Screening for diabetes in optometry practices: acceptability to users.

Science.gov (United States)

Howse, Jennifer H; Jones, Steve; Hungin, A Pali S

2011-07-01

Diabetes is a leading cause of blindness in the working age population. While optometrists have an established role in screening people with known diabetes for eye disease, their role in screening for diabetes has not been evaluated. For diabetes screening in optometry practices to be successful it must be acceptable to both optometrists and to the public. The purpose of this study was to determine acceptability to people attending optometry practices of using random capillary blood glucose (rCBG) tests to detect raised blood glucose levels in optometry practices. A screening service offering people with risk factors or symptoms of diabetes rCBG tests was piloted in five high street opticians' practices in North East England. One thousand and two people used the screening service during a 20 week period. Each was given a questionnaire to complete and return following a rCBG test. Nine hundred and thirty-nine questionnaires were returned (return rate 93.7%). The mean age of participants was 54.5 years, 63.3% were female and 75.0% had not been screened for diabetes previously. 99.1% agreed or strongly agreed that the location was convenient for them and 98.0% would recommend others to use the screening service. 83.8% of the participants would not have gone elsewhere to have any tests done and 148 (16.2%) responded that they would have sought a test elsewhere; 14.2% at the GP, 0.8% at a pharmacy and 0.5% elsewhere. Only 3.2% reported that the test procedure was uncomfortable.   To those attending opticians' practices, screening using rCBG tests is acceptable in terms of convenience and test comfort, and they would recommend the test to others. Screening in optometry practices provides an opportunity to identify people at risk of diabetes in a hitherto unutilised setting. Ophthalmic & Physiological Optics © 2011 The College of Optometrists.

Alignment of breast cancer screening guidelines, accountability metrics, and practice patterns.

Science.gov (United States)

Onega, Tracy; Haas, Jennifer S; Bitton, Asaf; Brackett, Charles; Weiss, Julie; Goodrich, Martha; Harris, Kimberly; Pyle, Steve; Tosteson, Anna N A

2017-01-01

Breast cancer screening guidelines and metrics are inconsistent with each other and may differ from breast screening practice patterns in primary care. This study measured breast cancer screening practice patterns in relation to common evidence-based guidelines and accountability metrics. Cohort study using primary data collected from a regional breast cancer screening research network between 2011 and 2014. Using information on women aged 30 to 89 years within 21 primary care practices of 2 large integrated health systems in New England, we measured the proportion of women screened overall and by age using 2 screening definition categories: any mammogram and screening mammogram. Of the 81,352 women in our cohort, 54,903 (67.5%) had at least 1 mammogram during the time period, 48,314 (59.4%) had a screening mammogram. Women aged 50 to 69 years were the highest proportion screened (82.4% any mammogram, 75% screening indication); 72.6% of women at age 40 had a screening mammogram with a median of 70% (range = 54.3%-84.8%) among the practices. Of women aged at least 75 years, 63.3% had a screening mammogram, with the median of 63.9% (range = 37.2%-78.3%) among the practices. Of women who had 2 or more mammograms, 79.5% were screened annually. Primary care practice patterns for breast cancer screening are not well aligned with some evidence-based guidelines and accountability metrics. Metrics and incentives should be designed with more uniformity and should also include shared decision making when the evidence does not clearly support one single conclusion.

Primary care practice organization influences colorectal cancer screening performance.

Science.gov (United States)

Yano, Elizabeth M; Soban, Lynn M; Parkerton, Patricia H; Etzioni, David A

2007-06-01

To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. Primary care director survey (1999-2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (pmanagement and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices.

Recommended Screening Practices for Launch Collision Aviodance

Science.gov (United States)

Beaver, Brian A.; Hametz, Mark E.; Ollivierre, Jarmaine C.; Newman, Lauri K.; Hejduk, Matthew D.

2015-01-01

The objective of this document is to assess the value of launch collision avoidance (COLA) practices and provide recommendations regarding its implementation for NASA robotic missions. The scope of this effort is limited to launch COLA screens against catalog objects that are either spacecraft or debris. No modifications to manned safety COLA practices are considered in this effort. An assessment of the value of launch COLA can be broken down into two fundamental questions: 1) Does collision during launch represent a significant risk to either the payload being launched or the space environment? 2) Can launch collision mitigation be performed in a manner that provides meaningful risk reduction at an acceptable level of operational impact? While it has been possible to piece together partial answers to these questions for some time, the first attempt to comprehensively address them is documented in reference (a), Launch COLA Operations: an Examination of Data Products, Procedures, and Thresholds, Revision A. This report is the product of an extensive study that addressed fundamental technical questions surrounding launch collision avoidance analysis and practice. The results provided in reference (a) will be cited throughout this document as these two questions are addressed. The premise of this assessment is that in order to conclude that launch COLA is a value-added activity, the answer to both of these questions must be affirmative. A "no" answer to either of these questions points toward the conclusion that launch COLA provides little or no risk mitigation benefit. The remainder of this assessment will focus on addressing these two questions.

Domestic violence screening practices of obstetrician-gynecologists.

Science.gov (United States)

Horan, D L; Chapin, J; Klein, L; Schmidt, L A; Schulkin, J

1998-11-01

To ascertain the current knowledge base and screening practices of obstetrician-gynecologists in the area of domestic violence. We mailed a survey to 189 ACOG Fellows who are members of the Collaborative Ambulatory Research Network. Questionnaires were also mailed to a random sample of 1250 nonmember Fellows. Obstetrician-gynecologists are aware of the nature of domestic violence and are familiar with common symptomatology that may be associated with domestic violence. For pregnant patients, 39% of respondents routinely screen at the first prenatal visit; 27% of respondents routinely screen nonpregnant patients at the initial visit. Screening is most likely to occur when the obstetrician-gynecologist suspects a patient is being abused, both during pregnancy (68%) and when the patient is not pregnant (72%). Only 30% of obstetrician-gynecologists received training on domestic violence during medical school; 37% received such instruction during residency training. The majority (67%) have received continuing education on the subject. Years since training and personal experiences with intimate-partner violence were associated with increased screening practices. Routine screening of all women for domestic violence has been recommended by ACOG for more than a decade. The majority of obstetrician-gynecologists screen both pregnant and nonpregnant patients when they suspect abuse. However, with universal screening, more female victims of violence can be identified and can receive needed services.

Screening and assessment of chronic pain among children with cerebral palsy: a process evaluation of a pain toolbox.

Science.gov (United States)

Orava, Taryn; Provvidenza, Christine; Townley, Ashleigh; Kingsnorth, Shauna

2018-06-08

Though high numbers of children with cerebral palsy experience chronic pain, it remains under-recognized. This paper describes an evaluation of implementation supports and adoption of the Chronic Pain Assessment Toolbox for Children with Disabilities (the Toolbox) to enhance pain screening and assessment practices within a pediatric rehabilitation and complex continuing care hospital. A multicomponent knowledge translation strategy facilitated Toolbox adoption, inclusive of a clinical practice guideline, cerebral palsy practice points and assessment tools. Across the hospital, seven ambulatory care clinics with cerebral palsy caseloads participated in a staggered roll-out (Group 1: exclusive CP caseloads, March-December; Group 2: mixed diagnostic caseloads, August-December). Evaluation measures included client electronic medical record audit, document review and healthcare provider survey and interviews. A significant change in documentation of pain screening and assessment practice from pre-Toolbox (<2%) to post-Toolbox adoption (53%) was found. Uptake in Group 2 clinics lagged behind Group 1. Opportunities to use the Toolbox consistently (based on diagnostic caseload) and frequently (based on client appointments) were noted among contextual factors identified. Overall, the Toolbox was positively received and clinically useful. Findings affirm that the Toolbox, in conjunction with the application of integrated knowledge translation principles and an established knowledge translation framework, has potential to be a useful resource to enrich and standardize chronic pain screening and assessment practices among children with cerebral palsy. Implications for Rehabilitation It is important to engage healthcare providers in the conceptualization, development, implementation and evaluation of a knowledge-to-action best practice product. The Chronic Pain Toolbox for Children with Disabilities provides rehabilitation staff with guidance on pain screening and assessment

Standardized assessment of infrared thermographic fever screening system performance

Science.gov (United States)

Ghassemi, Pejhman; Pfefer, Joshua; Casamento, Jon; Wang, Quanzeng

2017-03-01

Thermal modalities represent the only currently viable mass fever screening approach for outbreaks of infectious disease pandemics such as Ebola and SARS. Non-contact infrared thermometers (NCITs) and infrared thermographs (IRTs) have been previously used for mass fever screening in transportation hubs such as airports to reduce the spread of disease. While NCITs remain a more popular choice for fever screening in the field and at fixed locations, there has been increasing evidence in the literature that IRTs can provide greater accuracy in estimating core body temperature if appropriate measurement practices are applied - including the use of technically suitable thermographs. Therefore, the purpose of this study was to develop a battery of evaluation test methods for standardized, objective and quantitative assessment of thermograph performance characteristics critical to assessing suitability for clinical use. These factors include stability, drift, uniformity, minimum resolvable temperature difference, and accuracy. Two commercial IRT models were characterized. An external temperature reference source with high temperature accuracy was utilized as part of the screening thermograph. Results showed that both IRTs are relatively accurate and stable (<1% error of reading with stability of +/-0.05°C). Overall, results of this study may facilitate development of standardized consensus test methods to enable consistent and accurate use of IRTs for fever screening.

STD screening, testing, case reporting, and clinical and partner notification practices: a national survey of US physicians.

Science.gov (United States)

St Lawrence, Janet S; Montaño, Daniel E; Kasprzyk, Danuta; Phillips, William R; Armstrong, Keira; Leichliter, Jami S

2002-11-01

This study presents results from a national survey of US physicians that assessed screening, case reporting, partner management, and clinical practices for syphilis, gonorrhea, chlamydia, and HIV infection. Surveys were mailed to a random sample of 7300 physicians to assess screening, testing, reporting, and partner notification for syphilis, gonorrhea, chlamydia, and HIV. Fewer than one third of physicians routinely screened men or women (pregnant or nonpregnant) for STDs. Case reporting was lowest for chlamydia (37 percent), intermediate for gonorrhea (44 percent), and higher for syphilis, HIV, and AIDS (53 percent-57 percent). Physicians instructed patients to notify their partners (82 percent-89 percent) or the health department (25 percent-34 percent) rather than doing so themselves. STD screening levels are well below practice guidelines for women and virtually nonexistent for men. Case reporting levels are below those legally mandated; physicians rely instead on patients for partner notification. Health departments must increase collaboration with private physicians to improve the quality of STD care.

Promoting chlamydia screening with posters and leaflets in general practice--a qualitative study.

Science.gov (United States)

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-10-12

General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. The NCSP should consider developing a range of more discrete but eye

Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

Science.gov (United States)

Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

2009-01-01

Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP should consider developing

Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

Directory of Open Access Journals (Sweden)

Ford-Young William

2009-10-01

Full Text Available Abstract Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP, have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP

Reader practice in mammography screen reporting in Australia

International Nuclear Information System (INIS)

Reed, W.; Poulos, A.; Brennan, P.

2009-01-01

Full text: Reader variability is a problem in mammography image reporting and compromises the efficacy of screening programmes. The purpose of this exploratory study was to survey reader practice in reporting screening mammograms in Australia to identify aspects of practice that warrant further investigation. Mammography reporting practice and influences on concentration and attention were investigated by using an original questionnaire distributed to screen readers in Australia. A response rate of 71% (83 out of 117) was achieved. Demographic data indicated that the majority of readers were over 46 years of age (73%), have been reporting on screening mammograms for over 10 years (61%), take less than 1 min to report upon a screening mammogram examination (66%), report up to 200 examinations in a single session (83%) and take up to 2 h to report one session (61%). A majority report on more than 5000 examinations annually (66%); 93% of participants regard their search strategy as systematic, 87% agreed that their concentration can vary throughout a session, 64% agreed that the relatively low number of positives can lead to lapses in concentration and attention and almost all (94%) participants agreed that methods to maximise concentration should be explored. Participants identified a range of influences on concentration within their working environment including volume of images reported in one session, image types and aspects of the physical environment. This study has provided important evidence of the need to investigate adverse influences on concentration during mammography screen reporting

Variability in Institutional Screening Practices Related to Collegiate Student-Athlete Mental Health.

Science.gov (United States)

Kroshus, Emily

2016-05-01

Universal screening for mental health concerns, as part of the preparticipation examination in collegiate sports medicine settings, can be an important and feasible strategy for facilitating early detection of mental health disorders. To assess whether sports medicine departments at National Collegiate Athletic Association (NCAA) member colleges have policies related to identifying student-athlete mental health problems, the nature of preparticipation examination screening related to mental health, and whether other departmental or institutional screening initiatives are in place. I also aimed to characterize the variability in screening by institutional characteristics. Cross-sectional study. College sports medicine departments. Team physicians and head athletic trainers at NCAA member colleges (n = 365, 30.3% response rate). Electronic survey of departmental mental health screening activities. A total of 39% of respondents indicated that their institution had a written plan related to identifying student-athletes with mental health concerns. Fewer than half reported that their sports medicine department administers a written or verbal screening instrument for symptoms of disordered eating (44.5%), depression (32.3%), or anxiety (30.7%). The strongest predictors of mental health screening were the presence of a written plan related to identifying student-athlete mental health concerns and the employment of a clinical psychologist. Additionally, Division I institutions and institutions with a greater ratio of athletic trainers to student-athletes tended to engage in more screening. The substantial among-institutions variability in mental health screening suggests that opportunities exist to make these practices more widespread. To address this variability, recent NCAA mental health best-practice guidelines suggested that institutions should screen for a range of mental health disorders and risk behaviors. However, at some institutions, staffing deficits may need to

Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening.

LENUS (Irish Health Repository)

Buckley, B S

2011-12-12

Background:  Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of its diagnosis. Methods:  The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices and barriers to screening. Results:  Prevalence is most often reported as 2-6% of pregnancies. Prevalence may be lower towards the Northern Atlantic seaboard of Europe and higher in the Southern Mediterranean seaboard. Screening practice and policy is inconsistent across Europe, hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. Conclusions:  Europe-wide agreement on screening approaches and diagnostic standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.

Knowledge, attitudes, and practices regarding cervical cancer and screening among Ethiopian health care workers

Directory of Open Access Journals (Sweden)

Kress CM

2015-07-01

Full Text Available Catherine M Kress,1 Lisa Sharling,2 Ashli A Owen-Smith,3 Dawit Desalegn,4 Henry M Blumberg,2 Jennifer Goedken1 1Department of Gynecology and Obstetrics, 2Division of Infectious Diseases, Department of Medicine, 3Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA; 4Department of Gynecology and Obstetrics, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia Background: Though cervical cancer incidence has dramatically decreased in resource rich regions due to the implementation of universal screening programs, it remains one of the most common cancers affecting women worldwide and has one of the highest mortality rates. The vast majority of cervical cancer-related deaths are among women that have never been screened. Prior to implementation of a screening program in Addis Ababa University-affiliated hospitals in Ethiopia, a survey was conducted to assess knowledge of cervical cancer etiology, risk factors, and screening, as well as attitudes and practices regarding cervical cancer screening among women’s health care providers.Methods: Between February and March 2012 an anonymous, self-administered survey to assess knowledge, attitudes, and practices related to cervical cancer and its prevention was distributed to 334 health care providers at three government hospitals in Addis Ababa, Ethiopia and three Family Guidance Association clinics in Awassa, Adama, and Bahir Dar. Data were analyzed using SPSS software and chi-square test was used to test differences in knowledge, attitudes, and practices across provider type.Results: Overall knowledge surrounding cervical cancer was high, although awareness of etiology and risk factors was low among nurses and midwives. Providers had no experience performing cervical cancer screening on a routine basis with <40% having performed any type of cervical cancer screening. Reported barriers to performing screening were lack of

Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

Science.gov (United States)

Choma, Kim; McKeever, Amy E

2015-02-01

The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

Comparative assessment of knowledge, attitude and practice of ...

African Journals Online (AJOL)

This study was carried out to assess the level of knowledge, attitude and practice regarding cervical cancer and its screening among female clinical nursing students in Southern Nigeria. Methodology: ... There is need to adopt urgent and drastic intervention strategies to save our women from unnecessary death. Keywords: ...

Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach.

Science.gov (United States)

Seematter-Bagnoud, Laurence; Büla, Christophe

2018-01-01

This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status. It proposes using brief screening tests in primary care practice to identify patients who may need further comprehensive geriatric assessment or specific interventions.

Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire

Energy Technology Data Exchange (ETDEWEB)

Kirchheiner, K.; Czajka, A.; Komarek, E.; Hohenberg, G.; Poetter, R. [Medical University of Vienna (Austria). Dept. of Radiation Oncology; Ponocny-Seliger, E. [Sigmund Freud Private University, Vienna (Austria). Dept. of Psychology; Doerr, W. [Medical University of Vienna (Austria). Dept. of Radiation Oncology; Medical University of Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology

2013-07-15

Background: In order to identify cancer patients with psychosocial needs during radiotherapy, a routine screening questionnaire is widely recommended in the literature. Several tools focusing mainly on psychological issues have been developed during the past decade. However, problems with their implementation into clinical routine have been repeatedly reported, due to a lack of practicability for clinicians and nurses. This study reports the compilation of a multidisciplinary screening questionnaire and an analysis of the effectiveness of its implementation into clinical routine at the Department of Radiotherapy, Medical University of Vienna. Materials and methods: The screening questionnaire is based on a compilation of several subscales from established and validated assessment tools. It focuses on comprehensive information with high a clinical relevance for all professions. In a pilot study, patients' acceptance was assessed qualitatively. Analysis of missing screening data in consecutively admitted patients reflects the effectiveness of implementation and representativity of the data. A validation analysis of the psychological subscales was performed using external criteria and its internal consistency was tested with Cronbachs' {alpha}. Results: Qualitative patient acceptance of the screening questionnaire is good. The overall response rate in the screening procedure was 75 %. Missing patient screening data sets arose randomly - mainly due to organizational problems - and did not result in systematic errors. The psychological subscales identify highly distressed patients with a sensitivity of 89 and 78 %, and an internal consistency of 0.843 and 0.617. Conclusion: The multidisciplinary screening questionnaire compiled in this study has a high patient acceptance, provides reliable and representative data and identifies highly distressed patients with excellent sensitivity. Although requiring additional personnel resources, it can be implemented

Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire

International Nuclear Information System (INIS)

Kirchheiner, K.; Czajka, A.; Komarek, E.; Hohenberg, G.; Poetter, R.; Ponocny-Seliger, E.; Doerr, W.; Medical University of Vienna

2013-01-01

Background: In order to identify cancer patients with psychosocial needs during radiotherapy, a routine screening questionnaire is widely recommended in the literature. Several tools focusing mainly on psychological issues have been developed during the past decade. However, problems with their implementation into clinical routine have been repeatedly reported, due to a lack of practicability for clinicians and nurses. This study reports the compilation of a multidisciplinary screening questionnaire and an analysis of the effectiveness of its implementation into clinical routine at the Department of Radiotherapy, Medical University of Vienna. Materials and methods: The screening questionnaire is based on a compilation of several subscales from established and validated assessment tools. It focuses on comprehensive information with high a clinical relevance for all professions. In a pilot study, patients' acceptance was assessed qualitatively. Analysis of missing screening data in consecutively admitted patients reflects the effectiveness of implementation and representativity of the data. A validation analysis of the psychological subscales was performed using external criteria and its internal consistency was tested with Cronbachs' α. Results: Qualitative patient acceptance of the screening questionnaire is good. The overall response rate in the screening procedure was 75 %. Missing patient screening data sets arose randomly - mainly due to organizational problems - and did not result in systematic errors. The psychological subscales identify highly distressed patients with a sensitivity of 89 and 78 %, and an internal consistency of 0.843 and 0.617. Conclusion: The multidisciplinary screening questionnaire compiled in this study has a high patient acceptance, provides reliable and representative data and identifies highly distressed patients with excellent sensitivity. Although requiring additional personnel resources, it can be implemented successfully in

Mammographic screening practices among Chinese-Australian women.

Science.gov (United States)

Kwok, Cannas; Fethney, Judith; White, Kate

2012-03-01

To report mammographic screening practice among Chinese-Australian women, and to examine the relationship between demographic characteristics, acculturation factors (English proficiency and length of stay in Australia), cultural beliefs, and having a mammogram as recommended. Cross-sectional and descriptive. The study was conducted in 2009 in Sydney, Australia. Of 988 Chinese-Australian women over 18 years of age invited to participate in the study, 785 (79%) completed and returned the questionnaire. Of these women, 320 (40.8%) were in the target age range of 50 to 69 years. The Chinese Breast Cancer Screening Beliefs Questionnaire (CBCSB) was used as a data collection instrument. Analysis included descriptive statistics, bivariate analysis using chi-square and t tests, and logistic regression. Of the 320 women in the targeted age range of 50 to 69 years, 238 (74.4%) had a mammogram as recommended biannually. Being married-de facto, in the 60 to 69 age group, and speaking Cantonese at home were positively associated with women's mammographic screening practice. However, no statistically significant differences in acculturation factors and having a mammogram as recommended were found. In terms of CBCSB score, women who had mammograms as recommended had more positive attitudes toward health checkups and perceived fewer barriers to mammographic screening. Effort should be focused on specific subgroups of Chinese-Australian women in order to fully understand the barriers involved in participating in mammographic screening. Nurses can use the findings from the present study to design culturally sensitive breast cancer screening programs to encourage women's participation in mammography. © 2011 Sigma Theta Tau International.

National survey by specialty of U.S. physicians' HPV screening practices.

Science.gov (United States)

McCree, Donna Hubbard; Leichliter, Jami S; Hogben, Matthew; St Lawrence, Janet S

2003-02-01

High-risk types of HPV are the primary cause of cervical cancer. This article reports HPV screening and diagnosis from a survey evaluating community-based physicians' screening, testing, and clinical practices for sexually transmitted diseases. Surveys mailed to physicians (n = 7,300) obtained information on patients they screen for HPV and cases of HPV diagnosed. Seventy percent (70%) of the physicians returned completed surveys. HPV screening was most frequently conducted in female patients by obstetrician/gynecologists and family practice physicians.

The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord: screening and diagnosis recommendations.

Science.gov (United States)

Mehta, S; Guy, S D; Bryce, T N; Craven, B C; Finnerup, N B; Hitzig, S L; Orenczuk, S; Siddall, P J; Widerström-Noga, E; Casalino, A; Côté, I; Harvey, D; Kras-Dupuis, A; Lau, B; Middleton, J W; Moulin, D E; O'Connell, C; Parrent, A G; Potter, P; Short, C; Teasell, R; Townson, A; Truchon, C; Wolfe, D; Bradbury, C L; Loh, E

2016-08-01

Clinical practice guidelines. To develop the first Canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury (SCI). The guidelines are relevant for inpatient and outpatient SCI rehabilitation settings in Canada. The CanPainSCI Working Group reviewed evidence to address clinical questions regarding screening and diagnosis of neuropathic pain after SCI. A consensus process was followed to achieve agreement on recommendations and clinical considerations. Twelve recommendations, based on expert consensus, were developed for the screening and diagnosis of neuropathic pain after SCI. The recommendations address methods for assessment, documentation tools, team member accountability, frequency of screening and considerations for diagnostic investigation. Important clinical considerations accompany each recommendation. The expert Working Group developed recommendations for the screening and diagnosis of neuropathic pain after SCI that should be used to inform practice.

A UK guide to intake fish-screening regulations, policy and best practice with particular reference to hydroelectric power schemes

Energy Technology Data Exchange (ETDEWEB)

Turnpenny, A W.H.; Struthers, G; Hanson, P

1998-07-01

A review of fish screening regulations in England, Wales, Scotland, and Northern Ireland is presented, and a summary of findings on screening legislation is given. The views of hydroelectric scheme developers, owners and operators are considered, and recommendations including the development of a risk assessment procedure are discussed. Fish screening technology, bypasses and other escape routes, and common fault in screen design and operation are examined, and guidance to Best Practice is given. (UK)

Health impact assessment in the United States: Has practice followed standards?

International Nuclear Information System (INIS)

Schuchter, Joseph; Bhatia, Rajiv; Corburn, Jason; Seto, Edmund

2014-01-01

As an emerging practice, Health Impact Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and impact of practice. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA Practice Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental Impact Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used practice standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health impacts. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published practice standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and impacts. • Evaluation or monitoring plans were generally not included in

Health impact assessment in the United States: Has practice followed standards?

Energy Technology Data Exchange (ETDEWEB)

Schuchter, Joseph, E-mail: jws@berkeley.edu [University of California, Berkeley, School of Public Health, Department of Environmental Health Sciences, 50 University Hall, Berkeley, CA 94720-7360 (United States); Bhatia, Rajiv [University of California, Berkeley, Institute of Urban and Regional Development (United States); Corburn, Jason [University of California, Berkeley, College of Environmental Design, Department of City and Regional Planning (United States); Seto, Edmund [University of Washington, School of Public Health, Department of Environmental and Occupational Health (United States)

2014-07-01

As an emerging practice, Health Impact Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and impact of practice. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA Practice Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental Impact Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used practice standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health impacts. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published practice standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and impacts. • Evaluation or monitoring plans were generally not included in

Prevalence of Screening-Detected Eating Disorders in Chinese Females and Exploratory Associations with Dietary Practices

Science.gov (United States)

Watson, Hunna J.; Hamer, Robert M.; Thornton, Laura M.; Peat, Christine M.; Kleiman, Susan C.; Du, Shufa; Wang, Huijin; Bulik, Cynthia M.

2014-01-01

Objective China is undergoing dramatic Westernization, hence may be able to provide unique insights into the role of sociocultural factors in disease. The purpose of this exploratory study was two-fold: to describe the prevalence of screening-detected eating disorders and disordered eating in China at the first occasion of assessment in the large-scale China Health and Nutrition Survey (CHNS) and to explore the associations between dietary practices and disordered eating. Regarding the first objective, participants are provincially representative and in subsequent waves will be followed longitudinally. Method CHNS participants were recruited using multistage, cluster random sampling, beginning in 1989. In this study, participants comprised 259 female adolescents (12–17 years) and 979 women (18–35 years) who participated in the CHNS 2009 survey, which is the first CHNS survey to assess disordered eating. Dietary practice-disordered eating associations were investigated with logistic regression adjusting for age, body mass index, and urbanization. Results Of the participants, 6.3% (95% CI: 4.8, 8.2) of adults and 7.8% (95% CI: 5.0, 12.0) of adolescents had a screening-detected eating disorder. Dietary practices had non-significant associations with disordered eating at the general population level, except for protein consumption among women. There was evidence that skipping meals and a high-fat diet may confer risk. Discussion Screening-detected eating disorders in China are lower in prevalence than in developed countries. Dietary practices had fairly limited associations with disordered eating at the general population level; protein consumption, skipping meals, and a high-fat diet are candidate dietary practice exposures for disordered eating. PMID:25407415

Knowledge, attitude and practice for breast cancer risk factors and screening modalities in staff nurses of Ayub teaching hospital Abbottabad

International Nuclear Information System (INIS)

Ahmad, S.; Riaz, A.; Rizwan, M.; Qureshi, N.A.; Atta, S.

2012-01-01

Background: Breast cancer is the commonest cancer modality in female worldwide. Avoiding the risk factors can reduce its incidence and adhering to screening and early detection can reduce its mortality. A sufficient knowledge regarding the risk factors and screening modalities is therefore essential. We assessed the knowledge level about these parameters in our staff nurses. Methods: A self-administered questionnaire survey was performed. Knowledge regarding the risk factors and screening modalities were categorised into good, fair, poor and very poor categories. Results: Knowledge regarding most of the factors was found to be fair. A few things were termed as good knowledge like role of breast-feeding in protecting against breast cancer. Practice regarding the screening modalities was not satisfactory. Only a few nurses had good knowledge of the risk factors and screening modalities. Practice of the Screening modalities was also poor. Conclusion: There is a need to improve the nursing curriculum, training at the workplace and motivate them for screening practices. They should be encouraged to talk to their patients and their female attendants about prevention and early detection of breast cancer. (author)

Knowledge, Attitudes and Practices Regarding Cervical Cancer and Screening among Haitian Health Care Workers

Directory of Open Access Journals (Sweden)

Leilah Zahedi

2014-11-01

Full Text Available It is estimated that Haiti has the highest incidence of cervical cancer in the Western Hemisphere. There are currently no sustainable and affordable cervical cancer screening programs in Haiti. The current status of screening services and knowledge of health care professionals was assessed through a Knowledge, Attitudes, and Practices survey on cervical cancer screening and prevention. It was distributed to Project Medishare for Haiti health care workers (n = 27 in the Central Plateau. The majority (22/27 of participants stated pre-cancerous cells could be detected through screening, however, only four had ever performed a pap smear. All of the participants felt a screening program should be started in their area. Our data establishes that knowledge is fairly lacking among healthcare workers and there is an opportunity to train them in simple, cost effective “screen-and-treat” programs that could have a great impact on the overall health of the population.

Environmental scan of anal cancer screening practices: worldwide survey results

International Nuclear Information System (INIS)

Patel, Jigisha; Salit, Irving E; Berry, Michael J; Pokomandy, Alexandra de; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

2014-01-01

Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

Tuberculosis screening in patients with HIV

DEFF Research Database (Denmark)

Bjerrum, Stephanie Mia Katrine; Bonsu, Frank; Hanson-Nortey, Nii Nortey

2016-01-01

BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...

Cancer Screening Practice among Iranian Middle-aged Women

Directory of Open Access Journals (Sweden)

Behnaz Enjezab

2016-10-01

Full Text Available Background & aim: Breast, cervical, and colorectal cancers are the leading causes of mortality among women, the incidence rate of which has an upward trend with advancing age. Although cost-effective, easy, and available screening programs can help control these types of cancer in their early stages, it seems that cancer screening programs have not been implemented effectively. In this study, we investigated the rate of cancer screening practice in middle-aged women and explained the influential factors. Methods: This cross-sectional study with a sequential mixed method approach was conducted on 483 middle-age women selected through cluster random sampling in Yazd, Iran. Data were obtained by a research made questionnaire and analyzed with descriptive statistics and performing Pearson product-moment correlation, Student’s t-test, and One-way ANOVA tests, using SPSS version 16. In the second phase of the study, qualitative, semi-structured interviews were performed and data were analyzed through content analysis. Results: The majority of the subjects had never been screened for cancer through mammogram (87.7%, Pap test (64.2%, or fecal occult blood test (FOBT (89.8%. Educational level, employment status, perceived adequacy of income, perceived health status, and the number of children were significantly associated with breast and colon cancer screening practice. Qualitative data showed that lack of knowledge, the cost of screening exams, lack of financial independence, negligence of spouse, fear of cancer, embarrassment, and belief in destiny were the main reasons for non-adherence to cancer screening tests. In addition, knowledge and observing cancer in acquaintances and relatives were the main motivators of cancer screening. Conclusion: Middle-aged housewives, as well as women with low educational level and income were the most vulnerable groups, who did not adhere to cancer screening. Planning and management of cancer preventive programs and

Hiring and screening practices of agencies supplying paid caregivers to older adults.

Science.gov (United States)

Lindquist, Lee A; Cameron, Kenzie A; Messerges-Bernstein, Joanne; Friesema, Elisha; Zickuhr, Lisa; Baker, David W; Wolf, Michael

2012-07-01

To assess what screening practices agencies use in hiring caregivers and how caregiver competency is measured before assigning responsibilities in caring for older adults. One-to-one phone interviews in which interviewers posed as prospective clients seeking a caregiver for an older adult relative. Cross-sectional cohort of agencies supplying paid caregivers to older adults in Illinois, California, Florida, Colorado, Arizona, Wisconsin, and Indiana. Four hundred sixty-two home care agencies were contacted, of which 84 were no longer in service, 165 offered only nursing care, and 33 were excluded; 180 agencies completed interviews. Agencies were surveyed about their hiring methods, screening measures, training practices, skill competencies assessments, and supervision. Two coders qualitatively analyzed open-ended responses. To recruit caregivers, agencies primarily used print and Internet (e.g., Craigslist.com) advertising (n = 69, 39.2%) and word-of-mouth referrals (n = 49, 27.8%). In hiring, agencies required prior "life experiences" (n = 121, 68.8%) few of which (n = 33, 27.2%) were specific to caregiving. Screening measures included federal criminal background checks (n = 96, 55.8%) and drug testing (n = 56, 31.8%). Agencies stated that the paid caregiver could perform skills, such as medication reminding (n = 169, 96.0%). Skill competency was assessed according to caregiver self-report (n = 103, 58.5%), testing (n = 62, 35.2%), and client feedback (n = 62, 35.2%). General caregiver training length ranged from 0 to 7 days. Supervision ranged from none to weekly and included home visits, telephone calls, and caregivers visiting the central office. Using an agency to hire paid caregivers may give older adults and their families a false sense of security regarding the background and skill set of the caregiver. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

The iSCREEN Electronic Diabetes Dashboard: A Tool to Improve Knowledge and Implementation of Pediatric Clinical Practice Guidelines.

Science.gov (United States)

Zahanova, Stacy; Tsouka, Alexandra; Palmert, Mark R; Mahmud, Farid H

2017-12-01

Clinical practice guidelines (CPG) provide evidence-based recommendations for patient care but may not be optimally applied in clinical settings. As a pilot study, we evaluated the impact of a computerized, point-of-care decision support system (CDSS) on guideline knowledge and adherence in our diabetes clinic. iSCREEN, a CDSS, integrated with a province-wide electronic health record, was designed based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Evaluation data were gathered by retrospective chart review and clinician questionnaire prior to and after implementation of iSCREEN. Records of patients with type 1 diabetes, 14 to 18 years of age, were assessed for appropriate screening for complications and comorbidities. To assess guideline adherence, 50 charts were reviewed at 2 time periods (25 before and 25 after launch of iSCREEN). Results revealed improved frequency of appropriate screening for diabetic nephropathy (p=0.03) and retinopathy (p=0.04), accompanied by a decrease in under- and overscreening for these outcomes. To assess guideline knowledge, 58 surveys were collected (31 prior to and 27 after the launch of iSCREEN) from care providers in the field of pediatric diabetes. There was a trend toward improved guideline knowledge in all team members (p=0.06). Implementation of a de novo CDSS was associated with improved rates of appropriate screening for diabetes-related complications. A trend toward improvement in health professionals' knowledge of the guidelines was also observed. Evaluation of this point-of-care computerized decision support tool suggests that it may facilitate diabetes care by optimizing complication screening and CPG knowledge, with the potential for broader implementation. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Prevalence of screening-detected eating disorders in chinese females and exploratory associations with dietary practices.

Science.gov (United States)

Watson, Hunna J; Hamer, Robert M; Thornton, Laura M; Peat, Christine M; Kleiman, Susan C; Du, Shufa; Wang, Huijin; Bulik, Cynthia M

2015-01-01

China is undergoing dramatic Westernization, hence may be able to provide unique insights into the role of sociocultural factors in disease. The purpose of this exploratory study was two-fold: to describe the prevalence of screening-detected eating disorders and disordered eating in China at the first occasion of assessment in the large-scale China Health and Nutrition Survey (CHNS) and to explore the associations between dietary practices and disordered eating. Regarding the first objective, participants are provincially representative and in subsequent waves will be followed longitudinally. CHNS participants were recruited using multistage, cluster random sampling, beginning in 1989. In this study, participants comprised 259 female adolescents (12-17 years) and 979 women (18-35 years) who participated in the CHNS 2009 survey, which is the first CHNS survey to assess disordered eating. Dietary practice-disordered eating associations were investigated with logistic regression adjusting for age, body mass index, and urbanization. Of the participants, 6.3% (95% CI: 4.8, 8.2) of adults and 7.8% (95% CI: 5.0, 12.0) of adolescents had a screening-detected eating disorder. Dietary practices had non-significant associations with disordered eating at the general population level, except for protein consumption among women. There was evidence that skipping meals and a high-fat diet may confer risk. Screening-detected eating disorders in China are lower in prevalence than in developed countries. Dietary practices had fairly limited associations with disordered eating at the general population level; protein consumption, skipping meals, and a high-fat diet are candidate dietary practice exposures for disordered eating. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

Directory of Open Access Journals (Sweden)

Karen W. Geletko

2016-11-01

Full Text Available Purpose: The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes. We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. Methods: A statewide sample of Florida primary care medical residents (n = 61 and practicing physicians (n = 53 completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ 2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups. Results: Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes ( P = .0003. Medical residents were more likely to receive information about e-cigarettes from colleagues ( P = .0001. No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations. Conclusions: Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.

Practical determination of sensitometric properties of medical film-screen combinations

International Nuclear Information System (INIS)

Vassileva, J.; Ibrachim, K.

2000-01-01

The aim of the study is to to compare different sensitometric techniques for medical film-screen systems and to chose the optimal one for practical use in a clinical environment and to compare the sensitometric properties of different film-screen combinations practically used for chest radiography. The measurement have been performed using TUR D800-3 radiographic installation with twelve-pulse generator and DRX 124/30/60 oDw tube. The following screens and cassettes have been investigated: VARIMEX (Poland) with PERLUX screens (Germany); DuPomt cassette with QFD screens; Kodak X-Omatic LW cassette with Lanex Regular screens. They have been combined with 4 types of films: Sterling Cronex4 (blue); Agfa CP-BU New (blue); Agfa CP-G Plus (ortho) and Kodak TMG-RA (ortho). All cassettes have been examined for light tightness and screen-film contact and all film types have been checked for the compatibility with the safe lights in the darkroom. To simulate a patient for a chest radiography standard LucAl chest phantom has been designed. The measurements show that: 1) Sensitivity of Kodak cassette with green emitting rare-earth Kodak Lanex Regular screens combined with ortho Kodak film is highest; 2) From two emitting screens - PERLUX and QFD. both combined with blue sensitive films, QFD is 3.6 times more sensitive. 3) Films Agfa CP-BU New and Cronex 4 are of the same sensitivity class but the first has higher contrast. 4) The use of ortho-chromatic films in combination with PERLUX or QGD blue emitting screens results in a considerable loss of sensitivity

Environmental impact assessment screening tool

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-05-01

An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities. 2 figs. 7 refs.

Environmental impact assessment screening tool

International Nuclear Information System (INIS)

1995-05-01

An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities

Eurogin 2016 Roadmap: how HPV knowledge is changing screening practice.

Science.gov (United States)

Wentzensen, Nicolas; Arbyn, Marc; Berkhof, Johannes; Bower, Mark; Canfell, Karen; Einstein, Mark; Farley, Christopher; Monsonego, Joseph; Franceschi, Silvia

2017-05-15

Human papillomaviruses (HPVs) are the necessary cause of most cervical cancers, a large proportion of other anogenital cancers, and a subset of oropharyngeal cancers. The knowledge about HPV has led to development of novel HPV-based prevention strategies with important impact on clinical and public health practice. Two complementary reviews have been prepared following the 2015 Eurogin Conference to evaluate how knowledge about HPV is changing practice in HPV infection and disease control through vaccination and screening. This review focuses on screening for cervical and anal cancers in increasingly vaccinated populations. The introduction of HPV vaccines a decade ago has led to reductions in HPV infections and early cancer precursors in countries with wide vaccination coverage. Despite the high efficacy of HPV vaccines, cervical cancer screening will remain important for many decades. Many healthcare systems are considering switching to primary HPV screening, which has higher sensitivity for cervical precancers and allows extending screening intervals. We describe different approaches to implementing HPV-based screening efforts in different healthcare systems with a focus in high-income countries. While the population prevalence for other anogenital cancers is too low for population-based screening, anal cancer incidence is very high in HIV-infected men who have sex with men, warranting consideration of early detection approaches. We summarize the current evidence on HPV-based prevention of anal cancers and highlight important evidence gaps. © 2016 UICC.

Cancer screening in a middle-aged general population: factors associated with practices and attitudes

Directory of Open Access Journals (Sweden)

Perneger Thomas V

2009-04-01

Full Text Available Abstract Background The aim of this study was to identify factors associated with cancer screening practices and with general attitudes toward cancer screening in a general population. Methods Mailed survey of 30–60 year old residents of Geneva, Switzerland, that included questions about screening for five cancers (breast, cervix uteri, prostate, colon, skin in the past 3 years, attitudes toward screening, health care use, preventive behaviours and socio-demographic characteristics. Cancer screening practice was dichotomised as having done at least one screening test in the past 3 years versus none. Results The survey response rate was 49.3% (2301/4670. More women than men had had at least one cancer screening test in the past 3 years (83.2% vs 34.5%, p Conclusion Attitudes play an important role in cancer screening practices among middle-aged adults in the general population, independent of demographic variables (age and sex that determine in part screening recommendations. Negative attitudes were the most frequent among men and the most socio-economically disadvantaged. The moderate participation rate raises the possibility of selection bias.

Patients’ perceptions of oral cancer screening in dental practice: a cross-sectional study

Science.gov (United States)

2012-01-01

Background Oral cancer is increasing in incidence in the UK and indeed worldwide. Delay in diagnosis is common; up to half of patients are diagnosed with advanced lesions. Thus it is essential to develop methods to aid early detection. This study aimed to assess dental patients’ experiences and awareness of oral cancer and screening within general dental practice. Methods A cross-sectional questionnaire survey of 184 English-speaking adults, with no previous history of oral cancer was conducted. The questionnaire collected data on participant’s knowledge of oral cancer, experience of ‘screening’, attitudes and feelings towards having a screening, anticipated help-seeking behaviours, health-related behaviours (particularly risk factors) and sociodemographics. Results Twenty percent of respondents had never heard of oral cancer; 77% knew little or nothing about it and 72% did not know that their Dentist routinely screens for oral cancer. Overall, attitudes to screening were positive. Ninety two percent of respondents would like their Dentist to tell them if they were being screened for signs of oral cancer and 97% would like help from their Dentists to reduce their risk. Conclusion Patients seem generally unaware of oral cancer screening by their dentist but are happy to take part in screening, would like to be informed, and welcome the support of their Dentist to reduce their risk of developing oral cancer. PMID:23249393

Evaluating Referral, Screening, and Assessment Procedures for Middle School Trauma/Grief-Focused Treatment Groups

Science.gov (United States)

Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.

2018-01-01

There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require…

A brief screening tool for assessing psychological trauma in clinical practice: development and validation of the New York PTSD Risk Score.

Science.gov (United States)

Boscarino, Joseph A; Kirchner, H Lester; Hoffman, Stuart N; Sartorius, Jennifer; Adams, Richard E; Figley, Charles R

2011-01-01

The objective was to develop a brief posttraumatic stress disorder (PTSD) screening instrument that is useful in clinical practice, similar to the Framingham Risk Score used in cardiovascular medicine. We used data collected in New York City after the World Trade Center disaster (WTCD) and other trauma data to develop a new PTSD prediction tool--the New York PTSD Risk Score. We used diagnostic test methods to examine different clinical domains, including PTSD symptoms, trauma exposures, sleep disturbances, suicidal thoughts, depression symptoms, demographic factors and other measures to assess different PTSD prediction models. Using receiver operating curve (ROC) and bootstrap methods, five prediction domains, including core PTSD symptoms, sleep disturbance, access to care status, depression symptoms and trauma history, and five demographic variables, including gender, age, education, race and ethnicity, were identified. For the best prediction model, the area under the ROC curve (AUC) was 0.880 for the Primary Care PTSD Screen alone (specificity=82.2%, sensitivity=93.7%). Adding care status, sleep disturbance, depression and trauma exposure increased the AUC to 0.943 (specificity=85.7%, sensitivity=93.1%), a significant ROC improvement (Pdevelopment and validation samples. The New York PTSD Risk Score is a multifactor prediction tool that includes the Primary Care PTSD Screen, depression symptoms, access to care, sleep disturbance, trauma history and demographic variables and appears to be effective in predicting PTSD among patients seen in healthcare settings. This prediction tool is simple to administer and appears to outperform other screening measures. Copyright © 2011 Elsevier Inc. All rights reserved.

Screening and brief intervention in high schools: School nurses' practices and attitudes in Massachusetts.

Science.gov (United States)

Lunstead, Julie; Weitzman, Elissa R; Kaye, Dylan; Levy, Sharon

2017-01-01

Screening, brief intervention, and referral to treatment (SBIRT) is recommended as a strategy to prevent or reduce adolescent substance use. Offering SBIRT in schools may provide an opportunity to reach adolescents not accessing primary care. The objective is to assess school nurses' attitudes and practices regarding adolescent SBIRT. The authors administered electronically and in person a questionnaire including 29 items on SBIRT attitudes and practices to school nurses registered for the Northeastern University's School Health Institute Summer Program in Massachusetts (N = 168). Survey questions were adapted from a questionnaire originally developed by the American Academy of Pediatrics. One hundred and forty-four nurses completed the survey for a response rate of 85.7%. More than three quarters of the respondents (77.0%) were in favor of universal alcohol screening in schools. None of the respondents reported screening their students on a regular basis. More than half (64.4%) of nurses reported screening students; however, they did so only when they suspected alcohol use. During these instances, only 17.9% used a validated screening tool and almost all (98.2%) used face-to-face clinical interviews. When addressing alcohol use by a student, the large majority of respondents reported including the following recommended clinical strategies: asking about problems related to alcohol use (56.3%), explaining the harms of alcohol use (70.1%), and advising abstinence (73.6%). On average, respondents spend 5 to 10 minutes discussing alcohol use with their students. Survey respondents were supportive of universal alcohol screening in school, although few were doing so at the time. When respondents identified students using alcohol, their interventions were closely aligned with clinical recommendations for brief intervention. Implementation of SBIRT that focuses on standardized, annual screening has the potential to deliver high-quality care in this setting.

Psychological distress and streamlined BreastScreen follow-up assessment versus standard assessment.

Science.gov (United States)

Sherman, Kerry A; Winch, Caleb J; Borecky, Natacha; Boyages, John

2013-11-04

To establish whether altered protocol characteristics of streamlined StepDown breast assessment clinics heightened or reduced the psychological distress of women in attendance compared with standard assessment. Willingness to attend future screening was also compared between the assessment groups. Observational, prospective study of women attending either a mammogram-only StepDown or a standard breast assessment clinic. Women completed questionnaires on the day of assessment and 1 month later. Women attending StepDown (136 women) or standard assessment clinics (148 women) at a BreastScreen centre between 10 November 2009 and 7 August 2010. Breast cancer worries; positive and negative psychological consequences of assessment (Psychological Consequences Questionnaire); breast cancer-related intrusion and avoidance (Impact of Event Scale); and willingness to attend, and uneasiness about, future screening. At 1-month follow-up, no group differences were evident between those attending standard and StepDown clinics on breast cancer worries (P= 0.44), positive (P= 0.88) and negative (P = 0.65) consequences, intrusion (P = 0.64), and avoidance (P = 0.87). Willingness to return for future mammograms was high, and did not differ between groups (P = 0.16), although higher levels of unease were associated with lessened willingness to rescreen (P = 0.04). There was no evidence that attending streamlined StepDown assessments had different outcomes in terms of distress than attending standard assessment clinics for women with a BreastScreen-detected abnormality. However, unease about attending future screening was generally associated with less willingness to do so in both groups; thus, there is a role for psycho-educational intervention to address these concerns.

Suburban Families' Experience With Food Insecurity Screening in Primary Care Practices.

