282 research outputs found
Magnitude and Prognosis Associated With Ventricular Arrhythmias in Patients Hospitalized With Acute Coronary Syndromes (from the GRACE Registry)
No full textÁlvaro Avezum, Leopoldo S. Piegas, Robert J. Goldberg, David Brieger, Martin K. Stiles, Richard Paolini, Wei Huang, and Joel M. Gore, for the GRACE Investigator
Falling cholesterol trend at acute coronary syndrome presentation is strongly related to statin use for secondary prevention
No full textAbstract not availableThomas Chan, Bilyana Dabin, Karice Hyun, Isuru Ranasinghe, Lis Neubeck, Bernadette Aliprandi-Costa, Jeffrey Lefkovits, Gerard Devlin, Craig Juergens, Derek P. Chewh, David Brieger, S. Ben Freedma
The Books I Wanted to Write
No full textAuthor lists book titles he would have liked to have written and humorous descriptions of them
Long-term mortality following interhospital transfer for acute myocardial infarction
No full textEditors choiceBACKGROUND: Interhospital transfer of patients admitted with an acute myocardial infarction for specialised care is common and costly. However, the long-term mortality of transferred patients compared with patients solely treated at the presenting hospital has not been evaluated. Here, we assess the long-term mortality of patients who undergo interhospital transfer during their acute myocardial infarction admission. METHODS: We evaluated 40 482 patients with a ICD10-AM diagnosis of acute myocardial infarction admitted to hospitals in New South Wales, Australia, from 2004 to 2008, of whom 10 107 (25%) were transferred. We compared in-hospital and mortality up to 5.5 years postdischarge among transferred and non-transferred patients. We created a 1:1 propensity score matched cohort (n=16 854; 8427 per group) to account for selection bias. RESULTS: In the matched cohort, transferred patients were more likely to undergo revascularisation (55.6% vs 13.7%, RR 4.05; 95% CI 3.83 to 4.29) and had lower mortality at 30 days (3.5% vs 5.7%, HR 0.60; 95% CI 0.52 to 0.70), 1 year (7.5% vs 12.6%, HR 0.58; 95% CI 0.52 to 0.64) and at the end of follow-up (15.3% vs 22.5%, HR 0.65; 95% CI 0.61 to 0.70) than patients treated in presenting hospitals. With the exception of transfers originating from revascularisation capable hospitals, these findings were consistent across a range of subgroups, including patients of all ages, ST-elevation myocardial infarction and non ST-elevation myocardial infarction patients, and transfers originating from hospitals in regional and major city areas. Sensitivity analyses showed that these findings are unlikely to be due to survival bias or to confounding by unmeasured variables. CONCLUSIONS: Patients hospitalised for an acute myocardial infarction who are transferred to one or more hospitals for specialised care have higher rates of coronary revascularisation and experience lower long-term mortality.Isuru Ranasinghe, Federica Barzi, David Brieger, Martin Gallaghe
Long-term outcomes of patients with acute myocardial infarction presenting to regional and remote hospitals
No full textBackground: Acute myocardial infarction (AMI) has poorer outcomes in disadvantaged populations such as those in regional and remote locations. We compared long-term outcomes associated with presentation to regional or remote hospitals among AMI patients. Methods
and Results: Administrative claims data from New South Wales (27% regional and remote residents) was used to identify patients >18 years admitted to any NSW hospital with a principal diagnosis of AMI (ICD10 codes: I21·0-I21·4) between 01/07/2004 and 30/06/2008. Hospital of presentation location with a population of 250,000 were deemed urban. Receipt of revascularisation and mortality were analysed and adjusted for age, comorbidities and previous revascularisation. Patients were censored at death or end of the follow-up period (31 December 2009). 39,798 patients were identified with 9,393 (23.6%) regional and remote presenters. In multivariable models, regional and remote presentation was associated with reduced rates of revascularisation (OR 0.30 95%CI 0.28-0.32; p<0.001), no impact on overall mortality (HR 1.04 95%CI 0.99-1.02; p=0.11), but with increased mortality for patients presenting with STEMI (HR 1.14; 95% CI 1.06-1.23; p<0.001). The propensity analysis was consistent with these findings. Conclusions: Presentation to a regional and remote hospital was associated with lower revascularisation rates following AMI, but with a higher long-term mortality if presenting with ST segment elevation.Sradha Kotwal, Isuru Ranasinghe, David Brieger, Philip Clayton, Alan Cass, Martin Gallaghe
