality for 751-to 1,000-g birth weight infants born during 1977 to 1980.

scholarly journals MODEL MULTILEVEL PERTUMBUHAN ANAK USIA 0-24 BULAN DAN VARIABEL YANG MEMPENGARUHINYA

2013 ◽  
Vol 16 ◽  
pp. 130-142
Author(s):  
Irianton Aritonang
Keyword(s):  
Birth Weight ◽  
Nutritional Status ◽  
Path Analysis ◽  
Multilevel Model ◽  
Growth Index ◽  
Sampling Technique ◽  
Gender And Age ◽  
Level 3 ◽  
Level 1 ◽  
Level 2

Tujuan umum penelitian ini untuk mengkaji bagaimana berbagai variabel mempengaruhi pertumbuhan anak usia 0-24 bulan di kabupaten Sleman. Penelitian noneksperimen desain korelasional ini dilakukan pada 272 anak usia 0-24 bulan yang diambil secara acak stratifikasi dari dua kecamatan (Sleman dan Moyudan) yang ditentukan secara purposif. Analisis multilevel pertumbuhan anak dilakukan dengan program Stata-10 dan analisis jalur dilakukan dengan program Amos-8. Hasil penelitian menunjukkan bahwa ada hubungan variabel berat badan lahir, jenis kelamin dan strata usia anak dan status gizi ibu dengan pertumbuhan anak pada level-1 dan ada hubungan variabel hasil penimbangan pada level-2, sedangkan pada level 3 ada hubungan yang tidak signifikan hasil penimbangan dan pencapaian program. Hasil analisis jalur yang mempengaruhi pertumbuhan anak 0-24 bulan, yakni variabel endogenous terdiri dari status gizi ibu, pengetahuan ibu tentang gizi seimbang, pertumbuhan anak indeks BB/U, hasil penimbangan tingkat dusun dan hasil program tingkat desa. Sedangkan variabel exogenous terdiri dari sikap ibu terhadap posyandu, berat badan lahir, jenis kelamin dan stratifikasi usia anak. Kata kunci: Model multilevel, Pertumbuhan anak 0-24 bulan ______________________________________________________________A MULTILEVEL MODEL FOR THE GROWTH OF CHILDREN AGED 0-24 MONTHS AND THE VARIABLES AFFECTING IT Abstract The main objective of this study is to investigate how various variables contribute to the growth of children between 0-24  months old in Sleman Regency. This study was a non-experimental correlational design which was conducted on 272 children aged 0-24 months, selected using the purposive stratified random sampling technique from 21 hamlets in two districts (Sleman and Moyudan). The multilevel analysis of children’s growth of was carried out using the Stata-10 program and the path analysis using the Amos-8 program. The results show  that there is a significant correlation among variables of children's birth weight, gender, and age stratification and mothers' nutritional status to children's growth at level 1, and a correlation to the variable of children's weight at level 2, while at level 3 there is no significant correlation between children's weight and program achievement. The path analysis shows that the variables affecting the growth of children aged 0-24 months are endogenous variables, consisting of mothers' nutritional status, mothers' knowledge on balanced diet, children's growth index,  children's weights measured at the hamlet and the result of program at village level, and exogenous variables, consisting of mothers' attitude concerning Posyandu, children's birth weight, gender and age stratification.Keywords: multilevel model, growth of children aged 0-24 months

Mortality in Very Preterm and Very Low Birth Weight Infants According to Place of Birth and Level of Care: Results of a National Collaborative Survey of Preterm and Very Low Birth Weight Infants in the Netherlands

PEDIATRICS ◽  
1988 ◽  
Vol 81 (3) ◽  
pp. 404-411
Author(s):  
S. Pauline Verloove-Vanhorick ◽  
Robert A. Verwey ◽  
Marij C. A. Ebeling ◽  
Ronald Brand ◽  
Jan H. Ruys
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
The Netherlands ◽  
Very Low Birth Weight ◽  
Perinatal Care ◽  
Newborn Infants ◽  
Low Birth Weight Infants ◽  
Optimal Care ◽  
Levels Of Care ◽  
Level 3

As part of a collaborative project in the Netherlands in 1983, for which data were collected on 1,338 newborn infants (<32 weeks' gestation and/or <1,500 g birth weight), all infants were assigned to one of three levels of care according to hospital of birth. Considerable centralization was achieved by antenatal and neonatal transport. Although the uncorrected mortality rates were similar, the mortality odds (adjusted for four and 22 potential confounding perinatal factors, respectively) were significantly higher in level 1 and level 2 hospitals compared with level 3 hospitals (tertiary perinatal care centers). By extending the facilities for full perinatal intensive care in level 3 centers and thus providing optimal care for all such infants, the overall mortality rate is expected to decrease further.

