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Sample records for cancer audit survey

  1. A survey of community child health audit.

    Science.gov (United States)

    Spencer, N J; Penlington, E

    1993-03-01

    Community child health medical audit is established in most districts surveyed. A minority have integrated audit with hospital paediatric units. Very few districts use an external auditor. Subject audit is preferred to individual performance audit and school health services were the most common services subjected to medical audit. The need for integrated audit and audit forms suitable for use in the community services is discussed.

  2. USING SURVEY OF SERIES IN AUDIT

    Directory of Open Access Journals (Sweden)

    OFILEANU DIMI

    2014-12-01

    Full Text Available The efficiency of financial audit within an entity can be made by applying sampling statistical techniques. International auditing standards offer the possibility to test only part of financial information of an entity by means of different sampling techniques. The article is a rhetorical and practical speculation regarding the methodology and the possibility to apply a statistical survey of series in the research of documents and accounting records.

  3. An IAEA Survey of Dosimetry Audit Networks for Radiotherapy

    International Nuclear Information System (INIS)

    Grochowska, Paulina; Izewska, Joanna

    2013-01-01

    A Survey: In 2010, the IAEA undertook a task to investigate and review the coverage and operations of national and international dosimetry audit programmes for radiotherapy. The aim was to organize the global database describing the activities of dosimetry audit networks in radiotherapy. A dosimetry audit questionnaire has been designed at an IAEA consultants' meeting held in 2010 for organizations conducting various levels of dosimetry audits for radiotherapy. Using this questionnaire, a survey was conducted for the first time in 2010 and repeated in 2011. Request for information on different aspects of the dosimetry audit was included, such as the audit framework and resources, its coverage and scope, the dosimetry system used and the modes of audit operation, i.e. remotely and through on-site visits. The IAEA questionnaire was sent to over 80 organizations, members of the IAEA/WHO Network of Secondary Standards Dosimetry Laboratories (SSDLs) and other organizations known for having operated dosimetry audits for radiotherapy in their countries or internationally. Survey results and discussion: In response to the IAEA survey, 53 organizations in 45 countries confirmed that they operate dosimetry audit services for radiotherapy. Mostly, audits are conducted nationally, however there are five organizations offering audits abroad, with two of them operating in various parts of the world and three of them at the regional level, auditing radiotherapy centres in neighbouring countries. The distribution of dosimetry audit services in the world is given. (author)

  4. Audit of advanced gastric cancer at Ibn Sina Hospital, Khartoum ...

    African Journals Online (AJOL)

    Sudan Journal of Medical Sciences ... Background: Worldwide, gastric cancer is the second most common cancer (second to lung cancer). ... and age influences the clinico-pathological features of gastric cancer and to audit the outcome of ...

  5. ICA Communication Audit Survey Instrument: 1977 Organizational Norms.

    Science.gov (United States)

    Goldhaber, Gerald M.; And Others

    Section one of this paper describes the history and development of the "communicaton audit," a system for assessing communication effectiveness in organizations, by the International Communication Association. Section two describes the 16 audits conducted so far and the overall demographic characteristics of the current survey data bank.…

  6. Value of audits in breast cancer screening quality assurance programmes

    NARCIS (Netherlands)

    Geertse, Tanya D.; Holland, Roland; Timmers, Janine M. H.; Paap, Ellen; Pijnappel, Ruud M.; Broeders, Mireille J. M.; den Heeten, Gerard J.

    2015-01-01

    Our aim was to retrospectively evaluate the results of all audits performed in the past and to assess their value in the quality assurance of the Dutch breast cancer screening programme. The audit team of the Dutch Reference Centre for Screening (LRCB) conducts triennial audits of all 17 reading

  7. Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit

    NARCIS (Netherlands)

    van Rijssen, L. Bengt; Koerkamp, Bas G.; Zwart, Maurice J.; Bonsing, Bert A.; Bosscha, Koop; van Dam, Ronald M.; van Eijck, Casper H.; Gerhards, Michael F.; van der Harst, Erwin; de Hingh, Ignace H.; de Jong, Koert P.; Kazemier, Geert; Klaase, Joost; van Laarhoven, Cornelis J.; Molenaar, I. Quintus; Patijn, Gijs A.; Rupert, Coen G.; van Santvoort, Hjalmar C.; Scheepers, Joris J.; van der Schelling, George P.; Busch, Olivier R.; Besselink, Marc G.; Bollen, Thomas L.; Bruno, Marco J.; van Tienhoven, Geert-Jan; Norduyn, Arnold; Berry, David P.; Tingstedt, Bobby; Tseng, Jennifer F.; Wolfgang, Christopher L.

    2017-01-01

    Background: Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery. Methods: Performance indicators and case-mix factors were identified by a PubMed search for randomized

  8. John F. Kennedy Space Center, Safety, Reliability, Maintainability and Quality Assurance, Survey and Audit Program

    Science.gov (United States)

    1994-01-01

    This document is the product of the KSC Survey and Audit Working Group composed of civil service and contractor Safety, Reliability, and Quality Assurance (SR&QA) personnel. The program described herein provides standardized terminology, uniformity of survey and audit operations, and emphasizes process assessments rather than a program based solely on compliance. The program establishes minimum training requirements, adopts an auditor certification methodology, and includes survey and audit metrics for the audited organizations as well as the auditing organization.

  9. Value of audits in breast cancer screening quality assurance programmes.

    Science.gov (United States)

    Geertse, Tanya D; Holland, Roland; Timmers, Janine M H; Paap, Ellen; Pijnappel, Ruud M; Broeders, Mireille J M; den Heeten, Gerard J

    2015-11-01

    Our aim was to retrospectively evaluate the results of all audits performed in the past and to assess their value in the quality assurance of the Dutch breast cancer screening programme. The audit team of the Dutch Reference Centre for Screening (LRCB) conducts triennial audits of all 17 reading units. During audits, screening outcomes like recall rates and detection rates are assessed and a radiological review is performed. This study investigates and compares the results of four audit series: 1996-2000, 2001-2005, 2003-2007 and 2010-2013. The analysis shows increased recall rates (from 0.66%, 1.07%, 1.22% to 1.58%), increased detection rates (from 3.3, 4.5, 4.8 to 5.4 per 1000) and increased sensitivity (from 64.5%, 68.7%, 70.5% to 71.6%), over the four audit series. The percentage of 'missed cancers' among interval cancers and advanced screen-detected cancers did not change (p = 0.4). Our audits not only provide an opportunity for assessing screening outcomes, but also provide moments of self-reflection with peers. For radiologists, an accurate understanding of their performance is essential to identify points of improvement. We therefore recommend a radiological review of screening examinations and immediate feedback as part of an audit. • Radiological review and immediate feedback are recommended as part of an audit. • For breast screening radiologists, audits provide moments of self-reflection with peers. • Radiological review of screening examinations provides insights in recall behaviour. • Accurate understanding of radiologists' performance is essential to identify points of improvement.

  10. Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit.

    Science.gov (United States)

    van Rijssen, L Bengt; Koerkamp, Bas G; Zwart, Maurice J; Bonsing, Bert A; Bosscha, Koop; van Dam, Ronald M; van Eijck, Casper H; Gerhards, Michael F; van der Harst, Erwin; de Hingh, Ignace H; de Jong, Koert P; Kazemier, Geert; Klaase, Joost; van Laarhoven, Cornelis J; Molenaar, I Quintus; Patijn, Gijs A; Rupert, Coen G; van Santvoort, Hjalmar C; Scheepers, Joris J; van der Schelling, George P; Busch, Olivier R; Besselink, Marc G

    2017-10-01

    Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery. Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated. Morbidity, mortality, and length of stay were analyzed of all pancreatic resections registered during the first two audit years. Case ascertainment was cross-checked with the Dutch healthcare inspectorate and key-variables validated in all centers. Sixteen RCT's and three large series were found. Sixteen indicators and 20 case-mix factors were included in the audit. During 2014-2015, 1785 pancreatic resections were registered including 1345 pancreatoduodenectomies. Overall in-hospital mortality was 3.6%. Following pancreatoduodenectomy, mortality was 4.1%, Clavien-Dindo grade ≥ III morbidity was 29.9%, median (IQR) length of stay 12 (9-18) days, and readmission rate 16.0%. In total 97.2% of >40,000 variables validated were consistent with the medical charts. The Dutch Pancreatic Cancer Audit, with high quality data, reports good outcomes of pancreatic surgery on a national level. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  11. Audit of gynaecological cancers Queen Elizabeth Central Hospital ...

    African Journals Online (AJOL)

    The aim of the audit was to assess the trend of the gynaecological cancers for the first quarter of 2008, and the prevalence of HIV and syphilis among the cases. Gynaecological cancer cases accounted for 6% of gynaecological admissions at QECH between January and April 2008. The findings show that cervical cancer ...

  12. Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands : The national NABON Breast Cancer Audit

    NARCIS (Netherlands)

    van Bommel, Annelotte C.M.; Spronk, Pauline E.R.; Vrancken Peeters, Marie-Jeanne T.F.D.; Jager, Agnes; Lobbes, Marc; Maduro, John H.; Mureau, Marc A.M.; Schreuder, Kay; Smorenburg, Carolien; Verloop, Janneke; Westenend, Pieter J.; Wouters, Michel W.J.M.; Siesling, Sabine; Tjan-Heijnen, Vivianne C.G.; van Dalen, Thijs

    2017-01-01

    Background In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation-wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described. Methods Clinical and pathological

  13. Audit

    OpenAIRE

    1991-01-01

    Audit has long been a feature of good general practice. The literature is full of examples of audit by general practitioners and this Occasional Paper quotes many examples of audit which have produced valuable results. This chapter gives some advice to doctors wishing to audit their prescribing.

  14. An audit of colorectal cancer histopathology reports in a Tertiary ...

    African Journals Online (AJOL)

    Objective: To audit the completeness of histopathologic reports of Colorectal Cancer for prognostic information in a tertiary care hospital in the light of the minimum reporting standards for colorectal cancer resections recently proposed for use in Nigeria. Material and Methods: Twenty–five histopathology reports of colorectal ...

  15. UK intussusception audit: A national survey of practice and audit of reduction rates

    International Nuclear Information System (INIS)

    Hannon, Edward; Williams, Rhianydd; Allan, Rosemary; Okoye, Bruce

    2014-01-01

    Aim: To define current UK reduction practice and the reductions rates achieved. Materials and methods: Electronic surveys were sent to radiologists at 26 UK centres. This assessed methods of reduction, equipment, personnel, and protocol usage. Standardized audit proforma were also sent to evaluate all reductions performed in 2011. Results: Twenty-two of 26 centres (85%) replied. All used air enema under fluoroscopic guidance. Equipment was not standardized but could be broadly categorized into hand-pumped air-supply systems (seven centres) and pressurized air systems (15 centres). Seventeen centres followed a protocol based on British Society of Paediatric Radiologists (BSPR) guidelines. In 21 of the 22 centres a consultant paediatric radiologist led reductions and only 12 centres reported a surgeon being present. Three hundred and ten cases were reported across 22 centres. Cases per centre ranged from 0–31 (median 14). Reduction rates varied from 38–90% (median 71%). The overall perforation rate was 2.5%. Caseload did not significantly correlate with reduction rate, and there was no significant difference between the two types of equipment used. Median reduction rates were 15% higher in centres with a surgeon present at reduction (p < 0.05). Conclusion: Intussusception care in the UK lacks standardization of equipment and personnel involved. National reduction rates are lower than in current international literature. Improved standardization may lead to an improvement in reduction rates and a surgeon should always be present at reduction

  16. Comparing short versions of the AUDIT in a community-based survey of young people

    Science.gov (United States)

    2013-01-01

    Background The 10-item Alcohol Use Disorders Identification Test (AUDIT-10) is commonly used to monitor harmful alcohol consumption among high-risk groups, including young people. However, time and space constraints have generated interest for shortened versions. Commonly used variations are the AUDIT-C (three questions) and the Fast Alcohol Screening Test (FAST) (four questions), but their utility in screening young people in non-clinical settings has received little attention. Methods We examined the performance of established and novel shortened versions of the AUDIT in relation to the full AUDIT-10 in a community-based survey of young people (16–29 years) attending a music festival in Melbourne, Australia (January 2010). Among those reporting drinking alcohol in the previous 12 months, the following statistics were systematically assessed for all possible combinations of three or four AUDIT items and established AUDIT variations: Cronbach’s alpha (internal consistency), variance explained (R2) and Pearson’s correlation coefficient (concurrent validity). For our purposes, novel shortened AUDIT versions considered were required to represent all three AUDIT domains and include item 9 on alcohol-related injury. Results We recruited 640 participants (68% female) reporting drinking in the previous 12 months. Median AUDIT-10 score was 10 in males and 9 in females, and 127 (20%) were classified as having at least high-level alcohol problems according to WHO classification. The FAST scored consistently high across statistical measures; it explained 85.6% of variance in AUDIT-10, correlation with AUDIT-10 was 0.92, and Cronbach’s alpha was 0.66. A number of novel four-item AUDIT variations scored similarly high. Comparatively, the AUDIT-C scored substantially lower on all measures except internal consistency. Conclusions Numerous abbreviated variations of the AUDIT may be a suitable alternative to the AUDIT-10 for classifying high-level alcohol problems in a

  17. Combined audit of hospital antibiotic use and a prevalence survey of healthcare-associated infection.

    LENUS (Irish Health Repository)

    O'Neill, E

    2010-05-01

    Appropriate antibiotic use improves patient outcome and prevents the emergence of antibiotic resistance. A point-prevalence audit of antibiotic use at Beaumont Hospital, Dublin was carried out during the collection of data for the 2006 Hospital Infection Society (HIS) Prevalence Survey of Healthcare-Associated Infection. All inpatients who met the HIS survey entry criteria were included in the HIS survey, and all inpatients who were receiving antibiotics at the time of the survey were included in the point-prevalence audit of antibiotic use. Among these, 7.18% and 36.8% of patients had a healthcare-associated infection (HCAI) and were on antibiotics, respectively. Unnecessary collection of duplicate data was avoided by conducting an audit of antibiotic use and a national survey of HCAI simultaneously.

  18. HUBUNGAN ANTARA TIME BUDGET PRESSURE, LOCUS OF CONTROL DAN KOMITMEN ORGANISASI TERHADAP PERILAKU DISFUNGSIONAL AUDIT DAN PENGARUHNYA PADA KUALITAS AUDIT (Survey pada Auditor Perwakilan BPKP Provinsi Sulawesi Selatan)

    OpenAIRE

    Sampetoding, Pricilia Resky

    2014-01-01

    2014 Hubungan antara Time Budget Pressure, Locus Of Control dan Komitmen Organisasi terhadap Perilaku Disfungsional Audit dan Pengaruhnya pada Kualitas Audit (Survey pada Auditor Perwakilan BPKP Provinsi Sulawesi Selatan) Pricilia Resky Sampetoding Yulianus Sampe Agus Bandang Penelitian ini bertujuan untuk mengetahui hubungan antara time budget pressure, locus of control, dan komitmen organisasi terhadap perilaku ...

  19. A real-time audit of radiation therapy in a regional cancer center

    International Nuclear Information System (INIS)

    Brundage, Michael D.; Dixon, Peter F.; Mackillop, William J.; Shelley, Wendy E.; Hayter, Charles; Paszat, Lawrence F.; Youssef, Youssef M.; Robins, Jean M.; McNamee, Anne; Cornell, Annette

    1999-01-01

    Purpose: To report the development, structure, and implementation of a real-time clinical radiotherapy audit of the practice of radiation oncology in a regional cancer center. Methods and Materials: Radiotherapy treatment plans were audited by a real-time peer-review process over an 8-year period (1989-1996). The overall goal of the audit was to establish a process for quality assurance (QA) of radiotherapy planning and prescription for individual patients. A parallel process was developed to audit the implementation of intervention-specific radiotherapy treatment policies. Results: A total of 3052 treatment plans were audited. Of these, 124 (4.1%) were not approved by the audit due to apparent errors in radiation planning. The majority of the nonapproved plans (79%) were modified prior to initiating treatment; the audit provided important clinical feedback about individual patient care in these instances. Most of the remaining nonapproved plans were deviations from normal practice due to patient-specific considerations. A further 110 (3.6% of all audited plans) were not approved by the audit due to deviations from radiotherapy treatment policy. A minority of these plans (22%) were modified prior to initiating treatment and the remainder provided important feedback for continuous quality improvement of treatment policies. Conclusion: A real-time audit of radiotherapy practice in a regional cancer center setting proved feasible and provided important direct and indirect patient benefits

  20. Combining a survey approach and energy and indoor environment auditing in historic buildings

    DEFF Research Database (Denmark)

    Rohdin, Patrik; Dalewski, Mariusz; Moshfegh, Bahram

    2016-01-01

    Purpose – This paper presents an approach where a survey study is combined with energy and indoor environment auditing in the built environment. The combination of methods presented in this paper is one way to obtain a wider perspective on the indoor environment and energy use and also let...... this research project. Design/methodology/approach – A combination of energy and indoor environment auditing and standardized occupant surveys. Findings – The main findings in the paper are related to the good agreement between results from standardized occupant surveys and physical measurements...

  1. A comprehensive survey of government auditors' self-efficacy and professional development for improving audit quality.

    Science.gov (United States)

    Lee, Shue-Ching; Su, Jau-Ming; Tsai, Sang-Bing; Lu, Tzu-Li; Dong, Weiwei

    2016-01-01

    Government audit authorities supervise the implementation of government budgets and evaluate the use of administrative resources to ensure that funding is used wisely, economically, and effectively. A quality audit involves reviewing policies according to international standards and perspectives, and provides insight, predictions, and warnings to related organizations. Such practice can reflect the effectiveness of a government. Professional development and self-efficacy have strong influence upon the performance of auditors. To further understand the factors that may enhance their performance and to ultimately provide practical recommendations for the audit authorities, we have surveyed about 50 % of all the governmental auditors in Taiwan using the stratified random sampling method. The result showed that any auditing experience and professionalization can positively influence the professional awareness. Also, acquired knowledge and skillset of an auditor can effectively improve ones professional judgment. We also found that professional development (including organizational culture and training opportunities) and self-efficacy (including profession and experience as well as trends and performance) may significantly impact audit quality. We concluded that to retain auditors, audit authorities must develop an attractive future outlook emphasizing feedback and learning within an organization. Our study provides a workable management guidelines for strengthening the professional development and self-efficacy of audit authorities in Taiwan.

  2. Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit

    Science.gov (United States)

    Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

    2018-01-01

    Background Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. Aim To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Design and setting Clinical audit of cancer diagnosis in general practices in England. Method Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Results Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15–86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0–27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. Conclusion The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. PMID:29255111

  3. Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit.

    Science.gov (United States)

    Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

    2018-01-01

    Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Clinical audit of cancer diagnosis in general practices in England. Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15-86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0-27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. © British Journal of General Practice 2018.

  4. Patient-driven hand hygiene audit process at a regional cancer center.

    Science.gov (United States)

    Bow, E J; Bourrier, V; Trudel, J; Kostiuk, N; McLeod, J M

    2018-01-01

    A patient-driven hand hygiene compliance audit strategy was piloted in a Canadian provincial cancer agency during routine provision of cancer outpatient care by health care providers (physicians, nurses, and health care aides) under conditions where the deployment of an independent external auditor was not feasible. The results of the audit suggest the feasibility of this approach as a routine institutional performance metric. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. A survey to assess audit mechanisms practised by skeletal reporting radiographers

    International Nuclear Information System (INIS)

    Jones, H.C.; Manning, D.

    2008-01-01

    Purpose: This study investigates the role of plain film reporting radiographers and the methods they employ to evaluate the quality of their performance. Method: The survey was conducted in 2003. Questionnaires were sent, via the universities, to radiographers who had registered on a post-graduate musculoskeletal image interpretation course at a University in England since their introduction (9 years earlier). Results: The response rate was 37% (n = 112). Sixty-four percent of the trained reporting radiographers surveyed are creating independent reports on musculoskeletal images and an additional 15% contribute to a double reporting system. Twenty-one percent of the reporting radiographers in this study are not undertaking audit of their practice. Of the 79% who are participating in audit programmes the variety of methods being used are widespread. In order to protect against litigation, 19% of reporting radiographers have a portfolio of evidence supporting their competency; 71% have a specific job description for their advanced role; 73% of reporting radiographers are members of a trade union; and 82% of reporting radiographers work to a departmental protocol. Conclusion: The majority of reporting radiographers are participating in some form of audit. However, it is imperative that the sizeable minority who are not should initiate this process promptly. It is important that national standards are set so that these audit processes become embedded into practice for the protection of both the patient and radiographer. The inconsistency shown with regard to audit processes and protection against litigation suggests that further clarification is required from the professional bodies

  6. A survey to assess audit mechanisms practised by skeletal reporting radiographers

    Energy Technology Data Exchange (ETDEWEB)

    Jones, H.C. [Directorate of Radiology, Royal Liverpool University Hospital Trust, Prescot Street, Liverpool L7 8XP (United Kingdom)], E-mail: helen.jones@rlbuht.nhs.uk; Manning, D. [School of Medical Imaging Sciences, St. Martin' s College, Lancaster LA1 3JD (United Kingdom)

    2008-08-15

    Purpose: This study investigates the role of plain film reporting radiographers and the methods they employ to evaluate the quality of their performance. Method: The survey was conducted in 2003. Questionnaires were sent, via the universities, to radiographers who had registered on a post-graduate musculoskeletal image interpretation course at a University in England since their introduction (9 years earlier). Results: The response rate was 37% (n = 112). Sixty-four percent of the trained reporting radiographers surveyed are creating independent reports on musculoskeletal images and an additional 15% contribute to a double reporting system. Twenty-one percent of the reporting radiographers in this study are not undertaking audit of their practice. Of the 79% who are participating in audit programmes the variety of methods being used are widespread. In order to protect against litigation, 19% of reporting radiographers have a portfolio of evidence supporting their competency; 71% have a specific job description for their advanced role; 73% of reporting radiographers are members of a trade union; and 82% of reporting radiographers work to a departmental protocol. Conclusion: The majority of reporting radiographers are participating in some form of audit. However, it is imperative that the sizeable minority who are not should initiate this process promptly. It is important that national standards are set so that these audit processes become embedded into practice for the protection of both the patient and radiographer. The inconsistency shown with regard to audit processes and protection against litigation suggests that further clarification is required from the professional bodies.

  7. Reduced-Item Food Audits Based on the Nutrition Environment Measures Surveys.

    Science.gov (United States)

    Partington, Susan N; Menzies, Tim J; Colburn, Trina A; Saelens, Brian E; Glanz, Karen

    2015-10-01

    The community food environment may contribute to obesity by influencing food choice. Store and restaurant audits are increasingly common methods for assessing food environments, but are time consuming and costly. A valid, reliable brief measurement tool is needed. The purpose of this study was to develop and validate reduced-item food environment audit tools for stores and restaurants. Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed in 820 stores and 1,795 restaurants in West Virginia, San Diego, and Seattle. Data mining techniques (correlation-based feature selection and linear regression) were used to identify survey items highly correlated to total survey scores and produce reduced-item audit tools that were subsequently validated against full NEMS surveys. Regression coefficients were used as weights that were applied to reduced-item tool items to generate comparable scores to full NEMS surveys. Data were collected and analyzed in 2008-2013. The reduced-item tools included eight items for grocery, ten for convenience, seven for variety, and five for other stores; and 16 items for sit-down, 14 for fast casual, 19 for fast food, and 13 for specialty restaurants-10% of the full NEMS-S and 25% of the full NEMS-R. There were no significant differences in median scores for varying types of retail food outlets when compared to the full survey scores. Median in-store audit time was reduced 25%-50%. Reduced-item audit tools can reduce the burden and complexity of large-scale or repeated assessments of the retail food environment without compromising measurement quality. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Ideology and Audit Culture: Standardized Service Quality Surveys in Academic Libraries

    Science.gov (United States)

    Lilburn, Jeff

    2017-01-01

    This article examines the relationship between the standardized service quality survey LibQUAL+ and the rise of audit culture. Recent scholarship examining assessment and accountability systems and the ideological principles driving their implementation in higher education raises concerns about the impact these systems have on teaching, learning,…

  9. Diagnostic miss rate for colorectal cancer: an audit.

    Science.gov (United States)

    Than, Mary; Witherspoon, Jolene; Shami, Javed; Patil, Prachi; Saklani, Avanish

    2015-01-01

    Colorectal cancer (CRC) is a common cancer worldwide. While screening improves survival, avoiding delayed diagnosis in symptomatic patients is crucial. Computed tomographic colonography (CTC) or colonoscopy is recommended as first-line investigation and most societies recommend counseling patients undergoing colonoscopy about a miss rate of 5%. This audit evaluates "miss rate" of colorectal investigations, which have led to diagnostic delay in symptomatic cases in a district general hospital in the United Kingdom. This is a retrospective review of 150 consecutive CRC cases presenting between August 2010 and July 2011. Evidence of bowel investigations done in the 3 years prior to diagnosis was obtained from computerized health records. Data regarding previous bowel investigations such as colonoscopy, CTC, double contrast barium enema (DCBE), and CT abdomen/pelvis were collected. 6.7% cases were identified via screening pathway while 93% were identified through symptomatic pathway. 17% (26/150) of newly diagnosed CRC had been investigated in the preceding 3 years. Of these, 8% (12/150) had false negative results. The false negative rate for CRC diagnosis was 3.5% for colonoscopy (3/85), 6.7% for CTC (1/17), 9.4% for CT (5/53), and 26.7% for DCBE (4/15). Some patients had a missed diagnosis despite more than one diagnostic test. Time delay to diagnosis ranged from 21-456 days. 17% of patients diagnosed with CRC had been investigated in the previous 3 years. Higher miss rate of barium enema should preclude its use as a first-line modality to investigate CRC.

  10. Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit.

    Science.gov (United States)

    van Bommel, Annelotte C M; Spronk, Pauline E R; Vrancken Peeters, Marie-Jeanne T F D; Jager, Agnes; Lobbes, Marc; Maduro, John H; Mureau, Marc A M; Schreuder, Kay; Smorenburg, Carolien H; Verloop, Janneke; Westenend, Pieter J; Wouters, Michel W J M; Siesling, Sabine; Tjan-Heijnen, Vivianne C G; van Dalen, Thijs

    2017-03-01

    In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation-wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described. Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty-two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals. The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre- and post-operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast-conserving surgery for invasive cancer requiring re-operation were consistently low (∼5%). Other indicators, for example, the use of an MRI-scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation. Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243-249. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Survey VS audit by using method 2 to dedicate commercial grade services

    International Nuclear Information System (INIS)

    Martinez ayucar, F. J.

    2014-01-01

    Since the start of the commercial grade dedications, both 10CFR21 and EPRI documents, plus the dedication of commercial grade components, and the stage of commercial grade dedication of the services contemplated. And recently the NRC through various communications and answers trafficking among other issues the commercial grade dedication service. The NRC has detected repeatedly incorrect application of the survey as a method of commercial grade dedication and instead has done an audit of the program elements of commercial quality. (Author)

  12. PENGARUH TIME BUDGET PRESSURE DAN RISIKO AUDIT TERHADAP KUALITAS AUDIT (SURVEY PADA AUDITOR DI KANTOR AKUNTAN PUBLIK DI BANDUNG

    Directory of Open Access Journals (Sweden)

    Medianto Suryo

    2017-04-01

    Full Text Available Empirically the application of principles of corporate governance can improve the quality of financial statements. However, in the implementation of Good Corporate Government and the quality of financial statements has not been done perfectly. Based on the results of research indicates that the failure of GCG implementation in Indonesia can be seen from various cases of audit failure. Based on the above, it shows that GCG mechanism is not working properly, where the stakeholders can not use the financial statements because of the low quality of financial statements or irrelevant and unreliable. This study will provide an overview of the influence of time budget pressure and audit risk on audit quality at public accounting offices in Bandung. This research uses path analysis with Time Budget Pressure variables, Audit Risk, and Audit Quality. The result of the research shows that both independent variable (Time Budget Pressure and Audit Risk give contribution (influence to the Quality of Audit equal to 34,20%. While the rest of 65.80% influenced by other factors outside the two independent variables.

  13. Survey of legislation applicable in Germany for implementation of the EC Directive on environmental audits; Ueberblick ueber die in Deutschland fuer die Ausfuehrung der EG-Umwelt-Audit-Verordnung geltenden Rechtsvorschriften

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    The brochure presents a comprehensive survey of the relevant legislation applicable in Germany to implementation of the EC Directive on environmental auditing. Readers interested in performing such auditing at one glance will find in this compiulation all relevant laws and regulations in full text that are to be observed for implementation of this novel environmental auditing instrument. (orig./RHM) [Deutsch] Diese Broschuere vermittelt einen umfassenden Ueberblick ueber die in Deutschland fuer die Ausfuehrung der EG-Umwelt-Audit-Verordnung geltenden Rechtsvorschriften. Damit wird fuer alle Interessenten ein rascher Zugriff auf die Rechtstexte, die zur praktischen Anwendung des neuartigen Umwelt-Audit-Instruments notwendig sind, ermoeglicht. (orig./RHM)

  14. A primary care audit of familial risk in patients with a personal history of breast cancer.

    Science.gov (United States)

    Nathan, Paul; Ahluwalia, Aneeta; Chorley, Wendy

    2014-12-01

    Breast cancer is the most common cancer diagnosed in women, both in the UK and worldwide. A small proportion of women are at very high risk of breast cancer, having a particularly strong family history. The National Institute for Health and Clinical Excellence (NICE) has advised that practitioners should not, in most instances, actively seek to identify women with a family history of breast cancer. An audit was undertaken at an urban primary care practice of 15,000 patients, using a paper-based, self-administered questionnaire sent to patients identified with a personal history of breast cancer. The aim of this audit was to determine whether using targeted screening of relatives of patients with breast cancer to identify familial cancer risk is worthwhile in primary care. Since these patients might already expected to have been risk assessed following their initial diagnosis, this audit acts as a quality improvement exercise. The audit used a validated family history questionnaire and risk assessment tool as a screening approach for identifying and grading familial risk in line with the NICE guidelines, to guide referral to the familial cancer screening service. The response rate to family history questionnaires was 54 % and the majority of patients responded positively to their practitioner seeking to identify familial cancer risks in their family. Of the 57 returned questionnaires, over a half (54 %) contained pedigrees with individuals eligible for referral. Patients and their relatives who are often registered with the practice welcome the discussion. An appropriate referral can therefore be made. The findings suggest a role for primary care practitioners in the identification of those at higher familial risk. However integrated systems and processes need designing to facilitate this work.

  15. Improvement to visualization of nodes in breast cancer patients following audit: are we seeing the problem?

    Science.gov (United States)

    Paterson, Carolyn L; Hendry, Fraser R; Bolster, Alison A

    2018-06-01

    Successful localization of nodes in breast cancer patients depends upon the effectiveness of the lymphoscintigraphy technique employed. A benefit of performing imaging as part of this procedure is that it allows sites to audit their technique. An audit of breast cancer patients at the Glasgow Royal Infirmary (GRI) hospital showed nodes to be visualized in only 81% of patients. Current guidelines state that nodes should be seen in more than 95% of patients. A period of investigation and review led to changes being made to the injection and imaging technique employed at the GRI site. Following these changes a re-audit was performed that showed that the node visualization rate has successfully been increased to 97%, thereby meeting the standards set in the guidelines. This technical note details the results of the initial audit and re-audit, and explains the investigation and changes made to clinical procedures at the GRI site to improve the node visualization rate. The challenges that can occur when performing breast sentinel node procedures are also discussed.

  16. Preoperative assessment of lung cancer patients: evaluating guideline compliance (re-audit).

    Science.gov (United States)

    Jayia, Parminderjit Kaur; Mishra, Pankaj Kumar; Shah, Raajul R; Panayiotou, Andrew; Yiu, Patrick; Luckraz, Heyman

    2015-03-01

    Guidelines have been issued for the management of lung cancer patients in the United Kingdom. However, compliance with these national guidelines varies in different thoracic units in the country. We set out to evaluate our thoracic surgery practice and compliance with the national guidelines. An initial audit in 2011 showed deficiencies in practice, thus another audit was conducted to check for improvements in guideline compliance. A retrospective study was carried out over a 12-month period from January 2013 to January 2014 and included all patients who underwent radical surgical resection for lung cancer. Data were collected from computerized records. Sixty-eight patients had radical surgery for lung cancer between January 2013 and January 2014. Four patients were excluded from the analysis due to incomplete records. Our results showed improvements in our practice compared to our initial audit. More patients underwent surgery within 4 weeks of computed tomography and positron-emission tomography scanning. An improvement was noticed in carbon monoxide transfer factor measurements. Areas for improvement include measurement of carbon monoxide transfer factor in all patients, a cardiology referral in patients at risk of cardiac complications, and the use of a global risk stratification model such as Thoracoscore. Guideline-directed service delivery provision for lung cancer patients leads to improved outcomes. Our results show improvement in our practice compared to our initial audit. We aim to liaise with other thoracic surgery units to get feedback about their practice and any audits regarding adherence to the British Thoracic Society and National Institute for Health and Care Excellence guidelines. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Can missed breast cancer be recognized by regular peer auditing on screening mammography?

    Science.gov (United States)

    Pan, Huay-Ben; Yang, Tsung-Lung; Hsu, Giu-Cheng; Chiang, Chia-Ling; Huang, Jer-Shyung; Chou, Chen-Pin; Wang, Yen-Chi; Liang, Huei-Lung; Lee, San-Kan; Chou, Yi-Hong; Wong, Kam-Fai

    2012-09-01

    This study was conducted to investigate whether detectable missed breast cancers could be distinguished from truly false negative images in a mammographic screening by a regular peer auditing. Between 2004 and 2007, a total of 311,193 free nationwide biennial mammographic screenings were performed for 50- to 69-year-old women in Taiwan. Retrospectively comparing the records in Taiwan's Cancer registry, 1283 cancers were detected (4.1 per 1000). Of the total, 176 (0.6 per 1000) initial mammographic negative assessments were reported to have cancers (128 traditional films and 48 laser-printed digital images). We selected 186 true negative films (138 traditional films and 48 laser-printed ones) as control group. These were seeded into 4815 films of 2008 images to be audited in 2009. Thirty-four auditors interpreted all the films in a single-blind, randomized, pair-control study. The performance of 34 auditors was analyzed by chi-square test. A p value of auditing should reduce the probability of missed cancers. 2012 Published by Elsevier B.V

  18. Validating a benchmarking tool for audit of early outcomes after operations for head and neck cancer

    OpenAIRE

    Tighe, D.; Sassoon, I.; McGurk, M.

    2017-01-01

    INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regressi...

  19. The West Midlands breast cancer screening status algorithm - methodology and use as an audit tool.

    Science.gov (United States)

    Lawrence, Gill; Kearins, Olive; O'Sullivan, Emma; Tappenden, Nancy; Wallis, Matthew; Walton, Jackie

    2005-01-01

    To illustrate the ability of the West Midlands breast screening status algorithm to assign a screening status to women with malignant breast cancer, and its uses as a quality assurance and audit tool. Breast cancers diagnosed between the introduction of the National Health Service [NHS] Breast Screening Programme and 31 March 2001 were obtained from the West Midlands Cancer Intelligence Unit (WMCIU). Screen-detected tumours were identified via breast screening units, and the remaining cancers were assigned to one of eight screening status categories. Multiple primaries and recurrences were excluded. A screening status was assigned to 14,680 women (96% of the cohort examined), 110 cancers were not registered at the WMCIU and the cohort included 120 screen-detected recurrences. The West Midlands breast screening status algorithm is a robust simple tool which can be used to derive data to evaluate the efficacy and impact of the NHS Breast Screening Programme.

  20. SURF - SUrvey of Risk Factor management: first report of an international audit.

    Science.gov (United States)

    Cooney, Mt; Reiner, Z; Sheu, W; Ryden, L; Sutter, J de; De Bacquer, D; DeBacker, G; Mithal, A; Chung, N; Lim, Yt; Dudina, A; Reynolds, A; Dunney, K; Graham, I

    2014-07-01

    Despite the fact that subjects with established coronary heart disease (CHD) are at high risk of further events and deserve meticulous secondary prevention, current audits such as EUROASPIRE show poor control of major risk factors. Ongoing monitoring is required. We present a new risk factor audit system, SURF (Survey of Risk Factor management), that can be conducted much more quickly and easily than existing audit systems and has the potential to allow hospitals of all sizes to participate in a unified international audit system that will complement EUROASPIRE. Initial experience indicates that SURF is truly simple to undertake in an international setting, and this is illustrated with the results of a substantive pilot project conducted in Europe and Asia. The data collection system was designed to allow rapid and easy data collection as part of routine clinic work. Consecutive patients (aged 18 and over) with established CHD attending outpatient cardiology clinics were included. Information on demographics, previous coronary medical history, smoking history, history of hypertension, dyslipidaemia or diabetes, physical activity, attendance at cardiac rehabilitation, cardiac medications, lipid and glucose levels (and HbA1c in diabetics) if available within the last year, blood pressure, heart rate, body mass index, and waist circumference were collected using a one-page data collection sheet. Years spent in full time education was added as an additional question during the pilot phase. Three European countries - Ireland (n = 251), Belgium (n = 122), and Croatia (n = 124) - and four Asian countries - Singapore (n = 142), Taiwan (n = 334), India (n = 97), and Korea (n = 45) - were included in the pilot study. The results of initial field testing were confirmed in that it proved possible to collect data within 60-90 seconds per subject. There was poor control of several risk factors including high levels of physical inactivity (41

  1. Sample survey methods as a quality assurance tool in a general practice immunisation audit.

    Science.gov (United States)

    Cullen, R

    1994-04-27

    In a multidoctor family practice there are often just too many sets of patients records to make it practical to repeat an audit by census of even an age band of the practice on a regular basis. This paper attempts to demonstrate how sample survey methodology can be incorporated into the quality assurance cycle. A simple random sample (with replacement) of 120 from 580 children with permanent records who were aged between 6 weeks and 2 years old from an Auckland general practice was performed, with sample size selected to give a predetermined precision. The survey was then repeated after 4 weeks. Both surveys were able to be completed within the course of a normal working day. An unexpectedly low level of under 2 years olds that were recorded as not overdue for any immunisations was found (22.5%) with only a modest improvement after a standard telephone/letter catch up campaign. Seventy-two percent of the sample held a group one community services card. The advantages of properly conducted sample surveys in producing useful estimates of known precision without disrupting office routines excessively were demonstrated. Through some attention to methodology, the trauma of a practice census can be avoided.

  2. The national bowel cancer audit project: the impact of organisational structure on outcome in operative bowel cancer within the United Kingdom.

    Science.gov (United States)

    Cornish, J A; Tekkis, P P; Tan, E; Tilney, H S; Thompson, M R; Smith, J J

    2011-06-01

    To investigate the relationship between organisational structure, process and surgical outcomes for bowel cancer surgery. An e-survey was sent to the members of the Association of Coloproctology of Great Britain and Ireland to determine the organisational structure of their Trusts. Responses were combined with the National Bowel Cancer Audit (NBOCAP) data. Items investigated included; number of consultants, nurse specialists, volume of cases and intensive care facilities. Main outcome measures included: 30-day risk-adjusted mortality, length of stay (LOS), lymph node yield and circumferential margin involvement (CRM). One hundred and seventeen Trusts responded (65.8%), matched to 7666 patient episodes (NBOCAP data) from 54 (62.8%)Trusts who submitted data to the audit. Trusts treating 0.001), 0.001), 0001) and 0001) were more likely to have a 30-day-risk-adjusted mortality twice that of the national mean. Sixty five percent (n = 1603) of Trusts treating ≥ 190 cases/annum harvested ≥ 12 lymph nodes vs. 58.3% (n = 1435) in Trusts organisational infrastructure of hospitals appears to have as great an impact on patient outcomes as the volume of cases performed by hospital Trusts. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  3. An audit comparing the reporting of staging MRI scans for rectal cancer with the London Cancer Alliance (LCA) guidelines.

    Science.gov (United States)

    Siddiqui, M R S; Shanmuganandan, A P; Rasheed, S; Tekkis, P; Brown, G; Abulafi, A M

    2017-11-01

    This article focuses on the audit and assessment of clinical practice before and after introduction of MRI reporting guidelines. Standardised proforma based reporting may improve quality of MRI reports. Uptake of the use may be facilitated by endorsement from regional and national cancer organisations. This audit was divided into 2 phases. MRI reports issued between April 2014 and June 2014 were included in the first part of our audit. Phase II included MRI reports issued between April 2015 and June 2015. 14 out of 15 hospitals that report MRI scans in the LCA responded to our audit proposal. The completion rate of key MRI metrics/metrics was better in proforma compared to prose reports both before (98% vs 73%; p < 0.05) and after introduction of the guidelines (98% vs 71%; p < 0.05). There was an approximate doubling of proforma reporting after the introduction of guidelines and workshop interventions (39% vs 65%; p < 0.05). Evaluation of locally advanced cancers (tumours extending to or beyond the circumferential resection margin) for beyond TME surgery was reported in 3% of prose reports vs. 42% in proformas. Incorporation of standardised reporting in official guidelines improved the uptake of proforma based reporting. Proforma based reporting captured more MRI reportable items compared to prose summaries, before and after the implementation of guidelines. MRI reporting of advanced cancers for beyond TME surgery falls short of acceptable standards but is more detailed in proforma based reports. Further work to improve completion especially in beyond TME reporting is required. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  4. Time trends, improvements and national auditing of rectal cancer management over an 18-year period.

    Science.gov (United States)

    Kodeda, K; Johansson, R; Zar, N; Birgisson, H; Dahlberg, M; Skullman, S; Lindmark, G; Glimelius, B; Påhlman, L; Martling, A

    2015-09-01

    The main aims were to explore time trends in the management and outcome of patients with rectal cancer in a national cohort and to evaluate the possible impact of national auditing on overall outcomes. A secondary aim was to provide population-based data for appraisal of external validity in selected patient series. Data from the Swedish ColoRectal Cancer Registry with virtually complete national coverage were utilized in this cohort study on 29 925 patients with rectal cancer diagnosed between 1995 and 2012. Of eligible patients, nine were excluded. During the study period, overall, relative and disease-free survival increased. Postoperative mortality after 30 and 90 days decreased to 1.7% and 2.9%. The 5-year local recurrence rate dropped to 5.0%. Resection margins improved, as did peri-operative blood loss despite more multivisceral resections being performed. Fewer patients underwent palliative resection and the proportion of non-operated patients increased. The proportions of temporary and permanent stoma formation increased. Preoperative radiotherapy and chemoradiotherapy became more common as did multidisciplinary team conferences. Variability in rectal cancer management between healthcare regions diminished over time when new aspects of patient care were audited. There have been substantial changes over time in the management of patients with rectal cancer, reflected in improved outcome. Much indirect evidence indicates that auditing matters, but without a control group it is not possible to draw firm conclusions regarding the possible impact of a quality control registry on faster shifts in time trends, decreased variability and improvements. Registry data were made available for reference. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  5. Province wide clinical governance network for clinical audit for quality improvement in endometrial cancer management.

    Science.gov (United States)

    Mandato, Vincenzo Dario; Formisano, Debora; Pirillo, Debora; Ciarlini, Gino; Cerami, Lillo Bruno; Ventura, Alessandro; Spreafico, Lorenzo; Palmieri, Tamara; La Sala, Giovanni Battista; Abrate, Martino

    2012-01-01

    According to the hub-and-spoke model introduced in the Provincial Healthcare System of Reggio Emilia, early endometrial cancer is treated in peripheral low-volume hospitals (spokes) by general gynecologist, whereas more complex cancers are treated by gynecological oncologists at the main hospital (hub). To guarantee a uniformly high standard of care to all patients with endometrial cancer treated in hub and spoke hospitals of Reggio Emilia Province. The specialists of the 5 hospitals of Reggio Emilia Province instituted an inter hospital and multidisciplinary oncology group to write common and shared guidelines based on evidence-based medicine through the use of clinical audit. They valued the process indicators before and after guidelines introduction identifying the site of improvement and verifying the standard achievement. Diagnostic hysteroscopy use increased significantly from preguideline period, 53%, to postguideline period, 74%. Magnetic resonance use and accuracy increased significantly from preguideline to postguideline periods: 8.1% to 35.3% and 37.3% to 74.7%, respectively. Laparoscopy use increased from 1.6% (preguideline) to 18.6 (postguideline). Early surgical complications decreased from 16% (preguideline) to 9% (postguideline). Radiotherapy use increased from 14.% (preguideline) to 32.3% (postguideline). It is possible for a provincial oncology group to build an oncology network providing an improvement in the assistance of patients with endometrial cancer through the use of clinical audit. Clinical audit made it possible to obtain the full attendance of specialists of various disciplines involved in the treatment of endometrial cancer to optimize response time schematizing process.

  6. Pengaruh Gender dan Pengalaman Audit terhadap Audit Judgment

    Directory of Open Access Journals (Sweden)

    Erna Pasanda

    2013-12-01

    Full Text Available This study aims to examine the influence of gender and audit experience toward audit judgment and to examine gender and audit experience towards audit judgment when moderated by client credibility. The research was conducted on auditors who worked on KAP in Makassar South Sulawesi using survey. Sampling technique in this study was random sampling based on judgment. Data collected and then analyzed by employing regression method and Moderated Regression Analysis (MRA. The result indicates that gender does not significantly influence audit judgment while audit experience significantly influences audit judgment. Client credibility does not moderate the influence of gender and audit experience on the audit judgment.

  7. BASHH 2016 UK national audit and survey of HIV testing, risk assessment and follow-up: case note audit.

    Science.gov (United States)

    Bhaduri, Sumit; Curtis, Hilary; McClean, Hugo; Sullivan, Ann K

    2018-01-01

    This national audit demonstrated discrepancies between actual practice and that indicated by clinic policies following enquiry about alcohol, recreational drugs and chemsex use. Clinics were more likely to enquire about risk behaviour if this was clinic policy or routine practice. Previous testing was the most common reason for refusing HIV testing, although 33% of men who have sex with men had a prior test of more than three months ago. Of the group declining due to recent exposure in the window period, 21/119 cases had an exposure within the four weeks prior to presentation, but had a previous risk not covered by previous testing. Recommendations include provision of risk assessments for alcohol, recreational drug use and chemsex, documenting reasons for HIV test refusal, provision of HIV point-of-care testing, follow-up for cases at higher risk of HIV and advice about community testing or self-sampling/testing.

  8. How is feedback from national clinical audits used? Views from English National Health Service trust audit leads.

    Science.gov (United States)

    Taylor, Angelina; Neuburger, Jenny; Walker, Kate; Cromwell, David; Groene, Oliver

    2016-04-01

    To explore how the output of national clinical audits in England is used by professionals and whether and how their impact could be enhanced. A mixed-methods study with the primary recipients of four national clinical audits of cancer care of 607 local audit leads, 274 (45%) completed a questionnaire and 32 participated in an interview. Our questions focused on how the audits were used and whether barriers existed to using the audits for local service improvement. We described variation in questionnaire responses between the audits using chi-squared tests. Results are reported as percentages with their 95% confidence intervals. Qualitative data were analysed using Framework analysis. More than 90% of survey respondents believed that the audit findings were relevant to their clinical work, and interviewees described how they used the audits for a range of purposes. Forty-two percent of survey respondents said they had changed their clinical practice, and 56% had implemented service improvements in response to the audits. The degree of change differed between the four audits, evident in both the questionnaire and the interview data. In the interviews, two recurring barriers emerged: (1) the importance of data quality, which, in turn, influenced the perceived relevance and validity of the audit data and therefore the ability to make changes based on it and (2) the need for clear presentation of benchmarked local performance data. The perceived authority and credibility of the professional bodies supporting the audits was a key factor underpinning the use of the audit findings. National cancer audit and feedback is used to improve services, but their impact could be enhanced by improving the data quality and relevance of feedback. © The Author(s) 2016.

  9. Management of patients with incurable colorectal cancer: a retrospective audit.

    Science.gov (United States)

    Thavanesan, N; Abdalkoddus, M; Yao, C; Lai, C W; Stubbs, B M

    2018-04-13

    Counselling patients and their relatives about non-curative management options in colorectal cancer is difficult because of a paucity of published data. This study aims to determine outcomes in patients unsuitable for curative surgery and the rates of subsequent surgical intervention. This was an analysis of all colorectal cancers managed without curative surgery in a district general hospital from a prospectively maintained cancer registry between 2009 and 2016, as decided by a multidisciplinary team. Primary outcomes were overall survival and secondary outcomes were subsequent intervention rates and impact of tumour stage. In all, 183 patients out of 976 patients (18.8%) were identified. The median age at diagnosis was 81 years [interquartile range (IQR) 71-87 years]. Overall median survival from diagnosis was 205 days (IQR 60-532 days). One-year mortality was 62.3%. Patients were classified into two groups depending on the reason for a non-curable approach: patient-related (PR) or disease-related (DR). The difference in survival between PR (median 277 days, IQR 70-593) and DR (median 179 days, IQR 51-450) was 98 days (P = 0.023). Twenty-four patients were alive at the end of the study period; 19 out of 91 cases in PR (20.8%) and five out of 92 cases in DR (5.4%). Overall intervention rates were 11.9%, with higher rates in the DR group (P = 0.005). Disease stage was not associated with subsequent surgical intervention between the two groups (P = 0.392). Life expectancy for non-curatively managed patients within our unit was 6.8 months with one in nine patients requiring subsequent surgical admission for palliation. This information may be useful when counselling patients with incurable colorectal malignancy. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.

  10. Audit of lymphadenectomy in lung cancer resections using a specimen collection kit and checklist.

    Science.gov (United States)

    Osarogiagbon, Raymond U; Sareen, Srishti; Eke, Ransome; Yu, Xinhua; McHugh, Laura M; Kernstine, Kemp H; Putnam, Joe B; Robbins, Edward T

    2015-02-01

    Audits of operative summaries and pathology reports reveal wide discordance in identifying the extent of lymphadenectomy performed (the communication gap). We tested the ability of a prelabeled lymph node specimen collection kit and checklist to narrow the communication gap between operating surgeons, pathologists, and auditors of surgeons' operation notes. We conducted a prospective single cohort study of lung cancer resections performed with a lymph node collection kit from November 2010 to January 2013. We used the kappa statistic to compare surgeon claims on a checklist of lymph node stations harvested intraoperatively with pathology reports and an independent audit of surgeons' operative summaries. Lymph node collection procedures were classified into four groups based on the anatomic origin of resected lymph nodes: mediastinal lymph node dissection, systematic sampling, random sampling, and no sampling. From the pathology reports, 73% of 160 resections had a mediastinal lymph node dissection or systematic sampling procedure, 27% had random sampling. The concordance with surgeon claims was 80% (kappa statistic 0.69, 95% confidence interval: 0.60 to 0.79). Concordance between independent audits of the operation notes and either the pathology report (kappa 0.14, 95% confidence interval: 0.04 to 0.23) or surgeon claims (kappa 0.09, 95% confidence interval: 0.03 to 0.22) was poor. A prelabeled specimen collection kit and checklist significantly narrowed the communication gap between surgeons and pathologists in identifying the extent of lymphadenectomy. Audit of surgeons' operation notes did not accurately reflect the procedure performed, bringing its value for quality improvement work into question. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Healthcare professionals' perceptions on the emotional impact of having an inadequate response to antidepressant medications: survey and prospective patient audit.

    Science.gov (United States)

    Mago, Rajnish; Fagiolini, Andrea; Weiller, Emmanuelle; Weiss, Catherine

    2018-01-01

    Despite the availability of effective antidepressants, about half of patients with major depressive disorder (MDD) display an inadequate response to their initial treatment. A large patient survey recently reported that 29.8% of MDD patients experiencing an inadequate treatment response felt frustrated about their medication and 19.2% were frustrated with their healthcare provider. This survey and chart audit evaluated healthcare professionals' (HCP) views on the emotional impact of having an inadequate response to antidepressant medication. HCPs who frequently treat patients with MDD completed a survey and chart audit of their MDD patients currently experiencing an inadequate response to antidepressant treatment. 287 HCPs completed 1336 chart audits. HCPs reported that 38% of their patients were trusting/accepting of their MDD medications and 41% of their patients trusted/felt confident with their healthcare provision. Conversely, HCPs reported that 11% of their patients were frustrated with their medication and 5% with their healthcare benefits. HCPs cited impact on daily life (53%) and treatment issues (lack of efficacy and side effects; 50%) as the main drivers for their patients' feelings of frustration. When HCPs recognized patients' feelings of frustration, the top concerns of the HCPs were worsening of symptoms (43%) and non-compliance (41%). This survey and chart audit highlights the emotional burden associated with inadequate responses to MDD treatment in addition to persistent symptoms. Differences between the views of the HCPs and patients are highlighted and suggest that HCPs may underestimate the full impact that having to try numerous medications has on their patients.

  12. Point-of-care outcome assessment in the cancer clinic: Audit of data quality

    International Nuclear Information System (INIS)

    Wong, Karen; Huang, Shao Hui; O'Sullivan, Brian; Lockwood, Gina; Dale, Darlene; Michaelson, Terry; Waldron, John; Bayley, Andrew; Cummings, Bernard; Dawson, Laura A.; Kim, John; Liu, Geoffrey; Ringash, Jolie

    2010-01-01

    Background and purpose: To assess the completeness and accuracy of stage and outcome data in the Anthology of Outcomes (AOs), a prospective point-of-care physician-collected electronic data system for patients at Princess Margaret Hospital. Material and methods: A random sample of 10% of the AO cases registered between July 2003 and December 2005 was drawn. An audit was conducted of the AO data compared with chart review and cancer registry. Results: The AO system was applied first to a head and neck (HN) cancer patient cohort. From 1152 HN cases, 120 were audited. TNM stage was recorded in all cases. Discrepancy was found between the AO and primary data sources in 3-13% of cases. Physician review showed a 3% error rate in overall stage recorded in the AO. Sixty-two outcomes in 43 patients were found on chart review. No outcomes were incorrectly recorded in the AO. Nineteen (31%) outcomes in 17 patients were missed in the AO. Conclusions: Our experience has demonstrated the feasibility of real-time outcome recording at point-of-care. New processes needed to improve the completeness of capture of patient outcomes in the AO have more recently been introduced. This successful system has been expanded to other disease sites.

  13. Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

    Directory of Open Access Journals (Sweden)

    Leonard K. Katalambula

    2016-01-01

    Full Text Available Background. Colorectal cancer (CRC is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ2 tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06% and females (49.94%, although gender likelihood of diagnosis type (i.e., rectal or colon was significantly different (P=0.027. More than 60% of patients were between 40 and 69 years. Conclusions. Age (P=0.0183 and time (P=0.004 but not gender (P=0.0864 were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P=0.0405, age (P=0.0015, and time (P=0.0075 were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.

  14. Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

    International Nuclear Information System (INIS)

    Katalambula, L. K.; Buza, J.; Mpolya, E.

    2016-01-01

    Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (x 2 ) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different ( P= 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age ( P= 0.0183) and time () but not gender ( P = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender ( P = 0.0405), age ( P = 0.0015), and time ( P = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.