Science.gov (United States)

Palakshappa, Deepak; Doupnik, Stephanie; Vasan, Aditi; Khan, Saba; Seifu, Leah; Feudtner, Chris; Fiks, Alexander G

2017-07-01

Food insecurity (FI) remains a major public health problem. With the rise in suburban poverty, a greater understanding of parents' experiences of FI in suburban settings is needed to effectively screen and address FI in suburban practices. We conducted 23 semistructured interviews with parents of children practices and screened positive for FI. In the interviews, we elicited parents' perceptions of screening for FI, how FI impacted the family, and recommendations for how practices could more effectively address FI. All interviews were audio recorded and transcribed. We used a modified grounded theory approach to code the interviews inductively and identified emerging themes through an iterative process. Interviews continued until thematic saturation was achieved. Of the 23 parents interviewed, all were women, with 39% white and 39% African American. Three primary themes emerged: Parents expressed initial surprise at screening followed by comfort discussing their unmet food needs; parents experience shame, frustration, and helplessness regarding FI, but discussing FI with their clinician helped alleviate these feelings; parents suggested practices could help them more directly access food resources, which, depending on income, may not be available to them through government programs. Although most parents were comfortable discussing FI, they felt it was important for clinicians to acknowledge their frustrations with FI and facilitate access to a range of food resources. Copyright © 2017 by the American Academy of Pediatrics.

Women's knowledge, attitudes and practice about breast cancer screening in the region of Monastir (Tunisia).

Science.gov (United States)

El Mhamdi, Sana; Bouanene, Ines; Mhirsi, Amel; Sriha, Asma; Ben Salem, Kamel; Soltani, Mohamed Soussi

2013-01-01

Breast cancer remains a worldwide public health problem. In Tunisia, it is considered to be the primary women's cancer and causes high morbidity and mortality. This study aimed to investigate female knowledge, attitudes and practice of breast cancer screening in the region of Monastir (Tunisia). We conducted a descriptive cross-sectional design exploring knowledge, attitudes and practices of women in the region of Monastir on breast cancer screening. The study was conducted in health centres of this region from 1 March 2009 to 30 June 2009. Data were collected via a structured questionnaire containing 15 items on demographic status, knowledge of risk factors and screening methods and attitudes towards the relevance and effectiveness of breast cancer screening. A scoring scheme was used to score women's responses. A total of 900 women agreed to take part in the study. Their mean age was 41.6±12.4 years and 64% did not exceed the primary level of education. According to the constructed scores, 92% of participants had poor knowledge of the specific risk factors for breast cancer and 63.2% had poor knowledge of the screening methods. Proper practice of breast cancer screening was observed in 14.3% of cases. Multiple logistic regression analysis showed that good knowledge of risk factors and screening methods, higher level of education and positive family history of breast cancer were independently correlated with breast cancer screening practice. This study revealed poor knowledge of breast cancer and the screening methods as well as low levels of practice of breast cancer screening among women in the region of Monastir. Results justify educational programs to raise women's adherence to breast cancer screening programs in Tunisia.

Visual Impairment Screening Assessment (VISA) tool: pilot validation.

Science.gov (United States)

Rowe, Fiona J; Hepworth, Lauren R; Hanna, Kerry L; Howard, Claire

2018-03-06

To report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors. Prospective case cohort comparative study. Stroke units at two secondary care hospitals and one tertiary centre. 116 stroke survivors were screened, 62 by naïve and 54 by non-naïve screeners. Both the VISA screening tool and the comprehensive specialist vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention. Full completion of VISA tool and specialist vision assessment was achieved for 89 stroke survivors. Missing data for one or more sections typically related to patient's inability to complete the assessment. Sensitivity and specificity of the VISA screening tool were 90.24% and 85.29%, respectively; the positive and negative predictive values were 93.67% and 78.36%, respectively. Overall agreement was significant; k=0.736. Lowest agreement was found for screening of eye movement and visual inattention deficits. This early validation of the VISA screening tool shows promise in improving detection accuracy for clinicians involved in stroke care who are not specialists in vision problems and lack formal eye training, with potential to lead to more prompt referral with fewer false positives and negatives. Pilot validation indicates acceptability of the VISA tool for screening of visual impairment in stroke survivors. Sensitivity and specificity were high indicating the potential accuracy of the VISA tool for screening purposes. Results of this study have guided the revision of the VISA screening tool ahead of full clinical validation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Teaching child psychiatric assessment skills: Using pediatric mental health screening tools.

Science.gov (United States)

Hargrave, T M; Arthur, M E

2015-01-01

This article describes the workshop "Teaching Child Psychiatric Assessment Skills: Using Mental Health Screening Instruments," presented at the 35th Forum for Behavioral Sciences in Family Medicine on 20 September 2014. The goals of the presentation were (1) to teach family medicine behavioral health educators to use both general and problem-specific mental health screening tools (MHSTs) in their work with trainees to help satisfy the Accreditation Council for Graduate Medical Education (ACGME) mandate for behavioral and mental health experience during family medicine residency, (2) to reflect on how MHSTs might be integrated into the flow of family medicine teaching practices, and (3) to exemplify how evidence-based methods of adult education might be used in teaching such content. One general MHST, the Pediatric Symptom Checklist-17 and one problem-specific MHST for each of the four commonest pediatric mental health issues: for attention-deficit hyperactivity disorder, the Vanderbilt; for Anxiety, the Screen for Childhood Anxiety-Related Emotional Disorders; for Depression, the Patient Health Questionnaire-9 for teens; and for Aggression, the Retrospective-Modified Overt Aggression Scale, were practiced at least twice in the context of a clinical vignette. All of the selected MHSTs are free in the public domain and available for download from the website: www.CAPPCNY.org. Participants were asked to reflect on their own office practice characteristics and consider how MHSTs might be integrated into their systems of care. This workshop could be replicated by others wishing to teach the use of MHSTs in primary care settings or teaching programs. © The Author(s) 2015.

[New intensifying screens in clinical radiology. II. Examinations in clinical practice].

Science.gov (United States)

Freyschmidt, J; Saure, D; Hagemann, G

1976-09-01

A clinically applicable procedure for testing new intensifying rare earth screens, as well as the special Siemens' screen is described. The results are related to universal screens. The film-screen combination alpha 4XD (gadolinium oxysulphide with normal, green sensitive film) results in a reduction of radiation dose to half with detail comparable with universal screens. The Siemens' special screen has similar advantages. Screens with a higher intensification factor and reduction of the mAs to one sixth results in loss of detail. This does not necessarily reduce their clinical use if they are used for appropriate purposes. The results of this clinically orientated technique agreed well with physically objective methods using lead grids. The advantages of the new screens are discussed in terms of their practical application.

Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening

Directory of Open Access Journals (Sweden)

Tommi Kärki

2014-10-01

Full Text Available Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59% had implemented screening programmes and 15 (56% had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014. Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96% considered screening among migrants useful, and 24 (92% would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries.

Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials.

Science.gov (United States)

Sheridan, Stacey L; Golin, Carol; Bunton, Audrina; Lykes, John B; Schwartz, Bob; McCormack, Lauren; Driscoll, David; Bangdiwala, Shrikant I; Harris, Russell P

2012-11-13

Professional societies recommend shared decision making (SDM) for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1) examine the effects of a prostate cancer screening intervention to promote SDM and 2) determine whether framing prostate information in the context of other clearly beneficial men's health services affects decisions. We conducted two separate randomized controlled trials of the same prostate cancer intervention (with or without additional information on more clearly beneficial men's health services). For each trial, we enrolled a convenience sample of 2 internal medicine practices, and their interested physicians and male patients with no prior history of prostate cancer (for a total of 4 practices, 28 physicians, and 128 men across trials). Within each practice site, we randomized men to either 1) a video-based decision aid and researcher-led coaching session or 2) a highway safety video. Physicians at each site received a 1-hour educational session on prostate cancer and SDM. To assess intervention effects, we measured key components of SDM, intent to be screened, and actual screening. After finding that results did not vary by trial, we combined data across sites, adjusting for the random effects of both practice and physician. Compared to an attention control, our prostate cancer screening intervention increased men's perceptions that screening is a decision (absolute difference +41%; 95% CI 25 to 57%) and men's knowledge about prostate cancer screening (absolute difference +34%; 95% CI 19% to 50%), but had no effect on men's self-reported participation in shared decisions or their participation at their preferred level. Overall, the intervention decreased screening intent (absolute difference -34%; 95% CI -50% to -18%) and actual screening rates (absolute difference -22%; 95% CI -38 to -7%) with no difference in effect by frame. SDM interventions can

Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses.

Science.gov (United States)

Sinclair, Peter M; Day, Jenny; Levett-Jones, Tracy; Kable, Ashley

2017-10-01

Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia. An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses. Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence. The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting. © 2016 Asian Pacific Society of Nephrology.

Tuberculosis screening in patients with HIV

DEFF Research Database (Denmark)

Bjerrrum, Stephanie; Bonsu, Frank; Hanson-Nortey, Nii Nortey

2016-01-01

BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...... May and October 2014, before and after a performance feedback intervention in August 2014. The outcomes of interest were overall tuberculosis suspicion rate during consultations and provider adherence to the International Standards for Tuberculosis Care and the World Health Organizations' guidelines...

Knowledge, attitudes and practices toward breast cancer screening in a rural South African community

Directory of Open Access Journals (Sweden)

Dorah U. Ramathuba

2015-02-01

Full Text Available Objectives: The study assessed the knowledge, attitudes and breast cancer screening practices amongst women aged 30–65 years residing in a rural South African community. Method: A quantitative, descriptive cross-sectional design was used and a systematic sampling technique was employed to select 150 participants. The questionnaire was pretested for validity and consistency. Ethical considerations were adhered to in protecting the rights of participants. Thereafter, data were collected and analysed descriptively using the Predictive Analytics Software program. Results: Findings revealed that the level of knowledge about breast cancer of women in Makwarani Community was relatively low. The attitude toward breast cancer was negative whereas the majority of women had never performed breast cancer diagnostic methods. Conclusion: Health education on breast cancer screening practices is lacking and the knowledge deficit can contribute negatively to early detection of breast cancer and compound late detection. Based on the findings, community-based intervention was recommended in order to bridge the knowledge gap

Novel simple and practical nutritional screening tool for cancer inpatients: a pilot study.

Science.gov (United States)

Zekri, Jamal; Morganti, Julie; Rizvi, Azhar; Sadiq, Bakr Bin; Kerr, Ian; Aslam, Mohamed

2014-05-01

There is lack of consensus on how nutritional screening and intervention should be provided to cancer patients. Nutritional screening and support of cancer patients are not well established in the Middle East. We report our systematic and practical experience led by a qualified specialist dietician in a cancer inpatient setting, using a novel nutritional screening tool. Ninety-seven consecutive inpatients underwent nutritional screening and categorised into three nutritional risk groups based on oral intake, gastrointestinal symptoms, body mass index (BMI) and weight loss. Nutritional support was introduced accordingly. Statistical tests used included ANOVA, Bonferroni post hoc, chi-square and log rank tests. Median age was 48 (19-87)years. Patients were categorised into three nutritional risk groups: 55 % low, 37 % intermediate and 8 % high. Nutritional intervention was introduced for 36 % of these patients. Individually, weight, BMI, oral intake, serum albumin on admission and weight loss significantly affected nutritional risk and nutritional intervention (all significant P values). Eighty-seven, 60 and 55 % of patients admitted for chemotherapy, febrile neutropenia and other reasons, respectively, did not require specific nutritional intervention. There was a statistically significant relationship between nutritional risk and nutritional intervention (P=0.005). Significantly more patients were alive at 3 months in low (91 %) than intermediate (75 %) than high (37 %)-risk groups. About a third of cancer inpatients require nutritional intervention. The adopted nutritional risk assessment tool is simple and practical. The validity of this tool is supported by its significant relation with known individual nutritional risk factors. This should be confirmed in larger prospective study and comparing this new tool with other established ones.

Cultural Beliefs and Attitudes About Breast Cancer and Screening Practices Among Arabic Women in Australia.

Science.gov (United States)

Kwok, Cannas; Endrawes, Gihane; Lee, Chun Fan

2016-01-01

Arabic women have been consistently reported as having remarkably low participation rates in breast cancer screening measures in their home countries and after migration to Western countries. Little is known about the screening behaviors of Arabic women in Australia. This study aimed to report breast cancer screening practices among Arabic women in Australia and to examine the relationship between (1) demographic factors and (2) the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) score and women's breast screening behaviors. A descriptive cross-sectional method was used. Both English and Arabic versions of the BCSBQ were administered to the 251 Arabic Australian women 18 years or older who participated in the study. The majority of participants (62.9%-92%) had heard of breast awareness, clinical breast examination, and mammography. However, only 7.6% practiced breast awareness monthly, 21.4% had undergone clinical breast examination annually, and 40.3% had biannual mammography. Length of stay in Australia, being retired, and being unemployed were positively associated with the recommended performance of breast awareness and mammography. In terms of BCSBQ scores, women who engaged in the 3 screening practices had significantly higher scores on the attitudes to health check-ups and barriers to mammography subscales. Attitudes toward health check-ups and perceived barriers to mammography were important determinants of breast cancer screening practices among Arabic Australian women. To fully understand barriers discouraging Arabic Australian women from participating in breast cancer screening practices, efforts should be focused on specific subgroup (ie, working group) of Arabic Australian women.

Primary care practice and facility quality orientation: influence on breast and cervical cancer screening rates.

Science.gov (United States)

Goldzweig, Caroline Lubick; Parkerton, Patricia H; Washington, Donna L; Lanto, Andrew B; Yano, Elizabeth M

2004-04-01

Despite the importance of early cancer detection, variation in screening rates among physicians is high. Insights into factors influencing variation can guide efforts to decrease variation and increase screening rates. To explore the association of primary care practice features and a facility's quality orientation with breast and cervical cancer screening rates. Cross-sectional study of screening rates among 144 Department of Veterans Affairs (VA) medical centers and for a national sample of women. We linked practice structure and quality improvement characteristics of individual VA medical centers from 2 national surveys (1 to primary care directors and 1 to a stratified random sample of employees) to breast and cervical cancer screening rates determined from a review of random medical records. We conducted bivariate analyses and multivariate logistic regression of primary care practice and facility features on cancer screening rates, above and below the median. While the national screening rates were high for breast (87%) and cervical cancer (90%), higher screening rates were more likely when primary care providers were consistently notified of specialty visits and when staff perceived a greater organizational commitment to quality and anticipated rewards and recognition for better performance. Organization and quality orientation of the primary care practice and its facility can enhance breast and cervical cancer screening rates. Internal recognition of quality performance and an overall commitment to quality improvement may foster improved prevention performance, with impact varying by clinical service.

Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

Energy Technology Data Exchange (ETDEWEB)

Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

1996-03-01

Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River.

Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

International Nuclear Information System (INIS)

Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

1996-03-01

Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River

Nutritional Risk Screening 2002, Short Nutritional Assessment Questionnaire, Malnutrition Screening Tool, and Malnutrition Universal Screening Tool Are Good Predictors of Nutrition Risk in an Emergency Service.

Science.gov (United States)

Rabito, Estela Iraci; Marcadenti, Aline; da Silva Fink, Jaqueline; Figueira, Luciane; Silva, Flávia Moraes

2017-08-01

There is an international consensus that nutrition screening be performed at the hospital; however, there is no "best tool" for screening of malnutrition risk in hospitalized patients. To evaluate (1) the accuracy of the MUST (Malnutrition Universal Screening Tool), MST (Malnutrition Screening Tool), and SNAQ (Short Nutritional Assessment Questionnaire) in comparison with the NRS-2002 (Nutritional Risk Screening 2002) to identify patients at risk of malnutrition and (2) the ability of these nutrition screening tools to predict morbidity and mortality. A specific questionnaire was administered to complete the 4 screening tools. Outcomes measures included length of hospital stay, transfer to the intensive care unit, presence of infection, and incidence of death. A total of 752 patients were included. The nutrition risk was 29.3%, 37.1%, 33.6%, and 31.3% according to the NRS-2002, MUST, MST, and SNAQ, respectively. All screening tools showed satisfactory performance to identify patients at nutrition risk (area under the receiver operating characteristic curve between 0.765-0.808). Patients at nutrition risk showed higher risk of very long length of hospital stay as compared with those not at nutrition risk, independent of the tool applied (relative risk, 1.35-1.78). Increased risk of mortality (2.34 times) was detected by the MUST. The MUST, MST, and SNAQ share similar accuracy to the NRS-2002 in identifying risk of malnutrition, and all instruments were positively associated with very long hospital stay. In clinical practice, the 4 tools could be applied, and the choice for one of them should be made per the particularities of the service.

Cervical cancer screening: knowledge, attitude and practices among nursing staff in a tertiary level teaching institution of rural India.

Science.gov (United States)

Shekhar, Shashank; Sharma, Chanderdeep; Thakur, Sita; Raina, Nidhi

2013-01-01

Assessment of the nursing staff knowledge, attitude and practices about cervical cancer screening in a tertiary care teaching institute of rural India. A cross sectional, descriptive, interview- based survey was conducted with a pretested questionnaire among 262 staff nurses of a tertiary care teaching and research institute. In this study 77% respondents knew that Pap smear is used for detection of cervical cancer, but less than half knew that Pap smear can detect even precancerous lesions of cervix. Only 23.4% knew human papilloma virus infection as a risk factor. Only 26.7% of the respondents were judged as having adequate knowledge based on scores allotted for questions evaluating knowledge about cervical cancer and screening. Only 17 (7%) of the staff nurses had themselves been screened by Pap smear, while 85% had never taken a Pap smear of a patient. Adequate knowledge of cervical cancer and screening, higher parity and age >30 years were significantly associated with self screening for cervical cancer. Most nurses held a view that Pap test is a doctor procedure, and nearly 90% of nurses had never referred a patient for Pap testing. The majority of nursing staff in rural India may have inadequate knowledge about cervical cancer screening, and their attitude and practices towards cervical cancer screening could not be termed positive.

Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Women Attending a Teaching Hospital, Bharatpur, Chitwan.

Science.gov (United States)

Shrestha, Smita; Dhakal, Prativa

2017-03-01

Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics. Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194). Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening.

Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Women Attending a Teaching Hospital, Bharatpur, Chitwan

Science.gov (United States)

Shrestha, Smita; Dhakal, Prativa

2017-01-01

Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics. Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194). Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening. PMID:29114264

Developing an Assessment (Tool) for Touch Screen Devices.

Science.gov (United States)

Danial-Saad, Alexandra; Chiari, Lorenzo

2017-01-01

Touch screen devices have become prevalent in our lives. Assistive technology experts working with people with disabilities face difficulty in understanding and assessing the problems experienced by individuals with disabilities in operating touch screen devices. This paper presents the processes of collecting and creating the required knowledge needed for assessing the user's skills for operating various touch screen devices, in order to develop an application for assessing the user's abilities and limitations. A six step procedure was used to collect and validate the required knowledge for the assessment from a multidisciplinary team. To determine the agreement levels between the experts, content validity was calculated. To test correlation between the experts from the different disciplines, a comparison was made between the discipline groups and their choice of specific skills/measurements. The final number of domains and skills/measurements was 15 domains and 50 skills/measurements. The result of Cronbach's α test for the final assessment questionnaire (50 skills/measurements) was 0.94, which indicates a high degree of reliability. The results of Kruskal-Wallis test showed the lack of any significant difference between agreements of the clinicians and the technicians groups, but significant differences were found between the educators and the clinicians groups. Each of the skills appearing in the final questionnaire was illustrated in a flowchart in preparation for developing the assessment (tool) for using touch screen devices.

Reliability of a Simple Physical Therapist Screening Tool to Assess Errors during Resistance Exercises for Musculoskeletal Pain

DEFF Research Database (Denmark)

Andersen, Kenneth Jay; Sundstrup, E.; Andersen, L. L.

2014-01-01

The main objective was to investigate the intra- and intertester reliability of a simple screening tool assessing errors in exercise execution by visual observation. 38 participants with no previous resistance exercise experience practiced for two weeks four typical upper limb exercises using ela...

Species for the screening assessment. Columbia River Comprehensive Impact Assessment

International Nuclear Information System (INIS)

Becker, J.M.; Brandt, C.A.; Dauble, D.D.; Maughan, A.D.; O'Neil, T.K.

1996-03-01

Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Comprehensive Impact Assessment was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of the risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to the environment. The objective of the ecological risk assessment is to determine whether contaminants from the Columbia River pose a significant threat to selected receptor species that exist in the river and riparian communities of the study area. This report (1) identifies the receptor species selected for the screening assessment of ecological risk and (2) describes the selection process. The species selection process consisted of two tiers. In Tier 1, a master species list was developed that included many plant and animal species known to occur in the aquatic and riparian systems of the Columbia River between Priest Rapids Dam and the Columbia River estuary. This master list was reduced to 368 species that occur in the study area (Priest Rapids Dam to McNary Dam). In Tier 2, the 181 Tier 1 species were qualitatively ranked based on a scoring of their potential exposure and sensitivity to contaminants using a conceptual exposure model for the study area

Species for the screening assessment. Columbia River Comprehensive Impact Assessment

Energy Technology Data Exchange (ETDEWEB)

Becker, J.M.; Brandt, C.A.; Dauble, D.D.; Maughan, A.D.; O`Neil, T.K.

1996-03-01

Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Comprehensive Impact Assessment was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of the risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to the environment. The objective of the ecological risk assessment is to determine whether contaminants from the Columbia River pose a significant threat to selected receptor species that exist in the river and riparian communities of the study area. This report (1) identifies the receptor species selected for the screening assessment of ecological risk and (2) describes the selection process. The species selection process consisted of two tiers. In Tier 1, a master species list was developed that included many plant and animal species known to occur in the aquatic and riparian systems of the Columbia River between Priest Rapids Dam and the Columbia River estuary. This master list was reduced to 368 species that occur in the study area (Priest Rapids Dam to McNary Dam). In Tier 2, the 181 Tier 1 species were qualitatively ranked based on a scoring of their potential exposure and sensitivity to contaminants using a conceptual exposure model for the study area.

Effects of a 12-Month Educational Intervention on Clinicians' Attitudes/Practices Regarding the Screening Spiritual History.

Science.gov (United States)

Koenig, Harold G; Perno, Kathleen; Erkanli, Alaattin; Hamilton, Ted

2017-06-01

Patients' spiritual values, beliefs, and preferences are identified in outpatient medical settings by the taking of a screening spiritual history (SSH). We report the impact of an educational/training program on the attitudes/practices of physicians (MDs) and midlevel practitioners (MLPs). A convenience sample of 1082 MDs or MLPs in outpatient practices was approached to participate in a 12-month educational/training program in this single-group experimental study. Of the 1082 professionals, 48% (427 physicians, 93 MLPs) agreed to complete a questionnaire assessing demographics, practice characteristics, religiosity, and attitudes/practices regarding the SSH. Changes in attitudes/practices over time were examined and baseline predictors identified using mixed-effects regression. Of the 520 participants completing questionnaires at baseline, 436 were assessed at 1 month (83.8%) and 432 were assessed at 12 months (83.1%). The belief that MDs should take a SSH did not significantly change over time (B = -0.022, standard error [SE] 0.028, P = 0.426). However, those who took an SSH often/always increased from 16.7% at baseline to 34.8% at 12-month follow-up (B = 0.328, SE 0.030, P Educational programs of this type may be used to increase SSH taking by outpatient MDs and MLPs.

Screening-Level Ecological Risk Assessment Methods, Revision 3

Energy Technology Data Exchange (ETDEWEB)

Mirenda, Richard J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2012-08-16

This document provides guidance for screening-level assessments of potential adverse impacts to ecological resources from release of environmental contaminants at the Los Alamos National Laboratory (LANL or the Laboratory). The methods presented are based on two objectives, namely: to provide a basis for reaching consensus with regulators, managers, and other interested parties on how to conduct screening-level ecological risk investigations at the Laboratory; and to provide guidance for ecological risk assessors under the Environmental Programs (EP) Directorate. This guidance promotes consistency, rigor, and defensibility in ecological screening investigations and in reporting those investigation results. The purpose of the screening assessment is to provide information to the risk managers so informed riskmanagement decisions can be made. This document provides examples of recommendations and possible risk-management strategies.

Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky.

Science.gov (United States)

Dignan, Mark; Shelton, Brent; Slone, Stacey A; Tolle, Cheri; Mohammad, Sohail; Schoenberg, Nancy; Pearce, Kevin; Van Meter, Emily; Ely, Gretchen

2014-01-01

This report describes findings from a randomized controlled trial of an intervention to increase colorectal cancer (CRC) screening in primary care practices in Appalachian Kentucky. Sixty-six primary care practices were randomized to early or delayed intervention groups. The intervention was provided at practices using academic detailing, a method of education where providers receive information on a specific topic through personal contact. Data were collected in cross-sectional surveys of medical records at baseline and six months post-intervention. A total of 3844 medical records were reviewed at baseline and 3751 at the six-month follow-up. At baselines, colonoscopy was recommended more frequently (43.4%) than any other screening modality, followed by fecal occult blood testing (18.0%), flexible sigmoidoscopy (0.4%), and double-contrast barium enema (0.3%). Rates of documented screening results were higher for all practices at the six-month follow-up for colonoscopy (31.8% vs 29.6%) and fecal occult blood testing (12.2% vs 11.2%). For early intervention practices that recommended screening, colonoscopy rates increased by 15.7% at six months compared to an increase of 2.4% in the delayed intervention practices (p=.01). Using academic detailing to reach rural primary care providers with a CRC screening intervention was associated with an increase in colonoscopy. Copyright © 2013 Elsevier Inc. All rights reserved.

Screening assessment and requirements for a comprehensive assessment: Volume 1, Draft. Columbia River comprehensive impact assessment

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-04-01

To evaluate the impact to the Columbia River from the Hanford Site-derived contaminants, the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, tribal, stockholder, and public involvement, the CRCIA Management Team was formed in August 1995. The Team agreed to conduct CRCIA using a phased approach. The initial phase, includes two components: 1) a screening assessment to evaluate the potential impact to the river, resulting from current levels of Hanford-derived contaminants in order to support decisions on Interim Remedial Measures, and 2) a definition of the essential work remaining to provide an acceptable comprehensive river impact assessment. The screening assessment is described in Part I of this report. The essential work remaining is Part II of this report. The objective of the screening assessment is to identify areas where the greatest potential exists for adverse effects on humans or the environment. Part I of this report discusses the scope, technical approach, and results of the screening assessment. Part II defines a new paradigm for predecisional participation by those affected by Hanford cleanup decisions.

Screening assessment and requirements for a comprehensive assessment: Volume 1, Draft. Columbia River comprehensive impact assessment

International Nuclear Information System (INIS)

1997-04-01

To evaluate the impact to the Columbia River from the Hanford Site-derived contaminants, the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, tribal, stockholder, and public involvement, the CRCIA Management Team was formed in August 1995. The Team agreed to conduct CRCIA using a phased approach. The initial phase, includes two components: 1) a screening assessment to evaluate the potential impact to the river, resulting from current levels of Hanford-derived contaminants in order to support decisions on Interim Remedial Measures, and 2) a definition of the essential work remaining to provide an acceptable comprehensive river impact assessment. The screening assessment is described in Part I of this report. The essential work remaining is Part II of this report. The objective of the screening assessment is to identify areas where the greatest potential exists for adverse effects on humans or the environment. Part I of this report discusses the scope, technical approach, and results of the screening assessment. Part II defines a new paradigm for predecisional participation by those affected by Hanford cleanup decisions

Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials

Directory of Open Access Journals (Sweden)

Sheridan Stacey L

2012-11-01

Full Text Available Abstract Background Professional societies recommend shared decision making (SDM for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1 examine the effects of a prostate cancer screening intervention to promote SDM and 2 determine whether framing prostate information in the context of other clearly beneficial men’s health services affects decisions. Methods We conducted two separate randomized controlled trials of the same prostate cancer intervention (with or without additional information on more clearly beneficial men’s health services. For each trial, we enrolled a convenience sample of 2 internal medicine practices, and their interested physicians and male patients with no prior history of prostate cancer (for a total of 4 practices, 28 physicians, and 128 men across trials. Within each practice site, we randomized men to either 1 a video-based decision aid and researcher-led coaching session or 2 a highway safety video. Physicians at each site received a 1-hour educational session on prostate cancer and SDM. To assess intervention effects, we measured key components of SDM, intent to be screened, and actual screening. After finding that results did not vary by trial, we combined data across sites, adjusting for the random effects of both practice and physician. Results Compared to an attention control, our prostate cancer screening intervention increased men’s perceptions that screening is a decision (absolute difference +41%; 95% CI 25 to 57% and men’s knowledge about prostate cancer screening (absolute difference +34%; 95% CI 19% to 50%, but had no effect on men’s self-reported participation in shared decisions or their participation at their preferred level. Overall, the intervention decreased screening intent (absolute difference −34%; 95% CI −50% to −18% and actual screening rates (absolute difference −22%; 95% CI −38 to �

Medical Residents' and Practicing Physicians' e-Cigarette Knowledge and Patient Screening Activities: Do They Differ?

Science.gov (United States)

Geletko, Karen W; Myers, Karen; Brownstein, Naomi; Jameson, Breanna; Lopez, Daniel; Sharpe, Alaine; Bellamy, Gail R

2016-01-01

The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes). We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. A statewide sample of Florida primary care medical residents (n = 61) and practicing physicians (n = 53) completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ 2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups. Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes ( P = .0003). Medical residents were more likely to receive information about e-cigarettes from colleagues ( P = .0001). No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations. Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.

Qualitative vs. quantitative data: Controls on the accuracy of PID field screening in petroleum contamination assessment applications

International Nuclear Information System (INIS)

Luessen, M.J.; Allex, M.K.; Holzel, F.R.

1995-01-01

The use of photoionization detectors (PIDs) for field screening of soils for volatile organic contaminants has become a standard industry practice. PID screening data is generally utilized as a qualitative basis for selection of samples for laboratory analysis to quantify concentrations of specific contaminants of concern. Both qualitative field screening data and quantitative laboratory analytical data were reviewed for more than 100 hydrogeologic assessment sites in Ohio to evaluate controls on the effectiveness of field screening data. Assessment data evaluated was limited to sites at which the suspected contaminant source was a gasoline underground storage tanks system. In each case, a 10.0 eV (or greater) PID calibrated for benzene was used to screen soils which were analyzed for benzene, toluene, ethylbenzene and xylene (BTEX) by SW 846 method 8020. Controls on field screening which were evaluated for each site included (1) soil classification, (2) soil moisture, (3) weather conditions, (4) background levels, (5) equipment quality, (6) screening methodology, and (7) laboratory QA/QC. Statistical data analysis predictably indicated a general overestimate of total BTEX levels based on field screening (gasoline is approximately 25 weight percent BTEX). However, data locally indicated cases of both significant (i.e., more than an order of magnitude difference) over- and under-estimation of actual BTEX concentrations (i.e., quantitative laboratory data) by field screening data

Syphilis screening practices in blood transfusion facilities in Ghana

DEFF Research Database (Denmark)

Sarkodie, Francis; Hassall, Oliver; Owusu-Dabo, Ellis

2016-01-01

OBJECTIVES: The primary objective of this study was to compare laboratory practices for screening blood donors for syphilis at blood transfusion facilities in Ghana with the recommendations of the World Health Organization and the National Blood Service, Ghana (NBSG). The prevalence of syphilis a...

Do general practices adhere to organizational guidelines for effective cervical cancer screening?

NARCIS (Netherlands)

Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Braspenning, J C; Grol, R P

BACKGROUND: Well-organized cervical screening has been shown to be effective in the reduction of both morbidity and mortality from cancer of the uterine cervix. In The Netherlands, the GP plays an important role in the cervical screening. The question is whether the general practices are able to

Screening mammography among nursing home residents in the United States: Current guidelines and practice.

Science.gov (United States)

Mack, Deborah S; Epstein, Mara M; Dubé, Catherine; Clark, Robin E; Lapane, Kate L

2018-06-04

United States (US) guidelines regarding when to stop routine breast cancer screening remain unclear. No national studies to-date have evaluated the use of screening mammography among US long-stay nursing home residents. This cross-sectional study was designed to identify prevalence, predictors, and geographic variation of screening mammography among that population in the context of current US guidelines. Screening mammography prevalence, identified with Physician/Supplier Part B claims and stratified by guideline age classification (65-74, ≥75 years), was estimated for all women aged ≥65 years residing in US Medicare- and Medicaid- certified nursing homes (≥1 year) with an annual Minimum Data Set (MDS) 3.0 assessment, continuous Medicare Part B enrollment, and no clinical indication for screening mammography as of 2011 (n = 389,821). The associations between resident- and regional- level factors, and screening mammography, were estimated by crude and adjusted prevalence ratios from robust Poisson regressions clustered by facility. Women on average were 85.4 (standard deviation ±8.1) years old, 77.9% were disabled, and 76.3% cognitively impaired. Screening mammography prevalence was 7.1% among those aged 65-74 years (95% Confidence Interval (CI): 6.8%-7.3%) and 1.7% among those ≥75 years (95% CI, 1.7%-1.8%), with geographic variation observed. Predictors of screening in both age groups included race, cognitive impairment, frailty, hospice, and some comorbidities. These results shed light on the current screening mammography practices in US nursing homes. Thoughtful consideration about individual screening recommendations and the implementation of more clear guidelines for this special population are warranted to prevent overscreening. Copyright © 2018 Elsevier Inc. All rights reserved.

Syphilis screening practices in blood transfusion facilities in Ghana

Directory of Open Access Journals (Sweden)

Francis Sarkodie

2016-02-01

Conclusions: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health.

Impact of Cancer Awareness Drive on Generating Understanding and Improving Screening Practices for Breast Cancer: a Study on College Teachers in India

OpenAIRE

Shankar, Abhishek; Roy, Shubham; Rath, Goura Kishor; Chakraborty, Abhijit; Kamal, Vineet Kumar; Biswas, Aalekhya Sarma

2017-01-01

Background: Breast cancer is the most common cancer among women in India and most present at advanced stage. Although early detection is the only way to reduce morbidity and mortality, people have a very low awareness about breast cancer signs and symptoms and screening practices. The purpose of this study was to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Methods: This assessment was part of a pink chain camp...

Abnormal ovarian cancer screening test result: women's informational, psychological and practical needs.

Science.gov (United States)

Ryan, Patricia Y; Graves, Kristi D; Pavlik, Edward J; Andrykowski, Michael A

2007-01-01

Considerable effort has been devoted to the identification of cost-effective approaches to screening for ovarian cancer (OC). Transvaginal ultrasound (TVS) is one such screening approach. Approximately 5-7% of routine TVS screening tests yield abnormal results. Some women experience significant distress after receipt of an abnormal TVS screening test. Four focus groups provided in-depth, qualitative data regarding the informational, psychological, and practical needs of women after the receipt of an abnormal TVS result. Through question and content analytic procedures, we identified four themes: anticipation, emotional response, role of the screening technician, and impact of prior cancer experiences. Results provide initial guidance toward development of interventions to promote adaptive responses after receipt of an abnormal cancer screening test result.

The assessment of practical skills

OpenAIRE

Reiss, M. J.; Abrahams, I.

2015-01-01

Major changes are currently afoot as to how practical work will be assessed in high status examinations (GCSEs for 16 year-olds and ‘A’ levels for 18 year-olds) in England. We explore here how practical skills might best be assessed in school science and introduce two terms: direct assessment of practical skills (DAPS) and indirect assessment of practical skills (IAPS). We conclude that both the direct and indirect assessment of practical skills have their place in effective assessment of sch...

Intimate partner and sexual violence screening practices of college health care providers.

Science.gov (United States)

Sutherland, Melissa A; Hutchinson, M Katherine

2018-02-01

Female college students experience higher rates of intimate partner violence (IPV) and sexual violence (SV) compared to men of all ages, older women and young women who are not attending college. Experts and medical organizations have issued recommendations that health care providers should routinely screen women for IPV and SV. However, most female college students report they are not being screened for IPV and SV at college health centers. This exploratory study sought to examine the IPV and SV screening practices of college health care providers and identify individual and organizational influences using a cross-sectional, quantitative survey design. Sixty-four health care providers (physicians, nurse practitioners and registered nurses) from five colleges and universities in the northeastern U.S. were invited to participate in an anonymous, web-based survey about their IPV/SV-related screening practices and beliefs, and organizational characteristics of their college health centers. Twenty-six health care providers completed surveys (56% response rate). The median reported IPV/SV screening rate was 15%. More IPV/SV screening was reported by nurse practitioners, providers at state colleges, and by those in health centers that prioritized IPV/SV screening and had greater organizational capacity for change. College health centers represent unique, yet often missed, opportunities to screen for IPV/SV in a high-risk population. Provider- and organization-level influences should be incorporated into future interventions to improve IPV/SV screening in college health centers. Future studies with larger numbers of colleges and providers are needed to better understand organizational influences and identify mediators and moderators of effects. Copyright © 2017 Elsevier Inc. All rights reserved.

Generic Screening Models for Assessing Exposures to the Public and ICRP Reference Animals and Plants

Energy Technology Data Exchange (ETDEWEB)

Yankovich, Tamara L.; Proehl, Gerhard; Telleria, Diego [International Atomic Energy Agency, P.O. Box 100, 1400 Vienna (Austria); Berkovskyy, Volodymyr [Ukrainian Radiation Protection Institute (RPI), 53, Melnikova Street, 04050, Kiev (Ukraine)

2014-07-01

With the update of the IAEA Fundamental Safety Principles (SF-1) stating the objective to protect people and the environment from harmful effects of ionizing radiation, it has been necessary to update International Basic Safety Standards (BSS) on Radiation Protection and Safety of Radiation Sources and the underlying safety guides and technical documents to provide guidance on how this could be achieved in practice. The current paper provides an update on the status and plans to revise the IAEA Safety Report 'Generic Models for Use in Assessing the Impact of Discharges of Radioactive Substances to the Environment' (SRS 19) that was published in 2001. The models of SRS 19 (2001), which was focused on assessment of exposures to the public, is being expanded into three volumes that provide methodologies for screening assessments for the public, as well as for flora and fauna. The revised SRS 19 guide will ultimately facilitate the application of screening models for different levels of assessment using updated parameter values from database that have been developed as part of the IAEA's EMRAS (Environmental Modelling for Radiation Safety) and EMRAS II international model validation programmes. The scope of the revised SRS 19 covers prospective screening assessment of doses to the representative person and Reference Animals and Plants (RAPs), and will provide simple and robust assessment methods for radiological assessment related to planning and design, applying a graded approach. Tabulated screening coefficients and environmental dilution factors will be included for 825 radionuclides. The screening coefficients are developed assuming equilibrium conditions; they can be used to assess radiological impacts arising from routine discharges of radionuclides to terrestrial and aquatic receptors for planned exposure situations. Volumes 1 and 2 of the revised SRS 19 are at an advanced stage of completion and are focused on 'Screening Assessment of Public

Regulations and practices for systematic radiological screening within countries of the European community

International Nuclear Information System (INIS)

Lefaure, C.

1987-01-01

The presentation of the situation concerning the various types of mass radiological screening within the countries of the European community is a brief description of the following: - the status of public regulations, - recommendations issued by medical authorities in various countries, - the actual practices of the medical profession, whether governed or not by the aforementioned regulations and official recommendations. Regulations, recommendations and/or systematic mass radiological screening practices concern mainly three diseases: - tuberculosis, - cancer of the breast, - congenital dislocation of the hip

Knowledge about cervical cancer screening and its practice among female health care workers in southern Ethiopia: a cross-sectional study

Directory of Open Access Journals (Sweden)

Dulla D

2017-05-01

Full Text Available Dubale Dulla,1 Deresse Daka,2 Negash Wakgari1 1School of Nursing and Midwifery, 2Department of Medical Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia Background: Cervical cancer remains a major cause of morbidity and mortality among the women in the world. Early screening for cervical cancer is a key intervention in reduction of maternal deaths. Health care workers have a significant contribution to improve cervical cancer screening practice among women. Hence, this study aimed to assess the knowledge and practice of cervical cancer screening among female health care workers in southern Ethiopia.Methods: Institution-based cross-sectional study was conducted during March and April, 2015. All hospitals in Hawassa city administration and Sidama zone were purposively selected. A simple random sampling technique was used to draw the health centers. After proportional allocations to their respective health facilities, a total of 367 female health workers were selected by simple random sampling technique. A structured and pretested questionnaire was used to collect the data. Data were entered to SPSS version 20.0 for further analysis. Logistic regression analyses were used to see the association of different variables.Results: Out of the total respondents, 319 (86.9% had a good level of knowledge on cervical cancer. Similarly, a majority of them, 329 (89.6%, 321 (87.5%, and 295 (80.4%, knew about the risk factors, symptoms, and outcomes of cervical cancer, respectively. More than two thirds of the respondents, 283 (77.1%, knew that there is a procedure used to detect premalignant cervical lesions and 138 (37.6% of them mentioned visual inspection with acetic acid as a screening method. In this study, only 42 (11.4% of the respondents were screened for cervical cancer (confidence interval [CI]: 8.7, 13.9. Being a physician (adjusted odds ratio [AOR] =0.12, 95% CI: 0.02, 0.79 and working in a cervical cancer

Development of a Social Skills Assessment Screening Scale for Psychiatric Rehabilitation Settings: A Pilot Study.

Science.gov (United States)

Bhola, Poornima; Basavarajappa, Chethan; Guruprasad, Deepti; Hegde, Gayatri; Khanam, Fatema; Thirthalli, Jagadisha; Chaturvedi, Santosh K

2016-01-01

Deficits in social skills may present in a range of psychiatric disorders, particularly in the more serious and persistent conditions, and have an influence on functioning across various domains. This pilot study aimed at developing a brief measure, for structured evaluation and screening for social skills deficits, which can be easily integrated into routine clinical practice. The sample consisted of 380 inpatients and their accompanying caregivers, referred to Psychiatric Rehabilitation Services at a tertiary care government psychiatric hospital. The evaluation included an Inpatient intake Proforma and the 20-item Social Skills Assessment Screening Scale (SSASS). Disability was assessed using the Indian Disability Evaluation and Assessment Scale (IDEAS) for a subset of 94 inpatients. The analysis included means and standard deviations, frequency and percentages, Cronbach's alpha to assess internal consistency, t -tests to assess differences in social skills deficits between select subgroups, and correlation between SSASS and IDEAS scores. The results indicated the profile of social skills deficits assessed among the inpatients with varied psychiatric diagnoses. The "psychosis" group exhibited significantly higher deficits than the "mood disorder" group. Results indicated high internal consistency of the SSASS and adequate criterion validity demonstrated by correlations with select IDEAS domains. Modifications were made to the SSASS following the pilot study. The SSASS has potential value as a measure for screening and individualised intervention plans for social skills training in mental health and rehabilitation settings. The implications for future work on the psychometric properties and clinical applications are discussed.

'Screening audit' as a quality assurance tool in good clinical practice compliant research environments.

Science.gov (United States)

Park, Sinyoung; Nam, Chung Mo; Park, Sejung; Noh, Yang Hee; Ahn, Cho Rong; Yu, Wan Sun; Kim, Bo Kyung; Kim, Seung Min; Kim, Jin Seok; Rha, Sun Young

2018-04-25

With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics and human research protection beyond Institutional Review Board approval. Audits, one of the most effective tools for assessing quality assurance, are measures used to evaluate Good Clinical Practice (GCP) and protocol compliance in clinical research. However, they are laborious, time consuming, and require expertise. Therefore, we developed a simple auditing process (a screening audit) and evaluated its feasibility and effectiveness. The screening audit was developed using a routine audit checklist based on the Severance Hospital's Human Research Protection Program policies and procedures. The measure includes 20 questions, and results are summarized in five categories of audit findings. We analyzed 462 studies that were reviewed by the Severance Hospital Human Research Protection Center between 2013 and 2017. We retrospectively analyzed research characteristics, reply rate, audit findings, associated factors and post-screening audit compliance, etc. RESULTS: Investigator reply rates gradually increased, except for the first year (73% → 26% → 53% → 49% → 55%). The studies were graded as "critical," "major," "minor," and "not a finding" (11.9, 39.0, 42.9, and 6.3%, respectively), based on findings and number of deficiencies. The auditors' decisions showed fair agreement with weighted kappa values of 0.316, 0.339, and 0.373. Low-risk level studies, single center studies, and non-phase clinical research showed more prevalent frequencies of being "major" or "critical" (p = 0.002, audit grade (p audit results of post-screening audit compliance checks in "non-responding" and "critical" studies upon applying the screening audit. Our screening audit is a simple and effective way to assess overall GCP compliance by institutions and to

Nutritional screening for improving professional practice for patient outcomes in hospital and primary care settings.

Science.gov (United States)

Omidvari, Amir-Houshang; Vali, Yasaman; Murray, Susan M; Wonderling, David; Rashidian, Arash

2013-06-06

Given the prevalence of under-nutrition and reports of inadequate nutritional management of patients in hospitals and the community, nutritional screening may play a role in reducing the risks of malnutrition. Screening programmes can invoke costs to health systems and patients. It is therefore important to assess the effectiveness of nutritional screening programmes. To examine the effectiveness of nutritional screening in improving quality of care (professional practice) and patient outcomes compared with usual care. We searched the following databases: CENTRAL (The Cochrane Library), MEDLINE, EMBASE and CINAHL up to June 2012 to find relevant studies. Randomised controlled studies, controlled clinical trials, controlled before-after studies and interrupted time series studies assessing the effectiveness of nutritional screening were eligible for inclusion in the review. We considered process outcomes (for example patient identification, referral to dietitian) and patient outcomes (for example mortality, change in body mass index (BMI)). Participants were adult patients aged 16 years or over. We included studies conducted in different settings, including hospitals, out-patient clinics, primary care or long term care settings. We independently assessed the risk of bias and extracted data from the included studies. Meta-analysis was considered but was not conducted due to the discrepancies between the studies. The studies were heterogeneous in their design, setting, intervention and outcomes. We analysed the data using a narrative synthesis approach. After conducting initial searches and screening the titles and abstracts of the identified literature, 77 full text papers were retrieved and read. Ultimately three studies were included. Two controlled before-after studies were conducted in hospital settings (one in the UK and one in the Netherlands) and one cluster randomised controlled trial was conducted in a primary care setting (in the USA).The study conducted in

Domestic violence screening in a military setting: provider screening and attitudes.

Science.gov (United States)

Lutgendorf, Monica; Busch, Jeanne; Magann, Everett F; Morrison, John C

2010-06-01

Domestic violence is an important healthcare problem, and it appears more prevalent in military patient populations although no one has demonstrated the cause behind this phenomenon. The purpose of this observational study was to assess data regarding domestic violence screening from practitioners at one military training center. This study used an anonymous questionnaire for physicians, nurses and nurse midwives, which surveyed current methods, attitudes toward screening, and barriers for such assessment. Fifty-seven surveys were distributed, and 26 were returned for a response rate of 45.6%. Only about a third (38.5%) of the practitioners screened all obstetric patients while the remainder screened selected patients for domestic violence. Even less (19%) screened gynecology patients routinely, whereas 69% reported they screened selected women with chronic or somatic complaints. A history of prior abuse in the respondents led practitioners to try to identify such patients within their practice. Lack of education or training was the most common barrier to universal screening followed by time constraints and frustration about not being able to address adequately the problem when noted. These results emphasized the importance of an educational program to increase domestic violence awareness and routine screening.

Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009.

Science.gov (United States)

Hennedige, Anusha A; Kong, Tze Yean; Gandhi, Ashu

2011-07-01

Bilateral Breast Reduction (BBR) is a common procedure performed by Breast and Plastic surgeons in the UK. No consensus exists regarding preoperative screening for malignancy or for selective criteria for such screening. Preoperative BBR screening practices among UK Breast and Plastic surgeons are unknown. Ascertain the preoperative and postoperative BBR screening practices of UK Breast and Plastic surgeons. A questionnaire was posted to all 434 Breast and 335 Plastic surgeons in the UK. All results were analysed with relevant statistical methods. 64% of Breast surgeons and 72% of Plastic surgeons responded. 40% of Breast surgeons and 91% of Plastic surgeons perform BBR. Routine radiological screening: 92% Breast 41% Plastic (p Plastic. Routine histology for BBR specimens: 96% Breast 90% Plastic. Selective screening of patients aged 30-40 years old: Breast 38% Plastic 10%. Selective screening of patients aged 40-50: Breast 78%, Plastic 53%. Selective screening of patients with strong family history of breast cancer: Breast 72%, Plastic 91%. Selective screening of patients with previous breast cancer: Breast 77%, Plastic 93%. There are significant differences in practice between UK Breast surgeons and Plastic surgeons in preoperative oncological screening for BBR. The large discrepancy in preoperative radiological screening, reflects a ubiquitous pro-screening ideology among Breast surgeons not prevalent among Plastic surgeons. These results will provoke debate towards the direction of consensus to ultimately reflect best practice. Copyright © 2010. Published by Elsevier Ltd.