Medical Care and Preterm Infants of Normal Birth Weight

PEDIATRICS ◽  
1986 ◽  
Vol 77 (2) ◽  
pp. 158-166
Author(s):  
Nigel Paneth ◽  
Sylvan Wallenstein ◽  
John L. Kiely ◽  
Curtis P. Snook ◽  
Mervyn Susser
Keyword(s):  
Birth Weight ◽  
Care Center ◽  
Tertiary Care ◽  
Normal Weight ◽  
Tertiary Care Center ◽  
Normal Birth Weight ◽  
Normal Birth ◽  
Level 3 ◽  
Level 1 ◽  
Level 2

Preterm infants of normal birth weight (born before 37 completed weeks of gestation and weighing more than 2,250 g) experience a neonatal mortality risk almost four times higher than do term infants in the same weight range. In an analysis of the effect of hospital level of birth on neonatal mortality, such preterm normal weight infants were found to experience higher mortality if born outside of a Level 3 (tertiary care) center. For all singleton infants in this weight-gestation category born in New York City maternity services during a 3-year period (N = 23,257), the relative mortality risk for Level 1 births (compared with Level 3) was 1.72 (P < .01) and for Level 2 births 1.47 (P < .05). The excess mortality at Level 1 and Level 2 units was almost entirely due to a more than twofold higher death rate in black infants born in these units. Several potentially confounding socioeconomic, demographic, and biologic variables entered into a logistic regression model could not account for the higher mortality rates for black infants born in Level 1 and Level 2 units. Among black infants born at Level 1 units, deaths in preterm normal birth weight infants were less likely to occur in a receiving tertiary care center than were either deaths in low birth weight infants or deaths in term normal weight infants, suggesting that the need for special care of preterm normal birth weight infants is underestimated in some hospitals without newborn intensive care units.

EVALUASI PELATIHAN DI PT. PUPUK KUJANG CIKAMPEK

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Lania Muharsih ◽  
Ratih Saraswati
Keyword(s):  
Training Evaluation ◽  
Work Productivity ◽  
Learning Behavior ◽  
Level 3 ◽  
Level 1 ◽  
Four Levels ◽  
A Company ◽  
Level 2 ◽  
Evaluation Sheet ◽  
Assessment Factor

This study aims to determine the training evaluation at PT. Kujang Fertilizer. PT. Pupuk Kujang is a company engaged in the field of petrochemicals. Evaluation sheet of PT. Fertilizer Kujang is made based on Kirkpatrick's theory which consists of four levels of evaluation, namely reaction, learning, behavior, and results. At level 1, namely reaction, in the evaluation sheet is in accordance with the theory of Kirkpatrick, at level 2 that is learning should be held pretest and posttest but only made scale. At level 3, behavior, according to theory, but on assessment factor number 3, quantity and work productivity should not need to be included because they are included in level 4. At level 4, that is the result, here is still lacking to get a picture of the results of the training that has been carried out because only based on answers from superiors without evidence of any documents.   Keywords: Training Evaluation, Kirkpatrick Theory.    Penelitian ini bertujuan mengetahui evaluasi training di PT. Pupuk Kujang. PT. Pupuk Kujang merupakan perusahaan yang bergerak di bidang petrokimia. Lembar evaluasi PT. Pupuk Kujang dibuat berdasarkan teori Kirkpatrick yang terdiri dari empat level evaluasi, yaitu reaksi, learning, behavior, dan hasil. Pada level 1 yaitu reaksi, di lembar evaluasi tersebut sudah sesuai dengan teori dari Kirkpatrick, pada level 2 yaitu learning seharusnya diadakan pretest dan posttest namun hanya dibuatkan skala. Pada level 3 yaitu behavior, sudah sesuai teori namun pada faktor penilaian nomor 3 kuantitas dan produktivitas kerja semestinya tidak perlu dimasukkan karena sudah termasuk ke dalam level 4. Pada level 4 yaitu hasil, disini masih sangat kurang untuk mendapatkan gambaran hasil dari pelatihan yang sudah dilaksanakan karena hanya berdasarkan dari jawaban atasan tanpa bukti dokumen apapun.   Kata kunci: Evaluasi Pelatihan, Teori Kirkpatrick.