  15. Reduced Circumferential Resection Margin Involvement in Rectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit.

    Science.gov (United States)

    Gietelink, Lieke; Wouters, Michel W J M; Tanis, Pieter J; Deken, Marion M; Ten Berge, Martijn G; Tollenaar, Rob A E M; van Krieken, J Han; de Noo, Mirre E

    2015-09-01

    The circumferential resection margin (CRM) is a significant prognostic factor for local recurrence, distant metastasis, and survival after rectal cancer surgery. Therefore, availability of this parameter is essential. Although the Dutch total mesorectal excision trial raised awareness about CRM in the late 1990s, quality assurance on pathologic reporting was not available until the Dutch Surgical Colorectal Audit (DSCA) started in 2009. The present study describes the rates of CRM reporting and involvement since the start of the DSCA and analyzes whether improvement of these parameters can be attributed to the audit. Data from the DSCA (2009-2013) were analyzed. Reporting of CRM and CRM involvement was plotted for successive years, and variations of these parameters were analyzed in a funnelplot. Predictors of CRM involvement were determined in univariable analysis and the independent influence of year of registration on CRM involvement was analyzed in multivariable analysis. A total of 12,669 patients were included for analysis. The mean percentage of patients with a reported CRM increased from 52.7% to 94.2% (2009-2013) and interhospital variation decreased. The percentage of patients with CRM involvement decreased from 14.2% to 5.6%. In multivariable analysis, the year of DSCA registration remained a significant predictor of CRM involvement. After the introduction of the DSCA, a dramatic improvement in CRM reporting and a major decrease of CRM involvement after rectal cancer surgery have occurred. This study suggests that a national quality assurance program has been the driving force behind these achievements. Copyright © 2015 by the National Comprehensive Cancer Network.

  16. A Comparison of the Alcohol Use Disorder Identification Test (AUDIT) in General Population Surveys in nine European Countries

    DEFF Research Database (Denmark)

    Bloomfield, Kim; Knibbe, Ronald; Derickx, Mieke

    2006-01-01

    Aims: This study explored the suitability of the Alcohol Use Disorder Identification Test (AUDIT) for cross-national comparable estimates of problem drinking in general populations. On the item level the focus is on responsiveness to cross-national and gender differences. For the set of items...... the focus is on intercorrelations between items, indicating to what extent the AUDIT constitutes a scale. Methods: General population surveys from nine European countries were included. Cross-tabulations were used to analyse cross-national and gender differences in scores on the items. Reliability analysis...... was used to analyse intercorrelations between the items. Results: The items ‘blackouts' (men and women) and ‘guilt and remorse' (women) are the most frequently reported consequences. Gender differences tended to be smaller for ‘guilt and remorse' and ‘concern of others', and largest for ‘morning drinking...

  17. Apples and pears? A comparison of two sources of national lung cancer audit data in England

    Directory of Open Access Journals (Sweden)

    Aamir Khakwani

    2017-07-01

    Full Text Available In 2014, the method of data collection from NHS trusts in England for the National Lung Cancer Audit (NLCA was changed from a bespoke dataset called LUCADA (Lung Cancer Data. Under the new contract, data are submitted via the Cancer Outcome and Service Dataset (COSD system and linked additional cancer registry datasets. In 2014, trusts were given opportunity to submit LUCADA data as well as registry data. 132 NHS trusts submitted LUCADA data, and all 151 trusts submitted COSD data. This transitional year therefore provided the opportunity to compare both datasets for data completeness and reliability. We linked the two datasets at the patient level to assess the completeness of key patient and treatment variables. We also assessed the interdata agreement of these variables using Cohen's kappa statistic, κ. We identified 26 001 patients in both datasets. Overall, the recording of sex, age, performance status and stage had more than 90% agreement between datasets, but there were more patients with missing performance status in the registry dataset. Although levels of agreement for surgery, chemotherapy and external-beam radiotherapy were high between datasets, the new COSD system identified more instances of active treatment. There seems to be a high agreement of data between the datasets, and the findings suggest that the registry dataset coupled with COSD provides a richer dataset than LUCADA. However, it lagged behind LUCADA in performance status recording, which needs to improve over time.

  18. A federal audit of the Belgian radiotherapy departments in breast cancer treatment

    International Nuclear Information System (INIS)

    Houtte, Paul van; Bourgois, Nicolas; Renard, Francoise; Huget, Philippe; D'hoore, William; Scalliet, Pierre

    2007-01-01

    Background: The Belgian Federal College of Radiotherapy carried out an external audit of breast cancer patient documentation in the 26 Belgian radiotherapy centres. The objective was to assess compliance with the recommendations regarding minimal requirements for documentation of radiotherapy prescription and administration. All centres volunteered to take part in this audit. Methods: Two experienced radiation oncologists site-visited the departments over a 6 month period (Sept. 2003-Feb. 2004), with a list of items to be verified, including details on the surgery, the pathological report, details on systemic treatments, details on the radiotherapy prescription (and consistency with therapeutic guidelines) and delay surgery/radiotherapy. Findings: Three hundred and eighty-nine patients files were reviewed, for a total of 399 breast cancers (10 patients with bilateral cancer). Mean age was 57.8 y (range 29-96). Breast conservative surgery (BCS) was used in 71%; radical mastectomy in 29%. A complete pathological report was present in all files but 2 (99.5% conformity). 5.2% were treated for DCIS, 61.6% for pT1, 28.2% for pT2 and 5% for pT3-4. Data regarding resection margins were specified to be free in 76.2%, tangential in 12% (within 2 mm) and positive for DCIS in 3.8% or invasive cancer in 1.5% (no information, on margins in 6.5%). The pT stage was always specified, and consistent with the macroscopic and microscopic findings. Hormonal receptors were routinely assessed (94.7%), as well as Her2neu (87.4%). Axillary surgery was carried out in 92%, either by sentinel node biopsy or by complete clearance, in which case the median number of nodes analysed was 12 for all centres together (7-17). All radiotherapy prescriptions were in line with evidence-based standards of therapy (i.e., irradiation of breast after BCS or after mamectomy (in case of pN+), but one. The mean delay between surgery and radiotherapy was 5.5 weeks (SD 11days). Conclusion: There was a high

  19. A quality assurance audit: phase iii trial of maximal androgen deprivation in prostate cancer (TROG 96.01)

    International Nuclear Information System (INIS)

    Steigler, A.; Kovacev, O.; Denham, J.; Lamb, D.; North, J.

    2000-01-01

    In 1997 the Trans-Tasman Radiation Oncology Group (TROG) performed a quality assurance (QA) audit of its phase III randomized clinical trial investigating the effectiveness of different durations of maximal androgen deprivation prior to and during definitive radiation therapy for locally advanced carcinoma of the prostate (TROG 96.01). The audit reviewed a total of 60 cases from 15 centres across Australia and New Zealand. In addition to verification of technical adherence to the protocol, the audit also incorporated a survey of centre planning techniques and a QA time/cost analysis. The present report builds on TROG's first technical audit conducted in 1996 for the phase III accelerated head and neck trial (TROG 91.01) and highlights the significant progress TROG has made in the interim period. The audit provides a strong validation of the results of the 96.01 trial, as well as valuable budgeting and treatment planning information for future trials. Overall improvements were detected in data quality and quantity, and in protocol compliance, with a reduction in the rate of unacceptable protocol violations from 10 to 4%. Audit design, staff education and increased data management resources were identified as the main contributing factors to these improvements. In addition, a budget estimate of $100 per patient has been proposed for conducting similar technical audits. The next major QA project to be undertaken by TROG during the period 1998-1999 is an intercentre dosimetry study. Trial funding and staff education have been targeted as the key major issues essential to the continued success and expansion of TROG's QA programme. Copyright (1999) Blackwell Science Pty Ltd

  20. A quality assurance audit: phase III trial of maximal androgen deprivation in prostate cancer (TROG 96.01).

    Science.gov (United States)

    Steigler, A; Mameghan, H; Lamb, D; Joseph, D; Matthews, J; Franklin, I; Turner, S; Spry, N; Poulsen, M; North, J; Kovacev, O; Denham, J

    2000-02-01

    In 1997 the Trans-Tasman Radiation Oncology Group (TROG) performed a quality assurance (QA) audit of its phase III randomized clinical trial investigating the effectiveness of different durations of maximal androgen deprivation prior to and during definitive radiation therapy for locally advanced carcinoma of the prostate (TROG 96.01). The audit reviewed a total of 60 cases from 15 centres across Australia and New Zealand. In addition to verification of technical adherence to the protocol, the audit also incorporated a survey of centre planning techniques and a QA time/cost analysis. The present report builds on TROG's first technical audit conducted in 1996 for the phase III accelerated head and neck trial (TROG 91.01) and highlights the significant progress TROG has made in the interim period. The audit provides a strong validation of the results of the 96.01 trial, as well as valuable budgeting and treatment planning information for future trials. Overall improvements were detected in data quality and quantity, and in protocol compliance, with a reduction in the rate of unacceptable protocol violations from 10 to 4%. Audit design, staff education and increased data management resources were identified as the main contributing factors to these improvements. In addition, a budget estimate of $100 per patient has been proposed for conducting similar technical audits. The next major QA project to be undertaken by TROG during the period 1998-1999 is an intercentre dosimetry study. Trial funding and staff education have been targeted as the key major issues essential to the continued success and expansion of TROG's QA programme.

  1. Clinical survey of prostate cancer

    International Nuclear Information System (INIS)

    Takada, Tsuyoshi; Hatano, Koji; Satoh, Mototaka; Tsujimoto, Yuichi; Honda, Masahito; Matsumiya, Kiyomi; Fujioka, Hideki

    2007-01-01

    Treatment trends and outcomes for prostate cancer in our hospital were reported. A total of 482 patients with prostate cancer treated in our hospital between January, 1990 and December, 2004. The age distribution was from 51 to 99 years-old, with the mean age of 72.9 years-old at onset. The number of prostate cancer patients, especially asymptomatic patients with prostatic specific antigen (PSA) elevation, have increased recently. As for the clinical stage, 92 cases (19.1%), 238 cases (49.4%), 48 cases (10.0%) and 104 cases (21.6%) were stage A, B, C and D, respectively. 425 cases (88.2%) received some form of endocrine therapy. Retropubic prostatectomy or external beam radiation therapy was performed in 77 and 57 cases, respectively all cases. The cause-specific 5-year survival rate of the 482 cases was 79.7%, comprising 100% for stage A1, 96.8% for stage A2, 89.4% for stage B, 79.9% for stage C and 42.9% for stage D. The cause-specific 5-year survival was significantly better in the latter patients (1997-2004) than the former patients (1990-1996) in stage C (p=0.0226), D (p=0.0448). In stage C patients, the retropubic prostatectomy (with endocrine therapy) group, increased in the latter period and showed longer cause-specific 5-year survival than the endocrine therapy group (p=0.0027). In stage D2 patients, chemo-endocrine therapy with etoposide (VP-16), adriamycin (ADM) and cisplatin (CDDP) refractory and cause-specific 5-year survival was longer than endocrine therapy alone (p=0.0467, P=0.0381). Our results suggest that retropubic prostatectomy with endocrine therapy and chemo-endocrine therapy are useful for stage C and D prostate cancer patients, respectively. (author)

  2. Non-small cell lung cancer in young adults: presentation and survival in the English National Lung Cancer Audit.

    Science.gov (United States)

    Rich, A L; Khakwani, A; Free, C M; Tata, L J; Stanley, R A; Peake, M D; Hubbard, R B; Baldwin, D R

    2015-11-01

    Non-small cell lung cancer (NSCLC) in young adults is a rare but devastating illness with significant socioeconomic implications, and studies of this patient subgroup are limited. This study employed the National Lung Cancer Audit to compare the clinical features and survival of young adults with NSCLC with the older age groups. A retrospective cohort review using a validated national audit dataset. Data were analysed for the period between 1 January 2004 and 31 December 2011. Young adults were defined as between 18 and 39 years, and all others were divided into decade age groups, up to the 80 years and above group. We performed logistic and Cox regression analyses to assess clinical outcomes. Of a total of 1 46 422 patients, 651 (0.5%) were young adults, of whom a higher proportion had adenocarcinoma (48%) than in any other age group. Stage distribution of NSCLC was similar across the age groups and 71% of young patients had stage IIIb/IV. Performance status (PS) was 0-1 for 85%. Young adults were more likely to have surgery and chemotherapy compared with the older age groups and had better overall and post-operative survival. The proportion with adenocarcinoma, better PS and that receiving surgery or chemotherapy diminished progressively with advancing decade age groups. In our cohort of young adults with NSCLC, the majority had good PS despite the same late-stage disease as older patients. They were more likely to have treatment and survive longer than older patients. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Validating a benchmarking tool for audit of early outcomes after operations for head and neck cancer.

    Science.gov (United States)

    Tighe, D; Sassoon, I; McGurk, M

    2017-04-01

    INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores. RESULTS Thirty-day complication rates varied widely (34-51%) between the centres. The predictive score allowed imperfect risk adjustment (area under the curve: 0.70), with Hosmer-Lemeshow analysis suggesting good calibration. The Brier score changed from 0.19 for sites A-C to 0.23 when site D was also included, suggesting poor accuracy overall. CONCLUSIONS Marked differences in operative risk and patient case mix captured by the risk adjustment score do not explain all the differences in observed outcomes. Further investigation with different methods is recommended to improve modelling of risk. Morbidity is common, and usually has a major impact on patient recovery, ward occupancy, hospital finances and patient perception of quality of care. We hope comparative audit will highlight good performance and challenge underperformance where it exists.

  4. Staging cancer of the uterus: A national audit of MRI accuracy

    International Nuclear Information System (INIS)

    Duncan, K.A.; Drinkwater, K.J.; Frost, C.; Remedios, D.; Barter, S.

    2012-01-01

    Aim: To report the results of a nationwide audit of the accuracy of magnetic resonance imaging (MRI) staging in uterine body cancer when staging myometrial invasion, cervical extension, and lymph node spread. Materials and methods: All UK radiology departments were invited to participate using a web-based tool for submitting anonymized data for a 12 month period. MRI staging was compared with histopathological staging using target accuracies of 85, 86, and 70% respectively. Results: Of the departments performing MRI staging of endometrial cancer, 37/87 departments contributed. Targets for MRI staging were achieved for two of the three standards nationally with diagnostic accuracy for depth of myometrial invasion, 82%; for cervical extension, 90%; and for pelvic nodal involvement, 94%; the latter two being well above the targets. However, only 13/37 (35%) of individual centres met the target for assessing depth of myometrial invasion, 31/36 (86%) for cervical extension and 31/34 (91%) for pelvic nodal involvement. Statistical analysis demonstrated no significant difference for the use of intravenous contrast medium, but did show some evidence of increasing accuracy in assessment of depth of myometrial invasion with increasing caseload. Conclusion: Overall performance in the UK was good, with only the target for assessment of depth of myometrial invasion not being met. Inter-departmental variation was seen. One factor that may improve performance in assessment of myometrial invasion is a higher caseload. No other clear factor to improve performance were identified.

  5. Staging cancer of the uterus: A national audit of MRI accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, K.A., E-mail: k.duncan@nhs.net [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom); Drinkwater, K.J. [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom); Frost, C. [Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London (United Kingdom); Remedios, D.; Barter, S. [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom)

    2012-06-15

    Aim: To report the results of a nationwide audit of the accuracy of magnetic resonance imaging (MRI) staging in uterine body cancer when staging myometrial invasion, cervical extension, and lymph node spread. Materials and methods: All UK radiology departments were invited to participate using a web-based tool for submitting anonymized data for a 12 month period. MRI staging was compared with histopathological staging using target accuracies of 85, 86, and 70% respectively. Results: Of the departments performing MRI staging of endometrial cancer, 37/87 departments contributed. Targets for MRI staging were achieved for two of the three standards nationally with diagnostic accuracy for depth of myometrial invasion, 82%; for cervical extension, 90%; and for pelvic nodal involvement, 94%; the latter two being well above the targets. However, only 13/37 (35%) of individual centres met the target for assessing depth of myometrial invasion, 31/36 (86%) for cervical extension and 31/34 (91%) for pelvic nodal involvement. Statistical analysis demonstrated no significant difference for the use of intravenous contrast medium, but did show some evidence of increasing accuracy in assessment of depth of myometrial invasion with increasing caseload. Conclusion: Overall performance in the UK was good, with only the target for assessment of depth of myometrial invasion not being met. Inter-departmental variation was seen. One factor that may improve performance in assessment of myometrial invasion is a higher caseload. No other clear factor to improve performance were identified.

  6. The value of auditing negative lower GI investigations preceding a final diagnosis of colorectal cancer.

    Science.gov (United States)

    Somasekar, A; James, L; Stephenson, B M; Thompson, I W; Vellacott, K D; Allison, M C

    2009-09-01

    To review all preceding 'negative' large bowel investigations in patients with a final diagnosis of colorectal cancer, and to examine whether delayed diagnosis was associated with worse outcome. Details were gathered on all patients with a new diagnosis of colorectal adenocarcinoma presenting over 4.5 years. For each patient the hospital's clinical workstation and radiology and endoscopy databases were interrogated for all flexible sigmoidoscopies, colonoscopies and barium enemas during the 5 years prior to diagnosis. Among the 570 patients, 28 (5%) had undergone colonoscopy and/or flexible sigmoidoscopy that had not shown colorectal cancer during the 5 years preceding final diagnosis, and a further 28 (5%) had undergone 'negative' barium enemas. Polyp surveillance might have missed four lesions destined to become malignant. Correspondingly there were three patients undergoing IBD surveillance found to have CRC, having had a negative complete colonoscopy within the preceding 5 years. Among patients undergoing de novo colonoscopy for diagnosis the true miss rate was only one patient per year. At August 2007, 29 (58%) of those with delayed diagnosis were still alive, compared with 216 (42%) of those diagnosed during initial investigation (chi2 = 5.04, P auditing the quality assurance of lower gastrointestinal diagnostic services. Despite the delay, late diagnosis was found to be associated with improved survival and a lower likelihood of metastatic disease.

  7. Validation of risk assessment scoring systems for an audit of elective surgery for gastrointestinal cancer in elderly patients: an audit.

    Science.gov (United States)

    Wakabayashi, Hisao; Sano, Takanori; Yachida, Shinichi; Okano, Keiichi; Izuishi, Kunihiko; Suzuki, Yasuyuki

    2007-10-01

    The goal of this study was to validate the usefulness of risk assessment scoring systems for a surgical audit in elective digestive surgery for elderly patients. The validated scoring systems used were the Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) and the Portsmouth predictor equation for mortality (P-POSSUM). This study involved 153 consecutive patients aged 75 years and older who underwent elective gastric or colorectal surgery between July 2004 and June 2006. A retrospective analysis was performed on data collected prior to each surgery. The predicted mortality and morbidity risks were calculated using each of the scoring systems and were used to obtain the observed/predicted (O/E) mortality and morbidity ratios. New logistic regression equations for morbidity and mortality were then calculated using the scores from the POSSUM system and applied retrospectively. The O/E ratio for morbidity obtained from POSSUM score was 0.23. The O/E ratios for mortality from the POSSUM score and the P-POSSUM were 0.15 and 0.38, respectively. Utilizing the new equations using scores from the POSSUM, the O/E ratio increased to 0.88. Both the POSSUM and P-POSSUM over-predicted the morbidity and mortality in elective gastrointestinal surgery for malignant tumors in elderly patients. However, if a surgical unit makes appropriate calculations using its own patient series and updates these equations, the POSSUM system can be useful in the risk assessment for surgery in elderly patients.

  8. National Beef Quality Audit-2011: In-plant survey of targeted carcass characteristics related to quality, quantity, value, and marketing of fed steers and heifers

    Science.gov (United States)

    The National Beef Quality Audit – 2011 (NBQA-2011) assessed the current status of quality and consistency of fed steers and heifers. Beef carcasses (n = 9,802), representing approximately 10 percent of each production lot in 28 beef processing facilities, were selected randomly for the survey. Car...

  9. Pengaruh Gender dan Pengalaman Audit terhadap Audit Judgment

    OpenAIRE

    Erna Pasanda; Natalia Paranoan

    2013-01-01

    This study aims to examine the influence of gender and audit experience toward audit judgment and to examine gender and audit experience towards audit judgment when moderated by client credibility. The research was conducted on auditors who worked on KAP in Makassar South Sulawesi using survey. Sampling technique in this study was random sampling based on judgment. Data collected and then analyzed by employing regression method and Moderated Regression Analysis (MRA). The result indicates tha...

  10. An investigation of routes to cancer diagnosis in 10 international jurisdictions, as part of the International Cancer Benchmarking Partnership: survey development and implementation

    Science.gov (United States)

    Weller, David; Vedsted, Peter; Anandan, Chantelle; Zalounina, Alina; Fourkala, Evangelia Ourania; Desai, Rakshit; Liston, William; Jensen, Henry; Barisic, Andriana; Gavin, Anna; Grunfeld, Eva; Lambe, Mats; Law, Rebecca-Jane; Malmberg, Martin; Neal, Richard D; Kalsi, Jatinderpal; Turner, Donna; White, Victoria; Bomb, Martine

    2016-01-01

    Objectives This paper describes the methods used in the International Cancer Benchmarking Partnership Module 4 Survey (ICBPM4) which examines time intervals and routes to cancer diagnosis in 10 jurisdictions. We present the study design with defining and measuring time intervals, identifying patients with cancer, questionnaire development, data management and analyses. Design and setting Recruitment of participants to the ICBPM4 survey is based on cancer registries in each jurisdiction. Questionnaires draw on previous instruments and have been through a process of cognitive testing and piloting in three jurisdictions followed by standardised translation and adaptation. Data analysis focuses on comparing differences in time intervals and routes to diagnosis in the jurisdictions. Participants Our target is 200 patients with symptomatic breast, lung, colorectal and ovarian cancer in each jurisdiction. Patients are approached directly or via their primary care physician (PCP). Patients’ PCPs and cancer treatment specialists (CTSs) are surveyed, and ‘data rules’ are applied to combine and reconcile conflicting information. Where CTS information is unavailable, audit information is sought from treatment records and databases. Main outcomes Reliability testing of the patient questionnaire showed that agreement was complete (κ=1) in four items and substantial (κ=0.8, 95% CI 0.333 to 1) in one item. The identification of eligible patients is sufficient to meet the targets for breast, lung and colorectal cancer. Initial patient and PCP survey response rates from the UK and Sweden are comparable with similar published surveys. Data collection was completed in early 2016 for all cancer types. Conclusion An international questionnaire-based survey of patients with cancer, PCPs and CTSs has been developed and launched in 10 jurisdictions. ICBPM4 will help to further understand international differences in cancer survival by comparing time intervals and routes to cancer

  11. A survey on auditing, quality assurance systems and legal frameworks in five selected slaughterhouses in Bulawayo, south-western Zimbabwe.

    Science.gov (United States)

    Masanganise, Kaurai E; Matope, Gift; Pfukenyi, Davies M

    2013-01-01

    The purpose of this study was to explore the audits, quality assurance (QA) programmes and legal frameworks used in selected abattoirs in Zimbabwe and slaughterhouse workers' perceptions on their effectiveness. Data on slaughterhouse workers was gathered through a self-completed questionnaire and additional information was obtained from slaughterhouse and government records. External auditing was conducted mainly by the Department of Veterinary Public Health with little contribution from third parties. Internal auditing was restricted to export abattoirs. The checklist used on auditing lacked objective assessment criteria and respondents cited several faults in the current audit system. Most respondents (> 50.0%) knew the purposes and benefits of audit and QA inspections. All export abattoirs had QA programmes such as hazard analysis critical control point and ISO 9001 (a standard used to certify businesses' quality management systems) but their implementation varied from minimal to nil. The main regulatory defect observed was lack of requirements for a QA programme. Audit and quality assurance communications to the selected abattoirs revealed a variety of non-compliances with most respondents revealing that corrective actions to audit (84.3%) and quality assurance (92.3%) shortfalls were not done. A high percentage of respondents indicated that training on quality (76.8%) and regulations (69.8%) was critical. Thus, it is imperative that these abattoirs develop a food safety management system comprising of QA programmes, a microbial assessment scheme, regulatory compliance, standard operating procedures, internal and external auditing and training of workers.

  12. A survey on auditing, quality assurance systems and legal frameworks in five selected slaughterhouses in Bulawayo, south-western Zimbabwe

    Directory of Open Access Journals (Sweden)

    Kaurai E. Masanganise

    2013-06-01

    Full Text Available The purpose of this study was to explore the audits, quality assurance (QA programmes and legal frameworks used in selected abattoirs in Zimbabwe and slaughterhouse workers’ perceptions on their effectiveness. Data on slaughterhouse workers was gathered through a self-completed questionnaire and additional information was obtained from slaughterhouse and government records. External auditing was conducted mainly by the Department of Veterinary Public Health with little contribution from third parties. Internal auditing was restricted to export abattoirs. The checklist used on auditing lacked objective assessment criteria and respondents cited several faults in the current audit system. Most respondents (>50.0% knew the purposes and benefits of audit and QA inspections. All export abattoirs had QA programmes such as hazard analysis critical control point and ISO 9001 (a standard used to certify businesses’ quality management systems but their implementation varied from minimal to nil. The main regulatory defect observed was lack of requirements for a QA programme. Audit and quality assurance communications to the selected abattoirs revealed a variety of non-compliances with most respondents revealing that corrective actions to audit (84.3% and quality assurance (92.3% shortfalls were not done. A high percentage of respondents indicated that training on quality (76.8% and regulations (69.8% was critical. Thus, it is imperative that these abattoirs develop a food safety management system comprising of QA programmes, a microbial assessment scheme, regulatory compliance, standard operating procedures, internal and external auditing and training of workers.

  13. Radiation safety audit

    International Nuclear Information System (INIS)

    Kadadunna, K.P.I.K.; Mod Ali, Noriah

    2008-01-01

    Audit has been seen as one of the effective methods to ensure harmonization in radiation protection. A radiation safety audit is a formal safety performance examination of existing or future work activities by an independent team. Regular audit will assist the management in its mission to maintain the facilities environment that is inherently safe for its employees. The audits review the adequacy of facilities for the type of use, training, and competency of workers, supervision by authorized users, availability of survey instruments, security of radioactive materials, minimization of personnel exposure to radiation, safety equipment, and the required record keeping. All approved areas of use are included in these periodic audits. Any deficiency found in the audit shall be corrected as soon as possible after they are reported. Radiation safety audit is a proactive approach to improve radiation safety practices and identify and prevent any potential radiation accident. It is an excellent tool to identify potential problem to radiation users and to assure that safety measures to eliminate or reduce the problems are fully considered. Radiation safety audit will help to develop safety culture of the facility. It is intended to be the cornerstone of a safety program designed to aid the facility, staff and management in maintaining a safe environment in which activities are carried out. The initiative of this work is to evaluate the need of having a proper audit as one of the mechanism to manage the safety using ionizing radiation. This study is focused on the need of having a proper radiation safety audit to identify deviations and deficiencies of radiation protection programmes. It will be based on studies conducted on several institutes/radiation facilities in Malaysia in 2006. Steps will then be formulated towards strengthening radiation safety through proper audit. This will result in a better working situation and confidence in the radiation protection community

  14. Radioiodine (I-131) application in the management of differentiated thyroid cancer (DTC) audit

    International Nuclear Information System (INIS)

    Nanayakkara, D.

    2005-01-01

    Full text: Differentiated thyroid cancer (DTC) remains one of the curable of all cancers. All literature reviews and clinical experiences regarding I 131 use in DTC conclude the beneficial effects, better prognosis, longer survival time and an assurance for cure. The Overall prognosis of patients with DTC is excellent if treat scientifically, adequately and timely. The management of thyroid cancer depends on the resources available in different institutions. Nuclear Medicine unit (NMU), Faculty of Medicine Peradeniya, Sri Lanka is in the process of uplifting the services for thyroid cancer management. Clinical audit was carried out in NMU on patients who utilized the Nuclear Medicine facilities in the management of DTC. It is important to identify deficiencies in current practice to improve our services. During January 2004 to March 2005, 126 DTC patients were referred for radioiodine Whole body scan (WBS) and therapy. Their age, sex, histology, extent of surgery, adequacy of thyroxine suppression treatment, monitoring with serum thyroglobulin levels (Tg), WBS results and radioiodine therapy were analyzed. There were 104(82.5%) females and 22(17.5%) males giving sex ratio of 4.7: 1. The Mean age was 35.5 years (range 9-58 years). The commonest histological types were papillary carcinoma 55.5% (n=70), follicular carcinoma 35% (n=44) and follicular variant of papillary carcinoma 9.5% (n=12). Seventy five percent (n=95) had total thyroidectomy (TT), 17 %(n=21) had near total thyroidectomy (NTT) and 8%(n=10) had subtotal thyroidectomy (STT). Sixty-nine patients (54.8%) were on thyroid suppression therapy. Thirty-six patients (28.6%) were referred to the WBS soon after surgery without initiation of thyroxine treatment. Another twenty-one patients (16.6%) were not on thyroxine therapy since surgery. Serum thyroglobulin was assessed on 20.6% (n=26). WBS done using 3-4 mCi liquid radioiodine showed residual functioning thyroid tissues in 41% (n=52). Lymph nodes or bone

  15. Using health care audit to improve quality of clinical records: the preliminary experience of an Italian Cancer Institute.

    Science.gov (United States)

    Cadeddu, Chiara; Specchia, Maria Lucia; Cacciatore, Pasquale; Marchini, Raffaele; Ricciardi, Walter; Cavuto, Costanza

    2017-01-01

    Audit and feedback are recognized as part of a strategy for improving performance and supporting quality and safety in European health care systems. These considerations led the Clinical Management Staff of the "Regina Elena" Italian Cancer Institute to start a project of self-assessment of the quality of clinical records and organizational appropriateness through a retrospective review. The evaluation about appropriateness and congruity concerned both clinical records of 2013 and of 2015. At the end of the assessment of clinical records of each Care Unit, results were shared with medical staff in scheduled audit meetings. One hundred and thirteen clinical records (19%) did not meet congruity criteria, while 74 (12.6%) resulted as inappropriate. Considering the economic esteem calculated from the difference between Diagnosis Related Groups (DRG) primarily identified as main diagnosis and main surgical intervention or procedure and those modified during the Local Health Unit (LHU) assessment, 2 surgical Care Units produced a high negative difference in terms of economic value with a consequent drop of hospital discharge form (named in Italian "scheda di dimissione ospedaliera", SDO) remuneration, 7 Care Units produced about the same medium difference with almost no change as SDO remuneration, and 2 Care Units had a positive difference with a profit in terms of SDO remuneration. Concerning the quality assessment of clinical records of 2015, the most critical areas were related to medical documents and hospital discharge form compilation. Our experience showed the effectiveness of clinical audit in assessing the quality of filling in medical records and the appropriateness of hospital admissions and the acceptability of this tool by clinicians.

  16. A survey of etiologic hypotheses among testicular cancer researchers

    DEFF Research Database (Denmark)

    Stang, A; Trabert, B; Rusner, C

    2015-01-01

    Basic research results can provide new ideas and hypotheses to be examined in epidemiological studies. We conducted a survey among testicular cancer researchers on hypotheses concerning the etiology of this malignancy. All researchers on the mailing list of Copenhagen Testis Cancer Workshops...... and corresponding authors of PubMed-indexed articles identified by the search term 'testicular cancer' and published within 10 years (in total 2750 recipients) were invited to respond to an e-mail-based survey. Participants of the 8th Copenhagen Testis Cancer Workshop in May 2014 were subsequently asked to rate...... that scored as most plausible. We also present plans for improving the survey that may be repeated at a next international meeting of experts in testicular cancer. Overall 52 of 99 (53%) registered participants of the 8th Copenhagen Testis Cancer Workshop submitted the plausibility rating form. Fourteen of 27...

  17. IT auditing

    NARCIS (Netherlands)

    Fijneman, R.; Ho, K.H.; Roos Lindgreen, E.; Veltman, P.

    2008-01-01

    This textbook on IT auditing (EDP auditing) is intended for ICT, IT auditing and accountancy professionals and students. It provides a consistent introduction to all topics with which an IT auditor is confronted in practice. It also refers of course to the major standards and norms adopted in

  18. Assessment of paediatric clinical audit.

    LENUS (Irish Health Repository)

    Perrem, L M

    2012-02-01

    Consultant paediatricians in Ireland were surveyed to evaluate their perceptions of the hospital audit environment and assess their involvement in the audit process. Eighty nine (77%) replied of whom 66 (74%) had an audit department and 23 (26%) did not. Sixteen (18%) felt their hospital was well resourced for audit and 25 (28%) felt the culture was very positive but only 1 (1%) had protected time. For 61 (69%) consultants audit was very important with 38 (43%) being very actively involved in the process. The most frequent trigger for audit was non consultant hospital doctor (NCHD) career development, cited by 77 (87%). The new Professional Competence Scheme and the National Quality and Risk Management Standards will require the deficiencies identified in this survey be addressed.

  19. The dutch surgical colorectal audit

    NARCIS (Netherlands)

    Leersum, N.J. van; Snijders, H.S.; Henneman, D.; Kolfschoten, N.E.; Gooiker, G.A.; Berge, M.G. Ten; Eddes, E.H.; Wouters, M.W.; Tollenaar, R.A.E.M.; Bemelman, W.A.; Dam, R.M. van; Elferink, M.A.; Karsten, T.M.; Krieken, J.H. van; Lemmens, V.E.; Rutten, H.J.; Manusama, E.R.; Velde, C.J. van de; Meijerink, W.J.H.J.; Wiggers, T.; Harst, E. van der; Dekker, J.W.T.; Boerma, D.

    2013-01-01

    INTRODUCTION: In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated

  20. The Dutch surgical colorectal audit

    NARCIS (Netherlands)

    van Leersum, N. J.; Snijders, H. S.; Henneman, D.; Kolfschoten, N. E.; Gooiker, G. A.; ten Berge, M. G.; Eddes, E. H.; Wouters, M. W. J. M.; Tollenaar, R. A. E. M.; Bemelman, W. A.; van Dam, R. M.; Elferink, M. A.; Karsten, Th M.; van Krieken, J. H. J. M.; Lemmens, V. E. P. P.; Rutten, H. J. T.; Manusama, E. R.; van de Velde, C. J. H.; Meijerink, W. J. H. J.; Wiggers, Th; van der Harst, E.; Dekker, J. W. T.; Boerma, D.

    2013-01-01

    In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch

  1. Comparative effectiveness of audit-feedback versus additional physician communication training to improve cancer screening for patients with limited health literacy.

    Science.gov (United States)

    Price-Haywood, Eboni G; Harden-Barrios, Jewel; Cooper, Lisa A

    2014-08-01

    We designed a continuing medical education (CME) program to teach primary care physicians (PCP) how to engage in cancer risk communication and shared decision making with patients who have limited health literacy (HL). We evaluated whether training PCPs, in addition to audit-feedback, improves their communication behaviors and increases cancer screening among patients with limited HL to a greater extent than only providing clinical performance feedback. Four-year cluster randomized controlled trial. Eighteen PCPs and 168 patients with limited HL who were overdue for colorectal/breast/cervical cancer screening. Communication intervention PCPs received skills training that included standardized patient (SP) feedback on counseling behaviors. All PCPs underwent chart audits of patients' screening status semiannually up to 24 months and received two annual performance feedback reports. PCPs experienced three unannounced SP encounters during which SPs rated PCP communication behaviors. We examined between-group differences in changes in SP ratings and patient knowledge of cancer screening guidelines over 12 months; and changes in patient cancer screening rates over 24 months. There were no group differences in SP ratings of physician communication at baseline. At follow-up, communication intervention PCPs were rated higher in general communication about cancer risks and shared decision making related to colorectal cancer screening compared to PCPs who only received performance feedback. Screening rates increased among patients of PCPs in both groups; however, there were no between-group differences in screening rates except for mammography. The communication intervention did not improve patient cancer screening knowledge. Compared to audit and feedback alone, including PCP communication training increases PCP patient-centered counseling behaviors, but not cancer screening among patients with limited HL. Larger studies must be conducted to determine whether lack of

  2. Risk factors for anastomotic leakage and leak-related mortality after colonic cancer surgery in a nationwide audit.

    Science.gov (United States)

    Bakker, I S; Grossmann, I; Henneman, D; Havenga, K; Wiggers, T

    2014-03-01

    Surgical resection with restoration of bowel continuity is the cornerstone of treatment for patients with colonic cancer. The aim of this study was to identify risk factors for anastomotic leakage (AL) and subsequent death after colonic cancer surgery. Data were retrieved from the Dutch Surgical Colorectal Audit. Patients undergoing colonic cancer resection with creation of an anastomosis between January 2009 to December 2011 were included. Outcomes were AL requiring reintervention and postoperative mortality following AL. AL occurred in 7·5 per cent of 15 667 patients. Multivariable analyses identified male sex, high American Society of Anesthesiologists (ASA) fitness grade, extensive tumour resection, emergency surgery, and surgical resection types such as transverse resection, left colectomy and subtotal colectomy as independent risk factors for AL. A defunctioning stoma was created in a small group of patients, leading to a lower risk of leakage. The mortality rate was 4·1 per cent overall, and was significantly higher in patients with AL than in those without leakage (16·4 versus 3·1 per cent; P risk factors for death after AL. The adjusted risk of death after AL was twice as high following right compared with left colectomy. The elderly and patients with co-morbidity have a higher risk of death after AL. Accurate preoperative patient selection, intensive postoperative surveillance for AL, and early and aggressive treatment of suspected leakage is important, especially in patients undergoing right colectomy. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  3. Operations Research Applications in Audit Planning and Scheduling

    OpenAIRE

    Abdel-Aziz M. Mohamed

    2015-01-01

    This paper presents a state-of-the-art survey of the operations research models developed for internal audit planning. Two alternative approaches have been followed in the literature for audit planning: (1) identifying the optimal audit frequency; and (2) determining the optimal audit resource allocation. The first approach identifies the elapsed time between two successive audits, which can be presented as the optimal number of audits in a given planning horizon, or the ...

  4. Retractions in cancer research: a systematic survey

    OpenAIRE

    Bozzo, Anthony; Bali, Kamal; Evaniew, Nathan; Ghert, Michelle

    2017-01-01

    Background The annual number of retracted publications in the scientific literature is rapidly increasing. The objective of this study was to determine the frequency and reason for retraction of cancer publications and to determine how journals in the cancer field handle retracted articles. Methods We searched three online databases (MEDLINE, Embase, The Cochrane Library) from database inception until 2015 for retracted journal publications related to cancer research. For each article, the re...

  5. Audit committee: Some evidence from Malaysia.

    Directory of Open Access Journals (Sweden)

    Zulkarnain Muhamad Sori

    2006-11-01

    Full Text Available This study aimed to investigate the perceptions of senior managers of Malaysian publicly listed companies on issues relating to audit committee authority and effectiveness. Questionnaire survey technique was employed to seek the respondents perceptions on five issues, namely audit committee appoints the auditor, audit committee determines and reviews audit fees, audit committee determines and reviews the auditor’s scope and duties, and audit committee’s reports and meetings. The majority of respondents agreed that auditor would be more effective and independent if audit committee assumed the responsibility to appoint the auditor, determine and review the audit fees, and determine and review the external auditor’s scope and duties. It is also found that disclosure of audit committee report and quarterly meeting would enhance the perceptions of users of financial statement concerning the effectiveness of the committee.

  6. 20 CFR 638.809 - Audit.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit. 638.809 Section 638.809 Employees... THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.809 Audit. (a) The Secretary of Labor... purpose of making surveys, audits, examinations, excerpts, and transcripts. (b) The Secretary shall, with...

  7. 24 CFR 590.27 - Audit.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Audit. 590.27 Section 590.27... COMMUNITY FACILITIES URBAN HOMESTEADING § 590.27 Audit. (a) Access to records. The Secretary, the... funds or property transferred under this part, for the purpose of making surveys, audits, examinations...

  8. STATUTORY AUDIT AND PERFORMANCE AUDIT

    Directory of Open Access Journals (Sweden)

    Suciu Gheorghe

    2012-06-01

    Full Text Available The financial audit has two components: the statutory audit (mandatory for certain companies made by financial auditors and the optional audit which can be done by other professionals (chartered accountants, evaluators, and tax matters members. The statutory audit represents the examination done by an authorized and independent professional of the financial statement of a company, in order to express a motivated opinion regarding the position, situation and financial performance. The statutory audit is established by law for those companies which have a significant public impact. The financial statement represents the management’s statement through which the firm communicates with the stakeholders: shareholders, creditors, investors, clients, debtors, contractors, employees, state institutions and thepopulation. The objective of the performance audit is the efficiency and effectiveness with which the audited company uses its resources in order to accomplish its responsibilities. The audit committees have a greater responsibility especially after the scandals in the US (Enron, WorldCom, Adelphia, through the Sarbanes-Oxley act from 2002. The audit committee has the following attributions: it monitors the financial reports made by the executive management, helps internal investigations, monitors and evaluates the activity of the internal audit department, gives recommendations to the administration council regarding the problems encountered when communicating with the shareholders, replacing or extending the mandate of the external auditor and authorizes the approval of this person’s fees.

  9. Nonelective colon cancer resections in elderly patients: results from the dutch surgical colorectal audit

    NARCIS (Netherlands)

    Kolfschoten, N. E.; Wouters, M. W. J. M.; Gooiker, G. A.; Eddes, E. H.; Kievit, J.; Tollenaar, R. A. E. M.; Marang-van de Mheen, P. J.; Bemelman, W. A.; Busch, O. R. C.; van Dam, R. M.; van der Harst, E.; Jansen-Landheer, M. L. E. A.; Karsten, Th M.; van Krieken, J. H. J. M.; Kuijpers, W. G. T.; Lemmens, V. E.; Manusama, E. R.; Meijerink, W. J. H. J.; Rutten, H. J. T.; van de Velde, C. J. H.; Wiggers, T.

    2012-01-01

    The aim of the study was to assess which factors contribute to postoperative mortality, especially in elderly patients who undergo emergency colon cancer resections, using a nationwide population-based database. 6,161 patients (1,172 nonelective) who underwent a colon cancer resection in 2010 in the

  10. High mortality rates after nonelective colon cancer resection : results of a national audit

    NARCIS (Netherlands)

    Bakker, I. S.; Snijders, H. S.; Grossmann, I.; Karsten, T. M.; Havenga, K.; Wiggers, T.

    AimColon cancer resection in a nonelective setting is associated with high rates of morbidity and mortality. The aim of this retrospective study is to identify risk factors for overall mortality after colon cancer resection with a special focus on nonelective resection. MethodData were obtained from

  11. An audit of skeletal surveys for suspected non-accidental injury following publication of the British Society of Paediatric Radiology guidelines

    International Nuclear Information System (INIS)

    Swinson, S.; Tapp, M.; Brindley, R.; Chapman, S.; Offiah, A.; Johnson, K.

    2008-01-01

    Aim: To audit change in the content and standard of skeletal surveys in the UK following the publication of the British Society of Paediatric Radiology (BSPR) guidelines for skeletal surveys in suspected non-accidental injury. Materials and methods: One hundred skeletal surveys, which were performed throughout England and Wales between February 2004 and September 2006 and received for a second opinion at a single children's hospital, were reviewed. The views obtained were compared with the defined reference standard 20 views as recommended by the BSPR. Additionally, each view was assessed for technical quality out of a maximum score of 11. The results were compared with an earlier study published prior to the definitive guideline. Additional information included whether images were film or digital and whether a computed tomography examination of the head was documented. Results: A mean of 16.5 (range 5-20) of the 20 recommended views were covered per survey and 15% of surveys included all 20 recommended views (previously 0%). The mean technical score per film was 9.7/11 (88%). Sixty-two percent of the skeletal surveys were digitally acquired and 59% included a CT examination of the head. Conclusion: There is still considerable variation in skeletal surveys performed in the UK, but progress has been observed in all areas in the light of the BSPR guidelines. There remains room for improvement, and further publicity of the guidelines is recommended

  12. An audit of skeletal surveys for suspected non-accidental injury following publication of the British Society of Paediatric Radiology guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Swinson, S. [Birmingham Children' s Hospital, Birmingham (United Kingdom)], E-mail: sophieswinson@doctors.org.uk; Tapp, M.; Brindley, R.; Chapman, S. [Birmingham Children' s Hospital, Birmingham (United Kingdom); Offiah, A. [Great Ormond Street Hospital, London (United Kingdom); Johnson, K. [Birmingham Children' s Hospital, Birmingham (United Kingdom)

    2008-06-15

    Aim: To audit change in the content and standard of skeletal surveys in the UK following the publication of the British Society of Paediatric Radiology (BSPR) guidelines for skeletal surveys in suspected non-accidental injury. Materials and methods: One hundred skeletal surveys, which were performed throughout England and Wales between February 2004 and September 2006 and received for a second opinion at a single children's hospital, were reviewed. The views obtained were compared with the defined reference standard 20 views as recommended by the BSPR. Additionally, each view was assessed for technical quality out of a maximum score of 11. The results were compared with an earlier study published prior to the definitive guideline. Additional information included whether images were film or digital and whether a computed tomography examination of the head was documented. Results: A mean of 16.5 (range 5-20) of the 20 recommended views were covered per survey and 15% of surveys included all 20 recommended views (previously 0%). The mean technical score per film was 9.7/11 (88%). Sixty-two percent of the skeletal surveys were digitally acquired and 59% included a CT examination of the head. Conclusion: There is still considerable variation in skeletal surveys performed in the UK, but progress has been observed in all areas in the light of the BSPR guidelines. There remains room for improvement, and further publicity of the guidelines is recommended.

  13. Audit of mammography performed in our hospital

    International Nuclear Information System (INIS)

    Kantharia, Surita

    2013-09-01

    A medical audit is a compilation of patient outcomes over a certain period of time. Audit of Mammography provides an objective criterion of the appropriateness and accuracy in image interpretation, and is the best measure of a mammographer's performance. The audit assesses 3 important outcomes: i) detection of the percentage of cancers in a population, ii) finding these cancers while they are still curable (small and node negative), iii) finding these cancers through an acceptably low number of recalls and biopsies. With this background, I am presenting an audit of Mammography done at our centre from the period May 2010 to April 2013. (author)

  14. A survey of etiologic hypotheses among testicular cancer researchers.

    Science.gov (United States)

    Stang, A; Trabert, B; Rusner, C; Poole, C; Almstrup, K; Rajpert-De Meyts, E; McGlynn, K A

    2015-01-01

    Basic research results can provide new ideas and hypotheses to be examined in epidemiological studies. We conducted a survey among testicular cancer researchers on hypotheses concerning the etiology of this malignancy. All researchers on the mailing list of Copenhagen Testis Cancer Workshops and corresponding authors of PubMed-indexed articles identified by the search term 'testicular cancer' and published within 10 years (in total 2750 recipients) were invited to respond to an e-mail-based survey. Participants of the 8th Copenhagen Testis Cancer Workshop in May 2014 were subsequently asked to rate the plausibility of the suggested etiologic hypotheses on a scale of 1 (very implausible) to 10 (very plausible). This report describes the methodology of the survey, the score distributions by individual hypotheses, hypothesis group, and the participants' major research fields, and discuss the hypotheses that scored as most plausible. We also present plans for improving the survey that may be repeated at a next international meeting of experts in testicular cancer. Overall 52 of 99 (53%) registered participants of the 8th Copenhagen Testis Cancer Workshop submitted the plausibility rating form. Fourteen of 27 hypotheses were related to exposures during pregnancy. Hypotheses with the highest mean plausibility ratings were either related to pre-natal exposures or exposures that might have an effect during pregnancy and in post-natal life. The results of the survey may be helpful for triggering more specific etiologic hypotheses that include factors related to endocrine disruption, DNA damage, inflammation, and nutrition during pregnancy. The survey results may stimulate a multidisciplinary discussion about new etiologic hypotheses of testicular cancer. Published 2014. This article is a U. S. Government work and is in the public domain in the USA.

  15. Health survey on cancers about the Tricastin nuclear site

    International Nuclear Information System (INIS)

    2010-01-01

    This survey aims at describing the health status of the population around the Tricastin site, and more particularly at determining whether there is a difference between death or cancer occurrence frequencies observed around this site with respect to reference frequencies. It does not aim at assessing the health impact of the site industrial installations. Cancer mortality data, cancer diagnosis data, demographic data, child cancer data, data related to hospital stays in relationship with cancer, long duration hospital stay data, and mortality data are used. Several indicators are defined and used: standardised mortality ratio, standardised hospitalisation ratio. Data are also analysed in terms of location, and socio-demographic categories. It appears that there is no specific health situation for the considered area, except for pancreas cancer for women

  16. Reduced Circumferential Resection Margin Involvement in Rectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit

    NARCIS (Netherlands)

    Gietelink, Lieke; Wouters, Michel W. J. M.; Tanis, Pieter J.; Deken, Marion M.; ten Berge, Martijn G.; Tollenaar, Rob A. E. M.; van Krieken, J. Han; de Noo, Mirre E.

    2015-01-01

    Background: The circumferential resection margin (CRM) is a significant prognostic factor for local recurrence, distant metastasis, and survival after rectal cancer surgery. Therefore, availability of this parameter is essential. Although the Dutch total mesorectal excision trial raised awareness

  17. Reduced Circumferential Resection Margin Involvement in Rectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit

    NARCIS (Netherlands)

    Gietelink, L.; Wouters, M.W.; Tanis, P.J.; Deken, M.M.; Berge, M.G. Ten; Tollenaar, R.A.; Krieken, J.H.J.M. van; Noo, M.E. de

    2015-01-01

    BACKGROUND: The circumferential resection margin (CRM) is a significant prognostic factor for local recurrence, distant metastasis, and survival after rectal cancer surgery. Therefore, availability of this parameter is essential. Although the Dutch total mesorectal excision trial raised awareness

  18. AUDIT, AUDIT-C, and AUDIT-3: drinking patterns and screening for harmful, hazardous and dependent drinking in Katutura, Namibia.

    Directory of Open Access Journals (Sweden)

    Puja Seth

    Full Text Available To describe alcohol drinking patterns among participants in Katutura, Namibia, and to evaluate brief versions of the AUDIT against the full AUDIT to determine their effectiveness in detecting harmful drinking.A cross-sectional survey was conducted in four constituencies and 639 participants, 18 years or older, completed a sociodemographic survey and the AUDIT. The effectiveness of the AUDIT-C (first three questions and the AUDIT-3 (third question was compared to the full AUDIT.Approximately 40% were identified as harmful, hazardous or likely dependent drinkers, with men having a higher likelihood than women (57.2% vs. 31.0%, p<.0001. Approximately 32% reported making and/or selling alcohol from home. The AUDIT-C performed best at a cutoff ≥ 3, better in men (sensitivity: 99.3%, specificity: 77.8% than women (sensitivity: 91.7%, specificity: 77.4%. The AUDIT-3 performed poorly (maximum sensitivity: < 90%, maximum specificity: <51%. According to AUROC, the AUDIT-C performed better than the AUDIT-3.A large proportion of participants met criteria for alcohol misuse, indicating a need for screening and referral for further evaluation and intervention. The AUDIT-C was almost as effective as the full AUDIT and may be easier to implement in clinical settings as a routine screening tool in resource-limited settings because of its brevity.

  19. AUDIT, AUDIT-C, and AUDIT-3: Drinking Patterns and Screening for Harmful, Hazardous and Dependent Drinking in Katutura, Namibia

    Science.gov (United States)

    Seth, Puja; Glenshaw, Mary; Sabatier, Jennifer H. F.; Adams, René; Du Preez, Verona; DeLuca, Nickolas; Bock, Naomi

    2015-01-01

    Objectives To describe alcohol drinking patterns among participants in Katutura, Namibia, and to evaluate brief versions of the AUDIT against the full AUDIT to determine their effectiveness in detecting harmful drinking. Methods A cross-sectional survey was conducted in four constituencies and 639 participants, 18 years or older, completed a sociodemographic survey and the AUDIT. The effectiveness of the AUDIT-C (first three questions) and the AUDIT-3 (third question) was compared to the full AUDIT. Results Approximately 40% were identified as harmful, hazardous or likely dependent drinkers, with men having a higher likelihood than women (57.2% vs. 31.0%, pAUDIT-C performed best at a cutoff ≥ 3, better in men (sensitivity: 99.3%, specificity: 77.8%) than women (sensitivity: 91.7%, specificity: 77.4%). The AUDIT-3 performed poorly (maximum sensitivity: AUDIT-C performed better than the AUDIT-3. Conclusions A large proportion of participants met criteria for alcohol misuse, indicating a need for screening and referral for further evaluation and intervention. The AUDIT-C was almost as effective as the full AUDIT and may be easier to implement in clinical settings as a routine screening tool in resource-limited settings because of its brevity. PMID:25799590

  20. Environmental auditing: Theory and applications

    Science.gov (United States)

    Thompson, Dixon; Wilson, Melvin J.

    1994-07-01

    The environmental audit has become a regular part of corporate environmental management in Canada and is also gaining recognition in the public sector. A 1991 survey of 75 private sector companies across Canada revealed that 76% (57/75) had established environmental auditing programs. A similar survey of 19 federal, provincial, and municipal government departments revealed that 11% (2/19) had established such programs. The information gained from environmental audits can be used to facilitate and enhance environmental management from the single facility level to the national and international levels. This paper is divided into two sections: section one examines environmental audits at the facility/company level and discusses environmental audit characteristics, trends, and driving forces not commonly found in the available literature. Important conclusions are: that wherever possible, an action plan to correct the identified problems should be an integral part of an audit, and therefore there should be a close working relationship between auditors, managers, and employees, and that the first audits will generally be more difficult, time consuming, and expensive than subsequent audits. Section two looks at environmental audits in the broader context and discusses the relationship between environmental audits and three other environmental information gathering/analysis tools: environmental impact assessments, state of the environment reports, and new systems of national accounts. The argument is made that the information collected by environmental audits and environmental impact assessments at the facility/company level can be used as the bases for regional and national state of the environment reports and new systems of national accounts.

  1. Ultrasonography survey and thyroid cancer in the Fukushima Prefecture

    Energy Technology Data Exchange (ETDEWEB)

    Jacob, Peter; Kaiser, Jan Christian; Ulanovsky, Alexander [Helmholtz Zentrum Muenchen-German Research Center for Environmental Health, Department of Radiation Sciences, Institute of Radiation Protection, Neuherberg (Germany)

    2014-05-15

    Thyroid cancer is one of the major health concerns after the accident in the Fukushima Dai-ichi nuclear power station (NPS). Currently, ultrasonography surveys are being performed for persons residing in the Fukushima Prefecture at the time of the accident with an age of up to 18 years. Here, the expected thyroid cancer prevalence in the Fukushima Prefecture is assessed based on an ultrasonography survey of Ukrainians, who were exposed at an age of up to 18 years to {sup 131}I released during the Chernobyl NPS accident, and on differences in equipment and study protocol in the two surveys. Radiation risk of thyroid cancer incidence among survivors of the atomic bombings of Hiroshima and Nagasaki and preliminary estimates of thyroid dose due to the Fukushima accident were used for the prediction of baseline and radiation-related thyroid cancer risks. We estimate a prevalence of thyroid cancer of 0.027 % (95 % CI 0.010 %; 0.050 %) for the first screening campaign in the Fukushima Prefecture. Compared with the incidence rate in Japan in 2007, the ultrasonography survey is predicted to increase baseline thyroid cancer incidence by a factor of 7.4 (95 % CI 0.95; 17.3). Under the condition of continued screening, thyroid cancer during the first fifty years after the accident is predicted to be detected for about 2 % of the screened population. The prediction of radiation-related thyroid cancer in the most exposed fraction (a few ten thousand persons) of the screened population of the Fukushima Prefecture has a large uncertainty with the best estimates of the average risk of 0.1-0.3 %, depending on average dose. (orig.)

