To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
An estimated 293,300 healthcare-associated cases of Clostridium difficile infection (CDI) occur annually in the United States. To date, research has focused on developing risk prediction models for CDI that work well across institutions. However, this one-size-fits-all approach ignores important hospital-specific factors. We focus on a generalizable method for building facility-specific models. We demonstrate the applicability of the approach using electronic health records (EHR) from the University of Michigan Hospitals (UM) and the Massachusetts General Hospital (MGH).
We utilized EHR data from 191,014 adult admissions to UM and 65,718 adult admissions to MGH. We extracted patient demographics, admission details, patient history, and daily hospitalization details, resulting in 4,836 features from patients at UM and 1,837 from patients at MGH. We used L2 regularized logistic regression to learn the models, and we measured the discriminative performance of the models on held-out data from each hospital.
Using the UM and MGH test data, the models achieved area under the receiver operating characteristic curve (AUROC) values of 0.82 (95% confidence interval [CI], 0.80–0.84) and 0.75 ( 95% CI, 0.73–0.78), respectively. Some predictive factors were shared between the 2 models, but many of the top predictive factors differed between facilities.
A data-driven approach to building models for estimating daily patient risk for CDI was used to build institution-specific models at 2 large hospitals with different patient populations and EHR systems. In contrast to traditional approaches that focus on developing models that apply across hospitals, our generalizable approach yields risk-stratification models tailored to an institution. These hospital-specific models allow for earlier and more accurate identification of high-risk patients and better targeting of infection prevention strategies.
The incidence of schizophrenia and the prevalence of psychotic symptoms in the general adult population are elevated in migrant and ethnic minority groups relative to host populations. These increases are particularly prominent among African-Caribbean migrants to the UK. This study examined the associations of ethnicity and migrant status with a triad of putative antecedents of schizophrenia in a UK community sample of children aged 9–12 years. The antecedent triad comprised: (i) psychotic-like experiences; (ii) a speech and/or motor developmental delay or abnormality; and (iii) a social, emotional or behavioural problem.
Children (n=595) and their primary caregivers, recruited via schools and general practitioners in southeast London, completed questionnaires. Four indices of risk were examined for associations with ethnicity and migrant status: (i) certain experience of at least one psychotic-like experience; (ii) severity of psychotic-like experiences (total psychotic-like experience score); (iii) experience of the antecedent triad; and (iv) severity of antecedent triad experiences (triad score).
African-Caribbean children, as compared to white British children, experienced greater risk on all four indices. There were trends for South Asian and Oriental children to present lowered risk on several indices, relative to white British children. Migration status was unrelated to any risk index.
Prevalence of the putative antecedents of schizophrenia is greater among children of African-Caribbean origin living in the UK than among white British children. This parallels the increased incidence of schizophrenia and elevated prevalence of psychotic symptoms among adults of African-Caribbean origin.
Email your librarian or administrator to recommend adding this to your organisation's collection.