Variation in antibiotic use across intensive care units (ICU): A population-based cohort study in Ontario, Canada

2020 ◽  
Vol 41 (9) ◽  
pp. 1035-1041
Author(s):  
Erika Y. Lee ◽  
Michael E. Detsky ◽  
Jin Ma ◽  
Chaim M. Bell ◽  
Andrew M. Morris
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Ventilatory Support ◽  
Severity Of Illness ◽  
Antibiotic Use ◽  
Patient Factors ◽  
Days Of Therapy ◽  
Level 3 ◽  
Level 2

AbstractObjectives:Antibiotics are commonly used in intensive care units (ICUs), yet differences in antibiotic use across ICUs are unknown. Herein, we studied antibiotic use across ICUs and examined factors that contributed to variation.Methods:We conducted a retrospective cohort study using data from Ontario’s Critical Care Information System (CCIS), which included 201 adult ICUs and 2,013,397 patient days from January 2012 to June 2016. Antibiotic use was measured in days of therapy (DOT) per 1,000 patient days. ICU factors included ability to provide ventilator support (level 3) or not (level 2), ICU type (medical-surgical or other), and academic status. Patient factors included severity of illness using multiple-organ dysfunction score (MODS), ventilatory support, and central venous catheter (CVC) use. We analyzed the effect of these factors on variation in antibiotic use.Results:Overall, 269,351 patients (56%) received antibiotics during their ICU stay. The mean antibiotic use was 624 (range 3–1460) DOT per 1,000 patient days. Antibiotic use was significantly higher in medical-surgical ICUs compared to other ICUs (697 vs 410 DOT per 1,000 patient days; P < .0001) and in level 3 ICUs compared to level 2 ICUs (751 vs 513 DOT per 1,000 patient days; P < .0001). Higher antibiotic use was associated with higher severity of illness and intensity of treatment. ICU and patient factors explained 47% of the variation in antibiotic use across ICUs.Conclusions:Antibiotic use varies widely across ICUs, which is partially associated with ICUs and patient characteristics. These differences highlight the importance of antimicrobial stewardship to ensure appropriate use of antibiotics in ICU patients.

scholarly journals An Atmospheric Visibility Grading Method Based on Ensemble Learning and Stochastic Weight Average

Atmosphere ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 869
Author(s):  
Xiuguo Zou ◽  
Jiahong Wu ◽  
Zhibin Cao ◽  
Yan Qian ◽  
Shixiu Zhang ◽  
...  
Keyword(s):  
Ensemble Learning ◽  
Traffic Accidents ◽  
Feature Sets ◽  
Atmospheric Visibility ◽  
Average Accuracy ◽  
Level 3 ◽  
Visual Characteristics ◽  
Level 1 ◽  
Grading Model ◽  
Level 2

In order to adequately characterize the visual characteristics of atmospheric visibility and overcome the disadvantages of the traditional atmospheric visibility measurement method with significant dependence on preset reference objects, high cost, and complicated steps, this paper proposed an ensemble learning method for atmospheric visibility grading based on deep neural network and stochastic weight averaging. An experiment was conducted using the scene of an expressway, and three visibility levels were set, i.e., Level 1, Level 2, and Level 3. Firstly, the EfficientNet was transferred to extract the abstract features of the images. Then, training and grading were performed on the feature sets through the SoftMax regression model. Subsequently, the feature sets were ensembled using the method of stochastic weight averaging to obtain the atmospheric visibility grading model. The obtained datasets were input into the grading model and tested. The grading model classified the results into three categories, with the grading accuracy being 95.00%, 89.45%, and 90.91%, respectively, and the average accuracy of 91.79%. The results obtained by the proposed method were compared with those obtained by the existing methods, and the proposed method showed better performance than those of other methods. This method can be used to classify the atmospheric visibility of traffic and reduce the incidence of traffic accidents caused by atmospheric visibility.

Sign in / Sign up

Export Citation Format

Share Document