  2. The ICA Communication Audit and Perceived Communication Effectiveness Changes in 16 Audited Organizations.

    Science.gov (United States)

    Brooks, Keith; And Others

    1979-01-01

    Discusses the benefits of the International Communication Association Communication Audit as a methodology for evaluation of organizational communication processes and outcomes. An "after" survey of 16 audited organizations confirmed the audit as a valid diagnostic methodology and organization development intervention technique which…

  3. Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention.

    Science.gov (United States)

    Fraser, Kimberly D; O'Rourke, Hannah M; Baylon, Melba Andrea B; Boström, Anne-Marie; Sales, Anne E

    2013-02-13

    Audit with feedback is a moderately effective approach for improving professional practice in other health care settings. Although unregulated caregivers give the majority of direct care in long-term care settings, little is known about how they understand and perceive feedback reports because unregulated providers have not been directly targeted to receive audit with feedback in quality improvement interventions in long-term care. The purpose of this paper is to describe unregulated care providers' perceptions of usefulness of a feedback report in four Canadian long-term care facilities. We delivered monthly feedback reports to unregulated care providers for 13 months in 2009-2010. The feedback reports described a unit's performance in relation to falls, depression, and pain as compared to eight other units in the study. Follow-up surveys captured participant perceptions of the feedback report. We conducted descriptive analyses of the variables related to participant perceptions and multivariable logistic regression to assess the association between perceived usefulness of the feedback report and a set of independent variables. The vast majority (80%) of unregulated care providers (n = 171) who responded said they understood the reports. Those who discussed the report with others and were interested in other forms of data were more likely to find the feedback report useful for making changes in resident care. This work suggests that unregulated care providers can understand and feel positively about using audit with feedback reports to make changes to resident care. Further research should explore ways to promote fuller engagement of unregulated care providers in decision-making to improve quality of care in long-term care settings.

  4. Towards patient-centered colorectal cancer surgery : focus on risks, decisions and clinical auditing

    NARCIS (Netherlands)

    Snijders, Heleen Simone

    2014-01-01

    The aim of this thesis was to explore several aspects of both clinical decision making and quality assessment in colorectal cancer surgery. Part one focusses on benefits and risks of treatment options, preoperative information provision and Shared Decision Making (SDM); part two investigates changes

  5. People's willingness to accept overdetection in cancer screening: population survey.

    Science.gov (United States)

    Van den Bruel, Ann; Jones, Caroline; Yang, Yaling; Oke, Jason; Hewitson, Paul

    2015-03-03

    To describe the level of overdetection people would find acceptable in screening for breast, prostate, and bowel cancer and whether acceptability is influenced by the magnitude of the benefit from screening and the cancer specific harms from overdetection. Online survey. Women were presented with scenarios on breast and bowel cancer, men with scenarios on prostate and bowel cancer. For each particular cancer, we presented epidemiological information and described the treatment and its consequences. Secondly, we presented two different scenarios of benefit: one indicating a 10% reduction in cancer specific mortality and the second indicating a 50% reduction. Online survey of the population in the United Kingdom. Respondents were part of an existing panel of people who volunteer for online research and were invited by email or online marketing. We recruited 1000 respondents, representative for age and sex for the UK population. Number of cases of overdetection people were willing to accept, ranging from 0-1000 (complete screened population) for each cancer modality and each scenario of benefit. There was large variability between respondents in the level of overdetection they would find acceptable, with medians ranging from 113 to 313 cases of overdetection per 1000 people screened. Across all scenarios, 4-7% of respondents indicated they would accept no overdetection at all compared with 7-14% who thought that it would be acceptable for the entire screened population to be overdetected. Acceptability in screening for bowel cancer was significantly lower than for breast and prostate cancer. People aged 50 or over accepted significantly less overdetection, whereas people with higher education levels accepted more; 29% of respondents had heard of overdetection before. Acceptability of overdetection in cancer screening is variable. Invitations for screening should include clear information on the likelihood and consequences of overdetection to allow people to make an

  6. A survey on the effects of institutional ownership, internal audit and non-executive board members on forecasting crashes: Evidence from Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Mostafa Sohouli Vahed

    2014-11-01

    Full Text Available This paper presents an empirical investigation to study the effects of institutional ownership, internal audit system, the number of non-executive board members and having differentiation between chair and general managers’ responsibilities on the likelihood of stock price crash on 110 listed firms on Tehran Stock Exchange over the period 2004-2011. The study uses Chen’ model (2001 [Chen, J., Hong, H., & Stein, J. C. (2001. Forecasting crashes: Trading volume, past returns, and conditional skewness in stock prices. Journal of Financial Economics, 61(3, 345-381.] to perform the investigation. Based on the results of the survey, there is a negative and meaningful relationship between stock price crash and institutional ownership when the level of significance is ten percent. In addition, as the number of non-executive board members increases, the chance of stock price crash decreases when the level of significance is five percent. However, separation between the responsibility of chair and general managers did not seem to influence on stock price and also having internal audit system had no impact on the likelihood of stock price change.

  7. Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice.

    Science.gov (United States)

    Torras, M G; Canals, E; Jurado-Bruggeman, D; Marín-Borras, S; Macià, M; Jové, J; Boladeras, A M; Muñoz-Montplet, C; Molero, J; Picón, C; Puigdemont, M; Aliste, L; Torrents, A; Guedea, F; Borras, J M

    2018-06-01

    The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  8. 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

  9. Clinical audit in gynecological cancer surgery: development of a risk scoring system to predict adverse events.

    Science.gov (United States)

    Kondalsamy-Chennakesavan, Srinivas; Bouman, Chantal; De Jong, Suzanne; Sanday, Karen; Nicklin, Jim; Land, Russell; Obermair, Andreas

    2009-12-01

    Advanced gynecological surgery undertaken in a specialized gynecologic oncology unit may be associated with significant perioperative morbidity. Validated risk prediction models are available for general surgical specialties but currently not for gynecological cancer surgery. The objective of this study was to evaluate risk factors for adverse events (AEs) of patients treated for suspected or proven gynecological cancer and to develop a clinical risk score (RS) to predict such AEs. AEs were prospectively recorded and matched with demographical, clinical and histopathological data on 369 patients who had an abdominal or laparoscopic procedure for proven or suspected gynecological cancer at a tertiary gynecological cancer center. Stepwise multiple logistic regression was used to determine the best predictors of AEs. For the risk score (RS), the coefficients from the model were scaled using a factor of 2 and rounded to the nearest integer to derive the risk points. Sum of all the risk points form the RS. Ninety-five patients (25.8%) had at least one AE. Twenty-nine (7.9%) and 77 (20.9%) patients experienced intra- and postoperative AEs respectively with 11 patients (3.0%) experiencing both. The independent predictors for any AE were complexity of the surgical procedure, elevated SGOT (serum glutamic oxaloacetic transaminase, > or /=35 U/L), higher ASA scores and overweight. The risk score can vary from 0 to 14. The risk for developing any AE is described by the formula 100 / (1 + e((3.697 - (RS /2)))). RS allows for quantification of the risk for AEs. Risk factors are generally not modifiable with the possible exception of obesity.

  10. A centrally generated primary care physician audit report does not improve colonoscopy uptake after a positive result on a fecal occult blood test in Ontario's ColonCancerCheck program.

    Science.gov (United States)

    Stock, D; Rabeneck, L; Baxter, N N; Paszat, L F; Sutradhar, R; Yun, L; Tinmouth, J

    2017-02-01

    Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. In the present study, we evaluated the effectiveness of centrally generated, physician-targeted audit and feedback to improve colonoscopy uptake after a positive fecal occult blood test (fobt) result within Ontario's population-wide ColonCancerCheck Program. This prospective cohort study used data sets from Ontario's ColonCancerCheck Program (2008-2011) that were linked to provincial administrative health databases. Cox proportional hazards regression was used to estimate the effect of centralized, physician-targeted audit and feedback on colonoscopy uptake in an Ontario-wide fobt-positive cohort. A mailed physician audit and feedback report identifying individuals outstanding for colonoscopy for 3 or more months after a positive fobt result did not increase the likelihood of colonoscopy uptake (hazard ratio: 0.95; 95% confidence interval: 0.79 to 1.13). Duration of positive fobt status was strongly inversely associated with the hazard of follow-up colonoscopy ( p for linear trend: audit and feedback reports does not improve colonoscopy uptake for screening participants with a positive fobt result outstanding for 3 or more months. Mailed physician-targeted screening audit and feedback reports alone are unlikely to improve compliance with follow-up colonoscopy in Ontario. Other interventions such as physician audits or automatic referrals, demonstrated to be effective in other jurisdictions, might be warranted.

  11. Nonelective colon cancer resections in elderly patients: results from the dutch surgical colorectal audit.

    Science.gov (United States)

    Kolfschoten, N E; Wouters, M W J M; Gooiker, G A; Eddes, E H; Kievit, J; Tollenaar, R A E M; Marang-van de Mheen, P J

    2012-01-01

    The aim of the study was to assess which factors contribute to postoperative mortality, especially in elderly patients who undergo emergency colon cancer resections, using a nationwide population-based database. 6,161 patients (1,172 nonelective) who underwent a colon cancer resection in 2010 in the Netherlands were included. Risk factors for postoperative mortality were investigated using a multivariate logistic regression model for different age groups, elective and nonelective patients separately. For both elective and nonelective patients, mortality risk increased with increasing age. For nonelective elderly patients (80+ years), each additional risk factor increased the mortality risk. For a nonelective patient of 80+ years with an American Society of Anesthesiologists score of III+ and a left hemicolectomy or extended resection, postoperative mortality rate was 41% compared with 7% in patients without additional risk factors. For elderly patients with two or more additional risk factors, a nonelective resection should be considered a high-risk procedure with a mortality risk of up to 41%. The results of this study could be used to adequately inform patient and family and should have consequences for composing an operative team. Copyright © 2012 S. Karger AG, Basel.

  12. Common data items in seven European oesophagogastric cancer surgery registries: towards a European upper GI cancer audit (EURECCA Upper GI).

    Science.gov (United States)

    de Steur, W O; Henneman, D; Allum, W H; Dikken, J L; van Sandick, J W; Reynolds, J; Mariette, C; Jensen, L; Johansson, J; Kolodziejczyk, P; Hardwick, R H; van de Velde, C J H

    2014-03-01

    Seven countries (Denmark, France, Ireland, the Netherlands, Poland, Sweden, United Kingdom) collaborated to initiate a EURECCA (European Registration of Cancer Care) Upper GI project. The aim of this study was to identify a core dataset of shared items in the different data registries which can be used for future collaboration between countries. Item lists from all participating Upper GI cancer registries were collected. Items were scored 'present' when included in the registry, or when the items could be deducted from other items in the registry. The definition of a common item was that it was present in at least six of the seven participating countries. The number of registered items varied between 40 (Poland) and 650 (Ireland). Among the 46 shared items were data on patient characteristics, staging and diagnostics, neoadjuvant treatment, surgery, postoperative course, pathology, and adjuvant treatment. Information on non-surgical treatment was available in only 4 registries. A list of 46 shared items from seven participating Upper GI cancer registries was created, providing a basis for future quality assurance and research in Upper GI cancer treatment on a European level. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. EMERALD: Emergency visit audit of patients treated under medical oncology in a tertiary cancer center: Logical steps to decrease the burden.

    Science.gov (United States)

    Joshi, Amit; Patil, Vijay M; Noronha, Vanita; Ramaswamy, Anant; Gupta, Sudeep; Bhattacharjee, Atanu; Bonda, Avinash; Chandrakanth, M V; Ostwal, Vikas; Khattry, Navin; Banavali, Shripad; Prabhash, Kumar

    2017-01-01

    We are a tertiary care cancer center and have approximately 1000-1500 emergency visits by cancer patients undergoing treatment under the adult medical oncology unit each month. However, due to the lack of a systematic audit, we are unable to plan steps toward the improvement in quality of emergency services, and hence the audit was planned. All emergency visits under the adult medical oncology department in the month of July 2015 were audited. The cause of visit, the demographic details, cancer details, and chemotherapy status were obtained from the electronic medical records. The emergency visits were classified as avoidable or unavoidable. Descriptive statistics were performed. Reasons for avoidable emergency visits were sought. Out of 1199 visits, 1168 visits were classifiable. Six hundred and ninety-six visits were classified as unavoidable (59.6%, 95% CI: 56.7-62.4), 386 visits were classified as probably avoidable visit (33.0%, 95% CI: 30.4-35.8) whereas the remaining 86 (7.4%, 95% CI: 6.0-9.01) were classified as absolutely avoidable. Two hundred and ninety-seven visits happened on weekends (25.6%) and 138 visits converted into an inpatient admission (11.9%). The factors associated with avoidable visits were curative intention of treatment (odds ratio - 2.49), discontinued chemotherapy status (risk ratio [RR] - 8.28), and private category file status (RR - 1.89). A proportion of visits to emergency services can be curtailed. Approximately one-fourth of patients are seen on weekends, and only about one-tenth of patients get admitted.

  14. A criterion-based audit of the technical quality of external beam radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Brundage, Michael; Danielson, Brita; Pearcey, Robert; Bass, Brenda; Pickles, Tom; Bahary, Jean-Paul; Peng, Yingwei; Wallace, David; Mackillop, William

    2013-01-01

    Purpose: To evaluate the technical quality of external beam radiotherapy for prostate cancer in Canada. Methods: This was a multi-institution, retrospective study of a random sample of patients undergoing radiotherapy (RT) for prostate cancer in Canada. Patterns of care were determined by abstracting details of the patients’ management from original records. The quality of patient’s technical care was measured against a previously published, comprehensive suite of quality indicators. Results: 32 of the 37 RT centres participated. The total study population of 810 patients included 25% low-risk, 44% intermediate-risk, and 28% high-risk cases. 649 received external beam RT (EBRT) only, for whom compliance with 12 indicators of the quality of pre-treatment assessment ranged from 56% (sexual function documented) to 96% (staging bone scan obtained in high-risk patients). Compliance with treatment-related indicators ranged from 78% (dose to prostate ⩾74 Gy in intermediate risk patients not receiving hormone therapy) to 100% (3DCRT or IMRT plan). Compliance varied among centres; no centre demonstrated 100% compliance on all indicators and every centre was 100% compliant on at least some indicators. The number of assessment-related indicators (n = 13) with which a given centre was 100% compliant ranged from 4 to 11 (median 7) and the number of the treatment-specific indicators (n = 8) with which a given centre was 100% compliant ranged from 6 to 8 (median 8). ADT therapy was utilised in most high-risk cases (191, 92.3%). Conclusions: While patterns of prostate cancer care in Canada vary somewhat, compliance on the majority of quality indicators is very high. However, all centres showed room for improvement on several indicators and few individual patients received care that met target benchmarks on all quality measures. This variation is particularly important for indicators such as delivered dose where impact on disease outcome is known to exist, and suggests that

  15. Mass survey of lung cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Itoh, Chikako; Mitsuyama, Toyofumi; Mishima, Yasuhiro; Katsuta, Shizutomo.

    1978-01-01

    Men atomic bomb survivors over the age of 40 years received a survey of lung cancer by questionnaire together with the general survey for atomic bomb survivors, and the following results were obtained. The survey by questionnaire was carried out on 29780 cases during one year 1977 to 1978, and 6 cases of lung cancer were discovered. The discovery rate was 20.1 persons against a hundred thousand persons. Lung cancer discovered during 2 years from April, 1976 was 14 cases, and the discovery rate was 23.9 persons against a hundred thousand persons. The discovery rate according to exposure conditions was higher in order of a group entering Hiroshima city after A-bomb explosion and other group (33.2 persons), a group directly exposed over 2 km from the center of explosion (20.0 persons), and a group directly exposed within 2 km (1.5 persons). Therefore, results that the discovery rate of lung cancer was higher in short-distance group could not be obtained. (Tsunoda, M.)

  16. Risk factors and survival outcome for non-elective referral in non-small cell lung cancer patients--analysis based on the National Lung Cancer Audit.

    Science.gov (United States)

    Beckett, P; Tata, L J; Hubbard, R B

    2014-03-01

    Survival after diagnosis of lung cancer is poor and seemingly lower in the UK than other Western countries, due in large part to late presentation with advanced disease precluding curative treatment. Recent research suggests that around one-third of lung cancer patients reach specialist care after emergency presentation and have a worse survival outcome. Confirmation of these data and understanding which patients are affected may allow a targeted approach to improving outcomes. We used data from the UK National Lung Cancer Audit in a multivariate logistic regression model to quantify the association of non-elective referral in non-small cell lung cancer patients with covariates including age, sex, stage, performance status, co-morbidity and socioeconomic status and used the Kaplan-Meier method and Cox proportional hazards model to quantify survival by source of referral. In an analysis of 133,530 cases of NSCLC who presented 2006-2011, 19% of patients were referred non-electively (following an emergency admission to hospital or following an emergency presentation to A&E). This route of referral was strongly associated with more advanced disease stage (e.g. in Stage IV - OR: 2.34, 95% CI: 2.14-2.57, p<0.001) and worse performance status (e.g. in PS 4 - OR: 7.28, 95% CI: 6.75-7.86, p<0.001), but was also independently associated with worse socioeconomic status, and extremes of age. These patients were more likely to have died within 1 year of diagnosis (hazard ratio of 1.51 (95% CI: 1.49-1.54) after adjustment for key clinical variables. Our data confirm and quantify poorer survival in lung cancer patients who are referred non-electively to specialist care, which is more common in patients with poorer performance status, higher disease stage and less advantaged socioeconomic status. Work to tackle this late presentation should be urgently accelerated, since its realisation holds the promise of improved outcomes and better healthcare resource utilisation. Copyright

  17. An audit of referral and treatment patterns of high-risk prostate cancer patients in Alberta.

    Science.gov (United States)

    Alghamdi, Majed; Taggar, Amandeep; Tilley, Derek; Kerba, Marc; Kostaras, Xanthoula; Gotto, Geoffrey; Sia, Michael

    2016-01-01

    We aimed to determine the impact of clinical practice guidelines (CPG) on rates of radiation oncologist (RO) referral, androgen-deprivation therapy (ADT), radiation therapy (RT), and radical prostatectomy (RP) in patients with high-risk prostate cancer (HR-PCa). All men >18 years, diagnosed with PCa in 2005 and 2012 were identified from the Alberta Cancer Registry. Patient age, aggregated clinical risk group (ACRG) score, Gleason score (GS), pre-treatment prostate-specific antigen (PSA), RO referral, and treatment received were extracted from electronic medical records. Logistic regression modelling was used to examine associations between RO referral rates and relevant factors. HR-PCa was diagnosed in 261 of 1792 patients in 2005 and 435 of 2148 in 2012. Median age and ACRG scores were similar in both years (p>0.05). The rate of patients with PSA >20 were 67% and 57% in 2005 and 2012, respectively (p=0.004). GS ≤6 was found in 13% vs. 5% of patients, GS 7 in 27% vs. 24%, and GS ≥8 in 59% vs. 71% in 2005 and 2012, respectively (p<0.001). In 2005, RO referral rate was 68% compared to 56% in 2012 (p=0.001), use of RT + ADT was 53% compared to 32% (p<0.001), and RP rate was 9% vs. 17% (p=0.002). On regression analysis, older age, 2012 year of diagnosis and higher PSA were associated with decreased RO referral rates (odds ratios [OR] 0.49, 95% confidence interval [CI] 0.39-0.61; OR 0.51, 95% CI 0.34-0.76; and OR 0.64, 95% CI 0.39-0.61), respectively [p<0.001]). Since CPG creation in 2005, RO referral rates and ADT + RT use declined and RP rates increased, which demonstrates a need to improve adherence to CPG in the HR-PCa population.

  18. Auditing wildlife

    Directory of Open Access Journals (Sweden)

    B.K. Reilly

    2003-12-01

    Full Text Available Reilly B.K. and Y. Reilly. 2003. Auditing wildlife. Koedoe 46(2: 97–102. Pretoria. ISSN 0075-6458. Accountants and auditors are increasingly confronted with the problem of auditing wildlife populations on game ranches as their clients' asset base expands into this industry. This paper aims to provide guidelines on these actions based on case study data and research in the field of wildlife monitoring. Parties entering into dispute on numbers of animals on a property often resort to their auditors for advice. This paper tracks a method of deciding on whether or not to audit the population based on wildlife value and an initial sample count. This will act as a guideline for the accounting profession when confronted by this problem.

  19. Pengaruh Tekanan Waktu, Risiko Audit, Materialitas, Prosedur Review Dan Kontrol Kualitas, Komitmen Profesional, Dan Locus of Control Terhadap Penghentian Prematur Atas Prosedur Audit (Survey Pada Auditor Di Kap Wilayah Pekanbaru, Medan, Batam, Dan Padang)

    OpenAIRE

    Sari, Nurhardianty Kurnia; ', Kamaliah; Idrus, Rahmiati

    2016-01-01

    The objective of this study is to determine the effect of time pressure, audit risk, materiality, review procedures and quality control, professional commitment, locus of control on premature sign-off audit proceduress at the public accountant firm (KAP) in Pekanbaru, Batam, Medan, and Padang. This study uses primary data. Sample selection technique used is purposive sampling. The analytical method used is multiple linear regression with SPSS. Based on the overall hypothesis testing showed th...

  20. A prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network.

    Science.gov (United States)

    Parmar, K L; Zammit, M; Smith, A; Kenyon, D; Lees, N P

    2011-08-01

    The study aimed to identify the incidence of early stoma problems after surgery for colorectal cancer to identify predisposing factors and to assess the effect on discharge from hospital and the greater need for community stoma care. A prospective study of 192 patients was carried out over a six-month period in the 13 units of the Greater Manchester and Cheshire Cancer Network. Stoma problems were categorized into fistula, leakage, pancaking, necrosis, retraction, separation, stenosis, skin problems, parastomal hernia, suboptimal stoma site and need for resiting or refashioning. Differences in incidence between units (anonymized) were analysed, and the effect of stoma complications on length of hospital stay and the need for additional community stoma care was determined. One hundred and ninety-two patients with stomas were included, of which 52 (27.1%) were identified as being problematic (range 0-66.7% between units). Significant risk factors included stoma type (colostomy) (P stoma length (P = 0.006), higher BMI (P = 0.043), emergency surgery (P = 0.002) and lack of preoperative site marking (P stomas were associated with longer hospital stay (P care (P Stoma type, stoma length, body mass index, emergency surgery and lack of preoperative marking were significant risk factors. Overall complication rates compare favourably with other studies. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  1. Workshop Synthesis: Stated Preference Surveys and Experimental Design, an Audit of the Journey so far and Future Research Perspectives

    DEFF Research Database (Denmark)

    Cherchi, Elisabetta; Hensher, David A.

    2015-01-01

    This paper is a synthesis of the discussions and ideas that were generated during the workshop on “Stated preference surveys and experimental design” at the 2014 Travel Survey Methods Conference in Leura (Australia). The workshop addressed the challenges related to the design and implementation o...

  2. Internal Audit Service | Internal Audit Service

    Science.gov (United States)

    their internal auditing function in the areas of professional excellence, quality of service and Students and teachers Media Internal Audit Service Navbar Toggle Home About the Staff Risk Assessment and Planning Internal Audit Process Search for Search Home The mission of the Fermilab Internal Audit Service

  3. Safety Auditing and Assessments

    Science.gov (United States)

    Goodin, James Ronald (Ronnie)

    2005-01-01

    Safety professionals typically do not engage in audits and independent assessments with the vigor as do our quality brethren. Taking advantage of industry and government experience conducting value added Independent Assessments or Audits benefits a safety program. Most other organizations simply call this process "internal audits." Sources of audit training are presented and compared. A relation of logic between audit techniques and mishap investigation is discussed. An example of an audit process is offered. Shortcomings and pitfalls of auditing are covered.

  4. A Population-based Study on Lymph Node Retrieval in Patients with Esophageal Cancer: Results from the Dutch Upper Gastrointestinal Cancer Audit.

    Science.gov (United States)

    van der Werf, L R; Dikken, J L; van Berge Henegouwen, M I; Lemmens, V E P P; Nieuwenhuijzen, G A P; Wijnhoven, B P L

    2018-05-01

    For esophageal cancer, the number of retrieved lymph nodes (LNs) is often used as a quality indicator. The aim of this study is to analyze the number of retrieved LNs in The Netherlands, assess factors associated with LN yield, and explore the association with short-term outcomes. This is a population-based study on lymph node retrieval in patients with esophageal cancer, presenting results from the Dutch Upper Gastrointestinal Cancer Audit. For this retrospective national cohort study, patients with esophageal carcinoma who underwent esophagectomy between 2011 and 2016 were included. The primary outcome was the number of retrieved LNs. Univariable and multivariable regression analyses were used to test for association with ≥ 15 LNs. 3970 patients were included. Between 2011 and 2016, the median number of LNs increased from 15 to 20. Factors independently associated with ≥ 15 LNs were: 0-10 kg preoperative weight loss (versus: unknown weight loss, odds ratio [95% confidence interval]: 0.71 [0.57-0.88]), Charlson score 0 (versus: Charlson score 2: 0.76 [0.63-0.92]), cN2 category (reference: cN0, 1.32 [1.05-1.65]), no neoadjuvant therapy and neoadjuvant chemotherapy (reference: neoadjuvant chemoradiotherapy, 1.73 [1.29-2.32] and 2.15 [1.54-3.01]), minimally invasive transthoracic (reference: open transthoracic, 1.46 [1.15-1.85]), open transthoracic (versus open and minimally invasive transhiatal, 0.29 [0.23-0.36] and 0.43 [0.32-0.59]), hospital volume of 26-50 or > 50 resections/year (reference: 0-25, 1.94 [1.55-2.42] and 3.01 [2.36-3.83]), and year of surgery [reference: 2011, odds ratios (ORs) 1.48, 1.53, 2.28, 2.44, 2.54]. There was no association of ≥ 15 LNs with short-term outcomes. The number of LNs retrieved increased between 2011 and 2016. Weight loss, Charlson score, cN category, neoadjuvant therapy, surgical approach, year of resection, and hospital volume were all associated with increased LN yield. Retrieval of ≥ 15 LNs was not associated

  5. Diet Quality of Cancer Survivors and Non-Cancer Individuals: Results from a National Survey

    Science.gov (United States)

    Zhang, Fang Fang; Liu, Shanshan; John, Esther; Must, Aviva; Demark-Wahnefried, Wendy

    2015-01-01

    Background Patterns of poor nutritional intake may exacerbate elevated morbidity experienced by cancer survivors. It remains unclear whether cancer survivors adhere to existing dietary guidelines, and whether survivors’ diet differs from individuals without cancer long-term. Methods We evaluated dietary intake and quality in 1,533 adult cancer survivors in the National Health and Nutrition Examination Survey (NHANES) 1999–2010 and compared that to 3,075 individuals without a history of cancer who were matched to cancer survivors by age, gender, and race/ethnicity. Dietary intake was assessed using 24-hour dietary recalls. The Healthy Eating Index (HEI)-2010 was used to evaluate diet quality. Results The mean HEI-2010 total score was 47.2 (SD=0.5) in cancer survivors and 48.3 (SD=0.4) in non-cancer individuals (p=0.03). Compared to non-cancer individuals, cancer survivors had a significantly lower score of empty calories (13.6 vs. 14.4, p=0.001), which corresponds to worse adherence to dietary intake of calories from solid fats, alcohol and added sugars. Cancer survivors also had a significantly lower dietary intake of fiber than non-cancer individuals (15.0 vs. 15.9 grams/day, p=0.02). Survivors’ mean dietary intakes of vitamin D, vitamin E, potassium, fiber, and calcium were 31%, 47%, 55%, 60%, and 73% in relation to the recommended intake whereas the mean dietary intake of saturated fat and sodium was 112% and 133% of the recommended intake. Conclusions Cancer survivors had a poor adherence to the 2010 Dietary Guidelines for Americans, and their intake patterns were worse than those in the general population for empty calories and fiber. PMID:26624564

  6. Relationship between gender in the board of directors and the audit committee with the audit delay

    Directory of Open Access Journals (Sweden)

    Luis Antonio Lay

    2017-12-01

    Full Text Available The study verified the relationship between the gender in the composition of the board of directors and the audit committee with the audit delay. The survey sample consisted of 75 companies belonging to the IBrX 100 index. The variables surveyed were the presence of women on the board of directors and on the audit committee, size of the audit committee, independence of the board of directors, expertise, company size, debt, size of the audit firm and audit fees. Data collection took place in the Reference Form and the Economática® database. Data analysis was performed using descriptive statistics and multiple linear regression using SPSS® software. It was found that the presence of women is greater on the board than on the audit committee, with a small number of experienced members. The results showed that the presence of women on the audit committee has a negative and significant association with the audit delay, that is, the presence of women in this organism of corporate governance contributes to the reduction of the period of disclosure of the auditor's report. In addition, the size of the company and the independence of the board of directors were also important in the final model in relation to the audit delay. The presence of women on the board of directors was not significant with the delay in the audit.

  7. Internal audit function: a comparison between private and public sector in Nigeria

    OpenAIRE

    Madawaki Abdulkadir; Ahmi Aidi; Nasibah Ahmad Halimah

    2017-01-01

    This study compares the internal audit functions between private and the public sector. Features examined include hierarchical rank of internal audit function, internal audit transfer, outsourcing of internal audit services and working relationship of internal audit with external auditor. The study is based on a survey of internal audit managers and chief internal auditors in private and public sector entities in Nigeria. The results revealed that there is no much difference in hierarchical r...

  8. Aspects of audit. 4: Acceptability of audit.

    OpenAIRE

    Shaw, C D

    1980-01-01

    Whether or not audit is accepted in Britain will be determined principally by how it is controlled, how much it costs, and how effective it is. The objectives of audit have been defined as education, planning, evaluation, research, and anticipatory diplomacy--that is, starting internal audit before external audit is imposed on the medical profession. Published reports suggest that in Britain internal audit would be more effective andless expensive than the complex professional standards revie...

  9. AUDIT BISNIS

    Directory of Open Access Journals (Sweden)

    Yulius Jogi Cristiawan

    1999-01-01

    Full Text Available The purpose of financial audit is to give opinion that the financial statement present fairly, in all material respect, the financial position, the result of operation and cash flow in conformity with generally accepted accounting principles. In this case, the focus of financial audit is financial statement. A Independent Auditor do not consider that the financial statement is the reflections of company business transaction that result from accounting process. In the accounting process, the distorsion information could be happened in business transaction. For examples the finished good must be presented at historical cost at financial statement, but if, the competitor could sell with the lower price or there are any substitutes, its presentation must be adjusted. A financial statement could not present the information about the competitors. Hence the auditor must be understand all aspects of client business. A conceptual framework for understanding client business will be presented in this article. Abstract in Bahasa Indonesia : Audit atas Laporan Keuangan (Financial Audit bertujuan untuk memberikan pendapat apakah laporan keuangan suatu entitas menyajikan sejara wajar atau tidak posisi keuangan, hasil operasi dan arus kas sesuai dengan prinsip akuntansi yang berlaku umum. Disini jelas terlihat bahwa fokus audit adalah laporan keuangan. Auditor lupa bahwa laporan keuangan merupakan suatu laporan transaksi bisnis perusahaan yang telah mengalami proses akuntansi (dengan suatu asumsi-asumsi tertentu sehingga menjadi laporan keuangan. Selama proses akuntansi tersebut suatu transaksi bisnis kadang mengalami distorsi informasi. Contoh: suatu persediaan barang jadi yang secara fisik masih baik akan dilaporkan di dalam laporan keuangan sebesar cost-nya, tetapi kalau secara bisnis bisa dibuktikan bahwa atas barang tersebut pesaing bisa menjual barang dengan harga lebih murah atau telah ada barang pengganti maka atas barang tersebut harus disesuaikan

  10. 48 CFR 842.101 - Contract audit responsibilities.

    Science.gov (United States)

    2010-10-01

    ... CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contract Audit Services 842.101 Contract audit responsibilities. (a) Contracting officers may use the support services of other agencies to the extent feasible. Examples of such services include: pre-award surveys; quality assurance and technical...

  11. Mass survey of lung cancer in atomic bomb survivors

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Itoh, Chikako; Mitsuyama, Toyofumi; Mishima, Yasuhiro; Ohmura, Toshio.

    1980-01-01

    Mass survey of lung cancer was performed only by questionnaire together with general health examinations of a-bomb survivors during 3 years between April 1976 and March 1979, and the following results were obtained. The number of men aged more than 40 years old who had questionnaire was 89,778, and those who were required to have detailed examinations because they had bloody sputum and paroxysmal cough + a history of smoking were 1,453. Out of them, 861 a-bomb survivors had detailed examinations. The performance rate of detailed examinations was 59.3%. Lung cancer was found in 23 a-bomb survivors. The discovery rate was 25.6 per 100,000 persons, and it was a little higher than discovery rates reported by many researchers. It was low in men aged more than 40 years old. There was a straight line relationship between logarithm values of the discovery rate of lung cancer and age, and the discovery rate increased markedly with aging. Cytodiagnosis of sputum by Saccomanno method showed a positive test which was 20% higher than that by 3 days serial smear method. To discover lung cancer at an early stage, it is advisable to perform the first screening by chest x-ray examination and questionnaire on men aged over 40 years old, and to perform cytodiagnosis by Saccomanno method on men who were required to have detailed examinations. (Tsunoda, M.)

  12. Addressing information needs to reduce the audit expectation gap : Evidence from Dutch bankers, audited companies and auditors

    NARCIS (Netherlands)

    Litjens, Robin

    2015-01-01

    This study examines what the impact is of frequently proposed information needs on reducing the audit expectations gap (AEG), including information about the audited company, information about the audit process and changes to the auditors' report. We base our findings on a survey of 302 participants

  13. Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data.

    Science.gov (United States)

    Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

    2015-02-17

    For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of

  14. Audit of the introduction of CT colonography for detection of colorectal carcinoma in a non-academic environment and its implications for the national bowel cancer screening programme

    International Nuclear Information System (INIS)

    Thomas, S.; Atchley, J.; Higginson, A.

    2009-01-01

    Aim: To compare the sensitivity of double-contrast barium enema (DCBE) with computed tomography colonography (CTC) to determine whether CTC is superior for the detection of colorectal cancer (CRC) locally, and to compare the results to those of a national barium enema audit. Materials and methods: All patients undergoing diagnostic DCBE or CTC between January 2003 and December 2005 were identified from the picture archiving communication system (PACS). Patients with a confirmed diagnosis of CRC were identified from the local cancer registry. Patients who were not diagnosed as having CRC on imaging were assumed true negatives if they were not listed in the cancer registry by December 2007, giving a minimum of 2 years follow-up. DCBE and CTC reports of all patients with CRC were analysed, and cancer detection was considered to have occurred (positive test result) if the report stated the definite presence of CRC or possible CRC requiring further investigation. Results: 2520 DCBEs and 604 CTCs were included. Twenty-one of 33 patients with CRC were detected using DCBE (incidence 1.31%, sensitivity 63.7%). Thirty-two of 33 patients with CRC were -detected using CTC (incidence 5.46%, sensitivity 97.7%). Conclusion: CTC is more sensitive for the detection of CRC, and its introduction in a district general hospital is justified. However, there has been a consequent decline in DCBE sensitivity, which, if reflected nationally, suggests CTC is the preferential screening test for CRC

  15. Audit of the introduction of CT colonography for detection of colorectal carcinoma in a non-academic environment and its implications for the national bowel cancer screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, S. [Department of Radiology, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO3 6AD (United Kingdom)], E-mail: Susan.Thomas@porthosp.nhs.uk; Atchley, J.; Higginson, A. [Department of Radiology, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO3 6AD (United Kingdom)

    2009-02-15

    Aim: To compare the sensitivity of double-contrast barium enema (DCBE) with computed tomography colonography (CTC) to determine whether CTC is superior for the detection of colorectal cancer (CRC) locally, and to compare the results to those of a national barium enema audit. Materials and methods: All patients undergoing diagnostic DCBE or CTC between January 2003 and December 2005 were identified from the picture archiving communication system (PACS). Patients with a confirmed diagnosis of CRC were identified from the local cancer registry. Patients who were not diagnosed as having CRC on imaging were assumed true negatives if they were not listed in the cancer registry by December 2007, giving a minimum of 2 years follow-up. DCBE and CTC reports of all patients with CRC were analysed, and cancer detection was considered to have occurred (positive test result) if the report stated the definite presence of CRC or possible CRC requiring further investigation. Results: 2520 DCBEs and 604 CTCs were included. Twenty-one of 33 patients with CRC were detected using DCBE (incidence 1.31%, sensitivity 63.7%). Thirty-two of 33 patients with CRC were -detected using CTC (incidence 5.46%, sensitivity 97.7%). Conclusion: CTC is more sensitive for the detection of CRC, and its introduction in a district general hospital is justified. However, there has been a consequent decline in DCBE sensitivity, which, if reflected nationally, suggests CTC is the preferential screening test for CRC.

  16. The dutch national clinical audit for lung cancer: A tool to improve clinical practice? An analysis of unforeseen ipsilateral mediastinal lymph node involvement in the Dutch Lung Surgery Audit (DLSA).

    Science.gov (United States)

    Heineman, David Jonathan; Beck, Naomi; Wouters, Michael Wilhelmus; van Brakel, Thomas Jan; Daniels, Johannes Marlene; Schreurs, Wilhelmina Hendrika; Dickhoff, Chris

    2018-06-01

    Optimal treatment selection for patients with non-small cell lung cancer (NSCLC) depends on the clinical stage of the disease. Particularly patients with mediastinal lymph node involvement (stage IIIA-N2) should be identified since they generally do not benefit from upfront surgery. Although the standardized preoperative use of PET-CT, EUS/EBUS and/or mediastinoscopy identifies most patients with mediastinal lymph node metastasis, a proportion of these patients is only diagnosed after surgery. The objective of this study was to identify all patients with unforeseen N2 disease after surgical resection for NSCLC in a large nationwide database and to evaluate the preoperative clinical staging process. Data was derived from the Dutch Lung Surgery Audit. Patients with pathological stage IIIA NSCLC after an anatomical resection between 2013 and 2015 were evaluated. Clinical and pathological TNM-stage were compared and an analysis was performed on the diagnostic work-up of patients with unforeseen N2 disease. From 3585 patients undergoing surgery for NSCLC between 2013 and 2015, a total of 527 patients with pathological stage IIIA NSCLC were included. Of all 527 patients, 254 patients were upstaged from a clinical N0 (n = 186) or N1 (n = 68) disease to a pathological N2 disease (7.1% unforeseen N2). In these 254 patients, 18 endoscopic ultrasounds, 62 endobronchial ultrasounds and 67 mediastinoscopies were performed preoperatively. In real world clinical practice in The Netherlands, the percentage of unforeseen N2 disease in patients undergoing surgery for NSCLC is seven percent. To further reduce this percentage, optimization of the standardized preoperative workup is necessary. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  17. AUDIT INFORMATION CONTENT

    OpenAIRE

    Ioan Rus

    2012-01-01

    The audit of computer systems shows at least two features that make the auditwork not includable in other audit processes such as internal audit and financial audit. Thesetwo particularities refer to the specific software used in information systems auditing and reallevels of information systems audit. This paper presents the specific levels of a system ofauditing and specific techniques available for their implementation in practice. In the end theauthor suggests proposals for improving spec...

  18. Experiences of using the GMP audit preparation tool in pharmaceutical contract manufacturer audits.

    Science.gov (United States)

    Linna, Anu; Korhonen, Mirka; Airaksinen, Marja; Juppo, Anne Mari

    2010-06-01

    Use of external contractors is nowadays inevitable in the pharmaceutical industry. Therefore the amount of current good manufacturing practice audits has been increasing. During the audit, a large amount of items should be covered in a limited amount of time. Consequently, pharmaceutical companies should have systematic and effective ways to manage and prepare for the audits. This study is a continuation to the earlier study, where a tool for the preparation of cGMP audit was developed and its content was validated. The objective of this study was to evaluate the usefulness of the developed tool in audit preparation and during the actual cGMP audit. Three qualitative research methods were used in this study (observation, interviews, and opinion survey). First, the validity of the information given through the tool was examined by comparing the responses to the actual conditions observed during the contract manufacturer audits (n = 15). Additionally the opinions of the contract manufacturers of the tool were gathered (n = 10) and the auditors were interviewed (n = 2). The developed tool was proven to be useful in audit preparation phase from both the auditor's and the contract manufacturers' point of view. Furthermore, using the tool can also save some time when performing the audit. The results show that using the tool can give significant support in audit preparation phase and also during the actual audit.

  19. An audit of current practice and management of metastatic spinal cord compression at a regional cancer centre.

    LENUS (Irish Health Repository)

    Sui, J

    2012-02-01

    Metastatic spinal cord compression (MSCC) is an oncological emergency requiring prompt recognition and management to preserve neurological function and mobility. We performed an audit to assess current practice of MSCC against current best practice as outlined by NICE. Our retrospective audit identified 10 patients from January to December 2009 with confirmed MSCC. The most common primary tumours were prostate 3 (30%), breast 3 (30%) and lung 2 (20%). Pain was the main presenting symptom 9 (90%), followed by weakness 7 (70%) and sensory changes 1 (10%). 5 (50%) had MRI within 24 hours and only 6 (60%) underwent full MRI scan. 8 (80%) had corticosteroids before MRI scan. 6 (60%) received radiotherapy within 24 hours. Only 4 (40%) were referred to orthopaedics and none of these patients had been recommended surgery. Up 14 days following radiological confirmation of MSCC, the number of patients who were unable to walk increased by 20%. Only 5 (50%) were discharged during this period of study. Our audit reported a number of variances in management compared to NICE guideline. These can be improved by following a\\'fast track\\' referral pathway and regular education for junior doctors and primary care doctors.

  20. Alternative Auditing Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Kandt, Alicen J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-15

    This presentation for the 2017 Energy Exchange in Tampa, Florida, offers information about advanced auditing technologies and techniques including alternative auditing approaches and considerations and caveats.

  1. Performing of quality audits

    International Nuclear Information System (INIS)

    Rausch, W.P.

    1980-01-01

    A discussion of the need for Quality Audits both from the practical and regulatory point of view will be followed by presentation of the required steps of audit preparation, auditor assignment, checklist development, review of prior audits, notification, logistics, etc. The various examination steps of auditing, including pre-audit conference, checklist usage, interview, and objective evidence review, will be discussed as will the techniques used in finding development, post audit conference, audit report writing, and follow-up. An overview of organization for auditing, including training and certification, will be presented. (RW)

  2. Presentations to general practice before a cancer diagnosis in Victoria: a cross-sectional survey

    OpenAIRE

    Lacey, K; Bishop, JF; Cross, HL; Chondros, P; Lyratzopoulos, Georgios; Emery, JD

    2016-01-01

    OBJECTIVE: To assess variations in the number of general practitioner visits preceding a cancer diagnosis, and in the length of the interval between the patient first suspecting a problem and their seeing a hospital specialist. DESIGN, SETTING AND PARTICIPANTS: Analysis of data provided to the Cancer Patient Experience Survey (CPES; survey response rate, 37.7%) by 1552 patients with one of 19 cancer types and treated in one of five Victorian Comprehensive Cancer Centre hospitals, 1 October 20...

  3. Senior Audit Manager | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Responsible for ongoing quality review on audit projects: ... Functions and activities are adequately surveyed to identify risks, determine the nature of operations and the adequacy of the system of control to achieve established objectives; ...

  4. A Quebec survey of issues in cancer pain management.

    Science.gov (United States)

    MacDonald, Neil; Ayoub, Joseph; Farley, Justine; Foucault, Claudette; Lesage, Pauline; Mayo, Nancy

    2002-01-01

    We report the results of a cancer pain survey mailed to Quebec hematologist-oncologists and palliative care physicians in 1999. The survey was designed to sample views on the current status of pain management and on obstacles to the provision of adequate pain relief for patients. The survey, formulated by an ethics network centered at the Clinical Research Institute of Montreal, was distributed to all members of the Association of Hematologist-Oncologists of Quebec and to all physician members of the Quebec Palliative Care Association. Responses were obtained from 138 Palliative Care Association members (response rate 61%) and 76 hematologist-oncologists (response rate 45%). Major obstacles reported included inadequate assessment of both contributory psychosocial issues and severity of pain, patient reluctance to take opioids, and inadequate access to non-drug techniques for pain relief. Access to opioids was not regarded as a problem. Both groups felt generally competent in their ability to manage various aspects of cancer pain therapy. They gave little credit to their formal medical school or residency training. Fifty-six percent of the palliative care group and 57% of the hemato-oncologists rated their medical school experience as only "poor" or "fair" on a 4-point scale. Residency ratings were modestly better. We conclude that medical faculties should assign a high priority to teaching health professionals patient assessment techniques. Simple symptom assessment scales should be routinely used in oncology/palliative care practice. Medical school training in pain management is not highly regarded and should be enhanced. We also note that, based on response to the scenario of a patient presenting with severe pain, many physicians, while feeling competent in the use of opioids, may be overly conservative in their initial use.

  5. 78 FR 55264 - Submission for OMB Review; 30-Day Comment Request: Awareness and Beliefs About Cancer Survey...

    Science.gov (United States)

    2013-09-10

    ...; 30-Day Comment Request: Awareness and Beliefs About Cancer Survey, National Cancer Institute (NCI.... Proposed Collection: Awareness and Beliefs about Cancer Survey, 0925-NEW, National Cancer Institute (NCI... gather data about American adults' awareness and beliefs about cancer. The ultimate goal is to determine...

  6. The Internal Audit Outsourcing

    Directory of Open Access Journals (Sweden)

    Grzegorz Gołębiowski

    2010-06-01

    Full Text Available The article explores an issue of the internal audit outsourcing. It indicates the differences between internal audit, outsourcing and cosourcing of this service as well as their advantages and disadvantages. Drawing from the research on internal audit outsourcing the recent market trends were identified as well as motivations for choosing different forms of internal auditing.

  7. Auditing hazardous waste incineration

    International Nuclear Information System (INIS)

    Jayanty, R.K.M.; Allen, J.M.; Sokol, C.K.; von Lehmden, D.J.

    1990-01-01

    This paper reports that audit standards consisting of volatile and semivoltile organics have been established by the EPA to be provided to federal, state, and local agencies or their contractors for use in performance audits to assess the accuracy of measurement methods used during hazardous waste trial burns. The volatile organic audit standards currently total 29 gaseous organics in 5, 6, 7, 9, and 18-component mixtures at part-per-billion (ppb) levels (1 to 10 000 ppb) in compressed gas cylinders in a balance gas of nitrogen. The semivoltile organic audit standards currently total six organics which are spiked onto XAD-2 cartridges for auditing analysis procedures. Studies of all organic standards have been performed to determine the stability of the compounds and the feasibility of using them as performance audit materials. Results as of July 1987 indicate that all of the selected organic compounds are adequately stabile for use as reliable audit materials. Performance audits have been conducted with the audit materials to assess the accuracy of the measurement methods. To date, 160 performance audits have been initiated with the ppb-level audit gases. The audit results obtained with audit gases during hazardous waste trial burn tests were generally within ±50% of the audit concentrations. A limited number of audit results have been obtained with spiked XAD-2 cartridges, and the results have generally been within ±35% of the audit concentrations

  8. Features partnership in auditing

    Directory of Open Access Journals (Sweden)

    V.P. Bondar

    2015-06-01

    Full Text Available The notion of «institution partnerships in the audit» and its importance in Ukraine. Done overview of international experience in the Institute of partnerships in the audit business. Determined the nature of the audit, rights, duties and powers of the partnership during the audit. Done distribution of functions between the partner and the engagement partner in the synthesis of these blocks: taking on a new customer service or continued cooperation with existing customers (clients; familiarization with activities of customer audits, including an understanding of its internal control system; identification and assessment of risks of material misstatement of accounting; audit process and the audit and the formation of the final judgment. On the basis of the distribution of functions between the partner and the engagement partner, defined the overall structure of management system auditing firm. These conditions for implementation of partnerships in the audit business, and identified a number of advantages and disadvantages of partnerships for auditing.

  9. [Screening for colorectal cancer in Italy, 2010 survey].

    Science.gov (United States)

    Zorzi, Manuel; Fedato, Chiara; Grazzini, Grazia; Sassoli de' Bianchi, Priscilla; Naldoni, Carlo; Pendenza, Melania; Sassatelli, Romano; Senore, Carlo; Visioli, Carmen Beatriz; Zappa, Marco

    2012-01-01

    We present the main results of the 2010 survey of the Italian screening programmes for colorectal cancer carried out by the National centre for screening monitoring (Osservatorio nazionale screening, ONS) on behalf of the Ministry of health. By the end of 2010, 105 programmes were active, 9 of which had been activated during the year, and 65% of Italians aged 50-69 years were residing in areas covered by organised screening programmes (theoretical extension). Twelve regions had their whole population covered. In the South of Italy and Islands, 5 new programmes were activated in 2010, with a theoretical extension of 29%. The majority of programmes employed the faecal occult blood test (FIT), while some adopted flexible sigmoidoscopy (FS) once in a lifetime and FIT for non-responders to FS. Overall, about 3,404,000 subjects were invited to undergo FIT, 47.2% of those to be invited within the year. The adjusted attendance rate was 48% and approximately 1,568,796 subjects were screened. Large differences in the attendance rate were observed among regions: 10% of programmes reported values lower than 24%. Positivity rate of FIT programmes was 5.5% at first screening (range: 1.6-11.3%) and 4.3% at repeat screening (range: 3.2-6.7%). The average attendance rate to total colonoscopy (TC) was 81.4% and in one region it was lower than 70%. Completion rate for total colonoscopy (TC) was 88.7%. Among the 740,281 subjects attending screening for the first time, the detection rate (DR) per 1,000 screened subjects was 2.4 for invasive cancer and 10.3 for advanced adenomas (AA - adenomas with a diameter ≥1 cm, with villous/tubulo-villous type or with high-grade dysplasia). As expected, the corresponding figures in the 843,204 subjects at repeat screening were lower (1.2‰ and 7.6‰ for invasive cancer and AA, respectively). The DR of cancer and adenomas increased with age and was higher among males. Many programmes reported some difficulties in guaranteeing TC in the

  10. Quality Audits In Radiotherapy. Chapter 20

    International Nuclear Information System (INIS)

    Izewska, J.

    2017-01-01

    It is widely recognized that quality audits constitute a vital component of quality management in radiotherapy [20.1–20.3]. The main reason why quality audits are considered an important activity is that they help to review the quality of radiotherapy services and improve them. Quality audits check whether radiotherapy practices are adequate, i.e. that what should be done is being done; and in case it is not, audits provide recommendations to encourage improvements to be made. Without some form of auditing, it would be difficult to determine whether radiotherapy services are safe and effective for cancer treatment. In other words, a quality audit in radiotherapy is a method of reviewing whether the quality of activities in a radiotherapy department adheres to the standards of good practices to ensure that the treatment to the cancer patient is optimal. Overall, audits lead to improvements of professional practices and the general quality of services delivered. There are many recommendations regarding quality in radiotherapy practice, both national and international. Practices vary depending on the economic level of States, including specific procedures, equipment and facilities, as well as available resources. Good practices evolve with research developments, including new clinical trial results, progress in evidence based medicine and developments in radiotherapy technology. Quality audits involve the process of fact finding and comparing the findings against criteria for good practices in radiotherapy. Various issues and gaps may be identified by the auditors in the audit process, for example insufficiencies in structure, inadequacies in technology or deviations in procedures. This way the weak points or areas of concern are documented and recommendations for the audited centre are formulated that address these areas with the purpose of improving quality.

  11. Auditing Quality in China

    OpenAIRE

    Ding, Shengyan

    2012-01-01

    In the research area of Chinese auditing market, few studies have been conducted on the effects that auditor-related characteristics have on auditing quality. Thus, the paper is to examine the influences auditor-related attributes have on auditing quality, including size of the auditing firm, its income, and whether it is Big 4 or not. In addition to that, research topic on relationship between relationship between market concentration level and auditing quality is also an attractive one amon...

  12. Audits of oncology units – an effective and pragmatic approach

    Directory of Open Access Journals (Sweden)

    Raymond Pierre Abratt

    2017-06-01

    Full Text Available Background. Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. Objective. To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. Methods. Staff in oncology units who were part of the audit process completed the audit self-assessment form for the unit. This was followed by a visit to each unit by an assessor, and then subsequent personal contact, usually via telephone. The audit self-assessment document listed quality-assurance measures or items in the physical and functional areas of the oncology unit. There were a total of 153 items included in the audit. The online survey took place in October 2016. The invitation to participate was sent to 59 oncology units at which staff members had completed the audit process. Results. The online survey was completed by 54 (41% of the 132 potential respondents. The online survey found that the audit was very or extremely useful in maintaining personal professional standards in 89% of responses. The audit process and feedback was rated as very or extremely satisfactory in 80% and 81%, respectively. The self-assessment audit document was scored by survey respondents as very or extremely practical in 63% of responses. The feedback on the audit was that it was very or extremely helpful in formulating improvement plans in oncology units in 82% of responses. Major and minor changes that occurred as a result of the audit process were reported as 8% and 88%, respectively. Conclusion. The survey findings show that the audit process and its self- assessment document meet the aims of being helpful and pragmatic.

  13. THE EFFECT OF FUNCTIONAL TRAINING, INTEGRITY, COMPETENCY AND ORGANIZATIONAL COMMITMENT OF QUALITY AUDIT IN THE AUDIT BOARD OF REPUBLIC INDONESIA

    Directory of Open Access Journals (Sweden)

    Edi Sunyoto

    2017-07-01

    Full Text Available This research investigates about the influence of functional training, integrity, competence and organizational commitment to quality audit. The purpose of this research was to determine the effect of functional training, integrity, competence and organizational commitment to quality audit, in The Audit Board of Republic Indonesia, Jakarta in 2017. The research used survey method quantitative approach with path analysis technique. Methods of survey research using quantitative approach path analysis techniques. The data were collected from 100 auditors as a sample. The sample was selected by simple random sampling from 130 Auditor as population. The results showed there is the significant direct effect functional of training on quality audit; integrity on quality audit; competency on quality audit; organizational commitment on quality audit; functional training, Integrity, and Competence significant direct effect on organizational commitment; functional training and Integrity significant direct effect on the competence; direct effect on the integrity of functional training is significant.

