There is considerable variation in nutrition status for children with severe sepsis treated across this selected network of PICUs from different geographic regions. Severe undernutrition was independently associated with higher all-cause ICU mortality in children with severe sepsis. Severe overnutrition was independently associated with greater ICU length of stay in childhood survivors of severe sepsis.
The method of -stratification aims to reduce item overexposure in computerized adaptive testing, as items that are administered at very high rates may threaten the validity of test scores. In existing methods of -stratification, the item bank is partitioned into a fixed number of nonoverlapping strata according to the items' , or discrimination, parameters. This article introduces a continuous -stratification index which incorporates exposure control into the item selection index itself and thus eliminates the need for fixed discrete strata. The new continuous -stratification index is compared with existing stratification methods via simulation studies in terms of ability estimation bias, mean squared error, and control of item exposure rates.
Employment and health affect one another and mortality. Using the Panel Study of Income Dynamics (1968-2013; n=16,115; 261,804 person-years), we studied life-course dynamics of work, health, and mortality for African American and white women and men. We measured: (1) work limitations due to health; (2) difficulty doing activities of daily living; and (3) permanent disability. Using multinomial logistic Markov models and microsimulation, we created large populations, measuring work and disability status each month for each person, age 20 through death. The average age when African American (white) women with high school education last worked was 60.4 (63.6), when 21.1% (24.9%) were disabled. Analogous results with less education were 58.3 (61.6), and 28.0% (34.1%) (all p<0.001; similar results for men). Disability disparities increased following retirement, a result that questions the fairness of addressing Social Security's financial challenges by raising the retirement age without considering work patterns and ability to work. This paper will explore the experiences of older migrants in work and the challenges they face in extending working life. It is based on two qualitative studies involving older Korean people in the USA and older Chinese in the UK. Older migrants face significant barriers in maintaining employment: multiple discrimination; language barrier; and the lack of formal and transferable skills to name a few. Further, migrant workers are more likely to be in either contingent work or self employment than their native equivalents, and extended working life for many means a longer period of financial insecurity. Because migrant people tend to find work within their communities (neighbourhood enclaves) we argue that if they need to work longer, social support to help them to do so such as training can most effectively be channeled through community organizations. [NH]), are provided to nearly six million frail older adults in the US. Physical and cognitive decline are common among LTSS recipients. However, predictors of health care transitions (i.e., to hospitals, emergency departments, skilled nursing facilities or rehabilitation centers) among this population are poorly understood. The purpose of this study was to examine predictors of health care transitions among a cohort of 470 new LTSS recipients using data collected quarterly over two years. Using multivariable Poisson regression modeling within a generalized estimating equation framework, the mean number of care transitions over the two year period was 3.1 (median=2). New NH and ALF recipients experienced fewer transitions over time, while the transitions' profile for new HCBS recipients remained stable over time (p<0.001, time-LTSS interaction). High baseline quality of life (QoL) ratings were associated with a more rapid decline in transitions over time (p=0.013, time-QOL interaction). For every five additional medications at baseline, the rate of transitions increased by 11.5% (p=0.036) and for older adults requiring ambulation devices ...
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