OBJECTIVES:Medication nonadherence is prevalent and associated with adverse outcomes, including hospital readmissions. Outpatient pharmacies within health systems are well positioned to intervene and enhance the discharge process by ensuring that patients leave the hospital with all discharge medications. The goal of this study was to evaluate whether a simply designed discharge prescription program (DPP) could reduce readmission rates and increase patient satisfaction scores for participants versus patients who did not participate.METHODS:We conducted a retrospective cohort study across 15 hospital units in a large health system, evaluating inpatient visits from February 2013 to December 2014. Outcomes included the presence of a 7- or 30-day readmission following discharge date and patient satisfaction survey responses.RESULTS:Patients who participated in the DPP during a hospitalization were significantly less likely to be readmitted than patients who did not participate (P < 0.05). Participation in the DPP decreased odds of 7-day readmission by 20% and of 30-day readmission by 16%. An increase in positive responses for care management and overall experience satisfaction questions was also seen.CONCLUSION:A DPP offers a simple and unique opportunity to reduce readmissions and improve patient satisfaction by dispensing discharge medications before patients leave the hospital.

We conducted an interlaboratory study which differed from the typical study of this type because of its emphasis on comparing intralaboratory variability in results. We sent specimens to six laboratories experienced in the analysis of perfluorinated alkyl compounds in blood matrices and that use stringent procedures to control and assure accuracy and precision. Each received an identical set of 60 plasma specimens that were analyzed in six completely independent batches. Split specimens were included so that within- and between-batch coefficients of variation could be calculated. All laboratories used liquid chromatography–tandem mass spectrometry (LC–MS/MS). The concentrations of perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorohexanesulfonate (PFHxS) measured in the specimens in general showed a high level of agreement, although in some cases the agreement was only moderate. The average within- and between-batch coefficient of variation for PFOS was 9.1% and 9.3%; for PFOA was 14.5% and 14.5%; and for PFHxS was 14.5% and 17.0%. The recent availability of labeled internal standards, among other advances, has facilitated improvement in the accuracy and precision of the assays. Considering the degree of between-subject variation in levels among people in background-exposed populations, the results indicate that biomarker-based epidemiologic studies of associations with health could have reasonable precision.

Perfluorocarboxylic acids have been used in limited but important applications, such as in the production of fluoroelastomers and as components of fire-fighting foams. A method for the measurement of perfluorocarboxylic acids of different chain lengths in air is presented. Chain lengths tested included those having 8, 9, 10, 11, and 13 carbon atoms. Occupational Safety and Health Administration (OSHA) Versatile Sampler airtubes with glass fiber filter, XAD-4 resin, and polyurethane foam were fortified with analyte at levels corresponding to 0.1, 0.5, 1.0, and 2.0 times the level representing a 0.01 mg/m 3 analyte air concentration sampled for 8-hour period with an airflow rate of 1 L/min. Airtube sections were extracted with acetone. Analysis of analyte in airtube fraction extracts was by HPLC/MS using ammonium acetate in water and methanol mobile phase and single ion monitoring for quantification. The lower limit of quantification for the HPLC/MS was set at 0.0001 mg/m 3 for each analyte. Total recoveries of analytes within National Institute for Occupational Safety and Health (NIOSH) guidelines of ± 25% of the true value were obtained at three different atmospheric conditions: ambient, cool/dry, and warm/humid conditions. The maximum loading with acceptable recovery of each analyte was 9600 ng (48000 ng total) for the ambient and warm/humid conditions. The maximum loading with acceptable recovery was 4800 ng (24000 ng total) for the cool/dry condition. The ammonium salt of the eight-carbon perfluorocarboxylic acid, ammonium perfluorooctanoate, was similar to the parent acid in behavior at the ambient condition. Hydrohexadecafluorononanoic acid was tested as a possible surrogate standard for the method, and it was found unsuitable for use because of variable recoveries. Stability studies were completed, and the perfluorocarboxylic acid analytes were stable in airtube samplers for up to 14 days at either ambient or refrigerated condition.

Abstract In order to improve our understanding of the nature, measurement and prediction of salts of perfluorooctanoic acid (PFOA) in air, two studies were performed along the fence line of a fluoropolymer manufacturing facility. First, a six–event, 24–hr monitoring series was performed around the fence line using the OSHA versatile sampler (OVS) system. Perfluorooctanoate concentrations were determined as perfluorooctanoic acid (PFOA) via liquid chromatography and mass spectrometry. Those data indicated that the majority of the PFOA was present as a particulate. No vapor–phase PFOA was detected above a detection limit of approximately 0.07 μg/m3. A follow–up study using a high–volume cascade impactor verified the range of concentrations observed in the OVS data. Both studies aligned with the major transport direction and range of concentrations predicted by an air dispersion model, demonstrating that model predictions agreed with monitoring results. Results from both monitoring methods and predictions from air dispersion modeling showed the primary direction of transport for PFOA was in the prevailing wind direction. The PFOA concentration measured at the site fence over the 10–week sampling period ranged from 0.12 to 0.9 μg/m3. Modeled predictions for the same time period ranged from 0.12 to 3.84 μg/m3. Less than 6% of the particles were larger than 4 μm in size, while almost 60% of the particles were below 0.3 μm. These studies are believed to be the first published ambient air data for PFOA in the environment surrounding a manufacturing facility.