  14. Testing Behavior Change Techniques to Encourage Primary Care Physicians to Access Cancer Screening Audit and Feedback Reports: Protocol for a Factorial Randomized Experiment of Email Content

    Science.gov (United States)

    Witteman, Holly O; Bouck, Zachary; Bravo, Caroline A; Desveaux, Laura; Llovet, Diego; Presseau, Justin; Saragosa, Marianne; Taljaard, Monica; Umar, Shama; Grimshaw, Jeremy M; Tinmouth, Jill; Ivers, Noah M

    2018-01-01

    Background Cancer Care Ontario’s Screening Activity Report (SAR) is an online audit and feedback tool designed to help primary care physicians in Ontario, Canada, identify patients who are overdue for cancer screening or have abnormal results requiring follow-up. Use of the SAR is associated with increased screening rates. To encourage SAR use, Cancer Care Ontario sends monthly emails to registered primary care physicians announcing that updated data are available. However, analytics reveal that 50% of email recipients do not open the email and less than 7% click the embedded link to log in to their report. Objective The goal of the study is to determine whether rewritten emails result in increased log-ins. This manuscript describes how different user- and theory-informed messages intended to improve the impact of the monthly emails will be experimentally tested and how a process evaluation will explore why and how any effects observed were (or were not) achieved. Methods A user-centered approach was used to rewrite the content of the monthly email, including messages operationalizing 3 behavior change techniques: anticipated regret, material incentive (behavior), and problem solving. A pragmatic, 2x2x2 factorial experiment within a multiphase optimization strategy will test the redesigned emails with an embedded qualitative process evaluation to understand how and why the emails may or may not have worked. Trial outcomes will be ascertained using routinely collected administrative data. Physicians will be recruited for semistructured interviews using convenience and snowball sampling. Results As of April 2017, 5576 primary care physicians across the province of Ontario, Canada, had voluntarily registered for the SAR, and in so doing, signed up to receive the monthly email updates. From May to August 2017 participants received the redesigned monthly emails with content specific to their allocated experimental condition prompting use of the SAR. We have not yet

  15. Testing Behavior Change Techniques to Encourage Primary Care Physicians to Access Cancer Screening Audit and Feedback Reports: Protocol for a Factorial Randomized Experiment of Email Content.

    Science.gov (United States)

    Vaisson, Gratianne; Witteman, Holly O; Bouck, Zachary; Bravo, Caroline A; Desveaux, Laura; Llovet, Diego; Presseau, Justin; Saragosa, Marianne; Taljaard, Monica; Umar, Shama; Grimshaw, Jeremy M; Tinmouth, Jill; Ivers, Noah M

    2018-02-16

    Cancer Care Ontario's Screening Activity Report (SAR) is an online audit and feedback tool designed to help primary care physicians in Ontario, Canada, identify patients who are overdue for cancer screening or have abnormal results requiring follow-up. Use of the SAR is associated with increased screening rates. To encourage SAR use, Cancer Care Ontario sends monthly emails to registered primary care physicians announcing that updated data are available. However, analytics reveal that 50% of email recipients do not open the email and less than 7% click the embedded link to log in to their report. The goal of the study is to determine whether rewritten emails result in increased log-ins. This manuscript describes how different user- and theory-informed messages intended to improve the impact of the monthly emails will be experimentally tested and how a process evaluation will explore why and how any effects observed were (or were not) achieved. A user-centered approach was used to rewrite the content of the monthly email, including messages operationalizing 3 behavior change techniques: anticipated regret, material incentive (behavior), and problem solving. A pragmatic, 2x2x2 factorial experiment within a multiphase optimization strategy will test the redesigned emails with an embedded qualitative process evaluation to understand how and why the emails may or may not have worked. Trial outcomes will be ascertained using routinely collected administrative data. Physicians will be recruited for semistructured interviews using convenience and snowball sampling. As of April 2017, 5576 primary care physicians across the province of Ontario, Canada, had voluntarily registered for the SAR, and in so doing, signed up to receive the monthly email updates. From May to August 2017 participants received the redesigned monthly emails with content specific to their allocated experimental condition prompting use of the SAR. We have not yet begun analyses. This study will inform

  16. Trends and priorities in internal audit

    Directory of Open Access Journals (Sweden)

    Victoria STANCIU

    2016-09-01

    Full Text Available The status of the internal audit as an important pillar for corporate governance is recognized unanimously; however, this status is gained through a continuous and joined effort of all internal auditors and by a clear and solid vision of the internal audit function’s development, designed by the chief of internal audit. This status recognizes the internal audit’s support for the achievement of company objectives and the improvement of risk management and it also requires continuous quantitative accumulations in the work of internal auditors. From this perspective, the author’s attention focused on the main risks and priorities that the internal audit is facing as they are reflected by international studies and surveys. The conclusions emphasized by the author’s research may be considered important milestones for the improvement of the internal audit function in Romania and for its solid connection to the realities and problems the companies are confronting with.

  17. A Survey of the Role of Audit Committees in Promoting Corporate Governance and Accountability in Constituency Development Fund Management: A Case Study of Nairobi Province, Kenya

    Directory of Open Access Journals (Sweden)

    Samuel Kakui Kilika

    2013-07-01

    Full Text Available The purpose of thisstudy is to present a case for the need for audit committee in Constituency DevelopmentFund to promote corporate governance and accountability in constituencydevelopment fund management in Nairobi Province, Kenya. The study provides ananalysis and critique of the extent of engagement research in the field ofcorporate governance and accountability in constituency Development Fundmanagement and present case for further research that may be directed tooutside Nairobi province. The study found that the extent of literature in thefield of corporate governance and accountability and reporting in contrast tothe field to management CDF in Nairobi had largely ignored the practice withinCDF organizations.  The study argues thatCDF can benefit from the methodological and theoretical insights of auditcommittee and other disciplines. The study suggests where further contributionsmight be made by future research endeavors engaging with audit committees withorganizations. Engaging audit committee in CDF governance and accountabilityhas the potential to improve theorizing practice and the sustainabilityperformance with organizations. Drawing on the methods and theories of otherdisciplines and the papers in the special issues (of audit committee the studypresents away forward for researchers engaging with audit committees in organizationalpracticing corporate governance and accountability.

  18. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Contacts Monitoring Prior Approvals Annual Reporting and Auditing Transfer of a Grant Grant Closeout Training Cancer Training ... Contacts Monitoring Prior Approvals Annual Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training ...

  19. Ethical consciousness in auditing : a comparison of students and employees

    OpenAIRE

    Rong, Stine Mari Hilmarsen

    2011-01-01

    The purpose of this thesis has been to examine the difference in the level of consciousness towards ethics in auditing between students and employees, and further examine if the level of ethical consciousness comply with auditing standards. To examine the level of the different groups, a survey was conducted and distributed. The survey ...

  20. The cancer multi-disciplinary team from the co-ordinators’ perspective: results from a national survey in the UK

    Directory of Open Access Journals (Sweden)

    Jalil Rozh

    2012-12-01

    Full Text Available Abstract Background The MDT-Coordinators’ role is relatively new, and as such it is evolving. What is apparent is that the coordinator’s work is pivotal to the effectiveness and efficiency of an MDT. This study aimed to assess the views and needs of MDT-coordinators. Methods Views of MDT-coordinators were evaluated through an online survey that covered their current practice and role, MDT chairing, opinions on how to improve MDT meetings, and coordinators’ educational/training needs. Results 265 coordinators responded to the survey. More than one third of the respondents felt that the job plan does not reflect their actual duties. It was reported that medical members of the MDT always contribute to case discussions. 66.9% of the respondents reported that the MDTs are chaired by Surgeons. The majority reported having training on data management and IT skills but more than 50% reported that they felt further training is needed in areas of Oncology, Anatomy and physiology, audit and research, peer-review, and leadership skills. Conclusions MDT-Coordinators’ role is central to the care of cancer patients. The study reveals areas of training requirements that remain unmet. Improving the resources and training available to MDT-coordinators can give them an opportunity to develop the required additional skills and contribute to improved MDT performance and ultimately cancer care. Finally, this study looks forward to the impact of the recent launch of a new e-learning training programme for MDT coordinators and discusses implications for future research.

  1. Risk factors for anastomotic leakage and leak-related mortality after colonic cancer surgery in a nationwide audit

    NARCIS (Netherlands)

    Bakker, I. S.; Grossmann, I.; Henneman, D.; Havenga, K.; Wiggers, T.

    Background: Surgical resection with restoration of bowel continuity is the cornerstone of treatment for patients with colonic cancer. The aim of this study was to identify risk factors for anastomotic leakage (AL) and subsequent death after colonic cancer surgery. Methods: Data were retrieved from

  2. Probiotic Survey in Cancer Patients Treated in the Outpatient Department in a Comprehensive Cancer Center.

    Science.gov (United States)

    Ciernikova, Sona; Mego, Michal; Semanova, Maria; Wachsmannova, Lenka; Adamcikova, Zuzana; Stevurkova, Viola; Drgona, Lubos; Zajac, Vladimir

    2017-06-01

    Availability without prescription restriction, low cost, and simple oral administration allow cancer patients to use probiotics without knowledge of potential risks. We present a survey of probiotic use and the association with patient tumor characteristics in cancer patients treated at the outpatient department of the National Cancer Institute in Slovakia. Between March and December 2014, 499 patients were asked to evaluate their overall experience with probiotics by questionnaire form, including the length and method of use relative to anticancer therapy, expectations, side-effect experiences, understanding of the possible risks, dietary supplement use, and others. The relevant data were statistically evaluated. The cohort consisted of 323 women (64.7%) and 176 men (35.3%); 91.6% were undergoing chemotherapy (2.6% together with radiotherapy) and 8.4% had no anticancer therapy. The prevalence of probiotic use was 28.5% and only 12 patients using probiotics (8.5%) described negative side effects. Most patients declared consideration of probiotic use based on recommendation from a physician (37.3%) or a pharmacist (14.8%). Nevertheless, up to 86.6% of patients declared no knowledge of possible risks. Statistically significant correlation was found between probiotic use and age of patients (P probiotic use in cancer patients. Minimal knowledge of risks underlines the importance of an active approach by oncologists to inform patients about probiotic safety.

  3. Foley catheter for cervical priming in induction of labour at University Obstetrics Unit, Colombo, Sri Lanka: a clinical audit with a patient satisfaction survey.

    Science.gov (United States)

    Patabendige, M; Jayawardane, A

    2017-04-12

    Intracervical insertion of a Foley catheter (FC) has shown to be a safe, effective and relatively feasible mechanical method of cervical priming in induction of labour (IOL). We evaluated indications, effectiveness, patient acceptability and outcomes of FC use in IOL adhering to the ward protocol in our unit. A clinical audit with a patient satisfaction survey conducted between July and September 2013 in University Obstetric Unit, Colombo, Sri Lanka. Patients selected for IOL for obstetric reasons were primed with Foley as per ward protocol. All had singleton pregnancies with cephalic presentation, intact membranes and period of gestation of 37 weeks or above. Women with a history of more than one caesarean section or uterine surgery, low-lying placenta and fetal growth restriction were excluded. Subjects who had a Modified Bishop Score (MBS) of less than 3, a 16Fr FC was inserted into cervical canal. Catheter was left undisturbed until spontaneous expulsion or no longer than 48 h. In women with MBS of less than 6 at 48 h after FC insertion, 3 mg prostaglandin E2 vaginal tablet was used subsequently. Artificial membrane rupture with or without oxytocin was used if MBS of 6 or more and in women not in labour 24 h after prostaglandins. Patient satisfaction for Foley insertion was assessed with regards to the degree of comfort using a validated visual analogue scale (0-10). There were a total of 910 deliveries during the study period. Fifty-six women were primed with FC. Thirty-two (57%) were nulliparous. During induction of labour, 53(95%) reported mild or no discomfort. MBS of 6 or more was achieved in 36/56 (64%) Foley insertions. Twenty needed further intervention with prostaglandins. FC only group had 5 caesarean sections and 31 vaginal deliveries and Foley/prostaglandin group had 7 caesarean sections and 13 vaginal deliveries. Of the 24 women who were induced due to completion of 41 weeks of gestation with otherwise uncomplicated pregnancies, 17 had MBS >6

  4. E-Commerce Audit Judgment Expertise: Does Expertise in System Change Management and Information Technology Auditing Mediate E-Commerce Audit Judgment Expertise?

    Directory of Open Access Journals (Sweden)

    Jagdish PATHAK

    2010-01-01

    Full Text Available A global survey of 203 E-commerce auditors was conducted to investigate the perceptions about the potential determinants of expertise in E-commerce audits. We hypothesize and find evidence indicating that information technology and communication expertise are positively related to expertise in E-commerce audit judgment. We also find that system change management expertise and information technology audit expertise mediate this relationship.

  5. The effects of audit value added on audit survival: Evidence from CPAs of Thailand

    Directory of Open Access Journals (Sweden)

    Seerungrat Sudsomboon

    2016-03-01

    Full Text Available The purposes of this study are to investigate the relationship between antecedents and consequences of audit value added (AVA. AVA is performance of the auditors who work with dedication and commitment to quality work and usefulness for user. AVA composes three dimensions as well as audit best practice, audit continuous learning, and professional ethic awareness. The results from the questionnaire survey of 135 CPAs in Thailand. The findings identified that only two dimensions of AVA has positive relationship with all consequences as well as audit continuous learning and professional ethic awareness. Which the consequences of this study are financial information transparency, stakeholder acceptance, and audit survival. In addition, the finding shows the relationship between antecedence and audit value added are positive significant. Which the antecedence of this study are Stakeholder pressure, audit regulation change, and business environment climate. Surprisingly, have not significant the relationship between audit best practice that dimensions of audit value added and consequences. The summary of this paper not only provides theoretical and managerial contributions but also suggestions and directions of the future research are elaborate.

  6. From joint to single audits

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2018-01-01

    This study analyses audit quality differences between audits by a single big audit firm and joint audits with either one or two big audit firms. We exploit the unique situation in Denmark beginning on 1 January 2005, at which time a long-standing mandatory joint audit system for listed companies ...

  7. The Future of Audit

    Directory of Open Access Journals (Sweden)

    Danielle Lombardi

    2014-10-01

    Full Text Available The purpose of this study is to discuss the current state and future of auditing. Expert consensus is used as a basis to examine the current state of auditing and generate modifications both needed and likely to occur in the audit profession. This study contributes to the literature by using the Delphi method to develop predictions as to the direction of the audit industry and discuss the implications associated with these predictions. If auditors can better understand where the profession stands and where it is headed, then they can better prepare for the future. Some predictions emerging from this study relative to future audit practices include increasing automation of audit procedures, more predictive financial statements, continuous auditing of financial statements and transactions, and an increasingly global perspective regarding audit activities.

  8. Audit Information Management System

    Data.gov (United States)

    US Agency for International Development — USAID/OIG has initiated its new Audit Information Management System (AIMS) to track OIG's audit recommendations and USAID's management decisions. OIG's in-house...

  9. National Beef Quality Audit-2000: survey of targeted cattle and carcass characteristics related to quality, quantity, and value of fed steers and heifers.

    Science.gov (United States)

    McKenna, D R; Roebert, D L; Bates, P K; Schmidt, T B; Hale, D S; Griffin, D B; Savell, J W; Brooks, J C; Morgan, J B; Montgomery, T H; Belk, K E; Smith, G C

    2002-05-01

    The National Beef Quality Audit-2000 was conducted to assess the current status ofthe quality and consistency of U.S. fed steers and heifers. Between May and November 2000, survey teams assessed hide condition (n = 43,415 cattle for color, brands, mud/manure), bruises (n = 43,595 carcasses), offal and carcass condemnation (n = 8,588 cattle), and carcass quality and yield information (n = 9,396 carcasses) in 30 U.S. beef packing plants. Hide colors were black (45.1%), red (31.0%), yellow (8.0%), Holstein (5.7%), gray (4.0%), white (3.2%), brown (1.7%), and brindle (1.3%). Brand frequencies were no (49.3%), one (46.2%), and two or more (4.4%), and brands were located on the butt (36.3%), side (13.7%), and shoulder (3.6%). Most cattle had no (18.0%) or a small amount (55.8%) of mud/manure on their hides, and they had no (77.3%) horns. Most carcasses (53.3%) were not bruised, 30.9% had one bruise, and 15.8% had multiple bruises. Bruise location and incidence were round (14.9%), loin (25.9%), rib (19.4%), chuck (28.2%), and brisket, flank, and plate (11.6%). Condemnation item and incidence were liver (30.3%), lungs (13.8%), tripe (11.6%), heads (6.2%), tongues (7.0%), and carcasses (0.1%). Carcass evaluation revealed these traits and frequencies: steer (67.9%), heifer (31.8%), and bullock (0.3%) sex-classes; dark-cutters (2.3%); A (96.6%), B (2.5%), and C or older (0.9%) overall maturities; and native (90.1%), dairy-type (6.9%), and Bos indicus (3.0%) breed-types. Mean USDA yield grade traits were USDA yield grade (3.0), carcass weight (356.9 kg), adjusted fat thickness (1.2 cm), longissimus muscle area (84.5 cm2), and kidney, pelvic, and heart fat (2.4%). USDA yield grades were Yield Grade 1 (12.2%), Yield Grade 2 (37.4%), Yield Grade 3 (38.6%), Yield Grade 4 (10.4%), and Yield Grade 5 (1.3%). Mean USDA quality grade traits were USDA quality grade (Select85), marbling score (Small23), overall maturity (A66), lean maturity (A65), and skeletal maturity (A67). Marbling

  10. Physical activity and sedentary behavior of cancer survivors and non-cancer individuals: results from a national survey.

    Science.gov (United States)

    Kim, Roy B; Phillips, Allison; Herrick, Kirsten; Helou, Marieka; Rafie, Carlin; Anscher, Mitchell S; Mikkelsen, Ross B; Ning, Yi

    2013-01-01

    Increasing physical activity and decreasing sedentary behavior are associated with a higher quality of life and lower mortality rates for cancer survivors, a growing population group. Studies detailing the behavior of cancer survivors are limited. Therefore, we investigated physical activity and sedentary behavior of cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Participants were those who provided physical activity and sedentary behavior data. Those who were pregnant, physical activity, compared to non-cancer participants. These patterns are similar for breast and prostate cancer survivors, with prostate cancer survivors more likely to engage in physical activity for more than one hour per day (OR = 1.98, 95% CI (1.05, 3.71)). Our findings suggest that cancer survivors tend to have more physical activity, but they are also more likely to engage in sedentary behavior.

  11. Georgia : Accounting and Auditing

    OpenAIRE

    World Bank

    2007-01-01

    This report provides an assessment of accounting, financial reporting and auditing requirements and practices within the enterprise and financial sectors in Georgia. The report uses International Financial Reporting Standards (IFRS), International Standards on Auditing (ISA) and draws on international experience and good practices in the field of accounting and audit regulation, including in ...

  12. Hospital variation and the impact of postoperative complications on the use of perioperative chemo(radio)therapy in resectable gastric cancer. Results from the Dutch Upper GI Cancer Audit.

    Science.gov (United States)

    Schouwenburg, M G; Busweiler, L A D; Beck, N; Henneman, D; Amodio, S; van Berge Henegouwen, M I; Cats, A; van Hillegersberg, R; van Sandick, J W; Wijnhoven, B P L; Wouters, M W J; Nieuwenhuijzen, G A P

    2018-04-01

    Dutch national guidelines on the diagnosis and treatment of gastric cancer recommend the use of perioperative chemotherapy in patients with resectable gastric cancer. However, adjuvant chemotherapy is often not administered. The aim of this study was to evaluate hospital variation on the probability to receive adjuvant chemotherapy and to identify associated factors with special attention to postoperative complications. All patients who received neoadjuvant chemotherapy and underwent an elective surgical resection for stage IB-IVa (M0) gastric adenocarcinoma between 2011 and 2015 were identified from a national database (Dutch Upper GI Cancer Audit). A multivariable linear mixed model was used to evaluate case-mix adjusted hospital variation and to identify factors associated with adjuvant therapy. Of all surgically treated gastric cancer patients who received neoadjuvant chemotherapy (n = 882), 68% received adjuvant chemo(radio)therapy. After adjusting for case-mix and random variation, a large hospital variation in the administration rates for adjuvant was observed (OR range 0.31-7.1). In multivariable analysis, weight loss, a poor health status and failure of neoadjuvant chemotherapy completion were strongly associated with an increased likelihood of adjuvant therapy omission. Patients with severe postoperative complications had a threefold increased likelihood of adjuvant therapy omission (OR 3.07 95% CI 2.04-4.65). Despite national guidelines, considerable hospital variation was observed in the probability of receiving adjuvant chemo(radio)therapy. Postoperative complications were strongly associated with adjuvant chemo(radio)therapy omission, underlining the need to further reduce perioperative morbidity in gastric cancer surgery. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  13. Exploring audit assistants decision to leave the audit profession

    OpenAIRE

    Gertsson, Nellie; Sylvander, Johanna; Broberg, Pernilla; Friberg, Josefine

    2017-01-01

    Purpose - The purpose of this paper is to explore why audit assistants leave the audit profession. By including both the perceptions held by audit assistants that left the audit profession and the perceptions of audit assistants still working in the audit profession, this study aims to explore how determinants of job satisfaction are associated with decisions to leave the audit profession. Design/methodology/approach - To explore the association between determinants of job satisfaction and de...

  14. Are joint audits a proper instrument for increased audit quality?

    OpenAIRE

    Velte, Patrick; Azibi, Jamel

    2015-01-01

    Joint audits are recently controversial discussed to increase audit quality and decrease Audit market concentration in Europe, complementing the existing and future rotation rules by the 8th EC directive. First, this article presents a theoretical foundation of joint audits. In this context, the main influences on low balling are presented. The link between joint audits and audit quality is stillcontroversial. Then, the main results of empirical research on joint audit are focused. A clear po...

  15. A Survey of Cancer Pain Management Knowledge and Attitudes of British Columbian Physicians

    OpenAIRE

    Gallagher, R; Hawley, P; Yeomans, W

    2004-01-01

    INTRODUCTION: There are many potential barriers to adequate cancer pain management, including lack of physician education and prescription monitoring programs. The authors surveyed physicians about their specific knowledge of pain management and the effects of the regulation of opioids on their prescribing practices.METHODS: A questionnaire was mailed out to British Columbia physicians who were likely to encounter cancer patients. The survey asked for physicians' opinions about College of Phy...

  16. Diagnostic delay experienced among gynecological cancer patients: a nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Robinson, Kirstine M; Ottesen, Bent; Christensen, Karl Bang

    2009-01-01

    OBJECTIVE: To examine diagnostic delay among gynecological cancer patients. DESIGN: Nationwide study. SETTING: The cohort comprised all women receiving their first treatment for cervical, endometrial, or ovarian cancer between 1 October 2006 and 1 December 2007 in four of the five centers...... for gynecological cancer surgery in Denmark. SAMPLE: Of the 911 women alive, 648 participated, resulting in a response rate of 71.1%; of these, 30.1% were diagnosed with cervical cancer, 31.0% with endometrial cancer, and 38.9% with ovarian cancer. METHODS: Questionnaire survey. MAIN OUTCOME MEASURES: Diagnostic...... experiencing very long delays. Ovarian cancer patients experienced significantly shorter delays compared with other gynecological cancer patients in all parts of the health care system. CONCLUSIONS: Delays occur in all parts of the diagnostic process, suggesting that a multifaceted approach should be adopted...

  17. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Funding for Cancer Training ... Media Resources Media ...

  18. Stress and Depressive Symptoms in Cancer Survivors and Their Family Members: Korea Community Health Survey, 2012.

    Science.gov (United States)

    Han, Mi Ah

    2017-09-01

    This study examined the prevalence of perceived stress and depressive symptoms in cancer survivors and their family members compared with subjects without cancer and without family members with cancer. The subjects of this cross-sectional study were adults ≥19 years old who participated in the 2012 Korea Community Health Survey. Stress and depressive symptoms in cancer survivors and their family members were assessed and compared to symptoms in control groups by chi-square tests and multiple logistic regression analyses. Of the 6783 cancer survivors, 26.9% and 8.7% reported having stress and depressive symptoms, respectively, and 27.7% and 5.9% of family members of cancer survivors reported having stress and depressive symptoms, respectively. Cancer survivors showed higher adjusted odds ratio (aOR) for stress (aOR = 1.26, 95% confidence interval (CI) = 1.16-1.37) and depressive symptoms (aOR = 1.82, 95% CI = 1.57-2.11) than subjects without cancer history. Family members of cancer survivors showed a higher OR for stress and depressive symptoms than subjects without a family member who survived cancer. Cancer survivors and family members of cancer survivors had more stress and depressive symptoms than controls. Careful management for cancer patients and their family members should include screening for stress and depression to improve mental health associated with cancer survivorship.

  19. Survey of advanced radiation technologies used at designated cancer care hospitals in Japan

    International Nuclear Information System (INIS)

    Shikama, Naoto; Tsujino, Kayoko; Nakamura, Katsumasa; Ishikura, Satoshi

    2014-01-01

    Our survey assessed the use of advanced radiotherapy technologies at the designated cancer care hospitals in Japan, and we identified several issues to be addressed. We collected the data of 397 designated cancer care hospitals, including information on staffing in the department of radiation oncology (e.g. radiation oncologists, medical physicists and radiation therapists), the number of linear accelerators and the implementation of advanced radiotherapy technologies from the Center for Cancer Control and Information Services of the National Cancer Center, Japan. Only 53% prefectural designated cancer care hospitals and 16% regional designated cancer care hospitals have implemented intensity-modulated radiotherapy for head and neck cancers, and 62% prefectural designated cancer care hospitals and 23% regional designated cancer care hospitals use intensity-modulated radiotherapy for prostate cancer. Seventy-four percent prefectural designated cancer care hospitals and 40% regional designated cancer care hospitals employ stereotactic body radiotherapy for lung cancer. Our multivariate analysis of prefectural designated cancer care hospitals which satisfy the institute's qualifications for advanced technologies revealed the number of radiation oncologists (P=0.01) and that of radiation therapists (P=0.003) were significantly correlated with the implementation of intensity-modulated radiotherapy for prostate cancer, and the number of radiation oncologists (P=0.02) was correlated with the implementation of stereotactic body radiotherapy. There was a trend to correlate the number of medical physicists with the implementation of stereotactic body radiotherapy (P=0.07). Only 175 (51%) regional designated cancer care hospitals satisfy the institute's qualification of stereotactic body radiotherapy and 76 (22%) satisfy that of intensity-modulated radiotherapy. Seventeen percent prefectural designated cancer care hospitals and 13% regional designated cancer care hospitals

  20. Creation of Auditing Knowledge:

    DEFF Research Database (Denmark)

    Liempd, Dennis van

      Even though auditing research could play a role in understanding the many challenges that are threatening the profession, and in providing possible solutions, it seems to have failed in adequately doing so. This is for a major part because of a lack of research into auditing's basic assumptions......, and a too one-sided view on the creation of auditing knowledge. The purpose of this paper is to call for more (diverse) research in this area. Earlier calls have been few and far between, and have not resulted in a lot of research. Within the last two decades though, the auditing universe has changed so...... much that high-quality auditing research never has been needed more. By reviewing available literature challenges to the auditing profession are explored, and the creation of knowledge in general and auditing knowledge in particular are discussed with respect to methodological approaches and operative...

  1. Audits Made Simple

    Energy Technology Data Exchange (ETDEWEB)

    Belangia, David Warren [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-04-09

    A company just got notified there is a big external audit coming in 3 months. Getting ready for an audit can be challenging, scary, and full of surprises. This Gold Paper describes a typical audit from notification of the intent to audit through disposition of the final report including Best Practices, Opportunities for Improvement (OFI), and issues that must be fixed. Good preparation can improve the chances of success. Ensuring the auditors understand the environment and requirements is paramount to success. It helps the auditors understand that the enterprise really does think that security is important. Understanding and following a structured process ensures a smooth audit process. Ensuring follow-up on OFIs and issues in a structured fashion will also make the next audit easier. It is important to keep in mind that the auditors will use the previous report as a starting point. Now the only worry is the actual audit and subsequent report and how well the company has done.

  2. Audit mode change, corporate governance

    OpenAIRE

    Limei Cao; Wanfu Li; Limin Zhang

    2015-01-01

    This study investigates changes in audit strategy in China following the introduction of risk-based auditing standards rather than an internal control-based audit mode. Specifically, we examine whether auditors are implementing the risk-based audit mode to evaluate corporate governance before distributing audit resources. The results show that under the internal control-based audit mode, the relationship between audit effort and corporate governance was weak. However, implementation of the ri...

  3. Health survey on cancers about the Tricastin nuclear site; Etude sanitaire sur les cancers autour du site nucleaire du Tricastin

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    This survey aims at describing the health status of the population around the Tricastin site, and more particularly at determining whether there is a difference between death or cancer occurrence frequencies observed around this site with respect to reference frequencies. It does not aim at assessing the health impact of the site industrial installations. Cancer mortality data, cancer diagnosis data, demographic data, child cancer data, data related to hospital stays in relationship with cancer, long duration hospital stay data, and mortality data are used. Several indicators are defined and used: standardised mortality ratio, standardised hospitalisation ratio. Data are also analysed in terms of location, and socio-demographic categories. It appears that there is no specific health situation for the considered area, except for pancreas cancer for women

  4. Cancer Treatment in Patients With HIV Infection and Non-AIDS-Defining Cancers: A Survey of US Oncologists.

    Science.gov (United States)

    Suneja, Gita; Boyer, Matthew; Yehia, Baligh R; Shiels, Meredith S; Engels, Eric A; Bekelman, Justin E; Long, Judith A

    2015-05-01

    HIV-infected individuals with non-AIDS-defining cancers are less likely to receive cancer treatment compared with uninfected individuals. We sought to identify provider-level factors influencing the delivery of oncology care to HIV-infected patients. A survey was mailed to 500 randomly selected US medical and radiation oncologists. The primary outcome was delivery of standard treatment, assessed by responses to three specialty-specific management questions. We used the χ(2) test to evaluate associations between delivery of standard treatment, provider demographics, and perceptions of HIV-infected individuals. Multivariable logistic regression identified associations using factor analysis to combine several correlated survey questions. Our response rate was 60%; 69% of respondents felt that available cancer management guidelines were insufficient for the care of HIV-infected patients with cancer; 45% never or rarely discussed their cancer management plan with an HIV specialist; 20% and 15% of providers were not comfortable discussing cancer treatment adverse effects and prognosis with their HIV-infected patients with cancer, respectively; 79% indicated that they would provide standard cancer treatment to HIV-infected patients. In multivariable analysis, physicians comfortable discussing adverse effects and prognosis were more likely to provide standard cancer treatment (adjusted odds ratio, 1.52; 95% CI, 1.12 to 2.07). Physicians with concerns about toxicity and efficacy of treatment were significantly less likely to provide standard cancer treatment (adjusted odds ratio, 0.67; 95% CI, 0.53 to 0.85). Provider-level factors are associated with delivery of nonstandard cancer treatment to HIV-infected patients. Policy change, provider education, and multidisciplinary collaboration are needed to improve access to cancer treatment. Copyright © 2015 by American Society of Clinical Oncology.

  5. Cancer Patients and the Internet: a Survey Among German Cancer Patients.

    Science.gov (United States)

    Ebel, Marie-Desiree; Stellamanns, Jan; Keinki, Christian; Rudolph, Ivonne; Huebner, Jutta

    2017-09-01

    An increasing number of patients and relatives use the Internet to get additional or initial information about their disease. The aim of the study was to reevaluate the Internet usage among German cancer patients. Using a standardized questionnaire, we did an anonymous survey on patients attending a series of lectures on complementary medicine in 2014. We received 255 questionnaires. Nearly 80 % of the participants stated that they used the Internet to read up information about health or medicine issues. There was no significant difference regarding gender, age, or status (patient, current treatment/former treatment; relatives). Most users use the Internet in order to get additional information after a consultation with a physician (82.2 %). Important qualities from the view of the patient are a trustable source (65.3 %), information from experts (59.6 %), and actual information (52.8 %). There is an increasing number of patients in Germany looking for information in the Internet mostly in the intention of getting additional information. Yet, as the quality of information is heterogeneous, false information may lead to distrust in the doctor or wrong decision-making. Accordingly, organizations working on improving quality of cancer care should engage in conveying comprehensive and actual information adapted to the needs of patients. Physicians should know trustful websites for referral of patients.

  6. Survey of Enteric Pathogens Causing Bacteremia in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Enayatollah Kalantar

    2014-05-01

    Full Text Available Background: Symptomatic bacteraemia, is a frequent condition among cancer patients with a significant morbidity and mortality all over the world. Objectives: The aim of this study was to determine the burden of enteric pathogens causing bacteremia among cancer patients. Patients and Methods: Ten ml blood samples were withdrawn from the cancer patients under aseptic conditions. The blood specimens were added to the blood culture bottles and incubated at 37°C. The bacterial isolates from these samples were identified by routine biochemical reactions. Results: During the study period, 68 blood samples from cancer patients were analyzed for bacteremia. Of these patients, six were female (08/82% and 62 were male (91.18%; with age ranging from under 40 years to 85 years old (mean, 63 years. Gastro-intestinal cancer and cancers of head and neck were the most frequent cancer types in the studied group, accounting for 51 (75% and 15 (22.1% cases, respectively. The mean weight of patients was 69.18 Kg (range: 49-100 Kg. Similarly, the mean length of hospital stay was 8 days (range: 4-12 days. Positive blood cultures were detected in only 12 (17.65% and 11 (91.7% blood specimens from the Cancer Institute, Tehran, compared with one (08.33% from Shahid Kamali hospital, Karaj. From these patients, 15 bacteria were isolated; E. coli alone outnumbered other species and accounted for 33.33% of the episodes of bacteremia. Conclusions: In conclusion, our investigation revealed that cancers of GI tract are the most common cancer types causing bacteremia and also we identified that most common bacteria causing bacteremia in Cancer Institute, Tehran and Shahid Kamali Hospital, Karaj, are E. coli and S. aureus

  7. Inequalities in reported cancer patient experience by socio-demographic characteristic and cancer site: evidence from respondents to the English Cancer Patient Experience Survey.

    Science.gov (United States)

    Saunders, C L; Abel, G A; Lyratzopoulos, G

    2015-01-01

    Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69,086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P patients with cancers treated by the same specialty for five of nine services (P patients with ovarian, multiple myeloma, anal, hepatobiliary and renal cancer reported notably worse experiences than patients with other gynaecological, haematological, gastrointestinal and urological malignancies respectively. Initiatives to improve cancer patient experience across oncology services may be suitably targeted on patients at higher risk of poorer experience. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

  8. Development of dose audits for complex treatment techniques in radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M., E-mail: stefanic@cae.cnea.gov.ar [Centro Regional de Referencia con Patrones Secundarios para Dosimetria - CNEA, Presbitero Juan Gonzalez y Aragon 15, B1802AYA Ezeiza (Argentina)

    2014-08-15

    This work was performed in the frame of a Coordinated Research Project (CRP) with IAEA whose objective was to extend the scope of activities carried out by national TLD-based networks from dosimetry audit for rectangular radiation fields to irregular and small fields relevant to modern radiotherapy. External audit is a crucial element in QA programmes for clinical dosimetry in radiotherapy, therefore a methodology and procedures were developed and were made available for dose measurement of complex radiotherapy parameters used for cancer treatment. There were three audit steps involved in this CRP: TLD based dosimetry for irregular MLC fields for conformal radiotherapy, dosimetry in the presence of heterogeneities and 2D MLC shaped fields relevant to stereotactic radiotherapy and applicable to dosimetry for IMRT. In addition, a new development of film-based 2D dosimetry for testing dose distributions in small field geometry was included. The plan for each audit step involved a pilot study and a trial audit run with a few local hospitals. The pilot study focused on conducting and evaluation of the audit procedures with all participants. The trial audit run was the running of the audit procedures by the participants to test them with a few local radiotherapy hospitals. This work intends to provide audits which are much nearer clinical practice than previous audits as they involve significant testing of Tps methods, as well as verifications to determinate whether hospitals can correctly calculate dose delivery in radiation treatments. (author)

  9. Development of dose audits for complex treatment techniques in radiotherapy

    International Nuclear Information System (INIS)

    Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M.

    2014-08-01

    This work was performed in the frame of a Coordinated Research Project (CRP) with IAEA whose objective was to extend the scope of activities carried out by national TLD-based networks from dosimetry audit for rectangular radiation fields to irregular and small fields relevant to modern radiotherapy. External audit is a crucial element in QA programmes for clinical dosimetry in radiotherapy, therefore a methodology and procedures were developed and were made available for dose measurement of complex radiotherapy parameters used for cancer treatment. There were three audit steps involved in this CRP: TLD based dosimetry for irregular MLC fields for conformal radiotherapy, dosimetry in the presence of heterogeneities and 2D MLC shaped fields relevant to stereotactic radiotherapy and applicable to dosimetry for IMRT. In addition, a new development of film-based 2D dosimetry for testing dose distributions in small field geometry was included. The plan for each audit step involved a pilot study and a trial audit run with a few local hospitals. The pilot study focused on conducting and evaluation of the audit procedures with all participants. The trial audit run was the running of the audit procedures by the participants to test them with a few local radiotherapy hospitals. This work intends to provide audits which are much nearer clinical practice than previous audits as they involve significant testing of Tps methods, as well as verifications to determinate whether hospitals can correctly calculate dose delivery in radiation treatments. (author)

  10. A Follow-Up Community Survey of Knowledge and Beliefs About Cancer and Genetics.

    Science.gov (United States)

    Sweeney, Shannon M; Hastrup, Janice L; Hyland, Andrew; Rivard, Cheryl

    2016-06-01

    The purpose of this study is to assess changes since the launch of the US Surgeon General's campaign in the public's beliefs about the role of genetics in the etiology of cancer, as well as changes in recording family health history. We conducted a survey of 480 Western New York adults, assessing: (1) experiences with cancer, (2) beliefs about cancer and genetics, and (3) practices of recording family health history. Most respondents were aware of the importance of family history. The sample also showed increased knowledge about cancer and genetics compared with a previous survey. However, only 7 % kept written records that included medical conditions, which was not different from a previous survey. Time constraints, apathy, and reluctance to find out negative health information were the most reported barriers. Results suggest a need for continued education of the public, with increased emphasis on written family health records.

  11. Audits of oncology units – an effective and pragmatic approach ...

    African Journals Online (AJOL)

    Background. Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. Objective. To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. Methods. Staff in oncology units who ...

  12. 46 CFR Sec. 12 - Audit.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Audit. Sec. 12 Section 12 Shipping MARITIME... TRANSACTIONS UNDER AGENCY AGREEMENTS Reports and Audit Sec. 12 Audit. (a) The owner will audit as currently as possible subsequent to audit by the agent, all documents relating to the activities, maintenance and...

  13. Defense Contract Audit Agency Compensation Audits

    National Research Council Canada - National Science Library

    1999-01-01

    .... The Defense Contract Audit Agency (DCAA) assists the administrative contracting officer in accomplishing that responsibility by determining whether the contractor's compensation system is sound, reliable, consistently applied, and results...

  14. Single Audit: Single Audit Act Effectiveness Issues

    National Research Council Canada - National Science Library

    Thompson, Sally

    2002-01-01

    As discussed in the report we are releasing today, our work to review agency actions to ensure that recipients take timely and appropriate corrective actions to fix audit findings contained in single...

  15. Advance Care Planning Discussions with Adolescent and Young Adult Cancer Patients Admitted to a Community Palliative Care Service: A Retrospective Case-Note Audit.

    Science.gov (United States)

    Fletcher, Sophie; Hughes, Rachel; Pickstock, Sarah; Auret, Kirsten

    2018-02-01

    Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015. Information was collected regarding end-of-life care discussions, documentation of agreed plan of care, and care received. Twenty-seven AYA and 37 adult medical records were reviewed. Eighteen (66.7%) AYA patients died at home, compared with 19 (51.4%) adults (p = 0.028). Desire to pursue all available oncological therapies, including clinical trials, was documented for 14 (51.9%) AYA patients compared with 9 (24.3%) of the adult group (p = 0.02). Eleven AYA patients (40.7%) received chemotherapy during the last month of life compared with two (5.4%) adults (p = 0.001). The results indicate that end-of-life care preferences for this unique cohort may differ from those of the adult population and need to be captured and understood. An ACP document incorporating a discussion regarding goals of care, preferred location of care, preference for place of death, and consent to future intervention, including cardiopulmonary resuscitation and prompts for review, could assist in pursuing this objective.

  16. A survey of Internet utilization among patients with cancer.

    Science.gov (United States)

    Castleton, Kimra; Fong, Thomas; Wang-Gillam, Andrea; Waqar, Muhammad A; Jeffe, Donna B; Kehlenbrink, Lisa; Gao, Feng; Govindan, Ramaswamy

    2011-08-01

    Recently published articles have established that a substantial number of cancer patients utilize the Internet to gather information about their respective diagnoses. The challenges for medical providers include understanding the prevalence and characteristics of patients using the Internet, reasons for Internet use, and the effectiveness of currently available websites in providing useful health-related information to patients. Adults with cancer were asked to complete a self-administered, anonymous, 21-item questionnaire upon registration at the Alvin J. Siteman Cancer Center at the Washington University School of Medicine. There were 500 respondents (mean age 58 years (range 18-90), 83% Caucasian and 15% African-American). Three hundred ninety-eight participants (80%) reported access to the Internet, and 315 (63%) reported searching for information about cancer on the Internet. Patients accessing the Internet for cancer information were younger than those who did not (median age 56 vs. 63 years; p Internet usage for cancer information also differed by race (p Internet for cancer information, 13.3% of patients had their decisions towards treatments affected or changed, and 11.4% of patients had their choice in physicians affected or changed because of Internet use; 23.5% of patients sought information on clinical trials, and 9.5% of patients were influenced or changed their decision regarding clinical trial enrollment due to Internet information. Approximately two thirds of patients with cancer used the Internet to obtain information about their disease. Factors affecting Internet use for cancer information included age, race, and education. Clinical decisions can be affected by Internet use.

  17. Developing a framework for audit quality management in audit firms

    OpenAIRE

    Darius Vaicekauskas, Jonas Mackevičius

    2014-01-01

    Over the last few decades audit quality has been investigated by many scholars, although it still hasn’t been properly conceptualized and lacks one common definition. This may be explained by the constant shifting of audit theory and practice, and the complexity of the audit service. The objective of the paper is to investigate the existing definitions of audit quality, identify its main elements and provide a framework for audit quality management in audit firms. The main contribution of the...

  18. Internal Audit of a Comprehensive IMRT Program for Prostate Cancer: A Model for Centers in Developing Countries?

    International Nuclear Information System (INIS)

    Koh, Wee Yao; Ren Wei; Mukherjee, Rahul K.; Chung, Hans T.

    2009-01-01

    Purpose: With improving regional prosperity, significant capital investments have been made to rapidly expand radiotherapy capacity across Southeast Asia. Yet little has been reported on the implementation of adequate quality assurance (QA) in patient management. The objective of this study is to perform an in-depth QA assessment of our definitive intensity-modulated radiotherapy (IMRT) program for prostate cancer since its inception. Methods and Materials: The department's prostate IMRT program was modeled after that of University of California San Francisco. A departmental protocol consisting of radiotherapy volume/dose and hormone sequencing/duration and a set of 18 dose objectives to the target and critical organs were developed, and all plans were presented at the weekly departmental QA rounds. All patients treated with definitive IMRT for nonmetastatic prostate cancer were retrospectively reviewed. Protocol adherence, dosimetry data, toxicities, and outcomes were evaluated. Results: Since 2005, 76 patients received IMRT: 54 with whole-pelvis and 22 with prostate-only treatment. Of the 1,140 recorded dosimetric end points, 39 (3.3%) did not meet the protocol criteria. At QA rounds, no plans required a revision. Only one major protocol violation was observed. Two and two cases of Grade 3-4 acute and late toxicities, respectively, were observed. Five (8.8%) patients developed proctitis, but only one required argon laser therapy. Conclusions: Our comprehensive, practice-adapted QA measures appeared to ensure that we were able to consistently generate conforming IMRT plans with acceptable toxicities. These measures can be easily integrated into other clinics contemplating on developing such a program.

  19. AUDIT plan documenting method

    International Nuclear Information System (INIS)

    Cornecsu, M.

    1995-01-01

    The work describes a method of documenting the AUDIT plan upon the basis of two quantitative elements resulting from quality assurance program appraisal system function implementation degree as established from the latest AUDIT performed an system function weight in QAP, respectively, appraised by taking into account their significance for the activities that are to be performed in the period for which the AUDITs are planned. (Author) 3 Figs., 2 Refs

  20. Computer Assisted Audit Techniques

    OpenAIRE

    Eugenia Iancu; Mihaela Tulvinschi; Veronica Grosu

    2007-01-01

    From the modern point of view, audit takes intoaccount especially the information systems representingmainly the examination performed by a professional asregards the manner for developing an activity by means ofcomparing it to the quality criteria specific to this activity.Having as reference point this very general definition ofauditing, it must be emphasized that the best known segmentof auditing is the financial audit that had a parallel evolutionto the accountancy one.The present day pha...

  1. Audit Management System

    CERN Document Server

    Alconada, Federico

    2015-01-01

    In the need of renewing their system, the Internal Audit department has given a proposal for building a new one. Taking into consideration the problems of their system they elaborated a requirement's list with the functionalities and features they were expecting from the new management system. This new system would be primarily for the use of the Internal Audit staff but it would also support the follow-up of internal audit recommendations by potentially all CERN staff members.

  2. Auditing radiation sterilization facilities

    Science.gov (United States)

    Beck, Jeffrey A.

    The diversity of radiation sterilization systems available today places renewed emphasis on the need for thorough Quality Assurance audits of these facilities. Evaluating compliance with Good Manufacturing Practices is an obvious requirement, but an effective audit must also evaluate installation and performance qualification programs (validation_, and process control and monitoring procedures in detail. The present paper describes general standards that radiation sterilization operations should meet in each of these key areas, and provides basic guidance for conducting QA audits of these facilities.

  3. Survey of Differentially Methylated Promoters in Prostate Cancer Cell Lines

    Directory of Open Access Journals (Sweden)

    Yipeng Wang

    2005-08-01

    Full Text Available DNA methylation, copy number in the genomes of three immortalized prostate epithelial, five cancer cell lines (LNCaP, PC3, PC3M, PC3M-Pro4, PC3MLN4 were compared using a microarray-based technique. Genomic DNA is cut with a methylation-sensitive enzyme Hpall, followed by linker ligation, polymerase chain reaction (PCR amplification, labeling, hybridization to an array of promoter sequences. Only those parts of the genomic DNA that have unmethylated restriction sites within a few hundred base pairs generate PCR products detectable on an array. Of 2732 promoter sequences on a test array, 504 (18.5% showed differential hybridization between immortalized prostate epithelial, cancer cell lines. Among candidate hypermethylated genes in cancer-derived lines, there were eight (CD44, CDKN1A, ESR1, PLAU, RARB, SFN, TNFRSF6, TSPY previously observed in prostate cancer, 13 previously known methylation targets in other cancers (ARHI, bcl-2, BRCA1, CDKN2C, GADD45A, MTAP, PGR, SLC26A4, SPARC, SYK, TJP2, UCHL1, WIT-1. The majority of genes that appear to be both differentially methylated, differentially regulated between prostate epithelial, cancer cell lines are novel methylation targets, including PAK6, RAD50, TLX3, PIR51, MAP2K5, INSR, FBN1, GG2-1, representing a rich new source of candidate genes used to study the role of DNA methylation in prostate tumors.

  4. Clinical management of gastric cancer: results of a multicentre survey

    International Nuclear Information System (INIS)

    Zhang, Xiaolong; Wen, Feng; Jiang, Yu; Xu, Feng; Feng, Hong; Bi, Feng; Li, Qiu; Li, Nanjing; Wei, Wen; Yao, Wenxiu; Xie, Ke; Hu, Jiankun; Shen, Lida; Ji, Weizheng; Lu, You

    2011-01-01

    The National Comprehensive Cancer Network clinical practice guidelines in oncology-gastric cancer guidelines have been widely used to provide appropriate recommendations for the treatment of patients with gastric cancer. The aim of this study was to examine the adherence of surgical oncologists, medical oncologists, and radiation oncologists' to the recommended guidelines. A questionnaire asking the treatment options for gastric cancer cases was sent to 394 Chinese oncology specialists, including surgical oncologists, medical oncologists, and radiation oncologists working in hospitals joined in The Western Cooperative Gastrointestinal Oncology Group of China. The questionnaire involved a series of clinical scenarios regarding the interpretation of surgery, neoadjuvant, adjuvant, and advanced treatment planning of gastric cancer. Analysis of 358 respondents (91%) showed variations between each specialization and from the recommended guidelines in the management approaches to specific clinical scenarios. The majority of specialists admitted that less than 50% of patients received multidisciplinary evaluation before treatment. The participants gave different responses to questions involving adjuvant, neoadjuvant, and advanced settings, compared to the recommended guidelines. These results highlight the heterogeneity of the treatment of gastric cancer. Surgical oncologists, medical oncologists, and radiation oncologists are not adhering to the recommended guidelines

  5. Internal Audit Charter, Mar2018

    International Development Research Centre (IDRC) Digital Library (Canada)

    Jessica Perkins

    2018-03-02

    Mar 2, 2018 ... authorizes the Finance and Audit Committee to oversee IDRC's Internal ... reassignment, or dismissal of the Chief Audit Executive. ... Audit Executive's duties as the Senior Officer for disclosure pursuant to the Public Servants.

  6. Qlikview Audit Tool (QLIKVIEW) -

    Data.gov (United States)

    Department of Transportation — This tool supports the cyclical financial audit process. Qlikview supports large volumes of financial transaction data that can be mined, summarized and presented to...

  7. Complex logistics audit system

    Directory of Open Access Journals (Sweden)

    Zuzana Marková

    2010-02-01

    Full Text Available Complex logistics audit system is a tool for realization of logistical audit in the company. The current methods for logistics auditare based on “ad hok” analysis of logisticsl system. This paper describes system for complex logistics audit. It is a global diagnosticsof logistics processes and functions of enterprise. The goal of logistics audit is to provide comparative documentation for managementabout state of logistics in company and to show the potential of logistics changes in order to achieve more effective companyperformance.

  8. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Management Contacts Monitoring Prior Approvals Annual Reporting and Auditing Transfer of a Grant Grant Closeout Training Cancer ... Grants Management Contacts Monitoring Prior Approvals Annual Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training ...

  9. Audit mode change, corporate governance

    Directory of Open Access Journals (Sweden)

    Limei Cao

    2015-12-01

    Full Text Available This study investigates changes in audit strategy in China following the introduction of risk-based auditing standards rather than an internal control-based audit mode. Specifically, we examine whether auditors are implementing the risk-based audit mode to evaluate corporate governance before distributing audit resources. The results show that under the internal control-based audit mode, the relationship between audit effort and corporate governance was weak. However, implementation of the risk-based mode required by the new auditing standards has significantly enhanced the relationship between audit effort and corporate governance. Since the change in audit mode, the Big Ten have demonstrated a significantly better grasp of governance risk and allocated their audit effort accordingly, relative to smaller firms. The empirical evidence indicates that auditors have adjusted their audit strategy to meet the regulations, risk-based auditing is being achieved to a degree, reasonable and effective corporate governance helps to optimize audit resource allocation, and smaller auditing firms in particular should urgently strengthen their risk-based auditing capability. Overall, our findings imply that the mandatory switch to risk-based auditing has optimized audit effort in China.

  10. Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  11. Time to audit.

    Science.gov (United States)

    Smyth, L G; Martin, Z; Hall, B; Collins, D; Mealy, K

    2012-09-01

    Public and political pressures are increasing on doctors and in particular surgeons to demonstrate competence assurance. While surgical audit is an integral part of surgical practice, its implementation and delivery at a national level in Ireland is poorly developed. Limits to successful audit systems relate to lack of funding and administrative support. In Wexford General Hospital, we have a comprehensive audit system which is based on the Lothian Surgical Audit system. We wished to analyse the amount of time required by the Consultant, NCHDs and clerical staff on one surgical team to run a successful audit system. Data were collected over a calendar month. This included time spent coding and typing endoscopy procedures, coding and typing operative procedures, and typing and signing discharge letters. The total amount of time spent to run the audit system for one Consultant surgeon for one calendar month was 5,168 min or 86.1 h. Greater than 50% of this time related to work performed by administrative staff. Only the intern and administrative staff spent more than 5% of their working week attending to work related to the audit. An integrated comprehensive audit system requires a very little time input by Consultant surgeons. Greater than 90% of the workload in running the audit was performed by the junior house doctors and administrative staff. The main financial implications for national audit implementation would relate to software and administrative staff recruitment. Implementation of the European Working Time Directive in Ireland may limit the time available for NCHD's to participate in clinical audit.

  12. Self-testing for cancer: a community survey

    International Nuclear Information System (INIS)

    Wilson, Sue; Ryan, Angela V; Greenfield, Sheila M; Clifford, Sue C; Holder, Roger L; Pattison, Helen M; Fitzmaurice, David A; McManus, Richard J

    2008-01-01

    Cancer-related self-tests are currently available to buy in pharmacies or over the internet, including tests for faecal occult blood, PSA and haematuria. Self-tests have potential benefits (e.g. convenience) but there are also potential harms (e.g. delays in seeking treatment). The extent of cancer-related self-test use in the UK is not known. This study aimed to determine the prevalence of cancer-related self-test use. Adults (n = 5,545) in the West Midlands were sent a questionnaire that collected socio-demographic information and data regarding previous and potential future use of 18 different self-tests. Prevalence rates were directly standardised to the England population. The postcode based Index of Multiple Deprivation 2004 was used as a proxy measure of deprivation. 2,925 (54%) usable questionnaires were returned. 1.2% (95% CI 0.83% to 1.66%) of responders reported having used a cancer related self test kit and a further 36% reported that they would consider using one in the future. Logistic regression analyses suggest that increasing age, deprivation category and employment status were associated with cancer-related self-test kit use. We conclude that one in 100 of the adult population have used a cancer-related self-test kit and over a third would consider using one in the future. Self-test kit use could alter perceptions of risk, cause psychological morbidity and impact on the demand for healthcare

  13. Profile of e-patients: analysis of their cancer information-seeking from a national survey.

    Science.gov (United States)

    Kim, Kyunghye; Kwon, Nahyun

    2010-10-01

    Researchers have yet to fully understand how competent e-patients are in selecting and using health information sources, or, more importantly, who e-patients are. This study attempted to uncover how cancer e-patients differ from other cancer information seekers in terms of their sociodemographic background, social networks, information competence, and selection of cancer information sources. We analyzed data from the National Cancer Institute's 2005 Health Information National Trends Survey, and a series of chi-square tests showed that factors that distinguished cancer e-patients from other cancer information seekers were age, gender, education, employment status, health insurance, and membership in online support groups. They were not different in the other factors measured by the survey. Our logistic regression analysis revealed that the e-patients were older and talked about their health issues with friends or family more frequently compared with online health information seekers without cancer. While preferring information from their doctors over the Internet, e-patients used the Internet as their primary source. In contrast to previous literature, we found little evidence that e-patients were savvy health information consumers who could make informed decisions on their own health. The findings of this study addressed a need for a better design and delivery of health information literacy programs for cancer e-patients.

