Smaller nursing homes, as measured by average residentsʼ daily census, were less likely to report COVID-19 data (odds ratio (OR) =0.96; P < .001). Nonchain nursing homes were less likely to report data (OR = 0.74; P = .001). When comparing nursing homes with four-star quality ratings, nursing homes with three-star ratings were less likely to follow instructions and report COVID-19 data to CMS (OR = 0.75; P = .044). Measured by years of operation, newer nursing homes were less likely to report COVID-19 cases (OR = 0.99; P = .014). Nursing homes with a higher percentage of White residents and residents aged 65 years and older were less likely to be late reporters (OR = 0.996 (P = .05); and OR = 0.991 (P = .001), respectively). DISCUSSION Participation in data reporting requires particular information technology infrastructure and additional human and financial resources, 4 which may create barriers for smaller nursing homes. A recent study found that smaller nursing homes had a lower probability of having any COVID-19 cases, but after adjusting the size, they had a much higher outbreak size compared with nursing homes with more than 50 beds. 5 It is possible that smaller nursing homes had more COVID-19 cases adjusted by bed capacity. Therefore, they did not have additional resources to report to CMS. A similar trend was observed between chain-affiliated and freestanding nursing homes. Nonchain nursing homes may lack resources to conduct reporting, and they were more likely to have COVID-19 cases. 5 The finding of this study may signal a need to help small and nonchain nursing homes in receiving incentives or resources from CMS to overcome barriers in COVID-19 reporting. Nursing homes that operated longer in the market were more familiar with the requirement by the government in quality reporting, and they were more prepared with resources to comply with COVID-19 reporting. A study found that older adults (aged >65 years) faced a higher risk in getting COVID-19 and developing into critical conditions. 6 With more severe cases and higher death rates from older residents, especially those who are older than 65 years, nursing homes may pay more attention to COVID-19 reporting. We also spotted the racial disparity in reporting COVID-19 cases. Nursing homes with a higher percentage of minority populations were less likely to participate in reporting. Previous studies found that minority residents in nursing homes were more subject to coronavirus, which indicated a disproportionate impact of COVID-19 among different racial and ethnic groups. 5,7-9 Our study is consistent with previous findings, and CMS may need to focus on nursing homes with more minority residents and explore the underlying reasons for the disparity in COVID-19 reporting and residentsʼ cases and deaths. In conclusion, CMS successfully collected COVID-19 data from nursing homes with a wide geographical variation in participation. Additional support may be needed to help small and nonchain nursing homes to make sure they have sufficient resources to comply.
BackgroundMany HIV databases and applications focus on a limited domain of HIV knowledge. Since even a “simple” organism like HIV represents a very complex system with many interacting elements, the fractured structure of existing databases and applications likely limits our ability to investigate and understand HIV. To facilitate research, therefore, we have built HIVToolbox, which integrates much of the knowledge about HIV proteins and presents the data in an interactive web application. HIVToolbox allows quick and convenient hypotheses generation, experiment interpretation, and potential new drug structure creation.MethodsHIVToolbox was built as a standard three-tier J2EE web application, consisting of 1) an underlying relational MySQL database, 2) a set of standard Java data access objects that pull data from the database, and 3) a set of dynamic web pages the user interacts with. HIV-1 data from external sources such as the Protein Data Bank, NCBI, Los Alamos, etc. was collected, curated, and stored in the HIVToolbox database. Additional data, such as homology and position statistics matrices, was generated from existing data. Since version 1, drug binding site and drug resistant mutation data has also been added.ResultsHIVToolbox was used to create several new hypotheses about HIV-1 integrase, including predicting the location of a CK2 phosphorylation site, which was later confirmed by experiment. A new version of HIVToolbox support display of the 3D locations of drug resistant mutations on surface plots of HIV proteins and the drug binding sites for structures of complexes of HIV proteins with drugs.ConclusionHIVToolbox is an open-access web application that allows virologists and structural biologists to access detailed information about HIV-1 proteins, such as sequence, structure, functional sites and relationships, homology, drug binding sites, and drug resistant mutations, and to immediately see the relationships between any or all of them. Weblink: [http://hivtoolbox.bio-toolkit.com]
Introduction:Before October 2012 there was no service level agreement for psychiatry cover in Whiston Hospital, an acute trust in the UK. The Crisis team would visit on goodwill to assess patients. This changed when a Liaison Psychiatry (LP) service was commissioned to provide 24 hour cover, Monday to Sunday for the Emergency Department (ED) for adults.Aims:To quantify waiting times to be assessed by psychiatry, comparing the new LP Service (intervention group) to its predecessor (control). The null hypothesis being that the waiting time for the control and intervention group are the same.Methods:The authors prospectively collected data on all referrals received by the LP service in the first three months of operation n=305 and retrospectively collected data on a random sample of 50 patients referred from ED in the same months 2011 (control).Results:The median time from referral to the time of psychiatric assessment in the control group was 162.5 minutes [IQR 130–330], the mean time was 246.16 [95% CI 180 to 312]. The median time from referral to the time of psychiatric assessment following the introduction of the LP service was 30 minutes [IQR 15-90], the mean time was 79.63 [95% CI 65 to 93]. When the two samples were compared using an independent t test they were significantly different p<0.002.Conclusions:The new LP service has decreased the median wait for a psychiatry assessment by 132 minutes. The team currently seeS 82% of referrals within 60 minutes. This improves patient safety and encourages appropriate and timely discharge.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.