Publication Type: Poster
Abstract: This study involves a comparative analysis of the demographics of a jail population on a single day (any given day in a jail) in 1999 and 2006 (seven year time period). Has the change in demographics impacted the capacity levels in the jail? Data will be presented on inmate gender, charge type, charge status, and bond type in order to determine what types of offenders are behind bars in these temporary facilities. This research provides a prescription for change to jail administrators nationwide who face the dilemma of either streamlining the process between the courts and jails, adding more beds through expansion, or building new detention centers.

Publication Type: Abstract
Abstract: Objective:
Many studies have assessed the importance of requirements in the selection of health profession students. Some criteria include GPA, Pharmacy College Admissions Test, interview/communication skills, critical thinking skills, and the like. Several studies have also correlated admission criteria with performance and attrition rates. However, few, if any, of these studies have assessed the importance of these criteria from the students’ perspective. The investigators seek to identify which admission qualifications are considered essential to the student for a successful application based on their response.

Hypothesis:
Students in the process of obtaining prerequisite coursework for application to a professional program have significant opinions regarding the weight of admissions criteria.

Methods:
Sample size: 55 pre-pharmacy students currently matriculating in the undergraduate program. Students will complete an anonymous survey identifying and weighing possible admission criteria. They will also be asked to complete an open response section. Appropriate statistical analyses will be performed on the responses. Results will be considered statistically significant if p<0.05.

Outcomes/Implications:
· This survey forces the students to think about what they consider important traits for admission
· This survey could be given to external pre-pharmacy students to determine overlap or exclusion
· The results could be correlated with previous studies that identified admission criteria found to be important by admission officers in health professions schools
· The results could also be correlated with previous studies that identified predictors of success for matriculation in pharmacy school

Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: I explore the doctrine, first announced by Justice Lewis F. Powell, Jr. in University of California Regents v. Bakke in 1978, that the attainment of student body diversity is a constitutionally permissible goal. Justice Sandra Day O'Connor accepted the rule as doctrine in Grutter v. Bollinger in 2003. I argue that although Justices Powell and O'Connor used doctrinal arguments in their opinions, they could have used originalism to arrive at the same result. I further argue that originalism in Constitutional interpretation is required under American republicanism.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: Non-medical factors have been shown to play an important role in medical decision-making. As salient and socially-relevant attributes, excess body mass and its distribution are factors that may influence the course of treatment that hospitalized patients receive, perhaps even at advanced stages of care. This paper asks whether body mass and composition affect patients’ likelihood of being admitted to cardiac care units (CCU), and whether the process differs by gender. Analyses make use of hospital records abstracted prospectively over 20 years from a national survey of adults 25 to 74 years of age at baseline who were hospitalized during the survey (N=4,229). Anthropometric data, self-reported morbidity, and health care resource information are also used. Parameters are estimated with logistic regression with robust standard errors to account for the multistage sampling design. Results indicate that Body Mass Index was associated with greater likelihood of CCU admission, but that central adiposity was related to greater likelihood of CCU admission for women only. The findings suggest that medical personnel use non-medical information when considering serious treatment options for patients, but that adiposity distribution is evaluated differently in men and women.

Publication Type: Abstract
Abstract: Background
Antibiotic resistant infections are an increasing problem in hospitals in terms of the number of resistant organisms and their prevalence. Consequently, the costs of these infections, in terms of mortality, disability, and money, are also increasing. Antibiotic resistance (AR) increases the costs of care in various ways including increased length of stay, more admissions to ICU, and more intensive resource use by inpatients. Furthermore, these additional costs of care often go unreimbursed. Despite the implied incentive to adopt infection prevention guidelines to reduce these AR related costs, hospitals have implemented these guidelines to varying degrees.

Implementing clinical practice guidelines improves health care quality but, because providers incur the implementation costs while resulting savings accrue to payors, the third party payment system typically poses a barrier to guideline implementation. However, implementing infection prevention guidelines may generate provider savings by reducing hospital acquired, including AR, infections. If AR infection levels are to be contained or reduced, economic research must first focus on potential cost savings to the entity with the greatest influence over the adoption and implementation of preventive interventions—the hospital. In this study, we sought to assess the impact of AR levels, outbreaks, and control measures on hospital level expenses-per-admission.

Methods
We surveyed a nationally representative sample of 670 hospitals (stratified by bed size, teaching status, geographic region, and VA versus non-VA status) regarding levels and outbreaks of AR, their adherence to recommended AR prevention and control guidelines, and availability of information technology. Survey data were linked to the American Hospital Association Annual Survey to incorporate other hospital level financial and operational capacity characteristics. We use regression analysis to assess the impact of AR levels, outbreaks, and control measures on hospital expenses-per-admission.

Results
We estimate two cost models with expenses-per-admission as the dependent variable: one assesses the impact of AR levels and outbreaks; the other the impact of specific infection prevention measures. We find that hospital expenses-per-admission increase with levels of MRSA (the most common AR organism). This result was consistent both when pooling VA and non-VA hospitals, and analyzing non-VA hospitals separately. For non-VA hospitals, higher expenses-per-admission are also related to more recent outbreaks of another AR organism, K-ESBL. Cost models incorporating infection prevention measures found that, for non-VA hospitals, (1) using information technology to automate decisions to reduce errors (including, but not limited to, antibiotic prescribing) have lower expenses-per-admission, and (2) hospitals reporting active involvement of their infection control committee in AR prevention and control have higher expenses-per-admission. The former suggests a cost-saving means for hospitals equipped with the necessary IT, while the latter may just reflect the cost of improving quality.

Discussion
The successful implementation of infection prevention and control measures cannot occur without hospital administration support, and administrators will not support such measures until there is evidence that they are associated with cost savings. In presenting evidence that AR increases costs at the hospital level, the results of this study are a first step in providing the business case for improving infection prevention and control.