  14. The need for decision and communication aids: a survey of breast cancer survivors.

    Science.gov (United States)

    Belkora, Jeffrey K; Miller, Melissa F; Dougherty, Kasey; Gayer, Christopher; Golant, Mitch; Buzaglo, Joanne S

    2015-03-01

    Qualitative studies have identified barriers to communication and informed decision making among breast cancer survivors making treatment decisions. The prevalence of these barriers is unknown. To quantify the need for decision support among breast cancer survivors. We surveyed 2,521 breast cancer survivors participating in an online registry hosted by the Cancer Support Community to find out what proportion of breast cancer patients: made decisions during their first visit with a specialist; received satisfactory information before that visit; asked questions and received responses; and endorsed expanded use of decision support. We received 1,017 (41%) responses and analyzed 917 surveys from women who lived in the United States. Most of the respondents recalled making treatment decisions during their first visit (52%). A minority (14%) received information before the first specialist visit. At least 25% of respondents rated their satisfaction below 7 on a scale of 10 for decision-making, information, and questions asked and answered. Respondents endorsed the need for assistance with obtaining information, listing questions, taking notes, and making audio-recordings of visits. The respondent sample skewed younger and had higher-stage cancer compared with all breast cancer survivors. Responses were subject to recall bias. Cancer survivors expressed gaps in their care with respect to reviewing information, asking questions, obtaining answers, and making decisions. Implementing decision and communication aids immediately upon diagnosis, when treatment decisions are being made, would address these gaps. ©2015 Frontline Medical Communications.

  15. International variation in adherence to referral guidelines for suspected cancer: a secondary analysis of survey data.

    Science.gov (United States)

    Nicholson, Brian D; Mant, David; Neal, Richard D; Hart, Nigel; Hamilton, Willie; Shinkins, Bethany; Rubin, Greg; Rose, Peter W

    2016-02-01

    Variation in cancer survival persists between comparable nations and appears to be due, in part, to primary care practitioners (PCPs) having different thresholds for acting definitively in response to cancer-related symptoms. To explore whether cancer guidelines, and adherence to them, differ between jurisdictions and impacts on PCPs' propensity to take definitive action on cancer-related symptoms. A secondary analysis of survey data from six countries (10 jurisdictions) participating in the International Cancer Benchmarking Partnership. PCPs' responses to five clinical vignettes presenting symptoms and signs of lung (n = 2), colorectal (n = 2), and ovarian cancer (n = 1) were compared with investigation and referral recommendations in cancer guidelines. Nine jurisdictions had guidelines covering the two colorectal vignettes. For the lung vignettes, although eight jurisdictions had guidelines for the first, the second was covered by a Swedish guideline alone. Only the UK and Denmark had an ovarian cancer guideline. Survey responses of 2795 PCPs (crude response rate: 12%) were analysed. Guideline adherence ranged from 20-82%. UK adherence was lower than other jurisdictions for the lung vignette covered by the guidance (47% versus 58%; P nations and poor guideline adherence does not explain differential survival. Guidelines that fail to cover high-risk presentations or that recommend non-definitive action may reduce definitive diagnostic action. © British Journal of General Practice 2016.

  16. Quality-of-life survey for patients diagnosed with nonmuscle-invasive bladder cancer.

    Science.gov (United States)

    Abáigar-Pedraza, I; Megías-Garrigós, J; Sánchez-Payá, J

    2016-05-01

    To determine the reliability and validity of a quality-of-life survey for patients with nonmuscle-invasive bladder cancer. A total of 180 patients were included in the study. We developed a survey with 21 questions grouped into 5 areas. The patients filled in this survey and the Functional Assessment of Cancer Therapy - Bladder Cancer (FACT-BL) survey. To assess reliability, we calculated Cronbach's alpha coefficient and the kappa index. To determine criterion validity, we studied the association between the scores obtained from our survey and those from the FACT-BL survey using the Pearson correlation coefficient. To determine the construct validity (factorial and discriminatory), we performed a factor analysis, comparing it with Student's t-test for the scores obtained according to the tumour characteristics of reduced quality of life (e.g., malignancies located at the trigone of the bladder). Cronbach's alpha reliability coefficient was .83, and the kappa index varied between .7 and 1. For the association study between the new survey and the FACT-BL survey, we measured an r=.82 for the overall score and between r=.68 (disease) and r=.97 (sex life) in the various measures. In the factor analysis, we measured a Kaiser-Meyer-Olkin index of .77 and performed the Barlett test (P<.001). The comparison between the scores, in the presence or absence of certain tumour characteristics, has shown a reduced quality of life when those characteristics are present, which was statistically significant (P<.05) in the majority of cases. Our survey to measure the quality of life of patients with nonmuscle-invasive bladder cancer is reliable and valid. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Strengthen School Culture Using a Customer Service Audit.

    Science.gov (United States)

    Clement, Nicholas I.

    2002-01-01

    Describes customer-service audit of school district's internal and external communities that included site visits and inspection, focus groups with parents and students, a staff survey, and mystery phone calls to assess phone skills. (PKP)

  18. Prospective hospital-based survey of attitudes of Southern women toward surgical treatment of breast cancer.

    Science.gov (United States)

    Wei, J P; Sherry, R M; Baisden, B L; Peckel, J; Lala, G

    1995-07-01

    Breast-conserving surgery is equivalent to total mastectomy in the treatment of breast cancer. The Southern part of the United States has a low rate of breast conservation. We surveyed 300 women: 100 hospital personnel, 100 cancer clinic patients, and 100 non-cancer clinic patients. The women were asked about their attitudes toward breast cancer, surgery preferences, and factors that might influence their decisions. One hundred eighty-nine chose mastectomy as the best operation, 106 women chose lumpectomy, and five women were undecided. There was no difference in mean age, racial distribution, education level, income level, percentage of women who considered themselves Southern women, concerns about breast cancer, recent mammograms, previous breast surgery, previous breast cancer treatment, or acquaintances with breast cancer between the mastectomy and the lumpectomy groups. Women interested in saving the breast were more likely to pick lumpectomy (35 vs. 84%, p = 0.001). A fear of cancer recurrence played a role in the decision (88 vs. 40%, p = 0.001). Fear of radiation therapy (76 vs. 57%, p = 0.002) and of the side effects (80 vs. 63%, p = 0.005) was a significant factor. The choice of surgery for breast cancer is an individual process between a woman and her surgeon. Attitudes and fears regarding cancer recurrence and radiation therapy may make women select mastectomy over lumpectomy.

  19. Variation in use of neoadjuvant chemotherapy in patients with stage III breast cancer : Results of the Dutch national breast cancer audit

    NARCIS (Netherlands)

    Spronk, Pauline E.R.; van Bommel, A.C.M.; Siesling, S.; Wouters, M. W.J.M.; Vrancken Peeters, M.T.F.D.; Smorenburg, Carolien H.

    2017-01-01

    Objectives Neoadjuvant chemotherapy (NAC) is important in the optimal treatment of patients with locally advanced (stage III) breast cancer (BC). The objective of this study was to examine the clinical practice of NAC for stage III BC patients in all Dutch hospitals participating in BC care.

  20. Presentations to general practice before a cancer diagnosis in Victoria: a cross-sectional survey.

    Science.gov (United States)

    Lacey, Karen; Bishop, James F; Cross, Hannah L; Chondros, Patty; Lyratzopoulos, Georgios; Emery, Jon D

    2016-07-18

    To assess variations in the number of general practitioner visits preceding a cancer diagnosis, and in the length of the interval between the patient first suspecting a problem and their seeing a hospital specialist. Analysis of data provided to the Cancer Patient Experience Survey (CPES; survey response rate, 37.7%) by 1552 patients with one of 19 cancer types and treated in one of five Victorian Comprehensive Cancer Centre hospitals, 1 October 2012 - 30 April 2013. The primary outcome was the proportion of patients who had had three or more GP consultations about cancer-related health problems before being referred to hospital. The secondary outcome was the interval between the patient first suspecting a problem and their seeing a hospital specialist. 34% of the patients included in the final analyses (426 of 1248) had visited a GP at least three times before referral to a hospital doctor. The odds ratios (reference: rectal cancer; adjusted for age, sex, language spoken at home, and socio-economic disadvantage index score) varied according to cancer type, being highest for pancreatic cancer (3.2; 95% CI, 1.02-9.9), thyroid cancer (2.5; 95% CI, 0.9-6.6), vulval cancer (2.5; 95% CI, 0.7-8.7) and multiple myeloma (2.4; 95% CI, 1.1-5.5), and lowest for patients with breast cancer (0.4; 95% CI, 0.2-0.8), cervical cancer (0.5; 95% CI, 0.1-2.1), endometrial cancer (0.5; 95% CI, 0.2-1.4) or melanoma (0.7; 95% CI, 0.3-1.5). Cancer type also affected the duration of the interval from symptom onset to seeing a hospital doctor; it took at least 3 months for more than one-third of patients with prostate or colon cancer to see a hospital doctor. Certain cancer types were more frequently associated with multiple GP visits, suggesting they are more challenging to recognise early. In Victoria, longer intervals from the first symptoms to seeing a hospital doctor for colon or prostate cancer may reflect poorer community symptom awareness, later GP referral, or limited access to

  1. Screening for At-Risk Drinking in a Population Reporting Symptoms of Depression: A Validation of the AUDIT, AUDIT-C, and AUDIT-3.

    Science.gov (United States)

    Levola, Jonna; Aalto, Mauri

    2015-07-01

    Excessive alcohol use is common in patients presenting with symptoms of depression. The aim of this study was to evaluate how the Alcohol Use Disorders Identification Test (AUDIT) and its most commonly used abbreviated versions perform in detecting at-risk drinking among subjects reporting symptoms of depression. A subsample (n = 390; 166 men, 224 women) of a general population survey, the National FINRISK 2007 Study, was used. Symptoms of depression were measured with the Beck Depression Inventory-Short Form and alcohol consumption with the Timeline Follow-back (TLFB). At-risk drinking was defined as ≥280 g weekly or ≥60 g on at least 1 occasion in the previous 28 days for men, 140 and 40 g, respectively, for women. The AUDIT, AUDIT-C, and AUDIT-3 were tested against the defined gold standard, that is, alcohol use calculated from the TLFB. An optimal cutoff was designated as having a sensitivity and specificity of over 0.75, with emphasis on specificity. The AUDIT and its abbreviations were compared with carbohydrate-deficient transferrin (CDT) and gamma-glutamyltransferase. At-risk drinking was common. The AUDIT and AUDIT-C performed quite consistently. Optimal cutoffs for men were ≥9 for the AUDIT and ≥6 for AUDIT-C. The optimal cut-offs for women with mild symptoms of depression were ≥5 for the AUDIT and ≥4 for AUDIT-C. Optimal cutoffs could not be determined for women with moderate symptoms of depression (specificity AUDIT. The AUDIT-3 failed to perform in women, but in men, a good level of sensitivity and specificity was reached at a cutoff of ≥2. With standard threshold values, the biochemical markers demonstrated very low sensitivity (9 to 28%), but excellent specificity (83 to 98%). Screening for at-risk drinking among patients presenting with symptoms of depression using the full AUDIT is recommended, although the AUDIT-C performed almost equally well. Cut-offs should be adjusted according to gender, but not according to the severity

  2. Ghana : Accounting and Auditing

    OpenAIRE

    World Bank

    2004-01-01

    This report provides an assessment of accounting and auditing practices within the context of the Ghana institutional framework to ensure the quality of corporate financial reporting. The accounting and auditing practices in Ghana suffer from institutional weaknesses in regulation, compliance, and enforcement of standards and rules. Various weaknesses were identified in the laws and regula...

  3. Auditing measurement control programs

    International Nuclear Information System (INIS)

    Roberts, F.P.; Brouns, R.J.

    1979-10-01

    Requirements and a general procedure for auditing measurement control programs used in special nuclear material accounting are discussed. The areas of measurement control that need to be examined are discussed and a suggested checklist is included to assist in the preparation and performance of the audit

  4. Quality audit in design

    International Nuclear Information System (INIS)

    Horton, G.T.

    1976-01-01

    The subject is discussed under the headings: introduction (explanation of firm's responsibility to design and procure naval nuclear reactor plant for the Ministry of Defence, whose quality assurance requirements are laid down in Defence Standards); principles of quality audit; audit procedure. (U.K.)

  5. Peru : Accounting and Auditing

    OpenAIRE

    World Bank

    2004-01-01

    The report provides an assessment of accounting, financial reporting, and auditing practices within the corporate sector in Peru, using International Financial Reporting Standards (IFRS), and International Standards on Auditing (ISA) as benchmarks, drawing on international experience and best practices in that field. This Report on the Observance of Standards and Codes (ROSC) Accounting & ...

  6. Audit Validation Using Ontologies

    Directory of Open Access Journals (Sweden)

    Ion IVAN

    2015-01-01

    Full Text Available Requirements to increase quality audit processes in enterprises are defined. It substantiates the need for assessment and management audit processes using ontologies. Sets of rules, ways to assess the consistency of rules and behavior within the organization are defined. Using ontologies are obtained qualifications that assess the organization's audit. Elaboration of the audit reports is a perfect algorithm-based activity characterized by generality, determinism, reproducibility, accuracy and a well-established. The auditors obtain effective levels. Through ontologies obtain the audit calculated level. Because the audit report is qualitative structure of information and knowledge it is very hard to analyze and interpret by different groups of users (shareholders, managers or stakeholders. Developing ontology for audit reports validation will be a useful instrument for both auditors and report users. In this paper we propose an instrument for validation of audit reports contain a lot of keywords that calculates indicators, a lot of indicators for each key word there is an indicator, qualitative levels; interpreter who builds a table of indicators, levels of actual and calculated levels.

  7. Hungary : Accounting and Auditing

    OpenAIRE

    World Bank

    2004-01-01

    This report provides an assessment of accounting, financial reporting, and auditing requirements and practices within the enterprise and financial sectors in Hungary using International Financial Reporting Standards (IFRS),International Standards on Auditing (ISA), and the relevant portions of European Union (EU) law (also known as the acquis communautaire) as benchmarks. It also draws on ...

  8. Survey of thorotrast-associated liver cancers in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, S; Hosoda, S; Tateno, H; Kido, C; Takahashi, S

    1983-01-01

    Data on 93 autopsy cases (group A) of thorotrast-associated liver cancers were obtained from the Annual of Pathological Autopsy Cases in Japan from 1958 to 1979, and data on 78 autopsy cases (group B) of thorotrast-associated liver cancers were obtained from the Japanese literature from 1953 to 1980. Cholangiocarcinoma (CLC) constituted 58% of group A and 55% of group B. The curve of the cumulative numbers of patients with CLC versus year in group A was almost linear, showing an increasing risk per surviving patients with advancing time. Angiosarcoma (AGS) occurred in 25% of group A and 24% of group B. The number of patients with AGS increased significantly after 1969 in both groups. In group B, age and years after thorotrast injection of patients with AGS were statistically higher than those of patients with CLC. Hepatocellular carcinoma (HPC) accounted for 17 and 21% of groups A and B, respectively. When yearly distribution, age, and time after thorotrast injection of patients with HPC were correlated with those of patients with other liver cancers, the only statistically significant difference between patients with HPC and patients with CLC was in the years after thorotrast administration. Since 1977 multiple primary liver cancers including AGS developed in thorotrast-administered patients in both groups.

  9. a survey on drug related problems in cervical cancer patients

    African Journals Online (AJOL)

    userpc

    Cisplatin/5FU/paclitaxel. 6. 9.23. 6. Seizure. Cisplatin. 2. 3.08. 7. Loss of hair. Cisplatin/5FU/Paclitaxel. 3. 4.62. 8. Nephrotoxicity. Cisplatin. 3. 4.62. 9. Hypotension. Paclitaxel. 3. 4.62. TOTAL. 65. 100. Table 3: Relationship between cervical cancer patients' factors and DRPs. Patients Factor. Drug Related Problems (DRPs).

  10. A European survey of oncology nurse breakthrough cancer pain practices

    NARCIS (Netherlands)

    Rustoen, Tone; Geerling, Jenske I.; Pappa, Theodora; Rundstrom, Carina; Weisse, Isolde; Williams, Sian C.; Zavratnik, Bostjan; Kongsgaard, Ulf E.; Wengstrom, Yvonne

    Purpose of the research: Breakthrough cancer pain (BTCP) is a prevalent type of pain in which the nurse can play an important role in improving patients' pain symptoms and overall well-being. Nurses' experience with BTCP (number of patients, and estimates of severity and frequency), the treatment of

  11. Dutch Lung Surgery Audit: A National Audit Comprising Lung and Thoracic Surgery Patients.

    Science.gov (United States)

    Berge, Martijn Ten; Beck, Naomi; Heineman, David Jonathan; Damhuis, Ronald; Steup, Willem Hans; van Huijstee, Pieter Jan; Eerenberg, Jan Peter; Veen, Eelco; Maat, Alexander; Versteegh, Michel; van Brakel, Thomas; Schreurs, Wilhemina Hendrika; Wouters, Michel Wilhelmus

    2018-04-21

    The nationwide Dutch Lung Surgery Audit (DLSA) started in 2012 to monitor and evaluate the quality of lung surgery in the Netherlands as an improvement tool. This outline describes the establishment, structure and organization of the audit by the Dutch Society of Lung Surgeons (NVvL) and the Dutch Society of Cardiothoracic Surgeons (NVT), in collaboration with the Dutch Institute for Clinical Auditing (DICA). In addition, first four-year results are presented. The NVvL and NVT initiated a web-based registration including weekly updated online feedback for participating hospitals. Data verification by external data managers is performed on regular basis. The audit is incorporated in national quality improvement programs and participation in the DLSA is mandatory by health insurance organizations and the National Healthcare Inspectorate. Between 1 January 2012 and 31 December 2015, all hospitals performing lung surgery participated and a total of 19,557 patients were registered from which almost half comprised lung cancer patients. Nationwide the guideline adherence increased over the years and 96.5% of lung cancer patients were discussed in preoperative multidisciplinary teams. Overall postoperative complications and mortality after non-small cell lung cancer surgery were 15.5% and 2.0%, respectively. The audit provides reliable benchmarked information for caregivers and hospital management with potential to start local, regional or national improvement initiatives. Currently, the audit is further completed with data from non-surgical lung cancer patients including treatment data from pulmonary oncologists and radiation oncologists. This will ultimately provide a comprehensive overview of lung cancer treatment in The Netherlands. Copyright © 2018. Published by Elsevier Inc.

  12. Mass survey of gastric cancer and leukemia in Miyagi Prefecture, Japan

    Energy Technology Data Exchange (ETDEWEB)

    Sakka, Masatoshi; Sasano, Nobuaki; Uzuka, Yoshiro [Tohoku Univ., Sendai (Japan). School of Medicine; Hisamichi, Shigeru; Takano, Akira; Hashizume, Tadashi

    1982-11-01

    A little more than 20,000 examinees of x-ray mass survey of gastric cancer and the controls were followed up from 1960 to 1977. Cumulative doses of x-rays were calculated for each examinee, and a collective dose in person-year-rads was constructed. Incidence of leukemia was ascertained from Miyagi Prefectural Cancer Registry. Seven cases of leukemia were found out of 242,689 person-year-rads in the irradiated population, and 9 cases out of 273,344 person-years in the controls. Incidence rate in the two groups was identical. Therefore, the risk of this mass survey was disproved.

  13. Nature as the Most Important Coping Strategy Among Cancer Patients: A Swedish Survey.

    Science.gov (United States)

    Ahmadi, Fereshteh; Ahmadi, Nader

    2015-08-01

    The authors have conducted a quantitative survey to examine the extent to which the results obtained in a qualitative study among cancer patients in Sweden (Ahmadi, Culture, religion and spirituality in coping: The example of cancer patients in Sweden, Uppsala, Acta Universitatis Upsaliensis, 2006) are applicable to a wider population of cancer patients in this country. In addition to questions relating to the former qualitative study, this survey also references the RCOPE questionnaire (designed by Kenneth I Pargament) in the design of the new quantitative study. In this study, questionnaires were distributed among persons diagnosed with cancer; 2,355 people responded. The results show that nature has been the most important coping method among cancer patients in Sweden. The highest mean value (2.9) is the factor 'nature has been an important resource to you so that you could deal with your illnesses'. Two out of three respondents (68 %) affirm that this method helped them feel significantly better during or after illness. The second highest average (2.8) is the factor 'listening to 'natural music' (birdsong and the wind)'. Two out of three respondents (66 %) answered that this coping method significantly helped them feel better during illness. The third highest average (2.7) is the factor 'to walk or engage in any activity outdoors gives you a spiritual sense'. This survey concerning the role of nature as the most important coping method for cancer patients confirms the result obtained from the previous qualitative studies.

  14. Developing a framework for audit quality management in audit firms

    Directory of Open Access Journals (Sweden)

    Darius Vaicekauskas, Jonas Mackevičius

    2014-02-01

    Full Text Available Over the last few decades audit quality has been investigated by many scholars, although it still hasn’t been properly conceptualized and lacks one common definition. This may be explained by the constant shifting of audit theory and practice, and the complexity of the audit service. The objective of the paper is to investigate the existing definitions of audit quality, identify its main elements and provide a framework for audit quality management in audit firms. The main contribution of the paper is a developed framework for audit quality management, covering both main stakeholders of auditing triangular relationships: third-party users, as well as audit clients. Due to a slump in audit prices, complex competition and a high degree of homogeneity, the authors of the paper focus not only on external users’ perceptions, as the existing large body of literature does, but also stress audit clients’ need for satisfaction in the comprehensive framework. The framework covers various audit firms and audit engagement team factors affecting audit quality and leading to quality audit outputs: an accurate and reliable auditor report and a value adding management letter. Based on the framework presented, recommendations for future audit quality research are provided

  15. Associations of cancer site and type with occupation and industry from the Third National Cancer Survey Interview.

    Science.gov (United States)

    Williams, R R; Stegens, N L; Goldsmith, J R

    1977-10-01

    From the Third National Cancer Survey (TNCS) Interview Study of 7,518 incident cases, lifetime histories of occupations and industries were studied for associations with specific cancer sites and types while controlling for age, sex, race, education, use of cigarettes or alcohol, and geographic location. Lung cancer patients were found more often than expected among several categories including trucking, air transportation, wholesaling, painting, building construction, building maintenance, and manufacturing (furniture, transportation equipment, and food products). Controlling for cigarette smoking did not change these associations. Leukemia and multiple myeloma were associated with sales personnel of both sexes, whereas lymphomas and Hodgkin's disease were excessive among women working in the medical industry. Other associations included rectal cancer with several retail industries; prostate cancer with ministers, farmers, plumbers, and coal miners; malignant melanoma with school teachers; and invasive cervical cancer with women working in hotels and restaurants. Breast cancer patients were more common among women who were teachers or other professionals and who worked in business and finance (even after controlling for education). Many other findings are presented in detailed tables. Results are reported mainly as a research resource for use by other investigators doing work in this field. Suggestions are given for future studies.

  16. Retrospective Audit: Does Prior Assessment by Oral and Maxillofacial Surgeons Reduce the Risk of Osteonecrosis of The Jaw in Patients Receiving Bone-Targeted Therapies for Metastatic Cancers to the Skeleton?--Part II.

    Science.gov (United States)

    Turner, Bruce; Ali, Sacha; Pati, Jhumur; Nargund, Vinod; Ali, Enamul; Cheng, Leo; Wells, Paula

    2016-01-01

    Men who receive bone-targeted therapy for metastatic prostate cancer are at increased risk of osteonecrosis of the jaw (ONJ). Development of ONJ has been associated with the administration of bone-targeted therapies in association with other risk factors. ONJ can be distressing for a patient because it can cause pain, risk of jaw fracture, body image disturbance, difficultly eating, and difficulty maintaining good oral hygiene. The aim of this article is to report results of an audit of prior assessment by oral and maxillofacial surgeons (OMFS) before initiation of bone-targeted therapies and whether it may reduce the risk of ONJ in patients receiving bone-targeted therapies for advanced cancers.

  17. Aktivitas Komite Audit, Kepemilikan Institusional dan Biaya Audit

    Directory of Open Access Journals (Sweden)

    Linda Kusumaning Wedari

    2015-01-01

    Full Text Available This study investigates the influence of the audit committee activities and institutional ownership to the audit fees in Indonesia public companies. The research samples are manufacturing companies listed in Indonesia Stock Exchange for the period 2010 – 2013. There are 124 observations that meet the sample criteria, data are analyzed using Eviews 6.0. The results show that the audit committee activities which measured by the number of audit committee meetings have significant positive effect on the audit fees. Meanwhile, institutional ownership, diffused and blockholders institutional ownership do not significantly affect to the audit fees. However some of the control variables such as the number of wholly-owned subsidiaries, subsidiaries abroad, and audit quality have significant positive effect on audit fees, whereas leverage, loss and audit opinion have no significant effect on the audit fee.

  18. Evaluating the Needs of Patients Living With Solid Tumor Cancer: A Survey Design.

    Science.gov (United States)

    Schmidt, April L; Lorenz, Rebecca A; Buchanan, Paula M; McLaughlin, Laura

    2018-03-01

    To describe the unmet needs of adult patients living with solid tumor cancer. Survey design. Adult patients living with solid tumor cancer from two outpatient clinics were mailed the Sheffield Profile for Assessment and Referral to Care, a holistic screening questionnaire for assessing palliative care needs, and a demographics questionnaire. One hundred fifteen patients returned the instruments, corresponding to a 62% response rate. There were no significant differences by cancer type (breast, non-breast) or gender. However, Caucasians reported significantly more psychological issues, such as anxiety, than non-Caucasians ([ n = 101 (87.8%)] and [ n = 14 (12.2%)], respectively, p = .032). Older patients reported more concerns about loss of independence/activity ( p = .012) compared with younger age groups. Patients living with Stage III/IV cancer reported more distressed about independence/activity ( p = .034), family/social issues ( p = .007), and treatment side effects ( p = .027) than patients living with Stage I/II cancer. Patients living with solid tumor cancer have a myriad of unmet needs regardless of age, gender, cancer type, or cancer stage. There appears to be important differences by cancer stage. The Sheffield Profile for Assessment and Referral to Care questionnaire provides a holistic approach for nurses to identify unmet needs and concerns. Future research should explore the preferred methods of receiving support and information.

  19. People’s willingness to accept overdetection in cancer screening: population survey

    Science.gov (United States)

    Jones, Caroline; Yang, Yaling; Oke, Jason; Hewitson, Paul

    2015-01-01

    Objectives To describe the level of overdetection people would find acceptable in screening for breast, prostate, and bowel cancer and whether acceptability is influenced by the magnitude of the benefit from screening and the cancer specific harms from overdetection. Design Online survey. Women were presented with scenarios on breast and bowel cancer, men with scenarios on prostate and bowel cancer. For each particular cancer, we presented epidemiological information and described the treatment and its consequences. Secondly, we presented two different scenarios of benefit: one indicating a 10% reduction in cancer specific mortality and the second indicating a 50% reduction. Setting Online survey of the population in the United Kingdom. Participants Respondents were part of an existing panel of people who volunteer for online research and were invited by email or online marketing. We recruited 1000 respondents, representative for age and sex for the UK population. Main outcome measures Number of cases of overdetection people were willing to accept, ranging from 0-1000 (complete screened population) for each cancer modality and each scenario of benefit. Results There was large variability between respondents in the level of overdetection they would find acceptable, with medians ranging from 113 to 313 cases of overdetection per 1000 people screened. Across all scenarios, 4-7% of respondents indicated they would accept no overdetection at all compared with 7-14% who thought that it would be acceptable for the entire screened population to be overdetected. Acceptability in screening for bowel cancer was significantly lower than for breast and prostate cancer. People aged 50 or over accepted significantly less overdetection, whereas people with higher education levels accepted more; 29% of respondents had heard of overdetection before. Conclusions Acceptability of overdetection in cancer screening is variable. Invitations for screening should include clear information

  20. Internal audit consider the implications.

    Science.gov (United States)

    Baumgartner, Grant D; Hamilton, Angela

    2004-06-01

    Internal audit can not only allay external and internal concerns about appropriateness of business operations, but also help improve efficiency and the bottom line. To get an internal audit function under way, healthcare organizations need to obtain board buy-in, form an audit committee of the board, determine resources needed, perform a risk assessment, and develop an internal audit plan.

  1. Cancer pain management in China: current status and practice implications based on the ACHEON survey

    Directory of Open Access Journals (Sweden)

    Xia Z

    2017-08-01

    Full Text Available Zhongjun Xia Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaPurpose: Cancer pain can seriously impact the quality of life (QoL of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs.Materials and methods: In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL.Results: The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients’ fear of side effects (58%, patients’ fear of addiction (53%, patients’ reluctance to report pain (43%, physicians’ reluctance to prescribe (29%, physicians’ inadequacy of pain assessment (27% and excessive regulation of opioid analgesics (47%.Conclusion: Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain

  2. Cancer survivors' experiences of a community-based cancer-specific exercise programme: results of an exploratory survey.

    Science.gov (United States)

    Catt, Susan; Sheward, J; Sheward, E; Harder, H

    2018-04-05

    Exercise levels often decline following cancer diagnosis despite growing evidence of its benefits. Treatment side effects, older age, lack of confidence and opportunity to exercise with others in similar circumstances influence this. Our study explored the experiences of people attending a cancer-specific community-based exercise programme (CU Fitter™). A survey distributed to those attending the programme gathered demographic/clinical information, self-reported exercise levels, information provision and barriers to/benefits of exercise. Sixty surveys were evaluable from 65/100 returned (62% female, 68% > 60 years, 66% breast/prostate cancer). Most (68%) were receiving treatment. Sixty-eight percent attended classes once or twice weekly. Fifty-five percent received exercise advice after diagnosis, usually from their hospital doctor/nurse. More (73%) had read about exercising, but less used the Internet to source information (32%). Self-reported exercise levels were higher currently than before diagnosis (p = 0.05). Forty-eight percent said their primary barrier to exercising was the physical impact of cancer/treatment. Improving fitness/health (40%) and social support (16%) were the most important gains from the programme. Many (67%) had made other lifestyle changes and intented to keep (50%) or increase (30%) exercising. This community-based cancer-specific exercise approach engaged people with cancer and showed physical, psychological, and social benefits. Community-grown exercise initiatives bring cancer survivors together creating their own supportive environment. Combining this with instructors familiar with the population and providing an open-ended service may prove particularly motivating and beneficial. Further work is required to provide evidence for this.

  3. Audits of radiopharmaceutical formulations

    International Nuclear Information System (INIS)

    Castronovo, F.P. Jr.

    1992-01-01

    A procedure for auditing radiopharmaceutical formulations is described. To meet FDA guidelines regarding the quality of radiopharmaceuticals, institutional radioactive drug research committees perform audits when such drugs are formulated away from an institutional pharmacy. All principal investigators who formulate drugs outside institutional pharmacies must pass these audits before they can obtain a radiopharmaceutical investigation permit. The audit team meets with the individual who performs the formulation at the site of drug preparation to verify that drug formulations meet identity, strength, quality, and purity standards; are uniform and reproducible; and are sterile and pyrogen free. This team must contain an expert knowledgeable in the preparation of radioactive drugs; a radiopharmacist is the most qualified person for this role. Problems that have been identified by audits include lack of sterility and apyrogenicity testing, formulations that are open to the laboratory environment, failure to use pharmaceutical-grade chemicals, inadequate quality control methods or records, inadequate training of the person preparing the drug, and improper unit dose preparation. Investigational radiopharmaceutical formulations, including nonradiolabeled drugs, must be audited before they are administered to humans. A properly trained pharmacist should be a member of the audit team

  4. Internal audit function: a comparison between private and public sector in Nigeria

    Directory of Open Access Journals (Sweden)

    Madawaki Abdulkadir

    2017-01-01

    Full Text Available This study compares the internal audit functions between private and the public sector. Features examined include hierarchical rank of internal audit function, internal audit transfer, outsourcing of internal audit services and working relationship of internal audit with external auditor. The study is based on a survey of internal audit managers and chief internal auditors in private and public sector entities in Nigeria. The results revealed that there is no much difference in hierarchical rank of internal audit function in both sectors. While the results showed that differences exist in the reporting status between internal audit in the two sectors with private sector internal audit reporting to audit committee and chief executive officer and public sector internal audit reporting to chief executive officer and chief financial officer. Almost a similar amount of work is outsourced, and private sector entities are more likely to outsource than those in public sector. There is slight difference between internal audit activities and interaction with external auditor in the two sectors with private sector more likely to coordinate in the area of access to audit working papers.

  5. Bone scintigraphy in prostate cancer: a French national survey

    International Nuclear Information System (INIS)

    Boneu, A.; Corone, C.; Giammarile, F.; Lumbroso, J.; Resche, I.

    1997-01-01

    A national survey has been performed in France concerning bone scan in prostatic carcinoma. Its aim was to define methods of performing examinations, criteria of analysis of imaging results and indications of radionuclide imaging in initial evaluation and post-therapeutic follow-up of the disease. Replies are given and recommendations are proposed in order to improve imaging quality, optimize interpretation and rationalize prescription of bone scintigraphy in case of prostatic carcinoma. (authors)

  6. Comparing cancer screening estimates: Behavioral Risk Factor Surveillance System and National Health Interview Survey.

    Science.gov (United States)

    Sauer, Ann Goding; Liu, Benmei; Siegel, Rebecca L; Jemal, Ahmedin; Fedewa, Stacey A

    2018-01-01

    Cancer screening prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), designed to provide state-level estimates, and the National Health Interview Survey (NHIS), designed to provide national estimates, are used to measure progress in cancer control. A detailed description of the extent to which recent cancer screening estimates vary by key demographic characteristics has not been previously described. We examined national prevalence estimates for recommended breast, cervical, and colorectal cancer screening using data from the 2012 and 2014 BRFSS and the 2010 and 2013 NHIS. Treating the NHIS estimates as the reference, direct differences (DD) were calculated by subtracting NHIS estimates from BRFSS estimates. Relative differences were computed by dividing the DD by the NHIS estimates. Two-sample t-tests (2-tails), were performed to test for statistically significant differences. BRFSS screening estimates were higher than those from NHIS for breast (78.4% versus 72.5%; DD=5.9%, pNHIS, each survey has a unique and important role in providing information to track cancer screening utilization among various populations. Awareness of these differences and their potential causes is important when comparing the surveys and determining the best application for each data source. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Pan-European survey on the implementation of minimally invasive pancreatic surgery with emphasis on cancer

    NARCIS (Netherlands)

    de Rooij, Thijs; Besselink, Marc G.; Shamali, Awad; Butturini, Giovanni; Busch, Olivier R.; Edwin, Bjørn; Troisi, Roberto; Fernández-Cruz, Laureano; Dagher, Ibrahim; Bassi, Claudio; Abu Hilal, Mohammad

    2016-01-01

    Minimally invasive (MI) pancreatic surgery appears to be gaining popularity, but its implementation throughout Europe and the opinions regarding its use in pancreatic cancer patients are unknown. A 30-question survey was sent between June and December 2014 to pancreatic surgeons of the European

  8. Integration of early specialist palliative care in cancer care: Survey of oncologists, oncology nurses, and patients

    Directory of Open Access Journals (Sweden)

    Naveen Salins

    2016-01-01

    Conclusion: Oncologists, oncology nurses, and patients felt that integration of early specialist palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care. The perceptions of benefit of the palliative care intervention in the components surveyed, differed among the three groups.

  9. A Survey of Cancer Pain Management Knowledge and Attitudes of British Columbian Physicians

    Directory of Open Access Journals (Sweden)

    R Gallagher

    2004-01-01

    Full Text Available INTRODUCTION: There are many potential barriers to adequate cancer pain management, including lack of physician education and prescription monitoring programs. The authors surveyed physicians about their specific knowledge of pain management and the effects of the regulation of opioids on their prescribing practices.

  10. Audit culture revisited

    DEFF Research Database (Denmark)

    Shore, Cris; Wright, Susan

    2015-01-01

    the financial and the moral meet’ we ask, what new kinds of ‘ethics of accountability’ does audit produce? We build on the work of Mitchell (1999), Trouillot (2001) and Merry (2011) to identify five ways in which the techniques and logics of financial accountancy have notable ‘audit effects...... these new financialized techniques of governance, not least through the work of the ‘Big 4’ accountancy firms, and trace their impact across a number of different fields, from administration and the military to business corporations and universities. Following Strathern’s observation that audit is ‘where...

  11. International variation in adherence to referral guidelines for suspected cancer: a secondary analysis of survey data

    Science.gov (United States)

    Nicholson, Brian D; Mant, David; Neal, Richard D; Hart, Nigel; Hamilton, Willie; Shinkins, Bethany; Rubin, Greg; Rose, Peter W

    2016-01-01

    Background Variation in cancer survival persists between comparable nations and appears to be due, in part, to primary care practitioners (PCPs) having different thresholds for acting definitively in response to cancer-related symptoms. Aim To explore whether cancer guidelines, and adherence to them, differ between jurisdictions and impacts on PCPs’ propensity to take definitive action on cancer-related symptoms. Design and setting A secondary analysis of survey data from six countries (10 jurisdictions) participating in the International Cancer Benchmarking Partnership. Method PCPs’ responses to five clinical vignettes presenting symptoms and signs of lung (n = 2), colorectal (n = 2), and ovarian cancer (n = 1) were compared with investigation and referral recommendations in cancer guidelines. Results Nine jurisdictions had guidelines covering the two colorectal vignettes. For the lung vignettes, although eight jurisdictions had guidelines for the first, the second was covered by a Swedish guideline alone. Only the UK and Denmark had an ovarian cancer guideline. Survey responses of 2795 PCPs (crude response rate: 12%) were analysed. Guideline adherence ranged from 20–82%. UK adherence was lower than other jurisdictions for the lung vignette covered by the guidance (47% versus 58%; P <0.01) but similar (45% versus 46%) or higher (67% versus 38%; P <0.01) for the two colorectal vignettes. PCPs took definitive action least often when a guideline recommended a non-definitive action or made no recommendation. UK PCPs adhered to recommendations for definitive action less than their counterparts (P <0.01). There wasno association between jurisdictional guideline adherence and 1-year survival. Conclusion Cancer guideline content is variable between similarly developed nations and poor guideline adherence does not explain differential survival. Guidelines that fail to cover high-risk presentations or that recommend non-definitive action may reduce definitive

  12. Screening for colorectal cancer in Italy: 2011-2012 survey.

    Science.gov (United States)

    Zorzi, Manuel; Mangone, Lucia; Anghinoni, Emanuela; Baracco, Susanna; Borciani, Elisabetta; Caldarella, Adele; Falcini, Fabio; Fanetti, Anna Clara; Ferretti, Stefano; Giorgi Rossi, Paolo; Michiara, Maria; Randi, Giorgia; Stracci, Fabrizio; Vicentini, Massimo; Zucchetto, Antonella; Zappa, Marco

    2015-01-01

    The impact of organized screening programmes on colorectal cancer (CRC) can be observed at a population level only several years after the implementation of screening. We compared CRC characteristics by diagnostic modality (screen-detected, non-screen-detected) as an early outcome to monitor screening programme effectiveness. Data on CRCs diagnosed in Italy from 2000 to 2008 were collected by several cancer registries. Linkage with screening datasets made it possible to divide the cases by geographic area, implementation of screening, and modality of diagnosis (screen-detected, non-screen-detected).We compared the main characteristics of the different subgroups of CRCs through multivariate logistic regression models. The study included 23,668 CRCs diagnosed in subjects aged 50-69 years, of which 11.9% were screen-detected (N=2,806), all from the North-Centre of Italy. Among screen-detected CRCs, we observed a higher proportion of males, of cases in the distal colon, and a higher mean age of the patients. Compared with pre-screening cases, screen-detected CRCs showed a better distribution by stage at diagnosis (OR for stage III or IV: 0.40, 95%CI: 0.36-0.44) and grading (OR for poorly differentiated CRCs was 0.86, 95%CI: 0.75-1.00). Screen-detected CRCs have more favourable prognostic characteristics than non-screen-detected cases. A renewed effort to implement screening programmes throughout the entire country is recommended.

  13. Use of Chinese Herb Medicine in Cancer Patients: A Survey in Southwestern China

    Directory of Open Access Journals (Sweden)

    Tai-Guo Liu

    2012-01-01

    Full Text Available Chinese herb medicine (CHM is the most commonly reported traditional Chinese medicine (TCM modality. This study aimed to assess the prevalence and associated factors of CHM use in cancer patients in southwestern China. Cancer patients from eleven comprehensive cancer centers were asked to complete a structured questionnaire. Of 587 available replies, 53.0% used CHM. Multiple logistic regression analysis showed that educational level, stage of disease, duration of cancer since diagnosis, marital status, and previous use of CHM were strongly associated with CHM use after cancer diagnosis. The source of information about CHM was mainly from media and friends/family. CHM products were used without any consultation with a TCM practitioner by 67.5% of users. The majority used CHM to improve their physical and emotional well-beings and to reduce cancer therapy-induced toxicities. About 4.5% patients reported side effects of CHM. This survey revealed a high prevalence of CHM use among cancer patients. However, these patients did not get sufficient consultation about the indications and contradictions of these drugs. It is imperative for oncologists to communicate with their cancer patients about the usage of CHM so as to avoid the potential side effects.

  14. Diet quality of cancer survivors and noncancer individuals: Results from a national survey.

    Science.gov (United States)

    Zhang, Fang Fang; Liu, Shanshan; John, Esther M; Must, Aviva; Demark-Wahnefried, Wendy

    2015-12-01

    Patterns of poor nutritional intake may exacerbate the elevated morbidity experienced by cancer survivors. It remains unclear whether cancer survivors adhere to existing dietary guidelines and whether survivors' diets differ from those of individuals without cancer over the long term. The authors evaluated dietary intake and quality in 1533 adult cancer survivors who participated in the National Health and Nutrition Examination Survey from 1999 to 2010 compared with dietary intake and quality in 3075 individuals who had no history of cancer and were matched to the cancer survivors by age, sex, and race/ethnicity. Dietary intake was assessed using 24-hour dietary recalls. The 2010 Healthy Eating Index (HEI-2010) was used to evaluate diet quality. The mean ± standard deviation HEI-2010 total score was 47.2 ± 0.5 in the cancer survivors and 48.3 ± 0.4 in the noncancer group (P = .03). Compared with the noncancer group, cancer survivors had a significantly lower score for empty calories (13.6 vs 14.4; P = .001), which corresponded to worse adherence to dietary intake of calories from solid fats, alcohol, and added sugars. Cancer survivors also had significantly lower dietary intake of fiber than the noncancer group (15.0 vs 15.9 g per day; P = .02). In relation to recommended intake, survivors' mean dietary intake of vitamin D, vitamin E, potassium, fiber, and calcium was 31%, 47%, 55%, 60%, and 73%, respectively; whereas their mean dietary intake of saturated fat and sodium was 112% and 133%, respectively, of the recommended intake. Cancer survivors had poor adherence to the US Department of Agriculture 2010 Dietary Guidelines for Americans, and their intake patterns were worse than those in the general population for empty calories and fiber. © 2015 American Cancer Society.

  15. Can All Centers Plan Intensity-Modulated Radiotherapy (IMRT) Effectively? An External Audit of Dosimetric Comparisons Between Three-Dimensional Conformal Radiotherapy and IMRT for Adjuvant Chemoradiation for Gastric Cancer

    International Nuclear Information System (INIS)

    Chung, Hans T.; Lee, Brian; Park, Eileen; Lu, Jiade J.; Xia Ping

    2008-01-01

    Purpose: To compare dosimetric endpoints between three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) at our center with limited IMRT experience, and to perform an external audit of the IMRT plans. Methods and Materials: Ten patients, who received adjuvant chemoradiation for gastric cancer, formed the study cohort. For standardization, the planning target volume (PTV) and organs at risk were recontoured with the assistance of a study protocol radiologic atlas. The cohort was replanned with CMS Xio to generate coplanar 3D-CRT and IMRT plans. All 10 datasets, including volumes but without the plans (i.e., blinded), were transmitted to an experienced center where IMRT plans were designed using Nomos Corvus (IMRT-C) and ADAC Pinnacle (IMRT-P). All IMRT plans were normalized to D95% receiving 45 Gy. Results: Intensity-modulated radiotherapy yielded higher PTV V45 (volume that receives ≥45 Gy) (p < 0.001) than 3D-CRT. No difference in V20 was seen in the right (p = 0.9) and left (p 0.3) kidneys, but the liver mean dose (p < 0.001) was superior with IMRT. For the external audit, IMRT-C (p = 0.002) and IMRT-P (p < 0.001) achieved significantly lower left kidney V20 than IMRT, and IMRT-P (p < 0.001) achieved lower right kidney V20 than IMRT. The IMRT-C (p = 0.003) but not IMRT-P (p = 0.6) had lower liver mean doses than IMRT. Conclusions: At our institution with early IMRT experience, IMRT improved PTV dose coverage and liver doses but not kidney doses. An external audit of IMRT plans showed that an experienced center can yield superior IMRT plans

  16. Warning dreams preceding the diagnosis of breast cancer: a survey of the most important characteristics.

    Science.gov (United States)

    Burk, Larry

    2015-01-01

    There are rare reports of warning dreams about breast cancer in the dream literature and even fewer in the medical literature. Anxiety about breast cancer is increasing due to uncertainty about conflicting guidelines regarding mammography screening. The purpose of the study was to survey women with breast cancer who had warning dreams prior to diagnosis to determine the most common and important characteristics of these dreams. Eighteen women with a known diagnosis of breast cancer completed a survey of 19 Yes or No questions about their warning dreams and submitted dream narratives. The five most common characteristics of warning dreams in descending order of frequency reported in the survey were: a sense of conviction about the importance in 94%; the dreams were more vivid, real or intense than ordinary in 83%; an emotional sense of threat, menace or dread in 72%; the use of the specific words breast cancer/tumor in 44%; and the sense of physical contact with the breast in 39%. Warning dreams of breast cancer were often reported to be life changing experiences that prompted medical attention leading directly to diagnosis. Further research needs to be done to determine the frequency of such dreams in women without known breast cancer in order to assess the predictive value of a warning dream. These preliminary results suggest that keeping a dream diary might be a useful adjunct to routine self-examination as part of a breast self-care program, particularly for women in a high-risk category. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Recovery Audit Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Recovery Audit Programs mission is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on...

  18. Materiality in Financial Audit

    OpenAIRE

    Adriana Claudia GHIMIS

    2012-01-01

    The financial audit aims toward increasing the credibility of financial informaiton. The purpose of the paper is to outline the most important topics regarding the definition and application of significance limit.

  19. Harmonisation of Audit Practice

    DEFF Research Database (Denmark)

    Sormunen, Nina; Klarskov Jeppesen, Kim; Sundgren, Stefan

    2013-01-01

    The study uses a sample of 2,941 bankrupt firms from Denmark, Finland, Norway and Sweden in the period 2007 to 2011, and investigates the harmonisation of audit behaviour in terms of going-concern reporting. Even though the Nordic countries have similar legal systems and, for all practical purposes......, identical audit requirements regarding going-concern reporting, the study findings show significant differences in going-concern reporting before bankruptcy between the Nordic countries. One key result is that Danish and Norwegian companies get a going-concern opinion prior to bankruptcy more frequently...... and Norway compared to Sweden and Finland. Finally, the study findings also indicate that differences in audit reporting behaviour are moderated by international audit firm networks....

  20. TTVP Audit Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The data set contains information on retail market spot check audit purchases. Data are available from May 2001 to present with new data appended annually....

  1. INTERNAL AUDIT CHARTER

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sandra Blanchard

    2013-03-26

    Mar 26, 2013 ... ... conduct internal audits to assess that the corporation's accounts and records; financial and management controls; information systems and management .... o Information for decision making is accurate, relevant and timely; ...

  2. Auditing the Auditors: Has the Establishment of the Audit Oversight Board Affected Audit Quality?

    OpenAIRE

    Ismail, Hashanah; Theng, Ung Chui

    2015-01-01

    This paper reports on the results of a research into the relationship between audit quality during the years before and after the incorporation of the Audit Oversight Board (AOB) in Malaysia in 2010. As the AOB only audits auditors of listed companies this study is based on 50 companies’ audited financial statements 2 years before and after AOB was established. A total of 200 firm years were observed. Using reported companies’ earnings to proxy for earnings and audit quality the data collecte...

  3. Oneida Tribe Energy Audits

    Energy Technology Data Exchange (ETDEWEB)

    Olson, Ray [Energy Controls Manager; Schubert, Eugene [Policy Analyst

    2014-08-15

    Project funding energy audits of 44 Tribally owned buildings operated by the Oneida Tribe of Indians of WI. Buildings were selected for their size, age, or known energy concerns and total over 1 million square feet. Audits include feasibility studies, lists of energy improvement opportunities, and a strategic energy plan to address cost effective ways to save energy via energy efficiency upgrades over the short and long term.

  4. Auditing of Innovation Process: a case study in Inmetro

    Directory of Open Access Journals (Sweden)

    Vanessa Lage Bellazzi de Pellegrini

    2014-04-01

    Full Text Available The main objective of the research was to describe the contribution of the audit for the INMETRO innovation process. The intermediate objectives sought to characterize the innovation process INMETRO; identify the procedures and instruments used by the institute in the auditing of the innovation process, and describe the influence of the auditing in the development of two innovations by INMETRO. As a secondary objective the INMETRO innovation process was evaluated by using the evaluation model of Tidd, Bessant & Pavitt (2008.The research method was a single case study with a descriptive purpose. Semistructured interviews with eight employees working with audit and control as well as narratives of two innovations by employees who closely followed the development of innovations were used for data collection. The collected data were treated by means of content analysis. The survey results indicated that neither the innovation process nor the process innovation audit is institutionalized in INMETRO. This makes each main unit of the institute develop innovations according to a viewpoint itself. The absence of reports of audit processes of innovation management with suggestions for improvements in the processes of innovation, and the few references to issues related to audit on the accounts obtained during narratives of development of the innovations surveyed show that the influence of management innovation audit is still small in INMETRO. This is compounded by the fact that management innovation audit is still in its infancy. Paradoxically the legitimate concern of the Institute with normalization may be harming the correct understanding of what would be the appropriate procedures and instruments to an innovation audit. While not referring directly to the question innovation, often appear reports of respondents complaining of excessive standards.

  5. Computer Assisted Audit Techniques

    Directory of Open Access Journals (Sweden)

    Eugenia Iancu

    2007-01-01

    Full Text Available From the modern point of view, audit takes intoaccount especially the information systems representingmainly the examination performed by a professional asregards the manner for developing an activity by means ofcomparing it to the quality criteria specific to this activity.Having as reference point this very general definition ofauditing, it must be emphasized that the best known segmentof auditing is the financial audit that had a parallel evolutionto the accountancy one.The present day phase of developing the financial audithas as main trait the internationalization of the accountantprofessional. World wide there are multinational companiesthat offer services in the financial auditing, taxing andconsultancy domain. The auditors, natural persons and auditcompanies, take part at the works of the national andinternational authorities for setting out norms in theaccountancy and auditing domain.The computer assisted audit techniques can be classified inseveral manners according to the approaches used by theauditor. The most well-known techniques are comprised inthe following categories: testing data techniques, integratedtest, parallel simulation, revising the program logics,programs developed upon request, generalized auditsoftware, utility programs and expert systems.

  6. A Survey of Knowledge About and Perceived Barriers to Prostate Cancer Screening Among Medical Staff

    Directory of Open Access Journals (Sweden)

    Akbarizadeh

    2016-04-01

    Full Text Available Background Prostate cancer is the most common cancer among men and the second leading cause of deaths from cancer. Results of previous studies indicate the effectiveness of screening and early detection in reducing mortality from this disease. Objectives The purpose of this study was to survey the knowledge about prostate cancer and perceived barriers to prostate cancer screening among medical staff of two universities in Ahvaz, Iran. Materials and Methods This cross-sectional descriptive study was performed on 120 employees over 40 years old at Ahvaz Jundishapur University of Medical Sciences and Shahid Chamran University of Ahvaz, who were selected by using simple random sampling. The data collection tool was a researcher-created questionnaire based on the study of texts and other studies. Data analysis was performed using SPSS software and through analytical methods including descriptive and inferential statistics. Results The most common barriers to screening for prostate cancer were a lack of knowledge about where to go for tests and how screening tests are done (70.8%, a lack of emphasis on screening tests (59.1%, and a fear of thinking about the disease (50%. Results showed that there was no significant relationship between doing the serum antigen test and having knowledge regarding prostate cancer. But there was a significant association between prostate cancer screening and perceived barriers (P = 0.001. Conclusions Results showed that whereas knowledge by itself cannot guarantee men’s participation in prostate cancer screenings, perceived barriers can play an important role in discouraging men from cancer screening participation. Therefore, designing programs to address these barriers is very important.

  7. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Resources for ... Media Cancer Currents Blog About NCI NCI Overview History Contributing to Cancer Research Leadership Director's Page Deputy ...

  8. Leaving a joint audit system

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2014-01-01

    determinants model and an audit fee change model and include interaction terms. Findings: The authors find short-term fee reductions in companies switching to single audits, but only where the former joint audit contained a dominant auditor. The authors argue that in this situation bargaining power is more...... with the auditors than in a equally shared joint audit, and that the auditors' incentives to offer an initial fee discount are bigger. Research limitations/implications: The number of observations is constrained by the small Danish capital market. Future research could take a more qualitative research approach......, to examine whether the use of a single audit firm rather than two has an effect on audit quality. The area calls for further theory development covering audit fee and audit quality in joint audit settings. Practical implications: Comapnies should consider their relationship with their auditors before...

  9. The management of breakthrough cancer pain--educational needs a European nursing survey.

    Science.gov (United States)

    Wengström, Y; Rundström, C; Geerling, J; Pappa, T; Weisse, I; Williams, S C; Zavratnik, B; Rustøen, T

    2014-01-01

    Poorly managed cancer pain is well known to profoundly impact the patient's daily life and interfere with quality of life. Nurses who cared for patients with cancer from 12 European countries participated in a survey of breakthrough cancer pain practice. The purpose was to investigate how nurses assess breakthrough cancer pain, use of standardised tools, confidence in supporting patients and awareness of medications. Responses from 1241 participants showed country variations. The majority of the sample was female, Germany had the highest proportion of male nurses (21.0%), followed by Greece (15.8%). A significantly larger proportion of nurses with longer experience and more education (78.8%) used a comprehensive definition of breakthrough cancer pain. Significant variations in training were found; 71% of Finnish nurses had received training compared with 6% of Greek nurses. Training and using a standardised assessment tool was associated with a significant increase in the nurses' perceived ability to distinguish between breakthrough and background pain. Nurses in countries with the highest proportion of training were most confident in supporting patients. In conclusion, there still exists problems with effective management of patients' breakthrough cancer pain, continuing inability to define the difference between background and breakthrough cancer pain leads to poor treatment. © 2013 John Wiley & Sons Ltd.