An assessment of the utility of unselected coagulation screening in general hospital practice.

LENUS (Irish Health Repository)

McHugh, Johnny

2011-03-01

Coagulation screening using prothrombin time (PT) and activated partial thromboplastin time (APTT) is widely used. We performed an audit of coagulation screening in an Irish teaching hospital. We analysed PT and\\/or APTT results received during normal working hours during a 1-week period in our hospital. Abnormal results due to anticoagulants were excluded from further study. In samples with PT longer than 15.5 s and\\/or APTT longer than 42 s, we proceeded to 1: 1 mixing studies if the PT was prolonged and 1: 1 mixing studies, factor XII assay and lupus screen if the APTT was prolonged. We also obtained referral source for all samples and clinical details for abnormal samples. Six hundred and seventy-one coagulation requests were received during the study period. Three hundred and eighteen of 671 (47.4%) coagulation requests were for monitoring of anticoagulation. Three hundred and fifty-three of 671 (52.6%) requests were for coagulation screening rather than anticoagulant monitoring. In the coagulation screens received, PT was prolonged in 19 of 353 (5.4%). PT was longer than 20 s in four of 353 cases (1.1%). APTT was prolonged in 19 of 353 (5.4%). APTT was longer than 50 s in four of 353 (1.1%). No patients with abnormal PT or APTT had any bleeding sequelae during the study period. Unregulated coagulation screening has a low yield of abnormal results; the majority of these abnormal results show mild prolongation of PT or APTT with no evidence that they are associated with an increased bleeding risk.

Binding-site assessment by virtual fragment screening.

Directory of Open Access Journals (Sweden)

Niu Huang

2010-04-01

Full Text Available The accurate prediction of protein druggability (propensity to bind high-affinity drug-like small molecules would greatly benefit the fields of chemical genomics and drug discovery. We have developed a novel approach to quantitatively assess protein druggability by computationally screening a fragment-like compound library. In analogy to NMR-based fragment screening, we dock approximately 11,000 fragments against a given binding site and compute a computational hit rate based on the fraction of molecules that exceed an empirically chosen score cutoff. We perform a large-scale evaluation of the approach on four datasets, totaling 152 binding sites. We demonstrate that computed hit rates correlate with hit rates measured experimentally in a previously published NMR-based screening method. Secondly, we show that the in silico fragment screening method can be used to distinguish known druggable and non-druggable targets, including both enzymes and protein-protein interaction sites. Finally, we explore the sensitivity of the results to different receptor conformations, including flexible protein-protein interaction sites. Besides its original aim to assess druggability of different protein targets, this method could be used to identifying druggable conformations of flexible binding site for lead discovery, and suggesting strategies for growing or joining initial fragment hits to obtain more potent inhibitors.

Health Risk Screening Practices of Pharmacy and Chemist Shops in ...

African Journals Online (AJOL)

Methodology: Fifty two pharmacy and chemist shops were selected using simple random number sampling technique from 120 registered pharmacy and chemist shops in Jos Metropolis. A semi-structured questionnaire, examining the screening practice of the sales persons was interviewer administered to all the sales ...

Data for the screening assessment. Volume 1: Text, Columbia River Comprehensive Impact Assessment

International Nuclear Information System (INIS)

Miley, T.B.; O'Neil, T.K.; Gilbert, R.O.; Klevgard, L.A.; Walters, T.B.

1996-06-01

The Columbia River is a critical resource for residents of the Pacific Northwest. This resource drew the Manhattan Project's planners to the site now called Hanford to produce nuclear weapon materials. Production of those materials has left behind a legacy of chemical and radioactive contamination and materials that have, are, and will continue to pose a threat to the Columbia river for the foreseeable future. To evaluate the impact to the river from this Hanford-derived contamination, the US Department of Energy, US Environmental Protection Agency, and State of Washington Department of Ecology (the Tri-Party agencies) initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, stakeholder, tribal, and public involvement, the CRCIA Management Team was formed in August 1995. A major CRCIA Team decision was to organize CRCIA into phases, with additional phases to be identified as warranted after completion of the initial phase. The initial phase is comprised of two parts: (1) a screening assessment to evaluate the current impact to the river resulting from Hanford-derived contamination and (2) identification of requirements considered necessary by the CRCIA Management Team for a comprehensive assessment of impact to the river. The purpose of the screening assessment is to support cleanup decisions. The scope of the screening assessment is to evaluate the current risk to humans and the environment resulting from Hanford-derived contaminants. The screening assessment has the primary components of: identifying contaminants to be assessed; identifying a variety of exposure scenarios to evaluate human contaminant exposure; identifying a variety of other species to evaluate ecological contaminant exposure; and assessing risks posed by exposure of humans and other species to the contaminants

Data for the screening assessment. Volume 2: Appendices, Columbia River Comprehensive Impact Assessment

International Nuclear Information System (INIS)

Miley, T.B.; O'Neil, T.K.; Gilbert, R.O.; Klevgard, L.A.; Walters, T.B.

1996-06-01

The Columbia River is a critical resource for residents of the Pacific Northwest. This resource drew the Manhattan Project's planners to the site now called Hanford to produce nuclear weapon materials. Production of those materials has left behind a legacy of chemical and radioactive contamination and materials that have, are, and will continue to pose a threat to the Columbia river for the foreseeable future. To evaluate the impact to the river from this Hanford-derived contamination, the US Department of Energy, US Environmental Protection Agency, and State of Washington Department of Ecology (the Tri-Party agencies) initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, stakeholder, tribal, and public involvement, the CRCIA Management Team was formed in August 1995. A major CRCIA Team decision was to organize CRCIA into phases, with additional phases to be identified as warranted after completion of the initial phase. The initial phase is comprised of two parts: (1) a screening assessment to evaluate the current impact to the river resulting from Hanford-derived contamination and (2) identification of requirements considered necessary by the CRCIA Management Team for a comprehensive assessment of impact to the river. The purpose of the screening assessment is to support cleanup decisions. The scope of the screening assessment is to evaluate the current risk to humans and the environment resulting from Hanford-derived contaminants. The screening assessment has the primary components of: identifying contaminants to be assessed; identifying a variety of exposure scenarios to evaluate human contaminant exposure; identifying a variety of other species to evaluate ecological contaminant exposure; and assessing risks posed by exposure of humans and other species to the contaminants. This volume compiles the data from this study

Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

OpenAIRE

Karen W. Geletko; Karen Myers; Naomi Brownstein; Breanna Jameson; Daniel Lopez; Alaine Sharpe; Gail R. Bellamy

2016-01-01

Purpose: The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes). We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. Methods: A statewide sample of Florida primary care medical residents (n = 61) and practicing physicians (...

Primary prevention and screening practices among long-term breast cancer survivors.

Science.gov (United States)

Mandelzweig, Lori; Chetrit, Angela; Amitai, Tova; Silverman, Barbara; Siegelmann-Danieli, Nava; Sadetzki, Siegal

2017-07-01

Parallel to increasing survival of breast cancer (BC) patients, a need has arisen to characterize the follow-up required to improve and maintain their health. Our study aimed to assess changes in lifestyle habits over time among the study population, compare compliance rates of selected primary and secondary prevention practices between long-term BC survivors and an age-matched comparison group, and identify factors associated with compliance to these practices. The study population comprised 250 Israeli BC survivors, diagnosed with BC between 1999 and 2003, without evidence of disease after 8-12 years, and 250 women with no cancer history, individually matched to survivors by age and area of residence. Data collection and analysis were conducted during August 2012-June 2015 and included socio-demographic variables, lifestyle habits, health promotion by the family physician, and participation in screening procedures and prevention measures. Higher performance rates of mammography and colonoscopy among BC survivors were observed, as well as a greater likelihood of receiving an influenza vaccine and undergoing a bone mineral density scan (adjusted-ORs: 7.7, 1.48, 1.42, and 2.59, respectively) compared to controls. Factors identified with compliance to selected practices were age, higher levels of education and income, never smoking, and strenuous physical activity. The survivors adopted healthier lifestyles, which were similar to those of women who never had cancer. About 10 years after BC diagnosis, the survivors generally comply with primary and secondary prevention practices.

Correlation Between Screening Mammography Interpretive Performance on a Test Set and Performance in Clinical Practice.

Science.gov (United States)

Miglioretti, Diana L; Ichikawa, Laura; Smith, Robert A; Buist, Diana S M; Carney, Patricia A; Geller, Berta; Monsees, Barbara; Onega, Tracy; Rosenberg, Robert; Sickles, Edward A; Yankaskas, Bonnie C; Kerlikowske, Karla

2017-10-01

Evidence is inconsistent about whether radiologists' interpretive performance on a screening mammography test set reflects their performance in clinical practice. This study aimed to estimate the correlation between test set and clinical performance and determine if the correlation is influenced by cancer prevalence or lesion difficulty in the test set. This institutional review board-approved study randomized 83 radiologists from six Breast Cancer Surveillance Consortium registries to assess one of four test sets of 109 screening mammograms each; 48 radiologists completed a fifth test set of 110 mammograms 2 years later. Test sets differed in number of cancer cases and difficulty of lesion detection. Test set sensitivity and specificity were estimated using woman-level and breast-level recall with cancer status and expert opinion as gold standards. Clinical performance was estimated using women-level recall with cancer status as the gold standard. Spearman rank correlations between test set and clinical performance with 95% confidence intervals (CI) were estimated. For test sets with fewer cancers (N = 15) that were more difficult to detect, correlations were weak to moderate for sensitivity (woman level = 0.46, 95% CI = 0.16, 0.69; breast level = 0.35, 95% CI = 0.03, 0.61) and weak for specificity (0.24, 95% CI = 0.01, 0.45) relative to expert recall. Correlations for test sets with more cancers (N = 30) were close to 0 and not statistically significant. Correlations between screening performance on a test set and performance in clinical practice are not strong. Test set performance more accurately reflects performance in clinical practice if cancer prevalence is low and lesions are challenging to detect. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Knowledge, Attitude and Practice of Cervical Smear as a Screening ...

African Journals Online (AJOL)

Context: Carcinoma of the cervix is a preventable disease but it remains the most common genital cancer in African women. Objective: To determine the knowledge, attitude and practice of cervical smear as screening procedure for cervical cancer by female health workers in Ilorin, Nigeria. Study Design, Setting and ...

Good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders.

Science.gov (United States)

2012-04-06

Biochemical genetic testing and newborn screening are essential laboratory services for the screening, detection, diagnosis, and monitoring of inborn errors of metabolism or inherited metabolic disorders. Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations, laboratory testing is categorized on the basis of the level of testing complexity as either waived (i.e., from routine regulatory oversight) or nonwaived testing (which includes tests of moderate and high complexity). Laboratories that perform biochemical genetic testing are required by CLIA regulations to meet the general quality systems requirements for nonwaived testing and the personnel requirements for high-complexity testing. Laboratories that perform public health newborn screening are subject to the same CLIA regulations and applicable state requirements. As the number of inherited metabolic diseases that are included in state-based newborn screening programs continues to increase, ensuring the quality of performance and delivery of testing services remains a continuous challenge not only for public health laboratories and other newborn screening facilities but also for biochemical genetic testing laboratories. To help ensure the quality of laboratory testing, CDC collaborated with the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the National Institutes of Health to develop guidelines for laboratories to meet CLIA requirements and apply additional quality assurance measures for these areas of genetic testing. This report provides recommendations for good laboratory practices that were developed based on recommendations from the Clinical Laboratory Improvement Advisory Committee, with additional input from the Secretary's Advisory Committee on Genetics, Health, and Society; the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children; and representatives of newborn

Influence of qualitative research on women's health screening guidelines.

Science.gov (United States)

Abadir, Anna Maria; Lang, Ariella; Klein, Talia; Abenhaim, Haim Arie

2014-01-01

Considerable time and resources are allocated to carry out qualitative research. The purpose of our study was to evaluate the availability of qualitative research on women's health screening and assess its influence on screening practice guidelines in the United States, Canada, and the United Kingdom. Medline, CINHAL, and WEB of Science databases were used to identify the availability of qualitative research conducted in the past 15 years on 3 different women's health screening topics: cervical cancer screening, breast cancer screening, and prenatal first-trimester screening. Key national practice guidelines on women's health screening were selected using the National Guideline Clearinghouse web site. Bibliometric analysis was used to determine the frequency of qualitative references cited in the guidelines. A total of 272 qualitative research papers on women's health screening was identified: 109 on cervical cancer screening, 104 on breast cancer screening, and 59 on prenatal first-trimester screening. The qualitative studies focused on health care provider perspectives as well as ethical, ethnographic, psychological, and social issues surrounding screening. Fifteen national clinical practice guidelines on women's health screening were identified. A total of 943 references was cited, only 2 of which comprised of qualitative research cited by only 1 clinical practice guideline. Although there is considerable qualitative research that has been carried out on women's health screening, its incorporation into clinical practice guidelines is minimal. Further exploration of the disconnect between the two is important for enhancing knowledge translation of qualitative research within clinical practice. Copyright © 2014 Mosby, Inc. All rights reserved.

Improving the quality of cognitive screening assessments: ACEmobile, an iPad-based version of the Addenbrooke's Cognitive Examination-III.

Science.gov (United States)

Newman, Craig G J; Bevins, Adam D; Zajicek, John P; Hodges, John R; Vuillermoz, Emil; Dickenson, Jennifer M; Kelly, Denise S; Brown, Simona; Noad, Rupert F

2018-01-01

Ensuring reliable administration and reporting of cognitive screening tests are fundamental in establishing good clinical practice and research. This study captured the rate and type of errors in clinical practice, using the Addenbrooke's Cognitive Examination-III (ACE-III), and then the reduction in error rate using a computerized alternative, the ACEmobile app. In study 1, we evaluated ACE-III assessments completed in National Health Service (NHS) clinics ( n  = 87) for administrator error. In study 2, ACEmobile and ACE-III were then evaluated for their ability to capture accurate measurement. In study 1, 78% of clinically administered ACE-IIIs were either scored incorrectly or had arithmetical errors. In study 2, error rates seen in the ACE-III were reduced by 85%-93% using ACEmobile. Error rates are ubiquitous in routine clinical use of cognitive screening tests and the ACE-III. ACEmobile provides a framework for supporting reduced administration, scoring, and arithmetical error during cognitive screening.

Assessment of stereoscopic optic disc images using an autostereoscopic screen – experimental study

Directory of Open Access Journals (Sweden)

Vaideanu Daniella

2008-07-01

Full Text Available Abstract Background Stereoscopic assessment of the optic disc morphology is an important part of the care of patients with glaucoma. The aim of this study was to assess stereoviewing of stereoscopic optic disc images using an example of the new technology of autostereoscopic screens compared to the liquid shutter goggles. Methods Independent assessment of glaucomatous disc characteristics and measurement of optic disc and cup parameters whilst using either an autostereoscopic screen or liquid crystal shutter goggles synchronized with a view switching display. The main outcome measures were inter-modality agreements between the two used modalities as evaluated by the weighted kappa test and Bland Altman plots. Results Inter-modality agreement for measuring optic disc parameters was good [Average kappa coefficient for vertical Cup/Disc ratio was 0.78 (95% CI 0.62–0.91 and 0.81 (95% CI 0.6–0.92 for observer 1 and 2 respectively]. Agreement between modalities for assessing optic disc characteristics for glaucoma on a five-point scale was very good with a kappa value of 0.97. Conclusion This study compared two different methods of stereo viewing. The results of assessment of the different optic disc and cup parameters were comparable using an example of the newly developing autostereoscopic display technologies as compared to the shutter goggles system used. The Inter-modality agreement was high. This new technology carries potential clinical usability benefits in different areas of ophthalmic practice.

Assessment of Uncertainty-Based Screening Volumes for NASA Robotic LEO and GEO Conjunction Risk Assessment

Science.gov (United States)

Narvet, Steven W.; Frigm, Ryan C.; Hejduk, Matthew D.

2011-01-01

Conjunction Assessment operations require screening assets against the space object catalog by placing a pre-determined spatial volume around each asset and predicting when another object will violate that volume. The selection of the screening volume used for each spacecraft is a trade-off between observing all conjunction events that may pose a potential risk to the primary spacecraft and the ability to analyze those predicted events. If the screening volumes are larger, then more conjunctions can be observed and therefore the probability of a missed detection of a high risk conjunction event is small; however, the amount of data which needs to be analyzed increases. This paper characterizes the sensitivity of screening volume size to capturing typical orbit uncertainties and the expected number of conjunction events observed. These sensitivities are quantified in the form of a trade space that allows for selection of appropriate screen-ing volumes to fit the desired concept of operations, system limitations, and tolerable analyst workloads. This analysis will specifically highlight the screening volume determination and selection process for use in the NASA Conjunction Assessment Risk Analysis process but will also provide a general framework for other Owner / Operators faced with similar decisions.

Association of eHealth literacy with colorectal cancer knowledge and screening practice among internet users in Japan.

Science.gov (United States)

Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Oka, Koichiro

2012-11-13

In rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables. The present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices. Data were analyzed for 2970 Japanese adults (men, 49.9%; mean age±SD, 39.7±10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models. eHealth literacy was positively associated with CRC knowledge (β=.116, increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI=1.01-1.05) more likely to undergo CRC screening. Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy.

Can Australian radiographers assess screening mammograms accurately? First stage results from a four year prospective study

International Nuclear Information System (INIS)

Moran, S.; Warren-Forward, H.

2016-01-01

Introduction: Globally, the role of the radiographer is changing; some countries have developed advanced roles with specific scopes of practice. Other countries, like Australia, are in the process of this change. The aim of this research is to assess the diagnostic outcomes reported by the radiographers and compare them to those reported by current screen readers. Method: Six experienced radiographers were invited to participate in a prospective study conducted between 2010 and 2011. They were required to read 2000 mammograms each. Their results were compared with those of the radiologists. Statistical analysis of the results included overall cancer detection rates, recall rates, levels of agreement, kappa, sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results: A total of 9348 women were included in the study. The percentage of cancers detected by the radiographers ranged from 53% to 100% of the cancers detected by the radiologists. Radiologist recall rate ranged between 3.4% and 5.5% and the radiographers' range was 2.9%–9.8%. Level of agreement of the radiographers with the radiologists ranged from 90 to 96%. Conclusion: The potential for accuracy in screen reading by Australian radiographers is supported by the results of this study. Implementation of formal training is likely to result in an increase in the diagnostic accuracy of radiographers. - Highlights: • Radiographers prospectively read 2000 screening mammograms each. • These results support potential for accuracy in screen reading by radiographers. • Will advanced practice be introduced within BreastScreen Australia?.

Red reflex screening in New Zealand: a large survey of practices and attitudes in the Auckland region.

Science.gov (United States)

Raoof, Naz; Dai, Shuan

2016-07-15

Red reflex testing forms an essential part of newborn (within the first week of life) and infant (6 weeks of age) screening in New Zealand, as outlined in the Well Child/Tamariki Ora handbook. This survey of practitioners undertaking red reflex screening aimed to determine current practices and attitudes of screeners, as well as any barriers to screening. A short, multiple-choice, on-line questionnaire was sent to approximately 1,500 health care professionals undertaking red reflex screening, over a 4-week period. Four hundred and eighty-three survey responses were received from 267 GPs (55.4%), 153 midwives (31.7%), and 50 paediatricians (10.4%). Thirty-six respondents (7.8%) performed red reflex screening only when they had time to do so, 13 (2.8%) only undertook this when there were concerns raised by the parents. Most respondents (97.3%) used an ophthalmoscope to perform screening. Seventynine respondents (16.6%) felt they were "not sure/underconfident" at performing this test. Only 83 of 479 respondents (17.3%) had received any formal training. The development of an online resource or practical 'refresher' sessions would be well received and likely to improve current practices.

Hit Identification and Optimization in Virtual Screening: Practical Recommendations Based Upon a Critical Literature Analysis

Science.gov (United States)

Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B.; Szukala, Richard; Johnson, Michael E.; Hevener, Kirk E.

2013-01-01

A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, drug-like, and ADMET filters were applied to the reported hits to assess the quality of compounds reported and a careful analysis of a subset of the studies which presented hit optimization was performed. This data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, defining hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria. PMID:23688234

Hit identification and optimization in virtual screening: practical recommendations based on a critical literature analysis.

Science.gov (United States)

Zhu, Tian; Cao, Shuyi; Su, Pin-Chih; Patel, Ram; Shah, Darshan; Chokshi, Heta B; Szukala, Richard; Johnson, Michael E; Hevener, Kirk E

2013-09-12

A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses, and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, druglike, and ADMET filters were applied to the reported hits to assess the quality of compounds reported, and a careful analysis of a subset of the studies that presented hit optimization was performed. These data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, definition of hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria.

Breast cancer screening practices of African migrant women in Australia: a descriptive cross-sectional study.

Science.gov (United States)

Ogunsiji, Olayide Oluyemisi; Kwok, Cannas; Fan, Lee Chun

2017-04-17

Breast cancer is the most diagnosed cancer among women and a leading cause of mortality and morbidity, globally. Breast cancer mortality can be improved through routine cancer screening, yet migrant populations have lower participation rates. While African migrants are among the fastest growing migrant population in Australia, their breast cancer screening behaviour is under-studied. The aims of this study were to report breast cancer screening status of African migrant women and factors associated with their breast cancer screening behaviour in Australia. A descriptive, cross-sectional approach was utilised for this study. Two hundred and sixty four African migrant women aged 18-69 years and recruited from a number of organisations responded to a self-reported African version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Main research variables are breast cancer screening practices and demographic characteristics and total scores on each of the BCSBQ subscales. Multivariable logistic regression analyses were performed to investigate the impact of the demographic variables on the likelihood of women in the target age range 50-74 years having screening practices as recommended. While most of the participants heard of breast awareness (76.1%) and mammogram (85.2%), only 11.4% practised monthly breast awareness, whereas 65.9% had ever had a mammogram as frequently as recommended. Age and employment were determining factors for participating in mammogram. Significant different scores were found in the "Practical barriers" between women at the target age who had and had not performed breast awareness (80.4 versus 77.5, p-value = 0.002) and mammogram (77.1 versus 70.3, p-value = 0.009) regularly as recommended. Moreover, attitudes towards general health check-ups subscale scores were significantly higher in women who had performed clinical breast examination as frequently as recommended than those who had not. The research reveals that practical

Screening test recommendations for methicillin-resistant Staphylococcus aureus surveillance practices: A cost-minimization analysis.

Science.gov (United States)

Whittington, Melanie D; Curtis, Donna J; Atherly, Adam J; Bradley, Cathy J; Lindrooth, Richard C; Campbell, Jonathan D

2017-07-01

To mitigate methicillin-resistant Staphylococcus aureus (MRSA) infections, intensive care units (ICUs) conduct surveillance through screening patients upon admission followed by adhering to isolation precautions. Two surveillance approaches commonly implemented are universal preemptive isolation and targeted isolation of only MRSA-positive patients. Decision analysis was used to calculate the total cost of universal preemptive isolation and targeted isolation. The screening test used as part of the surveillance practice was varied to identify which screening test minimized inappropriate and total costs. A probabilistic sensitivity analysis was conducted to evaluate the range of total costs resulting from variation in inputs. The total cost of the universal preemptive isolation surveillance practice was minimized when a polymerase chain reaction screening test was used ($82.51 per patient). Costs were $207.60 more per patient when a conventional culture was used due to the longer turnaround time and thus higher isolation costs. The total cost of the targeted isolation surveillance practice was minimized when chromogenic agar 24-hour testing was used ($8.54 per patient). Costs were $22.41 more per patient when polymerase chain reaction was used. For ICUs that preemptively isolate all patients, the use of a polymerase chain reaction screening test is recommended because it can minimize total costs by reducing inappropriate isolation costs. For ICUs that only isolate MRSA-positive patients, the use of chromogenic agar 24-hour testing is recommended to minimize total costs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Optimizing Team Dynamics: An Assessment of Physician Trainees and Advanced Practice Providers Collaborative Practice.

Science.gov (United States)

Foster, Cortney B; Simone, Shari; Bagdure, Dayanand; Garber, Nan A; Bhutta, Adnan

2016-09-01

The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. PubMed, CINAHL, OVID MEDLINE, and Cochrane Review from 2002 to 2015. Experimental study designs conducted in an ICU setting. Two reviewers screened articles for eligibility and independently abstracted data using the identified search terms. We found 21 articles describing ICU team structure and outcomes. Four articles were found describing the impact of advanced practice providers on resident or fellow education. Two articles were found discussing strategies to promote collaboration between advanced practice providers and critical care fellows or residents. Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.

Quality Assessment of Colonoscopy Reporting: Results from a Statewide Cancer Screening Program

Directory of Open Access Journals (Sweden)

Jun Li

2010-01-01

Full Text Available This paper aimed to assess quality of colonoscopy reports and determine if physicians in practice were already documenting recommended quality indicators, prior to the publication of a standardized Colonoscopy Reporting and Data System (CO-RADS in 2007. We examined 110 colonoscopy reports from 2005-2006 through Maryland Colorectal Cancer Screening Program. We evaluated 25 key data elements recommended by CO-RADS, including procedure indications, risk/comorbidity assessments, procedure technical descriptions, colonoscopy findings, specimen retrieval/pathology. Among 110 reports, 73% documented the bowel preparation quality and 82% documented specific cecal landmarks. For the 177 individual polyps identified, information on size and morphology was documented for 87% and 53%, respectively. Colonoscopy reporting varied considerately in the pre-CO-RADS period. The absence of key data elements may impact the ability to make recommendations for recall intervals. This paper provides baseline data to assess if CO-RADS has an impact on reporting and how best to improve the quality of reporting.

Knowledge and Practices Related to Screening for Breast Cancer among Women in Delhi, India

Science.gov (United States)

Dahiya, Neha; Basu, Saurav; Singh, Megha Chandra; Garg, Suneela; Kumar, Rajesh; Kohli, Charu

2018-01-27

Background: Breast cancer is a major public health problem globally. The ongoing epidemiological, socio-cultural and demographic transition by accentuating the associated risk factors has disproportionately increased the incidence of breast cancer cases and resulting mortality in developing countries like India. Early diagnosis with rapid initiation of treatment reduces breast cancer mortality. Therefore awareness of breast cancer risk and a willingness to undergo screening are essential. The objective of the present study was to assess the knowledge and practices relating to screening for breast cancer among women in Delhi. Methods: Data were obtained from 222 adult women using a pretested selfadministered questionnaire. Results: Rates for knowledge of known risk factors of breast cancer were: family history of breast cancer, 59.5%; smoking, 57.7%; old age, 56.3%; lack of physical exercise, 51.9%; lack of breastfeeding, 48.2%; late menopause, 37.4%; and early menarche, 34.7%. Women who were aged awareness generation among adult women regarding risk factors and methods for early detection of breast cancer. Creative Commons Attribution License

Evaluation of low-dose CT implementation for lung cancer screening in a general practice hospital

Science.gov (United States)

Karostik, D. V.; Kamyshanskaya, I. G.; Cheremisin, V. M.; Drozdov, A. A.; Vodovatov, A. V.

2018-02-01

The aim of the current study was to evaluate the possibility of the implementation of LDCT for the screening for lung cancer and tuberculosis in a typical general hospital practice. Diagnostic and economic effectiveness, patient doses and the corresponding radiation risks for LDCT were compared with the existing digital chest screening radiography. The results of the study indicate that the implementation of LDCT allowed verifying false-positive cases or providing additional excessive diagnostic information, but did not significantly improve the sensitivity of screening. Per capita costs for LDCT were higher compared to digital radiography up to a factor of 12; corresponding radiation risk - by a factor of 4. Hence, it was considered unjustified to implement LDCT in a general practice hospital.

Breast cancer screening awareness, knowledge, and practice among arab women in the United Arab Emirates: a cross-sectional survey.

Directory of Open Access Journals (Sweden)

Yusra E Elobaid

Full Text Available BACKGROUND: Breast cancer screening can reduce morbidity and mortality and improve the survival rate for this malignancy. Low participation in screening programs has been attributable to many factors including lack of knowledge. The aim of this study was to assess breast cancer screening knowledge, attitudes and practices among women of screening age (≥40 years old in the city of Al Ain, United Arab Emirates (UAE. METHODS: A cross-sectional survey was conducted in 2013 using the Breast Cancer Awareness Measure (CAM. Four out of twelve cultural and religious community centers in Al Ain city were randomly selected. Two hundred and forty seven women were interviewed. Chi Square test and regression analysis were used to analyze the data. RESULTS: Despite the increase in the uptake of screening modalities in our study group, a lack of knowledge about breast cancer screening is still evident. Almost half (44.8% of women who never had a Clinical Breast Exam (CBE and 44.1% of women who never had a mammography expressed a lack of knowledge about the existence of these screening techniques. Nearly one third of the participants interpreted the presence of a breast lump incorrectly and, moreover, expressed fewer worries about the nature of the lump than would normally be expected. CONCLUSIONS: The National screening program needs to be improved and directed towards more efficient and targeted utilization of resources. Healthcare professionals play a major role in alerting women to the importance of periodic screening.

European Educational Systems and Assessment Practice

DEFF Research Database (Denmark)

Evans, Robert Harry; Cross, David; Grangeat, Michel

2018-01-01

Abstract This chapter surveys the status of educational systems and assessment practices across eight European countries that are part of the ASSIST-ME project. First, variations in country educational systems are examined to identify possible connections between systems and educational practices....... Such associations are useful both for understanding different existing assessment conditions as well as for providing possible pathways for change. Next, the chapter takes a closer look at teacher practices in these educational systems in order to identify the actual assessment practices of teachers in each country....... With these understandings of the systems and current uses of assessment, it is possible to identify affordances and challenges for improving assessment practices....

Prenatal screening: current practice, new developments, ethical challenges.

Science.gov (United States)

de Jong, Antina; Maya, Idit; van Lith, Jan M M

2015-01-01

Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. Recent developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing (NIPT) that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent 'reproductive autonomy' is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. © 2014 John Wiley & Sons Ltd.

A DPSIR model for ecological security assessment through indicator screening: a case study at Dianchi Lake in China.

Directory of Open Access Journals (Sweden)

Zhen Wang

Full Text Available Given the important role of lake ecosystems in social and economic development, and the current severe environmental degradation in China, a systematic diagnosis of the ecological security of lakes is essential for sustainable development. A Driving-force, Pressure, Status, Impact, and Risk (DPSIR model, combined with data screening for lake ecological security assessment was developed to overcome the disadvantages of data selection in existing assessment methods. Correlation and principal component analysis were used to select independent and representative data. The DPSIR model was then applied to evaluate the ecological security of Dianchi Lake in China during 1988-2007 using an ecological security index. The results revealed a V-shaped trend. The application of the DPSIR model with data screening provided useful information regarding the status of the lake's ecosystem, while ensuring information efficiency and eliminating multicollinearity. The modeling approach described here is practical and operationally efficient, and provides an attractive alternative approach to assess the ecological security of lakes.

Depression screening and management among adolescents in primary care: factors associated with best practice.

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Taliaferro, Lindsay A; Hetler, Joel; Edwall, Glenace; Wright, Catherine; Edwards, Anne R; Borowsky, Iris W

2013-06-01

To compare depression identification and management perceptions and practices between professions and disciplines in primary care and examine factors that increase the likelihood of administering a standardized depression screening instrument, asking about patients' depressive symptoms, and using best practice when managing depressed adolescents. Data came from an online survey of clinicians in Minnesota (20% response rate). Analyses involved bivariate tests and linear regressions. The analytic sample comprised 260 family medicine physicians, 127 pediatricians, 96 family nurse practitioners, and 54 pediatric nurse practitioners. Overall, few differences emerged between physicians and nurse practitioners or family and pediatric clinicians regarding addressing depression among adolescents. Two factors associated with administering a standardized instrument included having clear protocols for follow-up after depression screening and feeling better prepared to address depression among adolescents. Enhancing clinicians' competence to address depression and developing postscreening protocols could help providers implement universal screening in primary care.

Assessment: Examining Practice in Entrepreneurship Education

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Pittaway, Luke; Edwards, Corina

2012-01-01

Purpose: The purpose of this paper is to develop knowledge about the nature of student assessment practice in entrepreneurship education. Design/methodology/approach: This paper introduces general assessment practice issues and highlights key considerations. It explains prior research on assessment practice in entrepreneurship education and argues…

Comparison of different stepwise screening strategies for type 2 diabetes: Finding from Danish general practice, Addition-DK.

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Dalsgaard, Else-Marie; Christensen, Jesper O; Skriver, Mette Vinter; Borch-Johnsen, Knut; Lauritzen, Torsten; Sandbaek, Annelli

2010-12-01

To examine attendance, number of people with T2DM and costs of three different stepwise screening strategies for T2DM in general practice (GP). Diabetes risk questionnaires were mailed to individuals aged 40-69 years from 45 general practices in 2001-2002 and individuals at high risk for T2DM, were asked to contact their GP to arrange a screening test. In 2005-2006, 26 general practices were randomised into two different opportunistic screening programmes (OP-direct and OP-subsequent) and risk questionnaires were distributed to individuals aged 40-69 years during GP consultations. In the OP-direct approach, high-risk individuals were offered to start the screening during the actual consultation while high-risk individuals in the OP-subsequent approach, were invited to a screening test at a later date. We report attendance, number of people with T2DM and costs of each screening approach. The mail-distributed approach identified 0.8% of the target population with T2DM, the OP-direct approach and the OP-subsequent approach, 0.9% and 0.5% respectively. Cost per person with T2DM was in the mail-distributed approach: € 1058, OP-direct approach: € 707 and the OP-subsequent approach: € 727. This study indicates that opportunistic screening identifies the same level of unknown diabetes as a mail-distributed approach but with lower costs. Copyright © 2010 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

In vitro screening methods for assessing plant disease resistance

International Nuclear Information System (INIS)

Lebeda, A.; Svabova, L.

2010-01-01

A combination of biotechnological and phytopathological techniques provides an alternative approach to classical resistance breeding methods. Such techniques have been increasingly used since the 1980s, in parallel with the progress in plant biotechnology. In the approach of resistance screening and selection in vitro, both experimental objects, i.e., the plant and the pathogen, must first be transferred to in vitro conditions, and finally, the plant material must be transferred back to in vivo conditions and adapted to the outside settings. Specific attention must be paid to the methods of pathogen preparation for use in screening and selection in vitro. The selection agents are classified according to their origin, the methods of preparation, nature and content of active substances, and effective utilisation for screening or selection in vitro. Basic principles and methodological aspects of the in vitro work (explant cultures, sources of in vitro variability, screening and selection methods, types of selection agents) as well as examples of practical applications in the breeding of different crops are critically reviewed in this chapter. (author)

An evaluation of routine antenatal depression screening and psychosocial assessment in a regional private maternity setting in Australia.

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Kalra, Harish; Reilly, Nicole; Austin, Marie-Paule

2018-01-30

There is limited information relating to routine depression screening and psychosocial assessment programs in private maternity settings in Australia. To describe the psychosocial profile of a sample of private maternity patients who participated in a depression screening and psychosocial risk assessment program as part of routine antenatal care, and to explore women's experience of receiving this component of pregnancy care. We conducted a retrospective medical records audit of 455 consecutive women having a routine psychosocial assessment and referral. Assessment was undertaken using the Edinburgh Postnatal Depression Scale (EPDS) and the Antenatal Risk Questionnaire (ANRQ) for psychosocial risk; 101 women completed a feedback survey about their experience of receiving routine psychosocial care. Of the 87.7% of women who completed both EPDS and ANRQ, 4.3% scored 13 or more on the EPDS. On the ANRQ, 25.3% of women endorsed one risk factor, 11.6% two risk factors and 10.5% three or more risk factors. Elevated EPDS scores were associated with major stresses in the last 12 months, high trait anxiety and significant past mental health issue/s. Acceptability of depression screening and psychosocial risk assessment was high. This study highlights the need for, and acceptability of, depression and psychosocial assessment in the private maternity sector. These findings are particularly timely given the provision of new Medicare Benefits Scheme items for obstetricians to undertake psychosocial assessment (both antenatally and postnally) in line with recommended clinical best practice. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision.

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Todahl, Jeffrey L; Linville, Deanna; Chou, Liang-Ying; Maher-Cosenza, Patricia

2008-01-01

Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.

Noninvasive prenatal testing in routine clinical practice--an audit of NIPT and combined first-trimester screening in an unselected Australian population.

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McLennan, Andrew; Palma-Dias, Ricardo; da Silva Costa, Fabricio; Meagher, Simon; Nisbet, Debbie L; Scott, Fergus

2016-02-01

There are limited data regarding noninvasive prenatal testing (NIPT) in low-risk populations, and the ideal aneuploidy screening model for a pregnant population has yet to be established. To assess the implementation of NIPT into clinical practice utilising both first- and second-line screening models. Three private practices specialising in obstetric ultrasound and prenatal diagnosis in Australia offered NIPT as a first-line test, ideally followed by combined first-trimester screening (cFTS), or as a second-line test following cFTS, particularly in those with a calculated risk between 1:50 and 1:1000. NIPT screening was performed in 5267 women and as a first-line screening method in 3359 (63.8%). Trisomies 21 and 13 detection was 100% and 88% for trisomy 18. Of cases with known karyotypes, the positive predictive value (PPV) of the test was highest for trisomy 21 (97.7%) and lowest for monosomy X (25%). Ultrasound detection of fetal structural abnormality resulted in the detection of five additional chromosome abnormalities, two of which had high-risk cFTS results. For all chromosomal abnormalities, NIPT alone detected 93.4%, a contingent model detected 81.8% (P = 0.097), and cFTS alone detected 65.9% (P < 0.005). NIPT achieved 100% T21 detection and had a higher DR of all aneuploidy when used as a first-line test. Given the false-positive rate for all aneuploidies, NIPT is an advanced screening test, rather than a diagnostic test. The benefit of additional cFTS was the detection of fetal structural abnormalities and some unusual chromosomal abnormalities. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Chemical Risk Assessment Screening Tool of a Global Chemical Company

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Evelyn Tjoe-Nij

2018-03-01

Full Text Available Background: This paper describes a simple-to-use and reliable screening tool called Critical Task Exposure Screening (CTES, developed by a chemical company. The tool assesses if the exposure to a chemical for a task is likely to be within acceptable levels. Methods: CTES is a Microsoft Excel tool, where the inhalation risk score is calculated by relating the exposure estimate to the corresponding occupational exposure limit (OEL or occupational exposure band (OEB. The inhalation exposure is estimated for tasks by preassigned ART1.5 activity classes and modifying factors. Results: CTES requires few inputs. The toxicological data, including OELs, OEBs, and vapor pressure are read from a database. Once the substance is selected, the user specifies its concentration and then chooses the task description and its duration. CTES has three outputs that may trigger follow-up: (1 inhalation risk score; (2 identification of the skin hazard with the skin warnings for local and systemic adverse effects; and (3 status for carcinogenic, mutagenic, or reprotoxic effects. Conclusion: The tool provides an effective way to rapidly screen low-concern tasks, and quickly identifies certain tasks involving substances that will need further review with, nevertheless, the appropriate conservatism. This tool shows that the higher-tier ART1.5 inhalation exposure assessment model can be included effectively in a screening tool. After 2 years of worldwide extensive use within the company, CTES is well perceived by the users, including the shop floor management, and it fulfills its target of screening tool. Keywords: occupational exposure, risk assessment, risk management

A quantitative screening-level approach to incorporate chemical exposure and risk into alternative assessment evaluations.

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Arnold, Scott M; Greggs, Bill; Goyak, Katy O; Landenberger, Bryce D; Mason, Ann M; Howard, Brett; Zaleski, Rosemary T

2017-11-01

As the general public and retailers ask for disclosure of chemical ingredients in the marketplace, a number of hazard screening tools were developed to evaluate the so-called "greenness" of individual chemical ingredients and/or formulations. The majority of these tools focus only on hazard, often using chemical lists, ignoring the other part of the risk equation: exposure. Using a hazard-only focus can result in regrettable substitutions, changing 1 chemical ingredient for another that turns out to be more hazardous or shifts the toxicity burden to others. To minimize the incidents of regrettable substitutions, BizNGO describes "Common Principles" to frame a process for informed substitution. Two of these 6 principles are: "reduce hazard" and "minimize exposure." A number of frameworks have emerged to evaluate and assess alternatives. One framework developed by leading experts under the auspices of the US National Academy of Sciences recommended that hazard and exposure be specifically addressed in the same step when assessing candidate alternatives. For the alternative assessment community, this article serves as an informational resource for considering exposure in an alternatives assessment using elements of problem formulation; product identity, use, and composition; hazard analysis; exposure analysis; and risk characterization. These conceptual elements build on practices from government, academia, and industry and are exemplified through 2 hypothetical case studies demonstrating the questions asked and decisions faced in new product development. These 2 case studies-inhalation exposure to a generic paint product and environmental exposure to a shampoo rinsed down the drain-demonstrate the criteria, considerations, and methods required to combine exposure models addressing human health and environmental impacts to provide a screening level hazard and exposure (risk) analysis. This article informs practices for these elements within a comparative risk context

Barriers to antenatal psychosocial assessment and depression screening in private hospital settings.

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Connell, Tanya; Barnett, Bryanne; Waters, Donna

2017-10-11

The evidence of benefit for antenatal psychosocial assessment and depression screening has been sufficient to lead the implementation of screening in public hospitals in all states of Australia. Details of the implementation of perinatal screening in private obstetric settings is less well known. As any successful implementation relies on the identification of local barriers, we aimed to determine what perceived or actual barriers may exist for the implementation of evidence-based perinatal screening interventions in private obstetric care, and specifically within small private hospitals. The integrative literature review method offers a structured systematic approach to organise, synthesize and critique research from a range of sources. This method was used to determine what barriers have been identified in implementing psychosocial assessment and depression screening with women receiving obstetric care in private hospital settings. The integrative review findings suggest that barriers to implementing psychosocial screening in the private sector are similar to those experienced in the public sector but may also be influenced by the corporate focus of private services. Barriers were identified among health professionals, within the personal and psychosocial context of women and their families, and at provider or system level. Once identified, barriers can be systematically addressed to enhance the success of implementing psychosocial and depression screening in the private sector. Screening is likely to be influenced by the business models and operating systems of private service providers. Health professionals working within this environment need more support to conduct perinatal assessment within this context. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Child Maltreatment Screening and Anticipatory Guidance: A Description of Pediatric Nurse Practitioner Practice Behaviors.

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Hornor, Gail; Bretl, Deborah; Chapman, Evelyn; Herendeen, Pamela; Mitchel, Nancy; Mulvaney, Barbara; Quinones, Saribel Garcia; VanGraafeiland, Brigit

Given the number of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. The purpose of this study was to describe pediatric nurse practitioner (PNP) practice behaviors related to screening and providing anticipatory guidance for child maltreatment and its psychosocial risk factors. The Risk Assessment Survey was developed for this study by 12 PNPs, all of whom were members of NAPNAP's Child Maltreatment Special Interest Group to ensure face validity; all 12 PNPs were content experts in child maltreatment. The content of the survey was derived from key characteristics from the evidence on child maltreatment. The survey was emailed to the more than 8500 NAPNAP members. Two hundred forty-three PNPs responded to the survey, which represents a response rate of 3%. Approximately half of the participants (n = 121; 51%) stated that they never/rarely ask parents questions about domestic violence, more than one-fourth (n = 71; 30%) reported that they never/rarely ask parents questions about discipline, and half of the responding PNPs (n = 120; 50%) reported that they perform an ano-genital exam at well visits. This study demonstrates that a significant number of PNPs do not routinely screen for child maltreatment and psychosocial risk factors. This is especially true in regards to sexual abuse screening and anticipatory guidance. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study.

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VanDenHeuvel, A; Fitzgerald, M; Greiner, B; Perry, I J

2007-09-01

The objectives of this study were to assess the feasibility of administering the CHecklist for Autism in Toddlers (CHAT) at the 18-month developmental check, estimate the prevalence of screening positive for autism at the first and second administrations of the CHAT and estimate the prevalence of diagnosed cases of autism. A cross-sectional study design was utilised and data was collected at child developmental screening clinics in counties Cork and Kerry. The sample group consisted of infants attending the routine 18-month developmental assessment, who were broadly representative of infants in the catchment area. The main outcome measure was a medium or high-risk score following two administrations of the CHAT screening instrument and a positive diagnosis of autism after clinical assessment. The CHAT was administered to 2117 infants (79% of those approached) of whom 29 were scored at medium or high risk at first screening, resulting in a prevalence rate of 137 per 10,000 (95% CI: 87-187). A total of 7 of the 29 first screen positive infants were positive (medium or high risk) at second screening, 12 were low risk and 10 parents refused to participate. On subsequent clinical assessment of the 7 infants screening positive on first and second assessment and assessment of 5 of the 10 infants whose parents declined second screening, 7 children received a diagnosis of autism. Thus the overall prevalence of clinically diagnosed autism following this screening exercise was 33.1 per 10,000 (95% CI: 13.3 to 68.0). The CHAT instrument is a useful tool to help identify childhood autism among infants. Routine use of this instrument at 18-month developmental assessment merits consideration.

Malnutrition-Sarcopenia Syndrome: Is This the Future of Nutrition Screening and Assessment for Older Adults?

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Maurits F. J. Vandewoude

2012-01-01

Full Text Available Malnutrition is common across varying patient populations, particularly older adults, and sarcopenia prevalence increases with advancing age. Both malnutrition and sarcopenia are associated with substantial adverse outcomes affecting both the patient and the healthcare system, including increased morbidity, mortality, rehospitalization rates, and healthcare costs. Healthcare practitioners may assess patients for either malnutrition or sarcopenia; however, many patients clinically present with both conditions, resulting in the syndrome, Malnutrition-Sarcopenia Syndrome, which is the clinical presentation of both malnutrition and accelerated age-associated loss of lean body mass, strength, and/or functionality. Clinicians are urged to screen, assess, and treat these conditions currently so as to adequately address the full spectrum of patients’ nutritional issues. By examining aspects of both conditions, clinicians can more fully assess their patients’ clinical and nutritional status and can tailor targeted therapies to meet their needs and improve outcomes. This proposed syndrome embodies the inherent association of malnutrition and sarcopenia, highlighting their combined impact on clinical outcomes. The objective of this review paper is to characterize Malnutrition-Sarcopenia Syndrome to advance clinical practice, by providing clinicians with the necessary background information to integrate nutritional assessment along with loss of muscle mass and functionality in their everyday clinical practice.

Multicomponent Musculoskeletal Movement Assessment Tools: A Systematic Review and Critical Appraisal of Their Development and Applicability to Professional Practice.

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Bennett, Hunter; Davison, Kade; Arnold, John; Slattery, Flynn; Martin, Max; Norton, Kevin

2017-10-01

Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.

Assessing healthcare professional knowledge, attitudes, and practices on hypertension management. Announcing a new World Hypertension League resource.