The Matilda Wilson College Proposal of December 1956: The First Curricular Source for Oakland University
No full textIn November 1956, Matilda Dodge Wilson and Alfred Wilson decided to donate their Meadow Brook Farms estate and $2 million to the state of Michigan for the purpose of founding an educational institution. One month later, an 11-page memo envisioning the nature of the future Michigan State University Oakland (MSUO) emerged from the office of the Michigan State University (MSU) Vice President for Academic Affairs, Thomas Hamilton. The document was the first conceptualization of an academic program for the new institution which became MSUO, although the author called it the Matilda Wilson College
Thoughts on the American Dream and Its Future
No full textThe American Dream is an “ideograph”—a master symbol that fuses ideology and rhetoric and that, in the hands of authorities, mobilizes collective action, sentiment, and motive
Comparative effectiveness of population interventions to improve access to reperfusion for ST-segment-elevation myocardial infarction in Australia
No full textData source: Data Supplement, http://circoutcomes.ahajournals.org/content/suppl/2012/05/29/CIRCOUTCOMES.112.965111.DC10BACKGROUND: Improving timely access to reperfusion is a major goal of ST-segment-elevation myocardial infarction care. We sought to compare the population impact of interventions proposed to improve timely access to reperfusion therapy in Australia. METHODS AND RESULTS: Australian hospitals, population, and road network data were integrated using Geographical Information Systems. Hospitals were classified into those that provided primary percutaneous coronary intervention (PPCI) or fibrinolysis. Population impact of interventions proposed to improve timely access to reperfusion (PPCI, fibrinolysis, or both) were modeled and compared. Timely access to reperfusion was defined as the proportion of the population capable of reaching a fibrinolysis facility ≤60 minutes or a PPCI facility ≤120 minutes from emergency medical services activation. The majority (93.2%) of the Australian population has timely access to reperfusion, mainly (53%) through fibrinolysis. Only 40.2% of the population had timely access to PPCI, and access to PPCI services is particularly limited in regional and nonexistent in remote areas. Optimizing the emergency medical services' response or increasing PPCI services resulted in marginal improvement in timely access (1.8% and 3.7%, respectively). Direct transport to PPCI facilities and interhospital transfer for PPCI improves timely access to PPCI for 19.4% and 23.5% of the population, respectively. Prehospital fibrinolysis markedly improved access to timely reperfusion in regional and remote Australia. CONCLUSIONS: Significant gaps in timely provision of reperfusion remain in Australia. Systematic implementation of changes in service delivery has potential to improve timely access to PPCI for a majority of the population and improve access to fibrinolysis to those living in regional and remote areas.Isuru Ranasinghe, Fiona Turnbull, Andrew Tonkin, Robyn A. Clark, Neil Coffee, David Briege
"Die Zahlenwelt ist das Hotel" - Hilbert, Unendlichkeit und der Zahlenteufel in der Grundschule
No full text„Aus dem Paradies, das Cantor uns geschaffen, soll uns niemand vertreiben können“ (Hilbert, 1926, S. 170). Mit diesem Zitat bezieht sich David Hilbert auf die Manifestation des aktual Unendlichen in der Mengenlehre durch Georg Cantor. Zur Verbildlichung der Gleichmächtigkeit von Mengen der Mächtigkeit ℵ kann Hilberts Gedankenexperiment zum unendlich großen, aber vollends von unendlich vielen Gästen ausgebuchten Hotel herangezogen werden. Dieses Gedankenexperiment wurde im Rahmen einer Unterrichtsreihe zur Unendlichkeit an einer Grundschule (3. Klasse) mit Hilfe philosophischer Methoden erschlossen und diskutiert
Forum: What’s Good for the University?
No full textPerspectives on the future direction and needs of Oakland University
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