  10. Auditing of environmental management system

    Directory of Open Access Journals (Sweden)

    Čuchranová Katarína

    2001-12-01

    Full Text Available Environmental auditing has estabilished itself as a valueable instrument to verify and help to improve the environmental performance.Organizations of all kinds may have a need to demonstrate the environmental responsibility. The concept of environmental management systems and the associated practice of environmental auditing have been advanced as one way to satisfy this need.These system are intended to help an organization to establish and continue to meet its environmental policies, objectives, standards and other requirements.Environmental auditing is a systematic and documented verification process of objectively obtaining and evaluating audit evidence to determine whether an organizations environmental management system conforms to the environmental management system audit criteria set by the organization and for the communication of the results of this process to the management.The following article intercepts all parts of preparation environmental auditing.The audit programme and procedures should cover the activities and areas to be considered in audits, the frequency of audits, the responsibilities associated with managing and conducting audits, the communication of audit results, auditor competence, and how audits will be conducted.The International Standard ISO 140011 estabilishes the audit procedures that determine conformance with EMS audit criteria.

  11. Understanding Transgender Men's Experiences with and Preferences for Cervical Cancer Screening: A Rapid Assessment Survey.

    Science.gov (United States)

    Seay, Julia; Ranck, Atticus; Weiss, Roy; Salgado, Christopher; Fein, Lydia; Kobetz, Erin

    2017-08-01

    Transgender men are less likely than cisgender women to receive cervical cancer screening. The purpose of the current study was to understand experiences with and preferences for cervical cancer screening among transgender men. Ninety-one transgender men ages 21-63 completed the survey. The survey evaluated experiences with and preferences for screening, including opinions regarding human papillomavirus (HPV) self-sampling as a primary cervical cancer screening. Half (50.5%) of participants did not have Pap smear screening within the past 3 years. The majority (57.1%) of participants preferred HPV self-sampling over provider-collected Pap smear screening. Participants who reported discrimination were more likely to prefer HPV self-sampling (odds ratio = 3.29, 95% confidence interval 1.38-7.84, P = 0.007). Primary HPV testing via HPV self-sampling may improve cervical cancer screening uptake among transgender men. Future work should pilot this innovative cervical cancer screening method within this population.

  12. Japanese structure survey of radiation oncology in 2007 with special reference to designated cancer care hospitals

    International Nuclear Information System (INIS)

    Numasaki, Hodaka; Shibuya, Hitoshi; Nishio, Masamichi

    2011-01-01

    Background and Purpose: The structure of radiation oncology in designated cancer care hospitals in Japan was investigated in terms of equipment, personnel, patient load, and geographic distribution. The effect of changes in the health care policy in Japan on radiotherapy structure was also examined. Material and Methods: The Japanese Society of Therapeutic Radiology and Oncology surveyed the national structure of radiation oncology in 2007. The structures of 349 designated cancer care hospitals and 372 other radiotherapy facilities were compared. Results: Respective findings for equipment and personnel at designated cancer care hospitals and other facilities included the following: linear accelerators/facility: 1.3 and 1.0; annual patients/linear accelerator: 296.5 and 175.0; and annual patient load/full-time equivalent radiation oncologist was 237.0 and 273.3, respectively. Geographically, the number of designated cancer care hospitals was associated with population size. Conclusion: The structure of radiation oncology in Japan in terms of equipment, especially for designated cancer care hospitals, was as mature as that in European countries and the United States, even though the medical costs in relation to GDP in Japan are lower. There is still a shortage of manpower. The survey data proved to be important to fully understand the radiation oncology medical care system in Japan. (orig.)

  13. Psychologists involved in cancer palliative care in Japan: A nationwide survey.

    Science.gov (United States)

    Nakajima, Kasumi; Iwamitsu, Yumi; Matsubara, Mei; Oba, Akira; Hirai, Kei; Morita, Tatsuya; Kizawa, Yoshiyuki

    2015-04-01

    The aim of this study was to clarify, using a nationwide survey, what is perceived as necessary knowledge and skills for psychologists involved in cancer palliative care in Japan, the expectations of medical staff members, and the degree to which these expectations are met. We conducted a questionnaire survey of psychologists involved in cancer palliative care. A total of 419 psychologists from 403 facilities were asked to fill out the questionnaire and return it anonymously. Some 401 psychologists (89 males, 310 females, and 2 unspecified; mean age, 37.2 ± 9.5 years) responded about necessary knowledge and skills for psychologists working in cancer palliative care, the necessity for training, expectations at their current workplace, and the degree to which expectations are met. More than 90% of participants responded that many kinds of knowledge and skills related to the field of cancer palliative care are necessary. Over 80% of participants indicated a necessity for training related to these knowledge and skills. Although more than 50% (range, 50.1-85.8%) of participants responded that such services as "cooperation with medical staff within a hospital," "handling patients for whom psychological support would be beneficial," and "assessment of patients' mental state" were expected at their workplace, fewer than 60% (31.4-56.9%) responded that they actually performed these roles. Our results show that many psychologists in cancer palliative care feel unable to respond to the expectations at their current workplace and that they require more adequate knowledge and skills related to cancer palliative care to work effectively. No other nationwide surveys have generated this type of information in Japan, so we believe that the results of our study are uniquely important.

  14. Pilot Survey of Breast Cancer Management in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Verna D.N.K. Vanderpuye

    2017-06-01

    Full Text Available Purpose: To understand the current state of breast cancer management in sub-Saharan Africa. Methods: We conducted an anonymous online survey of breast cancer management among African Organization for Research and Treatment in Cancer (AORTIC members by using a 42-question structured questionnaire in both English and French in 2013. Results: Twenty members from 19 facilities in 14 countries responded to the survey. Twelve members (60% belonged to a multidisciplinary breast cancer team. Radiotherapy equipment was available in seven facilities (36%, but equipment had down time at least once a week in four facilities. Available chemotherapy drugs included methotrexate, cyclophosphamide, fluorouracil, anthracyclines, and vincristine, whereas trastuzumab, taxanes, vinorelbine, and gemcitabine were available in few facilities. Core-needle biopsy was available in 16 facilities (84%; mammogram, in 17 facilities (89%; computed tomography scan, in 15 facilities (79%; magnetic resonance imaging, in 11 facilities (58%; and bone scans, in nine facilities (47%. It took an average of 1 to 3 weeks to report histopathology. Immunohistochemistry was available locally in eight facilities (42%, outside hospitals but within the country in seven facilities (37%, and outside the country in four facilities (21%. Thirteen facilities (68% performed axillary node dissections as part of a breast protocol. Neoadjuvant chemotherapy was the most common therapy for locally advanced breast cancer in 13 facilities (68%. In three facilities (16%, receptor status did not influence the prescription of hormone treatment. Conclusion: This pilot survey suggests that AORTIC members in sub-Saharan Africa continue to make gains in the provision of access to multidisciplinary breast cancer care, but the lack of adequate pathology and radiotherapy services is a barrier. Focused attention on in-country and regional training needs and improvement of health systems deliverables is urgently

  15. Linking audit and clinical effectiveness in the lung tumour service

    LENUS (Irish Health Repository)

    Gorman, Sharon

    2009-05-28

    Clinical Audit plays an important role in the evaluation of care and clinical outcomes for all patients. In conjunction with the respiratory nurse specialist a retrospective chart audit of the regional lung cancer service was undertaken at the Midlands Regional Hospital Mullingar (MRHM). The lung cancer service has been established for four years and has set its standards in line with NICE guidelines and Irish guidelines for the clinical management of lung cancer. An audit tool was developed by the audit facilitator in conjunction with the respiratory nurse specialist and key department personnel. The tool aimed to measure length of time taken for key steps in the patients care pathway. A pilot audit was carried out and the tool was evaluated. The audit tool provided accurate recording of information at key points in the patient’s care which allows for a thorough service evaluation. The data collected and analysed gives vital information on the quality of service, and showed where there are deficits in service provision that need to be addressed.

  16. Energy audit: potential of energy - conservation in Jordanian ceramic industry

    International Nuclear Information System (INIS)

    Adas, H.; Taher, A.

    2005-01-01

    This paper represents the findings of the preliminary energy-audits performed by the Rational Use of Energy Division at the National Energy Research Center (NERC), as well as the findings of a detailed energy-audit carried out in the largest Ceramic plant in Jordan (Jordan Ceramic industries).These studies were preceded by a survey of the ceramic factories in Jordan. The survey was carried out in 1997. The performed preliminary energy-audits showed that an average saving-potential in most of theses plants is about 25 % of the total energy-bills in these plants, which constitutes a considerable portion of the total production-cost. This fact was verified through the detailed energy-audit performed by NERC team for the largest Ceramic Plant in Jordan in June 2003, which showed an energy-saving potential of about 30 %. This saving can be achieved by some no-cost or low-cost measures, in addition to some measures that need reasonable investments with an average pay-back period of about two years. This detailed energy-audit covered electrical systems, refrigeration systems, compressed-air systems, and kilns. The results of the detailed energy-audit can be disseminated to other Ceramic plant, because of the similarity in the production process between these plants and the plant where the detailed energy-audit was carried out. (author)

  17. Communication of Audit Risk to Students.

    Science.gov (United States)

    Alderman, C. Wayne; Thompson, James H.

    1986-01-01

    This article focuses on audit risk by examining it in terms of its components: inherent risk, control risk, and detection risk. Discusses applying audit risk, a definition of audit risk, and components of audit risk. (CT)

  18. Improving energy audit process and report outcomes through planning initiatives

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  19. Working conditions survey and trainees situation: new approach to auditing the situation of European trainees in obstetrics and gynaecology ten years later.

    Science.gov (United States)

    Rodríguez, David; Christopoulos, Panagiotis; Martins, Nuno; Pärgmäe, Pille; Werner, Henrica M J

    2009-12-01

    (1) To review the training and working conditions for trainees in obstetrics and gynaecology (Ob/Gyn) in Europe. (2) To suggest further improvements in working conditions for trainees in Ob/Gyn. It is an observational, descriptive, and cross-sectional study. The sample is constituted of the answers from the representatives of 25 European Network of Trainees in Ob/Gyn (ENTOG) member countries to a survey designed by ENTOG's executive. The current survey is based on the former ENTOG working conditions survey published in 1997, but has been extended to include questions that have become important recently, and to include new countries that have entered the European Union (EU) since that time. The total number of trainees represented in this study is 6056. The male/female ratio is 35/65. The average number of official working hours is 51.6 h weekly, but varies widely. The average number of duties/month is five, but varies widely from two to nine. Fewer than 50% of countries have a hospital visitation system implemented. Training abroad is possible in most training systems. Compared with the 1997 survey further harmonisation is taking place. Steps towards harmonisation are being made. Hospital visitation systems should be further introduced. Not all countries have remunerated training posts. Assessment should become more homogeneous. Compliance with the European Working Time Directive (EWTD) is a big challenge.

  20. A national survey of supportive practices for patients undergoing radiotherapy for oral cancers

    International Nuclear Information System (INIS)

    Osborn, Joanne; Doolan, Caroline

    2013-01-01

    Purpose: Xerostomia and mucositis are two of the main radiation induced toxicities experienced by patients undergoing radiotherapy to the oral cavity. These toxicities can lead to significant weight loss with the potential to cause complications with radiotherapy treatment. Literature has shown that nutritional intervention can help to minimise these side effects. The aim of the survey was to explore current practice across the UK in nutritional intervention for these patients. Method: Postal questionnaires were sent to all 63 radiotherapy departments in the UK in November 2009. Results: 29 responses (43%) were received. 90% (n = 26) of the departments used 3D-Conformal radiotherapy (3D-CRT) as the main technique for treatment of these patients, with 48% (n = 14) of departments having implemented Intensity modulated radiotherapy (IMRT). All departments referred their patients to a dietician. 93% (n = 27) of departments placed percutaneous endoscopic gastrostomy or radiologically-inserted gastrostomy tubes. 55% (n = 16) departments administered nasogastric tubes. Conclusion: This survey verified many common practices regarding dietary care and advice, some variation was evident in the use of feeding tubes. All responding centres referred patients to a dietician with the aim to maintain nutritional status and prevent weight loss that could contribute to uncertainty in treatment setup. This survey also demonstrated that since Macknelly and Day's (2009) study, a greater number of centres have implemented IMRT for patients undergoing radiotherapy to the head and neck. Although IMRT has been shown to reduce xerostomia, this audit found no changes in the dietary care and advice given to these patients

  1. What's missing in missing data? Omissions in survey responses among parents of children with advanced cancer.

    Science.gov (United States)

    Rosenberg, Abby R; Dussel, Veronica; Orellana, Liliana; Kang, Tammy; Geyer, J Russel; Feudtner, Chris; Wolfe, Joanne

    2014-08-01

    Missing data is a common phenomenon with survey-based research; patterns of missing data may elucidate why participants decline to answer certain questions. To describe patterns of missing data in the Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) study, and highlight challenges in asking sensitive research questions. Cross-sectional, survey-based study embedded within a randomized controlled trial. Three large children's hospitals: Dana-Farber/Boston Children's Cancer and Blood Disorders Center (DF/BCCDC); Children's Hospital of Philadelphia (CHOP); and Seattle Children's Hospital (SCH). At the time of their child's enrollment, parents completed the Survey about Caring for Children with Cancer (SCCC), including demographics, perceptions of prognosis, treatment goals, quality of life, and psychological distress. Eighty-six of 104 parents completed surveys (83% response). The proportion of missing data varied by question type. While 14 parents (16%) left demographic fields blank, over half (n=48; 56%) declined to answer at least one question about their child's prognosis, especially life expectancy. The presence of missing data was unrelated to the child's diagnosis, time from progression, time to death, or parent distress (p>0.3 for each). Written explanations in survey margins suggested that addressing a child's life expectancy is particularly challenging for parents. Parents of children with cancer commonly refrain from answering questions about their child's prognosis, however, they may be more likely to address general cure likelihood than explicit life expectancy. Understanding acceptability of sensitive questions in survey-based research will foster higher quality palliative care research.

  2. FINANCIAL AUDIT -RISKS IDENTIFIED IN THE AUDIT PLANNING STAGE

    Directory of Open Access Journals (Sweden)

    Stelian Selisteanu

    2015-09-01

    Full Text Available The general objective of the audit activity is to currently present, under all significant aspects, a financial situation and to state an opinion according to which all economic operations are indeed correct and pursuant the law. As any activity that involves the human factor, the audit activity is subject to the influence of certain risks, risks that emerge, firstly, from an organizational level of the audited entity. In audit, risk is a very important influence element, whose ignorance can generate major implications in achieving the final goal to create an evidences database on which a pertinent and objective opinion can be founded, concerning the audited financial situations. In this context, one of the main objectives, that takes place during the planning phase of the audit, is represented by assessing risks to which the audited activity is subjected to, evaluation that helps the determining the work volume implied by the audit.

  3. Audit result and its users

    Directory of Open Access Journals (Sweden)

    Shalimova Nataliya S.

    2014-01-01

    Full Text Available The article identifies essence of the “audit result” and “users of audit result” notions and characteristics of the key audit results user. It shows that in order to give a wide characteristic of users it is expedient to unite all objects, which could be used (audit report, fact of refusal to conduct audit and information that is submitted to managers in the process of audit with the term “audit result” and classify it depending on the terms of submission by final and intermediate result. The article offers to define audit results user as a person, persons or category of persons for whom the auditor prepares the audit report and, in cases, envisaged by international standards of the audit and domestic legislative and regulatory acts, provides other additional information concerning audit issues. In order to identify the key audit results user the article distributes all audit tasks into two groups depending on possibilities of identification of users. The article proves that the key user should be identified especially in cases of a mandatory audit and this process should go in interconnection with the mechanism of allocation of a key user of financial reports. It offers to consider external users with direct financial interests, who cannot request economic subjects directly to provide information and who should rely on general financial reports and audit report when receiving significant portion of information they need, as the key user. The article makes proposals on specification of the categorical mechanism in the sphere of audit, which are the basis for audit quality assessment, identification of possibilities and conditions of appearance of the necessary and sufficient trust to the auditor opinion.

  4. PILLARS OF THE AUDIT ACTIVITY: MATERIALITY AND AUDIT RISK

    OpenAIRE

    ANA MARIA JOLDOŞ; IONELA CORNELIA STANCIU; GABRIELA GREJDAN

    2010-01-01

    The purpose of this article is to present the issues of materiality and audit risk within the activity of financial audit. The concepts of materiality and audit risk are described from a theoretical perspective, providing approaches found within the national and international literature and within the specific legislation. A case study on the calculation of materiality and audit risk for an entity is presented in the last part of the article. Through the theoretical approach and the case stud...

  5. A telephone survey of cancer awareness among frontline staff: informing training needs

    Science.gov (United States)

    Cook, N; Hart, A; Nuttall, K; Simpson, K; Turnill, N; Grant-Pearce, C; Damms, P; Allen, V; Slade, K; Dey, P

    2011-01-01

    Background: Studies have shown limited awareness about cancer risk factors among hospital-based staff. Less is known about general cancer awareness among community frontline National Health Service and social care staff. Methods: A cross-sectional computer-assisted telephone survey of 4664 frontline community-based health and social care staff in North West England. Results: A total of 671 out of 4664 (14.4%) potentially eligible subjects agreed to take part. Over 92% of staff recognised most warning signs, except an unexplained pain (88.8%, n=596), cough or hoarseness (86.9%, n=583) and a sore that does not heal (77.3%, n=519). The bowel cancer-screening programme was recognised by 61.8% (n=415) of staff. Most staff agreed that smoking and passive smoking ‘increased the chance of getting cancer.' Fewer agreed about getting sunburnt more than once as a child (78.0%, n=523), being overweight (73.5%, n=493), drinking more than one unit of alcohol per day (50.2%, n=337) or doing less than 30 min of moderate physical exercise five times a week (41.1%, n=276). Conclusion: Cancer awareness is generally good among frontline staff, but important gaps exist, which might be improved by targeted education and training and through developing clearer messages about cancer risk factors. PMID:21750554

  6. 10 CFR 603.1295 - Periodic audit.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Periodic audit. 603.1295 Section 603.1295 Energy... Used in this Part § 603.1295 Periodic audit. An audit of a participant, performed at an agreed-upon... an audit may cover. A periodic audit of a participant differs from an award-specific audit of an...

  7. 7 CFR 1773.7 - Audit standards.

    Science.gov (United States)

    2010-01-01

    ... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.7 Audit standards. (a) The audit must be performed in accordance with GAGAS and this part. The audit must be performed in accordance with GAGAS in effect at the audit date unless the borrower is directed otherwise, in writing, by RUS...

  8. Effective quality auditing

    International Nuclear Information System (INIS)

    Sivertsen, Terje

    2004-01-01

    The present report focuses on how to improve the effectiveness of quality audits and organization-wide quality management. It discusses several concepts related to internal quality auditing, includes guidelines on how to establish auditing as a key process of the organization, and exemplifies its application in the management of quality, strategy, and change. The report follows a line of research documented previously in the reports 'Continuous Improvement of Software Quality' (HWR-584) and 'ISO 9000 Quality Systems for Software Development' (HWR-629). In particular, the concepts of measurement programmes and process improvement cycles, discussed in HWR-584, form the basis for the approach advocated in the present report to the continual improvement of the internal quality audit process. Internal auditing is an important ingredient in ISO 9000 quality systems, and continual improvement of this process is consistent with the process-oriented view of the 2000 revision of the ISO 9000 family (HWR-629). The overall aim of the research is to provide utilities and their system vendors with better tools for quality management in digital I and C projects. The research results are expected to provide guidance to the choice of software engineering practices to obtain a system fulfilling safety requirements at an acceptable cost. For licensing authorities, the results are intended to make the review process more efficient through the use of appropriate measures (metrics), and to be of help in establishing requirements to software quality assurance in digital I and C projects. (Author)

  9. Winning a prudence audit

    International Nuclear Information System (INIS)

    Shepherd, S.H.; Quan, T.F.; Carroll, D.W.T.

    1989-01-01

    The greatest hazard that a utility faces from owning a nuclear power plant is not radiation--it is regulation. Retrospective prudence audits have been used by public utility commissions (PUCs) as a basis to disallow recovery of billions of dollars of nuclear plant construction costs. These disallowances have caused severe financial damage to many utilities. Although a final decision on rates has not been made, the Arizona Corporation Commission's (ACC's) auditor recently completed its examination of the construction costs of the Palo Verde Nuclear Generating Station (PVNGS). The auditor reported that PVNGS was prudently designed and constructed. It concluded that ∼1% of the project (approximately $60.2 million out of the plant's overall $5.9 billion cost) was unreasonably expended. The auditor also found that the project management team had actually saved ratepayers over $300 million through exceptional management actions. This is a resounding endorsement of the work of the staff and management of Arizona Public Service (APS), Bechtel, Combustion Engineering, the AFL-CIO, and the hundreds of suppliers and contractors that participated in the construction of PVNGS. It is also a much different result from that of other recent prudence audits. The history, strategy, planning, and conduct of the audit overcame the biases that had produced proposals for large disallowances on other good plants. This paper describes the efforts taken that promoted fair and balanced audit findings (although APS does not endorse all of the audit findings)

  10. Audit Fee Determinants and Audit Quality in Ethiopian Commercial ...

    African Journals Online (AJOL)

    However, among the factors considered important by the regulatory bank, credit risk is found to be insignificant. With regard to audit quality, the study did not find significant relationship between the extent of earning management and abnormal audit fees, indicating that auditors do not seem to compromise audit quality to ...

  11. Audit Fee Determinants and Audit Quality in Ethiopian Commercial ...

    African Journals Online (AJOL)

    user

    Secondly, the presence of vigilant regulation places a countervailing effect in the audit ... market and the stiff competition (partly triggered by the bidding system) ... accounting profession, and lower audit quality concern afforded in the country, ..... those earnings and give it a better audit opinion than the facts merit (Xie et al.

  12. What impact has tendering had on trainees? Results of a national survey by British Association for Sexual Health and HIV Trainees' Collaborative for audit, research and quality improvement projects.

    Science.gov (United States)

    Wiggins, Helen; Hartley, Anna; Clarke, Emily; Foley, Elizabeth; Nandwani, Rak; Carlin, Elizabeth; Waters, Laura; Ahmed, Nadia

    2018-01-01

    In April 2013, local authorities gained responsibility for commissioning sexual health services in England. With many services going out to tender and resultant change in services or service provider, there is anecdotal evidence that this has impacted on the education, training and morale of genitourinary medicine (GUM) trainees. The aim of this study was to evaluate the impact of tendering on GUM trainees. An electronic survey designed by the British Association for Sexual Health and HIV Trainees' Collaborative for Audit, Research and Quality Improvement Projects (T-CARQ) was distributed to GUM trainees and newly appointed consultants. Eighty-two individuals responded (74% GUM trainees, 25% newly appointed consultants, 1% locum appointed for service). Sixty-three per cent (45/72) had experience of training within a service which was being tendered. Of these, 59% (24/41) felt their training was not considered during the tendering process and 20% (8/41) felt that it was. Forty-four per cent (18/41) felt adequately supported. Thirty per cent (12/40) reported active participation in the tendering process. On a scale of 0 (no impact) to 5 (major impact), the median score for impact of tendering on training was 2. The positive/negative impact of tendering on different training elements was rated: other than management experience the overall impact on all parameters was negative, namely morale, senior support and education. In conclusion, this survey describes the variable impact of service tendering on GUM training. Our recommendations for maintaining training standards despite tendering include actively involving trainees and education partners, inclusion of specialist GUM training in service specifications, development of guidance for commissioners and services for the management of GUM training within tendering.

  13. Web-based survey of fertility issues in young women with breast cancer.

    Science.gov (United States)

    Partridge, Ann H; Gelber, Shari; Peppercorn, Jeffrey; Sampson, Ebonie; Knudsen, Katherine; Laufer, Marc; Rosenberg, Randi; Przypyszny, Michele; Rein, Alison; Winer, Eric P

    2004-10-15

    Young women with breast cancer often seek advice about whether treatment will affect their fertility. We sought to gain a better understanding of women's attitudes about fertility and how these concerns affect decision making. We developed a survey about fertility issues for young women with a history of early-stage breast cancer. The survey was e-mailed to all registered Young Survival Coalition survivor members (N = 1,702). E-mail reminders were used. Six hundred fifty-seven eligible respondents completed the survey. Mean age at breast cancer diagnosis was 32.9 years; mean current age was 35.8 years. Ninety percent of women were white; 62% were married; 76% were college graduates. Stages at diagnosis were as follows: 0, 10%; I, 27%; II, 47%; III, 13%. Sixty-two percent of women were within 2 years of diagnosis. Fifty-seven percent recalled substantial concern at diagnosis about becoming infertile with treatment. In multivariate logistic regression, greater concern about infertility was associated with wish for children/more children (odds ratio [OR], 120; P women reported that infertility concerns influenced treatment decisions. Seventy-two percent of women reported discussing fertility concerns with their doctors; 51% felt their concerns were addressed adequately. Women seemed to overestimate their risk of becoming postmenopausal with treatment. Fertility after treatment is a major concern for young women with breast cancer. There is a need to communicate with and educate young patients regarding fertility issues at diagnosis and a need for future research directed at preserving fertility for young breast cancer survivors.

  14. Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey.

    Science.gov (United States)

    Berretta, Massimiliano; Della Pepa, Chiara; Tralongo, Paolo; Fulvi, Alberto; Martellotta, Ferdinando; Lleshi, Arben; Nasti, Guglielmo; Fisichella, Rossella; Romano, Carmela; De Divitiis, Chiara; Taibi, Rosaria; Fiorica, Francesco; Di Francia, Raffaele; Di Mari, Anna; Del Pup, Lino; Crispo, Anna; De Paoli, Paolo; Santorelli, Adriano; Quagliariello, Vincenzo; Iaffaioli, Rosario Vincenzo; Tirelli, Umberto; Facchini, Gaetano

    2017-04-11

    Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey. Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use. Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.

  15. External audit in radiotherapy dosimetry

    International Nuclear Information System (INIS)

    Thwaites, D.I.; Western General Hospital, Edinburgh

    1996-01-01

    Quality audit forms an essential part of any comprehensive quality assurance programme. This is true in radiotherapy generally and in specific areas such as radiotherapy dosimetry. Quality audit can independently test the effectiveness of the quality system and in so doing can identify problem areas and minimize their possible consequences. Some general points concerning quality audit applied to radiotherapy are followed by specific discussion of its practical role in radiotherapy dosimetry, following its evolution from dosimetric intercomparison exercises to routine measurement-based on-going audit in the various developing audit networks both in the UK and internationally. Specific examples of methods and results are given from some of these, including the Scottish+ audit group. Quality audit in radiotherapy dosimetry is now well proven and participation by individual centres is strongly recommended. Similar audit approaches are to be encouraged in other areas of the radiotherapy process. (author)

  16. Field Audit Checklist Tool (FACT)

    Science.gov (United States)

    Download EPA's The Field Audit Checklist Tool (FACT). FACT is intended to help auditors perform field audits, to easily view monitoring plan, quality assurance and emissions data and provides access to data collected under MATS.

  17. Results of a survey of the treatment policy for early stage tongue and oral floor cancer

    International Nuclear Information System (INIS)

    Asakura, Kohji; Kataura, Akikatsu; Hareyama, Masato

    1998-01-01

    To realize the treatment policy for early stage oral cancer, a survey of 102 institutes in Japan was performed by questionnaire. A majority of the otolaryngologists preferred surgery for the treatment of T1N0 and T2N0 cases of oral cancer. The preferred method of treatment for the T1N0 cases was simple tumor resection and that for the T2N0 cases was extended tumor resection with plastic surgery, elective neck dissection and combined radio-and/or chemotherapy. A majority of the radiologists preferred brachytherapy for T1N0 and non-invasive T2N0 cases. For invasive cases of T2N0 oral cancer, radiologists preferred either surgical treatment or the combination of brachytherapy and external irradiation. (author)

  18. Structure analysis of designated hospitals for cancer control in Japan from JASTRO census survey database 2005

    International Nuclear Information System (INIS)

    Ikeda, Hiroshi; Kagami, Yoshikazu; Nishio, Masamichi; Kataoka, Masaaki; Matsumoto, Yasuo; Hatano, Kazuo; Ogino, Takashi

    2008-01-01

    The structures of 288 hospitals designated for cancer control and approved by Ministry of Health, Labour and Welfare in February 2006 were analyzed from radiotherapy aspects according to the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) 2005 census survey data. The data were compiled from 266 hospitals. Overall 78,086 new patients were treated at these designated hospitals, which accounts for just a half the total number of patients in Japan. The structure of radiotherapy (RT) must be essential for cancer management, and our study showed the designated hospitals are insufficient in the RT requirement. No RT equipment is installed in 14 hospitals. Of 266, 109 hospitals treated less than 200 new patients, and 25 hospitals less than 100 in 2005. The data analysis revealed that academic hospitals, JACC hospitals and others are reasonable in terms of structures and capacity of radiotherapy. Moreover, both academic and JACC hospitals play similar roles to designated prefectural hospitals in cancer management by radiotherapy. (author)

  19. Improving the Deaf community's access to prostate and testicular cancer information: a survey study

    Science.gov (United States)

    Folkins, Ann; Sadler, Georgia Robins; Ko, Celine; Branz, Patricia; Marsh, Shane; Bovee, Michael

    2005-01-01

    Background Members of the Deaf community face communication barriers to accessing health information. To resolve these inequalities, educational programs must be designed in the appropriate format and language to meet their needs. Methods Deaf men (102) were surveyed before, immediately following, and two months after viewing a 52-minute prostate and testicular cancer video in American Sign Language (ASL) with open text captioning and voice overlay. To provide the Deaf community with information equivalent to that available to the hearing community, the video addressed two cancer topics in depth. While the inclusion of two cancer topics lengthened the video, it was anticipated to reduce redundancy and encourage men of diverse ages to learn in a supportive, culturally aligned environment while also covering more topics within the partnership's limited budget. Survey data were analyzed to evaluate the video's impact on viewers' pre- and post-intervention understanding of prostate and testicular cancers, as well as respondents' satisfaction with the video, exposure to and use of early detection services, and sources of cancer information. Results From baseline to immediately post-intervention, participants' overall knowledge increased significantly, and this gain was maintained at the two-month follow-up. Men of diverse ages were successfully recruited, and this worked effectively as a support group. However, combining two complex cancer topics, in depth, in one video appeared to make it more difficult for participants to retain as many relevant details specific to each cancer. Participants related that there was so much information that they would need to watch the video more than once to understand each topic fully. When surveyed about their best sources of health information, participants ranked doctors first and showed a preference for active rather than passive methods of learning. Conclusion After viewing this ASL video, participants showed significant increases

  20. Corporate social responsibility audit: Theoretical aspects

    Directory of Open Access Journals (Sweden)

    Artem Koldovskyi

    2015-08-01

    Full Text Available This paper puts a conceptual framework to outline research for corporate social responsibility (CSR audit based on the analysis of current CRS literature and audit models as implementation of CSR. It is intended to make clear the phenomena about the relationship between audit, implementation of business ethics principles and corporate governance. However, most studies do not take into account modify CSR audit. This paper reports part of a research we carried out on the theoretical interpretation of the corporate social responsibility audit. This paper examines the corporate social responsibility audit as a composition of four categories - management system audits, on-site audits, verbal probability expressions (VPE audits and technology audits. The paper concludes suggests to systematize multiple audits so that they can be conduct in three types of audits - environmental management audits covering in-house companies, environmental technology audits of products, and environmental audits of sites, including non-manufacturing sites and non-consolidated subsidiaries.

  1. Disparities in Oral Cancer Awareness: a Population Survey in Tehran, Iran.

    Science.gov (United States)

    Azimi, Somayyeh; Ghorbani, Zahra; Ghasemi, Erfan; Tennant, Marc; Kruger, Estie

    2018-03-10

    Oral cancer is a life-threatening disease with low survival rates, especially when diagnosed in an advanced stage. Lack of awareness about this cancer among the population is proposed as a possible reason for this diagnostic delay. The aim of this study was to evaluate oral cancer awareness, as well as the association of this with sociodemographic status in Tehran. In this cross-sectional population-based survey, 1800 self-administered questionnaires (collecting sociodemographic data, questions regarding oral cancer awareness and the source of information) were distributed through multistage stratified random sampling. Scores for questions ranged from 0 to 4, and totals were summed. The outcome of question responses was also analyzed separately. In total, 1312 questionnaires were available for analysis, from 788 females and 489 males (37.8 ± 9.02 years). Only 30% of the respondents were aware of oral cancer. The average score for awareness was 1.09 ± 1.6 with no significant differences between age groups and genders. Almost 6.5% of participants had complete awareness about oral cancer. A significant difference was found between mean scores in different levels of education and occupation (p = 0.0001). From 585 responses to the "source of information" question, "public media" was the most important source (almost 50%). Only 2% mentioned "dentists" as a source of information. This study indicated an alarming lack of oral cancer awareness and literacy in Tehran, Iran. Dentists should be obliged to practice their pivotal role in informing the public about oral cancer.

  2. An ethnopharmacological survey of medicinal plants traditionally used for cancer treatment in the Ashanti region, Ghana.

    Science.gov (United States)

    Agyare, Christian; Spiegler, Verena; Asase, Alex; Scholz, Michael; Hempel, Georg; Hensel, Andreas

    2018-02-15

    Cancer represents a major health burden and drain on healthcare resources in the world. The majority of the people of Africa still patronize traditional medicine for their health needs, including various forms of cancer. The aim of the following study is the identification of medicinal plants used for cancer treatment by the traditional healers in the Ashanti area of Ghana and to cross-reference the identified plant species with published scientific literature. Validated questionnaires were administered to 85 traditional healers in 10 communities within Ashanti region. For cross-validation, also 7 healers located outside Ashanti region were investigated to evaluate regional differences. Interviews and structured conversations were used to administer the questionnaires. Selected herbal material dominantly used by the healers was collected and identified. The ethnopharmacological survey revealed 151 plant species used for cancer treatment. Identified species were classified into different groups according to their frequency of use, resulting in the "top-22" plants. Interestingly group I (very frequent use) contained 5 plant species (Khaya senegalensis, Triplochiton scleroxylon, Azadirachta indica, Entandrophragma angolense, Terminalia superba), three of which belong to the plant family Meliaceae, phytochemically mainly characterized by the presence of limonoids. Cross-referencing of all plants identified by current scientific literature revealed species which have not been documented for cancer therapy until now. Special interest was laid on use of plants for cancer treatment of children. A variety of traditionally used anti-cancer plants from Ghana have been identified and the widespread use within ethnotraditional medicine is obvious. Further in vitro and clinical studies will be performed in the near future to rationalize the phytochemical and functional scientific background of the respective extracts for cancer treatment. Copyright © 2017 Elsevier B.V. All

  3. Providing written information increases patient satisfaction: a web-based questionnaire survey of Japanese cancer survivors.

    Science.gov (United States)

    Sakai, Hitomi; Katsumata, Noriyuki; Takahashi, Miyako

    2017-07-01

    The Institute of Medicine (IOM) of the United States recommends that all cancer survivors be provided with a survivorship care plan (SCP), which includes a patient treatment summary and a follow-up care plan. However, SCPs have not been widely adopted in Japan. To provide basic data necessary for implementing SCPs in Japan, we aimed to investigate the forms of clinical and survivorship-related information that Japanese cancer survivors receive from their healthcare providers, and to examine whether written information increases their satisfaction. We performed a cross-sectional online survey of cancer survivors who underwent acute cancer treatment and had at least one follow-up with a physician in the past year. Cancer survivors provided the elements and forms (verbally and/or written) of information they received, as well as the degree of satisfaction with the information provided. Responses were obtained from 545 cancer survivors. Information elements such as surgical procedure (98.3%), surgical outcome (98.1%), and names of administered chemotherapy agents (97.8%) were commonly provided, whereas mental care resources and providers (29.7%), effects on marital relationship and sexual health (35.7%), and effects on fertility (43.4%) were less common. A large proportion of cancer survivors received verbal information only. For 18 of 20 elements, except for effects on fertility and duration of hormonal therapy, satisfaction was significantly higher when both forms of information were provided (P information can better meet the needs of Japanese cancer survivors. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. Lung cancer multidisciplinary team meetings: a survey of participants at a national conference

    Energy Technology Data Exchange (ETDEWEB)

    Bydder, S [Sir Charles Gairdner Hospital, University of Western Australia, Western Australia, Australia (Australia). Dept. of Radiation Oncology; Hasani, A [Sir Charles Gairdner Hospital, University of Western Australia, Western Australia, Australia (Australia). Dept. of Medical Oncology; Broderick, C [Curtin Health Innovation Research Institute, Curtin University of technology, Perth, Australia (Australia). WA Cancer and Palliative Care Network; Semmens, J [Curtin Health Innovation Research Institute, Curtin University of technology, Perth, Australia (Australia). Centr for Population Health Research

    2008-04-15

    Full text: Multidisciplinary meetings (MDMs) are a useful aid for the development of comprehensive treatment plans for cancer patients. However, little is known about the requirements for effective MDM function. Attendees at a national lung cancer conference who participated at least weekly in lung cancer MDMs were surveyed. The survey addressed the attendees' perceptions regarding the aims of MDMs, and for their own institutional MDMs, the importance and need for improvement for each of: (i) the attendance of nine discipline groups; and (ii) 15 aspects related to MDM function derived from the literature. The survey also asked participants if MDMs met their needs. There was a general agreement on the aims of the meetings. There was also an agreement on the importance of various groups' attendance and each of the examined aspects of MDMs. However, many respondents reported their meetings required moderate or substantial improvements in one or more areas. More than 20% of the respondents indicated improvement was required for the attendance of three discipline groups (palliative care physicians, pathologists and cardiothoracic surgeons) and 10 of the 15 examined aspects (more than half in the case of computerised databases). Only 9% of the respondents reported that none of the features surveyed needed either moderate or substantial improvement. MDMs met the needs of 79% of the respondents. We found general agreement on the aims of the meetings, the importance of various groups' attendance at MDMs and each of the examined aspects of MDMs. However, moderate or substantial improvements were thought to be required by many respondents. The performance of individual institutions' MDMs and the resources they have available to achieve their aims should be assessed and periodically reviewed. The survey applied here may provide a framework for MDM members to do this.

  5. Awareness about past diagnosis and treatment history: nationwide survey of childhood cancer survivors and their parents.

    Science.gov (United States)

    Ahn, Eunmi; Park, Hyeon Jin; Baek, Hee Jo; Hwang, Pyoung Han; Lee, Young Ho; Park, Byung-Kiu; Kim, Young So; Shim, Hye-Young; Shin, Dongwook; Yang, Hyung Kook; Park, Jong Hyock; Park, Kyung Duk

    2017-10-01

    To assess the awareness of past medical history and long-term care issues of childhood cancer survivors (CCS) in Korea. A nationwide survey was conducted on CCS and their parents in 10 regional cancer centers in Korea. Answers regarding cancer diagnosis and treatment history were compared with the treatment summary and categorized into three ('specific,' 'general,' and 'no') or two ('yes' and 'no') groups. Out of 343 contacts, 293 dyads completed the survey, and 281 dyads were analyzed. Awareness of cancer diagnosis was mostly specific for parents (76.5%) and CCS (35.2%). Awareness of anti-cancer treatment exposure was mostly general (84.6% for surgery, 67.9% for chemotherapy, and 53.9% for hematopoietic stem cell transplantation) rather than specific. In particular, more than half of the parents were not aware of the exposure to cardiotoxic agents (72.9%) or radiation therapy (56.3%). Providing information about long-term side effects and prevention of secondary cancer was significantly correlated only with more concern and more follow-up visits (P ≤ 0.001, respectively), without correlation with more specific awareness of exposure to cardiotoxic agents or radiation. Most of the parents of CCS were not aware of treatment-related risk factors necessary for long-term care. Providing information was significantly correlated with more concern and more follow-up visits, without improving corresponding knowledge about their past medical history. Effort aimed towards improving awareness about risk factors, the manner of providing information, and the patient referral system within which we use this information is warranted. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. Emergency diagnosis of cancer and previous general practice consultations: insights from linked patient survey data.

    Science.gov (United States)

    Abel, Gary A; Mendonca, Silvia C; McPhail, Sean; Zhou, Yin; Elliss-Brookes, Lucy; Lyratzopoulos, Georgios

    2017-06-01

    Emergency diagnosis of cancer is common and aetiologically complex. The proportion of emergency presenters who have consulted previously with relevant symptoms is uncertain. To examine how many patients with cancer, who were diagnosed as emergencies, have had previous primary care consultations with relevant symptoms; and among those, to examine how many had multiple consultations. Secondary analysis of patient survey data from the 2010 English Cancer Patient Experience Survey (CPES), previously linked to population-based data on diagnostic route. For emergency presenters with 18 different cancers, associations were examined for two outcomes (prior GP consultation status; and 'three or more consultations' among prior consultees) using logistic regression. Among 4647 emergency presenters, 1349 (29%) reported no prior consultations, being more common in males (32% versus 25% in females, P <0.001), older (44% in ≥85 versus 30% in 65-74-year-olds, P <0.001), and the most deprived (35% versus 25% least deprived, P = 0.001) patients; and highest/lowest for patients with brain cancer (46%) and mesothelioma (13%), respectively ( P <0.001 for overall variation by cancer site). Among 3298 emergency presenters with prior consultations, 1356 (41%) had three or more consultations, which were more likely in females ( P <0.001), younger ( P <0.001), and non-white patients ( P = 0.017) and those with multiple myeloma, and least likely for patients with leukaemia ( P <0.001). Contrary to suggestions that emergency presentations represent missed diagnoses, about one-third of emergency presenters (particularly those in older and more deprived groups) have no prior GP consultations. Furthermore, only about one-third report multiple (three or more) consultations, which are more likely in 'harder-to-suspect' groups. © British Journal of General Practice 2017.

  7. Internal Audit and Risk Management

    OpenAIRE

    Constantin Nicolae Vasile; Alexandru Georgiana

    2011-01-01

    Internal audit and risk management have the same goal: the control of risk. There are various roles for the internal audit in respect of risk management. The main limitations of internal audit in respect of risk management regards assuming risk management tasks. One of the main issues regarding risk management is to make sure that the key risks are taken into consideration and that the management and the board of the organization take action as needed. Internal audit could give advice to mana...

  8. Software Engineering Reviews and Audits

    CERN Document Server

    Summers, Boyd L

    2011-01-01

    Accurate software engineering reviews and audits have become essential to the success of software companies and military and aerospace programs. These reviews and audits define the framework and specific requirements for verifying software development efforts. Authored by an industry professional with three decades of experience, Software Engineering Reviews and Audits offers authoritative guidance for conducting and performing software first article inspections, and functional and physical configuration software audits. It prepares readers to answer common questions for conducting and perform

  9. UPDATES REGARDING AUDIT REPORTING

    Directory of Open Access Journals (Sweden)

    Daniel Botez

    2017-07-01

    Full Text Available In 2009, the International Federation of Professional Accountants - IFAC initiated a process of reviewing reporting standards. The purpose of this process is to improve the auditor's way of communicating and to increase the relevance of the audit globally, meaning that the auditor's report is more informative by presenting more information about the entity and about the audit of the financial statements. Thus, reporting standards have been amended, a new standard has been published, and the impact of these changes on other standards used by the auditor has been reported. The most relevant aspects concern the introduction of new paragraphs in the auditor's report regarding key aspects of the audit and the assumption of business continuity. Also, the structure of the report has been modified.

  10. Proof Auditing Formalised Mathematics

    Directory of Open Access Journals (Sweden)

    Mark Miles Adams

    2016-01-01

    Full Text Available The first three formalisations of major mathematical proofs have heralded a new age in formalised mathematics, establishing that informal proofs at the limits of what can be understood by humans can be checked by machine. However, formalisation itself can be subject to error, and yet there is currently no accepted process in checking, or even much concern that such checks have not been performed. In this paper, we motivate why we should be concerned about correctness, and argue the need for proof auditing, to rigorously and independently check a formalisation. We discuss the issues involved in performing an audit, and propose an effective and efficient auditing process. Throughout we use the Flyspeck Project, that formalises the Kepler Conjecture proof, to illustrate our point.

  11. ICT in Auditing

    DEFF Research Database (Denmark)

    Kacanski, Slobodan

    2016-01-01

    Productivity incentives have lately been driving auditors to introduce and utilize various computer-based tools to assist their work. The aim of this study is to understand how and why productivity incentives may disturb interpersonal interaction and relations between auditors at different ranks......, in the context of assurance service. A case study was carried out with auditors affiliated with Danish subsidiaries of Big 4 audit firms to inspect the implementation and utilization of global audit methodology (GAM), which is the ICT-based platform that guides subordinate auditors through the audit process....... The results highlight that superior auditors tend to experience prevalent trust in ICT tool over subordinate auditors, where such conditions reduce the opportunity for experiencing comfort by subordinates, while superiors still perceive comfort due to being comfortable with procedures that are administered...

  12. Inconsistencies between alcohol screening results based on AUDIT-C scores and reported drinking on the AUDIT-C questions: prevalence in two US national samples

    Science.gov (United States)

    2014-01-01

    Background The AUDIT-C is an extensively validated screen for unhealthy alcohol use (i.e. drinking above recommended limits or alcohol use disorder), which consists of three questions about alcohol consumption. AUDIT-C scores ≥4 points for men and ≥3 for women are considered positive screens based on US validation studies that compared the AUDIT-C to “gold standard” measures of unhealthy alcohol use from independent, detailed interviews. However, results of screening—positive or negative based on AUDIT-C scores—can be inconsistent with reported drinking on the AUDIT-C questions. For example, individuals can screen positive based on the AUDIT-C score while reporting drinking below US recommended limits on the same AUDIT-C. Alternatively, they can screen negative based on the AUDIT-C score while reporting drinking above US recommended limits. Such inconsistencies could complicate interpretation of screening results, but it is unclear how often they occur in practice. Methods This study used AUDIT-C data from respondents who reported past-year drinking on one of two national US surveys: a general population survey (N = 26,610) and a Veterans Health Administration (VA) outpatient survey (N = 467,416). Gender-stratified analyses estimated the prevalence of AUDIT-C screen results—positive or negative screens based on the AUDIT-C score—that were inconsistent with reported drinking (above or below US recommended limits) on the same AUDIT-C. Results Among men who reported drinking, 13.8% and 21.1% of US general population and VA samples, respectively, had screening results based on AUDIT-C scores (positive or negative) that were inconsistent with reported drinking on the AUDIT-C questions (above or below US recommended limits). Among women who reported drinking, 18.3% and 20.7% of US general population and VA samples, respectively, had screening results that were inconsistent with reported drinking. Limitations This study did not include an

  13. Questionnaire survey of current status and reserve for breast cancer screening in Mie prefecture. Achievement of a 50% participation rate

    International Nuclear Information System (INIS)

    Kobayashi, Shigeki; Tanaka, Yukio; Matsuo, Michiko

    2012-01-01

    Mie Medical Network of Breast Cancer Screening, a NPO, was assigned the task of breast cancer screening in Mie prefecture in April, 2010. For breast cancer screening in Mie prefecture in 2009, a questionnaire survey was performed toward both consigner and consignee. Consigners were local public offices managing breast cancer screening for local inhabitants, and consignees were facilities offering breast cancer screening. The number of breast cancer screening was investigated toward all 29 of consigners in Mie prefecture. The questionnaire survey was conducted toward all 52 of the facilities possessing mammography systems (breast cancer screening being performed at 48 of them) in Mie prefecture in 2009. We investigated the predictive additional number of breast cancer screening and also investigated the requisite number of staff to achieve the predictive maximum number of breast cancer screening. As a result, the total number of breast cancer screenings was 93,525, and the participation rate was 27.5% which was calculated by reduction of continuator in Mie prefecture in 2009. The continuator accounted for over 30% of all breast cancer screenings. The predictive additional number was 126,950, this indicates that a possible participation rate of 75.2% after 2011. To achieve this high participation rate, active support is essential for short-handed facilities, and about 20% increase of medical staff is necessary. To achieve a participation rate of over 50% as a goal, new screenees should be recruited and breast cancer screening of every other year should be enlightened. (author)

  14. Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test.

    Science.gov (United States)

    Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony P; Conigrave, Katherine M; Simpson, Lynette; Bliss, Donna; Allan, Julaine

    2014-09-01

    The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT. Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk. The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent. Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90.

  15. Research in auditing: main themes

    Directory of Open Access Journals (Sweden)

    Marcelo Porte

    Full Text Available ABSTRACT The passage of the Sarbanes-Oxley Act (SOX was a turning point in auditing and in auditors practice for the academic world. Research concerning the characterization of academic production related to auditing is in its third decade. Its analysis is accomplished by means of definition of keywords, abstracts or title, and information on thematic association within the academic production itself in auditing is undisclosed. In order to revise this gap in auditing literature, this study identified the main themes in auditing and their association in post-SOX era by analyzing the content of objectives and hypothesis of 1,650 publications in Web of Science (2002-2014. The findings in this study extended those from the study by Lesage and Wechtler (2012 from 16 auditing thematic typologies to 22. The results demonstrate that the themes audit report & financial statement users, corporate governance, audit market, external audit, socio-economic data of the company, international regulation, and fraud risk & audit risk were the most addressed in the publications about auditing. Corporate governance has a broader association with the other themes in the area. Future researches may use these themes and relate them to the methodologies applied to audit studies.

  16. Conducting One's Own Communication Audit.

    Science.gov (United States)

    Rogers, Donald P.; Goldhaber, Gerald M.

    1978-01-01

    Guidelines are offered to a college or university for conducting a communication audit. These include steps in planning the audit, use of the variety of tools available for administering the audit, the development and feedback to the institution, and development of recommendations to improve institutional communication. (JMF)

  17. Environmental auditing at Ranger

    International Nuclear Information System (INIS)

    Armstrong, A.; Reid, A.

    1989-01-01

    A preliminary external audit was carried out on three aspects of the Ranger Environmental Impact Statement (EIS), namely meteorological data, water release and water quality of releases. It assessed the accuracy of forecasts and predictive data statements against the actual environmental data obtained during operations, and concluded that impacts of the project were adequately described but inadequately quantified. The second state of the auditing is concerned with the assessment of the effectiveness of practices and procedures which are integrated into the ongoing environmental management program. 7 tabs. 2 figs

  18. Communication Audits in the Age of the Internet.

    Science.gov (United States)

    Goldhaber, Gerald M.

    2002-01-01

    Describes the history of a multi-instrument approach for auditing the communication behavior of organizations. Notes that with the advent of the Internet, limitations of survey research have virtually been eliminated. Outlines four necessary steps involved in a Web-based communication survey. (PM)

  19. ENERGY AUDIT ANALYSIS BY BUSINESS INTELLIGENCE APPLICATION

    Directory of Open Access Journals (Sweden)

    Alfa Firdaus

    2015-12-01

    Full Text Available Energy audit is one of the first tasks to be performed in the accomplishment of an effective energy cost control program. To obtain the best information for a successful energy audit, the auditor must make some measurements during the audit visit. One of the tools that primarily used in audit visit is the portable Power Quality Analyzers (PQA for measuring single to three-phase lines with a high degree of precision and accuracy. It is utilized for monitoring and recording power supply anomalies. For most survey applications, changing currents makes it mandatory for data to be compiled over a period of time with enormous amount of electricity data. Hence, this paper proposed a Business Intelligence approach that can facilitate the auditor to quickly analyze the PQA data. There are five Key Performance Indicators (KPI to be displayed for analyze in form of dashboard. The method that uses to construct the dashboard is classification and association rules with the help of orange dataminer tools. Classification method is utilized to display the data distributions by frequency on a bar chart. Once we got the frequent sets, they allow us to extract association rules among the item sets, where we make some statement about how likely are two sets of items to co-occur or to conditionally occur. The result of this paper is a dashboard of five scorecards, namely unbalanced voltage, unbalanced currents, voltage harmonic, currents harmonic, and power factor. 

  20. Patterns of Cancer Genetic Testing: A Randomized Survey of Oregon Clinicians

    International Nuclear Information System (INIS)

    Cox, S. L.; Zlot, A. I.; Silvey, S. K.; Silvey, S. K.

    2012-01-01

    Introduction. Appropriate use of genetic tests for population-based cancer screening, diagnosis of inherited cancers, and guidance of cancer treatment can improve health outcomes. We investigated clinicians’ use and knowledge of eight breast, ovarian, and colorectal cancer genetic tests. Methods. We conducted a randomized survey of 2,191 Oregon providers, asking about their experience with fecal DNA, OncoVue, BRCA, MMR, CYP2D6, tumor gene expression profiling, UGT1A1, and KRAS. Results. Clinicians reported low confidence in their knowledge of medical genetics; most confident were OB-GYNs and specialists. Clinicians were more likely to have ordered/recommended BRCA and MMR than the other tests, and OB-GYNs were twice as likely to have ordered/recommended BRCA testing than primary care providers. Less than 10% of providers ordered/recommended OncoVue, fecal DNA, CYP2D6, or UGT1A1; less than 30% ordered/recommended tumor gene expression profiles or KRAS. The most common reason for not ordering/recommending these tests was lack of familiarity. Conclusions. Use of appropriate, evidence-based testing can help reduce incidence and mortality of certain cancers, but these tests need to be better integrated into clinical practice. Continued evaluation of emerging technologies, dissemination of findings, and an increase in provider confidence and knowledge are necessary to achieve this end.

  1. Cancer pain management by radiotherapists: a survey of radiation therapy oncology group physicians

    International Nuclear Information System (INIS)

    Cleeland, Charles S.; Janjan, Nora A.; Scott, Charles B.; Seiferheld, Wendy F.; Curran, Walter J.

    2000-01-01

    Purpose: Radiation Therapy Oncology Group (RTOG) physicians were surveyed to determine their approach to and attitudes toward cancer pain management. Methods and Materials: Physicians completed a questionnaire assessing their estimates of the magnitude of pain as a specific problem for cancer patients, their perceptions of the adequacy of pain management, and their report of how they manage pain in their own practice setting. Results: Eighty-three percent believed the majority of cancer patients with pain were undermedicated. Forty percent reported that pain relief in their own practice setting was poor or fair. Assessing a case scenario, 23% would wait until the patient's prognosis was 6 months or less before starting maximal analgesia. Adjuvants and prophylactic side effect management were underutilized in the treatment plan. Barriers to pain management included poor pain assessment (77%), patient reluctance to report pain (60%), patient reluctance to take analgesics (72%), and staff reluctance to prescribe opioids (41%). Conclusions: Physicians' perceptions of barriers to cancer pain management remain quite stable over time, and physicians continue to report inadequate pain treatment education. Future educational efforts should target radiation oncologists as an important resource for the treatment of cancer pain

  2. Interest in genomic SNP testing for prostate cancer risk: a pilot survey.

    Science.gov (United States)

    Hall, Michael J; Ruth, Karen J; Chen, David Yt; Gross, Laura M; Giri, Veda N

    2015-01-01

    Advancements in genomic testing have led to the identification of single nucleotide polymorphisms (SNPs) associated with prostate cancer. The clinical utility of SNP tests to evaluate prostate cancer risk is unclear. Studies have not examined predictors of interest in novel genomic SNP tests for prostate cancer risk in a diverse population. Consecutive participants in the Fox Chase Prostate Cancer Risk Assessment Program (PRAP) (n = 40) and unselected men from surgical urology clinics (n = 40) completed a one-time survey. Items examined interest in genomic SNP testing for prostate cancer risk, knowledge, impact of unsolicited findings, and psychosocial factors including health literacy. Knowledge of genomic SNP tests was low in both groups, but interest was higher among PRAP men (p testing in both groups. Multivariable modeling identified several predictors of higher interest in a genomic SNP test including higher perceived risk (p = 0.025), indicating zero reasons for not wanting testing (vs ≥1 reason) (p = 0.013), and higher health literacy (p = 0.016). Knowledge of genomic SNP testing was low in this sample, but higher among high-risk men. High-risk status may increase interest in novel genomic tests, while low literacy may lessen interest.