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Campbell, Norm R C; Dashdorj, Naranjargal; Baatarsuren, Uurtsaikh; Myanganbayar, Maral; Dashtseren, Myagmartseren; Unurjargal, Tsolmon; Zhang, Xin-Hua; Veiga, Eugenia Velludo; Beheiry, Hind Mamoun; Mohan, Sailesh; Almustafa, Bader; Niebylski, Mark; Lackland, Daniel

2017-09-01

To assist hypertension control programs and specifically the development of training and education programs on hypertension for healthcare professionals, the World Hypertension League has developed a resource to assess knowledge, attitudes, and practices on hypertension management. The resource assesses: (1) the importance of hypertension as a clinical and public health risk; (2) education in national or international hypertension recommendations; (3) lifestyle causes of hypertension; (4) measurement of blood pressure, screening, and diagnosis of hypertension; (5) lifestyle therapy counseling; (6) cardiovascular risk assessment; (7) antihypertensive drug therapy; and (8) adherence to therapy. In addition, the resource assesses the attitudes and practices of healthcare professionals for task sharing/shifting, use of care algorithms, and use of registries with performance reporting functions. The resource is designed to help support the Global Hearts Alliance to provide standardized and enhanced hypertension control globally. ©2017 Wiley Periodicals, Inc.

Obesity prevention, screening, and treatment: practices of pediatric providers since the 2007 expert committee recommendations.

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Rausch, John Conrad; Perito, Emily Rothbaum; Hametz, Patricia

2011-05-01

This study surveyed pediatric primary care providers at a major academic center regarding their attitudes and practices of obesity screening, prevention, and treatment. The authors compared the care providers' reported practices to the 2007 American Medical Association and Centers for Disease Control and Prevention Expert Committee Recommendations to evaluate their adherence to the guidelines and differences based on level of training and specialty. Of 96 providers surveyed, less than half used the currently recommended criteria for identifying children who are overweight (24.7%) and obese (34.4%), with attendings more likely to use the correct criteria than residents (P obesity, the majority felt their counseling was not effective. There was considerable variability in reported practices of lab screening and referral patterns of overweight and obese children. More efforts are needed to standardize providers' approach to overweight and obese children.

Geriatric screening in first opinion practice – results from 45 dogs

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Davies, M

2012-01-01

Objectives To evaluate and report the results of screening geriatric dogs in a first opinion practice. Methods A prospective health screen of dogs over nine-years-old involving history taking, physical examination and urinalysis. Results At least one previously unrecognised problem was identified in 80% of 45 dogs and 353 findings (mean 7·8 per dog) were recorded. Owners often failed to recognise and report serious signs of age-related disease. However, they most often reported increased sleeping (31%), loss of hearing (29%) or sight (20%), stiffness or lameness (22%) and “slowing down” (20%). Increased lens opacity (64%), increased thirst (58%), pain (24%), increased frequency of urination (24%), signs of osteoarthritis (24%) and dental disease (22%) were most frequently identified at the time of consultation. Potentially, life-threatening findings included respiratory distress, palpable abdominal masses and metastatic lung disease. Screening resulted in 29 further diagnostic procedures, including 10 dental procedures, seven medical treatments, two surgical procedures and euthanasia of two dogs. Clinical Significance Screening elderly dogs identified unrecognised and unreported health risk factors resulting in lifestyle modification and ongoing monitoring, as well as signs of age-related diseases resulting in diagnostic investigations, early diagnoses and surgical and medical interventions to improve quality of life. PMID:22835038

Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening

DEFF Research Database (Denmark)

Buckley, B S; Harreiter, J; Damm, P

2012-01-01

Background: Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects...... of its diagnosis. Methods: The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide...... an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices...

Knowledge, attitude and practice of cervical cancer screening (pap smear) among female nurses in Nnewi, South Eastern Nigeria.

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Udigwe, G O

2006-06-01

To determine the knowledge and practice of cervical cancer screening among practicing female nurses with a view to sensitizing them as a first step towards increasing screening uptake in the community. A self administered questionnaire survey of all the female nurses working in Nnamdi Azikiwe university Teaching Hospital Nnewi center. 144 out of 166 questionnaires were correctly completed and returned. 122 (87%) were aware of the existence of screening services. Although 9.3% had lost relations to cancer of the cervix, only 5.7% had ever undergone a pap smear. While 52 (37.1%) had no reason for not screening, 21 (15%) were afraid of the possible outcome and 35 (25%) felt they were not likely candidates for cancer of the cervix. knowledge of cervical cancer screening services among female nurses in Nnewi is high while uptake rate is abysmally poor. There is need to further educate the nurses who will play a major role in enlightening the public on the availability and need for cervical screening services.

Risk factor assessment to anticipate performance in the National Developmental Screening Test in children from a disadvantaged area.

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Montes, Alejandro; Pazos, Gustavo

2016-02-01

Identifying children at risk of failing the National Developmental Screening Test by combining prevalences of children suspected of having inapparent developmental disorders (IDDs) and associated risk factors (RFs) would allow to save resources. 1. To estimate the prevalence of children suspected of having IDDs. 2. To identify associated RFs. 3. To assess three methods developed based on observed RFs and propose a pre-screening procedure. The National Developmental Screening Test was administered to 60 randomly selected children aged between 2 and 4 years old from a socioeconomically disadvantaged area from Puerto Madryn. Twenty-four biological and socioenvironmental outcome measures were assessed in order to identify potential RFs using bivariate and multivariate analyses. The likelihood of failing the screening test was estimated as follows: 1. a multivariate logistic regression model was developed; 2. a relationship was established between the number of RFs present in each child and the percentage of children who failed the test; 3. these two methods were combined. The prevalence of children suspected of having IDDs was 55.0% (95% confidence interval: 42.4%-67.6%). Six RFs were initially identified using the bivariate approach. Three of them (maternal education, number of health checkups and Z scores for height-for-age, and maternal age) were included in the logistic regression model, which has a greater explanatory power. The third method included in the assessment showed greater sensitivity and specificity (85% and 79%, respectively). The estimated prevalence of children suspected of having IDDs was four times higher than the national standards. Seven RFs were identified. Combining the analysis of risk factor accumulation and a multivariate model provides a firm basis for developing a sensitive, specific and practical pre-screening procedure for socioeconomically disadvantaged areas. Sociedad Argentina de Pediatría.

Disparities in the use of screening magnetic resonance imaging of the breast in community practice by race, ethnicity, and socioeconomic status.

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Haas, Jennifer S; Hill, Deirdre A; Wellman, Robert D; Hubbard, Rebecca A; Lee, Christoph I; Wernli, Karen J; Stout, Natasha K; Tosteson, Anna N A; Henderson, Louise M; Alford-Teaster, Jennifer A; Onega, Tracy L

2016-02-15

Uptake of breast magnetic resonance imaging (MRI) coupled with breast cancer risk assessment offers the opportunity to tailor the benefits and harms of screening strategies for women with differing cancer risks. Despite the potential benefits, there is also concern for worsening population-based health disparities. Among 316,172 women aged 35 to 69 years from 5 Breast Cancer Surveillance Consortium registries (2007-2012), the authors examined 617,723 negative screening mammograms and 1047 screening MRIs. They examined the relative risks (RRs) of MRI use by women with a college or technical school were 43% more likely and those who had at least a college degree were 132% more likely to receive an MRI compared with those with a high school education or less. Among women with a ≥20% lifetime risk, there was no statistically significant difference noted with regard to the use of screening MRI by race or ethnicity, but high-risk women with a high school education or less were less likely to undergo screening MRI than women who had graduated from college (RR, 0.40; 95% confidence interval, 0.25-0.63). Uptake of screening MRI of the breast into clinical practice has the potential to worsen population-based health disparities. Policies beyond health insurance coverage should ensure that the use of this screening modality reflects evidence-based guidelines. © 2015 American Cancer Society.

A new motor screening assessment for children at risk for motor disorders: construct validity

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Paola Matiko Martins Okuda

Full Text Available ABSTRACT Objective: To develop a motor screening assessment and provide preliminary evidence of its psychometric properties. Methods: A sample of 365 elementary school students was assessed, with structural equation modeling applied to obtain evidence of the adequacy of the factor structure of the motor screening assessment. As well, differential item functioning was used to evaluate whether various identifiable subgroups of children (i.e., sex and grade perform particular tasks differently. Results: Overall, girls obtained higher scores than boys while, for both sexes, the assessment scores increased with age. Furthermore, differential item function analysis revealed that the precision of the test was highest for those with moderate to low motor performance, suggesting that this tool would be appropriate for identifying individuals with movement difficulties. Conclusion: Although further tests of its psychometric properties are required, the motor screening assessment appears to be a reliable, valid, and quickly-administered tool for screening children's movements.

Esophageal cancer screening in achalasia: is there a consensus?

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Ravi, K; Geno, D M; Katzka, D A

2015-04-01

Achalasia is an important but relatively uncommon disorder. While highly effective therapeutic options exist, esophageal cancer remains a long-term potential complication. The risk of esophageal cancer in achalasia remains unclear, with current guidelines recommending against routine endoscopic screening. However, given limited data and conflicting opinion, it is unknown whether consensus regarding screening practices in achalasia among experts exists. A 10-question survey to assess screening practices in achalasia was created and distributed to 28 experts in the area of achalasia. Experts were identified based on publications and meeting presentations in the field. Survey responses were received from 17 of 28 (61%) experts. Wide geographic distribution was seen among respondents, with eight (47%) from Europe or Australia, seven (41%) from the United States, and two (12%) from Asia. Screening for esophageal cancer was inconsistent, with nine (53%) experts endorsing the practice and eight (47%) not. Screening practices did not differ among geographic regions. No consensus regarding the risk for esophageal cancer in achalasia was seen, with three experts reporting no increased risk compared with the general population, eight experts a lifetime risk of 0.1-0.5%, three experts a 0.5-1% risk, two experts a 1-2% risk, and one expert a 3-5% risk. However, these differences in perception of risk did not influence screening practices. Upper endoscopy was utilized among all experts who endorsed screening. However, practices still varied with screening commencing at or within 1 year of diagnosis in two practices compared with 5 and 10 years in three respective practices each. Surveillance intervals also varied, performed every 2 years in four practices, every 3 years in four practices, and every 5 years in one practice. Practice variation in the management of achalasia itself was also seen, with initial treatment with Heller myotomy endorsed by eight experts, pneumatic

Development and initial testing of a computer-based patient decision aid to promote colorectal cancer screening for primary care practice

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Fowler Beth

2005-11-01

Full Text Available Abstract Background Although colorectal cancer screening is recommended by major policy-making organizations, rates of screening remain low. Our aim was to develop a patient-directed, computer-based decision aid about colorectal cancer screening and investigate whether it could increase patient interest in screening. Methods We used content from evidence-based literature reviews and our previous decision aid research to develop a prototype. We performed two rounds of usability testing with representative patients to revise the content and format. The final decision aid consisted of an introductory segment, four test-specific segments, and information to allow comparison of the tests across several key parameters. We then conducted a before-after uncontrolled trial of 80 patients 50–75 years old recruited from an academic internal medicine practice. Results Mean viewing time was 19 minutes. The decision aid improved patients' intent to ask providers for screening from a mean score of 2.8 (1 = not at all likely to ask, 4 = very likely to ask before viewing the decision aid to 3.2 afterwards (difference, 0.4; p Conclusion We conclude that a computer-based decision aid can increase patient intent to be screened and increase interest in screening. Practice Implications: This decision aid can be viewed by patients prior to provider appointments to increase motivation to be screened and to help them decide about which modality to use for screening. Further work is required to integrate the decision aid with other practice change strategies to raise screening rates to target levels.

U.S. military enlisted accession mental health screening: history and current practice.

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Cardona, Robert Andrew; Ritchie, Elspeth Cameron

2007-01-01

Through the stimulus of war and concerns about neuropsychiatric disability, the U.S. military developed methods to rapidly screen the mental health of World War I and II draftees. Intelligence testing and brief psychiatric screening expanded the accession physical examination and underwent revision to identify only gross mental health disability. Supplemental psychiatric evaluations and written psychological screening tools were abandoned after postwar assessments; they demonstrated poor predictive power in evaluating recruit service capacity for combat environments. Currently, only three mental health accession tools are used to screen applicants before their entrance into military service, namely, educational achievement, cognitive testing, and a cursory psychiatric evaluation. The Navy and Air Force use a fourth screening measure during entry-level training. Educational attainment with high school graduation has been the strongest predictor of finishing a service term. The purpose of this article is to provide both a historical review and a review of testing efforts.

Assessing reader performance in radiology, an imperfect science: Lessons from breast screening

Energy Technology Data Exchange (ETDEWEB)

Soh, B.P., E-mail: bsoh6456@uni.sydney.edu.au [Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Lidcombe, NSW (Australia); Lee, W.; Kench, P.L.; Reed, W.M.; McEntee, M.F.; Poulos, A.; Brennan, P.C. [Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Lidcombe, NSW (Australia)

2012-07-15

The purpose of this article is to review the limitations associated with current methods of assessing reader accuracy in mammography screening programmes. Clinical audit is commonly used as a quality-assurance tool to monitor the performance of screen readers; however, a number of the metrics employed, such as recall rate as a surrogate for specificity, do not always accurately measure the intended clinical feature. Alternatively, standardized screening test sets, which benefit from ease of application, immediacy of results, and quicker assessment of quality improvement plans, suffer from experimental confounders, thus questioning the relevance of these laboratory-type screening test sets to clinical performance. Four key factors that impact on the external validity of screening test sets were identified: the nature and extent of scrutiny of one's action, the artificiality of the environment, the over-simplification of responses, and prevalence of abnormality. The impact of these factors on radiological and other contexts is discussed, and although it is important to acknowledge the benefit of standardized screening test sets, issues relating to the relevance of test sets to clinical activities remain. The degree of correlation between performance based on real-life clinical audit and performances at screen read test sets must be better understood and specific causal agents for any lack of correlation identified.

Maternal and paternal parenting practices and their influence on children's adiposity, screen-time, diet and physical activity.

Science.gov (United States)

Lloyd, Adam B; Lubans, David R; Plotnikoff, Ronald C; Collins, Clare E; Morgan, Philip J

2014-08-01

The primary aim of this study was to examine a range of potential behavioral and maternal/paternal correlates of adiposity in children. Secondary aims were to examine (a) correlates of screen-time, diet and physical activity and (b) if there were differences in maternal and paternal physical activity- and dietary-related parenting practices. Cross-sectional analysis was conducted using 70 families with children (59% boys (41/70), mean age 8.4 (±2.4) years). Parenting practices were measured using the Parenting Strategies for Eating and Activity Scale. Children's outcomes included: 7-day pedometry (physical activity), screen-time, percent energy from core foods (Food frequency questionnaire) and BMI z-score. Multiple regression models were generated to examine the associations between maternal and paternal parenting practices and children's variables. In the regression analyses, fathers' BMI (p parenting practices [limit setting (p = .01), reinforcement (p = .02)] and child screen-time (p = .02) were significantly associated with intake of core foods. Despite some similarities within families, three out of five parenting constructs were significantly different between mothers and fathers. Mothers and fathers have different parental influences on their children's weight status and lifestyle behaviors and both should be included in lifestyle interventions targeting children. A focus on maternal parenting specifically relating to screen-time and diet, and father's physical activity parenting and weight status may support their children in developing more healthy behaviors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Accuracy of quick and easy undernutrition screening tools--Short Nutritional Assessment Questionnaire, Malnutrition Universal Screening Tool, and modified Malnutrition Universal Screening Tool--in patients undergoing cardiac surgery

NARCIS (Netherlands)

van Venrooij, Lenny M. W.; van Leeuwen, Paul A. M.; Hopmans, Wendy; Borgmeijer-Hoelen, Mieke M. M. J.; de Vos, Rien; de Mol, Bas A. J. M.

2011-01-01

The objective of this study was to compare the quick-and-easy undernutrition screening tools, ie, Short Nutritional Assessment Questionnaire and Malnutrition Universal Screening Tool, in patients undergoing cardiac surgery with respect to their accuracy in detecting undernutrition measured by a

Practical considerations and effects of metallic screen fluorescence and backscatter control in gamma computed radiography

International Nuclear Information System (INIS)

Mango, Steven

2016-01-01

It is a fairly common misconception that the role of metallic screens used with computed radiography is primarily that of scatter control, and that any amplification of the image signal is minimal. To the contrary, this paper shows how the physical interaction between gamma rays and front metallic screens can yield a significant boost in signal and whether that increased signal is, in fact, beneficial or detrimental to image quality. For rear metallic screens, this signal boost is differentiated from backscatter, and image quality considerations should be more carefully thought out because of the separation between the screen and the imaging layer provided by the imaging plate support. Various physical interactions are explained, and a series of practical experiments show the various changes in signal level and image quality with various thicknesses of lead and copper screens. Recommendations are made for the configuration of the imaging plate and screens for optimum image quality and for the control and monitoring of scatter.

Improving Breast Cancer Outcomes among Women in China: Practices, Knowledge, and Attitudes Related to Breast Cancer Screening

Directory of Open Access Journals (Sweden)

Tsu-Yin Wu

2012-01-01

Full Text Available Background. Breast cancer is a major public health issue and the most commonly diagnosed cancer for women worldwide. Despite lower incidence rates than those living in Western countries, breast cancer incidence among Chinese women has increased dramatically in the past 20 years. Nevertheless, there is a paucity of studies reporting the attitudes toward and practices of breast cancer screening among Chinese women. Methods. This cross-sectional study examined the practices, knowledge, and attitudes toward breast cancer screening (BCS on a convenience sample of 400 Chinese women. Results. Among study participants, 75% of the women never had a mammogram and the top three barriers reported were low priority, feeling OK, and lack of awareness/knowledge toward breast cancer screening. The results from the logistic regression model showed increased self-efficacy; having performed monthly self-exams, and having had clinical breast exams in the past two years were significant correlates while demographic variables were not correlated with screening behaviors. Conclusion. The findings provide a foundation to better understand beliefs and practices of Chinese women toward BCS and highlight the critical need for general public, health professionals, and the health care system to work collaboratively toward improving the quality of breast cancer care in this population.

Screening food-borne and zoonotic pathogens associated with livestock practices in the Sumapaz region, Cundinamarca, Colombia.

Science.gov (United States)

Arenas, Nelson E; Abril, Diego A; Valencia, Paola; Khandige, Surabhi; Soto, Carlos Yesid; Moreno-Melo, Vilma

2017-04-01

Hazardous practices regarding antibiotics misuse, unsanitary milking procedures, and the commercial sales of raw milk and unpasteurized dairy products are currently being practiced by livestock farmers in the Sumapaz region (Colombia). The purpose of this study was to screen for food-borne and zoonotic pathogens associated with local livestock practices. We evaluated 1098 cows from 46 livestock farms in the Sumapaz region that were selected by random. Of the total population of cattle, 962 animals (88%) were tested for bovine TB using a caudal-fold tuberculin test and 546 (50%) for brucellosis by a competitive ELISA. In the population tested, 23 cows were positive for Brucella sp. representing a 4.2% seroprevalence and no cases of bovine tuberculosis were found. In addition, food-borne contamination with Escherichia coli and Staphylococcus aureus was assessed together with antibiotic susceptibility for ten different antibiotics in milk samples from 16 livestock farms. We found that 12 of the farms (75%) were contaminated with these food-borne pathogens. Noteworthy, all of the isolated pathogenic strains were resistant to multiple antibiotics, primarily to oxytetracycline and erythromycin. Our findings suggest that livestock products could be a source of exposure to Brucella and multidrug-resistant E. coli and S. aureus strains as a result of unhygienic livestock practices in the Sumapaz region. Training in good farming practices is the key to improving safety in food production.

Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool.

Science.gov (United States)

Renfro, Mindy Oxman; Fehrer, Steven

2011-01-01

Unintentional falls is an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. This article describes the content selection and development of a simple-to-administer, multifactorial, Fall Risk Assessment & Screening Tool (FRAST), designed specifically for use in primary care settings to identify those older adults with high fall risk. Fall Risk Assessment & Screening Tool incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. Fall Risk Assessment & Screening Tool has been developed to assess fall risk in the target population of older adults (older than 65 years) living and ambulating independently in the community. Many fall risk factors have been considered and 15 items selected for inclusion. Fall Risk Assessment & Screening Tool includes 4 previously validated measures to assess balance, depression, falls efficacy, and home safety. Reliability and validity studies of FRAST are under way. Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing primary care practitioners (PCPs) with a very simple screening tool is imperative. Fall Risk Assessment & Screening Tool was created to allow for safe, quick, and low-cost administration by minimally trained office staff with interpretation and

Breast cancer screening; cost-effective in practice?

International Nuclear Information System (INIS)

Koning, Harry J. de

2000-01-01

The main aim of national breast screening is a reduction in breast cancer mortality. The data on the reduction in breast cancer mortality from three (of the five) Swedish trials in particular gave rise to the expectation that the Dutch programme of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. In all likelihood, many of the years of life gained as a result of screening are enjoyed in good health. According to its critics the actual benefit that can be achieved from the national breast cancer screening programmes is overstated. Considerable benefits have recently been demonstrated in England and Wales. However, the fall was so considerable in such a relatively short space of time that screening (started in 1987) was thought to only have played a small part. As far as the Dutch screening programme is concerned it is still too early to reach any conclusions about a possible reduction in mortality. The first short-term results of the screening are favourable and as good as (or better than) expectations. In Swedish regions where mammographic screening was introduced, a 19% reduction in breast cancer mortality can be estimated at population level, and recently a 20% reduction was presented in the UK. In countries where women are expected to make appointments for screening themselves, the attendance figures are significantly lower and the quality of the process as a whole is sometimes poorer. The benefits of breast cancer screening need to be carefully balanced against the burden to women and to the health care system. Mass breast screening requires many resources and will be a costly service. Cost-effectiveness of a breast cancer screening programme can be estimated using a computer model. Published cost-effectiveness ratios may differ tremendously, but are often the result of different types of calculation, time periods considered, including or excluding downstream cost. The approach of simulation and estimation is here

Time-trend of melanoma screening practice by primary care physicians: A meta-regression analysis

OpenAIRE

Valachis, Antonis; Mauri, Davide; Karampoiki, Vassiliki; Polyzos, Nikolaos P; Cortinovis, Ivan; Koukourakis, Georgios; Zacharias, Georgios; Xilomenos, Apostolos; Tsappi, Maria; Casazza, Giovanni

2009-01-01

Objective To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time. Methods Meta-regression analyses of available data. Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials. Results Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%?82% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening ten...

Factors affecting compliance with clinical practice guidelines for pap smear screening among healthcare providers in africa: systematic review and meta-summary of 2045 individuals.

Directory of Open Access Journals (Sweden)

Etienne Asonganyi

Full Text Available Although the importance of the Pap smear in reducing cancer incidence and mortality is known, many countries in Africa have not initiated yet widespread national cervical cancer screening programs. The World Health Organization (WHO has published Clinical Practice Guidelines (CPGs on cervical cancer screening in developing countries; however, there is a gap between expectations and clinical performance. Thus, the aim of this study was to conduct a systematic review and meta-summary to identify factors affecting compliance with CPGs for Pap screening among healthcare providers in Africa.And Findings: MEDLINE, Scirus, Opengate and EMBASE databases were searched in January 2012. Studies involving medical personnel practicing in Africa, whose outcome measured any factors that affect medical personnel from using a Pap smear to screen for cervical cancer, were included. Two reviewers independently evaluated titles and abstracts, then full-texts, extracted data and assessed quality of the included studies. A descriptive analysis of the included studies was conducted. We calculated Frequency effect sizes (FES for each finding and Intensity effect sizes (IES for each article to represent their magnitudes in the analyses. Of 1011 studies retrieved, 11 studies were included (2045 individuals. Six different themes related to the factors affecting compliance with CPGs were identified: Insufficient Knowledge/Lack of awareness (FES = 82%, Negligence/Misbeliefs (FES = 82%, Psychological Reasons (FES = 73%, Time/Cost Constraint (FES = 36%, Insufficient infrastructure/training (FES = 45% and also no reason given (FES = 36%. IES for articles ranged between 33 and 83%.These results suggest that prevention initiatives should be comprehensive to include education and resources needs assessments and improvement, Pap smear test training, strategies on costing, and practitioner time studies.

Yield of opportunistic targeted screening for type 2 diabetes in primary care: the diabscreen study.

NARCIS (Netherlands)

Klein Woolthuis, E.P.; Grauw, W.J.C. de; Gerwen, W.H.E.M. van; Hoogen, H.J.M. van den; Lisdonk, E.H. van de; Metsemakers, J.F.M.; Weel, C. van

2009-01-01

PURPOSE: In screening for type 2 diabetes, guidelines recommend targeting high-risk individuals. Our objectives were to assess the yield of opportunistic targeted screening for type 2 diabetes in primary care and to assess the diagnostic value of various risk factors. METHODS: In 11 family practices

Screening of hepatitis B and C among people visiting general practice clinics in rural district of Sindh, Pakistan

International Nuclear Information System (INIS)

Kumar, A.; Lalani, S.; Afridi, A.A.K.; Khuwaja, A.K.

2010-01-01

Background: Hepatitis B (HB), Hepatitis C (HC) and their risk factors are amongst the major health problems in developing countries including Pakistan. This study aimed to screen for HB and HC among people who visited General Practice clinics and also to identify the differences of screening positive cases by age and sex. Methods: This was a retrospective study conducted in Tando Muhammad Khan city, one of the rural districts of Sindh. All together we reviewed 5989 laboratory reports of people for hepatitis B and C on consecutive basis from two laboratories. A pre-designed and structured perform was used to collect the required information. Chi-squared test and univariate analysis was calculated to assess the difference in HB and HC proportion by age groups and sex. Results: One-fourth of reports were positive for at least one entity whereas 8% and 17% of reviewed reports of adults (>18 years and above) were screened positive for HB and HC respectively. Positive screened tests were higher among older age group compared to young age group (HB: older age group=56.6% vs. younger age group=43.4%; OR=1.07) and (HC: older age group=58.3% vs. younger age group=41.7%; OR=1.08). In the same way, positive screened tests were higher among men compared to women (HB: men=67.0% vs. women=33.0%; OR=1.2) and (HC: men=62.0% vs. women=38.0%; OR=1.3). Conclusion: A large proportion of people were screened positive for HB and HC in this study. Prevention and screening are suggested at larger scale for urgent planning and implementation of intervention strategies in this regard. Further research is also recommended to explore this important health issue at large scale. (author)

Ethical, legal, and social issues in health technology assessment for prenatal/preconceptional and newborn screening: a workshop report.

Science.gov (United States)

Potter, B K; Avard, D; Entwistle, V; Kennedy, C; Chakraborty, P; McGuire, M; Wilson, B J

2009-01-01

Prenatal/preconceptional and newborn screening programs have been a focus of recent policy debates that have included attention to ethical, legal, and social issues (ELSIs). In parallel, there has been an ongoing discussion about whether and how ELSIs may be addressed in health technology assessment (HTA). We conducted a knowledge synthesis study to explore both guidance and current practice regarding the consideration of ELSIs in HTA for prenatal/preconceptional and newborn screening. As the concluding activity for this project, we held a Canadian workshop to discuss the issues with a diverse group of stakeholders. Based on key workshop themes integrated with our study results, we suggest that population-based genetic screening programs may present particular types of ELSIs and that a public health ethics perspective is potentially highly relevant when considering them. We also suggest that approaches to addressing ELSIs in HTA for prenatal/preconceptional and newborn screening may need to be flexible enough to respond to diversity in HTA organizations, cultural values, stakeholder communities, and contextual factors. Finally, we highlight a need for transparency in the way that HTA producers move from evidence to conclusions and the ways in which screening policy decisions are made. Copyright © 2008 S. Karger AG, Basel.

A multicenter family practitioners' research on Chronic Obstructive Pulmonary Disease screening using the COPD Assessment Test.

Science.gov (United States)

Demirci, Hakan; Eniste, Koncuy; Basaran, Ebru Onuker; Ocakoglu, Gokhan; Yilmaz, Zeynep; Tuna, Sumeyye

2017-11-01

Spirometry is known to be a gold standard for the diagnosis of chronic obstructive pulmonary disease (COPD). COPD Assessment Test (CAT) is an eight-item questionnaire currently in use to evaluate patients with COPD. In the present study, we aimed to evaluate if CAT is an adequate tool for screening COPD. In total, 600 persons aging ⩾40 years old were randomly selected from three different family practice units located in the city center. CAT was asked to the participants and a spirometry was used to assess pulmonary obstruction. Pulmonary obstruction was defined as forced expiratory volume in first second/forced vital capacity (FEV1/FVC)COPD diagnosis was confirmed with the reversibility test. The relationship between CAT results and pulmonary function test values was evaluated. In this sampling, the prevalence of COPD was 4.2%. Reliability of the CAT in the study group was acceptable (Cronbach's α: 0.84). The CAT scores was significantly higher in patients with COPD (PCOPD. CAT is a reliable questionnaire and there is an apparent relationship between the total CAT scores and COPD. However, CAT's ability to screen COPD is limited since it may miss the symptom-free cases.

Clinical Practice Guidelines on the Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention in Saudi Arabia.

Science.gov (United States)

Al-Mandeel, Hazem Mahmoud; Sagr, Emad; Sait, Khalid; Latifah, Hassan Mohamed; Al-Obaid, Abdulaziz; Al-Badawi, Ismail A; Alkushi, Abdulmohsen O; Salem, Hany; Massoudi, Nada S; Schunemann, Holger; Mustafa, Reem A; Brignardello-Petersen, Romina

2016-01-01

Cervical cancer is the third most common gynecological malignancy in Saudi women with an estimated incidence rate of 1.9 cases per 100 000 women-years. More than 40% of cervical cancer cases are diagnosed at advanced stages due to lack of a routine screening program in Saudi Arabia. Thus, national guidelines for routine screening and treatment of precancerous cervical lesions are needed. The Saudi Centre for Evidence-Based Healthcare invited a panel of local experts and partnered them with a team from McMaster University in Canada for methodological support, to develop national clinical practice guidelines on the screening and treatment of precancerous lesions for cervical cancer. After the panel identified key clinical questions, the McMaster University working group updated existing systematic reviews that had been used for the 2013 WHO Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Recommendations were based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. Those recommendations took into account the available evidence, patient values and preferences, and resource use in the Saudi context. The panel provided recommendations on two major issues: screening for precancerous lesions (cervical intraepithelial neoplasia 2 & 3) and treatment of those lesions to prevent cervical cancer in women who tested positive after screening. The Saudi expert panel recommends using the HPV DNA test followed by colposcopy or cytology (Pap test) followed by colposcopy to screen for CIN2+ in women at risk of cervical cancer. The panel recommends cryotherapy or loop excision electrosurgery procedure (LEEP) over cold knife cone biopsy to treat women at risk of cervical cancer that tests positive for CIN2+. Universal screening for precancerous cervical dysplasia in women in Saudi Arabia is recommended using HPV testing and or cytology. Either cryotherapy or LEEP are preferred for treatment. National

Evidence-based screening for low bone mineral density in HIV-infected men.

Science.gov (United States)

Albright, Patsi; Du, Ping; Haas, Richard E; Pugh, Linda C

2014-01-01

Low bone mineral density, which leads to osteoporosis and fracture risk, is an emerging clinical problem in HIV-infected patients. Our evidence-based practice project screened a convenience sample of 225 HIV-infected men for low bone mineral density using the Osteoporosis Self-Assessment Tool, and of those men, 173 were also screened by quantitative ultrasound of the calcaneus. One hundred twelve men had low bone mineral density by either or both screening methods. Seventy-one of these 112 men were tested by dual-energy x-ray absorptiometry and 73% had low bone mineral density. The positive protective value of the Osteoporosis Self-Assessment Tool was 73% and for quantitative ultrasound was 88%. These results suggest that routine low bone mineral density screening should be included as standard practice for all HIV-infected patients. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Risk assessment and clinical decision making for colorectal cancer screening.

Science.gov (United States)

Schroy, Paul C; Caron, Sarah E; Sherman, Bonnie J; Heeren, Timothy C; Battaglia, Tracy A

2015-10-01

Shared decision making (SDM) related to test preference has been advocated as a potentially effective strategy for increasing adherence to colorectal cancer (CRC) screening, yet primary care providers (PCPs) are often reluctant to comply with patient preferences if they differ from their own. Risk stratification advanced colorectal neoplasia (ACN) provides a rational strategy for reconciling these differences. To assess the importance of risk stratification in PCP decision making related to test preference for average-risk patients and receptivity to use of an electronic risk assessment tool for ACN to facilitate SDM. Mixed methods, including qualitative key informant interviews and a cross-sectional survey. PCPs at an urban, academic safety-net institution. Screening preferences, factors influencing patient recommendations and receptivity to use of a risk stratification tool. Nine PCPs participated in interviews and 57 completed the survey. Despite an overwhelming preference for colonoscopy by 95% of respondents, patient risk (67%) and patient preferences (63%) were more influential in their decision making than patient comorbidities (31%; P decision making, yet few providers considered risk factors other than age for average-risk patients. Providers were receptive to the use of a risk assessment tool for ACN when recommending an appropriate screening test for select patients. © 2013 John Wiley & Sons Ltd.

Best practices in identifying, reporting and screening operating experience at nuclear power plants

International Nuclear Information System (INIS)

2008-03-01

IAEA Safety Standards Series No. SF-1 entitled Fundamental Safety Principles: Safety Fundamentals states the need for operating organizations to establish a programme for the collection and analysis of operating experience in nuclear power plants. Such a programme ensures that operating experience is analysed, events important to safety are reviewed in depth, lessons learned are disseminated to the staff of the organization and to relevant national and international organizations, and corrective actions are effectively implemented. This publication has been developed to provide advice and assistance to nuclear installations, and related institutions including contractors and support organizations to strengthen and enhance their own feedback process through the implementation of best practices in identifying, reporting and screening processes and to assess the effectiveness of the above areas. To support a proactive safety management approach the nuclear installations are enhancing the operating experience feedback (OEF) processes. For this purpose, the nuclear industry is striving to collect more information on occurrences that are useful to address the early signs of declining performance and improve operational safety performance. In this environment a strong reporting culture that motivates people to identify and report issues is an important attribute. As a consequence, the number and diversity of issues identified increases, and there is a need to set thresholds of screening for further treatment. Thus, the establishment of an effective identification, reporting and screening process is very beneficial to streamline the efforts, and ensure that major incidents and latent weaknesses are being addressed and that operating experience is treated according to its significance. This leads to improved safety and production. This publication was written to complement the publication IAEA Services Series No. 10 - PROSPER Guidelines - Guidelines for Peer Review and for

Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia

Directory of Open Access Journals (Sweden)

Ranjita Misra

2016-01-01

Full Text Available This project utilized a cross-sectional study design to assess diabetes risk among 540 individuals from 12 counties using trained extension agents and community organizations in West Virginia. Individuals were screened for diabetes using (1 the validated 7-item diabetes risk assessment survey and (2 hemoglobin A1c tests. Demographic and lifestyle behaviors were also collected. The average age, body mass index, and A1c were 51.2±16.4, 31.1±7.5, and 5.8±0.74, respectively. The majority were females, Non-Hispanic Whites with no prior diagnosis of diabetes. Screenings showed that 61.8% of participants were at high risk for diabetes. Family history of diabetes (siblings or parents, overweight or obese status, sedentary lifestyle, and older age were commonly prevalent risk factors. Higher risk scores computed from the 7-item questions correlated positively with higher A1c (r=0.221, P<0.001. In multivariate logistic regression analyses, higher diabetes risk was predicted by obesity, older age, family history of hypertension, and gestational diabetes. Females were 4 times at higher risk than males. The findings indicated that community-based screenings were an effective way to assess diabetes risk in rural West Virginia. Linking diabetes screenings with referrals to lifestyle programs for high risk individuals can help reduce the burden of diabetes in the state.

Cancer Screening Among Patients Who Self-Identify as Muslim: Combining Self-Reported Data with Medical Records in a Family Practice Setting.

Science.gov (United States)

Lofters, A K; Slater, M; Vahabi, M

2018-02-01

Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice. Religious affiliation was classified as Muslim, other affiliation, or atheist/no religious affiliation. 5311 patients were included in the study sample. Muslim patients were significantly less likely to prefer English for spoken communication than the other two groups, less likely to be Canadian-born, more likely to have a female family physician, and were over-represented in the lowest income quintile. Muslim women were most likely to be up-to-date on breast cancer screening (85.2 vs. 77.5 % for those with other religions vs. 69.5 % for those with no religious affiliation). There were no significant differences in cancer screening by physician sex. In this pilot study conducted within a primary care practice, we used self-reported data on religious affiliation to examine possible inequities in cancer screening and observed intriguing variations in screening by self-identified religious affiliation. Future efforts to collect and use similar patient-level data should incorporate non-official languages and intensively outreach to patients with less health system contact. Regardless, the family medicine context may be the ideal setting to collect and act on patient-level sociodemographic data such as religious affiliation.

Sex/Gender Differences in Screening for Autism Spectrum Disorder: Implications for Evidence-Based Assessment.

Science.gov (United States)

Evans, Spencer C; Boan, Andrea D; Bradley, Catherine; Carpenter, Laura A

2018-03-30

Autism spectrum disorder (ASD) is diagnosed more often in boys than in girls; however, little is known about the nature of this sex/gender discrepancy or how it relates to diagnostic assessment practices. This study examined the performance of the Social Communication Questionnaire (SCQ) in screening for ASD among boys and girls. Data were drawn from the South Carolina Children's Educational Surveillance Study, a population-based study of ASD prevalence among children 8-10 years of age. Analyses were conducted using SCQ data from 3,520 children, with direct assessment data from 272 with elevated SCQ scores. A bifactor model based on the Diagnostic and Statistical Manual of Mental Disorders's (5th ed.) two ASD symptom domains fit the data well and performed slightly better for girls. In the general population sample, girls exhibited fewer social communication/interaction and restricted-repetitive behavior symptoms than boys. In the direct assessment sample, however, girls with ASD showed greater impairment in social communication/interaction than boys with ASD. Items pertaining to social communication/interaction problems at ages 4-5 were among the most diagnostically efficient overall and particularly for girls. Similarly, receiver operating characteristic analyses suggested that the SCQ performs adequately among boys and well among girls. Results support the use of the SCQ in screening for ASD but do not indicate sex/gender-specific cutoffs. Girls with ASD may exhibit pronounced intraindividual deficits in social communication/interaction compared to male peers with ASD and female peers without ASD. Although more research is needed, careful attention to social communication/interaction deficits around 4-5 years of age may be especially useful for assessing ASD in girls.

Sexual Violence Screening Practices of Student Health Centers Located on Universities in Florida

Science.gov (United States)

Halstead, Valerie; Williams, Jessica R.; Gattamorta, Karina; Gonzalez-Guarda, Rosa

2017-01-01

Objective: The purpose of this study is to describe current sexual violence screening practices of student health centers located on universities in Florida. Participants: Institutional level data was collected from 33 student health centers from November 2015 through January 2016. The student health centers were located on public or private…

Assessing Screening Policies for Childhood Obesity

Science.gov (United States)

Wein, Lawrence M.; Yang, Yan; Goldhaber-Fiebert, Jeremy D.

2014-01-01

To address growing concerns over childhood obesity, the United States Preventive Services Task Force (USPSTF) recently recommended that children undergo obesity screening beginning at age 6 [1]. An Expert Committee recommends starting at age 2 [2]. Analysis is needed to assess these recommendations and investigate whether there are better alternatives. We model the age- and sex-specific population-wide distribution of body mass index (BMI) through age 18 using National Longitudinal Survey of Youth data [3]. The impact of treatment on BMI is estimated using the targeted systematic review performed to aid the USPSTF [4]. The prevalence of hypertension and diabetes at age 40 are estimated from the Panel Study of Income Dynamics [5]. We fix the screening interval at 2 years, and derive the age- and sex-dependent BMI thresholds that minimize adult disease prevalence, subject to referring a specified percentage of children for treatment yearly. We compare this optimal biennial policy to biennial versions of the USPSTF and Expert Committee recommendations. Compared to the USPSTF recommendation, the optimal policy reduces adult disease prevalence by 3% in relative terms (the absolute reductions are disease prevalence at a 28% reduction in treatment referral rate. If compared to the Expert Committee recommendation, the reductions change to 6% and 40%, respectively. The optimal policy treats mostly 16 year olds and few children under age 14. Our results suggest that adult disease is minimized by focusing childhood obesity screening and treatment on older adolescents. PMID:22240724

Terrestrial Eco-Toxicological Tests as Screening Tool to Assess Soil Contamination in Krompachy Area

Science.gov (United States)

Ol'ga, Šestinová; Findoráková, Lenka; Hančuľák, Jozef; Fedorová, Erika; Tomislav, Špaldon

2016-10-01

In this study, we present screening tool of heavy metal inputs to agricultural and permanent grass vegetation of the soils in Krompachy. This study is devoted to Ecotoxicity tests, Terrestrial Plant Test (modification of OECD 208, Phytotoxkit microbiotest on Sinapis Alba) and chronic tests of Earthworm (Dendrobaena veneta, modification of OECD Guidelines for the testing of chemicals 317, Bioaccumulation in Terrestrial Oligochaetes) as practical and sensitive screening method for assessing the effects of heavy metals in Krompachy soils. The total Cu, Zn, As, Pb and Hg concentrations and eco-toxicological tests of soils from the Krompachy area were determined of 4 sampling sites in 2015. An influence of the sampling sites distance from the copper smeltery on the absolutely concentrations of metals were recorded for copper, lead, zinc, arsenic and mercury. The highest concentrations of these metals were detected on the sampling sites up to 3 km from the copper smeltery. The samples of soil were used to assess of phytotoxic effect. Total mortality was established at earthworms using chronic toxicity test after 7 exposure days. The results of our study confirmed that no mortality was observed in any of the study soils. Based on the phytotoxicity testing, phytotoxic effects of the metals contaminated soils from the samples 3KR (7-9) S.alba seeds was observed.

Linking Child Welfare and Mental Health Using Trauma-Informed Screening and Assessment Practices

Science.gov (United States)

Conradi, Lisa; Wherry, Jeffrey; Kisiel, Cassandra

2011-01-01

An abundance of research suggests that children in the child welfare system (CWS) have experienced numerous traumatic events and are exhibiting traumatic stress symptoms. Therefore, it is critical that the CWS work closely with the mental health system to ensure that these children receive the appropriate trauma screening, trauma-focused…

Chemical Risk Assessment Screening Tool of a Global Chemical Company

OpenAIRE

Evelyn Tjoe-Nij; Christophe Rochin; Nathalie Berne; Alessandro Sassi; Antoine Leplay

2018-01-01

Background: This paper describes a simple-to-use and reliable screening tool called Critical Task Exposure Screening (CTES), developed by a chemical company. The tool assesses if the exposure to a chemical for a task is likely to be within acceptable levels. Methods: CTES is a Microsoft Excel tool, where the inhalation risk score is calculated by relating the exposure estimate to the corresponding occupational exposure limit (OEL) or occupational exposure band (OEB). The inhalation exposure i...

Systematic review of knowledge of, attitudes towards, and practices for newborn hearing screening among healthcare professionals.

Science.gov (United States)

Ravi, Rohit; Gunjawate, Dhanshree R; Yerraguntla, Krishna; Rajashekhar, Bellur

2018-01-01

The success of newborn hearing screening programs lies in the timely identification, diagnosis, and management of children with hearing loss accomplished via a multidisciplinary newborn hearing screening (NHS) team. The team is typically comprised of various healthcare professionals who act as decision makers as well as facilitators for different stages in the screening process. Team members' knowledge of, attitudes towards, and practices for early hearing detection and intervention programs are critical for success and prevention of loss to follow up. In this context, it becomes crucial to understand their knowledge of, attitudes towards, and practices for towards newborn hearing screening. A systematic review was conducted on the following databases; PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, Science Direct and Cochrane Library. This search was carried out using various keywords such as practitioners, newborn hearing screening, knowledge, attitudes, and practices in different combinations. The review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. A total of 271 hits were obtained of which 20 articles were found suitable for inclusion in the final review. Overall, similar results were found regarding team members' knowledge of NHS programs, regardless of country of origin. Similarly, attitudes toward NHS programs were positive. Team members' experiences with NHS programs varied from country-to-country and across healthcare professionals. Results consistently showed gaps in team members' knowledge suggesting the need for outreach and professional education programs on NHS. NHS teams members from different countries, healthcare systems, and early hearing detection and intervention programs show gaps in critical knowledge warranting outreach and educational programs. Copyright © 2017 Elsevier B.V. All rights reserved.

An Investigation of the Factors Affecting Performance of Environmental Impact Assessment Practices (EIA in Pakistan

Directory of Open Access Journals (Sweden)

Shahbaz Hussain

2015-01-01

Full Text Available Environmental Impact Assessment is used to detect changes that a proposed project may have on environment. The intent of present study is to investigate impact of institutional capacity and legal framework on performance of Environmental Impact Assessment practices in Pakistan such as screening, scoping and mitigation, environmental management plan and reporting. Sample of 200 EIA professionals have been selected by using random sampling approach from all provinces of Pakistan. Data has been collected through structured questionnaire and analysed by using AMOS 19 (Analysis of Moment Structures software. Results of path analysis indicated that institutional capacity and legal framework have significant direct impact on performance of all EIA practices in Pakistan. Model fit statistics such as GFI, RMR, NFI, IFI, TLI, RFI, CFI indicate the fitness of research model in this context. It has been suggested that there must be relevant and sufficient human resources that can uplift institutional capacity and legal framework must be well implemented because it will lead to enhanced performance of EIA practices in Pakistan.

SEA screening of voluntary climate change plans: A story of non-compliant discretion

International Nuclear Information System (INIS)

Kørnøv, Lone; Wejs, Anja

2013-01-01

Screening within Strategic Environmental Assessment (SEA) is the first critical stage involving considerations on whether an assessment is carried out or not. Although legislation and guidance offer practitioners a legal and logical approach to the screening process, it is inevitable that discretionary judgement takes place and will impact on the screening decision. This article examines the results of discretion involved in screening of climate change plans (CCPs) in a Danish context. These years voluntary CCPs are developed as a response to the global and local emergence of both mitigation and adaptation, and the voluntary commitment by the local authorities is an indication of an emerging norm of climate change as an important issue. This article takes its point of departure in the observation that SEA is not undertaken for these voluntary CCPs. The critical analysis of this phenomenon rests upon a documentary study of Danish CCPs, interviews with a lawyer and ministerial key person and informal discussions between researchers, practitioners and lawyers on whether climate change plans are covered by SEA legislation and underlying reasons for the present practice. Based on a critical analysis of mandatory SEA and/or obligation to screen CCPs according to significance criteria, the authors find that 18 out of the 48 CCPs are mandatory to SEA and 9 would require a screening of significance and thereby potentially be followed by a SEA. In practice only one plan was screened and one was environmentally assessed. The legal, democratic and environmental consequences of this SEA practice are critically discussed. Hereunder is the missed opportunity to use the broad environmental scope of SEA to avoid a narrow focus on energy and CO 2 in CCPs, and the question whether this practice in Denmark complies with the EU Directive. -- Highlights: ► It is inevitable that discretionary judgement takes place and will impact on the screening decision. ► The article hereby calls

SEA screening of voluntary climate change plans: A story of non-compliant discretion

Energy Technology Data Exchange (ETDEWEB)

Kørnøv, Lone, E-mail: lonek@plan.aau.dk; Wejs, Anja

2013-07-15

Screening within Strategic Environmental Assessment (SEA) is the first critical stage involving considerations on whether an assessment is carried out or not. Although legislation and guidance offer practitioners a legal and logical approach to the screening process, it is inevitable that discretionary judgement takes place and will impact on the screening decision. This article examines the results of discretion involved in screening of climate change plans (CCPs) in a Danish context. These years voluntary CCPs are developed as a response to the global and local emergence of both mitigation and adaptation, and the voluntary commitment by the local authorities is an indication of an emerging norm of climate change as an important issue. This article takes its point of departure in the observation that SEA is not undertaken for these voluntary CCPs. The critical analysis of this phenomenon rests upon a documentary study of Danish CCPs, interviews with a lawyer and ministerial key person and informal discussions between researchers, practitioners and lawyers on whether climate change plans are covered by SEA legislation and underlying reasons for the present practice. Based on a critical analysis of mandatory SEA and/or obligation to screen CCPs according to significance criteria, the authors find that 18 out of the 48 CCPs are mandatory to SEA and 9 would require a screening of significance and thereby potentially be followed by a SEA. In practice only one plan was screened and one was environmentally assessed. The legal, democratic and environmental consequences of this SEA practice are critically discussed. Hereunder is the missed opportunity to use the broad environmental scope of SEA to avoid a narrow focus on energy and CO{sub 2} in CCPs, and the question whether this practice in Denmark complies with the EU Directive. -- Highlights: ► It is inevitable that discretionary judgement takes place and will impact on the screening decision. ► The article hereby

Methicillin-resistant Staphylococcus aureus screening as a patient safety initiative: using patients' experiences to improve the quality of screening practices.