Perfluorooctanoic acid is a completely fluorinated carboxylic acid that is usually used in the ammonium salt form as a processing aid in the production of many fluoropolymers and fluoroelastomers. Ammonium perfluorooctanoate readily dissociates in water to give the ammonium and perfluorooctanoate ions. Peifluorooctanoate has been reported to be present in low levels in human serum in the United States and Europe. This study reports on the development and validation of a method for the determination of perfluorooctanoic acid in air samples. This method uses the Occupational Safety and Health Administration (OSHA) Versatile Sampler (OVS) with a nominal 0.3 mu m filter and polystyrene resin sorbent (XAD-2 or XAD-4)followed by determination of the perfluorooctanoate anion by liquid chromatography mass spectrometry. The method was validated in the range of 0.474 to 47.4 mu g/m(3) for a 480-L sample. Breakthrough studies showed samples could be collected at I L/min for 24 hours or at 15 L/min tip to 8 hours without breakthrough. Extract storage stability tests showed that sample extracts in methanol remain stable in glass autosampler vials for up to 13 days following initial injection. Perfluorooctanoic acid stability on OVS tubes was unaffected at both refrigerated and ambient temperatures. The overall average retention efficiency was 92.1% with a pooled RSD95 of 5.8% at five concentration levels (0.474 mu g/m(3) to 47.4 mu g/m(3).

A method was developed for the trace level analysis of pentadecafluorooctanoic acid (C8), heptadecafluorononanoic acid (C9), nonadecafluorodecanoic acid (C10), heneicosafluoroundecanoic acid (C11) and pentacosafluorotridecanoic acid (C13) in water. Samples were concentrated by solid-phase extraction (SPE) before analysis by combined liquid chromatography/electrospray tandem mass spectrometry (LC/MS/MS). A surrogate standard, 9-hydrohexadecafluorononanoic acid (9H), was used to monitor recovery. The lower limit of quantitation (LLOQ) for C8, C9, C10, C11, and C13 was determined to be 25 ng/L in water. The specificity of the method was established by showing no significant interferences (<20% of the LLOQ standard) in control samples of well, stream, spring, tap, omnisolve, and type I water at the retention time of the target analytes. The linearity of the method was determined; the coefficients of determination for the five calibration curves generated were all >0.985. Good within-day and between-day accuracy and precision were demonstrated. Extracts and standards were shown to be stable after remaining at room temperature for approximately 24 h. Samples fortified with C8, C9, C10, and C11 were shown to be stable after remaining at room temperature for 14 days before extraction. Samples fortified with C13 were shown to be stable after remaining at room temperature for 7 days before extraction. Fortified samples, extracts, and standards demonstrated stability after being stored in a refrigerator for 14 days for all analytes. Long-term storage stability was demonstrated for methanolic stock solutions.

Changes in home owners’ wealth is measured by using an index of property prices constructed from sales transactions. Since only a very small proportion of the housing stock is offered to the market in any given time period, the index is a proxy for change in the price of all properties. The accuracy of the index determines its suitability as a ‘good’ proxy in reflecting price changes. Several methods of index construction may be employed to measure price changes. A brief review of these methodologies and their shortcomings is presented. A hedonic regression analysis is employed to construct an index for ten Melbourne suburbs. The results are compared with the standard approach commonly employed by the property profession.

(2000). A high aperture beamline for vacuum ultraviolet circular dichroism on the srs. Synchrotron Radiation News: Vol. 13, No. 2, pp. 21-27.

This paper examines the diversity of Australian dwelling type and of Australian property occupancy based on ABS census data. A number of standard diversity measures are employed to calculate an index of diversity. In addition to these measures the standard deviation has been employed to provide an ideal with which to make comparisons. While the results indicate that although Australian dwelling type is becoming more diverse, occupancy type is becoming less diverse.

This study employs a large database of pooled data on transaction prices and associated apartment attributes to estimate a number of competing hedonic price equations with the end objective of isolating the separate contributions of height, view and apartment building on the value of high rise apartments in the Melbourne Docklands Apartments Precinct.

Abstract

Residential property represents a major proportion of the wealth held by Australian households. Compared with the rest of the world, home ownership in Australia represents a comparatively larger proportion of personal wealth. The benefits of home ownership are not only important in the creation of wealth and the satisfaction and enjoyment derived from owning one's own home, but can also provide an important financial buffer during retirement. Home ownership is seen as desirable by the vast majority of Australians and has been enthusiastically supported by governments of both political persuasions. Indeed, the fortunes of the housing industry are frequently linked to that of the wider economy. This survey examines the changing structure of the housing market over time and how it has been impacted by a number of key factors.