  3. A survey of Canadian cancer patients' perspectives on the characteristics and treatment of breakthrough pain.

    Science.gov (United States)

    Bedard, Gillian; Hawley, Philippa; Zhang, Liying; Slaven, Marissa; Gagnon, Pierre; Bisland, Stuart; Bennett, Margaret; Tardif, Francois; Chow, Edward

    2013-09-01

    Breakthrough pain is defined as a transient exacerbation of pain that occurs spontaneously or in response to a trigger despite stable and controlled background pain. The purpose of this study was to explore Canadian patients' awareness of and experience with breakthrough pain in cancer (BTPc). Four Canadian cancer centers participated in a non-interventional survey recruiting cancer patients who experienced breakthrough pain. These patients were asked about their pain, its impact on functioning, current management and interest in new treatments of BTPc. Ninety-four Canadian cancer patients participated in this study, with 96% stating that cancer pain impacted their daily living with over half unable to go to work or shopping. Fifty percent of patients said that an episode of BTPc lasted greater than 60 minutes, with the pain score being on average 7.8/10, impacting normal work (7.2/10) and general activity (7.1/10). Only 35% of patients were very satisfied with the speed of relief of their medications. Those who did not take their breakthrough pain medication for every episode stated that was because the pain was not always severe (37%), or they were afraid of becoming tolerant (23%) or addicted (12%). Patients stated that the most important features of a new treatment for BTPc were the ability to relieve pain completely (47%), and quickly (43%). Patients expressed willingness to try transmucosal products (80%) or nasal products (59%). Breakthrough cancer pain in Canadian cancer patients greatly impacts their daily lives. There is room for improvement in the management of BTPc, and the majority of patients would be willing to try new treatments.

  4. Readiness for Implementation of Lung Cancer Screening. A National Survey of Veterans Affairs Pulmonologists.

    Science.gov (United States)

    Tukey, Melissa H; Clark, Jack A; Bolton, Rendelle; Kelley, Michael J; Slatore, Christopher G; Au, David H; Wiener, Renda Soylemez

    2016-10-01

    To mitigate the potential harms of screening, professional societies recommend that lung cancer screening be conducted in multidisciplinary programs with the capacity to provide comprehensive care, from screening through pulmonary nodule evaluation to treatment of screen-detected cancers. The degree to which this standard can be met at the national level is unknown. To assess the readiness of clinical facilities in a national healthcare system for implementation of comprehensive lung cancer screening programs, as compared with the ideal described in policy recommendations. This was a cross-sectional, self-administered survey of staff pulmonologists in pulmonary outpatient clinics in Veterans Health Administration facilities. The facility-level response rate was 84.1% (106 of 126 facilities with pulmonary clinics); 88.7% of facilities showed favorable provider perceptions of the evidence for lung cancer screening, and 73.6% of facilities had a favorable provider-perceived local context for screening implementation. All elements of the policy-recommended infrastructure for comprehensive screening programs were present in 36 of 106 facilities (34.0%); the most common deficiencies were the lack of on-site positron emission tomography scanners or radiation oncology services. Overall, 26.5% of Veterans Health Administration facilities were ideally prepared for lung cancer screening implementation (44.1% if the policy recommendations for on-site positron emission tomography scanners and radiation oncology services were waived). Many facilities may be less than ideally positioned for the implementation of comprehensive lung cancer screening programs. To ensure safe, effective screening, hospitals may need to invest resources or coordinate care with facilities that can offer comprehensive care for screening through downstream evaluation and treatment of screen-detected cancers.

  5. PENGARUH MULTIDIMENSI KOMITMEN PROFESIONAL TERHADAP PERILAKU AUDIT DISFUNGSIONAL

    Directory of Open Access Journals (Sweden)

    Adanan Silaban

    2011-11-01

    Full Text Available The purposes of this study are two fold. First is to examine validity of Meyer et al.’s (1993three-component model of commitment professional among on auditor which working in auditfirms. The second is to examine relations dimension of commitment professional todysfunctional audit behaviors. Dysfunctional audit behaviors include auditors’ act duringperformance audit program which directly or indirectly reduced audit quality namely auditquality reduction (AQR and Under Reporting of Time (URT behaviors. This study conductedwith survey method on auditors working in audit firms at three mayor cities in Indonesia i.e.;Jakarta, Surabaya, and Medan. Research samples are 348 respondents. Data analysis withStructural Equation Modeling used AMOS. The result of confirmatory factor analyses andtest of reliability and validity provide support for three separate dimensions of professionalcommitment. Affective professional commitment has negative associated with AQR behavior,but it relationship with URT behavior is not significant. The influence of continuanceprofessional commitment to AQR and URT behaviors is not significant. Normativeprofessional commitment is inversely related to AQR and URT behaviors. The results ofresearch contribute to literature and interpreting the prior research and for consideringfuture research on auditors’ commitment professional are presented. Keywords:dysfunctional audit behaviors, audit quality reduction behavior, underreporting oftime behaviors, multi-dimension professional commitment.

  6. Faktor-Faktor Yang Mempengaruhi Perilaku Auditor Dalam Penghentian Prematur Atas Prosedur Audit

    OpenAIRE

    Putriana, Astia; Respati, Novita Weningtyas; Chairina, Chairina

    2015-01-01

    The purpose of this research is to examine the effect of time pressure, audit risk, materiality, review procedure and quality control, need for achievement, and professional commitments on the auditor in premature termination on audit procedures. This reseach applies a mail survey as data collection method and convienece sampling as sample collection method. Research subjects are 106 auditor at the Supreme Audit Board of the Republic of Indonesia (BPK RI) Representative of South Kalimantan an...

  7. Faktor-Faktor yang Mempengaruhi Perilaku Auditor dalam Penghentian Prematur atas Prosedur Audit

    OpenAIRE

    Astia Putriana; Novita Weningtyas Respati; Chairina Chairina

    2016-01-01

    The purpose of this research is to examine the effect of time pressure, audit risk, materiality, review procedure and quality control, need for achievement, and professional commitments on the auditor in premature termination on audit procedures. This reseach applies a mail survey as data collection method and convienece sampling as sample collection method. Research subjects are 106 auditor at the Supreme Audit Board of the Republic of Indonesia (BPK RI) Representative of South Kalimantan an...

  8. The use of safety audits

    International Nuclear Information System (INIS)

    Waldram, I.M.

    1991-01-01

    It is now widely recognized that implementation of an effective safety policy must include arrangements for auditing and feedback to the policy maker. In the E and P industry safety audits should cover the whole range of activities, from exploration to production, and including the specialist contractors widely employed. Audit schemes can be developed internally, or purchased as a package. In this paper, the development of a comprehensive audit policy is described, and a range of audit techniques are reviewed. The use of these techniques is described with special reference to drilling, diving and offshore construction in the UK sector of the North Sea

  9. Environmental audits: A lawyer's perspective

    International Nuclear Information System (INIS)

    Walls, S.K.

    1992-01-01

    This paper reviews the advantages and disadvantages of using environmental compliance audits to help detect potential environmental violations and/or potential problems. The paper focuses on the legal issues inherent in this type of audit. The primary purpose of conducting such an audit is to determine the suitability of a facility or a site prior to a transaction or to determine a company's own compliance before a regulatory agency identifies it. The paper discusses how to set up a compliance audit and then reviews how various government agencies view voluntary environmental audits. These voluntary actions are perceived by most agencies as commendable and result in significant decreases in penalties and assessments

  10. Population Survey of Knowledge about Oral Cancer and Related Factors in the Capital of Iran.

    Science.gov (United States)

    Azimi, Somayyeh; Ghorbani, Zahra; Tennant, Marc; Kruger, Estie; Safiaghdam, Hannaneh; Rafieian, Nasrin

    2017-08-24

    Knowledge about oral cancer risk factors and signs is thought to improve prevention and early diagnosis, and in turn, increases survival. In this population-based survey, knowledge about oral cancer was assessed in Iran. A total of 1800 self-administered questionnaires (collecting sociodemographic data and questions regarding oral cancer risk factors and signs) were distributed through random sampling. Final scores ranged between 0 and 15 for the risk factors and 0-11 for the signs. Scores below the median indicated a low level of knowledge, scores representing the third quartile of correct answers indicated a moderate level of knowledge, and scores representing the upper quartile indicated a high level of knowledge. Statistical tests were used for analysis of knowledge level in different sociodemographic categories. A total of 1312 participants completed the questionnaires. The average of knowledge scores for risk factors was 5.3 ± 3.0 and for signs was 4.5 ± 2.9. Overall, 75 and 56% respectively were able to identify major risk factors (smoking and alcohol); 23.5% could not define any related signs and symptoms. Dividing scores into quartiles indicated that three out of four people had "low" knowledge about risk factors and 58% had "low" knowledge about signs and symptoms. Females and highly educated people had more knowledge of oral cancer. Significant difference was found between job and level of knowledge (P = 0.001). This survey revealed that public knowledge of oral cancer was not satisfactory in Iran. Efforts should be done to inform and educate people with risk factors, initial clinical presentation, and symptoms, in order to improve prevention and promote early diagnosis.

  11. Information Systems Security Audit

    OpenAIRE

    Gheorghe Popescu; Veronica Adriana Popescu; Cristina Raluca Popescu

    2007-01-01

    The article covers:Defining an information system; benefits obtained by introducing new information technologies; IT management;Defining prerequisites, analysis, design, implementation of IS; Information security management system; aspects regarding IS security policy; Conceptual model of a security system; Auditing information security systems and network infrastructure security.

  12. INTERNAL AUDIT CHARTER

    International Development Research Centre (IDRC) Digital Library (Canada)

    sblanchard

    2015-03-30

    Mar 30, 2015 ... Assurance and Advice to Support Innovating for Development ... IDRC's Board of Governors approves the Internal Audit Charter which outlines the ... the principles of integrity, objectivity, confidentiality, and competency, and IDRC's Code of. Conduct and the Values and Ethics Code for the Public Service;.

  13. Conducting a Technology Audit

    Science.gov (United States)

    Flaherty, William

    2011-01-01

    Technology is a critical component in the success of any high-functioning school district, thus it is important that education leaders should examine it closely. Simply put, the purpose of a technology audit is to assess the effectiveness of the technology for administrative or instructional use. Rogers Public Schools in Rogers, Arkansas, recently…

  14. FEATURES ROAD SAFETY AUDIT

    Directory of Open Access Journals (Sweden)

    L. Abramova

    2015-07-01

    Full Text Available Development of the road network, increasing motorization of the population significantly increase the risk of accidents. Experts in the field of traffic are developing methods to reduce the probability of accidents. The ways of solving the problems of road safety audit at various stages of the «life» of roads are considered.

  15. Auditing with incomplete logs

    NARCIS (Netherlands)

    Mian, Umbreen Sabir; den Hartog, Jeremy; Etalle, Sandro; Zannone, Nicola

    2015-01-01

    The protection of sensitive information is of utmost importance for organizations. The complexity and dynamism of modern businesses are forcing a re-think of traditional protection mechanisms. In particular, a priori policy en-forcement mechanisms are often complemented with auditing mechanisms that

  16. Quality of pathology reports for advanced ovarian cancer: are we missing essential information? An audit of 479 pathology reports from the EORTC-GCG 55971/NCIC-CTG OV13 neoadjuvant trial.

    Science.gov (United States)

    Verleye, Leen; Ottevanger, Petronella B; Kristensen, Gunnar B; Ehlen, Tom; Johnson, Nick; van der Burg, Maria E L; Reed, Nick S; Verheijen, René H M; Gaarenstroom, Katja N; Mosgaard, Berit; Seoane, Jose M; van der Velden, Jacobus; Lotocki, Robert; van der Graaf, Winette; Penninckx, Björn; Coens, Corneel; Stuart, Gavin; Vergote, Ignace

    2011-01-01

    To assess the quality of surgical pathology reports of advanced stage ovarian, fallopian tube and primary peritoneal cancer. This quality assurance project was performed within the EORTC-GCG 55971/NCIC-CTG OV13 study comparing primary debulking surgery followed by chemotherapy with neoadjuvant chemotherapy and interval debulking surgery. Four hundred and seventy nine pathology reports from 40 institutions in 11 different countries were checked for the following quality indicators: macroscopic description of all specimens, measuring and weighing of major specimens, description of tumour origin and differentiation. All specimens were macroscopically described in 92.3% of the reports. All major samples were measured and weighed in 59.9% of the reports. A description of the origin of the tumour was missing in 20.5% of reports of the primary debulking group and in 23.4% of the interval debulking group. Assessment of tumour differentiation was missing in 10% of the reports after primary debulking and in 20.8% of the reports after interval debulking. Completeness of reports is positively correlated with accrual volume and adversely with hospital volume or type of hospital (academic versus non-academic). Quality of reports differs significantly by country. This audit of ovarian cancer pathology reports reveals that in a substantial number of reports basic pathologic data are missing, with possible adverse consequences for the quality of cancer care. Specialisation by pathologists and the use of standardised synoptic reports can lead to improved quality of reporting. Further research is needed to better define pre- and post-operative diagnostic criteria for ovarian cancer treated with neoadjuvant chemotherapy. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. THE AUDIT OF RECEPTION PROCESS

    Directory of Open Access Journals (Sweden)

    Dorina MOCUŢA

    2013-01-01

    Full Text Available The object of study case is to analyze the quality of the logistics department, focusing on the audit process. Purpose of this paper is to present the advantages resulting from the systematic audit processes and methods of analysis and improvement of nonconformities found. The case study is realised at SC Miele Tehnica SRL Brasov, twelfth production line, and the fourth from outside Germany. The specific objectives are: clarifying the concept of audit quality, emphasizing requirements ISO 19011:2003 "Guidelines for auditing quality management systems and / or environment" on audits; cchieving quality audit and performance analysis; improved process performance reception materials; compliance with legislation and auditing standards applicable in EU and Romania.

  18. POSITIONINGS AND DELIMITATIONS CONCERNING THE PERFORMANCE AUDIT

    OpenAIRE

    Victoria FIRESCU

    2014-01-01

    The objectives of the present research are related to the approaches concerning the “performance audit” concept in the specialized literature and practice as well as the clear delimitation of this concept of financial audit and internal audit. For a clear emphasis of the objectives and principles of the performance audit, I highlighted the similarities and differences among the three types of audit by means of several criteria such as: audit standards, audited subjects, nature of the audit ev...

  19. Health audit survey in the high level natural radiation areas of Kerala coast: prevalence of congenital malformations, late onset diseases and untoward pregnancy outcomes in the study area

    International Nuclear Information System (INIS)

    Cheriyan, V.D.; Koya, P.K.M.; Jaikrishan, G.; Anil Kumar, V.; Seshadri, M.

    2010-01-01

    A total population of 2,52,735 was surveyed (1,24,246 males, 1,28,489 females; (sex ratio 1000:1034). congenital malformation was reported among 2951 individuals with a frequency of 1.17%. The percentage of individuals with birth defects ranged from 1% in Oachira to 1.46% in Neendakara. At least one of the late onset diseases were reported in 33,199 (13.14%) individuals. Percentage of individuals with any of the late onset diseases ranged from 10.7% in Panmana to 17.9% in Alappad. The distribution of birth defects is the eight panchayats is similar (both Kruskal Wallis and median test P > .20) whereas the distribution of late onset disease does not appear to be similar in all the panchayats (Kruskal Wallis chi-square with 7 d.f = 32.3, P < .001; median test chi-square with 7 d.f. = 15.1; P= .035). The frequency of late onset diseases among males and females in different age groups suggest that females in the age group of 30-59 report more late onset disease than their male counterparts

  20. Alcohol Use Among Active Duty Women: Analysis AUDIT Scores From the 2011 Health-Related Behavior Survey of Active Duty Military Personnel.

    Science.gov (United States)

    Jeffery, Diana D; Mattiko, Mark

    2016-01-01

    Numerous studies document higher substance use among military men after deployment; similar studies focused on military women are limited. This study examines alcohol use of active duty women and deployment factors, social/environmental/attitudinal factors, and psychological/intrapersonal factors. Secondary data analysis of the 2011 Survey of Health-Related Behavior of active duty military personnel was conducted using bivariate statistics and multiple regression analyses with Alcohol Use Disorders Identification Test scores as the dependent variable. Nearly 94% had low risk for alcohol use disorders. Length of combat experience and extent of combat exposure were unrelated to Alcohol Use Disorders Identification Test scores; noncombat deployment was unrelated after controlling for marital status, age of first drink, pay grade, and branch of service. Significant motivators (p risk propensity, lifetime prevalence of suicidal ideation, and depressed mood were significant predictors in the regression model after controlling for covariates. Findings suggest that some active duty women use alcohol to cope with adverse emotional states, whereas others use alcohol consistent with propensity for high-risk behaviors. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  1. Incidence of anemia in pediatric cancer patients in Europe: results of a large, international survey.

    Science.gov (United States)

    Michon, Jean

    2002-10-01

    Anemia occurs frequently in children with cancer, but there is little information quantifying the incidence of anemia or treatment. A survey was conducted in 1998 in Europe by The Research Partnership with the objective of determining the incidence of anemia, identifying the hemoglobin triggers that initiated anemia treatment, and the current anemia treatment options available to clinicians. The survey was conducted in the 10 largest pediatric oncology centers each in France, Germany, Italy, Spain, and the UK, and in the 8 largest centers in both Belgium and The Netherlands. Telephone interviews with the most senior physician available in the institution were used to collect data, which included the numbers of patients treated or under follow-up, cancer types, and treatment practices for anemia. Data were collected for 25,093 patients. Over 80% of patients were anemic (WHO: hemoglobin disadvantages of epoetin alfa as a treatment option for treating anemia in children with cancer, which reflects the limited knowledge of and experience with this agent. Copyright 2002 Wiley-Liss, Inc.

  2. National audit of provision of MRI services 2006/07

    Energy Technology Data Exchange (ETDEWEB)

    Barter, S. [Royal College of Radiologists, London (United Kingdom)], E-mail: sue.barter@addenbrookes.nhs.uk; Drinkwater, K.; Remedios, D. [Royal College of Radiologists, London (United Kingdom)

    2009-03-15

    In 2003 the Royal College of Radiologists Clinical Radiology Audit Sub-Committee began an audit process evaluating the standards of provision of magnetic resonance imaging (MRI) services. This was prompted by the publication of the 2002 Audit Commission Report, which had identified that lack of MRI provision was responsible for more than half of the total waiting times for diagnostic imaging investigations. The audit found that the time from request to report did not meet the standard for cancer staging examinations, but nationally, was within the target set for routine orthopaedic examinations. However, national mean waiting times were longer than recommended for both cancer and orthopaedic MRI. Since then, there has been massive investment in MRI capacity, both from installation of MRI systems in NHS Trusts, and in England, from outsourcing of routine MRI cases through the Department of Health contract with an independent provider. A re-audit in 2006/7 shows that there has been a significant improvement in waiting times for routine orthopaedic examinations, but the position with cancer staging examinations has deteriorated. Control chart methodology shows that underperformance is due to common cause variation, i.e., improvements need to be made to the overall process from receiving the request for MRI to the issue of the report. Follow-up with participating departments demonstrated there were some common themes for underperformance, and suggestions for improvement are made from departments with best performance.

  3. National audit of provision of MRI services 2006/07

    International Nuclear Information System (INIS)

    Barter, S.; Drinkwater, K.; Remedios, D.

    2009-01-01

    In 2003 the Royal College of Radiologists Clinical Radiology Audit Sub-Committee began an audit process evaluating the standards of provision of magnetic resonance imaging (MRI) services. This was prompted by the publication of the 2002 Audit Commission Report, which had identified that lack of MRI provision was responsible for more than half of the total waiting times for diagnostic imaging investigations. The audit found that the time from request to report did not meet the standard for cancer staging examinations, but nationally, was within the target set for routine orthopaedic examinations. However, national mean waiting times were longer than recommended for both cancer and orthopaedic MRI. Since then, there has been massive investment in MRI capacity, both from installation of MRI systems in NHS Trusts, and in England, from outsourcing of routine MRI cases through the Department of Health contract with an independent provider. A re-audit in 2006/7 shows that there has been a significant improvement in waiting times for routine orthopaedic examinations, but the position with cancer staging examinations has deteriorated. Control chart methodology shows that underperformance is due to common cause variation, i.e., improvements need to be made to the overall process from receiving the request for MRI to the issue of the report. Follow-up with participating departments demonstrated there were some common themes for underperformance, and suggestions for improvement are made from departments with best performance

  4. Risk management and internal audit: Evidence from Greece

    Directory of Open Access Journals (Sweden)

    George Drogalas

    2017-07-01

    Full Text Available Risk management is ranked by financial executives as one of their most important objectives. For this reason, a wide range of literature on risk management has been developed. Within this fluid business environment, internal audit plays a key role in monitoring a company’s risk profile and identifying areas for improving risk management processes. The purpose of this study is to provide a comprehensive overview of the factors that impact on risk management regarding internal audit function. Empirical evidence was collected by means of a mailed survey. Regression analysis is used in order to illustrate the information gathered. Consistent with theory and our expectations, the results indicate that internal audit, internal auditor and added value of internal audit are statistically significantly associated with risk management.

  5. Exploring Knowledge, Attitudes, and Practices Related to Breast and Cervical Cancers in Mongolia: A National Population-Based Survey.

    Science.gov (United States)

    Yerramilli, Pooja; Dugee, Otgonduya; Enkhtuya, Palam; Knaul, Felicia M; Demaio, Alessandro R

    2015-11-01

    Mongolia bears the second-highest cancer burden in the world (5,214 disability-adjusted life years per 100,000 people, age standardized). To determine drivers of the growing burden of noncommunicable diseases, including breast and cervical cancers, a national knowledge, attitudes, and practices (KAP) survey was implemented in 2010. This paper analyzed the results of the 2010 KAP survey, which sampled 3,450 households nationally. Reflecting Mongolian screening policies, women aged 30 and older were included in analyses of questions regarding breast and cervical cancer (n = 1,193). Univariate and multivariate odds ratios (MORs) were derived through logistic regression to determine associations between demographic covariables (residence, age, education, employment) and survey responses. This study found that 25.7% (95% confidence interval [CI]: 23.3-28.3) and 22.1% (95% CI: 19.8-24.5) of female participants aged 30 years or older self-rated their knowledge of breast and cervical cancers, respectively, as "none." Employment and education were associated with greater awareness of both cancers and participation in screening examinations (p migration. Finally, although there is awareness that early detection improves outcomes, a significant proportion of women do not engage in screening. These trends warrant further research on barriers and solutions. The rising burden of breast and cervical cancers, particularly in low- and middle-income countries, necessitates the development of effective strategies for cancer control. This paper examines barriers to health service use in Mongolia, a country with a high cancer burden. The 2010 national knowledge, attitude and practices survey data indicate that cancer control efforts should focus on improving health education among lower-educated, rural, and unemployed populations, who display the least knowledge of breast and cervical cancers. Moreover, the findings support the need to emphasize individual risk for disease in cancer

  6. Breast cancer screening among shift workers: a nationwide population-based survey in Korea.

    Science.gov (United States)

    Son, Heesook; Kang, Youngmi

    2017-04-01

    We aimed to examine the association between shift work types and participation in breast cancer screening (BCS) programs by comparing rates of participation for BCS among regular daytime workers and alternative shift workers using data from a nationally representative, population-based survey conducted in Korea. In addition, the results were analyzed according to sociodemographic factors, including occupation, education, income, private health insurance, age, and number of working hours a week. This secondary cross-sectional analysis used data from the 2012 Korean National Health and Nutritional Examination Survey. The target population included women aged ≥ 40 years who responded as to whether they had undergone BCS in the previous year. Accordingly, we analyzed survey data for a total of 1,193 women and used a multivariate logistic regression analysis to evaluate the differences in factors affecting BCS between regular daytime and alternative shift workers. A logistic regression analysis was performed considering private health insurance as a significant sociodemographic factor for BCS among regular daytime shift workers. In contrast, none of the tested variables could significantly predict adherence to BCS among alternative shift workers. The results of this study suggest the need for the development of comprehensive workplace breast cancer prevention programs by considering shift work types. More attention should be given to female workers with low education levels, those who are uninsured, and young workers to improve the participation rate for BCS at the workplace.

  7. Availability of stage at diagnosis, cancer treatment delay and compliance with cancer guidelines as cancer registry indicators for cancer care in Europe: Results of EUROCHIP-3 survey

    NARCIS (Netherlands)

    Siesling, Sabine; Kwast, A.; Gavin, A.; Baili, P.; Otter, R.

    2013-01-01

    EUROCHIP (European Cancer Health Indicators Project) focuses on understanding inequalities in the cancer burden, care and survival by the indicators “stage at diagnosis,” “cancer treatment delay” and “compliance with cancer guidelines” as the most important indicators. Our study aims at providing

  8. A national survey of lung cancer specialists' views on low-dose CT screening for lung cancer in Korea.

    Directory of Open Access Journals (Sweden)

    Dong Wook Shin

    Full Text Available Lung cancer specialists play an important role in designing and implementing lung cancer screening. We aimed to describe their 1 attitudes toward low-dose lung computed tomography (LDCT screening, 2 current practices and experiences of LDCT screening and 3 attitudes and opinions towards national lung cancer screening program (NLCSP. We conducted a national web-based survey of pulmonologists, thoracic surgeons, medical oncologists, and radiological oncologists who are members of Korean Association for Lung Cancer (N = 183. Almost all respondents agreed that LDCT screening increases early detection (100%, improves survival (95.1%, and gives a good smoking cessation counseling opportunity (88.6%. Most were concerned about its high false positive results (79.8% and the subsequent negative effects. Less than half were concerned about radiation hazard (37.2%. Overall, most (89.1% believed that the benefits outweigh the risks and harms. Most (79.2% stated that they proactively recommend LDCT screening to those who are eligible for the current guidelines, but the screening propensity varied considerably. The majority (77.6% agreed with the idea of NLCSP and its beneficial effect, but had concerns about the quality control of CT devices (74.9%, quality assurance of radiologic interpretation (63.3%, poor access to LDCT (56.3%, and difficulties in selecting eligible population using self-report history (66.7%. Most (79.2% thought that program need to be funded by a specialized fund rather than by the National Health Insurance. The opinions on the level of copayment for screening varied. Our findings would be an important source for health policy decision when considering for NLCSP in Korea.

  9. Awareness of cancer susceptibility genetic testing: the 2000, 2005, and 2010 National Health Interview Surveys.

    Science.gov (United States)

    Mai, Phuong L; Vadaparampil, Susan Thomas; Breen, Nancy; McNeel, Timothy S; Wideroff, Louise; Graubard, Barry I

    2014-05-01

    Genetic testing for several cancer susceptibility syndromes is clinically available; however, existing data suggest limited population awareness of such tests. To examine awareness regarding cancer genetic testing in the U.S. population aged ≥25 years in the 2000, 2005, and 2010 National Health Interview Surveys. The weighted percentages of respondents aware of cancer genetic tests, and percent changes from 2000-2005 and 2005-2010, overall and by demographic, family history, and healthcare factors were calculated. Interactions were used to evaluate the patterns of change in awareness between 2005 and 2010 among subgroups within each factor. To evaluate associations with awareness in 2005 and 2010, percentages were adjusted for covariates using multiple logistic regression. The analysis was performed in 2012. Awareness decreased from 44.4% to 41.5% (pAwareness increased between 2005 and 2010 in most subgroups, particularly among individuals in the South (pinteraction=0.03) or with a usual place of care (pinteraction=0.01). In 2005 and 2010, awareness was positively associated with personal or family cancer history and high perceived cancer risk, and inversely associated with racial/ethnic minorities, age 25-39 or ≥60 years, male gender, lower education and income levels, public or no health insurance, and no provider contact in 12 months. Despite improvement from 2005 to 2010, ≤50% of the U.S. adult population was aware of cancer genetic testing in 2010. Notably, disparities persist for racial/ethnic minorities and individuals with limited health care access or income. Published by Elsevier Inc.

  10. Treatment decisions and employment of breast cancer patients: Results of a population-based survey.

    Science.gov (United States)

    Jagsi, Reshma; Abrahamse, Paul H; Lee, Kamaria L; Wallner, Lauren P; Janz, Nancy K; Hamilton, Ann S; Ward, Kevin C; Morrow, Monica; Kurian, Allison W; Friese, Christopher R; Hawley, Sarah T; Katz, Steven J

    2017-12-15

    Many patients with breast cancer work for pay at the time of their diagnosis, and the treatment plan may threaten their livelihood. Understanding work experiences in a contemporary population-based sample is necessary to inform initiatives to reduce the burden of cancer care. Women who were 20 to 79 years old and had been diagnosed with stage 0 to II breast cancer, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries in 2014-2015, were surveyed. Of the 3672 eligible women, 2502 responded (68%); 1006 who reported working before their diagnosis were analyzed. Multivariate models evaluated correlates of missing work for >1 month and stopping work altogether versus missing work for ≤1 month. In this diverse sample, most patients (62%) underwent lumpectomy; 16% underwent unilateral mastectomy (8% with reconstruction); and 23% underwent bilateral mastectomy (19% with reconstruction). One-third (33%) received chemotherapy. Most (84%) worked full-time before their diagnosis; however, only 50% had paid sick leave, 39% had disability benefits, and 38% had flexible work schedules. Surgical treatment was strongly correlated with missing >1 month of work (odds ratio [OR] for bilateral mastectomy with reconstruction vs lumpectomy, 7.8) and with stopping work altogether (OR for bilateral mastectomy with reconstruction vs lumpectomy, 3.1). Chemotherapy receipt (OR for missing >1 month, 1.3; OR for stopping work altogether, 3.9) and race (OR for missing >1 month for blacks vs whites, 2.0; OR for stopping work altogether for blacks vs whites, 1.7) also correlated. Those with paid sick leave were less likely to stop working (OR, 0.5), as were those with flexible schedules (OR, 0.3). Working patients who received more aggressive treatments were more likely to experience substantial employment disruptions. Cancer 2017;123:4791-9. © 2017 American Cancer Society. © 2017 American Cancer Society.

  11. Facebook advertisements recruit parents of children with cancer for an online survey of web-based research preferences.

    Science.gov (United States)

    Akard, Terrah Foster; Wray, Sarah; Gilmer, Mary Jo

    2015-01-01

    Studies involving samples of children with life-threatening illnesses and their families face significant challenges, including inadequate sample sizes and limited diversity. Social media recruitment and Web-based research methods may help address such challenges yet have not been explored in pediatric cancer populations. This study examined the feasibility of using Facebook advertisements to recruit parent caregivers of children and teenagers with cancer. We also explored the feasibility of Web-based video recording in pediatric palliative care populations by surveying parents of children with cancer regarding (a) their preferences for research methods and (b) technological capabilities of their computers and phones. Facebook's paid advertising program was used to recruit parent caregivers of children currently living with cancer to complete an electronic survey about research preferences and technological capabilities. The advertising campaign generated 3 897 981 impressions, which resulted in 1050 clicks at a total cost of $1129.88. Of 284 screened individuals, 106 were eligible. Forty-five caregivers of children with cancer completed the entire electronic survey. Parents preferred and had technological capabilities for Web-based and electronic research methods. Participant survey responses are reported. Facebook was a useful, cost-effective method to recruit a diverse sample of parent caregivers of children with cancer. Web-based video recording and data collection may be feasible and desirable in samples of children with cancer and their families. Web-based methods (eg, Facebook, Skype) may enhance communication and access between nurses and pediatric oncology patients and their families.

  12. [Survey and analysis of awareness of lung cancer prevention and control in a LDCT lung cancer screening project in Tianjin Dagang Oilfield of China].

    Science.gov (United States)

    Ren, Guanhua; Ye, Jianfei; Fan, Yaguang; Wang, Jing; Sun, Zhijuan; Jia, Hui; Du, Xinxin; Hou, Chaohua; Wang, Ying; Zhao, Yongcheng; Zhou, Qinghua

    2014-02-01

    It has been proven that increase of the awareness level of lung cancer prevention and control could enhance participation of lung cancer screening of lung cancer high risk group. The aim of this study is to investigate the awareness level of lung cancer prevention and control and the effect of individual characteristics on lung cancer awareness, and to provide evidence for comprehensive lung cancer prevention in high risk areas of lung cancer. Staffs of Tianjin Dagang Oil Field who participate low dose CT (LDCT) lung cancer screening by cluster sampling or according to voluntary principle were surveyed, data of lung cancer awareness were collected by questionnaire. A total of 1,633 valid questionnaires were collected. The average age of respondents was 60.08±6.58. Most participants were males (82.2%) while female only accounted for 17.8%. The proportions of awareness about lung cancer in China, risk factors, screening methods and the knowledge of health examination were 64.5%, 77.1%, 43.7%, 49.6% respectively. Result of multiple logistic regression analysis showed that education level, smoking (pack-year), age, prior tuberculosis were the influencing factors of lung cancer awareness with adjusted Ors for education and age level as of 0.567 (95%CI: 0.439-0.733) and 1.373 (95%CI: 1.084-1.739) respectively. 80.3% of the participants can accept health examination once a year, while the ability to pay the medical expenses was not high. The influencing factors of health examination willingness were gender, age, income, the knowledge of lung cancer. Education level and smoking affect the awareness of lung cancer prevention and control, health education for lung cancer should be conducted especially in population with low education level. Comprehensive lung cancer control in high risk areas should combined lung cancer screening, tobacco control and health education.

  13. Energy audit practices in China: National and local experiences and issues

    International Nuclear Information System (INIS)

    Shen Bo; Price, Lynn; Lu Hongyou

    2012-01-01

    China set an ambitious goal of reducing its energy use per unit of GDP by 20% between 2006 and 2010. Much of the country’s effort is focused on improving the energy efficiency of the industrial sector, which consumes about two-thirds of China’s primary energy. Industrial energy audits are an important part of China’s efforts to improve its energy intensity. Such audits are employed to help enterprises identify energy-efficiency improvement opportunities and serve as a means to collect critical energy-consuming information. Information about energy audit practices in China is, however, little known to the outside world. This study combines a review of China’s national policies and programs on energy auditing with information collected from surveying a variety of Chinese institutions involved in energy audits. A key goal of the study is to conduct a gap analysis to identify how current practices in China related to energy auditing differ from energy auditing practices found around the world. This article presents our findings on the study of China’s energy auditing practices at the national and provincial levels. It discusses key issues related to the energy audits conducted in China and offers policy recommendations that draw upon international best practices. - Highlights: ► We examine China’s national and regional energy auditing practices in the 11th FYP. ► Energy audits have helped China achieve its energy efficiency target. ► Issues still remain preventing energy auditing from achieving its full potential. ► Gap analysis is conducted to compare with other international auditing program. ► We offer recommendations for the development of best energy audit practices.

  14. Antibiotic prophylaxis audit and questionnaire study: Traffic Light Poster improves adherence to protocol in gastrointestinal surgery.

    Science.gov (United States)

    Cameron, Michaella; Jones, Stacey; Adedeji, Olufunso

    2015-07-01

    To measure adherence to antibiotic prophylaxis (AP) protocol amongst surgeons and anesthetists and explore their understanding of AP prescribing in practice. A prospective audit of AP in gastrointestinal surgery and re-audit after intervention. A questionnaire survey of practice. 58 (38%- clean; 62%- clean contaminated) operations were audited and 73 (48%-clean; 51%-clean contaminated) operations were re-audited after intervention with "Traffic Light Poster" (TFP) .55 colleagues (32 consultants and 23 trainees) were recruited for questionnaire survey in three West Midlands hospitals. Audit and Re-Audits. Only 31% of procedures followed the protocol correctly in the initial audit and this increased to 73% in the re-audit. 73% of patients undergoing clean procedures received AP inappropriately in the initial audit but reduced significantly to 20% (p audit. In the initial audit, 62% of clean contaminated procedures did not receive the appropriate first line AP but this fell to 35% (p audit. Questionnaire Survey- Only 30% of respondents would not give AP in clean surgery as recommended. 45% would use appropriate AP for clean-contaminated wounds. 73% of respondents will give AP at induction, 20% 1 h pre op and 7% just before incision. There is poor compliance with AP protocols in gastrointestinal surgery in part due to general lack of awareness. An educational intervention in the form of a 'Traffic Light Poster' improved adherence to AP protocol two fold. There was improved rationalizing of AP. Clean procedures, in particular, had less inappropriate prescribing. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  15. Electronic Self-report Assessment--Cancer (ESRA-C): Working towards an integrated survey system.

    Science.gov (United States)

    Karras, Bryant T; Wolpin, Seth; Lober, William B; Bush, Nigel; Fann, Jesse R; Berry, Donna L

    2006-01-01

    The Clinical Informatics Research Group and Biobehavioral Nursing and Health Systems at the University of Washington are working with interdisciplinary teams to improve patient care and tracking of patient-reported symptoms and outcomes by creating an extensible web-based survey and intervention platform. The findings and cumulative experience from these processes have led to incremental improvements and variations in each new implementation of the platform. This paper presents progress in the first year of a three-year NIH study entitled Electronic Self Report Assessment--Cancer (ESRA-C). The project's goals are to enhance and evaluate the web-based computerized patient self-reporting and assessment system at the Seattle Cancer Care Alliance. Preliminary work and lessons learned in the modification of the platform and enhancements to the system will be described.

  16. Development and validation of the BRIGHTLIGHT Survey, a patient-reported experience measure for young people with cancer.

    Science.gov (United States)

    Taylor, Rachel M; Fern, Lorna A; Solanki, Anita; Hooker, Louise; Carluccio, Anna; Pye, Julia; Jeans, David; Frere-Smith, Tom; Gibson, Faith; Barber, Julie; Raine, Rosalind; Stark, Dan; Feltbower, Richard; Pearce, Susie; Whelan, Jeremy S

    2015-07-28

    Patient experience is increasingly used as an indicator of high quality care in addition to more traditional clinical end-points. Surveys are generally accepted as appropriate methodology to capture patient experience. No validated patient experience surveys exist specifically for adolescents and young adults (AYA) aged 13-24 years at diagnosis with cancer. This paper describes early work undertaken to develop and validate a descriptive patient experience survey for AYA with cancer that encompasses both their cancer experience and age-related issues. We aimed to develop, with young people, an experience survey meaningful and relevant to AYA to be used in a longitudinal cohort study (BRIGHTLIGHT), ensuring high levels of acceptability to maximise study retention. A three-stage approach was employed: Stage 1 involved developing a conceptual framework, conducting literature/Internet searches and establishing content validity of the survey; Stage 2 confirmed the acceptability of methods of administration and consisted of four focus groups involving 11 young people (14-25 years), three parents and two siblings; and Stage 3 established survey comprehension through telephone-administered cognitive interviews with a convenience sample of 23 young people aged 14-24 years. Stage 1: Two-hundred and thirty eight questions were developed from qualitative reports of young people's cancer and treatment-related experience. Stage 2: The focus groups identified three core themes: (i) issues directly affecting young people, e.g. impact of treatment-related fatigue on ability to complete survey; (ii) issues relevant to the actual survey, e.g. ability to answer questions anonymously; (iii) administration issues, e.g. confusing format in some supporting documents. Stage 3: Cognitive interviews indicated high levels of comprehension requiring minor survey amendments. Collaborating with young people with cancer has enabled a survey of to be developed that is both meaningful to young

  17. Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe

    Directory of Open Access Journals (Sweden)

    Alexandra S. Rashedi

    2017-06-01

    Full Text Available Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale. Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health–funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services. Results: Sixty-three responses were received (response rate, 25%, and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75% showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61% stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding. Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements.

  18. Prospective survey of erectile dysfunction after external beam radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Kikuchi, Eiji; Ando, Toshiyuki; Nagata, Hirohiko; Miyajima, Akira; Nakagawa, Ken; Oya, Mototsugu; Nakashima, Jun; Marumo, Ken

    2011-01-01

    We prospectively evaluated the effect of external beam radiotherapy on erectile function in patients with localized or locally advanced prostate cancer using the Japanese version of the International Index of Erectile Function (IIEF) survey. From 2000 to 2007, we identified 55 patients who underwent external beam radiotherapy at our institution for localized or locally advanced prostate cancer and could respond to the IIEF survey. The patients did not receive neo- and/or adjuvant hormone therapy and they were followed-up for at least 12 months after radiotherapy. Mean patient age was 69 years and the mean prostate specific antigen (PSA) level before radiotherapy was 24.9 ng/ml. First we evaluated the change of the erectile function domain score over time before and after radiotherapy. The population of severe erectile dysfunction (ED) increased while those with no or mild ED decreased after radiotherapy. The erectile function and intercourse satisfaction domain score of the IIEF declined significantly after radiotherapy, however, the orgasmic function, sexual desire, and overall satisfaction domain scores did not change after external beam radiation. Of the 34 patients who had erectile function at baseline, 10 patients could maintain erectile function 12 months after radiotherapy. Though there were no significant differences in clinical features between patients who could maintain erectile function and those who had worsening erectile function 12 months after radiotherapy, the sexual desire domain score before radiotherapy was significantly higher in patients who could maintain erectile function than their counterparts. Using the IIEF survey, external beam radiation was found to affect erectile function in patients with localized or locally advanced prostate cancer. (author)

  19. Statistical study on the self-selection bias in FDG-PET cancer screening by a questionnaire survey

    International Nuclear Information System (INIS)

    Kita, Tamotsu; Yano, Fuzuki; Watanabe, Sadahiro; Soga, Shigeyoshi; Hama, Yukihiro; Shinmoto, Hiroshi; Kosuda, Shigeru

    2008-01-01

    A questionnaire survey was performed to investigate the possible presence of self-selection bias in 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) cancer screening (PET cancer screening). Responders to the questionnaires survey consisted of 80 healthy persons, who answered whether they undergo PET cancer screening, health consciousness, age, sex, and smoking history. The univariate and multivariate analyses on the four parameters were performed between the responders who were to undergo PET cancer screening and the responders who were not. Statistically significant difference was found in health consciousness between the above-mentioned two groups by both univariate and multivariate analysis with the odds ratio of 2.088. The study indicated that self-selection bias should exist in PET cancer screening. (author)

  20. Determining the use of prophylactic antibiotics in breast cancer surgeries: a survey of practice

    Directory of Open Access Journals (Sweden)

    Acuna Sergio A

    2012-08-01

    Full Text Available Abstract Background Prophylactic antibiotics (PAs are beneficial to breast cancer patients undergoing surgery because they prevent surgical site infection (SSI, but limited information regarding their use has been published. This study aims to determine the use of PAs prior to breast cancer surgery amongst breast surgeons in Colombia. Methods An online survey was distributed amongst the breast surgeon members of the Colombian Association of Mastology, the only breast surgery society of Colombia. The scope of the questions included demographics, clinical practice characteristics, PA prescription characteristics, and the use of PAs in common breast surgical procedures. Results The survey was distributed amongst eighty-eight breast surgeons of whom forty-seven responded (response rate: 53.4%. Forty surgeons (85.1% reported using PAs prior to surgery of which >60% used PAs during mastectomy, axillary lymph node dissection, and/or breast reconstruction. Surgeons reported they targeted the use of PAs in cases in which patients had any of the following SSI risk factors: diabetes mellitus, drains in situ, obesity, and neoadjuvant therapy. The distribution of the self-reported PA dosing regimens was as follows: single pre-operative fixed-dose (27.7%, single preoperative dose followed by a second dose if the surgery was prolonged (44.7%, single preoperative dose followed by one or more postoperative doses for >24 hours (10.6%, and single preoperative weight-adjusted dose (2.1%. Conclusion Although this group of breast surgeons is aware of the importance of PAs in breast cancer surgery there is a discrepancy in how they use it, specifically with regards to prescription and timeliness of drug administration. Our findings call for targeted quality-improvement initiatives, such as standardized national guidelines, which can provide sufficient evidence for all stakeholders and therefore facilitate best practice medicine for breast cancer surgery.

  1. Radiotherapy for invasive breast cancer in North America and Europe: Results of a survey

    International Nuclear Information System (INIS)

    Ceilley, Elizabeth; Jagsi, Reshma; Goldberg, Saveli; Grignon, Laurent; Kachnic, Lisa; Powell, Simon; Taghian, Alphonse

    2005-01-01

    Purpose: To document and explain the current radiotherapeutic management of invasive breast cancer in North America and Europe. We also identified a number of areas of agreement, as well as controversy, toward which additional clinical research should be directed. Methods and materials: An original survey questionnaire was developed to assess radiation oncologists' self-reported management of breast cancer. The questionnaire was administered to physician members of the American Society for Therapeutic Radiology and Oncology and the European Society for Therapeutic Radiology and Oncology. We present the results of the comparative analysis of 702 responses from North America and 435 responses from Europe. Results: Several areas of national and international controversy were identified, including the selection of appropriate candidates for postmastectomy radiation therapy (RT) and the appropriate management of the regional lymph nodes after mastectomy, as well as after lumpectomy. Only 40.7% and 36.1% of respondents would use postmastectomy RT in patients with 1-3 positive lymph nodes in North America and Europe, respectively. Sentinel lymph node biopsy was offered more frequently by North American than European respondents (p < 0.0001) and more frequently by academic than nonacademic respondents in North America (p < 0.05). The average radiation fraction size was larger in Europe than in North America (p < 0.01). European respondents offered RT to the internal mammary chain more often than did the North American respondents (p < 0.001). North American respondents were more likely to offer RT to the supraclavicular fossa (p < 0.001) and axilla (p < 0.01). Conclusion: Marked differences were found in physician opinions regarding the management of breast cancer, with statistically significant international differences in patterns of care. This survey highlighted areas of controversy, providing support for international randomized trials to optimize the RT management of

  2. THE EFFECT OF AUDIT FOLLOW-UP AND SIZES ON THE AUDIT QUALITY

    OpenAIRE

    Mahpiansyah Mahpiansyah

    2017-01-01

    ABSTRAK Penelitian ini mengukur pengaruh ukuran audit dan tindak lanjut hasil audit terhadap kualitas audit di Indonesia. Pemerintah Indonesia memiliki dua institusi audit: eksternal dan internal audit. Tindak lanjut audit adalah perkembangan pelaksanaan rekomendasi audit dari audit eksternal untuk memperbaiki laporan keuangan auditee. Penelitian ini menganalisa data 33 provinsi dari tahun 2009 sampai dengan tahun 2013 dari Ikhtisar Laporan Hasil Pemeriksaan Badan Pemeriksa Keuangan (ILHP ...

  3. Academicians' and Practitioners' Views on the Importance of the Topical Content in the First Auditing Course

    Science.gov (United States)

    Armitage, Jack; Poyzer, Jillian K.

    2010-01-01

    The research question addressed in this study is to compare and identify differences between academics teaching auditing classes and practicing accountants regarding the importance of topics covered in the first university auditing course. This is accomplished by surveying academics and practitioners regarding their perceptions of the importance…

  4. Internal Audit: Does it Enhance Governance in the Australian Public University Sector?

    Science.gov (United States)

    Christopher, Joe

    2015-01-01

    This study seeks to confirm if internal audit, a corporate control process, is functioning effectively in Australian public universities. The study draws on agency theory, published literature and best-practice guidelines to develop an internal audit evaluation framework. A survey instrument is thereafter developed from the framework and used as a…

  5. 29 CFR 96.12 - Audit requirements.

    Science.gov (United States)

    2010-07-01

    .... (b) The audit requirements contained in 29 CFR part 99 shall be followed for audits of all fiscal... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirements. 96.12 Section 96.12 Labor Office of the Secretary of Labor AUDIT REQUIREMENTS FOR GRANTS, CONTRACTS, AND OTHER AGREEMENTS Audits of States, Local...

  6. 29 CFR 99.230 - Audit costs.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit costs. 99.230 Section 99.230 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230 Audit... years ending after December 31, 2003) and is thereby exempted under § 99.200(d) from having an audit...

  7. 11 CFR 9038.1 - Audit.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Audit. 9038.1 Section 9038.1 Federal Elections... EXAMINATIONS AND AUDITS § 9038.1 Audit. (a) General. (1) The Commission will conduct an audit of the qualified... primary matching funds. The audit may be conducted at any time after the date of the candidate's...

  8. 30 CFR 725.19 - Audit.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Audit. 725.19 Section 725.19 Mineral Resources... REGULATIONS REIMBURSEMENTS TO STATES § 725.19 Audit. The agency shall arrange for an independent audit no less... Circular No. A-102, Attachment P. The audits will be performed in accordance with the “Standards for Audit...

  9. 32 CFR 37.1325 - Periodic audit.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Periodic audit. 37.1325 Section 37.1325 National... TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1325 Periodic audit. An audit of... awards. Appendix C to this part describes what such an audit may cover. A periodic audit of a participant...

  10. 30 CFR 735.22 - Audit.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Audit. 735.22 Section 735.22 Mineral Resources... ENFORCEMENT § 735.22 Audit. The agency shall arrange for an independent audit no less frequently than once..., Attachment P. The audits will be performed in accordance with the “Standards for Audit of Governmental...

  11. Proxy and patient reports of health-related quality of life in a national cancer survey.

    Science.gov (United States)

    Roydhouse, Jessica K; Gutman, Roee; Keating, Nancy L; Mor, Vincent; Wilson, Ira B

    2018-01-05

    Proxy respondents are frequently used in surveys, including those assessing health-related quality of life (HRQOL). In cancer, most research involving proxies has been undertaken with paired proxy-patient populations, where proxy responses are compared to patient responses for the same individual. In these populations, proxy-patient differences are small and suggest proxy underestimation of patient HRQOL. In practice, however, proxy responses will only be used when patient responses are not available. The difference between proxy and patient reports of patient HRQOL where patients are not able to report for themselves in cancer is not known. The objective of this study was to evaluate the difference between patient and proxy reports of patient HRQOL in a large national cancer survey, and determine if this difference could be mitigated by adjusting for clinical and sociodemographic information about patients. Data were from the Cancer Care Outcomes Research and Surveillance (CanCORS) study. Patients or their proxies were recruited within 3-6 months of diagnosis with lung or colorectal cancer. HRQOL was measured using the SF-12 mental and physical composite scales. Differences of ½ SD (=5 points) were considered clinically significant. The primary independent variable was proxy status. Linear regression models were used to adjust for patient sociodemographic and clinical covariates, including cancer stage, patient age and education, and patient co-morbidities. Of 6471 respondents, 1011 (16%) were proxies. Before adjustment, average proxy-reported scores were lower for both physical (-6.7 points, 95% CI -7.4 to -5.9) and mental (-6 points, 95% CI -6.7 to -5.2) health. Proxy-reported scores remained lower after adjustment (physical: -5.8 points, -6.6 to -5; mental: -5.8 points, -6.6 to 5). Proxy-patient score differences remained clinically and statistically significant, even after adjustment for sociodemographic and clinical variables. Proxy-reported outcome scores

  12. Epidemiological survey of radiation workers. Risk of leukemia and solid cancer by low level radiation exposure

    International Nuclear Information System (INIS)

    Tatsumi, Kouichi

    2011-01-01

    An interim report on the epidemiological survey of cohort involving radiation workers in the nuclear power plants in Japan was introduced. It consists of eight chapters such as introduction, the objects of mortality rate survey from death causes and creating a cohort, the method of tracking the life and death, analytical methods of mortality rate, analytical results, confounded effects of life style, discussion: contrast the report on the mortality rate of solid cancer except leukemia in Japan and other countries and the conclusions. The subjects of mortality rate of the forth survey were about 277,000 workers including from the first to the third survey. In a prospective cohort study, 203,904 workers were screened for analytical study, and they included 14,224 deaths (5,711 from malignant neoplasm, 6,310 from nonmalignant neoplasm and 1,995 from extrinsic death). The analytical results were shown by three types of death caused from leukemia, malignant neoplasm except for leukemia and nonmalignant neoplasm. Analytical results of the mortality rate from death caused in third and forth study, change of analytical results from the first to the forth observation period were illustrated. (S.Y.)

  13. PILLARS OF THE AUDIT ACTIVITY: MATERIALITY AND AUDIT RISK

    Directory of Open Access Journals (Sweden)

    ANA MARIA JOLDOŞ

    2010-01-01

    Full Text Available The purpose of this article is to present the issues of materiality andaudit risk within the activity of financial audit. The concepts of materiality and audit risk aredescribed from a theoretical perspective, providing approaches found within the national andinternational literature and within the specific legislation. A case study on the calculation ofmateriality and audit risk for an entity is presented in the last part of the article. Through thetheoretical approach and the case study, it was concluded that materiality has an importantrole in determining the type of report to be issued, that is why it can be considered helpful forthose involved in the audit process.

  14. Audit in forensic pathology.

    Science.gov (United States)

    Burke, M P; Opeskin, K

    2000-09-01

    Autopsy numbers in Australian hospitals have declined markedly during the past decade despite evidence of a relatively static rate of demonstrable clinical misdiagnosis during this time. The reason for this decrease in autopsy numbers is multifactorial and may include a general lack of clinical and pathologic interest in the autopsy with a possible decline in autopsy standard, a lack of clinicopathologic correlation after autopsies, and an increased emphasis on surgical biopsy reporting within hospital pathology departments. Although forensic autopsies are currently maintaining their numbers, it is incumbent on forensic pathologists to demonstrate the wealth of important information a carefully performed postmortem examination can reveal. To this end, the Pathology Division of the Victorian Institute of Forensic Medicine has instituted a program of minimum standards in varied types of coroner cases and commenced a system of internal and external audit. The minimum standard for a routine, sudden, presumed natural death is presented and the audit system is discussed.

  15. Auditing nuclear materials statements

    International Nuclear Information System (INIS)

    Anon.

    1973-01-01

    A standard that may be used as a guide for persons making independent examinations of nuclear materials statements or reports regarding inventory quantities on hand, receipts, production, shipment, losses, etc. is presented. The objective of the examination of nuclear materials statements by the independent auditor is the expression of an opinion on the fairness with which the statements present the nuclear materials position of a nuclear materials facility and the movement of such inventory materials for the period under review. The opinion is based upon an examination made in accordance with auditing criteria, including an evaluation of internal control, a test of recorded transactions, and a review of measured discards and materials unaccounted for (MUF). The standard draws heavily upon financial auditing standards and procedures published by the American Institute of Certified Public Accountants

  16. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... of Discovery Research Tools, Specimens, and Data Grants & Training Research Grants Research Funding Opportunities Research Program Contacts ... and Auditing Transfer of a Grant Grant Closeout Training Cancer Training at NCI Funding for Cancer Training ...

  17. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Resources for ... Staging Prognosis Questions to Ask ... This statistic is another method used to estimate cancer-specific survival that does ...

  18. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Funding for ... Staging Prognosis Questions to Ask about ... This statistic is another method used to estimate cancer-specific survival that does ...