Science.gov (United States)

Currie, Kay; Knussen, Christina; Price, Lesley; Reilly, Jacqui

2014-01-01

To explore the patient experience and acceptability of methicillin-resistant Staphylococcus aureus screening of inpatient admissions to acute hospital settings. Prevention of healthcare-associated infections such as methicillin-resistant Staphylococcus aureus is a major patient safety concern internationally. Screening of patients for methicillin-resistant Staphylococcus aureus colonisation is becoming a routine aspect of hospital admission; however, evidence of the patient experience and acceptability of methicillin-resistant Staphylococcus aureus screening is limited. A mixed-methods study set in six acute care hospitals in three Scottish regions. Data collection involved postdischarge self-report survey of patients who had been screened (n = 54) and qualitative patient interviews (n = 10). Theoretical constructs derived from the Health Belief Model and Theory of Planned Behaviour used in analysis. Findings indicated that methicillin-resistant Staphylococcus aureus screening was broadly acceptable to patients. The experience of screening did not appear to be problematic; responses demonstrate that screening provided reassurance and generated confidence that health organisations were tackling healthcare-associated infections. Patients were less positive regarding the provision of information, the possibility of refusing a screen and the consequences of a positive test result. Furthermore, there were indications that patients wanted to be told the results of the screen and strong support for screening of hospital staff. Analysis of constructs from our theoretical frameworks provides evidence that attitudes were largely positive; responses indicate a belief in the beneficial impact of methicillin-resistant Staphylococcus aureus screening for patients and the wider community. However, it is important that health professionals continually assess the patient experience of 'routine' aspects of health care such as MRSA screening. The findings from this study suggest that

Assessing Clinical Microbiology Practice Guidelines: American Society for Microbiology Ad Hoc Committee on Evidence-Based Laboratory Medicine Practice Guidelines Assessment.

Science.gov (United States)

Nachamkin, Irving; Kirn, Thomas J; Westblade, Lars F; Humphries, Romney

2017-11-01

As part of the American Society for Microbiology (ASM) Evidence-Based Laboratory Medicine Practice Guidelines Committee of the Professional Practice Committee, an ad hoc committee was formed in 2014 to assess guidelines published by the committee using an assessment tool, Appraisal of Guidelines for Research Evaluation II (AGREE II). The AGREE II assessment helps reviewers determine whether published guidelines are robust, transparent, and clear in presenting practice recommendations in a standardized manner. Identifying strengths and weaknesses of practice guidelines by ad hoc assessments helps with improving future guidelines through the participation of key stakeholders. This minireview describes the development of the ad hoc committee and results from their review of several ASM best practices guidelines and a non-ASM practice guideline from the Emergency Nurses Association. Copyright © 2017 American Society for Microbiology.

Screening Level Risk Assessment for the New Waste Calcining Facility

Energy Technology Data Exchange (ETDEWEB)

M. L. Abbott; K. N. Keck; R. E. Schindler; R. L. VanHorn; N. L. Hampton; M. B. Heiser

1999-05-01

This screening level risk assessment evaluates potential adverse human health and ecological impacts resulting from continued operations of the calciner at the New Waste Calcining Facility (NWCF) at the Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Engineering and Environmental Laboratory (INEEL). The assessment was conducted in accordance with the Environmental Protection Agency (EPA) report, Guidance for Performing Screening Level Risk Analyses at Combustion Facilities Burning Hazardous Waste. This screening guidance is intended to give a conservative estimate of the potential risks to determine whether a more refined assessment is warranted. The NWCF uses a fluidized-bed combustor to solidify (calcine) liquid radioactive mixed waste from the INTEC Tank Farm facility. Calciner off volatilized metal species, trace organic compounds, and low-levels of radionuclides. Conservative stack emission rates were calculated based on maximum waste solution feed samples, conservative assumptions for off gas partitioning of metals and organics, stack gas sampling for mercury, and conservative measurements of contaminant removal (decontamination factors) in the off gas treatment system. Stack emissions were modeled using the ISC3 air dispersion model to predict maximum particulate and vapor air concentrations and ground deposition rates. Results demonstrate that NWCF emissions calculated from best-available process knowledge would result in maximum onsite and offsite health and ecological impacts that are less then EPA-established criteria for operation of a combustion facility.

Assessment of Jordanian Patient's Colorectal Cancer Awareness and Preferences towards CRC Screening: Are Jordanians Ready to Embrace CRC Screening?

Science.gov (United States)

Omran, Suha; Barakat, Husam; Muliira, Joshua Kanaabi; Bashaireh, Ibrahim; Batiha, Abdul-Moni'm

2015-01-01

Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the population's level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US$) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.

Effects of screening for psychological distress on patient outcomes in cancer : A systematic review

NARCIS (Netherlands)

Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

Objective: Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients

Terrestrial avoidance behaviour tests as screening tool to assess soil contamination

International Nuclear Information System (INIS)

Loureiro, Susana; Soares, Amadeu M.V.M.; Nogueira, Antonio J.A.

2005-01-01

To assess soil quality and risk assessment, bioassays can be useful tools to gauge the potential toxicity of contaminants focusing on their bioavailable fraction. A rapid and sublethal avoidance behaviour test was used as a screening tool with the earthworm Eisenia andrei and the isopod Porcellionides pruinosus, where organisms were exposed during 48 h to several chemicals (lindane, dimethoate and copper sulphate, for isopods and carbendazim, benomyl, dimethoate and copper sulphate for earthworms). Both species were also exposed to soils from an abandoned mine. For all bioassays a statistical approach was used to derive EC 50 values. Isopods and earthworms were able to perceive the presence of toxic compounds and escaping from contaminated to clean soil. Furthermore the behaviour parameter was equally or more sensitive then other sublethal parameters (e.g. reproduction or growth), expressing the advantages of Avoidance Behaviour Tests as screening tools in ERA. - Avoidance Behaviour Tests with earthworms and isopods can be used as screening tools in the evaluation of soil contamination

Implementation of baby boomer hepatitis C screening and linking to care in gastroenterology practices: a multi-center pilot study.

Science.gov (United States)

Younossi, Zobair M; LaLuna, Louis L; Santoro, John J; Mendes, Flavia; Araya, Victor; Ravendhran, Natarajan; Pedicone, Lisa; Lio, Idania; Nader, Fatema; Hunt, Sharon; Racila, Andrei; Stepanova, Maria

2016-04-04

Estimates suggest that only 20 % of HCV-infected patients have been identified and gastroenterology practices in patients previously unscreened for HCV. After obtaining patient informed consent, demographics, clinical and health-related quality of life (HRQOL) data were collected. A blood sample was screened for HCV antibody (HCV AB) using the OraQuick HCV Rapid Antibody Test. HCV AB-positive patients were tested for presence of HCV RNA and, if HCV RNA positive, patients underwent treatment discussions. We screened 2,000 individuals in 5 gastroenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid-Atlantic and 1 Southeast). Of the screened population, 10 individuals (0.5 %) were HCV AB-positive. HCV RNA testing was performed in 90 % (9/10) of HCV AB-positive individuals. Of those, 44.4 % (4/9) were HCV RNA-positive, and all 4 (100 %) were linked to caregiver. Compared to HCV AB negative subjects, HCV AB-positive individuals tended to be black (20.0 vs. 5.2 %, p = 0.09) and reported significantly higher rates of depression: 60.0 vs. 21.5 %, p = 0.009. These individuals also reported a significantly lower HRQOL citing having more fatigue, poorer concentration, and a decreased level of energy (p gastroenterology centers, the linkage to care was very high. The sample of patients used in this study may be biased, so further studies are needed to assess the effectiveness of the CDC screening recommendations. Implementation of the Baby Boomer Screening for HCV requires identifying screening environement with high prevalence of HCV+ individuals as well as an efficient process of linking them to care.

Differences in diagnostic activity in general practice and findings for individuals invited to the danish screening programme for colorectal cancer: a population-based cohort study.

Science.gov (United States)

Juul, Jakob Søgaard; Andersen, Berit; Laurberg, Søren; Carlsen, Anders Helles; Olesen, Frede; Vedsted, Peter

2018-06-22

To investigate the diagnostic activity in general practice and the cumulative incidence of colorectal cancer (CRC) in individuals invited to the Danish national screening programme for CRC. A historical population-based cohort study. The Danish CRC screening programme and general practice. The 376,198 individuals invited to the Danish CRC screening programme from 1 March to 31 December 2014. The diagnostic activity (consultations and haemoglobin measures) in general practice in the year preceding the screening invitation and the cumulated incidence of CRC in the year following the screening invitation. Screening participants had significantly higher diagnostic activity than non-participants. Individuals with a positive faecal immunochemical test (FIT) had higher diagnostic activity compared to individuals with a negative FIT, and a small increase in the months leading up to the invitation. Individuals with a screen-detected CRC had lower diagnostic activity than individuals with no CRC. In total, 308 (25.3%) of CRCs diagnosed in the invited population were diagnosed outside the screening programme. Non-participants with CRC more often had low socio-economic status, high comorbidity and stage IV CRC than participants with CRC. There was a tendency that participants and those with a positive FIT had a higher diagnostic activity the year before the screening. This was not seen for those with CRC detected through screening. CRC must still be diagnosed in general practice in the invited population and non-participants are of special interest as they have higher risk of late stage CRC. Key Points Current awareness:Individuals with colorectal cancer (CRC) in screening may be symptomatic and CRC may still occur outside screening in the invited population. Most important points:The majority of individuals with CRC in screening cannot be expected to be diagnosed on symptomatic presentation in general practice GPs have to be aware that CRC still occurs outside screening in

Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report: Clinical Practice Guidelines for Screening Siblings of Children With Vesicoureteral Reflux and Neonates/Infants With Prenatal Hydronephrosis.

Science.gov (United States)

Skoog, Steven J; Peters, Craig A; Arant, Billy S; Copp, Hillary L; Elder, Jack S; Hudson, R Guy; Khoury, Antoine E; Lorenzo, Armando J; Pohl, Hans G; Shapiro, Ellen; Snodgrass, Warren T; Diaz, Mireya

2010-09-01

The American Urological Association established the Vesicoureteral Reflux Guideline Update Committee in July 2005 to update the management of primary vesicoureteral reflux in children guideline. The Panel defined the task into 5 topics pertaining to specific vesicoureteral reflux management issues, which correspond to the management of 3 distinct index patients and the screening of 2 distinct index patients. This report summarizes the existing evidence pertaining to screening of siblings and offspring of index patients with vesicoureteral reflux and infants with prenatal hydronephrosis. From this evidence clinical practice guidelines are developed to manage the clinical scenarios insofar as the data permit. The Panel searched the MEDLINE(R) database from 1994 to 2008 for all relevant articles dealing with the 5 chosen guideline topics. The database was reviewed and each abstract segregated into a specific topic area. Exclusions were case reports, basic science, secondary reflux, review articles and not relevant. The extracted article to be accepted should have assessed a cohort of children, clearly stating the number of children undergoing screening for vesicoureteral reflux. Vesicoureteral reflux should have been diagnosed with a cystogram and renal outcomes assessed by nuclear scintigraphy. The screening articles were extracted into data tables developed to evaluate epidemiological factors, patient and renal outcomes, and results of treatment. The reporting of meta-analysis of observational studies elaborated by the MOOSE group was followed. The extracted data were analyzed and formulated into evidence-based recommendations regarding the screening of siblings and offspring in index cases with vesicoureteral reflux and infants with prenatal hydronephrosis. In screened populations the prevalence of vesicoureteral reflux is 27.4% in siblings and 35.7% in offspring. Prevalence decreases at a rate of 1 screened person every 3 months of age. The prevalence is the same

Global landscape assessment of screening technologies for medicine quality assurance: stakeholder perceptions and practices from ten countries.

Science.gov (United States)

Roth, Lukas; Nalim, Ameena; Turesson, Beth; Krech, Laura

2018-04-25

The spread of substandard and falsified (SF) medical products constitutes a growing global public health concern. Some countries use portable, handheld screening technologies (STs) in the field to accelerate detection of SF medicines and reduce the number of medicine samples that undergo costly and time-consuming confirmatory analysis. A multi-country, multi-stakeholder landscape assessment utilizing qualitative methodology was used to examine practices and perceptions related to the use of STs. Qualitative interview guides were designed using the results of a literature review and comprised of open-ended questions with the study participants, who were from national medicine regulatory authorities, pharmaceutical manufacturers, pharmacies, and distributors. Ten geographically and economically diverse countries were selected: Argentina, China, Egypt, India, Jordan, Mexico, Nigeria, Philippines, the United States, and Zimbabwe. Of the completed 53 interviews, 32 were in-person, 16 were phone interviews, and 5 were via written questionnaires. Data analysis shows a wide variation in understanding and usage of STs in different sectors. Virtually all of the study participants indicated a lack of objective, accessible information on STs to advise them on what technologies would be beneficial for their needs. Study participants also described their ideal capabilities of the next generation of STs, including shareable spectral libraries, lower acquisition costs, lesser training requirements, and in-country maintenance and technical support. The results and recommendations presented in this article can be used to help regulators communicate and justify their needs to acquire and invest in new STs. There is a need for additional standardized, trustworthy and scientifically sound evaluations of STs, and to support regulators to effectively deploy the most promising technologies. ST manufacturers can take into account some of the limitations of the technologies the interviewees

English Teachers Classroom Assessment Practices

Science.gov (United States)

Saefurrohman; Balinas, Elvira S.

2016-01-01

The new language assessment policies in the Philippines and in Indonesia have impact on English teachers' assessment practices. Classroom assessment; as mandated in the current curriculum of both countries swifts from sources of information to the inseparable process of teaching and learning. This study describes Filipino and Indonesian high…

The effect of an online video intervention 'Movie Models' on specific parenting practices and parental self-efficacy related to children's physical activity, screen-time and healthy diet: a quasi experimental study.

Science.gov (United States)

De Lepeleere, Sara; De Bourdeaudhuij, Ilse; Cardon, Greet; Verloigne, Maïté

2017-04-27

In children, being sufficiently physically active, having low levels of screen-time and having a healthy diet are largely influenced by parenting practices. Children of parents applying positive parenting practices are at lower risk for overweight and obesity. Therefore, we investigated the effect of a health promoting online video intervention for parents ('Movie Models') on children's physical activity (PA), screen-time and healthy diet, and on specific parenting practices and parental self-efficacy related to these parenting practices. The online videos are delivered to parents of primary schoolchildren, and were based on real-life scenarios. A two-armed, quasi experimental design was used. Parents of primary schoolchildren were recruited between November and December 2013 by spreading an appeal in social media, and by contacting primary schools. Participating parents were predominantly of high socio-economic status (SES) (83.1%), and only 6.8% of children were overweight/obese. Intervention group participants were invited to watch online videos for 4 weeks. Specific parenting practices, parental self-efficacy, PA, screen-time and healthy diet of the child were assessed at baseline (T0), at one (T1) and at four (T2) months post baseline. Repeated Measures (Multivariate) ANOVAs were used to examine intervention effects. The potential moderating effect of age and gender of the child and parental SES was also examined. Between T0 and T2, no significant intervention effects were found on children's PA, screen-time or healthy diet. Most significant intervention effects were found for more complex parenting practices (e.g., an increase in motivating the child to eat fruit). Subgroup analyses showed that the intervention had more effect on the actual parenting practices related to PA, screen-time and healthy diet in parents of older children (10-12 years old), whereas intervention effects on parental self-efficacy related to those behaviors were stronger in parents of

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

Science.gov (United States)

... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

Screening for microalbuminuria in patients with type 2 diabetes is incomplete in general practice

DEFF Research Database (Denmark)

Knudsen, Soren Tang; Mosbech, Thomas Hammershaimb; Hansen, Birtha

2012-01-01

screening for microalbuminuria. RESULTS: The mean age of the patients was 66.2 +/- 11.6 years and 58.7% were male. Only 57.2% of the patients had been screened for microalbuminuria with any method within the preceding 12 months period; of these 76.0% had normo- and 21.0% had microalbuminuria, whereas 3......INTRODUCTION: National Danish guidelines recommend screening for microalbuminuria with assessment of urinary albumin/creatinine ratio at least annually in patients with type 2 diabetes. To which extent such screening is actually performed is not known. MATERIAL AND METHODS: A total of 2.......0% had overt proteinuria. In contrast, 97.6% of patients had had a minimum of one plasma-creatinine measurement within the past year. CONCLUSION: In Danish primary care, screening for microalbuminuria in type 2 diabetes is insufficiently implemented, whereas renal function is evaluated in almost all...

Relativity Screens for Misvalued Medical Services: Impact on Noninvasive Diagnostic Radiology.

Science.gov (United States)

Rosenkrantz, Andrew B; Silva, Ezequiel; Hawkins, C Matthew

2017-11-01

In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services. The frequency of having ever undergone a screen was compared between the two groups. Screened radiology codes were further evaluated regarding the RVU impact of subsequent revaluation. Of noninvasive diagnostic radiology codes, 46.0% (201 of 437) were screened versus 22.2% (1,460 of 6,575) of remaining codes (P < .001). Most common screens for which radiology codes were identified as potentially misvalued were (1) high expenditures (27.5%) and (2) high utilization (25.6%). The modality and body region most likely to be identified in a screen were CT (82.1%) and breast (90.9%), respectively. Among screened radiology codes, work RVUs, practice expense RVUs, and nonfacility total RVUs decreased in 20.3%, 65.9%, and 75.3%, respectively. All screened CT, MRI, brain, and spine codes exhibited decreased total RVUs. Policymakers' ongoing search for potentially misvalued medical services has disproportionately impacted noninvasive diagnostic radiology services, risking the introduction of unintended or artificial shifts in physician practice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Psychosocial consequences of skin cancer screening

Directory of Open Access Journals (Sweden)

Patricia Markham Risica

2018-06-01

Full Text Available Screening for melanoma may save lives, but may also cause patient distress. One key reason that preventative visual skin examinations for skin cancer are not currently recommended is the inadequate available evidence to assess potential harm to psychosocial wellbeing. We investigated potential psychological harms and benefits of skin examinations by conducting telephone surveys in 2015 of 187 screened participants; all were ≥35 years old. Participants had their skin examined by practitioners who had completed INFORMED, a validated web-based training for detection of skin cancers, particularly melanoma. Participants underwent the Spielberger State-Trait Anxiety Inventory (STAI, Psychological Consequences of Screening (PCQ, Hospital Anxiety and Depression (HAD scale, and the 12-Item Short Form Health Survey (SF-12. Analyses were conducted in 2017. Of the entire study sample, 40% were thoroughly screened as determined by patient-reported level of undress and skin areas examined. Participants who were thoroughly screened: did not differ on negative psychosocial measures; scored higher on measures of positive psychosocial wellbeing (PCQ; and were more motivated to conduct monthly self-examinations and seek annual clinician skin examinations, compared to other participants (p < 0.05. Importantly, thoroughly screened patients were more likely to report skin prevention practices (skin self-examinations to identify a concerning lesion, practitioner provided skin exam, recommend skin examinations to peers, and feel satisfied with their skin cancer education than less thoroughly screened individuals (p < 0.01. Our results suggest that visual screening for skin cancer does not worsen patient psychosocial wellbeing and may be associated with improved skin cancer-related practices and attitudes. Keywords: Cancer, Melanoma, Cancer prevention, Screening

Adolescent idiopathic scoliosis screening for school, community, and clinical health promotion practice utilizing the PRECEDE-PROCEED model

Directory of Open Access Journals (Sweden)

Wyatt Lawrence A

2005-11-01

Full Text Available Abstract Background Screening for adolescent idiopathic scoliosis (AIS is a commonly performed procedure for school children during the high risk years. The PRECEDE-PROCEDE (PP model is a health promotion planning model that has not been utilized for the clinical diagnosis of AIS. The purpose of this research is to study AIS in the school age population using the PP model and its relevance for community, school, and clinical health promotion. Methods MEDLINE was utilized to locate AIS data. Studies were screened for relevance and applicability under the auspices of the PP model. Where data was unavailable, expert opinion was utilized based on consensus. Results The social assessment of quality of life is limited with few studies approaching the long-term effects of AIS. Epidemiologically, AIS is the most common form of scoliosis and leading orthopedic problem in children. Behavioral/environmental studies focus on discovering etiologic relationships yet this data is confounded because AIS is not a behavioral. Illness and parenting health behaviors can be appreciated. The educational diagnosis is confounded because AIS is an orthopedic disorder and not behavioral. The administration/policy diagnosis is hindered in that scoliosis screening programs are not considered cost-effective. Policies are determined in some schools because 26 states mandate school scoliosis screening. There exists potential error with the Adam's test. The most widely used measure in the PP model, the Health Belief Model, has not been utilized in any AIS research. Conclusion The PP model is a useful tool for a comprehensive study of a particular health concern. This research showed where gaps in AIS research exist suggesting that there may be problems to the implementation of school screening. Until research disparities are filled, implementation of AIS screening by school, community, and clinical health promotion will be compromised. Lack of data and perceived importance by

An Improved On-line Contingency Screening for Power System Transient Stability Assessment

DEFF Research Database (Denmark)

Weckesser, Johannes Tilman Gabriel; Jóhannsson, Hjörtur; Glavic, Mevludin

2017-01-01

This paper presents a contingency screening method and a framework for its on-line implementation. The proposed method carries out contingency screening and on-line stability assessment with respect to first-swing transient stability. For that purpose, it utilizes the single machine equivalent...... method and aims at improving the prior developed contingency screening approaches. In order to determine vulnerability of the system with respect to a particular contingency, only one time-domain simulation needs to be performed. An early stop criteria is proposed so that in a majority of the cases...... the simulation can be terminated after a few hundred milliseconds of simulated system response. The method's outcome is an assessment of the system's stability and a classification of each considered contingency. The contingencies are categorized by exploiting parameters of an equivalent one machine infinite bus...

Assessment of presurgical psychological screening in patients undergoing spine surgery: use and clinical impact.

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Young, Arthur K; Young, Benjamin K; Riley, Lee H; Skolasky, Richard L

2014-04-01

Prospective survey. To determine the prevalence of use of presurgical psychological screening (PPS) among spine surgeons in the United States, identify factors associated with PPS use, evaluate surgeons' opinions of PPS, and investigate how PPS is applied in clinical practice. The United States Preventive Services Task Force recommends PPS for patients undergoing back surgery. The prevalence of PPS is unknown. Thus, it may be difficult to improve preoperative care for such patients with psychological conditions. An online survey invitation was emailed to 340 spine surgeons. Questions addressed surgeon characteristics (eg, number of years in practice), practice characteristics (eg, practice type), inclusion of integrated rehabilitation and psychological services, and use of PPS. The impact of psychological factors on rehabilitation and recovery was assessed using an 11-point Likert scale (0, no impact; 10, highest impact). We analyzed the 110 (32%) responses with a χ(2) test (significance, Ppsychological factors on pain relief, adherence to therapy, and return to work (mean impact rating, >7.0); however, impact on return for follow-up was only moderate (mean rating, 5.8). A minority of surgeons reported using PPS. Surgeons were less likely to use PPS if they had completed residency or begun practice within 14 years, had fewer than 200 cases annually, or were university affiliated. This study highlights the need to advocate for the use of North American Spine Society guidelines regarding the use of PPS.

Radiological mass screening within the Member States of the European Community. Regulations, practices, effectiveness. Proceedings of a seminar

International Nuclear Information System (INIS)

Lochard, J.

1987-01-01

Under the Euratom Treaty it is the task of the Commission of the European Community to ensure the health protection of workers and the general public against the dangers of ionizing radiation. Dose limits and the principals of radiation protection were first laid down in a Council Directive of 1959, and have since been repeatedly adapted. The specific problems of radiation protection of persons undergoing medical examination or treatment are the subject of a separate Council Directive of 3 September 1984. This directive specifies that 'all medical exposures must be medically justified and kept as low as reasonably achievable'. The concept of justification is particularly critical in the case of mass-screening activities. For some diseases with low prevalence the radiological detriment to the population resulting from radiological mass-screening procedures might be greater than the individual benefit of the diagnosis. In addition the costs of public health care are rising in all Member States of the European Community and the effectiveness of public health care programmes like mass-screening must be carefully examined. A technical workshop on practices and regulations in the field of radiological mass-screening within the Member States (Luxembourg, 4-5 December 1984) and a seminar on the same subject (Luxembourg, 3-4 December 1985) were therefore organized by the Commission of the European Communities in cooperation with the Commissariat a l'energie Atomique, CEA, and the Centre d'etude sur l'evaluation de la protection dans le domaine nucleaire, CEPN (France). The workshop provided up-to-date information on effectiveness and cost of radiological mass-screening programmes in the Member States. The seminar provided the representatives of the national authorities responsible for radiation protection, public health and occupational medicine with an opportunity to discuss mass-screening practices with experts. This publication contains the papers presented at the

Psychosocial screening and assessment in oncology and palliative care settings

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Luigi eGrassi

2015-01-01

Full Text Available Psychiatric and psychosocial disorders among cancer patients have been reported as a major consequence of the disease and treatment. The problems in applying a pure psychiatric approach have determined the need for structuring more defined methods, including screening for distress and emotional symptoms and a more specific psychosocial assessment, to warrant proper care to cancer patients with psychosocial problems. This review examines some of the most significant issues related to these two steps, screening and assessment of psychosocial morbidity in cancer and palliative care. With regard to this , the many different variables, such as the factors affecting individual vulnerability (e.g. life events, chronic stress and allostatic load, well-being, and health attitudes and the psychosocial correlates of medical disease (e.g. psychiatric disturbances, psychological symptoms, illness behavior, and quality of life which are possibly implicated not only in classical psychiatric disorders but more broadly in psychosocial suffering. Multidimensional tools (e.g. and specific psychosocially oriented interview (e.g. the Diagnostic Criteria for Psychosomatic Research - DCPR represent a way to screen for and assess emotional distress, anxiety and depression, maladaptive coping, dysfunctional attachment, as well as other significant psychosocial dimensions secondary to cancer, such as demoralization and health anxiety. Cross-cultural issues, such as language, ethnicity, race, and religion, are also discussed as possible factors influencing the patients and families perception of illness, coping mechanisms, psychological response to a cancer diagnosis.

A review of current practices to increase Chlamydia screening in the community--a consumer-centred social marketing perspective.

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Phillipson, Lyn; Gordon, Ross; Telenta, Joanne; Magee, Chris; Janssen, Marty

2016-02-01

Chlamydia trachomatis is one of the most frequently reported sexually transmitted infections (STI) in Australia, the UK and Europe. Yet, rates of screening for STIs remain low, especially in younger adults. To assess effectiveness of Chlamydia screening interventions targeting young adults in community-based settings, describe strategies utilized and assess them according to social marketing benchmark criteria. A systematic review of relevant literature between 2002 and 2012 in Medline, Web of Knowledge, PubMed, Scopus and the Cumulative Index to Nursing and Allied Health was undertaken. Of 18 interventions identified, quality of evidence was low. Proportional screening rates varied, ranging from: 30.9 to 62.5% in educational settings (n = 4), 4.8 to 63% in media settings (n = 6) and from 5.7 to 44.5% in other settings (n = 7). Assessment against benchmark criteria found that interventions incorporating social marketing principles were more likely to achieve positive results, yet few did this comprehensively. Most demonstrated customer orientation and addressed barriers to presenting to a clinic for screening. Only one addressed barriers to presenting for treatment after a positive result. Promotional messages typically focused on providing facts and accessing a testing kit. Risk assessment tools appeared to promote screening among higher risk groups. Few evaluated treatment rates following positive results; therefore, impact of screening on treatment rates remains unknown. Future interventions should consider utilizing a comprehensive social marketing approach, using formative research to increase insight and segmentation and tailoring of screening interventions. Easy community access to both screening and treatment should be prioritized. © 2015 John Wiley & Sons Ltd.

The WERCAP Screen and the WERC Stress Screen: psychometrics of self-rated instruments for assessing bipolar and psychotic disorder risk and perceived stress burden.

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Mamah, Daniel; Owoso, Akinkunle; Sheffield, Julia M; Bayer, Chelsea

2014-10-01

Identification of individuals in the prodromal phase of bipolar disorder and schizophrenia facilitates early intervention and promises an improved prognosis. There are no current assessment tools for clinical risk symptoms of bipolar disorder, and psychosis-risk assessment generally involves semi-structured interviews, which are time consuming and rater dependent. We present psychometric data on two novel quantitative questionnaires: the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen for assessing bipolar and psychotic disorder risk traits, and the accompanying WERC Stress Screen for assessing individual and total psychosocial stressor severities. Prevalence rates of the WERCAP Screen were evaluated among 171 community youth (aged 13-24 years); internal consistency was assessed and k-means cluster analysis was used to identify symptom groups. In 33 participants, test-retest reliability coefficients were assessed, and ROC curve analysis was used to determine the validity of the psychosis section of the WERCAP Screen (pWERCAP) against the Structured Interview of Psychosis-Risk Symptoms (SIPS). Correlations of the pWERCAP, the affectivity section of the WERCAP Screen (aWERCAP) and the WERC Stress Screen were examined to determine the relatedness of scores with cognition and clinical measures. Cluster analysis identified three groups of participants: a normative (47%), a psychosis-affectivity (18%) and an affectivity only (35%) group. Internal consistency of the aWERCAP and pWERCAP resulted in alphas of 0.87 and 0.92, and test-retest reliabilities resulted in intraclass correlation coefficients of 0.76 and 0.86 respectively. ROC curve analysis showed the optimal cut-point on the pWERCAP as a score of >30 (sensitivity: 0.89; specificity: 1.0). There was a significant negative correlation between aWERCAP scores and total cognition (R=-0.42), and between pWERCAP scores and sensorimotor processing speed. Total stress scores correlated

A household survey on screening practices of household contacts of smear positive tuberculosis patients in Vietnam

NARCIS (Netherlands)

Thanh, Thuy Hoang Thi; Ngoc, Sy Dinh; Viet, Nhung Nguyen; van, Hung Nguyen; Horby, Peter; Cobelens, Frank G. J.; Wertheim, Heiman F. L.

2014-01-01

Close contacts of tuberculosis (TB) patients are at increased risk of developing tuberculosis. Although passive contact screening guidelines are incorporated in the national TB control program, currently it is unknown how frequent close contacts are screened for TB in Vietnam. This study assesses

A human reliability assessment screening method for the NRU upgrade project

International Nuclear Information System (INIS)

Bremner, F.M.; Alsop, C.J.

1997-01-01

The National Research Universal (NRU) reactor is a 130MW, low pressure, heavy water cooled and moderated research reactor. The reactor is used for research, both in support of Canada's CANDU development program, and for a wide variety of other research applications. In addition, NRU plays an important part in the production of medical isotopes, e.g., generating 80% of worldwide supplies of Molybdenum-99. NRU is owned and operated by Atomic Energy of Canada Ltd. (AECL), and is currently undergoing upgrading as part of AECL's continuing commitment to operate their facilities in a safe manner. As part of these upgrades both deterministic and probabilistic safety assessments are being carried out. It was recognized that the assignment of Human Error Probabilities (HEPs) is an important part of the Probabilistic Safety Assessment (PSA) studies, particularly for a facility whose design predates modern ergonomic practices, and which will undergo a series of backfitted modifications whilst continuing to operate. A simple Human Reliability Assessment (HRA) screening method, looking at both pre- and post-accident errors, was used in the initial safety studies. However, following review of this method within AECL and externally by the regulator, it was judged that benefits could be gained for future error reduction by including additional features, as later described in this document. The HRA development project consisted of several stages; needs analysis, literature review, development of method (including testing and evaluation), and implementation. This paper discusses each of these stages in further detail. (author)

State of affairs of tuberculosis in prison facilities: a systematic review of screening practices and recommendations for best TB control

NARCIS (Netherlands)

Vinkeles Melchers, Natalie V. S.; van Elsland, Sabine L.; Lange, Joep M. A.; Borgdorff, Martien W.; van den Hombergh, Jan

2013-01-01

Prisoners are at high risk of developing tuberculosis (TB), causing morbidity and mortality. Prison facilities encounter many challenges in TB screening procedures and TB control. This review explores screening practices for detection of TB and describes limitations of TB control in prison

Cancer screening in patients infected with HIV.

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Sigel, Keith; Dubrow, Robert; Silverberg, Michael; Crothers, Kristina; Braithwaite, Scott; Justice, Amy

2011-09-01

Non-AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to the general population; anal cancer, hepatocellular carcinoma, Hodgkin's lymphoma, and lung cancer all have good evidence demonstrating an enhanced risk in HIV-infected persons. A number of cancer screening interventions have shown benefit for specific cancers in the general population, but data on the application of these tests to HIV-infected persons are limited. Here we review the epidemiology and background literature relating to cancer screening interventions in HIV-infected persons. We then use these data to inform a conceptual model for evaluating HIV-infected patients for cancer screening.

Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?

Science.gov (United States)

Donnelly, Tam Truong; Al Khater, Al-Hareth; Al Kuwari, Mohamed Ghaith; Al-Bader, Salha Bujassoum; Al-Meer, Nabila; Abdulmalik, Mariam; Singh, Rajvir; Chaudhry, Sofia; Fung, Tak

2015-01-22

Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ(2) tests and multivariate logistic regression analyses. Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women. Published by the BMJ Publishing Group Limited. For permission to

Bidirectional associations between activity-related parenting practices, and child physical activity, sedentary screen-based behavior and body mass index: a longitudinal analysis.

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Sleddens, Ester F C; Gubbels, Jessica S; Kremers, Stef P J; van der Plas, Eline; Thijs, Carel

2017-07-06

It has been generally assumed that activity-related parenting practices influence children's activity behavior and weight status. However, vice versa parents may also change their parenting behaviors in response to their perceptions of their child's activity behavior and weight status. This study examined the bidirectional relationships between activity-related parenting practices, and physical activity, sedentary screen-based behavior, and body mass index (BMI) between children's age of 5 and 7 years. Three scales of the Activity-related Parenting Questionnaire (i.e. 'restriction of sedentary behavior', 'stimulation of physical activity', and 'monitoring of physical activity') were completed by 1694 parents of the Dutch KOALA Birth Cohort Study at the child's age of around 5 and again around age 7. Physical activity, sedentary screen-based behavior and BMI were measured at both ages as well. Linear regression models were used to estimate the bidirectional associations between each parenting practice and the child's physical activity levels, sedentary screen-based behavior and BMI z-scores. Several parenting practices at age 5 predicted child physical activity, sedentary screen-based behavior, and BMI z-scores at age 7. Restriction of sedentary behavior positively predicted child BMI and sedentary screen-based behavior, whereas this practice negatively predicted child physical activity. In addition, stimulation of physical activity at age 5 was significantly associated with higher levels of child physical activity at age 7. The following child factors at age 5 predicted parenting practices at age 7: Child physical activity positively predicted parental stimulation of physical activity and monitoring activities. Sedentary screen-based behavior was associated with lower parental stimulation to be active. Findings generally revealed that parents and children mutually influence each other's behavior. A reinforcing feedback loop was present between parental stimulation

Optimisation and assessment of three modern touch screen tablet computers for clinical vision testing.

Directory of Open Access Journals (Sweden)

Humza J Tahir

Full Text Available Technological advances have led to the development of powerful yet portable tablet computers whose touch-screen resolutions now permit the presentation of targets small enough to test the limits of normal visual acuity. Such devices have become ubiquitous in daily life and are moving into the clinical space. However, in order to produce clinically valid tests, it is important to identify the limits imposed by the screen characteristics, such as resolution, brightness uniformity, contrast linearity and the effect of viewing angle. Previously we have conducted such tests on the iPad 3. Here we extend our investigations to 2 other devices and outline a protocol for calibrating such screens, using standardised methods to measure the gamma function, warm up time, screen uniformity and the effects of viewing angle and screen reflections. We demonstrate that all three devices manifest typical gamma functions for voltage and luminance with warm up times of approximately 15 minutes. However, there were differences in homogeneity and reflectance among the displays. We suggest practical means to optimise quality of display for vision testing including screen calibration.

Optimisation and assessment of three modern touch screen tablet computers for clinical vision testing.

Science.gov (United States)

Tahir, Humza J; Murray, Ian J; Parry, Neil R A; Aslam, Tariq M

2014-01-01

Technological advances have led to the development of powerful yet portable tablet computers whose touch-screen resolutions now permit the presentation of targets small enough to test the limits of normal visual acuity. Such devices have become ubiquitous in daily life and are moving into the clinical space. However, in order to produce clinically valid tests, it is important to identify the limits imposed by the screen characteristics, such as resolution, brightness uniformity, contrast linearity and the effect of viewing angle. Previously we have conducted such tests on the iPad 3. Here we extend our investigations to 2 other devices and outline a protocol for calibrating such screens, using standardised methods to measure the gamma function, warm up time, screen uniformity and the effects of viewing angle and screen reflections. We demonstrate that all three devices manifest typical gamma functions for voltage and luminance with warm up times of approximately 15 minutes. However, there were differences in homogeneity and reflectance among the displays. We suggest practical means to optimise quality of display for vision testing including screen calibration.

Older adult mistreatment risk screening: contribution to the validation of a screening tool in a domestic setting.

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Lindenbach, Jeannette M; Larocque, Sylvie; Lavoie, Anne-Marise; Garceau, Marie-Luce

2012-06-01

ABSTRACTThe hidden nature of older adult mistreatment renders its detection in the domestic setting particularly challenging. A validated screening instrument that can provide a systematic assessment of risk factors can facilitate this detection. One such instrument, the "expanded Indicators of Abuse" tool, has been previously validated in the Hebrew language in a hospital setting. The present study has contributed to the validation of the "e-IOA" in an English-speaking community setting in Ontario, Canada. It consisted of two phases: (a) a content validity review and adaptation of the instrument by experts throughout Ontario, and (b) an inter-rater reliability assessment by home visiting nurses. The adaptation, the "Mistreatment of Older Adult Risk Factors" tool, offers a comprehensive tool for screening in the home setting. This instrument is significant to professional practice as practitioners working with older adults will be better equipped to assess for risk of mistreatment.

More comprehensive discussion of CRC screening associated with higher screening.

Science.gov (United States)

Mosen, David M; Feldstein, Adrianne C; Perrin, Nancy A; Rosales, A Gabriella; Smith, David H; Liles, Elizabeth G; Schneider, Jennifer L; Meyers, Ronald E; Elston-Lafata, Jennifer

2013-04-01

Examine association of comprehensiveness of colorectal cancer (CRC) screening discussion by primary care physicians (PCPs) with completion of CRC screening. Observational study in Kaiser Permanente Northwest, a group-model health maintenance organization. A total of 883 participants overdue for CRC screening received an automated telephone call (ATC) between April and June 2009 encouraging CRC screening. Between January and March 2010, participants completed a survey on PCPs' discussion of CRC screening and patient beliefs regarding screening. receipt of CRC screening (assessed by electronic medical record [EMR], 9 months after ATC). Primary independent variable: comprehensiveness of CRC screening discussion by PCPs (7-item scale). Secondary independent variables: perceived benefits of screening (4-item scale assessing respondents' agreement with benefits of timely screening) and primary care utilization (EMR; 9 months after ATC). The independent association of variables with CRC screening was assessed with logistic regression. Average scores for comprehensiveness of CRC discussion and perceived benefits were 0.4 (range 0-1) and 4.0 (range 1-5), respectively. A total of 28.2% (n = 249) completed screening, 84% of whom had survey assessments after their screening date. Of screeners, 95.2% completed the fecal immunochemical test. More comprehensive discussion of CRC screening was associated with increased screening (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.03-2.21). Higher perceived benefits (OR = 1.46, 95% CI = 1.13-1.90) and 1 or more PCP visits (OR = 5.82, 95% CI = 3.87-8.74) were also associated with increased screening. More comprehensive discussion of CRC screening was independently associated with increased CRC screening. Primary care utilization was even more strongly associated with CRC screening, irrespective of discussion of CRC screening.

"I think we've got too many tests!": Prenatal providers' reflections on ethical and clinical challenges in the practice integration of cell-free DNA screening.

Science.gov (United States)

Gammon, B L; Kraft, S A; Michie, M; Allyse, M

2016-01-01

The recent introduction of cell-free DNA-based non-invasive prenatal screening (cfDNA screening) into clinical practice was expected to revolutionize prenatal testing. cfDNA screening for fetal aneuploidy has demonstrated higher test sensitivity and specificity for some conditions than conventional serum screening and can be conducted early in the pregnancy. However, it is not clear whether and how clinical practices are assimilating this new type of testing into their informed consent and counselling processes. Since the introduction of cfDNA screening into practice in 2011, the uptake and scope have increased dramatically. Prenatal care providers are under pressure to stay up to date with rapidly changing cfDNA screening panels, manage increasing patient demands, and keep up with changing test costs, all while attempting to use the technology responsibly and ethically. While clinical literature on cfDNA screening has shown benefits for specific patient populations, it has also identified significant misunderstandings among providers and patients alike about the power of the technology. The unique features of cfDNA screening, in comparison to established prenatal testing technologies, have implications for informed decision-making and genetic counselling that must be addressed to ensure ethical practice. This study explored the experiences of prenatal care providers at the forefront of non-invasive genetic screening in the United States to understand how this testing changes the practice of prenatal medicine. We aimed to learn how the experience of providing and offering this testing differs from established prenatal testing methodologies. These differences may necessitate changes to patient education and consent procedures to maintain ethical practice. We used the online American Congress of Obstetricians and Gynecologists Physician Directory to identify a systematic sample of five prenatal care providers in each U.S. state and the District of Columbia. Beginning

Prostate cancer screening practices of African-American and non-African-American US primary care physicians: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Richards TB

2012-09-01

Full Text Available Thomas B Richards,1 Sun Hee Rim,1 Ingrid J Hall,1 Lisa C Richardson,1 Louie E Ross21Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; 2North Carolina A and T State University, Greensboro, NC, USAPurpose: We explored whether African-American (AA primary care physicians (PCPs have different prostate cancer screening practices compared to non-AA PCPs, after adjustment for potential confounding factors such as the proportion of AA patients in PCP practices.Methods: We used SAS/SUDAAN to compare weighted responses from AA PCPs (n = 604 with those from non-AA PCPs (n = 647 in the 2007–2008 National Survey of Primary Care Physician Practices Regarding Prostate Cancer Screening. We used multivariate logistic regression to calculate the weighted odds ratios (OR and 95% confidence intervals (CI.Results: We found that AA PCPs had higher odds of working in practices with above-the-median (≥21% proportions of AA male patients (OR, 9.02; 95% CI: 5.85–13.91. A higher proportion of AA PCPs (53.5%; 95% CI: 49.5–57.4 reported an above-the-median proportion (≥91% of PSA testing during health maintenance exams as compared to non-AA PCPs (39.4%; 95% CI: 35.5–43.4; P < 0.0002. After adjusting for the proportion of AA patients and other factors, we found that AA PCPs had higher odds of using PSA tests to screen men (OR, 1.74; 95% CI: 1.11–2.73.Conclusion: This study quantifies the magnitude of the differences reported in previous focus group studies. Our results may be helpful in hypothesis generation and in planning future research studies.Keywords: African-American, physician practice patterns, prostate-specific antigen, screening tests

Assessment Practices in Undergraduate Accounting Programs

Science.gov (United States)

Lusher, Anna L.

2010-01-01

This study examined accounting program assessment plans at 102 colleges and universities in the United States. The research focused on identifying assessment practices in undergraduate accounting programs by examining the skills and competencies assessed and determining the methods of assessment used. The study also investigated what course and/or…

The effect of an online video intervention ‘Movie Models’ on specific parenting practices and parental self-efficacy related to children’s physical activity, screen-time and healthy diet: a quasi experimental study

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Sara De Lepeleere

2017-04-01

Full Text Available Abstract Background In children, being sufficiently physically active, having low levels of screen-time and having a healthy diet are largely influenced by parenting practices. Children of parents applying positive parenting practices are at lower risk for overweight and obesity. Therefore, we investigated the effect of a health promoting online video intervention for parents (‘Movie Models’ on children’s physical activity (PA, screen-time and healthy diet, and on specific parenting practices and parental self-efficacy related to these parenting practices. The online videos are delivered to parents of primary schoolchildren, and were based on real-life scenarios. Methods A two-armed, quasi experimental design was used. Parents of primary schoolchildren were recruited between November and December 2013 by spreading an appeal in social media, and by contacting primary schools. Participating parents were predominantly of high socio-economic status (SES (83.1%, and only 6.8% of children were overweight/obese. Intervention group participants were invited to watch online videos for 4 weeks. Specific parenting practices, parental self-efficacy, PA, screen-time and healthy diet of the child were assessed at baseline (T0, at one (T1 and at four (T2 months post baseline. Repeated Measures (Multivariate ANOVAs were used to examine intervention effects. The potential moderating effect of age and gender of the child and parental SES was also examined. Results Between T0 and T2, no significant intervention effects were found on children’s PA, screen-time or healthy diet. Most significant intervention effects were found for more complex parenting practices (e.g., an increase in motivating the child to eat fruit. Subgroup analyses showed that the intervention had more effect on the actual parenting practices related to PA, screen-time and healthy diet in parents of older children (10–12 years old, whereas intervention effects on parental self

The "DOC" screen: Feasible and valid screening for depression, Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention clinics.

Science.gov (United States)

Swartz, Richard H; Cayley, Megan L; Lanctôt, Krista L; Murray, Brian J; Cohen, Ashley; Thorpe, Kevin E; Sicard, Michelle N; Lien, Karen; Sahlas, Demetrios J; Herrmann, Nathan

2017-01-01

Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment ("DOC") are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool ("DOC" screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment. All consecutive new referrals to a regional Stroke Prevention Clinic who were English-speaking and non-aphasic were eligible to be screened. Time for screen completion was logged. DOC screen results were compared to the neuropsychological battery and polysomnogram assessments using a modified receiver operator characteristic and area under the curve analysis. Data is reported to conform to STARD guidelines. 1503 people were screened over 2 years. 89% of eligible patients completed the screen in 5 minutes or less (mean 4.2 minutes), less than half the time it takes to complete the Montreal Cognitive Assessment (MoCA). 437 people consented to detailed testing. Of those, 421 completed the Structured Clinical Interview for Depression within 3 months of screening, 387 completed detailed neuropsychological testing within 3 months, and 88 had overnight polysomnograms. Screening scores combined with demographic variables (age, sex, education, body mass index), had excellent validity compared to gold standard diagnoses: DOC-Mood AUC 0.90; DOC-Apnea AUC 0.80; DOC-Cog AUC 0.81. DOC screen scores can reliably categorize patients in to low-, intermediate- or high-risk groups for further action and can do so with comparable accuracy to more time-consuming screens. Systematic screening of depression, obstructive sleep apnea, and cognitive impairment in 5 minutes or less is feasible and valid in a high volume stroke clinic using the DOC screen. The DOC screen may facilitate improved identification and treatment

A Brief Vestibular/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussions

Science.gov (United States)

Mucha, Anne; Collins, Michael W.; Elbin, R.J.; Furman, Joseph M.; Troutman-Enseki, Cara; DeWolf, Ryan M.; Marchetti, Greg; Kontos, Anthony P.

2014-01-01

Background Vestibular and ocular motor impairments and symptoms have been documented in patients with sport-related concussions. However, there is no current brief clinical screen to assess and monitor these issues. Purpose To describe and provide initial data for the internal consistency and validity of a brief clinical screening tool for vestibular and ocular motor impairments and symptoms after sport-related concussions. Study Design Cross-sectional study; Level of evidence, 2. Methods Sixty-four patients, aged 13.9 ± 2.5 years and seen approximately 5.5 ± 4.0 days after a sport-related concussion, and 78 controls were administered the Vestibular/Ocular Motor Screening (VOMS) assessment, which included 5 domains: (1) smooth pursuit, (2) horizontal and vertical saccades, (3) near point of convergence (NPC) distance, (4) horizontal vestibular ocular reflex (VOR), and (5) visual motion sensitivity (VMS). Participants were also administered the Post-Concussion Symptom Scale (PCSS). Results Sixty-one percent of patients reported symptom provocation after at least 1 VOMS item. All VOMS items were positively correlated to the PCSS total symptom score. The VOR (odds ratio [OR], 3.89; P concussed group. An NPC distance ≥5 cm and any VOMS item symptom score ≥2 resulted in an increase in the probability of correctly identifying concussed patients of 38% and 50%, respectively. Receiver operating characteristic curves supported a model including the VOR, VMS, NPC distance, and ln(age) that resulted in a high predicted probability (area under the curve = 0.89) for identifying concussed patients. Conclusion The VOMS demonstrated internal consistency as well as sensitivity in identifying patients with concussions. The current findings provide preliminary support for the utility of the VOMS as a brief vestibular/ocular motor screen after sport-related concussions. The VOMS may augment current assessment tools and may serve as a single component of a comprehensive approach

A framework provided an outline toward the proper evaluation of potential screening strategies.

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Adriaensen, Wim J; Matheï, Cathy; Buntinx, Frank J; Arbyn, Marc

2013-06-01

Screening tests are often introduced into clinical practice without proper evaluation, despite the increasing awareness that screening is a double-edged sword that can lead to either net benefits or harms. Our objective was to develop a comprehensive framework for the evaluation of new screening strategies. Elaborating on the existing concepts proposed by experts, a stepwise framework is proposed to evaluate whether a potential screening test can be introduced as a screening strategy into clinical practice. The principle of screening strategy evaluation is illustrated for cervical cancer, which is a template for screening because of the existence of an easily detectable and treatable precursor lesion. The evaluation procedure consists of six consecutive steps. In steps 1-4, the technical accuracy, place of the test in the screening pathway, diagnostic accuracy, and longitudinal sensitivity and specificity of the screening test are assessed. In steps 5 and 6, the impact of the screening strategy on the patient and population levels, respectively, is evaluated. The framework incorporates a harm and benefit trade-off and cost-effectiveness analysis. Our framework provides an outline toward the proper evaluation of potential screening strategies before considering implementation. Copyright © 2013 Elsevier Inc. All rights reserved.

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style

Directory of Open Access Journals (Sweden)

Alex Ghanouni

2017-04-01

Full Text Available Abstract Background There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. Methods A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and ‘decision-making styles’ (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent. The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. Results After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009. Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively. Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

Science.gov (United States)

Ghanouni, Alex; Renzi, Cristina; Waller, Jo

2017-04-18

There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively). Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008) and bowel (OR: 2.58, p = .015) information; an

The ADDITION-Cambridge trial protocol: a cluster – randomised controlled trial of screening for type 2 diabetes and intensive treatment for screen-detected patients

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Kinmonth Ann

2009-05-01

Full Text Available Abstract Background The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, the benefits of such a strategy remain uncertain. Methods and design The ADDITION-Cambridge study aims to evaluate the effectiveness and cost-effectiveness of (i a stepwise screening strategy for type 2 diabetes; and (ii intensive multifactorial treatment for people with screen-detected diabetes in primary care. 63 practices in the East Anglia region participated. Three undertook the pilot study, 33 were allocated to three groups: no screening (control, screening followed by intensive treatment (IT and screening plus routine care (RC in an unbalanced (1:3:3 randomisation. The remaining 27 practices were randomly allocated to IT and RC. A risk score incorporating routine practice data was used to identify people aged 40–69 years at high-risk of undiagnosed diabetes. In the screening practices, high-risk individuals were invited to take part in a stepwise screening programme. In the IT group, diabetes treatment is optimised through guidelines, target-led multifactorial treatment, audit, feedback, and academic detailing for practice teams, alongside provision of educational materials for newly diagnosed participants. Primary endpoints are modelled cardiovascular risk at one year, and cardiovascular mortality and morbidity at five years after diagnosis of diabetes. Secondary endpoints include all-cause mortality, development of renal and visual impairment, peripheral neuropathy, health service costs, self-reported quality of life, functional status and health utility. Impact of the screening programme at the population level is also assessed through measures of mortality, cardiovascular morbidity, health status and health service use among high-risk individuals. Discussion ADDITION-Cambridge is conducted in a defined high-risk group

[How to assess clinical practice guidelines with AGREE II: The example of neonatal jaundice].

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Renesme, L; Bedu, A; Tourneux, P; Truffert, P

2016-03-01

Neonatal jaundice is a very frequent condition that occurs in approximately 50-70% of term or near-term (>35 GA) babies in the 1st week of life. In some cases, a high bilirubin blood level can lead to kernicterus. There is no consensus for the management of neonatal jaundice and few countries have published national clinical practice guidelines for the management of neonatal jaundice. The aim of this study was to assess the quality of these guidelines. We conducted a systematic review of the literature for national clinical practice guidelines for the management of neonatal jaundice in term or near-term babies. Four independent reviewers assessed the quality of each guideline using the AGREE II evaluation. For each of the clinical practice guidelines, the management modalities were analyzed (screening, treatment, follow-up, etc.). Seven national clinical practice guidelines were found (South Africa, USA AAP, UK NICE, Canada, Norway, Switzerland, and Israel). The AGREE II score showed widespread variation regarding the quality of these national guidelines. There was no major difference between the guidelines concerning the clinical management of these babies. The NICE guideline is the most valuable guideline regarding the AGREE II score. NICE showed that, despite a strong and rigorous methodology, there is no evidenced-based recommended code of practice (RCP). Comparing RCPs, we found no major differences. The NICE guideline showed the best quality. The AGREE II instrument should be used as a framework when developing clinical practice guidelines to improve the quality of the future guideline. In France, a national guideline is needed for a more standardized management of neonatal jaundice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Developmental Surveillance and Screening Practices by Pediatric Primary Care Providers: Implications for Early Intervention Professionals

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Porter, Sallie; Qureshi, Rubab; Caldwell, Barbara Ann; Echevarria, Mercedes; Dubbs, William B.; Sullivan, Margaret W.

2016-01-01

This study used a survey approach to investigate current developmental surveillance and developmental screening practices by pediatric primary care providers in a diverse New Jersey county. A total of 217 providers were contacted with a final sample size of 57 pediatric primary care respondents from 13 different municipalities. Most providers…

The Cost-Effectiveness of School-Based Eating Disorder Screening

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Austin, S. Bryn; LeAnn Noh, H.; Jiang, Yushan; Sonneville, Kendrin R.

2014-01-01

Objectives. We aimed to assess the value of school-based eating disorder (ED) screening for a hypothetical cohort of US public school students. Methods. We used a decision-analytic microsimulation model to model the effectiveness (life-years with ED and quality-adjusted life-years [QALYs]), total direct costs, and cost-effectiveness (cost per QALY gained) of screening relative to current practice. Results. The screening strategy cost $2260 (95% confidence interval [CI] = $1892, $2668) per student and resulted in a per capita gain of 0.25 fewer life-years with ED (95% CI = 0.21, 0.30) and 0.04 QALYs (95% CI = 0.03, 0.05) relative to current practice. The base case cost-effectiveness of the intervention was $9041 per life-year with ED avoided (95% CI = $6617, $12 344) and $56 500 per QALY gained (95% CI = $38 805, $71 250). Conclusions. At willingness-to-pay thresholds of $50 000 and $100 000 per QALY gained, school-based ED screening is 41% and 100% likely to be cost-effective, respectively. The cost-effectiveness of ED screening is comparable to many other accepted pediatric health interventions, including hypertension screening. PMID:25033131

The Role of Developmental Screening Practices in Early Diagnosis of Autism Spectrum Disorders: An Analysis of All-Payer Claims Data in New Hampshire

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Humphreys, Betsy P.

2013-01-01

Universal developmental screening during pediatric well child care detects early delays in development and is a critical gateway to early intervention for young children at risk for Autism Spectrum Disorders (ASD). Developmental screening practices are highly variable, and few studies have examined screening utilization for children at risk for…

Chlamydia and Gonorrhea Screening and Expedited Partner Therapy (EPT) Practices of College Student Health Centers

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Oswalt, Sara B.; Eastman-Mueller, Heather P.

2017-01-01

Objective: To examine college student health centers' (SHCs) practices related to sexually transmitted disease (STD) screening and treatment over a 5-year period. Participants: College SHCs that completed the ACHA Pap and STI Survey between 2010 and 2014. Methods: Chi-square tests were conducted with Cramer's V providing a measure of association.…

Using game authoring platforms to develop screen-based simulated functional assessments in persons with executive dysfunction following traumatic brain injury.

Science.gov (United States)

Martínez-Pernía, David; Núñez-Huasaf, Javier; Del Blanco, Ángel; Ruiz-Tagle, Amparo; Velásquez, Juan; Gomez, Mariela; Robert Blesius, Carl; Ibañez, Agustin; Fernández-Manjón, Baltasar; Slachevsky, Andrea

2017-10-01

The assessment of functional status is a critical component of clinical neuropsychological evaluations used for both diagnostic and therapeutic purposes in patients with cognitive brain disorders. There are, however, no widely adopted neuropsychological tests that are both ecologically valid and easily administered in daily clinical practice. This discrepancy is a roadblock to the widespread adoption of functional assessments. In this paper, we propose a novel approach using a serious game authoring platform (eAdventure) for creating screen-based simulated functional assessments. We created a naturalistic functional task that consisted of preparing a cup of tea (SBS-COT) and applied the assessment in a convenience sample of eight dyads of therapists/patients with mild executive dysfunction after traumatic brain injury. We had three main aims. First, we performed a comprehensive review of executive function assessment in activities of daily living. Second, we were interested in measuring the feasibility of this technology with respect to staffing, economic and technical requirements. Third, a serious game was administered to patients to study the feasibility of this technology in the clinical context (pre-screening test). In addition, quantitative (Technology Acceptance Model (TAM) questionnaires) and qualitative (semistructured interviews) evaluations were applied to obtain user input. Our results suggest that the staffing, economic and technical requirements of the SBS-COT are feasible. The outcomes of the pre-screening test provide evidence that this technology is useful in the functional assessment of patients with executive dysfunction. In relation to subjective data, the TAM questionnaire showed good user acceptability from a professional perspective. Interview analyses with professionals and patients showed positive experiences related to the use of the SBS-COT. Our work indicates that the use of these types of authoring platforms could have positive long

A Qualitative Study of Doctors of Chiropractic in a Nova Scotian Practice-based Research Network: Barriers and Facilitators to the Screening and Management of Psychosocial Factors for Patients With Low Back Pain.

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Stilwell, Peter; Hayden, Jill A; Des Rosiers, Piaf; Harman, Katherine; French, Simon D; Curran, Janet A; Hefford, Warren

2018-01-01

This study aimed to assess chiropractors' awareness of clinical practice guidelines for low back pain and to identify barriers and facilitators to the screening and management of psychosocial factors in patients with low back pain. This qualitative study used semi-structured interviews informed by the Theoretical Domains Framework with 10 Nova Scotian chiropractors who were members of a practice-based research network. The participants correctly identified what the guidelines generally recommend and described the value of psychosocial factors; however, none of the participants could name specific clinical practice guidelines for low back pain. We identified 6 themes related to barriers and facilitators for chiropractors screening and managing psychosocial factors. The themes revolved around the participants' desire to fulfill patients' anatomy-focused treatment expectations and a perceived lack of training for managing psychosocial factors. Participants had concerns about going beyond the chiropractic scope of practice, and they perceived a lack of practical psychosocial screening and management resources. Social factors, such as the influence of other health care practitioners, were reported as both barriers and facilitators to screening and managing psychosocial factors. The participants in this study reported that they mostly treated with an anatomical and biomechanical focus and that they did not always address psychosocial factors identified in their patients with low back pain. Although these findings are limited to Nova Scotian chiropractors, the barriers identified appeared to be potentially modifiable and could be considered in other groups. Low-cost interventions, such as continuing education using evidence-informed behavior change techniques, could be considered to address these barriers. Copyright © 2017. Published by Elsevier Inc.

Comparative Assessment of Knowledge, Attitude and Practice of ...

African Journals Online (AJOL)

TNHJOURNALPH

screening among female clinical nursing students in Southern Nigeria. ... female clinical nursing students in Delta. State University ... and drastic intervention strategies to save our women from unnecessary death. KEYWORDS. Comparative Assessment; Cervical cancer; Southern Nigeria. Correspondence: Dr. R. U. lbekwe.

Knowledge Regarding Symptoms and Risk Factors and Screening of Breast Cancer in Women Under 30 Years and Their Practice Relative to Self-Examination

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F. Jafari

2013-08-01

Full Text Available Background: Breast cancer is the most common malignancy among women worldwide. In Iran, breast cancer ranks first among cancers diagnosed in women. Nevertheless, many of women haven’t enough knowledge about breast cancer risk factors and symptoms. The main reason for this escalating mortality is lack of awareness and late diagnosis of disease. The aim of present study assessed the knowledge about risk factors and symptoms of breast cancer, also the screening method and practice (Breast self examination about it. Methods: This is a descriptive and cross-sectional study. In this study 340 red crescent volunteer women participated in a national congress were selected with convenience sampling method. The data collection instrument consisted of a three part questionnaire which included demographic factors, Knowledge level about risk factors, symptoms and screening methods of breast cancer and questions concerning practice about breast self examination (BSE.The study tool was a researcher-designed questionnaire which could evaluated a number of variables. After data collection, analysis was carried out with descriptive tests by SPSS.16 software. Results: The mean age of subjects was 23±2.1yrs. Knowledge about breast cancer risk factors was very poor, the most widely known risk factor and lowest among the participants was family history of breast cancer (30.6 % and early menarche (under 12 years (0.3% respectively. Only 47.9% respondents correctly recognized breast lump and 11.2% breast discharge as the most common symptoms of breast cancer.30% of subjects were aware of BSE. However, a lesser proportion (9.4% was done BSE regular monthly every few months. Conclusion: Regarding the low level of the women’s knowledge about breast cancer especially in young educated women, screening and interventional programs to improve awareness and practice is essential.

Screening vs. non-screening detected colorectal cancer: Differences in pre-therapeutic work up and treatment.

Science.gov (United States)

Saraste, D; Martling, A; Nilsson, P J; Blom, J; Törnberg, S; Janson, M

2017-06-01

Objectives To compare preoperative staging, multidisciplinary team-assessment, and treatment in patients with screening detected and non-screening detected colorectal cancer. Methods Data on patient and tumour characteristics, staging, multidisciplinary team-assessment and treatment in patients with screening and non-screening detected colorectal cancer from 2008 to 2012 were collected from the Stockholm-Gotland screening register and the Swedish Colorectal Cancer Registry. Results The screening group had a higher proportion of stage I disease (41 vs. 15%; p team-assessed than the non-screening group ( p team-assessed than patients with surgically resected cancers ( p team assessed more extensively than patients with non-screening detected cancers. Staging and multidisciplinary team assessment prior to endoscopic resection was less complete compared with surgical resection. Extensive surgical and (neo)adjuvant treatment was given in stage I disease. Participation in screening reduced the risk of emergency surgery for colorectal cancer.

Hepatitis B maternal screening, infant vaccination, and infant prophylaxis practices in North Carolina.

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Pierce, R L; Smith, S; Rowe-West, B; Sterritt, B

1999-06-01

To determine if the Advisory Committee on Immunization Practices hepatitis B screening, vaccination, and prophylaxis recommendations were being followed in North Carolina, and to establish a baseline hepatitis B seroprevalence rate. A survey of mother and infant birthing facility medical records. Four birthing facilities selected from each of the 7 districts in North Carolina (a total of 28 facilities). A probability proportional to size survey design was used to select 4763 mother-infant record pairs. All records came from the 1996 birth cohort. Maternal hepatitis B screening status, infant vaccination status, infants prophylaxis status, hepatitis B seroprevalence rate, demographic and clinical predictors for maternal infection, failure to receive prenatal care or for whom status was unknown, failure to screen, and failure to vaccinate. Ninety-two percent of pregnant women were screened for hepatitis B surface antigen. Eighty-six percent of infants received dose 1 of the hepatitis B vaccine. Four of the 9 infants with mothers who were hepatitis B surface antigen-positive did not receive both vaccine and hepatitis B immune globulin. The hepatitis B seroprevalence rate was 0.2%. Mothers who were not screened for infection were 3.4 times more likely to have infants who were not vaccinated. White mothers were twice as likely not to have their child vaccinated as mothers of other races. Not all infants with hepatitis B-infected mothers were receiving vaccine and hepatitis B immune globulin as recommended. Seroprevalence of hepatitis B infection may be lower in North Carolina than in other states. Hepatitis B laboratory test results should be included in every mother's medical record.

Feasibility of using touch screen technology for early cognitive assessment in children.

Science.gov (United States)

Twomey, Deirdre M; Wrigley, Conal; Ahearne, Caroline; Murphy, Raegan; De Haan, Michelle; Marlow, Neil; Murray, Deirdre M

2018-03-13

To explore the feasibility of using a touch screen assessment tool to measure cognitive capacity in toddlers. 112 typically developing children with a median age of 31 months (IQR: 26-34) interacted with a touch screen cognitive assessment tool. We examined the sensitivity of the tool to age-related changes in cognition by comparing the number of items completed, speed of task completion and accuracy in two age groups; 24-29 months versus 30-36 months. Children aged 30-36 months completed more tasks (median: 18, IQR: 18-18) than those aged 24-29 months (median: 17, IQR: 15-18). Older children also completed two of the three working memory tasks and an object permanence task faster than their younger peers. Children became faster at completing the working memory items with each exposure and registered similar completion times on the hidden object retrieval items, despite task demands being twofold on the second exposure. A novel item required children to integrate what they had learnt on preceding items. The older group was more likely to complete this item and to do so faster than the younger group. Children as young as 24 months can complete items requiring cognitive engagement on a touch screen device, with no verbal instruction and minimal child-administrator interaction. This paves the way for using touch screen technology for language and administrator independent developmental assessment in toddlers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Screening Risk Assessment for Possible Radionuclides in the Amchitka Marine Environment

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NNSA/NV

2002-10-31

As part of its environmental stewardship program the U.S. Department of Energy (DOE) is reevaluating three sites where underground nuclear tests were conducted in the deep subsurface of Amchitka Island, Alaska. The tests (i.e., Long Shot, Milrow, and Cannikin) were conducted in 1965, 1969, and 1971, respectively. Extensive investigations were conducted on these tests and their effect on the environment. Evaluations at the time of testing indicated limited release of radionuclides and absence of risk related to the testing; however, these are being reevaluated under the current DOE environmental stewardship program. A screening risk assessment of potential radionuclide release into the marine environment is an important part of this reevaluation. The risk assessment is one of three interrelated activities: a groundwater model and this screening risk assessment, both of which guide the decisions in the third activity, the site closure plan. Thus, the overall objective of the work is to understand, and subsequently manage, any risk to humans and the environment through a closure and long-term stewardship plan. The objective of this screening risk assessment is to predict whether possible releases of radionuclides at the ocean floor would represent potential risks to Native Alaskans by consumption of marine subsistence species. In addition, risks were predicted for consumers of commercial catches of marine organisms. These risks were calculated beginning with estimates of possible radionuclide release at the seafloor (from a groundwater modeling study), into the seawater, through possible uptake by marine organisms, and finally possible consumption by humans. The risk assessment model has 11 elements, progressing from potential release at the seafloor through water and food chains to human intake. Data for each of these elements were systematically found and synthesized from many sources, and represent the best available knowledge. Whenever precise data were lacking

Effects of peer health education on perception and practice of screening for cervical cancer among urban residential women in south-east Nigeria: a before and after study.

Science.gov (United States)

Mbachu, Chinyere; Dim, Cyril; Ezeoke, Uche

2017-06-09

Effective female education on cervical cancer prevention has been shown to increase awareness and uptake of screening. However, sustaining increase in uptake poses a challenge to control efforts. Peer health education has been used as an effective tool for ensuring sustained behavior change. This study was undertaken to assess the effectiveness of peer health education on perception, willingness to screen and uptake of cervical cancer screening by women. A before and after intervention study was undertaken in 2 urban cities in Enugu state, Nigeria among women of reproductive age attending women's meeting in Anglican churches. Multistage sampling was used to select 300 women. Peer health education was provided once monthly for 3 consecutive sessions over a period of 3 months. Data was collected at baseline and after the intervention using pre-tested questionnaires. Descriptive statistics and tests of significance of observed differences and associations were done at p-value of education, employment status and parity (p education is an effective strategy for increasing women's perception of benefits of early detection of cervical cancer through screening. It is also effective for increasing their practice of screening for cervical cancer.

Health beliefs and practices related to cancer screening among Arab Muslim women in an urban community.

Science.gov (United States)

Salman, Khlood Faik

2012-01-01

In this exploratory study I investigated the participation status in breast and cervical cancer screening of a group of American immigrant Arab Muslim women (AMW). Perceived knowledge of and barriers to screening participation, relationships among demographic variables, health practice and beliefs, and self-reports of traditionalism and acculturation also are studied. Factors including religious and cultural beliefs, economic concerns, and modesty and embarrassment were considered. To reach the goals of Healthy People 2010 (HP 2010), an effective and meaningful educational initiative to raise awareness about breast and cervical cancer of AMW will require specific interventions consistent with their cultural and religious traditions.

Patient Assessment Skills Pertinent to Practicing Pharmacists

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Jennifer A. Wilson

2015-01-01

Full Text Available Objectives: To describe pharmacists’ opinions regarding which patient assessment skills are necessary to understand and/or perform to provide optimal patient care in pharmacy practice. Methods: An online questionnaire was distributed to pharmacists licensed in North Carolina (n=14,167, as identified by the Board of Pharmacy. The 80 patient assessment items in the questionnaire were derived from a course text book and faculty experience. Participants indicated whether they “need to understand and be able to perform”, “need to understand only”, or “not need to understand or be able to perform” each item in their current practice setting. Descriptive statistics were used to describe background demographics and perceived need for each item. Post-hoc chi-square analyses were performed to determine differences in need based on practice setting and Pharm.D. degree completion. Results: Of 1036 responses received, 770 were used in data analysis; incomplete questionnaires and non-practicing pharmacist responses were excluded. Fifty-nine percent of respondents held a Pharm.D. degree. Participants identified their practice site(s as inpatient (29%, outpatient (16%, community/retail (50%, long term care (5%, and other (8%. The top five patient assessment items respondents identified as important to understand and perform included automatic blood pressure measurement (63%, point of care testing (57%, manual blood pressure measurement (53%, heart rate measurement (52%, and peak flow meter use (47%. Post-hoc analyses showed a significant difference among those with a Pharm.D. versus those without for the response “need to understand and be able to perform” for 20 patient assessment items; a significant difference was also noted among practice settings for 29 items. Conclusions: The top items pharmacists identified they need to both understand and perform could be applied in various practice settings. The study results may guide which patient

Practical session assessments in human anatomy: Weightings and performance.

Science.gov (United States)

McDonald, Aaron C; Chan, Siew-Pang; Schuijers, Johannes A

2016-07-08

Assessment weighting within a given module can be a motivating factor for students when deciding on their commitment level and time given to study a specific topic. In this study, an analysis of assessment performances of second year anatomy students was performed over four years to determine if (1) students performed better when a higher weighting was given to a set of practical session assessments and (2) whether an improved performance in the practical session assessments had a carry-over effect on other assessment tasks within that anatomy module and/or other anatomy modules that follow. Results showed that increasing the weighting of practical session assessments improved the average mark in that assessment and also improved the percentage of students passing that assessment. Further, it significantly improved performance in the written end-semester examination within the same module and had a carry-over effect on the anatomy module taught in the next teaching period, as students performed better in subsequent practical session assessments as well as subsequent end-semester examinations. It was concluded that the weighting of assessments had significant influences on a student's performance in that, and subsequent, assessments. It is postulated that practical session assessments, designed to develop deep learning skills in anatomy, improved efficacy in student performance in assessments undertaken in that and subsequent anatomy modules when the weighting of these assessments was greater. These deep learning skills were also transferable to other methods of assessing anatomy. Anat Sci Educ 9: 330-336. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

The longitudinal impact of patient navigation on equity in colorectal cancer screening in a large primary care network.

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Percac-Lima, Sanja; López, Lenny; Ashburner, Jeffrey M; Green, Alexander R; Atlas, Steven J

2014-07-01

The long-term effects of interventions to improve colorectal (CRC) screening in vulnerable populations are uncertain. The authors evaluated the impact of patient navigation (PN) on the equity of CRC prevention over a 5-year period. A culturally tailored CRC screening PN program was implemented in 1 community health center (CHC) in 2007. In a primary care network, CRC screening rates from 2006 to 2010 among eligible patients from the CHC with PN were compared with the rates from other practices without PN. Multivariable logistic regression models for repeated measures were used to assess differences over time. Differences in CRC screening rates diminished among patients at the CHC with PN and at other practices between 2006 (49.2% vs 62.5%, respectively; P practices (5% vs 3.4% per year; P practices, lower CRC screening rates in 2006 (47.5% vs 52.1%, respectively; P = .02) were higher by 2010 (73.5% vs 67.3%, respectively; P practices in 2006 (44.3% vs 44.7%, respectively; P = .79) were higher at the CHC by 2010 (70.6% vs 58.6%, respectively; P practices (both P < .001). A PN program increased CRC screening rates in a CHC and improved equity in vulnerable patients. Long-term funding of PN programs has the potential to reduce cancer screening disparities. © 2014 American Cancer Society.

Assessing potential health effects from municipal sludge incinerators: screening methodology

Energy Technology Data Exchange (ETDEWEB)

Fradkin, L.; Bruins, J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.; Rubin, A.

1987-04-01

This paper describes a risk assessment methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e., facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium.

Method for screening prevention and control measures and technologies based on groundwater pollution intensity assessment

Energy Technology Data Exchange (ETDEWEB)

Li, Juan, E-mail: lijuan@craes.org.cn [College of Water Sciences, Beijing Normal University, Beijing 100875 (China); Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Yang, Yang [College of Environment, Beijing Normal University, Beijing 100875 (China); Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Huan, Huan; Li, Mingxiao [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Xi, Beidou, E-mail: xibd413@yeah.net [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Lanzhou Jiaotong University, Lanzhou 730070 (China); Lv, Ningqing [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China); Wu, Yi [Guizhou Academy of Environmental Science and Designing, Guizhou 550000 (China); Xie, Yiwen, E-mail: qin3201@126.com [School of Chemical and Environmental Engineering, Dongguan University of Technology, Dongguan, 523808 (China); Li, Xiang; Yang, Jinjin [Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); State Environmental Protection Key Laboratory of Simulation and Control of Groundwater Pollution, Beijing, 100012 (China)

2016-05-01

index-based methodology to assess the groundwater pollution intensity (GPI). • GPI assessment includes PSH assessment and GIV assessment. • Measures to prevent and control groundwater pollution based on GPI assessment. • An index-based methodology for prevention and control technologies (PCT) screening. • PCT screening based on GPI assessment results and TOPSIS method.

Method for screening prevention and control measures and technologies based on groundwater pollution intensity assessment

International Nuclear Information System (INIS)

Li, Juan; Yang, Yang; Huan, Huan; Li, Mingxiao; Xi, Beidou; Lv, Ningqing; Wu, Yi; Xie, Yiwen; Li, Xiang; Yang, Jinjin

2016-01-01

index-based methodology to assess the groundwater pollution intensity (GPI). • GPI assessment includes PSH assessment and GIV assessment. • Measures to prevent and control groundwater pollution based on GPI assessment. • An index-based methodology for prevention and control technologies (PCT) screening. • PCT screening based on GPI assessment results and TOPSIS method.

State of affairs of tuberculosis in prison facilities: a systematic review of screening practices and recommendations for best TB control.

Directory of Open Access Journals (Sweden)

Natalie V S Vinkeles Melchers

Full Text Available BACKGROUND: Prisoners are at high risk of developing tuberculosis (TB, causing morbidity and mortality. Prison facilities encounter many challenges in TB screening procedures and TB control. This review explores screening practices for detection of TB and describes limitations of TB control in prison facilities worldwide. METHODS: A systematic search of online databases (e.g., PubMed and Embase and conference abstracts was carried out. Research papers describing screening and diagnostic practices among prisoners were included. A total of 52 articles met the inclusion criteria. A meta-analysis of TB prevalence in prison facilities by screening and diagnostic tools was performed. RESULTS: The most common screening tool was symptom questionnaires (63·5%, mostly reporting presence of cough. Microscopy of sputum with Ziehl-Neelsen staining and solid culture were the most frequently combined diagnostic methods (21·2%. Chest X-ray and tuberculin skin tests were used by 73·1% and 50%, respectively, as either a screening and/or diagnostic tool. Median TB prevalence among prisoners of all included studies was 1,913 cases of TB per 100,000 prisoners (interquartile range [IQR]: 332-3,517. The overall annual median TB incidence was 7·0 cases per 1000 person-years (IQR: 2·7-30·0. Major limitations for successful TB control were inaccuracy of diagnostic algorithms and the lack of adequate laboratory facilities reported by 61·5% of studies. The most frequent recommendation for improving TB control and case detection was to increase screening frequency (73·1%. DISCUSSION: TB screening algorithms differ by income area and should be adapted to local contexts. In order to control TB, prison facilities must improve laboratory capacity and frequent use of effective screening and diagnostic tools. Sustainable political will and funding are critical to achieve this.

Improving work-up of the abnormal mammogram through organized assessment: results from the ontario breast screening program.

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Quan, May Lynn; Shumak, Rene S; Majpruz, Vicky; Holloway, Claire M D; O'Malley, Frances P; Chiarelli, Anna M

2012-03-01

Women with an abnormal screening mammogram should ideally undergo an organized assessment to attain a timely diagnosis. This study evaluated outcomes of women undergoing work-up after abnormal mammogram through a formal breast assessment affiliate (BAA) program with explicit care pathways compared with usual care (UC) using developed quality indicators for screening mammography programs. Between January 1 and December 31, 2007, a total of 320,635 women underwent a screening mammogram through the Ontario Breast Screening Program (OBSP), of whom 25,543 had an abnormal result requiring further assessment. Established indicators assessing timeliness, appropriateness of follow-up, and biopsy rates were compared between women who were assessed through either a BAA or UC using χ(2) analysis. Work-up of the abnormal mammogram for patients screened through a BAA resulted in a greater proportion of women attaining a definitive diagnosis within the recommended time interval when a histologic diagnosis was required. In addition, use of other quality measures including specimen radiography for both core biopsies and surgical specimens and preoperative core needle biopsy was greater in BAA facilities. These findings support future efforts to increase the number of BAAs within the OBSP, because the pathways and reporting methods associated with them result in improvements in our ability to provide timely and appropriate care for women requiring work-up of an abnormal mammogram.

Assessing the special need for protection of vulnerable refugees: testing the applicability of a screening method (RHS-15) to detect traumatic disorders in a refugee sample in Germany.

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Stingl, Markus; Knipper, Michael; Hetzger, Björge; Richards, Jessica; Yazgan, Bülent; Gallhofer, Bernd; Hanewald, Bernd

2017-10-29

Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the way for the implementation of an adequate instrument which at the same time assesses these needs of suffering people whilst responding to the need for mental health assessments specifically designed for refugees. This was done by testing the implementation of a screening method (Refugee Health Screener RHS-15) for trauma related mental health problems in refugees. Two refugee samples in Germany (differing in arrival time: 126 applicants for asylum residing in the initial reception center and 116 living in long term communal accommodations) were assessed with the culturally sensitive Refugee Health Screener (RHS-15) to detect the incidence of mental health problems amongst them. Test fairness, reasonableness, susceptibility, transparency, acceptance, external design, utility and economy of the instrument were examined to check the applicability of the RHS-15 standardization test. The RHS-15 indicates a good practical feasibility as the examination of the focused psychometric characteristics suggests. It became apparent, that implementing a screening procedure depends on political, legal and medical context factors that need to be considered. 2/3 of the participants had a positive screening result, which needs further diagnostic clarification in a second step. The RHS-15 seems to be practicable, economical, and rapidly deployable for the widespread detection of traumatic disorders in refugees living in Europe. The tool proved useful to aid diagnostic assessments and provide treatment to individuals in need, however the time of examination (resp. the duration of staying in the target land) influences the results.

Assessment of vegetable production practices in Qwaqwa within ...

African Journals Online (AJOL)

In this study, the information such as biographical information of the vegetable farmers, information about the vegetable gardens or farms, the current vegetable farming practices, irrigation practices on the vegetable soil and the farmers' physical and financial records were assessed. The assessment was conducted through ...

Cognitive Assessment Practices: A Survey of School Psychologists

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Sotelo-Dynega, Marlene; Dixon, Shauna G.

2014-01-01

The present article describes an exploratory study regarding the preferred cognitive assessment practices of current school psychologists. Three hundred and twenty-three school psychologists participated in the survey. The results suggest that the majority of school psychologists endorsed that they base their assessment practices on an underlying…

Depression screening and patient outcomes in cardiovascular care : a systematic review

NARCIS (Netherlands)

Thombs, Brett D.; de Jonge, Peter; Coyne, James C.; Whooley, Mary A.; Frasure-Smith, Nancy; Mitchell, Alex J.; Zuidersma, Marij; Eze-Nliam, Chete; Lima, Bruno B.; Smith, Cheri G.; Soderlund, Karl; Ziegelstein, Roy C.

2008-01-01

Context Several practice guidelines recommend that depression be evaluated and treated in patients with cardiovascular disease, but the potential benefits of this are unclear. Objective To evaluate the potential benefits of depression screening in patients with cardiovascular disease by assessing (

Assessment of the Diagnostic Potential of Clinotech TB Screen Test ...

African Journals Online (AJOL)

The Clinotech TB Screen test, a 3rd generation multi-antigen rapid chromatographic immunoassay for detection of IgG antibodies in serum against recombinant protein antigens 38kDa, 16kDa and 6kDa, was assessed for its diagnostic potential for diagnosis of active pulmonary TB in routine TB control programme in Abia ...

Investigating the Dynamics of Formative Assessment: Relationships between Teacher Knowledge, Assessment Practice and Learning

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Herman, Joan; Osmundson, Ellen; Dai, Yunyun; Ringstaff, Cathy; Timms, Michael

2015-01-01

This exploratory study of elementary school science examines questions central to policy, practice and research on formative assessment: What is the quality of teachers' content-pedagogical and assessment knowledge? What is the relationship between teacher knowledge and assessment practice? What is the relationship between teacher knowledge,…

Cancer Screening Awareness and Practice in a Middle Income Country; A Systematic Review from Iran

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Majidi, Azam; Majidi, Somayye; Salimzadeh, Somayye; Khazaee- Pool, Maryam; Sadjadi, Alireza; Salimzadeh, Hamideh; Delavari, Alireza

2017-12-28

Objective: Ageing population and noticeable changes in lifestyle in developing countries like Iran caused an increase in cancer incidence. This requires organized cancer prevention and screening programs in population level, but most importantly community should be aware of these programs and willing to use them. This study explored existing evidence on public awareness and practice, as well as, adherence to cancer screening in Iranian population. Methods: Major English databases including Web of Science, PubMed, Scopus, and domestic Persian databases i.e., SID, Magiran, and Barakat search engines were searched. All publications with focus on Iranian public awareness about cancer prevention, screening, and early detection programs which were published until August 2015, were explored in this systematic review. For this purpose, we used sensitive Persian phrases/key terms and English keywords which were extracted from medical subject headings (MeSH). Taking PRISMA guidelines into considerations eligible documents, were evaluated and abstracted by two separate reviewers. Results: We found 72 articles relevant to this topic. Screening tests were known to, or being utilized by only a limited number of Iranians. Most Iranian women relied on physical examination particularly self-examination, instead of taking mammogram, as the most standard test to find breast tumors. Less than half of the average-risk adult populations were familiar with colorectal cancer risk factors and its screening tests, and only very limited number of studies reported taking at least one time colonoscopy or FOBT, at most 5.0% and 15.0%, respectively. Around half of women were familiar with cervical cancer and Pap-smear test with less than 45% having completed at least one lifetime test. The lack of health insurance coverage was a barrier to participate in screening tests. Furthermore some people would not select to be screened only because they do not know how or where they can receive these

Implications of Overdiagnosis: Impact on Screening Mammography Practices

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Morris, Elizabeth; Feig, Stephen A.; Drexler, Madeline

2015-01-01

Abstract This review article explores the issue of overdiagnosis in screening mammography. Overdiagnosis is the screen detection of a breast cancer, histologically confirmed, that might not otherwise become clinically apparent during the lifetime of the patient. While screening mammography is an imperfect tool, it remains the best tool we have to diagnose breast cancer early, before a patient is symptomatic and at a time when chances of survival and options for treatment are most favorable. In 2015, an estimated 231,840 new cases of breast cancer (excluding ductal carcinoma in situ) will be diagnosed in the United States, and some 40,290 women will die. Despite these data, screening mammography for women ages 40–69 has contributed to a substantial reduction in breast cancer mortality, and organized screening programs have led to a shift from late-stage diagnosis to early-stage detection. Current estimates of overdiagnosis in screening mammography vary widely, from 0% to upwards of 30% of diagnosed cancers. This range reflects the fact that measuring overdiagnosis is not a straightforward calculation, but usually one based on different sets of assumptions and often biased by methodological flaws. The recent development of tomosynthesis, which creates high-resolution, three-dimensional images, has increased breast cancer detection while reducing false recalls. Because the greatest harm of overdiagnosis is overtreatment, the key goal should not be less diagnosis but better treatment decision tools. (Population Health Management 2015;18:S3–S11) PMID:26414384

Screening food-borne and zoonotic pathogens associated with livestock practices in the Sumapaz region, Cundinamarca, Colombia

DEFF Research Database (Denmark)

Arenas, Nelson E.; Abril, Diego A.; Valencia, Paola

2017-01-01

-borne and zoonotic pathogens associated with local livestock practices. We evaluated 1098 cows from 46 livestock farms in the Sumapaz region that were selected by random. Of the total population of cattle, 962 animals (88%) were tested for bovine TB using a caudal-fold tuberculin test and 546 (50%) for brucellosis...... findings suggest that livestock products could be a source of exposure to Brucella and multidrug-resistant E. coli and S. aureus strains as a result of unhygienic livestock practices in the Sumapaz region. Training in good farming practices is the key to improving safety in food production.......Hazardous practices regarding antibiotics misuse, unsanitary milking procedures, and the commercial sales of raw milk and unpasteurized dairy products are currently being practiced by livestock farmers in the Sumapaz region (Colombia). The purpose of this study was to screen for food...

Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study

OpenAIRE

VanDenHeuvel, A.; Fitzgerald, M.; Greiner, Birgit A.; Perry, Ivan J.

2007-01-01

VanDenHeuvel A, Fitzgerald M, Greiner B, Perry IJ. Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study. Ir Med J. 2007;100(8):565-7. The objectives of this study were to assess the feasibility of administering the CHecklist for Autism in Toddlers (CHAT) at the 18-month developmental check, estimate the prevalence of screening positive for autism at the first and second administrations of the CHAT and estimate the prevalence of diagnos...

Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study.

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Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit; Vedsted, Peter

2015-12-01

Population-based cancer screening is offered in many countries to detect early stages of cancer and reduce mortality. Screening efficiency and equality is susceptible due to a group of non-participants. We investigated associations between self-assessed health, perceived stress and subsequent non-participation in breast cancer screening. This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50-69 years) for the first organised breast cancer screening programme -3 years later in the Central Denmark Region in 2008-2009. A U-shaped association was observed for physical health assessment as women with the highest (PR=1.28, 95% CI: 1.06-1.55), and the lowest (PR=1.41, 95% CI: 1.18-1.68) physical health scores were less likely to participate in the programme than women with physical health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR=1.44, 95% CI: 1.22-1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores (PR=1.27, 95% CI: 1.07-1.51) compared with women scoring in the middle range. Women with highest and lowest self-assessed physical health, with lowest mental health or highest perceived stress were significantly more likely not to participate in breast cancer screening 2-3 years later than women who reported average health. Interventions targeting these groups may promote equal participation in future breast cancer screening programmes. Copyright © 2015 Elsevier Inc. All rights reserved.

Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes.

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Sirey, Jo Anne; Berman, Jacquelin; Salamone, Aurora; DePasquale, Alyssa; Halkett, Ashley; Raeifar, Elmira; Banerjee, Samprit; Bruce, Martha L; Raue, Patrick J

2015-01-01

The goal of this pilot program was to test the feasibility of mental health screening among elder abuse victims and of offering those victims a brief psychotherapy for depression and anxiety. Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomized to receive one of three different interventions concurrent with abuse resolution services. Staff were able to screen 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was successfully implemented in two different formats with collaboration between staff workers. These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice.

Cross-cultural validity of standardized motor development screening and assessment tools: a systematic review.

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Mendonça, Bianca; Sargent, Barbara; Fetters, Linda

2016-12-01

To investigate whether standardized motor development screening and assessment tools that are used to evaluate motor abilities of children aged 0 to 2 years are valid in cultures other than those in which the normative sample was established. This was a systematic review in which six databases were searched. Studies were selected based on inclusion/exclusion criteria and appraised for evidence level and quality. Study variables were extracted. Twenty-three studies representing six motor development screening and assessment tools in 16 cultural contexts met the inclusion criteria: Alberta Infant Motor Scale (n=7), Ages and Stages Questionnaire, 3rd edition (n=2), Bayley Scales of Infant and Toddler Development, 3rd edition (n=8), Denver Developmental Screening Test, 2nd edition (n=4), Harris Infant Neuromotor Test (n=1), and Peabody Developmental Motor Scales, 2nd edition (n=1). Thirteen studies found significant differences between the cultural context and normative sample. Two studies established reliability and/or validity of standardized motor development assessments in high-risk infants from different cultural contexts. Five studies established new population norms. Eight studies described the cross-cultural adaptation of a standardized motor development assessment. Standardized motor development assessments have limited validity in cultures other than that in which the normative sample was established. Their use can result in under- or over-referral for services. © 2016 Mac Keith Press.

Oral cancer screening: knowledge is not enough.

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Tax, C L; Haslam, S Kim; Brillant, Mgs; Doucette, H J; Cameron, J E; Wade, S E

2017-08-01

The purpose of this cross-sectional study was to investigate whether dental hygienists are transferring their knowledge of oral cancer screening into practice. This study also wanted to gain insight into the barriers that might prevent dental hygienists from performing these screenings. A 27-item survey instrument was constructed to study the oral cancer screening practices of licensed dental hygienists in Nova Scotia. A total of 623 practicing dental hygienists received the survey. The response rate was 34% (n = 212) yielding a maximum margin of error of 5.47 at a 95% confidence level. Descriptive statistics were calculated using IBM SPSS Statistics v21 software (Armonk, NY:IBM Corp). Qualitative thematic analysis was performed on any open-ended responses. This study revealed that while dental hygienists perceived themselves as being knowledgeable about oral cancer screening, they were not transferring this knowledge to actual practice. Only a small percentage (13%) of respondents were performing a comprehensive extra-oral examination, and 7% were performing a comprehensive intra-oral examination. The respondents identified several barriers that prevented them from completing a comprehensive oral cancer screening. Early detection of oral cancer reduces mortality rates so there is a professional responsibility to ensure that comprehensive oral cancer screenings are being performed on patients. Dental hygienists may not have the authority in a dental practice to overcome all of the barriers that are preventing them from performing these screenings. Public awareness about oral cancer screenings could increase the demand for screenings and thereby play a role in changing practice norms. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The “DOC” screen: Feasible and valid screening for depression, Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention clinics

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Swartz, Richard H.; Cayley, Megan L.; Lanctôt, Krista L.; Murray, Brian J.; Cohen, Ashley; Thorpe, Kevin E.; Sicard, Michelle N.; Lien, Karen; Sahlas, Demetrios J.; Herrmann, Nathan

2017-01-01

Background Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment (“DOC”) are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool (“DOC” screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment. Methods All consecutive new referrals to a regional Stroke Prevention Clinic who were English-speaking and non-aphasic were eligible to be screened. Time for screen completion was logged. DOC screen results were compared to the neuropsychological battery and polysomnogram assessments using a modified receiver operator characteristic and area under the curve analysis. Data is reported to conform to STARD guidelines. Findings 1503 people were screened over 2 years. 89% of eligible patients completed the screen in 5 minutes or less (mean 4.2 minutes), less than half the time it takes to complete the Montreal Cognitive Assessment (MoCA). 437 people consented to detailed testing. Of those, 421 completed the Structured Clinical Interview for Depression within 3 months of screening, 387 completed detailed neuropsychological testing within 3 months, and 88 had overnight polysomnograms. Screening scores combined with demographic variables (age, sex, education, body mass index), had excellent validity compared to gold standard diagnoses: DOC-Mood AUC 0.90; DOC-Apnea AUC 0.80; DOC-Cog AUC 0.81. DOC screen scores can reliably categorize patients in to low-, intermediate- or high-risk groups for further action and can do so with comparable accuracy to more time-consuming screens. Conclusions Systematic screening of depression, obstructive sleep apnea, and cognitive impairment in 5 minutes or less is feasible and valid in a high volume stroke clinic using the DOC screen. The DOC screen may

NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

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Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

2015-06-01

The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

Guidance Manual for Conducting Screening Level Ecological Risk Assessments at the INEL

Energy Technology Data Exchange (ETDEWEB)

R. L. VanHorn; N. L. Hampton; R. C. Morris

1995-06-01

This document presents reference material for conducting screening level ecological risk assessments (SLERAs)for the waste area groups (WAGs) at the Idaho National Engineering Laboratory. Included in this document are discussions of the objectives of and processes for conducting SLERAs. The Environmental Protection Agency ecological risk assessment framework is closely followed. Guidance for site characterization, stressor characterization, ecological effects, pathways of contaminant migration, the conceptual site model, assessment endpoints, measurement endpoints, analysis guidance, and risk characterization are included.

Insecticide Exposures on Commercial Aircraft: A Literature Review and Screening Level Assessment

Energy Technology Data Exchange (ETDEWEB)

Maddalena, Randy I.; McKone, Thomas E.

2008-10-01

The objective of this project was to provide initial estimates of the relationship between insecticide use on passenger aircraft and exposure levels present in the cabin environment. The work was initially divided into three tasks including 1) a review of insecticide application practices in commercial aircraft, 2) exploratory measurements of insecticide concentrations in treated aircraft and 3) screening level exposure modeling. Task 1 gathered information that is needed to assess the time-concentration history of insecticides in the airline cabin. The literature review focused on application practices, information about the cabin environment and existing measurements of exposure concentrations following treatment. Information from the airlines was not available for estimating insecticide application rates in the U.S. domestic fleet or for understanding how frequently equipment rotate into domestic routes following insecticide treatment. However, the World Health Organization (WHO) recommends several methods for treating aircraft with insecticide. Although there is evidence that these WHO guidelines may not always be followed, and that practices vary by airline, destination, and/or applicator company, the guidelines in combination with information related to other indoor environments provides a plausible basis for estimating insecticide loading rates on aircraft. The review also found that while measurements of exposure concentrations following simulated aerosol applications are available, measurements following residual treatment of aircraft or applications in domestic aircraft are lacking. Task 2 focused on developing an approach to monitor exposure concentrations in aircraft using a combination of active and passive sampling methods. An existing active sampling approach was intended to provide data immediately following treatment while a passive sampler was developed to provide wider coverage of the fleet over longer sampling periods. The passive sampler, based

The validity of the Brain Injury Cognitive Screen (BICS) as a neuropsychological screening assessment for traumatic and non-traumatic brain injury.

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Vaughan, Frances L; Neal, Jo Anne; Mulla, Farzana Nizam; Edwards, Barbara; Coetzer, Rudi

2017-04-01

The Brain Injury Cognitive Screen (BICS) was developed as an in-service cognitive assessment battery for acquired brain injury patients entering community rehabilitation. The BICS focuses on domains that are particularly compromised following TBI, and provides a broader and more detailed assessment of executive function, attention and information processing than comparable screening assessments. The BICS also includes brief assessments of perception, naming, and construction, which were predicted to be more sensitive to impairments following non-traumatic brain injury. The studies reported here examine preliminary evidence for its validity in post-acute rehabilitation. In Study 1, TBI patients completed the BICS and were compared with matched controls. Patients with focal lesions and matched controls were compared in Study 2. Study 3 examined demographic effects in a sample of normative data. TBI and focal lesion patients obtained significantly lower composite memory, executive function and attention and information processing BICS scores than healthy controls. Injury severity effects were also obtained. Logistic regression analyses indicated that each group of BICS memory, executive function and attention measures reliably differentiated TBI and focal lesion participants from controls. Design Recall, Prospective Memory, Verbal Fluency, and Visual Search test scores showed significant independent regression effects. Other subtest measures showed evidence of sensitivity to brain injury. The study provides preliminary evidence of the BICS' sensitivity to cognitive impairment caused by acquired brain injury, and its potential clinical utility as a cognitive screen. Further validation based on a revised version of the BICS and more normative data are required.

Perception and practices on screening and vaccination for carcinoma cervix among female healthcare professional in tertiary care hospitals in Bangalore, India.

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Swapnajaswanth, M; Suman, G; Suryanarayana, S P; Murthy, N S

2014-01-01

Cervical cancer is potentially the most preventable and treatable cancer. Despite the known efficacy of cervical screening, a significant number of women do not avail themselves of the procedure due to lack of awareness. This study was conducted to elicit information on the knowledge, attitude and practice (KAP) regarding screening (Pap test) and vaccination for carcinoma cervix among female doctors and nurses in a tertiary care hospital in Bangalore and to assess barriers to acceptance of the Pap test. A cross-sectional, descriptive study was conducted with semi-structured, self-administered questionnaire among female health professionals. The study subjects were interviewed for KAP regarding risk factors for cancer cervix, Pap test and HPV vaccination for protection against carcinoma cervix. Higher proportion of doctors 45 (78.9%) had very good knowledge as compared to only 13 (13.3%) of the nurses, about risk factors for cancer cervix and Pap test (p=0.001). As many as 138(89.6%) of the study subjects had favorable attitude towards Pap test and vaccination, but 114 (73.6%) of the study subjects never had a Pap test and the most common reason 35 (31%) for not practicing was absence of disease symptoms. In spite of good knowledge and attitudes towards cancer cervix and Pap test being good, practice remained low among the study subjects and most common reasons for not undergoing Pap test was absence of disease symptoms. The independent predictors of ever having a Pap test done was found to be the occupation and duration of married life above 9 yrs. Hence there is a strong need to improve uptake of Pap test by health professionals by demystifying the barriers.

Microchip screening platform for single cell assessment of NK cell cytotoxicity

Directory of Open Access Journals (Sweden)

Karolin eGuldevall

2016-04-01

Full Text Available Here we report a screening platform for assessment of the cytotoxic potential of individual natural killer (NK cells within larger populations. Human primary NK cells were distributed across a silicon-glass microchip containing 32 400 individual microwells loaded with target cells. Through fluorescence screening and automated image analysis the numbers of NK and live or dead target cells in each well could be assessed at different time points after initial mixing. Cytotoxicity was also studied by time-lapse live-cell imaging in microwells quantifying the killing potential of individual NK cells. Although most resting NK cells (≈75% were non-cytotoxic against the leukemia cell line K562, some NK cells were able to kill several (≥3 target cells within the 12 hours long experiment. In addition, the screening approach was adapted to increase the chance to find and evaluate serial killing NK cells. Even if the cytotoxic potential varied between donors it was evident that a small fraction of highly cytotoxic NK cells were responsible for a substantial portion of the killing. We demonstrate multiple assays where our platform can be used to enumerate and characterize cytotoxic cells, such as NK or T cells. This approach could find use in clinical applications, e.g. in the selection of donors for stem cell transplantation or generation of highly specific and cytotoxic cells for adoptive immunotherapy.

Microchip Screening Platform for Single Cell Assessment of NK Cell Cytotoxicity

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Guldevall, Karolin; Brandt, Ludwig; Forslund, Elin; Olofsson, Karl; Frisk, Thomas W.; Olofsson, Per E.; Gustafsson, Karin; Manneberg, Otto; Vanherberghen, Bruno; Brismar, Hjalmar; Kärre, Klas; Uhlin, Michael; Önfelt, Björn

2016-01-01

Here, we report a screening platform for assessment of the cytotoxic potential of individual natural killer (NK) cells within larger populations. Human primary NK cells were distributed across a silicon–glass microchip containing 32,400 individual microwells loaded with target cells. Through fluorescence screening and automated image analysis, the numbers of NK and live or dead target cells in each well could be assessed at different time points after initial mixing. Cytotoxicity was also studied by time-lapse live-cell imaging in microwells quantifying the killing potential of individual NK cells. Although most resting NK cells (≈75%) were non-cytotoxic against the leukemia cell line K562, some NK cells were able to kill several (≥3) target cells within the 12-h long experiment. In addition, the screening approach was adapted to increase the chance to find and evaluate serial killing NK cells. Even if the cytotoxic potential varied between donors, it was evident that a small fraction of highly cytotoxic NK cells were responsible for a substantial portion of the killing. We demonstrate multiple assays where our platform can be used to enumerate and characterize cytotoxic cells, such as NK or T cells. This approach could find use in clinical applications, e.g., in the selection of donors for stem cell transplantation or generation of highly specific and cytotoxic cells for adoptive immunotherapy. PMID:27092139

Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

Science.gov (United States)

Besharati, Fereshteh; Karimi-Shahanjarini, Akram; Hazavehei, Seyed Mohammad Mehdi; Bashirian, Saeid; Bagheri, Fahimeh; Faradmal, Javad

2017-08-27

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (Pintervention addressing CRC screening among Iranian population. Creative Commons Attribution License

Assessment Training: A Precondition for Teachers' Competencies and Use of Classroom Assessment Practices

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Koloi-Keaikitse, Setlhomo

2016-01-01

Student assessment, particularly at classroom level, remains an integral part of teaching and learning and is a driving force for the implementation of educational policies and practices in many countries. Nevertheless, problems associated with teachers' classroom assessment practices continue to exist in schools and research shows that teachers…

Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study.

Science.gov (United States)

Hafez, Dina; Nelson, Daniel B; Martin, Evan G; Cohen, Alicia J; Northway, Rebecca; Kullgren, Jeffrey T

2017-04-04

Early diagnosis and treatment of prediabetes and type 2 diabetes mellitus (T2DM) can prevent future health problems, yet many individuals with these conditions are undiagnosed. This could be due, in part, to primary care physicians' (PCP) screening practices, about which little is known. The objectives of this study were to identify factors that influence PCPs' decisions to screen patients for T2DM and to characterize their interpretation and communication of screening test results to patients. We conducted semi-structured chart-stimulated recall interviews with 20 University of Michigan Health System (UMHS) primary care physicians. PCPs were asked about their recent decisions to screen or not screen 134 purposively sampled non-diabetic patients who met American Diabetes Association criteria for screening for T2DM. Interviews were audio-recorded, transcribed, and analyzed using qualitative directed content analysis. Data on patient demographic characteristics and comorbidities were abstracted from the electronic health record. The most common reasons PCPs gave for not screening 63 patients for T2DM were knowledge of a previously normal screening test (49%) and a visit for reasons other than a health maintenance examination (48%). The most common reasons PCPs gave for screening 71 patients for T2DM were knowledge of a previously abnormal screening test (49%), and patients' weight (42%) and age (38%). PCPs correctly interpreted 89% of screening test results and communicated 95% of test results to patients. Among 24 patients found to have prediabetes, PCPs usually (58%) recommended weight loss and increased physical activity but never recommended participation in a Diabetes Prevention Program or use of metformin. Previous screening test results, visit types, and patients' weight and age influenced PCPs' decisions to screen for T2DM. When patients were screened, test results were generally correctly interpreted and consistently communicated. Recommendations to patients

An open framework for automated chemical hazard assessment based on GreenScreen for Safer Chemicals: A proof of concept.

Science.gov (United States)

Wehage, Kristopher; Chenhansa, Panan; Schoenung, Julie M

2017-01-01

GreenScreen® for Safer Chemicals is a framework for comparative chemical hazard assessment. It is the first transparent, open and publicly accessible framework of its kind, allowing manufacturers and governmental agencies to make informed decisions about the chemicals and substances used in consumer products and buildings. In the GreenScreen® benchmarking process, chemical hazards are assessed and classified based on 18 hazard endpoints from up to 30 different sources. The result is a simple numerical benchmark score and accompanying assessment report that allows users to flag chemicals of concern and identify safer alternatives. Although the screening process is straightforward, aggregating and sorting hazard data is tedious, time-consuming, and prone to human error. In light of these challenges, the present work demonstrates the usage of automation to cull chemical hazard data from publicly available internet resources, assign metadata, and perform a GreenScreen® hazard assessment using the GreenScreen® "List Translator." The automated technique, written as a module in the Python programming language, generates GreenScreen® List Translation data for over 3000 chemicals in approximately 30 s. Discussion of the potential benefits and limitations of automated techniques is provided. By embedding the library into a web-based graphical user interface, the extensibility of the library is demonstrated. The accompanying source code is made available to the hazard assessment community. Integr Environ Assess Manag 2017;13:167-176. © 2016 SETAC. © 2016 SETAC.

A practical approach to competency assessment.

Science.gov (United States)

Claflin, N

1997-01-01

Assessing clinical performance is difficult. Members of the Nursing Service Clinical Practice Committee at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix developed a comprehensive program of competency assessment based on performance measures. This article describes the committee's process of developing and implementing the program and includes a blueprint for competency assessment and selected performance measures for all nursing staff who provide patient care. The approach to competency assessment includes performance measures specific to patients' ages.

Quantitative assessment of smoking-induced emphysema progression in longitudinal CT screening for lung cancer

Science.gov (United States)

Suzuki, H.; Mizuguchi, R.; Matsuhiro, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.; Moriyama, N.

2015-03-01

Computed tomography has been used for assessing structural abnormalities associated with emphysema. It is important to develop a robust CT based imaging biomarker that would allow quantification of emphysema progression in early stage. This paper presents effect of smoking on emphysema progression using annual changes of low attenuation volume (LAV) by each lung lobe acquired from low-dose CT images in longitudinal screening for lung cancer. The percentage of LAV (LAV%) was measured after applying CT value threshold method and small noise reduction. Progression of emphysema was assessed by statistical analysis of the annual changes represented by linear regression of LAV%. This method was applied to 215 participants in lung cancer CT screening for five years (18 nonsmokers, 85 past smokers, and 112 current smokers). The results showed that LAV% is useful to classify current smokers with rapid progression of emphysema (0.2%/year, pemphysema in CT screening for lung cancer.

Cervical cancer screening among Lebanese women.

Science.gov (United States)

Bou-Orm, I R; Sakr, R E; Adib, S M

2018-02-01

Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this paper was to assess the prevalence of Pap smear screening for cervical cancer among Lebanese women and to determine associated sociodemographic and psychosocial characteristics. This national survey included 2255 women, selected by multi-stage random cluster sampling across Lebanon. A questionnaire about practices and perceptions related to cervical cancer screening was developed based on the "Health Belief Model". The weighted national prevalence of "ever-use" of the Pap smear for screening purposes was 35%. Most important determinants of screening behavior were: residence within Greater Beirut, higher socio-economic status and educational attainment, marriage status, presence of a health coverage, awareness of Pap smear usefulness, knowing someone who had already done it, and a balance between perceived benefits and perceived barriers to Pap smear screening. Regular information campaigns regarding the availability and effectiveness of the test should be devised, targeting in priority the sexually vulnerable women in Lebanon. Moreover, healthcare providers should be encouraged to discuss with their patients the opportunity of obtaining a Pap smear. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Effect of routine mental health screening in a low-resource pediatric primary care population.

Science.gov (United States)

Berger-Jenkins, Evelyn; McCord, Mary; Gallagher, Trish; Olfson, Mark

2012-04-01

Despite evidence for its feasibility, the usage of mental health screening in primary care practices with overburdened providers and few referral options remains unclear. This study explores the effects of routine screening on mental health problem identification and management in a low-resource setting. Medical records of 5 to 12 year-old children presenting for well visits before and after screening was implemented were reviewed. Multivariate logistic regression was used to explore associations between study period and identification/management practices. Changes in the number of visits and wait times for a co-located referral service were assessed post hoc. Parents disclosed more mental health problems, and providers initiated more workups but referred fewer patients after screening was implemented. The proportion of new visits and wait times for the referral service did not change. Even in low-resource settings, screening may facilitate parental disclosure and increase clinical attention to mental health problems without overburdening referral services.

Richtlijn 'screening en diagnostiek van het mammacarcinoom' (herziening).

NARCIS (Netherlands)

Zonderland, H.M.; Tuut, M.K.; den Heeten, G.J.; Asperen, C.J.; de Bock, G.H.; Rutqers, E.J.; Westenend, P.J.; Smit, G.M.; Benraadt, J.

2008-01-01

Revised practice guideline 'Screening and diagnosis of breast cancer' The evidence-based revision of the practice guideline 'Screening and diagnosis of breast cancer' was necessitated by new insights, for instance on the cost-effectiveness of screening modalities other than mammography. Mammography

Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

Science.gov (United States)

Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

2002-01-01

Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

Practical Assessment, Research and Evaluation, 2001.

Science.gov (United States)

Rudner, Lawrence M., Ed.; Schafer, William D., Ed.

2001-01-01

This document consists of articles 23 through 26 published in the electronic journal "Practical Assessment, Research & Evaluation" in 2001: (23) "Effects of Removing the Time Limit on First and Second Language Intelligence Test Performance" (Jennifer Mullane and Stuart J. McKelvie); (24) "Consequences of (Mis)use of the Texas Assessment of…

Approaches to virtual screening and screening library selection.

Science.gov (United States)

Wildman, Scott A

2013-01-01

The ease of access to virtual screening (VS) software in recent years has resulted in a large increase in literature reports. Over 300 publications in the last year report the use of virtual screening techniques to identify new chemical matter or present the development of new virtual screening techniques. The increased use is accompanied by a corresponding increase in misuse and misinterpretation of virtual screening results. This review aims to identify many of the common difficulties associated with virtual screening and allow researchers to better assess the reliability of their virtual screening effort.

NASA Conjunction Assessment Organizational Approach and the Associated Determination of Screening Volume Sizes

Science.gov (United States)

Newman, Lauri K.; Hejduk, Matthew D.

2015-01-01

NASA is committed to safety of flight for all of its operational assets Performed by CARA at NASA GSFC for robotic satellites Focus of this briefing Performed by TOPO at NASA JSC for human spaceflight he Conjunction Assessment Risk Analysis (CARA) was stood up to offer this service to all NASA robotic satellites Currently provides service to 70 operational satellites NASA unmanned operational assets Other USG assets (USGS, USAF, NOAA) International partner assets Conjunction Assessment (CA) is the process of identifying close approaches between two orbiting objects; sometimes called conjunction screening The Joint Space Operations Center (JSpOC) a USAF unit at Vandenberg AFB, maintains the high accuracy catalog of space objects, screens CARA-supported assets against the catalog, performs OD tasking, and generates close approach data.

Cognitive screening in Parkinson's disease: Comparison of the Parkinson Neuropsychometric Dementia Assessment (PANDA) with 3 other short scales.

Science.gov (United States)

Gasser, A-I; Calabrese, P; Kalbe, E; Kessler, J; Rossier, P

2016-02-01

Cognitive screening is crucial in Parkinson's disease (PD). However, there is still a lack of short tools in French. In this study, we aimed to compare the Parkinson Neuropsychometric Dementia Assessment (PANDA) with the Mini Mental Parkinson (MMP), the Mini Mental State Examination (MMSE) and the Clock Test in French-speaking patients. We also aimed to propose cut-off scores for cognitive impairment and dementia for the French language version of the PANDA. Fifty-one patients with PD took the PANDA, the MMSE, the MMP, and the Clock Test. They also underwent extensive neuropsychological testing by a neuropsychologist who was blinded to the above-mentioned screening test results. Patients were classified as either having normal cognition (n=15), mild cognitive impairment (n=20) or dementia (n=16). When compared with the three other screening tools, the PANDA exhibited the highest area under the curve (AUC) for both cognitive disorders and dementia. Using the cut-off scores proposed for the German version, the PANDA had 94% specificity and 100% sensitivity for dementia and 100% and 72%, respectively for cognitive disorders. In our study, the PANDA exhibited a higher discriminative power than the three other tests in detecting cognitive disorders and dementia. In PD patients, the PANDA should thus be considered for the detection of cognitive impairment in routine clinical practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Increasing chlamydia screening tests in general practice: a modified Zelen prospective Cluster Randomised Controlled Trial evaluating a complex intervention based on the Theory of Planned Behaviour.

Science.gov (United States)

McNulty, Cliodna A M; Hogan, Angela H; Ricketts, Ellie J; Wallace, Louise; Oliver, Isabel; Campbell, Rona; Kalwij, Sebastian; O'Connell, Elaine; Charlett, Andre

2014-05-01

To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15-24 years attending English general practitioner (GP) practices. A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention. Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15-24-year-olds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15-24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93). This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63%) and efficacy of this educational intervention in general practice; it should be used more often. The trial was registered on the UK Clinical Research Network Study Portfolio database

Pairing motivational interviewing with a nutrition and physical activity assessment and counseling tool in pediatric clinical practice: a pilot study.

Science.gov (United States)

Christison, Amy L; Daley, Brendan M; Asche, Carl V; Ren, Jinma; Aldag, Jean C; Ariza, Adolfo J; Lowry, Kelly W

2014-10-01

Recommendations to screen and counsel for lifestyle behaviors can be challenging to implement during well-child visits in the primary care setting. A practice intervention was piloted using the Family Nutrition and Physical Activity (FNPA) Screening Tool paired with a motivational interviewing (MI)-based counseling tool during well-child visits. Acceptability and feasibility of this intervention were assessed. Its impact on parent-reported obesigenic behavior change and provider efficacy in lifestyle counseling were also examined. This was an observational study in a pediatric primary care office. During well-child visits of 100 patients (ages 4-16 years), the FNPA tool was implemented and providers counseled patients in an MI-consistent manner based on its results. Duration of implementation, patient satisfaction of the intervention, and success of stated lifestyle goals were measured. Provider self-efficacy and acceptability were also surveyed. The FNPA assessment was efficient to administer, requiring minutes to complete and score. Patient acceptability was high, ranging from 4.0 to 4.8 on a 5-point scale. Provider acceptability was good, with the exception of duration of counseling; self-efficacy in assessing patient "readiness for change" was improved. Parent-reported success of primary lifestyle goal was 68% at 1 month and 46% at 6 months. The FNPA assessment with an MI-based counseling tool shows promise as an approach to identify and address obesigenic behaviors during pediatric well-child visits. It has the potential to improve provider efficacy in obesity prevention and also influence patient health behaviors, which can possibly impact childhood excessive weight gain. After refinement, this practice intervention will be used in a larger trial.

Time-trend of melanoma screening practice by primary care physicians: a meta-regression analysis.

Science.gov (United States)

Valachis, Antonis; Mauri, Davide; Karampoiki, Vassiliki; Polyzos, Nikolaos P; Cortinovis, Ivan; Koukourakis, Georgios; Zacharias, Georgios; Xilomenos, Apostolos; Tsappi, Maria; Casazza, Giovanni

2009-01-01

To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time. Meta-regression analyses of available data. MEDLINE, ISI, Cochrane Central Register of Controlled Trials. Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%-82% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening tended to decrease by 1.72% per year (P =0.086). Corresponding annual changes in European, North American, and Australian settings were -0.68% (P =0.494), -2.02% (P =0.044), and +2.59% (P =0.010), respectively. Changes were not influenced by national guide-lines. Considering the increasing incidence of melanoma and other skin malignancies, as well as their relative potential consequences, the FBSE implementation time-trend we retrieved should be considered a worrisome phenomenon.

Practical considerations in voltage stability assessment

Energy Technology Data Exchange (ETDEWEB)

Kundur, P; Gao, B [Powertech Labs. Inc., Surrey, BC (Canada)

1994-12-31

This paper deals with some of the most important practical issues related to voltage stability assessment of large practical systems. A brief discussion of the practical aspects of voltage stability problem and prevention of voltage instability is given first, followed by descriptions of different analytical techniques and tools for voltage stability analysis. Presentations of analytical tools is focused on the VSTAB program which incorporates the modal analysis, continuation power flow, and shortest distance to instability techniques, Finally, an example case study of a practical large system is presented. The case study illustrates how modal analysis is used to determine the most effective load shedding scheme for preventing voltage instability. (author) 15 refs., 2 figs., 2 tabs.

Knowledge, attitude and preventive practices for breast cancer

International Nuclear Information System (INIS)

Pervez, T.; Anwar, M.S.

2001-01-01

Objective: To determine the knowledge and practice of the breast cancer in medical community. The study was carried out in the Department of Oncology, Service Hospital, Lahore and completed in one month. Subjects and Methods: About 200 female doctors and nurses of the Hospital were involved. Each subject was asked to fill up a pro forma designed to assess knowledge, risk factors and preventive practices of the breast cancer. Using non-probability convenience sampling technique, breast self-examination (BSE) and mammography was performed as screening of breast cancer. Results: A majority had good knowledge of the risk factors and screening method for the early detection of breast cancer. Majority had the consensus on the benefit of mammography. Conclusions: The study shows that although medical professionals had fairly good knowledge about screening methods and risk factors of breast cancer. Their preventive practices were scanty in high risk population and, therefore, physicians and nurses need proper training. (author)

Screening methodology for assessing potential health effects from municipal sludge incinerators

Energy Technology Data Exchange (ETDEWEB)

Fradkin, L.; Bruins, R.J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.

1987-01-01

This paper describes a risk assessment methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e., facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium.

Measures for assessing practice change in medical practitioners.

Science.gov (United States)

Hakkennes, Sharon; Green, Sally

2006-12-06

There are increasing numbers of randomised trials and systematic reviews examining the efficacy of interventions designed to bring about a change in clinical practice. The findings of this research are being used to guide strategies to increase the uptake of evidence into clinical practice. Knowledge of the outcomes measured by these trials is vital not only for the interpretation and application of the work done to date, but also to inform future research in this expanding area of endeavour and to assist in collation of results in systematic reviews and meta-analyses. The objective of this review was to identify methods used to measure change in the clinical practices of health professionals following an intervention aimed at increasing the uptake of evidence into practice. All published trials included in a recent, comprehensive Health Technology Assessment of interventions to implement clinical practice guidelines and change clinical practice (n = 228) formed the sample for this study. Using a standardised data extraction form, one reviewer (SH), extracted the relevant information from the methods and/or results sections of the trials. Measures of a change of health practitioner behaviour were the most common, with 88.8% of trials using these as outcome measures. Measures that assessed change at a patient level, either actual measures of change or surrogate measures of change, were used in 28.8% and 36.7% of studies (respectively). Health practitioners' knowledge and attitudes were assessed in 22.8% of the studies and changes at an organisational level were assessed in 17.6%. Most trials of interventions aimed at changing clinical practice measured the effect of the intervention at the level of the practitioner, i.e. did the practitioner change what they do, or has their knowledge of and/or attitude toward that practice changed? Less than one-third of the trials measured, whether or not any change in practice, resulted in a change in the ultimate end-point of

Measures for assessing practice change in medical practitioners

Directory of Open Access Journals (Sweden)

Green Sally

2006-12-01

Full Text Available Abstract Background There are increasing numbers of randomised trials and systematic reviews examining the efficacy of interventions designed to bring about a change in clinical practice. The findings of this research are being used to guide strategies to increase the uptake of evidence into clinical practice. Knowledge of the outcomes measured by these trials is vital not only for the interpretation and application of the work done to date, but also to inform future research in this expanding area of endeavour and to assist in collation of results in systematic reviews and meta-analyses. Methods The objective of this review was to identify methods used to measure change in the clinical practices of health professionals following an intervention aimed at increasing the uptake of evidence into practice. All published trials included in a recent, comprehensive Health Technology Assessment of interventions to implement clinical practice guidelines and change clinical practice (n = 228 formed the sample for this study. Using a standardised data extraction form, one reviewer (SH, extracted the relevant information from the methods and/or results sections of the trials. Results Measures of a change of health practitioner behaviour were the most common, with 88.8% of trials using these as outcome measures. Measures that assessed change at a patient level, either actual measures of change or surrogate measures of change, were used in 28.8% and 36.7% of studies (respectively. Health practitioners' knowledge and attitudes were assessed in 22.8% of the studies and changes at an organisational level were assessed in 17.6%. Conclusion Most trials of interventions aimed at changing clinical practice measured the effect of the intervention at the level of the practitioner, i.e. did the practitioner change what they do, or has their knowledge of and/or attitude toward that practice changed? Less than one-third of the trials measured, whether or not any change

Psychometric Properties of the Breast Cancer Screening Beliefs Questionnaire Among Women of Indian Ethnicity Living in Australia.

Science.gov (United States)

Kwok, Cannas; Pillay, Rona; Lee, Chun Fan

2016-01-01

Indian women have been consistently reported as having low participation in breast cancer screening practices. A valid and reliable instrument to explore their breast cancer beliefs is essential for development of interventions to promote breast cancer screening practices. The aim of this study was to report the psychometric properties of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) in an Indian community in Australia. A convenience sample of 242 Indian Australian women was recruited from Indian community organizations and personal networking. Explanatory factor analysis was conducted to study the factor structure. Clinical validity was examined by Cuzick's nonparametric test, and Cronbach's α was used to assess internal consistency reliability. Exploratory factor analysis showed a similar fit to the hypothesized 3-factor structure. The frequency of breast cancer screening practices was significantly associated with attitudes toward general health check-up. Knowledge and perceptions about the breast cancer scale were not significantly associated with clinical breast examinations and mammography. Perceived barriers to mammography were much less evident among women who engaged in breast awareness and clinical breast examination. Results indicated that the BCSBQ had satisfactory validity and internal consistency. Cronbach's α of the 3 subscales ranged from .81 to .91. The BCSBQ is a culturally appropriate, valid, and reliable instrument for assessing the beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices among women of Indian ethnic extraction living in Australia. The BCSBQ can be used to provide nurses with information relevant for the development of culturally sensitive breast health education programs.

Universal screening as the great equalizer: Eliminating disproportionality in special education referrals

Science.gov (United States)

Raines, Tara C.

The overrepresentation of minority students identified for special education services continues to plague schools and serves as a challenge for researchers and practitioners (Ferri & Conner, 2005). Teacher nomination, office discipline referrals (ODR), and functional behavior assessments (FBA) continue to guide referral processes (Bradshaw, Mitchell, O'Brennen, & Leaf, 2010; Eklund, et al., 2009; Mustian, 2010). These methods have been found to be riddled with inconsistencies. Practices used to identify students for behavioral and emotional interventions over-identify students from culturally and linguistically diverse backgrounds. The use of a behavioral and emotional screener to make data-based decisions regarding placement and services could provide an objective assessment of student risk. The first chapter of this dissertation reviews methods used in the identification of students for behavioral and emotional support services. Additionally, the use of universal screening in conjunction with student self-report are proposed as tools for alleviating the overrepresentation of minority students in special education programs for behavioral and emotional disorders. The second chapter of this dissertation explores the measurement equivalence of Behavior Assessment System for Children, Second Edition (BASC-2) Behavioral and Emotional Screening System Student form (BESS Student) across the Black, Hispanic, and White participants in the norming sample. The BESS Student as a universal screening tool is poised to alleviate the disproportionate number of children of color identified by schools as having behavior and emotional disorders. This instrument also provides an avenue to identify students with internalizing disorders who are often overlooked in present referral practices (Bradshaw, Buckley, & Ialongo, 2008; Kataoka, Zhang, & Wells, 2002). The findings of the measurement equivalence study suggests that the BESS Student is, as designed, identifying behavioral and

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

Science.gov (United States)

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Implications of teacher educators' practices in assessment for ...

African Journals Online (AJOL)

This study presents findings on teacher educators' practices in assessment and their implications for student learning in Tanzania. Research on classroom assessment has been dichotomizing assessment and teaching-learning processes instead of viewing assessment as an integral part of the teachinglearning process.

A Randomized Controlled Trial (RCT) to Assess and Improve the Effectiveness of Post-Deployment Screening for Mental Illness

Science.gov (United States)

2014-09-01

Committee (Ref 187/GEN/10, the King’s College London Psychiatry, Nursing & Midwifery Research Ethics Subcommittee (Ref PNM/10/10/11-112) and the US Army...Ministry of Defence Research Ethics Committee (Ref 187/GEN/1) and the King’s College London Psychiatry, Nursing and Midwifery Research Ethics...increase acceptability of mental health screening programmes in paediatric care [22,23]. Concerns about the practicalities of implementing screening

Screening, diagnosis, and management of intrauterine growth restriction.

Science.gov (United States)

Lausman, Andrea; McCarthy, Fergus P; Walker, Melissa; Kingdom, John

2012-01-01

To provide comprehensive background knowledge relevant to the SOGC Maternal-Fetal Medicine Committee-approved guideline entitled "Intrauterine Growth Restriction: Screening, Diagnosis, and Management." Publications in English were retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library in January 2011 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and any key words (fetal growth, restriction, growth retardation, intrauterine growth restriction [IUGR], low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized controlled trials or controlled clinical trials, and high-quality prospective and retrospective observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Evidence obtained from at least one properly randomized controlled trial, Cochrane Reviews, and high quality cohort data have been combined to provide clinicians with evidence to optimize their practice for screening, diagnosis, and management of intrauterine growth restriction. Considerable advances have been made to improve clinicians' ability to screen, diagnose, and manage pregnancies with suspected IUGR more effectively, including several properly randomized controlled trials. Pregnancies with late-onset IUGR may be managed equally effectively by early delivery or delayed delivery (with increased surveillance) anticipating favourable outcomes. By contrast, many aspects of the management of early-onset IUGR require further clinical trials.

Use of ecotoxicological screening action levels in ecological risk assessment at Los Alamos National Laboratory

International Nuclear Information System (INIS)

Ferenbauah, R.; Ebinger, M.; Gallegos, A.; Hansen, W.; Myers, O.; Wenzel, W.

1995-01-01

Regulatory drivers found in several environmental statutes require that ecological risk assessment and Natural Resource Damage Assessment be performed to assess potential environmental impact from contaminated sites and from proposed remedial alternatives. At Los Alamos National Laboratory, the initial phase of the ecological risk assessment process required preliminary evaluation of contaminated sites to determine whether potential for ecological impact exists. The preliminary evaluations were made using Ecotoxicological Screening Action Levels (ESALS) calculated as a function of reference toxicity dose, body weight, food/water/air intake, and fraction of soil intake with food. Reference toxicity doses were derived from the Environmental Protection Agency Integrated Risk Information System (IRIS) and Health Effects Assessment Summary Tables (HEAST) toxicology databases. Other parameters required for ESAL calculations were derived from physiological, metabolic, and behavioral data available in the literature. The Los Alamos ESALs were derived for guilds of animals with similar behavioral patterns, which were identified from natural resource survey data collected at Los Alamos. Subsequent to development of Ecotoxicological Screening Action Levels, Hazard Quotients, which are ratios of soil concentrations to Ecotoxicological Screening Action Levels, were calculated for potential contaminants of concern. The Hazard Quotients were used to identify which potential contaminants of concern should be evaluated further for ecological impact. There is potential for ecological impact when the Hazard Quotient is equal to or greater than one

Lay health educators within primary care practices to improve cancer screening uptake for South Asian patients: challenges in quality improvement

Directory of Open Access Journals (Sweden)

Lofters AK

2017-03-01

Full Text Available AK Lofters,1–4 M Vahabi,5 V Prakash,6 L Banerjee,7 P Bansal,8 S Goel,7,8 S Dunn1,2,9 1Department of Family and Community Medicine, 2Dalla Lana School of Public Health, University of Toronto, 3Department of Family and Community Medicine, 4Centre for Urban Health Solutions, St Michael’s Hospital, 5Daphne Cockwell School of Nursing, Ryerson University, Toronto, 6Screening Saves Lives Program, Canadian Cancer Society, Mississauga, 7Wise Elephant Family Health Team, Brampton, 8Mississauga Halton Central West Regional Cancer Program, Mississauga, 9Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada Background: Cancer screening uptake is known to be low among South Asian residents of Ontario. The objective of this pilot study was to determine if lay health educators embedded within the practices of primary care providers could improve willingness to screen and cancer screening uptake for South Asian patients taking a quality improvement approach.Materials and methods: Participating physicians selected quality improvement initiatives to use within their offices that they felt could increase willingness to screen and cancer screening uptake. They implemented initiatives, adapting as necessary, for six months.Results: Four primary care physicians participated in the study. All approximated that at least 60% of their patients were of South Asian ethnicity. All physicians chose to work with a preexisting lay health educator program geared toward South Asians. Health ambassadors spoke to patients in the office and telephoned patients. For all physicians, ~60% of South Asian patients who were overdue for cancer screening and who spoke directly to health ambassadors stated they were willing to be screened. One physician was able to track actual screening among contacted patients and found that screening uptake was relatively high: from 29.2% (colorectal cancer to 44.6% (breast cancer of patients came in for screening

Assessment of general education teachers' Tier 1 classroom practices: contemporary science, practice, and policy.

Science.gov (United States)

Reddy, Linda A; Fabiano, Gregory A; Jimerson, Shane R

2013-12-01

Progress monitoring is a type of formative assessment. Most work on progress monitoring in elementary school settings has been focused on students. However, teachers also can benefit from frequent evaluations. Research addressing teacher progress monitoring is critically important given the recent national focus on teacher evaluation and effectiveness. This special topic section of School Psychology Quarterly is the first to showcase the current research on measuring Tier 1 instructional and behavioral management practices used by prekindergarten and elementary school teachers in general education settings. The three studies included in the special section describe the development and validation efforts of several teacher observational and self-report measures of instruction and/or behavioral management. These studies provide evidence for the utility of such assessments for documenting the use of classroom practices, and these assessment results may be leveraged in innovative coaching models to promote best practice. These articles also offer insight and ideas for the next generation of teacher practice assessment for the field. Finally, the special topic is capped by a commentary synthesizing the current work and offers "big ideas" for future measurement development, policy, and professional development initiatives. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Women's attitude towards routine human platelet antigen-screening in pregnancy.

Science.gov (United States)

Winkelhorst, Dian; Loeff, Rosanne M; van den Akker-Van Marle, M Elske; de Haas, Masja; Oepkes, Dick

2017-08-01

Fetal and neonatal alloimmune thrombocytopenia is a potentially life-threatening disease with excellent preventative treatment available for subsequent pregnancies. To prevent index cases, the effectiveness of a population-based screening program has been suggested repeatedly. Therefore, we aimed to evaluate women's attitude towards possible future human platelet antigen-screening in pregnancy. We performed a cross-sectional questionnaire study among healthy pregnant women receiving prenatal care in one of seven participating midwifery practices. Attitude was assessed using a questionnaire based on the validated Multidimensional Measurement of Informed Choice model, containing questions assessing knowledge, attitude and intention to participate. A total of 143 of the 220 women (65%) completed and returned the questionnaire. A positive attitude towards human platelet antigen-screening was expressed by 91% of participants, of which 94% was based on sufficient knowledge. Attitude was more likely to be negatively influenced by the opinion that screening can be frightening. Informed choices were made in 87% and occurred significantly less in women from non-European origin, 89% in European women vs. 60% in non-European women (p = 0.03). Pregnant women in the Netherlands expressed a positive attitude towards human platelet antigen-screening in pregnancy. We therefore expect a high rate of informed uptake when human platelet antigen-screening is implemented. In future counseling on human platelet antigen-screening, ethnicity and possible anxiety associated with a screening test need to be specifically addressed. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Basic elements for breast screening programs for Rwanda

International Nuclear Information System (INIS)

Abenanye, Emmanuel

2015-02-01

Mammography refers to the X-ray examination of the human breast, and is considered the single most important diagnostic tool in the early detection of breast cancer, which is by far the most common cancer among women. There is good evidence from clinical trials, that mammographic screening can reduce the breast cancer mortality with about 30%. The side effects include a small and age related risk of carcinogenesis due to the exposure of the glandular tissues in the breast to ionizing radiation. As for all X-ray examinations, and of special importance when investigating large populations of asymptomatic women, the relationship between radiation risk and diagnostic accuracy in mammography must be optimized. The overall objective of this thesis was to investigate and improve methods for average glandular dose (AGD) and image quality evaluation in mammography and provide some practical guidance. To assess the behavioral factors influencing breast screening the best set up of the mammography unit as well as equipment construction and the skills of people operating the machines in terms of the radiation protection screening programs. There has been doubts about the efficiency of so called service screening, i.e. routine screening programs (Sjonell and Stahle, 1999), but there is evidence suggesting a reduction of breast cancer mortality similar to that observed in the randomised trials (Duffy et al. 2002). However no study has been carried out in Rwanda of this nature to see what are the basic breast screening elements and behavioral elements that influence it. Therefore, the factors that influence women's mammography screening behavior is an important issue to be uncovered, in order to facilitate the understanding of such a behavior. This report sets out to investigate the factors that influence participation in mammography screening in Rwanda. Such an investigation aims to raise the awareness of health care providers of the factors that influence Rwanda's women

Screening physical health? Yes! But...: nurses' views on physical health screening in mental health care.

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Happell, Brenda; Scott, David; Nankivell, Janette; Platania-Phung, Chris

2013-08-01

To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service. People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated. Qualitative exploratory study. Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile (HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework. Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions. Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness. Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a

Protein-observed (19)F-NMR for fragment screening, affinity quantification and druggability assessment.

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Gee, Clifford T; Arntson, Keith E; Urick, Andrew K; Mishra, Neeraj K; Hawk, Laura M L; Wisniewski, Andrea J; Pomerantz, William C K

2016-08-01

NMR spectroscopy can be used to quantify the binding affinity between proteins and low-complexity molecules, termed 'fragments'; this versatile screening approach allows researchers to assess the druggability of new protein targets. Protein-observed (19)F-NMR (PrOF NMR) using (19)F-labeled amino acids generates relatively simple spectra that are able to provide dynamic structural information toward understanding protein folding and function. Changes in these spectra upon the addition of fragment molecules can be observed and quantified. This protocol describes the sequence-selective labeling of three proteins (the first bromodomains of Brd4 and BrdT, and the KIX domain of the CREB-binding protein) using commercially available fluorinated aromatic amino acids and fluorinated precursors as example applications of the method developed by our research group. Fragment-screening approaches are discussed, as well as Kd determination, ligand-efficiency calculations and druggability assessment, i.e., the ability to target these proteins using small-molecule ligands. Experiment times on the order of a few minutes and the simplicity of the NMR spectra obtained make this approach well-suited to the investigation of small- to medium-sized proteins, as well as the screening of multiple proteins in the same experiment.

Validation of screening tools to assess appetite among geriatric patients.

Science.gov (United States)

Hanisah, R; Suzana, S; Lee, F S

2012-07-01

Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite questionnaire (CNAQ) and the simplified nutritional appetite questionnaire (SNAQ) against the appetite, hunger and sensory perception questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the subjective global assessment (SGA) while food intake was measured using the dietary history questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach's alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the geriatric outpatients and inpatients. SNAQ was more reliable and valid as an appetite screening tool among this special

Predicting Child Physical Activity and Screen Time: Parental Support for Physical Activity and General Parenting Styles

Science.gov (United States)

Crain, A. Lauren; Senso, Meghan M.; Levy, Rona L.; Sherwood, Nancy E.

2014-01-01

Objective: To examine relationships between parenting styles and practices and child moderate-to-vigorous physical activity (MVPA) and screen time. Methods: Participants were children (6.9 ± 1.8 years) with a body mass index in the 70–95th percentile and their parents (421 dyads). Parent-completed questionnaires assessed parental support for child physical activity (PA), parenting styles and child screen time. Children wore accelerometers to assess MVPA. Results: Parenting style did not predict MVPA, but support for PA did (positive association). The association between support and MVPA, moreover, varied as a function of permissive parenting. For parents high in permissiveness, the association was positive (greater support was related to greater MVPA and therefore protective). For parents low in permissiveness, the association was neutral; support did not matter. Authoritarian and permissive parenting styles were both associated with greater screen time. Conclusions: Parenting practices and styles should be considered jointly, offering implications for tailored interventions. PMID:24812256

Systematic review of model-based cervical screening evaluations.

Science.gov (United States)

Mendes, Diana; Bains, Iren; Vanni, Tazio; Jit, Mark

2015-05-01

Optimising population-based cervical screening policies is becoming more complex due to the expanding range of screening technologies available and the interplay with vaccine-induced changes in epidemiology. Mathematical models are increasingly being applied to assess the impact of cervical cancer screening strategies. We systematically reviewed MEDLINE®, Embase, Web of Science®, EconLit, Health Economic Evaluation Database, and The Cochrane Library databases in order to identify the mathematical models of human papillomavirus (HPV) infection and cervical cancer progression used to assess the effectiveness and/or cost-effectiveness of cervical cancer screening strategies. Key model features and conclusions relevant to decision-making were extracted. We found 153 articles meeting our eligibility criteria published up to May 2013. Most studies (72/153) evaluated the introduction of a new screening technology, with particular focus on the comparison of HPV DNA testing and cytology (n = 58). Twenty-eight in forty of these analyses supported HPV DNA primary screening implementation. A few studies analysed more recent technologies - rapid HPV DNA testing (n = 3), HPV DNA self-sampling (n = 4), and genotyping (n = 1) - and were also supportive of their introduction. However, no study was found on emerging molecular markers and their potential utility in future screening programmes. Most evaluations (113/153) were based on models simulating aggregate groups of women at risk of cervical cancer over time without accounting for HPV infection transmission. Calibration to country-specific outcome data is becoming more common, but has not yet become standard practice. Models of cervical screening are increasingly used, and allow extrapolation of trial data to project the population-level health and economic impact of different screening policy. However, post-vaccination analyses have rarely incorporated transmission dynamics. Model calibration to country

Screening methodology for assessing potential health effects from municipal sludge incinerators

Energy Technology Data Exchange (ETDEWEB)

Fradkin, L.; Bruins, R.J.F.; Lutkenhoff, S.D.; Stara, J.F.; Lomnitz, E.; Rubin, A.

1987-04-01

This paper describes a risk assessment of methodology for preliminary assessment of municipal sludge incineration. The methodology is a valuable tool in that it can be used for determining the hazard indices of chemical contaminants that might be present in sewage sludge used in incineration. The paper examines source characteristics (i.e. facility design), atmospheric dispersion of emission, and resulting human exposure and risk from sludge incinerators. Seven of the ten organics were screened for further investigation. An example of the calculations are presented for cadmium. (Refs. 5).

Improving Patient-Centered Care for Young People in General Practice With a Codesigned Screening App: Mixed Methods Study.

Science.gov (United States)

Webb, Marianne Julie; Wadley, Greg; Sanci, Lena Amanda

2017-08-11

Despite experiencing a high prevalence and co-occurrence of mental health disorders and health-compromising behaviors, young people tend not to seek professional help for these concerns. However, they do regularly attend primary care, making primary care providers ideally situated to identify and discuss mental health and lifestyle issues as part of young people's routine health care. The aim was to investigate whether using a codesigned health and lifestyle-screening app, Check Up GP, in general practice influenced young people's assessment of the quality of their care (measures of patient-centered care and youth friendliness), and their disclosure of sensitive issues. In addition, this study aimed to explore young people's acceptance and experience of using a screening app during regular health care. This was a mixed methods implementation study of Check Up GP with young people aged 14 to 25 years attending a general practice clinic in urban Melbourne, Australia. A 1-month treatment-as-usual group was compared to a 2-month intervention group in which young people and their general practitioners (GPs) used Check Up GP. Young people in both groups completed an exit survey immediately after their consultation about disclosure, patient-centered and youth-friendly care, and judgment. In addition, participants in the intervention group were surveyed about app acceptability and usability and their willingness to use it again. Semistructured interviews with participants in the intervention group expanded on themes covered in the survey. The exit survey was completed by 30 young people in the treatment-as-usual group and 85 young people in the intervention group. Young people using Check Up GP reported greater disclosure of health issues (Ptime to ask questions. In all, 86% (73/85) of young people felt the app was a "good idea" and only 1% (1/85) thought it a "bad idea." Thematic analysis of qualitative interviews with 14 participants found that Check Up GP created scope

EIA screening and nature protection in Denmark

DEFF Research Database (Denmark)

Christensen, Per; Kørnøv, Lone

2011-01-01

The number of environmental impact assessment (EIA) screenings in Denmark has increased dramatically since 2000. This is a consequence of increased pig production as well as the concentration of production on larger farms. In the same period, EIA rules have developed primarily due to an increased...... in screening practices. In this paper, the demands formulated in the guidelines of local authorities were analysed in order to investigate how the protection of groundwater, coastal waters, lakes and Natura 2000 sites develops through EIA screening. It is concluded that the level of protection has improved......, and that the main cause for this is not EIA regulations as such, but the positive role which the implementation of the Natura 2000 objectives has played in this development. However, it was also found that the formulation of demands varies greatly between the counties, thus often resulting in ambiguity and leaving...

Theory in Practice: Helping Providers Address Depression in Diabetes Care

Science.gov (United States)

Osborn, Chandra Y.; Kozak, Cindy; Wagner, Julie

2010-01-01

Introduction: A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. Methods: Participants completed assessments of attitudes, confidence,…

Evaluating wait times from screening to breast cancer diagnosis among women undergoing organised assessment vs usual care.

Science.gov (United States)

Chiarelli, Anna M; Muradali, Derek; Blackmore, Kristina M; Smith, Courtney R; Mirea, Lucia; Majpruz, Vicky; O'Malley, Frances P; Quan, May Lynn; Holloway, Claire Mb

2017-05-09

Timely coordinated diagnostic assessment following an abnormal screening mammogram reduces patient anxiety and may optimise breast cancer prognosis. Since 1998, the Ontario Breast Screening Program (OBSP) has offered organised assessment through Breast Assessment Centres (BACs). For OBSP women seen at a BAC, an abnormal mammogram is followed by coordinated referrals through the use of navigators for further imaging, biopsy, and surgical consultation as indicated. For OBSP women seen through usual care (UC), further diagnostic imaging is arranged directly from the screening centre and/or through their physician; results must be communicated to the physician who is then responsible for arranging any necessary biopsy and/or surgical consultation. This study aims to evaluate factors associated with diagnostic wait times for women undergoing assessment through BAC and UC. Of the 2 147 257 women aged 50-69 years screened in the OBSP between 1 January 2002 and 31 December 2009, 155 866 (7.3%) had an abnormal mammogram. A retrospective design identified two concurrent cohorts of women diagnosed with screen-detected breast cancer at a BAC (n=4217; 47%) and UC (n=4827; 53%). Multivariable logistic regression analyses examined associations between wait times and assessment and prognostic characteristics by pathway. A two-sided 5% significance level was used. Screened women with breast cancer were two times more likely to be diagnosed within 7 weeks when assessed through a BAC vs UC (OR=1.91, 95% CI=1.73-2.10). In addition, compared with UC, women assessed through a BAC were significantly more likely to have their first assessment procedure within 3 weeks of their abnormal mammogram (OR=1.25, 95% CI=1.12-1.39), ⩽3 assessment procedures (OR=1.54, 95% CI=1.41-1.69), ⩽2 assessment visits (OR=1.86, 95% CI=1.70-2.05), and ⩾2 procedures per visit (OR=1.41, 95% CI=1.28-1.55). Women diagnosed through a BAC were also more likely than those in UC to have imaging (OR=1.99, 95

EIA screening and nature protection in Denmark.

Science.gov (United States)

Christensen, Per; Kørnøv, Lone

2011-04-01

The number of environmental impact assessment (EIA) screenings in Denmark has increased dramatically since 2000. This is a consequence of increased pig production as well as the concentration of production on larger farms. In the same period, EIA rules have developed primarily due to an increased focus on the protection of groundwater and Natura 2000 sites. In particular, the implementation of Natura 2000 in Danish legislation has increased the demands on many farms. In its rulings on appealed cases, the Nature Protection Board of Appeal has strengthened its demands, and this is mirrored in screening practices. In this paper, the demands formulated in the guidelines of local authorities were analysed in order to investigate how the protection of groundwater, coastal waters, lakes and Natura 2000 sites develops through EIA screening. It is concluded that the level of protection has improved, and that the main cause for this is not EIA regulations as such, but the positive role which the implementation of the Natura 2000 objectives has played in this development. However, it was also found that the formulation of demands varies greatly between the counties, thus often resulting in ambiguity and leaving room for quite different practices in different counties. Copyright © 2010 Elsevier Ltd. All rights reserved.

Initiation of universal tumor screening for Lynch syndrome in colorectal cancer patients as a model for the implementation of genetic information into clinical oncology practice.

Science.gov (United States)

Cohen, Stacey A; Laurino, Mercy; Bowen, Deborah J; Upton, Melissa P; Pritchard, Colin; Hisama, Fuki; Jarvik, Gail; Fichera, Alessandro; Sjoding, Britta; Bennett, Robin L; Naylor, Lorraine; Jacobson, Angela; Burke, Wylie; Grady, William M

2016-02-01

Lynch syndrome confers a hereditary predisposition to colorectal and other cancers. Universal tumor screening (UTS) for Lynch syndrome is recommended by several professional societies, but the implementation can be complex. This article describes the evaluation, process development, and initiation of Lynch syndrome UTS at a tertiary referral cancer center. A multidisciplinary team developed the new process design. Issues in 5 themes were noted: timing, funding, second-opinion patients, result processing, and the role of genetics providers. A committee approach was used to examine each issue for process-improvement development. The issues related to testing were addressed individually for the successful implementation of UTS at the institutional level. In the conventional-care period, 9 of 30 cases (30%) received Lynch syndrome screening, and 4 cases were referred to medical genetics. During the 6 months following the implementation of UTS, 32 of 44 patients (73%) received Lynch syndrome screening. The 13 unscreened patients all had identified reasons for nonscreening (eg, financial limitations). Ten patients were referred to medical genetics, which identified no new cases of Lynch syndrome, but a low-risk adenomatous polyposis coli (APC) variant was detected in 1 individual. The implementation of effective Lynch syndrome UTS can feasibly alter practice at the institutional level. This experience with the assessment and management of issues relevant to the successful implementation of a new clinical care paradigm based on emerging technology has implications for the uptake of advances across molecular oncology into clinical practice, and this is highly relevant in the current era of rapidly evolving genomic technology. © 2015 American Cancer Society.

Patient education for colon cancer screening: a randomized trial of a video mailed before a physical examination.

Science.gov (United States)

Zapka, Jane G; Lemon, Stephenie C; Puleo, Elaine; Estabrook, Barbara; Luckmann, Roger; Erban, Stephen

2004-11-02

Colorectal cancer screening is underused, and primary care clinicians are challenged to provide patient education within the constraints of busy practices. To test the effect of an educational video, mailed to patients' homes before a physical examination, on performance of colorectal cancer screening, particularly sigmoidoscopy. Randomized, controlled trial. 5 primary care practices in central Massachusetts. 938 patients age 50 to 74 years who were scheduled for an upcoming physical examination, had no personal history of colorectal cancer, and were eligible for lower-endoscopy screening according to current guidelines. Participants were randomly assigned to receive usual care (n = 488) or a video about colorectal cancer, the importance of early detection, and screening options (n = 450). Baseline and 6-month follow-up telephone assessments were conducted. A dependent variable classified screening since baseline as 1) sigmoidoscopy with or without other tests, 2) another test or test combination, or 3) no tests. Overall screening rates were the same in the intervention and control groups (55%). In regression modeling, intervention participants were nonsignificantly more likely to complete sigmoidoscopy alone or in combination with another test (odds ratio, 1.22 [95% CI, 0.88 to 1.70]). Intervention dose (viewing at least half of the video) was significantly related to receiving sigmoidoscopy with or without another test (odds ratio, 2.81 [CI, 1.85 to 4.26]). Recruitment records showed that at least 23% of people coming for periodic health assessments were currently screened by a lower-endoscopy procedure and therefore were not eligible. The primary care sample studied consisted primarily of middle-class white persons who had high screening rates at baseline. The results may not be generalizable to other populations. The trial was conducted during a period of increased health insurance coverage for lower-endoscopy procedures and public media attention to colon

Factors related to the practice of breast self examination (BSE and Pap smear screening among Malaysian women workers in selected electronics factories

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Shamsuddin K

2003-05-01

Full Text Available Abstract Background The Malaysian Ministry of Health promotes breast self-examination (BSE for all women, and Pap smear screening every three years for all sexually active women ages 20 years and above. The objectives of this paper were to examine the practice of these two screening tests among women production workers in electronics factories, and to identify factors related to practice. Methods This was a cross-sectional survey of women production workers from ten electronics factories. Data was collected by a self-administered questionnaire from a total of 1,720 women. The chi-square test, odds ratio and binomial logistic regression were used in bivariate and multivariate analysis. Results Prevalence rates were 24.4% for BSE once a month, and 18.4% for Pap smear examination within the last three years. Women who were significantly more likely to perform BSE every month were 30 years and older, Malays, with upper secondary education and above, answered the BSE question correctly, and had a Pap smear within the last three years. The proportion of women who had a Pap smear within the last three years were significantly higher among those who were older, married, with young children, on the contraceptive pill or intra-uterine device, had a medical examination within the last five years, answered the Pap smear question correctly, and performed BSE monthly. Conclusion Screening practice rates in this study were low when compared to national rates. Socio-demographic and health care factors significantly associated with screening practice are indicative of barriers which should be further understood so that more effective educational and promotional strategies could be developed.

Refining lecturers' assessment practices through formal professional ...

African Journals Online (AJOL)

The Higher Education Quality Committee's emphasis on the assessment of student learning in its criteria for institutional audits (June 2004) signals that institutional arrangements to ensure quality assessment practices are to come under the spotlight. One means to demonstrate institutional commitment to quality in ...

The diagnosis of autism in community pediatric settings: does advanced training facilitate practice change?

Science.gov (United States)

Swanson, Amy R; Warren, Zachary E; Stone, Wendy L; Vehorn, Alison C; Dohrmann, Elizabeth; Humberd, Quentin

2014-07-01

The increased prevalence of autism spectrum disorder and documented benefits of early intensive intervention have created a need for flexible systems for determining eligibility for autism-specific services. This study evaluated the effectiveness of a training program designed to enhance autism spectrum disorder identification and assessment within community pediatric settings across the state. Twenty-seven pediatric providers participated in regional trainings across a 3.5-year period. Trainings provided clinicians with strategies for conducting relatively brief within-practice interactive assessments following positive autism spectrum disorder screenings. Program evaluation was measured approximately 1.5 years following training through (a) clinician self-reports of practice change and (b) blind diagnostic verification of a subset of children assessed. Pediatric providers participating in the training reported significant changes in screening and consultation practices following training, with a reported 85% increase in diagnostic identification of children with autism spectrum disorder within their own practice setting. In addition, substantial agreement (86%-93%) was found between pediatrician diagnostic judgments and independent, comprehensive blinded diagnostic evaluations. Collaborative training methods that allow autism spectrum disorder identification within broader community pediatric settings may help translate enhanced screening initiatives into more effective and efficient diagnosis and treatment. © The Author(s) 2013.

Integrating Occupational Therapy Specific Assessments in Practice: Exploring Practitioner Experiences

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Eric Asaba

2017-01-01

Full Text Available Background. Occupational therapists sometimes find it challenging to integrate client-centered and occupational therapy specific assessments in practice. The aim of this study was to explore the use of occupational therapy specific assessments such as the Assessment of Motor and Process Skills (AMPS among occupational therapists in Sweden and Japan. Methods. Interviews and qualitative thematic analyses were utilized. Findings. Four themes are reported: (1 use it or lose it, (2 simply no space until after hours, (3 biggest barriers can be colleagues, and (4 being more specific: communication. Conclusion. In keeping with previous studies, occupational therapists often find it challenging to implement client-centered and occupation-based assessment tools into practice. However, more work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice.

Assessment of the contents related to screening on Portuguese language websites providing information on breast and prostate cancer

Directory of Open Access Journals (Sweden)

Daniel Ferreira

2013-11-01

Full Text Available The objective of this study was to assess the quality of the contents related to screening in a sample of websites providing information on breast and prostate cancer in the Portuguese language. The first 200 results of each cancer-specific Google search were considered. The accuracy of the screening contents was defined in accordance with the state of the art, and its readability was assessed. Most websites mentioned mammography as a method for breast cancer screening (80%, although only 28% referred to it as the only recommended method. Almost all websites mentioned PSA evaluation as a possible screening test, but correct information regarding its effectiveness was given in less than 10%. For both breast and prostate cancer screening contents, the potential for overdiagnosis and false positive results was seldom addressed, and the median readability index was approximately 70. There is ample margin for improving the quality of websites providing information on breast and prostate cancer in Portuguese.

COMPETENCE ASSESSMENT: BEST PRACTICES IN EUROPEAN COUNTRIES

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Magdalena VELCIU

2014-04-01

Full Text Available In the current changing environment of work, the process of competence assessment is increasingly relevant as workers gain knowledge and practical skills through fulfilling different and new working tasks and through self-education. In this context, innovative tools for competence assessment and validation are very useful for encouraging movement of individuals between jobs and from unemployment or inactivity to employment and for increasing the capacity of companies to respond and adapt to changing and challenging environments. This article presents an overview of best practices for competence assessment and validation in order to identify and select methods that have been effective in various European countries including Romania. The article concludes with a set of „learned lessons” and short recommendations in order to improve the framework of competence assessment in Romanian context. Our findings are useful for the new human resources management that aims toward efficiently usage of the workforce, inside companies and in a global labour market, encouraging flexibility and adaptability.

Quality improvement project in cervical cancer screening: practical measures for monitoring laboratory performance.

Science.gov (United States)

Tarkkanen, Jussi; Geagea, Antoine; Nieminen, Pekka; Anttila, Ahti

2003-01-01

We conducted a quality improvement project in a cervical cancer screening programme in Helsinki in order to see if detection of precancerous lesions could be influenced by external (participation rate) and internal (laboratory praxis) quality measures. In order to increase the participation rate, a second personal invitation to Pap-test was mailed to nonparticipants of the first call. In order to improve the quality of screening, the cytotechnicians monitored their performance longitudinally by recording the number of slides reviewed per day, the pick-up rate of abnormal smears, the report of the consulting cytopathologist, and the number of histologically verified lesions detected from the cases that they had screened. Regular sessions were held to compare the histological findings with the cytological findings of all cases referred for colposcopy. No pressure was applied on the cytotechnicians to ensure that they felt comfortable with their daily workload. A total of 110 000 smears were screened for cervical cancer at the Helsinki City Hospital during 1996-99. Initially, the overall participation rate increased from 62% to 71%. The number of histologically confirmed precancerous lesions (CIN 1-3) more than doubled and their detection rate increased from 0.32% to 0.72%. Continuous education and feedback from daily work performance were important, yet rather inexpensive means in increasing laboratory performance. Additional measures are needed to further increase the participation rate. Impact of the quality measures on cancer incidence needs to be assessed later on.

Original article Prostate Screening Practices Among Male Staff of the ...

African Journals Online (AJOL)

2010-11-03

Nov 3, 2010 ... leading cause of cancer related death in the world. ... Objective: This study assessed the knowledge, attitude and practice of prostate cancer ... method known by these respondents was serum Prostate Specific Antigen ... Asia (1.9 cases per 100.000 in China) and ... Nigeria, is a tertiary academic institution.

Comfortably engaging: which approach to alcohol screening should we use?

Science.gov (United States)

Vinson, Daniel C; Galliher, James M; Reidinger, Carol; Kappus, Jennifer A

2004-01-01

We wanted to compare 2 screening instruments for problem drinking, the CAGE and a single question, assessing frequency of use, patient and clinician comfort, and patient engagement in change. The study was a crossover, cluster-randomized clinical trial with 31 clinicians in Missouri and 13 in the American Academy of Family Physicians (AAFP) National Network for Family Practice and Primary Care Research; 2,800 patients provided data. The clinician was the unit of randomization. Clinicians decided whether to screen each patient; if they chose to screen, they used the screening approach assigned for that block of patients. The clinician and patient separately completed questionnaires immediately after the office visit to assess each one's comfort with screening (and any ensuing discussion) and the patient's engagement in change. Missouri clinicians screened more patients when assigned the single question (81%) than the CAGE (69%, P = .001 in weighted analysis). There was no difference among AAFP network clinicians (96% of patients screened with the CAGE, 97% with the single question). Eighty percent to 90% of clinicians and 70% of patients reported being comfortable with screening and the ensuing discussion, with no difference between approaches in either network. About one third of patients who were identified as problem drinkers reported thinking about or planning to change their drinking behavior, with no difference in engagement between screening approaches. Clinicians and patients reported similar comfort with the CAGE questions and the single-question screening tools for problem drinking, and the 2 instruments were equal in their ability to engage the patient. In Missouri, the single question was more likely to be used.

Test-Retest Reliability of a Serious Game for Delirium Screening in the Emergency Department.

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Tong, Tiffany; Chignell, Mark; Tierney, Mary C; Lee, Jacques S

2016-01-01

Introduction: Cognitive screening in settings such as emergency departments (ED) is frequently carried out using paper-and-pencil tests that require administration by trained staff. These assessments often compete with other clinical duties and thus may not be routinely administered in these busy settings. Literature has shown that the presence of cognitive impairments such as dementia and delirium are often missed in older ED patients. Failure to recognize delirium can have devastating consequences including increased mortality (Kakuma et al., 2003). Given the demands on emergency staff, an automated cognitive test to screen for delirium onset could be a valuable tool to support delirium prevention and management. In earlier research we examined the concurrent validity of a serious game, and carried out an initial assessment of its potential as a delirium screening tool (Tong et al., 2016). In this paper, we examine the test-retest reliability of the game, as it is an important criterion in a cognitive test for detecting risk of delirium onset. Objective: To demonstrate the test-retest reliability of the screening tool over time in a clinical sample of older emergency patients. A secondary objective is to assess whether there are practice effects that might make game performance unstable over repeated presentations. Materials and Methods: Adults over the age of 70 were recruited from a hospital ED. Each patient played our serious game in an initial session soon after they arrived in the ED, and in follow up sessions conducted at 8-h intervals (for each participant there were up to five follow up sessions, depending on how long the person stayed in the ED). Results: A total of 114 adults (61 females, 53 males) between the ages of 70 and 104 years ( M = 81 years, SD = 7) participated in our study after screening out delirious patients. We observed a test-retest reliability of the serious game (as assessed by correlation r -values) between 0.5 and 0.8 across adjacent

Ethical issues is psychological screening of nuclear power personnel

International Nuclear Information System (INIS)

Lowman, R.L.

1987-01-01

Ethical issues of mandatory psychological screening of nuclear power plant personnel have not been explored adequately. This paper examines several ethical issues in this area that need more attention. (1) Informed Consent: psychologists' ethics (like those of virtually all science and practice-oriented disciplines) require subjects participating in research or practice to be informed of procedures applied to them, the purposes, and possible consequences. (2) Feedback: psychologists' ethical guidelines require feedback to assesses when it is requested. (3) Validity: psychologists' ethics require that they use instrumentation only for the purposes intended and only for uses for which there is a preponderance of validity data available. In short, there is no question that psychological tests can significantly improve the effectiveness of a work force when they are properly (i.e., validly) used by well-trained and qualified professional psychologists. However, with the abundance of clinicians who are providing such services and with the complexity of the ethical issues involved in conducting these screenings, employers in psychologically high-risk settings should proceed with great caution to assure that assesses are treated in a fair and ethical manner

Impact of Cancer Awareness Drive on Generating Understanding and Improving Screening Practices for Breast Cancer: a Study on College Teachers in India

Science.gov (United States)

Shankar, Abhishek; Roy, Shubham; Rath, Goura Kishor; Chakraborty, Abhijit; Kamal, Vineet Kumar; Biswas, Aalekhya Sarma

2017-07-27

Background: Breast cancer is the most common cancer among women in India and most present at advanced stage. Although early detection is the only way to reduce morbidity and mortality, people have a very low awareness about breast cancer signs and symptoms and screening practices. The purpose of this study was to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Methods: This assessment was part of a pink chain campaign on cancer awareness. During events from 2011 to 2015 at various women colleges in different parts in India, a pre-test of knowledge related to breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive sessions, at 6 months and after1 year. Results: A total of 872 out of 985 teachers participated in the study (overall response rate of 88.5 %). Mean age of the study population was 41.6 years (range 28-59 yrs). There was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self-examination (BSE) was significantly more frequent in comparison to CBE and mammography. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer for more than 60% of teachers. Regarding post-awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons came out to be ignorance (83%) at the start of the campaign which was changed to lack of time (37.7%), lethargic attitude (32.2 %) and lack of time (31.5 %) at 6 months and same at 1 year also. Conclusions: With our awareness program there was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography. To inculcate safe lifestyle practices in people, awareness programmes such as

Implementing academic detailing for breast cancer screening in underserved communities

Directory of Open Access Journals (Sweden)

Ashford Alfred R

2007-12-01

Full Text Available Abstract Background African American and Hispanic women, such as those living in the northern Manhattan and the South Bronx neighborhoods of New York City, are generally underserved with regard to breast cancer prevention and screening practices, even though they are more likely to die of breast cancer than are other women. Primary care physicians (PCPs are critical for the recommendation of breast cancer screening to their patients. Academic detailing is a promising strategy for improving PCP performance in recommending breast cancer screening, yet little is known about the effects of academic detailing on breast cancer screening among physicians who practice in medically underserved areas. We assessed the effectiveness of an enhanced, multi-component academic detailing intervention in increasing recommendations for breast cancer screening within a sample of community-based urban physicians. Methods Two medically underserved communities were matched and randomized to intervention and control arms. Ninety-four primary care community (i.e., not hospital based physicians in northern Manhattan were compared to 74 physicians in the South Bronx neighborhoods of the New York City metropolitan area. Intervention participants received enhanced physician-directed academic detailing, using the American Cancer Society guidelines for the early detection of breast cancer. Control group physicians received no intervention. We conducted interviews to measure primary care physicians' self-reported recommendation of mammography and Clinical Breast Examination (CBE, and whether PCPs taught women how to perform breast self examination (BSE. Results Using multivariate analyses, we found a statistically significant intervention effect on the recommendation of CBE to women patients age 40 and over; mammography and breast self examination reports increased across both arms from baseline to follow-up, according to physician self-report. At post-test, physician

Environmental screening tools for assessment of infrastructure plans based on biodiversity preservation and global warming (PEIT, Spain)

International Nuclear Information System (INIS)

Garcia-Montero, Luis G.; Lopez, Elena; Monzon, Andres; Otero Pastor, Isabel

2010-01-01

Most Strategic Environmental Assessment (SEA) research has been concerned with SEA as a procedure, and there have been relatively few developments and tests of analytical methodologies. The first stage of the SEA is the 'screening', which is the process whereby a decision is taken on whether or not SEA is required for a particular programme or plan. The effectiveness of screening and SEA procedures will depend on how well the assessment fits into the planning from the early stages of the decision-making process. However, it is difficult to prepare the environmental screening for an infrastructure plan involving a whole country. To be useful, such methodologies must be fast and simple. We have developed two screening tools which would make it possible to estimate promptly the overall impact an infrastructure plan might have on biodiversity and global warming for a whole country, in order to generate planning alternatives, and to determine whether or not SEA is required for a particular infrastructure plan.

Cardiac pre-competiton screening in Swiss athletes. Current situation in competitive athletes and short-time assessment of an exemplary local screening program.

Science.gov (United States)

Schmied, Christian; Notz, Sara; Cribari, Marco; Gähwiler, Roman; Keller, Dagmar I; Lüscher, Thomas F

2012-05-31

In Switzerland, screening concepts for the prevention of sports-associated sudden cardiac death are still insufficiently established in the large group of competitive athletes who are not integrated in an Olympic- or other high-level squad. The aim of the present study was to objectively determine the current situation in this particular group of athletes concerning cardiac pre-competition screening and define specific features of an "ideal" Swiss screening concept. Based on these data, the feasibility and validity was tested by the implementation of an exemplary local screening programme. A standardised questionnaire was completed by 1,047 competitive athletes of different ages and gender. The individual, sports-specific profile of an athlete and furthermore, the personal attitude towards and the vision of a "perfect" cardiac screening were assessed. Based on the results, an exemplary local screening programme for competitive athletes was implemented at the "Academic Sports Association Zurich" (ASVZ) in Zurich, Switzerland and evaluated 1 year after its introduction. Only 9% of the 1,047 interviewed competitive athletes (aged 13 to 64 years; median age 22 years, SD = 5.87) had previously undergone a cardiac screening. Only 47% of the interviewed competitive athletes expressed their interest to undergo a cardiac screening at all. Male and older athletes showed a significantly higher acceptance rate for the screening programme than women and younger athletes. All athletes accepted to bear the expenses for the baseline screening programme, adapted to international standards (minimal accepted fee of 60 Swiss Francs). Almost half of the athletes (49.2%) preferred easy accessibility to a sports cardiologist (max. distance of 10 kilometres). The exemplary local screening programme proved to be feasible and successful. However, only 30% of the 102 screened individuals were female and most of the athletes (80%) who made use of the screening had a specific concern or

Violence Risk Assessment Practices in Denmark: A Multidisciplinary National Survey

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Nielsen Louise Hjort

2015-12-01

Full Text Available With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Broset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.

SUPPORTING TEACHERS IN IMPLEMENTING FORMATIVE ASSESSMENT PRACTICES IN EARTH SYSTEMS SCIENCE

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Harris, C. J.; Penuel, W. R.; Haydel Debarger, A.; Blank, J. G.

2009-12-01

An important purpose of formative assessment is to elicit student thinking to use in instruction to help all students learn and inform next steps in teaching. However, formative assessment practices are difficult to implement and thus present a formidable challenge for many science teachers. A critical need in geoscience education is a framework for providing teachers with real-time assessment tools as well as professional development to learn how to use formative assessment to improve instruction. Here, we describe a comprehensive support system, developed for our NSF-funded Contingent Pedagogies project, for addressing the challenge of helping teachers to use formative assessment to enhance student learning in middle school Earth Systems science. Our support system is designed to improve student understanding about the geosphere by integrating classroom network technology, interactive formative assessments, and contingent curricular activities to guide teachers from formative assessment to instructional decision-making and improved student learning. To accomplish this, we are using a new classroom network technology, Group Scribbles, in the context of an innovative middle-grades Earth Science curriculum called Investigating Earth Systems (IES). Group Scribbles, developed at SRI International, is a collaborative software tool that allows individual students to compose “scribbles” (i.e., drawings and notes), on “post-it” notes in a private workspace (a notebook computer) in response to a public task. They can post these notes anonymously to a shared, public workspace (a teacher-controlled large screen monitor) that becomes the centerpiece of group and class discussion. To help teachers implement formative assessment practices, we have introduced a key resource, called a teaching routine, to help teachers take advantage of Group Scribbles for more interactive assessments. Routine refers to a sequence of repeatable interactions that, over time, become

Delirium screening in intensive care: A life saving opportunity.

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Lamond, E; Murray, S; Gibson, C E

2018-02-01

Delirium is described as 'acute brain failure' and constitutes a medical emergency which presents a hazard for people cared for in intensive care units. The Scottish intensive care society audit group recommend that all people cared for in intensive care units be screened for signs of delirium so that treatment and management of complications can be implemented at an early stage. There is inconsistent evidence about when and how the assessment of delirium is carried out by nursing staff in the intensive care setting. This narrative review explores the pathophysiology and current practices of delirium screening in intensive care. Consideration is given to the role of the nurse in detecting and managing delirium and some barriers to routine daily delirium screening are critically debated. It is argued that routine delirium screening is an essential element of safe, effective and person centred nursing care which has potential to reduce morbidity and mortality. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Screening for disability in a community: the 'ten questions' screen for ...

African Journals Online (AJOL)

Background: Although the need for early identification and interventions of disabilities is evident, the current state of routine screening practice in Kenya needs intensive training of screeners before more rigorous techniques are introduced. Objective: To compare the precision and practical utility of the 'ten questions' and ...

Practicalities of developing a breast magnetic resonance imaging screening service for women at high risk for breast cancer.

Science.gov (United States)

Kiely, Belinda E; Hossack, Lucinda K; Shadbolt, Clair L; Davis, Anna; Cassumbhoy, Robin; Moodie, Kate; Antill, Yoland; Mitchell, Gillian

2011-10-01

Demand for screening breast magnetic resonance imaging (MRI) for women with a hereditary predisposition to breast cancer has increased since the introduction of a medicare item number. To aid future service planning, we examined the practicalities of establishing and running a breast MRI screening programme for high risk women and to describe the early outcomes of our screening programme. We undertook a retrospective audit of prospectively collected data. Women detection rate; and patient satisfaction via questionnaire. From 2006 to 2009, 82 women completed a round one screening MRI and 45, 21 and one women completed second, third and fourth round annual MRI studies, respectively. Median MRI process times were: booking 20 min; attendance in radiology department 90 min; imaging duration 45 min; reporting by one radiologist 30 min. Of the 82 round one studies, 23 (28%) were reported as ≥Breast Imaging Reporting and Data System three requiring further investigation. Of the round two and three studies completed, 13/45 (28%) and 2/21 (9%) have been recalled, respectively. Seven malignancies were detected. Questionnaires revealed women were satisfied with the service. Significant time, staff and equipment is required to run an effective breast MRI screening programme and this must be considered by future service providers.

SAUDI TEACHERS’ PRACTICES OF FORMATIVE ASSESSMENT: A QUALITATIVE STUDY

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Saeed Almuntasheri

2016-12-01

Full Text Available Shifting from teacher-centred to student-centred practices requires teachers to understand strategies to interact with students in science classes. Formative assessment strategies are very critical component of classroom interaction where teachers obtain information about student learning wherever possible. Traditionally, however, teachers ask questions and evaluate student responses but without investigating student contributions to the classroom interaction. This qualitative study aimed at developing teachers’ knowledge of formative assessment strategies when teaching science-based inquiry in Saudi Arabia. 12 teachers were observed when teaching science and details of one teachers’ practices of formative assessment is presented in this study. Formative assessment framework that describes assessment conversations is used and modified to observe teachers’ assessment practices. Assessment conversation consists of four-step cycles, where the teacher elicits information from students through questioning, the student responds, the teacher recognizes the student’s response, and then uses the information to develop further inquiry. Findings indicate that teachers ask questions and receive responses but rarely allow students to share their own ideas or discuss their own thinking. The study underlines the importance of integrating formative assessment strategies during scientific inquiry teaching for professional development as a way to increase student participation and allow opportunities for students’ inquiry in science classes.

Primary care physicians' reported use of pre-screening discussions for prostate cancer screening: a cross-sectional survey.

Science.gov (United States)

Linder, Suzanne K; Hawley, Sarah T; Cooper, Crystale P; Scholl, Lawrence E; Jibaja-Weiss, Maria; Volk, Robert J

2009-03-18

Professional medical organizations recommend individualized patient decision making about prostate cancer screening. Little is known about primary care physicians' use of pre-screening discussions to promote informed decision making for prostate cancer screening. The aim of this study is to explore physicians' use of pre-screening discussions and reasons why physicians would or would not try to persuade patients to be screened if they initially refuse testing. Primary care physicians completed a self-administered survey about prostate cancer screening practices for informed decision making. Sixty-six physicians (75.9%) completed the survey, and 63 were used in the analysis. Thirteen physicians (20.6%) reported not using prescreening discussions, 45 (71.4%) reported the use of prescreening discussions, and 3 (4.8%) reported neither ordering the PSA test nor discussing it with patients. Sixty-nine percent of physicians who reported not having discussions indicated they were more likely to screen African American patients for prostate cancer, compared to 50% of physicians who reported the use of discussions (Chi-square(1) = 1.62, p = .20). Similarly, 91% of physicians who reported not having discussions indicated they are more likely to screen patients with a family history of prostate cancer, compared to 46% of those who reported the use of discussion (Chi-square(1) = 13.27, p practice styles. Future research needs to consider the nature of discussions and the degree to which informed decision making is being achieved in clinical practice.

Improving School Nurse Pain Assessment Practices for Students With Intellectual Disability.

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Quinn, Brenna L; Smolinski, Megan

2017-01-01

School nurses are afforded minimal resources related to assessing pain in students with intellectual disability (ID) and have called for continuing education. The purpose of this study was to measure the effectiveness of an education program regarding best practices for assessing pain in students with ID. Educational sessions were presented to 248 school nurses. Pre-, post-, and follow-up surveys measured (1) difficulty school nurses face when assessing pain, (2) knowledge and use of pain assessment methods, and (3) intent to change and actual changes to professional practices. Participants experienced less difficulty assessing pain following the educational program. Almost all participants intended to change pain assessment practices, but large caseloads limited new practice adoption. Policy makers must consider population size and acuity when determining school nurse staffing. Trainings and other resources should be made available to school nurses in order to make pain assessments for students with ID more thorough and efficient.

Primary care physicians' reported use of pre-screening discussions for prostate cancer screening: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Cooper Crystale P

2009-03-01

Full Text Available Abstract Background Professional medical organizations recommend individualized patient decision making about prostate cancer screening. Little is known about primary care physicians' use of pre-screening discussions to promote informed decision making for prostate cancer screening. The aim of this study is to explore physicians' use of pre-screening discussions and reasons why physicians would or would not try to persuade patients to be screened if they initially refuse testing. Methods Primary care physicians completed a self-administered survey about prostate cancer screening practices for informed decision making. Results Sixty-six physicians (75.9% completed the survey, and 63 were used in the analysis. Thirteen physicians (20.6% reported not using prescreening discussions, 45 (71.4% reported the use of prescreening discussions, and 3 (4.8% reported neither ordering the PSA test nor discussing it with patients. Sixty-nine percent of physicians who reported not having discussions indicated they were more likely to screen African American patients for prostate cancer, compared to 50% of physicians who reported the use of discussions (Chi-square(1 = 1.62, p = .20. Similarly, 91% of physicians who reported not having discussions indicated they are more likely to screen patients with a family history of prostate cancer, compared to 46% of those who reported the use of discussion (Chi-square(1 = 13.27, p Conclusion Although guidelines recommend discussing the risks and benefits of prostate cancer screening, physicians report varying practice styles. Future research needs to consider the nature of discussions and the degree to which informed decision making is being achieved in clinical practice.

Association of Wage With Employee Participation in Health Assessments and Biometric Screening.

Science.gov (United States)

Sherman, Bruce W; Addy, Carol

2018-02-01

To understand differences in health risk assessment (HRA) and biometric screening participation rates among benefits-enrolled employees in association with wage category. Cross-sectional analysis of employee eligibility file and health benefits (wellness and claims) data. Data from self-insured employers participating in the RightOpt private exchange (Conduent HR Services) during 2014. Active employees from 4 companies continuously enrolled in health insurance for which wage data were available. Measures included HRA and biometric screening participation rates and wage status, with employee age, sex, employer, job tenure, household income, geographic location, and health benefits deductible as a percentage of total wages serving as covariates. Employees were separated into 5 groups based on wage status. Logistic regression analysis incorporated other measures as covariates to adjust for differences between groups, with HRA and biometric screening participation rates determined as binary outcomes. Participation rates for HRA and biometric screening were 90% and 87%, respectively, in the highest wage category, decreasing to 67% and 60%, respectively, among the lowest wage category. Employee wage status is associated with significant differences in HRA and biometric participation rates. Generalizing the results generated by modest participation in these offerings to entire populations may risk misinterpretation of results based on variable participation rates across wage categories.

Assessing traumatic event exposure: general issues and preliminary findings for the Stressful Life Events Screening Questionnaire.

Science.gov (United States)

Goodman, L A; Corcoran, C; Turner, K; Yuan, N; Green, B L

1998-07-01

This article reviews the psychometric properties of the Stressful Life Events Screening Questionnaire (SLESQ), a recently developed trauma history screening measure, and discusses the complexities involved in assessing trauma exposure. There are relatively few general measures of exposure to a variety of types of traumatic events, and most of those that exist have not been subjected to rigorous psychometric evaluation. The SLESQ showed good test-retest reliability, with a median kappa of .73, adequate convergent validity (with a lengthier interview) with a median kappa of .64, and good discrimination between Criterion A and non-Criterion A events. The discussion addresses some of the challenges of assessing traumatic event exposure along the dimensions of defining traumatic events, assessment methodologies, reporting consistency, and incident validation.

Ocena funkcjonalna zawodników uprawiających futbol amerykański z wykorzystaniem testu Functional Movement Screen = Functional evaluation of competitors practicing American football with using Functional Movement Screen test

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Bartosz Kochański

2015-10-01

of injury, assessment of quality of movement patterns and to determine the occurrence of restrictions and asymmetries within the musculoskeletal system. Aim of the study. The aim of the study is functional evaluation of American football players using Functional Movement Screen (FMS and to determine the correlation between FMS test result and a history trauma and injuries in American football players. Materials and methods. The study was conducted on a group of 30 professional American football players representing the "KS Bydgoszcz Archers". Functional evaluation was performed by using the Functional Movement Screen. The study was carried out during the season. The study used the device and protocol of FMS test. Results. The average score in the FMS test earned by people practicing American football is 14.5/21 points. The average of the majority of the tests oscillates around two points, which means that the movement patterns are made of compensation. In American football players we observed a statistically significant correlation between a history trauma and injuries, and the results achieved in test 2, 4 and 6 in the FMS test. Conclusions. 1. In American football players observed irregularities in patterns of mobility, stability and neuromuscular coordination in the FMS test. 2. The risk of injury and injury in American football players is relatively high according to the FMS test. 3. FMS test result correlates with a history of trauma and injuries in American football players.   Słowa kluczowe: ocena funkcjonalna, FMS, Functional Movement Screen, futbol amerykański. Keywords: functional evaluation, FMS, Functional Movement Screen, American football.

Primary care colorectal cancer screening correlates with breast cancer screening: implications for colorectal cancer screening improvement interventions.

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Weiss, Jennifer M; Pandhi, Nancy; Kraft, Sally; Potvien, Aaron; Carayon, Pascale; Smith, Maureen A

2018-04-25

National colorectal cancer (CRC) screening rates have plateaued. To optimize interventions targeting those unscreened, a better understanding is needed of how this preventive service fits in with multiple preventive and chronic care needs managed by primary care providers (PCPs). This study examines whether PCP practices of other preventive and chronic care needs correlate with CRC screening. We performed a retrospective cohort study of 90 PCPs and 33,137 CRC screening-eligible patients. Five PCP quality metrics (breast cancer screening, cervical cancer screening, HgbA1c and LDL testing, and blood pressure control) were measured. A baseline correlation test was performed between these metrics and PCP CRC screening rates. Multivariable logistic regression with clustering at the clinic-level estimated odds ratios and 95% confidence intervals for these PCP quality metrics, patient and PCP characteristics, and their relationship to CRC screening. PCP CRC screening rates have a strong correlation with breast cancer screening rates (r = 0.7414, p < 0.001) and a weak correlation with the other quality metrics. In the final adjusted model, the only PCP quality metric that significantly predicted CRC screening was breast cancer screening (OR 1.25; 95% CI 1.11-1.42; p < 0.001). PCP CRC screening rates are highly concordant with breast cancer screening. CRC screening is weakly concordant with cervical cancer screening and chronic disease management metrics. Efforts targeting PCPs to increase CRC screening rates could be bundled with breast cancer screening improvement interventions to increase their impact and success.

Automated assessment of patients' self-narratives for posttraumatic stress disorder screening using natural language processing and text mining

NARCIS (Netherlands)

He, Qiwei; Veldkamp, Bernard P.; Glas, Cornelis A.W.; de Vries, Theo

2017-01-01

Patients’ narratives about traumatic experiences and symptoms are useful in clinical screening and diagnostic procedures. In this study, we presented an automated assessment system to screen patients for posttraumatic stress disorder via a natural language processing and text-mining approach. Four

Bioassays for Evaluating Water Quality: Screening for total bioactivity to assess water safety

Science.gov (United States)

Bioassays are a potential solution for assessing complex samples since they screen for total bioactivity for a given pathway or mode of action (MOA), such as estrogen receptor activation, in the samples. Overall, they can account for the three challenges listed above, and can sim...

Congestion game scheduling for virtual drug screening optimization

Science.gov (United States)

Nikitina, Natalia; Ivashko, Evgeny; Tchernykh, Andrei

2018-02-01

In virtual drug screening, the chemical diversity of hits is an important factor, along with their predicted activity. Moreover, interim results are of interest for directing the further research, and their diversity is also desirable. In this paper, we consider a problem of obtaining a diverse set of virtual screening hits in a short time. To this end, we propose a mathematical model of task scheduling for virtual drug screening in high-performance computational systems as a congestion game between computational nodes to find the equilibrium solutions for best balancing the number of interim hits with their chemical diversity. The model considers the heterogeneous environment with workload uncertainty, processing time uncertainty, and limited knowledge about the input dataset structure. We perform computational experiments and evaluate the performance of the developed approach considering organic molecules database GDB-9. The used set of molecules is rich enough to demonstrate the feasibility and practicability of proposed solutions. We compare the algorithm with two known heuristics used in practice and observe that game-based scheduling outperforms them by the hit discovery rate and chemical diversity at earlier steps. Based on these results, we use a social utility metric for assessing the efficiency of our equilibrium solutions and show that they reach greatest values.

Assessment, Student Learning and Classroom Practice: A Review

Science.gov (United States)

Amua-Sekyi, Ekua Tekyiwa

2016-01-01

Assessment in its various forms has always been a central part of educational practice. Evidence gleaned from the empirical literature suggests that assessment, especially high stakes external assessment has effect on how teachers teach and consequently, how students learn. Through focus group discussions, this paper draws upon the experiences of…

Behavioral Screening for Toxicology | Science Inventory | US ...

Science.gov (United States)

Screening for behavioral toxicity, or neurotoxicity, has been in use for decades; however, only in the past 20 years has this become a standard practice in toxicology. Current screening batteries, such as the functional observational battery (FOB), are derived from protocols used in pharmacology, toxicology, and psychology. Although there is a range of protocols in use today, all focus on detailed observations and specific tests of reflexes and responses. Several neurological functions are typically assessed, including autonomic, neuromuscular, and sensory, as well as levels of activity and excitability. The tests have been shown to be valid in detecting expected effects of known neurotoxicants, and reliable and reproducible whn compared across laboratories. Regardless of the specific protocol used, proper conduct and statistical analyses of the data are critical. Interpretation is based on the information from individual end points as well as the profile, or pattern, of effects observed. As long as continual refinements are made, behavioral screening methods will continue to be important tools with which to protect human health in the future.autonomic function; behavior; behavioral phenotypes; behavioral toxicity; excitability; functional observational battery ; motor activity; mouse; neuromuscular function; positive controls; rat; screening battery ; sensory function Screening for behavioral toxicity, or neurotoxicity, has been in use for decades; how

Screening for trisomy 21 based on maternal age, nuchal translucency measurement, first trimester biochemistry and quantitative and qualitative assessment of the flow in the DV - the assessment of efficacy.

Science.gov (United States)

Czuba, Bartosz; Zarotyński, Dariusz; Dubiel, Mariusz; Borowski, Dariusz; Węgrzyn, Piotr; Cnota, Wojciech; Reska-Nycz, Małgorzata; Mączka, Marek; Wielgoś, Mirosław; Sodowski, Krzysztof; Serafin, Dawid; Kubaty, Anna; Bręborowicz, Grzegorz H

2017-01-01

The aim of the study was to compare effects of addition of two methods of ductus venosus (DV) flow assessment: qualitative - the assessment of shape of the A-wave (positive or negative), and quantitative - based on the pulsatility index for veins (DVPI) to the basic screening for trisomy 21 at 11 to 13 + 6 weeks of pregnancy. The ultrasound examination was performed in 8230 fetuses in singleton pregnancies at 11- -13 + 6 wks, as a part of a routine screening for chromosomal defects. In DV A-wave was assessed and DVPI was calculated. After the scan blood sample was taken for first trimester biochemistry (BC). Risk for chromosomal defects was calculated and high-risk patients were offered an invasive test for karyotyping. Basic screening with following combination of markers: MA, NT and BC provided lowest detection rate (DR) 87.50% for FPR = 6.94%. After adding qualitative DV A-wave assessment DR increased to 88.75% for FPR = 5.65%. The best DR = 93.75% for FPR = 5.55% was achieved when quantitative DVPI was added. The application of the Receiver Operating Curves curve confirmed validity of the addition of DV flow assessment to the screening model. The highest diagnostic power of the test was achieved when DVPI was added, with the ROC AUC of 0.974. The assessment of DV flow performed at 11-13 + 6 weeks increases DR for trisomy 21 and reduces FPR. The screening model based on the quantitative DV flow analysis (DVPI) gives better results compared to the qualitative flow assessment.

Self-Assessment in Librarianship: Current Practices and Future Possibilities

Directory of Open Access Journals (Sweden)

Ania Dymarz

2015-07-01

Full Text Available The authors of this qualitative study set out to investigate self-assessment practices within the library profession. The researchers conducted semi-structured interviews with a purposeful sample of nine librarians coming from a range of library settings and possessing a diversity of library experience. Interviews were then transcribed and coded in NVIVO to identify emergent themes. This paper details some of the results of that study, highlighting motivations, limitations, and strategies with regard to self-assessment. The findings present a summary of a range of approaches to the practice of assessment as reported by the interviewees. One area of possible growth for our profession, as highlighted by the findings, is in the development of peer networks as a support for the individual practice of self-assessment. While the results of this small case study cannot be generalized, the authors hope these preliminary findings can open up the conversation around self-assessment both for individual librarians and for those librarians and managers working to shape their workplace culture.

Wind turbine environmental assessment -- Vol 1: Screening document

International Nuclear Information System (INIS)

2000-04-01

The environmental effects of the proposed construction and operation of up to three wind turbines on the Toronto waterfront are evaluated in accordance with the requirements of the Canadian Environmental Assessment Act (CEAA) and Regulations. The nine sections of the report provide background on the environmental assessment and the wind turbine project; provide justification for the project and describes alternative sites and wind turbine technologies; outlines the scope of the project; sketches the biophysical and socio-economic environment; presents an evaluation of the environmental impacts and proposed mitigating measures; describes the public consultation program that was carried out; summarizes the comments received from interested parties; presents the conclusion of the environmental impact assessment; and responds to the public comments received on the draft screening document. Most of the concerns raised involved avoidance reactions by birds, disruption or fragmentation of wildlife, the potential for high kill rate of small nocturnal migrants and young birds, and the effect of noise on breeding birds. The overall recommendation of the consultants is that the project is not likely to cause significant adverse environmental effects and its construction and operations should be authorized. 115 refs., 8 tabs., 2 figs. (14 appendices are in volume 2)

Toward standardizing and reporting colorectal cancer screening indicators on an international level: The International Colorectal Cancer Screening Network

NARCIS (Netherlands)

Benson, Victoria S.; Atkin, Wendy S.; Green, Jane; Nadel, Marion R.; Patnick, Julietta; Smith, Robert A.; Villain, Patricia; Patnick, J.; Atkin, W. S.; Altenhofen, L.; Ancelle-Park, R.; Benson, V. S.; Green, J.; Levin, T. R.; Moss, S. M.; Nadel, M.; Ransohoff, D.; Segnan, N.; Smith, R. A.; Villain, P.; Weller, D.; Koukari, A.; Young, G.; López-Kostner, F.; Antoljak, N.; Suchánek, S.; Zavoral, M.; Holten, I.; Malila, N.; Salines, E.; Brenner, G.; Herszényi, L.; Tulassay, Z.; Rennert, G.; Senore, C.; Zappa, M.; Zorzi, M.; Saito, H.; Leja, M.; Dekker, E.; Jansen, J.; Hol, L.; Kuipers, E.; Kaminski, M. F.; Regula, J.; Sfarti, C.; Trifan, A.; Tang, C.-L.; Hrcka, R.; Binefa, G.; Espinàs, J. A.; Peris, M.; Chen, T. H.; Steele, R.; Pou, G.; Bisges, D.; Dwyer, D.; Groves, C.; Courteau, S.; Kramer, R.; Siegenthaler, K.; Lane, D.; Herrera, C.; Rogers, J.; Rojewski, M.; Wolf, Holly; Sung, J. J.; Ling, K.; Bryant, H.; Rabeneck, L.; Dale, J.; Sware, L.; Yang, H.; Viguier, J.; Von Karsa, L.; Kupcinskas, L.; Deutekom, M.; Törnberg, S.; Austoker, J.; Beral, V.; Monk, C.; Valori, R.; Watson, J.; Kobrin, S.; Pignone, M.; Taplin, S.

2012-01-01

The International Colorectal Cancer Screening Network was established in 2003 to promote best practice in the delivery of organized colorectal cancer screening programs. To facilitate evaluation of such programs, we defined a set of universally applicable colorectal cancer screening measures and

Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

Science.gov (United States)

Hall, Michael J.; Ruth, Karen; Giri, Veda N.

2011-01-01

Background Screening by fecal occult blood test and lower endoscopy have lowered colorectal cancer (CRC) mortality, but compliance gaps persist. Of concern are possible disparities in uptake of CRC screening between White and African American (AA) men. Our goal was to assess for disparities in uptake of CRC screening among men participating in a high-risk prostate cancer clinic. If present, such disparities could support hypotheses for further research examining racial differences in awareness and patient preferences in undergoing CRC screening. Methods Baseline data on a racially diverse cohort of men age 50–69 at increased risk of prostate cancer collected via the prostate cancer risk assessment program (PRAP) at Fox Chase Cancer Center were analyzed. Predictors of uptake of CRC screening were assessed using multivariable logistic regression. Results Compared to Whites, AA men had statistically significantly lower uptake of fecal occult blood testing (AA 49.0% vs White 60.7%, p=0.035), lower endoscopy (AA 44.1% vs White 58.5%, p=0.011), and any CRC screening (AA 66.2% vs White 76.3%, p=0.053). Predictors of uptake of lower endoscopy among AA men included older age (OR 3.61, 95% CI 1.87–6.97), family history of CRC (OR 3.47, 95% CI 1.30–9.25), and insurance status (OR 1.90, 95% CI 1.04–3.46). Conclusion Despite awareness of cancer risk and motivation to seek prostate cancer screening through a specialized prostate cancer risk assessment program, evidence supporting compliance gaps with CRC screening among men was found. Tailored messages to younger AA men with and without a family history of CRC are needed. PMID:21751189