  19. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Resources for ... Staging Prognosis Questions to Ask about ... This statistic is another method used to estimate cancer-specific survival that does ...

  20. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Funding for ... NCI NCI Overview History Contributing to Cancer Research Leadership Director's Page Deputy Director's Page Previous NCI Directors ...

  1. Colorectal cancer screening of high-risk populations: A national survey of physicians

    Directory of Open Access Journals (Sweden)

    White Pascale M

    2012-01-01

    Full Text Available Abstract Background The incidence of colorectal cancer can be decreased by appropriate use of screening modalities. Patients with a family history of colon cancer and of African-American ethnicity are known to be at higher risk of developing colorectal cancer. We aimed to determine if there is a lack of physician knowledge for colorectal cancer screening guidelines based on family history and ethnicity. Between February and April 2009 an anonymous web-based survey was administered to a random sample selected from a national list of 25,000 internists, family physicians and gastroenterologists. A stratified sampling strategy was used to include practitioners from states with high as well as low CRC incidence. All data analyses were performed following data collection in 2009. Results The average knowledge score was 37 ± 18% among the 512 respondents. Gastroenterologists averaged higher scores compared to internists, and family physicians, p = 0.001. Only 28% of physicians correctly identified the screening initiation point for African-Americans while only 12% of physicians correctly identified the screening initiation point and interval for a patient with a family history of CRC. The most commonly cited barriers to referring high-risk patients for CRC screening were "patient refusal" and "lack of insurance reimbursement." Conclusions There is a lack of knowledge amongst physicians of the screening guidelines for high-risk populations, based on family history and ethnicity. Educational programs to improve physician knowledge and to reduce perceived barriers to CRC screening are warranted to address health disparities in colorectal cancer.

  2. Radiation techniques used in patients with breast cancer: Results of a survey in Spain

    Science.gov (United States)

    Algara, Manuel; Arenas, Meritxell; De las Peñas Eloisa Bayo, Dolores; Muñoz, Julia; Carceller, José Antonio; Salinas, Juan; Moreno, Ferran; Martínez, Francisco; González, Ezequiel; Montero, Ángel

    2012-01-01

    Aim To evaluate the resources and techniques used in the irradiation of patients with breast cancer after lumpectomy or mastectomy and the status of implementation of new techniques and therapeutic schedules in our country. Background The demand for cancer care has increased among the Spanish population, as long as cancer treatment innovations have proliferated. Radiation therapy in breast cancer has evolved exponentially in recent years with the implementation of three-dimensional conformal radiotherapy, intensity modulated radiotherapy, image guided radiotherapy and hypofractionation. Material and Methods An original survey questionnaire was sent to institutions participating in the SEOR-Mama group (GEORM). In total, the standards of practice in 969 patients with breast cancer after surgery were evaluated. Results The response rate was 70% (28/40 centers). In 98.5% of cases 3D conformal treatment was used. All the institutions employed CT-based planning treatment. Boost was performed in 56.4% of patients: electrons in 59.8%, photons in 23.7% and HDR brachytherapy in 8.8%. Fractionation was standard in 93.1% of patients. Supine position was the most frequent. Only 3 centers used prone position. The common organs of risk delimited were: homolateral lung (80.8%) and heart (80.8%). In 84% histograms were used. An 80.8% of the centers used isocentric technique. In 62.5% asymmetric fields were employed. CTV was delimited in 46.2%, PTV in 65% and both in 38.5%. A 65% of the centers checked with portal films. IMRT and hypofractionation were used in 1% and in 5.5% respectively. Conclusion In most of centers, 3D conformal treatment and CT-based planning treatment were used. IMRT and hypofractionation are currently poorly implemented in Spain. PMID:24377012

  3. Audit risk assessment model

    OpenAIRE

    Jodelienė, Rita

    2010-01-01

    The recent changes of the global scale caused by the development of business and an excessive use of subjective decisions and estimates when drawing up financial statements have caused an increased pressure that may lead to fraudulent financial reporting. Audit firms are obligated to express an independent opinion on the truthfulness and fairness of the information presented in financial statements to enable the users to take informed economic decisions. Therefore, it is important to further ...

  4. FY 2012 Audit Plan

    Science.gov (United States)

    2011-10-01

    September 30, 2012 and 2011 Objective: Determine whether KPMG complied, in all material respects, with U.S. generally accepted government auditing...reported the same 13 material internal control weaknesses as the previous year. These pervasive and longstanding financial management issues...Defense Contract Management Agency’s Investigation and Control of Nonconforming Materials (D2011-D000CD-0264.000) Objective: Examine the Defense

  5. Auditing Organizational Security

    Science.gov (United States)

    2017-01-01

    Organi- zation for Standardiza- tion ( ISO ): ISO 27000 : Information Systems Se- curity Management. A robust program of internal auditing of a...improvement is the basis and underpinning of the ISO . All processes must be considered ongoing and never at an “end state.” Top management develops a...security management system, including security policies and security objectives, plus threats and risks. Orga- nizations already working with ISO 9000

  6. Faktor-Faktor yang Mempengaruhi Perilaku Auditor dalam Penghentian Prematur atas Prosedur Audit

    Directory of Open Access Journals (Sweden)

    Astia Putriana

    2016-03-01

    Full Text Available The purpose of this research is to examine the effect of time pressure, audit risk, materiality, review procedure and quality control, need for achievement, and professional commitments on the auditor in premature termination on audit procedures. This reseach applies a mail survey as data collection method and convienece sampling as sample collection method. Research subjects are 106 auditor at the Supreme Audit Board of the Republic of Indonesia (BPK RI Representative of South Kalimantan and Central Kalimantan. Empirical evidence finds that audit risk effect toward premature termination on the audit procedures. However, time pressure, materiality, review procedure and quality control, need for achievement and professional commitment does not effect toward premature termination on the audit procedures.

  7. Public awareness of the link between alcohol and cancer in England in 2015: a population-based survey

    Directory of Open Access Journals (Sweden)

    Penny Buykx

    2016-11-01

    Full Text Available Abstract Background Public knowledge of the association between alcohol and cancer is reported to be low. We aimed to provide up-to-date evidence for England regarding awareness of the link between alcohol and different cancers and to determine whether awareness differs by demographic characteristics, alcohol use, and geographic region. Methods A representative sample of 2100 adults completed an online survey in July 2015. Respondents were asked to identify which health outcomes, including specific cancers, may be caused by alcohol consumption. Logistic regressions explored whether demographic, alcohol use, and geographic characteristics predicted correctly identifying alcohol-related cancer risk. Results Unprompted, 12.9% of respondents identified cancer as a potential health outcome of alcohol consumption. This rose to 47% when prompted (compared to 95% for liver disease and 73% for heart disease. Knowledge of the link between alcohol and specific cancers varied between 18% (breast and 80% (liver. Respondents identified the following cancers as alcohol-related where no such evidence exists: bladder (54%, brain (32%, ovarian (17%. Significant predictors of awareness of the link between alcohol and cancer were being female, more highly educated, and living in North-East England. Conclusion There is generally low awareness of the relationship between alcohol consumption and cancer, particularly breast cancer. Greater awareness of the relationship between alcohol and breast cancer in North-East England, where a mass media campaign highlighted this relationship, suggests that population awareness can be influenced by social marketing.

  8. Public awareness of the link between alcohol and cancer in England in 2015: a population-based survey.

    Science.gov (United States)

    Buykx, Penny; Li, Jessica; Gavens, Lucy; Hooper, Lucie; Lovatt, Melanie; Gomes de Matos, Elena; Meier, Petra; Holmes, John

    2016-11-30

    Public knowledge of the association between alcohol and cancer is reported to be low. We aimed to provide up-to-date evidence for England regarding awareness of the link between alcohol and different cancers and to determine whether awareness differs by demographic characteristics, alcohol use, and geographic region. A representative sample of 2100 adults completed an online survey in July 2015. Respondents were asked to identify which health outcomes, including specific cancers, may be caused by alcohol consumption. Logistic regressions explored whether demographic, alcohol use, and geographic characteristics predicted correctly identifying alcohol-related cancer risk. Unprompted, 12.9% of respondents identified cancer as a potential health outcome of alcohol consumption. This rose to 47% when prompted (compared to 95% for liver disease and 73% for heart disease). Knowledge of the link between alcohol and specific cancers varied between 18% (breast) and 80% (liver). Respondents identified the following cancers as alcohol-related where no such evidence exists: bladder (54%), brain (32%), ovarian (17%). Significant predictors of awareness of the link between alcohol and cancer were being female, more highly educated, and living in North-East England. There is generally low awareness of the relationship between alcohol consumption and cancer, particularly breast cancer. Greater awareness of the relationship between alcohol and breast cancer in North-East England, where a mass media campaign highlighted this relationship, suggests that population awareness can be influenced by social marketing.

  9. Analisis Pengaruh Keahlian, Independensi, Perencanaan Audit dan Supervisi Audit terhadap Kualitas Audit pada Inspektorat Provinsi Sumatera Utara

    OpenAIRE

    Pohan, Nur Aisah

    2015-01-01

    The objective of the research was to analyze the influence of skill, independence, audit planning, and audit supervision on audit quality simultaneously and partially and to find out that motivation could moderate the correlation of skill, independence, audit planning, and audit supervision with audit quality at the Inspectorate of North Sumatera Province office. The research used causal research method. The population and the samples consisted of 66 supervision officials at the Inspectorate ...

  10. National audit of a system for rectal contact brachytherapy

    Directory of Open Access Journals (Sweden)

    Laia Humbert-Vidan

    2017-01-01

    Full Text Available Background and purpose: Contact brachytherapy is used for the treatment of early rectal cancer. An overview of the current status of quality assurance of the rectal contact brachytherapy systems in the UK, based on a national audit, was undertaken in order to assist users in optimising their own practices. Material and methods: Four UK centres using the Papillon 50 contact brachytherapy system were audited. Measurements included beam quality, output and radiation field size and uniformity. Test frequencies and tolerances were reviewed and compared to both existing recommendations and published reviews on other kV and electronic brachytherapy systems. External validation of dosimetric measurements was provided by the National Physical Laboratory. Results: The maximum host/audit discrepancy in beam quality determination was 6.5%; this resulted in absorbed dose variations of 0.2%. The host/audit agreement in absorbed dose determination was within 2.2%. The median of the radiation field uniformity measurements was 2.7% and the host/audit agreement in field size was within 1 mm. Test tolerances and frequencies were within the national recommendations for kV units. Conclusions: The dosimetric characterisation of the Papillon 50 was validated by the audit measurements for all participating centres, thus providing reassurance that the implementation had been performed within the standards stated in previously published audit work and recommendations for kV and electronic brachytherapy units. However, optimised and standardised quality assurance testing could be achieved by reducing some methodological differences observed. Keywords: Contact brachytherapy, Electronic brachytherapy, Audit

  11. INTERNAL AUDIT AND RISK MANAGEMENT

    OpenAIRE

    Elena RUSE; Georgiana SUSMANSCHI (BADEA); Daniel DĂNECI-PĂTRĂU

    2014-01-01

    The existence of risk in economic activity can not be denied. In fact, the risk is a concept which exists in every activity, the term of risk being identified with uncertainty, respectively the (un)chance to produce an undesirable event. Internal audit and risk management aim at the same goal, namely the control of risks. Internal Audit performs several roles in risk management plan. The objectives of the internal audit function varies from company to company, but in all economic entities int...

  12. The ambiguous identity of auditing

    DEFF Research Database (Denmark)

    Lindeberg, Tobias

    2007-01-01

    This paper analyses the identity of auditing by comparing performance auditing to financial auditing and programme evaluation. Based on an analysis of textbooks, it is concluded that these evaluative practices are situated on a continuum. This implies that studies that rely on ‘audit’ as a label...... to attribute identity to a distinct evaluative practice become insensitive to issues concerning the relevance of their results to evaluative practices in general and their relation to specific characteristic of certain evaluative practices...

  13. Satisfaction with information provided to Danish cancer patients: validation and survey results.

    Science.gov (United States)

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit; Lundstrøm, Louise Hyldborg; Groenvold, Mogens

    2013-11-01

    To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction. The questionnaire was validated by patient-observer agreement and cognitive interviews. The prevalence of dissatisfaction was assessed in a cross-sectional sample of all cancer patients in contact with hospitals during the past year in three Danish counties. The validation showed that the CPWQ performed well. Between 3 and 23% of the 1490 participating patients were dissatisfied with each of the measured aspects of information. The highest level of dissatisfaction was reported regarding the guidance, support and help provided when the diagnosis was given. Younger patients were consistently more dissatisfied than older patients. The brief CPWQ performs well for survey purposes. The survey depicts the heterogeneous patient population encountered by hospital staff and showed that younger patients probably had higher expectations or a higher need for information and that those with more severe diagnoses/prognoses require extra care in providing information. Four brief questions can efficiently assess information needs. With increasing demands for information, a wide range of innovative initiatives is needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Underuse of brachytherapy for the treatment of dysphagia owing to esophageal cancer. An Italian survey.

    Science.gov (United States)

    Fuccio, Lorenzo; Guido, Alessandra; Hassan, Cesare; Frazzoni, Leonardo; Arcelli, Alessandra; Farioli, Andrea; Giaccherini, Lucia; Galuppi, Andrea; Mandolesi, Daniele; Cellini, Francesco; Mantello, Giovanna; Macchia, Gabriella; de Bortoli, Nicola; Repici, Alessandro; Valentini, Vincenzo; Bazzoli, Franco; Morganti, Alessio Giuseppe

    2016-10-01

    International guidelines strongly recommend brachytherapy as valid alternative or in addition to stenting in patients with dysphagia owing to esophageal cancer. However, for not well understood reasons, brachytherapy is definitively underused for the palliative treatment of malignant dysphagia. Aim of the current survey was to investigate the use of brachytherapy for the treatment of malignant dysphagia in Italy. A structured questionnaire was submitted to the 1510 members of the Italian Association of Radiation Oncologists (AIRO). These members refer to 177 centres of radiotherapy across Italy and in 68 (38.4%) of them brachytherapy is routinely performed. Of the 1510 invited members, 178 completed the survey (11.7%). The answers provided by the 178 participants allowed to get information on 40 out of 68 brachytherapy centres (58.8%). Seven out of 40 (17.5%) centres perform brachytherapy of the oesophagus, in 3 out of 40 (7.5%) centres brachytherapy represents the first line of treatment. The main reason why brachytherapy is not routinely performed is the lack of experience. Despite the strong recommendations of the international guidelines and the wide diffusion of brachytherapy centres across Italy, only very few of them routinely considered brachytherapy for the treatment of dysphagia due to esophageal cancer. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. A population-based audit of ethnicity and breast cancer risk in one general practice catchment area in North London, UK: implications for practice

    Directory of Open Access Journals (Sweden)

    Ferris Michelle

    2007-09-01

    Full Text Available Abstract Objectives To conduct a pilot population-based study within a general practice catchment area to determine whether the incidence of breast cancer was increased in the Ashkenazi population. Design Population-based cohort study. Setting A single general practice catchment area in North London. Participants 1947 women over the age of 16 who responded to a questionnaire about ethnicity and breast cancer. Main outcome measures Incidence of breast cancer, ethnicity. Results This study showed a 1.5-fold (95% CI 0.93–2.39 increase in breast cancer risk in the Ashkenazim compared with the non-Ashkenazi white population. The increased incidence was for both premenopausal and postmenopausal breast cancer (expected incidence pre:post is 1:4 whereas in the Ashkenazim it was 1:1; 51 and 52% of cases respectively. This increase was not shown in the Sephardim. Asians had a reduction in incidence (OR = 0.44; 95% CI 0.10–1.89. Results were adjusted for other risk factors for breast cancer. Conclusion This study showed a 1.5-fold increase in breast cancer rates in Ashkenazim compared with the non-Jewish white population when adjusted for age (i.e. corrections were made to allow comparison of age groups and this is not observed in the Sephardic population. The proportion of premenopausal breast cancer was just over double that of the general population. This is the first general practice population-based study in the UK to address this issue and has implications for general practitioners who care for patients from the Ashkenazi community.

  16. Variability in the quality of rectal cancer care in public hospitals in Catalonia (Spain): clinical audit as a basis for action.

    Science.gov (United States)

    Manchon-Walsh, P; Borras, J M; Espinas, J A; Aliste, L

    2011-04-01

    Clinical practice guidelines in cancer are a relevant component of Catalonian Cancer Strategy aimed at promoting equity of access to therapy and quality of cancer care. The colorectal cancer (CRC) guideline was first published in 2003 and subsequently updated in 2008. This study examined the quality of therapy administered to patients with rectal cancer in public hospitals in Catalonia (Spain) in 2005 and 2007, according to CRC guideline recommendations. We conducted a multicentre retrospective cohort study of patients who underwent curative-intent surgery for primary rectal cancer at Catalonian public hospitals in 2005 and 2007. Data were drawn from clinical records. The study covered 1831 patients with rectal cancer. Performance of total mesorectal excision (TME) was poorly reported by surgeons (46.4%) and pathologists (36.2%). Pre-operative radiotherapy was performed on 52% of stage-II and -III patients. Compared to high-caseload hospitals, those with a low caseload (≤11 cases/year) registered more Hartman's procedures, worse TME quality, a higher rate of post-operative complications and lower adherence to recommended pre-operative radio-chemotherapy. Reporting quality of care is essential for ascertaining current performance status and opportunities for improvement. In our case, there is a need for the quality of the information included in clinical records to be improved, and variability in adherence to guideline recommendations to be reduced. In view of the fact that heterogeneity in the quality of the health care process was linked to hospital caseload, the health authorities have decided to reorganise the provision of rectal cancer care. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Correlation analysis of lung cancer and urban spatial factor: based on survey in Shanghai.

    Science.gov (United States)

    Wang, Lan; Zhao, Xiaojing; Xu, Wangyue; Tang, Jian; Jiang, Xiji

    2016-09-01

    The density of particulate matter (PM) in mega-cities in China such as Beijing and Shanghai has exceeded basic standards for health in recent years. Human exposure to PMs has been identified as traceable and controllable factor among all complicated risk factors for lung cancer. While the improvement of air quality needs tremendous efforts and time, certain revision of PM's density might happen associated with the adjustment of built environment. It is also proved that urban built environment is directly relevant to respiratory disease. Studies have respectively explored the indoor and outdoor factors on respiratory diseases. More comprehensive spatial factors need to be analyzed to understand the cumulative effect of built environment upon respiratory system. This interdisciplinary study examines the impact of both indoor (including age of housing, interval after decoration, indoor humidity etc.) and outdoor spatial factors (including density, parking, green spaces etc.) on lung cancer. A survey of lung cancer patients and a control group has been conducted in 2014 and 2015. A total of 472 interviewees are randomly selected within a pool of local residents who have resided in Shanghai for more than 5 years. Data are collected including their socio-demographic factors, lifestyle factors, and external and internal residential area factors. Regression models are established based on collected data to analyze the associations between lung cancer and urban spatial factors. Regression models illustrate that lung cancer presents significantly associated with a number of spatial factors. Significant outdoor spatial factors include external traffic volume (P=0.003), main plant type (P=0.035 for trees) of internal green space, internal water body (P=0.027) and land use of surrounding blocks (P=0.005 for residential areas of 7-9 floors, P=0.000 for residential areas of 4-6 floors, P=0.006 for business/commercial areas over 10 floors, P=0.005 for business/commercial areas of

  18. A lack of information engagement among colorectal cancer screening non-attenders: cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Lindsay C. Kobayashi

    2016-07-01

    Full Text Available Abstract Background The NHS Cancer Screening Programmes in England now operate a policy of ‘informed choice’ about participation in cancer screening. Engagement with written information about screening is important to facilitate informed choice, although the degree to which the screening-eligible public engages with the available information is unknown. We examined the association between reading of the standard informational booklet (‘Bowel Cancer Screening: The Facts' and participation in the nationally organised NHS Bowel Cancer Screening Programme in England. Methods Face-to-face interviews were conducted with 1307 adults who were age-eligible for nationally organised colorectal cancer (CRC; also called bowel cancer in a population-based survey in England in 2014. Respondents were shown an image of ‘The Facts’ booklet and were asked how much of it they had read when they received their screening invitation (‘none’, ‘a little’, ‘some’, ‘most’, ‘almost all’, or ‘all’. Logistic regression was used to estimate the associations between screening uptake status (‘never’ vs. ‘ever’ and self-reported reading of ‘The Facts’ booklet (dichotomised to ‘none vs. ‘any’, adjusting for age, sex, ethnicity, educational attainment, and occupation-based social grade. Results Overall, 69 % of the sample (908/1307 had participated in CRC screening at least once (‘ever’ screeners. One-fifth of the sample reported that they had read ‘none’ of ‘The Facts’ booklet (22 %; 287/1307, while half reported having read ‘all’ of it (52 %; 680/1307. Reading of the booklet was strongly differential according to screening uptake status: nearly two-thirds of ‘never’ screeners had read none of ‘The Facts’ booklet (63 %; 251/399, compared to less than one in twenty ‘ever’ screeners (4 %; 36/908; adjusted OR = 39.0; 95 % CI: 26.2-58.1 for reading ‘none’ in ‘never’ vs.

  19. Health-Related Quality of Life in Cervical Cancer Survivors: A Population-Based Survey

    International Nuclear Information System (INIS)

    Korfage, Ida J.; Essink-Bot, Marie-Louise; Mols, Floortje; Poll-Franse, Lonneke van de; Kruitwagen, Roy; Ballegooijen, Marjolein van

    2009-01-01

    Purpose: In a population-based sample of cervical cancer survivors, health-related quality of life (HRQoL) was assessed 2-10 years postdiagnosis. Methods and Materials: All patients given a diagnosis of cervical cancer in 1995-2003 in the Eindhoven region, The Netherlands, and alive after Jan 2006 were identified through the cancer registry. Generic HRQoL (36-Item Short-Form Health Survey, EQ-5D), cervical cancer-specific HRQoL (European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module), and anxiety (6-item State Trait Anxiety Inventory) were assessed and compared with a reference population (n = 349). Data for tumor characteristics at diagnosis and disease progression were available. Results: A total of 291 women responded (69%), with a mean age of 53 ± 13 (SD) years (range, 31-88 years). Treatment had consisted of surgery (n = 195) or a combination of therapies (n = 75); one woman had not been treated. Of all women, 85% were clinically disease free, 2% had a recurrence/metastasis, and in 13%, this was unknown. After controlling for background characteristics (age, education, job and marital status, having children, and country of birth), generic HRQoL scale scores were similar to the reference population, except for worse mental health in survivors. The most frequent symptoms were crampy pain in the abdomen or belly (17%), urinary leakage (15%), menopausal symptoms (18%), and problems with sexual activity. Compared with the 6-10-year survivors, more sexual worry and worse body image were reported by the 2-5-year survivors. Compared with surgery only, especially primary radiotherapy was associated with an increased frequency of treatment-related side effects, also after controlling for age and disease stage at diagnosis and follow-up. Conclusions: Most cervical cancer survivors were coping well, although their mental health was worse than in the reference population. Even after 2-10 years, radiotherapy was

  20. 7 CFR 4284.18 - Audit requirements.

    Science.gov (United States)

    2010-01-01

    ... Grant Programs § 4284.18 Audit requirements. Grantees must comply with the audit requirements of 7 CFR part 3052. The audit requirements apply to the years in which grant funds are received and years in...

  1. 7 CFR 1290.10 - Audit requirements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Audit requirements. 1290.10 Section 1290.10 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... audit, a copy of the audit results. ...

  2. The ICA Communication Audit: Process, Status, Critique

    Science.gov (United States)

    Goldhaber, Gerald M.; Krivonos, Paul D.

    1977-01-01

    Explores the International Communication Association (ICA) Audit process including goals, products, instruments, audit logistics and timetable, feedback of results and follow-up, costs, current status and audits conducted to date. (ED.)

  3. Internal Audits of QMS (COTS) -

    Data.gov (United States)

    Department of Transportation — This is an internal audit workflow application used to automate business processes that support the AVS Quality Management System (QMS) and several Flight Standards...

  4. Contemporary management of prostate cancer: a practice survey of Ontario genitourinary radiation oncologists

    International Nuclear Information System (INIS)

    Rodrigues, George; D'Souza, David; Crook, Juanita; Malone, Shawn; Sathya, Jinka; Morton, Gerard

    2003-01-01

    Objective: To survey radiation oncology practice in the utilization of hormonal and radiation therapy in the primary, adjuvant and salvage treatment of localized prostate cancer. Materials and methods: Genitourinary radiation oncologists practicing in Ontario were invited to participate in a practice survey examining staging, hormonal and radiation management, and radiation technique for a variety of common clinical scenarios. Background demographic information was collected on all respondents. The survey consisted of three cases relating to the hormonal/radiation management of low-, intermediate-, and high-risk prostate cancer as well as two adjuvant and one salvage post-prostatectomy scenarios. The survey response rate was 70% (26/37). Results: Clinicians were more likely to utilize laboratory and imaging studies for staging as the risk categorization increased. Low-risk disease was managed with radiation alone in 26/26 (70 Gy in 65%, 74-79.8 Gy in 35%). Intermediate-risk disease was managed with radiation (70 Gy in 46%, 74-79.8 Gy in 54%) with neoadjuvant hormones in 58%. All respondents managed high-risk disease with adjuvant hormones in addition to radiation therapy (70-71 Gy in 85%, and 76 Gy in 15%). In the pT3a, margin negative (PSA undetectable) scenario, most individuals would not recommend adjuvant radiation (73%). If margins were positive, 30% would still not recommend adjuvant radiation. In the salvage scenario (slowly rising PSA 4 years post-prostatectomy for pT2a close margin disease), all respondents would manage with radiation therapy. Hormones were not routinely recommended in the initial management of the adjuvant and salvage scenarios. Radiation doses utilized for both adjuvant and salvage treatment ranged from 60-70 Gy (median 66 Gy). Conclusions: General agreement exists for the management of low- and high-risk disease and in the post-prostatectomy salvage setting. Use of dose-escalation and neoadjuvant hormones in the intermediate

  5. Comorbidity of common mental disorders with cancer and their treatment gap: Findings from the World Mental Health Surveys

    Science.gov (United States)

    Nakash, Ora; Levav, Itzhak; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Florescu, Slivia; de Girolamo, Giovanni; Gureje, Oye; He, Yanling; Hu, Chiyi; de Jonge, Peter; Karam, Elie G.; Kovess-Masfety, Viviane; Medina-Mora, Maria Elena; Moskalewicz, Jacek; Murphy, Sam; Nakamura, Yosikazu; Piazza, Marina; Posada-Villa, Jose; Stein, Dan J.; Taib, Nezar Ismet; Zarkov, Zahari; Kessler, Ronald C.; Scott, Kate M.

    2014-01-01

    Objective To study the comorbidity of common mental disorders (CMDs) and cancer, and the mental health treatment gap among community residents with active cancer, cancer survivors and cancer-free respondents in 13 high- and 11 low-middle income countries. Methods Data were derived from the World Mental Health Surveys (N=66,387; n=357 active cancer, n=1,373 cancer survivors, n=64,657 cancer free respondents). The WHO/Composite International Diagnostic Interview was used in all surveys to estimate CMDs prevalence rates. Respondents were also asked about mental health service utilization in the preceding 12 months. Cancer status was ascertained by self-report of physician’s diagnosis. Results Twelve month prevalence rates of CMDs were higher among active cancer (18.4% SE=2.1) than cancer free respondents (13.3%, SE=0.2) adjusted for socio-demographic confounders and other lifetime chronic conditions (Adjusted Odds Ratio (AOR)=1.44 95% CI 1.05–1.97). CMD rates among cancer survivors (14.6% SE=0.9) compared with cancer-free respondents did not differ significantly (AOR=0.95 95% CI 0.82–1.11). Similar patterns characterized high and low-middle income countries. Of respondents with active cancer who had CMD in the preceding 12 months 59% sought services for mental health problems (SE=5.3). The pattern of service utilization among people with CMDs by cancer status (highest among persons with active cancer, lower among survivors and lowest among cancer-free respondents) was similar in high- (64.0% SE=6.0, 41.2% SE=3.0, 35.6% SE=0.6) and low-middle income countries (46.4% SE=11.0, 22.5% SE=9.1, 17.4% SE=0.7). Conclusions Community respondents with active cancer have relatively higher CMD rates and relatively high treatment gap. Comprehensive cancer care should consider both factors. PMID:23983079

  6. Colorectal cancer screening in patients with spinal cord injury yields similar results to the general population with an effective bowel preparation: a retrospective chart audit.

    Science.gov (United States)

    Teng, Brandon J; Song, Shawn H; Svircev, Jelena N; Dominitz, Jason A; Burns, Stephen P

    2018-03-01

    Retrospective chart audit. To compare adequacy of colonoscopy bowel preparation and diagnostic findings between persons with SCI receiving an extended inpatient bowel preparation and the general population. Veterans Affairs Puget Sound Healthcare System, Seattle, WA, USA. We reviewed an electronic database of all colonoscopies performed at a tertiary Veterans Affairs medical center between 7/12/13 and 15/10/15. Patients with SCI received a multi-day bowel preparation with magnesium citrate, and 8-10 liters of polyethylene glycol-3350 and electrolyte colonic lavage solution (PEG-ELS) over two and one half days. The control population received a standard bowel preparation consisting of magnesium citrate and 4 liters of PEG-ELS over 1 day. Two hundred and fifty-five patients were included in the study, including 85 patients with SCI. Average risk screening was a more common colonoscopy indication in patients with SCI vs. the control population (24 vs. 13% p = 0.03). There was no difference in adequacy of bowel preparation (87 vs. 85%, p = 0.73) or adenoma detection rate (55 vs. 51%, p = 0.59) when comparing patients with SCI with the control population. No difference in polyp histopathology was detected (p = 0.748). Our study demonstrated that an extended bowel preparation for patients with SCI produces similar bowel preparation results and diagnostic yield when compared to patients without SCI undergoing colonoscopy.

  7. A Review on Audit Quality Factors

    OpenAIRE

    Hosseinniakani, Seyed; Inácio, Coelho Helena; Mota, Rui

    2014-01-01

    Audit Quality” is not easy to define because of many diverse factors affecting quality. According to the consultation paper of the International Auditing and Assurance Standards Board (IAASB), audit quality is the significant issue that requires more considerable attention. Understanding how audit quality is important requires investigating audit quality factors more precisely. So, the present article aims to review and summarize the different audit quality factors, comparing the results ach...

  8. Is a nurse-led telephone intervention a viable alternative to nurse-led home care and standard care for patients receiving oral capecitabine? Results from a large prospective audit in patients with colorectal cancer.

    Science.gov (United States)

    Craven, Olive; Hughes, Carol Anne; Burton, Amy; Saunders, Mark P; Molassiotis, Alex

    2013-05-01

    Home care nursing has been shown to be a valuable service for patients receiving oral chemotherapy; however, associated costs can be high and telephone-based services may be more cost-effective options. This prospective audit explored the usefulness of a nurse-led telephone intervention for supporting cancer patients treated with Capecitabine, comparing historical findings from a randomised trial evaluating a home-based intervention over standard care with a modified nurse-led telephone follow-up intervention. Self-reported toxicity and service use were assessed in 298 patients who received nurse-led telephone follow-up, compared with historical data from 164 patients (81 receiving standard care and 83 home care intervention). Findings suggested that nurse-led telephone follow-up can potentially lead to reduced toxicity (chest pain, vomiting, oral mucositis, nausea, insomnia) when compared with standard care, and that it has a similar impact on the management of some symptoms when compared with home care (i.e. vomiting, oral mucositis), although it was not as effective as the home care intervention for other toxicities (diarrhoea and insomnia). These encouraging findings need to be explored further using a randomised trial design before we reach any conclusions. Further research should also include a health economics study to assess the cost-effectiveness of the telephone-based services for patients receiving oral chemotherapy. © 2013 Blackwell Publishing Ltd.

  9. Audit Expectation Gap: Perspectives of Auditors and Audited ...

    African Journals Online (AJOL)

    This study empirically examined Audit Expectation Gap: Perspectives of Auditors and Audited Account Users. For the purpose of this study primary and secondary data were used. Data were sourced through the examination of vast array of relevant literature like journals, standard textbooks, magazine and questionnaires.

  10. NEVER AUDIT ALONE--THE CASE FOR AUDIT TEAMS

    Science.gov (United States)

    On-site audits conducted by technical and quality assurance (QA) experts at the data-gathering location are the core of an effective QA program. However, inadequate resources for such audits are the bane of a QA program, and the proposed solution frequently is to send only one au...

  11. Audit Fee Determinants and Audit Quality in Ethiopian Commercial ...

    African Journals Online (AJOL)

    user

    auditor derives a high proportion of revenue from a particular client creates economic ... identified in prior bank audit fee studies holds for Ethiopian commercial .... firms as smaller firms have fewer clients and so each client represents a larger ...... higher level of liquid assets relative to their total assets pay lower audit fees.

  12. Evaluation of the Acquisition Audit Process

    National Research Council Canada - National Science Library

    Smolenyak, Barbara

    1997-01-01

    The objectives were to evaluate the efficiency and effectiveness of the acquisition audit process, determine whether reductions can be achieved by improvements in prioritizing audits, and determine...

  13. Audit Database and Information Tracking System

    Data.gov (United States)

    Social Security Administration — This database contains information about the Social Security Administration's audits regarding SSA agency performance and compliance. These audits can be requested...

  14. On the nature of auditing: The audit partner effect : Research on the effect of individual audit partners on audit quality and the information dynamics of accounting data

    OpenAIRE

    Buuren, van, J.P.

    2009-01-01

    This doctoral thesis is about whether auditing is ‘static and mechanic’ of nature or the opposite: ‘dynamic and organic’. If auditing is considered ‘static and mechanic’ of nature, this implies that standard audit solutions are available and can uniformly be applied by the audit partners. Moreover, it suggests that the level of audit quality can be guaranteed to a large extent by the audit firm’s control and governance structures. In such an environment, audit firm size and the actual audit q...

  15. User survey of Nanny Angel Network, a free childcare service for mothers with cancer.

    Science.gov (United States)

    Cohen, L; Schwartz, N; Guth, A; Kiss, A; Warner, E

    2017-08-01

    The purpose of the present study was to determine user satisfaction with Nanny Angel Network (nan), a free childcare service for mothers undergoing cancer treatment. All 243 living mothers who had used the nan service were invited by telephone to participate in an online research survey; 197 mothers (81%) consented to participate. The survey, sent by e-mail, consisted of 39 items divided into these categories: demographics, supports, use, satisfaction, and general comments. Of the 197 mothers who consented to receive the e-mailed survey, 104 (53%) completed it. More than 90% of the mothers were very satisfied with the help and support from their Nanny Angel. Many mothers mentioned that the Nanny Angel was most helpful during treatment and medical appointments, with 75% also mentioning that their Nanny Angel helped them to adhere to their scheduled medical appointments. However, 64% felt that they had not received enough visits from their Nanny Angel. Satisfaction with the nan childcare provider was high, but mothers wished the service had been available to them more often. Our study highlights the importance of providing childcare to mothers with inadequate support systems, so as to allow for greater adherence to treatment and medical appointments, and for more time to recover.

  16. Coordination of Breast Cancer Care Between Radiation Oncologists and Surgeons: A Survey Study

    International Nuclear Information System (INIS)

    Jagsi, Reshma; Abrahamse, Paul; Morrow, Monica; Hamilton, Ann S.; Graff, John J.; Katz, Steven J.

    2012-01-01

    Purpose: To assess whether radiation oncologists and surgeons differ in their attitudes regarding the local management of breast cancer, and to examine coordination of care between these specialists. Methods and Materials: We surveyed attending surgeons and radiation oncologists who treated a population-based sample of patients diagnosed with breast cancer in metropolitan Detroit and Los Angeles. We identified 419 surgeons, of whom 318 (76%) responded, and 160 radiation oncologists, of whom 117 (73%) responded. We assessed demographic, professional, and practice characteristics; challenges to coordinated care; and attitudes toward management in three scenarios. Results: 92.1% of surgeons and 94.8% of radiation oncologists indicated access to a multidisciplinary tumor board. Nevertheless, the most commonly identified challenge to radiation oncologists, cited by 27.9%, was failure of other providers to include them in the treatment decision process early enough. Nearly half the surgeons (49.7%) stated that few or almost none of the breast cancer patients they saw in the past 12 months had consulted with a radiation oncologist before undergoing definitive surgery. Surgeons and radiation oncologists differed in their recommendations in management scenarios. Radiation oncologists were more likely to favor radiation than were surgeons for a patient with 3/20 lymph nodes undergoing mastectomy (p = 0.03); surgeons were more likely to favor more widely clear margins after breast conservation than were radiation oncologists (p = 0.001). Conclusions: Despite the widespread availability of tumor boards, a substantial minority of radiation oncologists indicated other providers failed to include them in the breast cancer treatment decision-making process early enough. Earlier inclusion of radiation oncologists may influence patient decisions, and interventions to facilitate this should be considered.

  17. Nutritional care of cancer patients: a survey on patients' needs and medical care in reality.

    Science.gov (United States)

    Maschke, J; Kruk, U; Kastrati, K; Kleeberg, J; Buchholz, D; Erickson, N; Huebner, J

    2017-02-01

    Cancer patients represent a patient group with a wide-range of nutrition related problems which are often under-recognized and undertreated. In order to assess the status quo of nutritional care in Germany, we conducted a survey among patients with different types of cancer. A standardized questionnaire was distributed online by two national umbrella organizations for self-help groups. 1335 participants completed the questionnaire. 69 % of the participants reported having received information on nutrition and/or specific nutrition-related symptoms. Most often this information was derived from print media (68.5 %) or from within self-help groups (58.7 %). 57.0 % of participants reported having had questions concerning nutrition and/or problems with food intake. most frequently named topics of interest were "healthy diet" (35.0 %) weakness/fatigue (24.3 %), dietary supplements (21.3 %) and taste changes (19.8 %). Nutrition information was most often provided by dietitians (38.7 %) followed by physicians (9.8 %). Women reported receiving nutrition counseling in the hospital nearly twice as often as men (12.5 % versus 5.7 %; p nutrition information more often reported using supplements (p Nutrition is an essential element in cancer care and patients report a high interest and need: Yet, many patients do not have access to high quality nutrition therapy during and after cancer therapy. With respect to survival and quality of life, increasing the availability and resources for provision of evidence based nutrition information seems mandatory.

  18. Coordination of Breast Cancer Care Between Radiation Oncologists and Surgeons: A Survey Study

    Energy Technology Data Exchange (ETDEWEB)

    Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Abrahamse, Paul [Department of Internal Medicine, University of Michigan, Ann Arbor, MI (United States); Morrow, Monica [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Hamilton, Ann S. [Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA (United States); Graff, John J. [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Katz, Steven J. [Department of Internal Medicine, Division of General Medicine and Department of Health Management and Policy, School of Public Health, University of Michigan Health System, Ann Arbor, MI (United States)

    2012-04-01

    Purpose: To assess whether radiation oncologists and surgeons differ in their attitudes regarding the local management of breast cancer, and to examine coordination of care between these specialists. Methods and Materials: We surveyed attending surgeons and radiation oncologists who treated a population-based sample of patients diagnosed with breast cancer in metropolitan Detroit and Los Angeles. We identified 419 surgeons, of whom 318 (76%) responded, and 160 radiation oncologists, of whom 117 (73%) responded. We assessed demographic, professional, and practice characteristics; challenges to coordinated care; and attitudes toward management in three scenarios. Results: 92.1% of surgeons and 94.8% of radiation oncologists indicated access to a multidisciplinary tumor board. Nevertheless, the most commonly identified challenge to radiation oncologists, cited by 27.9%, was failure of other providers to include them in the treatment decision process early enough. Nearly half the surgeons (49.7%) stated that few or almost none of the breast cancer patients they saw in the past 12 months had consulted with a radiation oncologist before undergoing definitive surgery. Surgeons and radiation oncologists differed in their recommendations in management scenarios. Radiation oncologists were more likely to favor radiation than were surgeons for a patient with 3/20 lymph nodes undergoing mastectomy (p = 0.03); surgeons were more likely to favor more widely clear margins after breast conservation than were radiation oncologists (p = 0.001). Conclusions: Despite the widespread availability of tumor boards, a substantial minority of radiation oncologists indicated other providers failed to include them in the breast cancer treatment decision-making process early enough. Earlier inclusion of radiation oncologists may influence patient decisions, and interventions to facilitate this should be considered.

  19. Patient Discussion About Sexual Health With Health Care Providers After Cancer-A National Survey.

    Science.gov (United States)

    Ben Charif, Ali; Bouhnik, Anne-Déborah; Courbiere, Blandine; Rey, Dominique; Préau, Marie; Bendiane, Marc-Karim; Peretti-Watel, Patrick; Mancini, Julien

    2016-11-01

    A discussion about sexuality should become a routine part of the personalized care pathway for patients with cancer. To assess rates of patient discussion about sexuality with health care providers after cancer. We used data from the representative French nationwide 2012 VICAN survey, which included 4,349 adults 18 to 82 years old who were still alive 2 years after diagnosis at 12 cancer sites. Self-reported rates of discussion about sexuality with health care providers were assessed, and associated factors were tested after systematic adjustment for a sexual health indicator (created from six items of the Relationship and Sexuality Scale). Of 4,181 respondents to the question on a discussion about sexuality, 54.7% reported that nobody had proposed a discussion to them, 21.9% did not want any discussion, and 23.4% had had a discussion. Women had less discussion about sexuality with health care providers (11.1% vs 36.7% of men, P < .001) and were more likely to request a discussion at their own initiative (62.9% vs 48.0% of men, P < .001). Discussion about sexuality was more frequent with patients with prostate (56.3%) and cervical (39.6%) cancer, but increasing age was associated with a greater reluctance to discuss this issue (odds ratio = 1.17, 95% CI = 1.04-1.2). The likelihood of discussion increased with severe sexual problems, radiotherapy, general sequelae, having an information-seeker profile, previous professional psychological help, and initial treatment in private centers. Patients initially wishing for psychological help were more likely to desire a discussion about sexuality. Sexuality receives little attention in French patients with cancer. Inequalities in the discussion about sexuality were observed in relation to the type of care center where the patient was initially managed. Information on supportive interventions, including more systematic referral for professional psychological help, should be developed to facilitate discussion and should be

  20. Cancer mortality and incidence survey around the Aube's low- and medium-activity radioactive waste storage site

    International Nuclear Information System (INIS)

    2010-01-01

    This report presents the main results of a survey performed in 2010 to describe the health status of the population around the Aube's low- and medium-activity radioactive waste storage site. The aim of this survey was to determine whether the frequencies of death and hospitalization on account of cancer are different for this population (15 km around the site) with respect to two reference populations (the population of the Champagne-Ardennes region and the French metropolitan population). Results of mortality, hospitalization, and lung cancer are presented under the form of maps and tables giving global data or data for males, females, adults, or children

  1. Sector smart meter audit review report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-03-31

    This paper presented the results of an electricity distributor sector smart meter audit review conducted by the Ontario Energy Board (OEB) for the period of January 1, 2006 to September 30, 2009. The review summarized the results of a questionnaire related to distributors' smart meter regulatory accounting treatment. Seventy-eight distributors responded to the survey. The review included details of: (1) total investments in smart metering initiative for capital expenditures (CAPEX) and operating maintenance and administrative expenses (OM and A), (2) funding dollars received by the distributors, (3) board-approved recoveries for CAPEX and OM and A, (4) recorded stranded meter costs, and (5) number of smart meters installed in the review period. The audit review demonstrated that some distributors incorrectly recorded carrying charges related to smart meter OM and A expenses, and that some smart meter transactions were recorded in accounts other than OEB established accounts in the general ledger. Results of the audit will be used to provide further accounting assistance to electricity distributors. 7 tabs.

  2. Ultraviolet radiation protection and skin cancer awareness in recreational athletes: a survey among participants in a running event.

    Science.gov (United States)

    Christoph, Sebastian; Cazzaniga, Simone; Hunger, Robert Emil; Naldi, Luigi; Borradori, Luca; Oberholzer, Patrick Antony

    2016-01-01

    Ultraviolet radiation (UVR) protection and skin cancer awareness are essential in the avoidance of cutaneous malignancies. Skin cancer prevention programmes involve public educational campaigns, for example, for outdoor workers or school children. Since nonprofessional sun exposure (e.g. during outdoor sport) is increasing with today's lifestyle, we assessed UVR protection and skin cancer awareness among recreational athletes. This survey-based, paper/pencil study was designed to assess UVR protection and skin cancer awareness among recreational athletes attending the largest running event in Switzerland. All adults (age 18 and older) attending this run were invited to complete our survey at our study booth. Our form consisted of questions about participants' personal characteristics such as age, gender, educational attainment, skin type, history of sunburns, and personal/family history of skin cancer, as well as participants' subjective attitudes and behaviours relating to UVR protection and skin cancer avoidance. We calculated separate scores for individual UVR protection and skin cancer awareness. We tested these two scores in relation to educational level as a primary endpoint. In addition, the impacts of further distinct characteristics were assessed in multivariable analysis. A total of 970 runners (457 males, 513 females, mean age 41.0 years) completed our survey. Our results indicate that UVR protection is dependent on age, gender, skin type and personal history of skin cancer. Educational attainment (at univariate level), age, gender and skin type (in multivariable analysis) significantly affected the skin cancer awareness score. Our findings suggest that protection measures among recreational sportsmen can be improved. Achievements are notable in older, fair skinned, female runners. Our findings indicate that further work is needed in the education of the general public, and athletes in particular.

  3. Retrospective audit of clinico-pathologic features and treatment outcomes in a cohort of elderly non-Hodgkin's lymphoma patients in a tertiary cancer center.

    Science.gov (United States)

    Nair, C K; Patil, V M; Raghavan, V; Babu, S; Nayanar, S

    2015-01-01

    There is limited data from India regarding elderly non-Hodgkin's lymphomas (NHL) patients. Hence, this audit was planned to study the clinic-pathological features and treatment outcomes in elderly NHL patients. Retrospective analysis of all NHL patients above age of 59 years treated at the author's institute, between December 2010 and December 2013 was done. Case records were reviewed for baseline details, staging details, prognostic factors, treatment delivered, response, toxicity and efficacy. SPSS version 16 (IBM, Newyork) was used for analysis. Descriptive statistics was performed. Kaplan-Meir survival analysis was done for estimation of progression-free survival (PFS) and overall survival (OS). Univariate analysis was done for identifying factors affecting PFS and OS. Out of 141 NHL patients, 67 patients were identified subjected to the inclusion criteria. The median age was 68 years (60-92). Majority were B-cell NHL (86.6%). The commonest subtype in B-cell was diffuse large B-cell lymphoma (55.2%). Fifty-four patients took treatment. The treatment intent was curative in 41 patients (61.2%). Among the patients receiving curative treatment, 16 patients couldn't receive treatment in accordance with NCCN guidelines due to financial issues. Two years PFS was 55%. Two years PFS for B-cell NHL and T-cell NHL were 55% and 50% respectively (P = 0.982). Two years PFS for standard Rx and nonstandard Rx were 62% and 50% respectively, but it didn't reach statistical significance (P = 0.537). Two years OS for the entire cohort was 84%. Standard treatment in accordance with guidelines can be delivered in elderly patients irrespective of age. There is a need for creating financial assistance for patients, so that potentially curative treatments are not denied.

  4. Audit quality and the audit partner effect : Evidence from European listed companies

    OpenAIRE

    Buuren, van, J.P.

    2009-01-01

    The main objective of this study is to provide evidence on the differences in audit quality amongst audit partners. I attribute these dissimilarities to (i) differences in the audit risk perception and the risk appetite of individual audit partners and (ii) to differences in the personal business case of audit partners. As a result, three audit partner archetypes have been identified: liberal, high quality and conservative. This paper will provide evidence that 50% of the audit partners (53% ...

  5. Common energy audit report

    Energy Technology Data Exchange (ETDEWEB)

    Kolesnikov, A.I.; Sheina, L.S.; Ivanov, N.S. [RDIEE, Moswoc (Russian Federation); Draborg, S.; Oestergaard, T. [Dansk Energi Analyse A/S, Vanloese (Denmark)

    1998-12-31

    The project encompassed following activities: Elaboration of a description of the Russian dairy sector including a mapping of the entire sector in respect of production capacity, actual production, products, production technologies and energy consumption; Energy audits at twelve selected dairies with different typical productions; Elaboration of an `Energy Audit Guidance` which describes how to perform energy audits in dairies and where to expect energy saving possibilities. The energy savings possibilities are often due to the same kind of problems, e.g. low production, inefficient equipment or manually control of the process equipment. The main problems that Russian dairies faces can be divided into the following categories: Old and inefficient technological equipment which is operated at low capacity with very low energy efficiency; Lack of knowledge about new energy efficient technologies; Financial problems which causes low interest and few possibilities for using funds for investment in energy efficient equipment; Energy savings do not lead to personal gains for the persons in the dairy management or other employees which causes low interst in energy savings. At some dairies it seemed to be a problem for the management to adapt to the new and very different conditions for enterprises in Russian today, where sales, production, production capacity and raw milk available are interconnected. With respect to energy matters it was often a wish to replace existing oversized equipment with new equipment of the same size no matter that it is unlikely that the production will increase considerable in the future. The project has discovered that there is a need for demonstrating energy saving measures by implementation because it was in many ways hard for the dairy management`s to believe that, the energy consumption could be reduced dramatically without affecting could production or the processes. Furthermore, the project has discovered a need for transferring to the

  6. Common energy audit report

    Energy Technology Data Exchange (ETDEWEB)

    Kolesnikov, A I; Sheina, L S; Ivanov, N S [RDIEE, Moswoc (Russian Federation); Draborg, S; Oestergaard, T [Dansk Energi Analyse A/S, Vanloese (Denmark)

    1999-12-31

    The project encompassed following activities: Elaboration of a description of the Russian dairy sector including a mapping of the entire sector in respect of production capacity, actual production, products, production technologies and energy consumption; Energy audits at twelve selected dairies with different typical productions; Elaboration of an `Energy Audit Guidance` which describes how to perform energy audits in dairies and where to expect energy saving possibilities. The energy savings possibilities are often due to the same kind of problems, e.g. low production, inefficient equipment or manually control of the process equipment. The main problems that Russian dairies faces can be divided into the following categories: Old and inefficient technological equipment which is operated at low capacity with very low energy efficiency; Lack of knowledge about new energy efficient technologies; Financial problems which causes low interest and few possibilities for using funds for investment in energy efficient equipment; Energy savings do not lead to personal gains for the persons in the dairy management or other employees which causes low interst in energy savings. At some dairies it seemed to be a problem for the management to adapt to the new and very different conditions for enterprises in Russian today, where sales, production, production capacity and raw milk available are interconnected. With respect to energy matters it was often a wish to replace existing oversized equipment with new equipment of the same size no matter that it is unlikely that the production will increase considerable in the future. The project has discovered that there is a need for demonstrating energy saving measures by implementation because it was in many ways hard for the dairy management`s to believe that, the energy consumption could be reduced dramatically without affecting could production or the processes. Furthermore, the project has discovered a need for transferring to the

  7. Effective planning for internal audit

    OpenAIRE

    Cirtautas, Marius

    2016-01-01

    The purpose of this thesis is to find a way to effectively plan for internal audit. Conditions necessary for effective planning are formulated by using analysis of scientific literature. In second part author suggests a model for effective internal audit planning. In third part model is applied and analyzed using a case study.

  8. Fuzzy audit risk modeling algorithm

    Directory of Open Access Journals (Sweden)

    Zohreh Hajihaa

    2011-07-01

    Full Text Available Fuzzy logic has created suitable mathematics for making decisions in uncertain environments including professional judgments. One of the situations is to assess auditee risks. During recent years, risk based audit (RBA has been regarded as one of the main tools to fight against fraud. The main issue in RBA is to determine the overall audit risk an auditor accepts, which impact the efficiency of an audit. The primary objective of this research is to redesign the audit risk model (ARM proposed by auditing standards. The proposed model of this paper uses fuzzy inference systems (FIS based on the judgments of audit experts. The implementation of proposed fuzzy technique uses triangular fuzzy numbers to express the inputs and Mamdani method along with center of gravity are incorporated for defuzzification. The proposed model uses three FISs for audit, inherent and control risks, and there are five levels of linguistic variables for outputs. FISs include 25, 25 and 81 rules of if-then respectively and officials of Iranian audit experts confirm all the rules.

  9. Your Audit and Financial Controls.

    Science.gov (United States)

    Hatch, Mary B.; And Others

    Audits should be performed on school accounting systems because they are required by law and they provide independent reviews of school financial procedures and suggestions for improvement. A licensed certified public accountant, public accountant, or an accountant who has met the Continuation of Education requirement should perform the audit.…

  10. A "Quick & Dirty" Strategic Audit

    Science.gov (United States)

    Brawley, Dorothy E.

    2016-01-01

    In teaching Strategic Management, it is imperative that students first learn how to audit the firm before they begin analysis, planning and implementation. Unfortunately this is a step often overlooked. Without a complete and up to date audit, any analysis conducted would have questionable validity and reliability. This report focuses on an…

  11. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...

  12. Fundamentals of Financial Statements Audit

    OpenAIRE

    World Bank

    2011-01-01

    The purpose of an audit is to enhance the degree of confidence of intended users in the financial statements. The objective of an audit of financial statements is to enable an auditor to express an opinion as to whether the financial statements are prepared, in all material respects, in accordance with International Financial Reporting Standards or another identified financial reporting fr...

  13. Defining a Forensic Audit

    Directory of Open Access Journals (Sweden)

    Stevenson G. Smith

    2009-03-01

    Full Text Available Disclosures about new financial frauds and scandals are continually appearing in the press.  As a consequence, the accounting profession's traditional methods of monitoring corporate financial activities are under intense scrutiny.  At the same time, there is recognition that principles-based GAAP from the International Accounting Standards Board will become the recognized standard in the U.S.  The authors argue that these two factors will change the practices used to fight corporate malfeasance as investigators adapt the techniques of accounting into a forensic audit engagement model.

  14. Practical energy auditing

    Energy Technology Data Exchange (ETDEWEB)

    Jones, C. D.E.

    1979-07-01

    Graphs are shown depicting energy consumption over a period to illustrate the impact various factors have on energy consumption. Some recommendations are made to improve consumption including weatherization of the building; proper operation of equipment; and insulating pipelines, etc. Formulas are given from which can be determined the factors (seasonal variations, heat losses, etc.) causing fuel consumption variations. Electric power usage for space HVAC systems and for processes is dealt with separately and can usually be audited separately. Some payback times for specific conservation measures are given. (MCW)

  15. Simplifying the audit of risk factor recording and control

    DEFF Research Database (Denmark)

    Zhao, Min; Cooney, Marie Therese; Klipstein-Grobusch, Kerstin

    2016-01-01

    BACKGROUND: To simplify the assessment of the recording and control of coronary heart disease risk factors in different countries and regions. DESIGN: The SUrvey of Risk Factors (SURF) is an international clinical audit. METHODS: Data on consecutive patients with established coronary heart disease...

  16. A Library Communication Audit for the Twenty-First Century

    Science.gov (United States)

    Chalmers, Mardi; Liedtka, Theresa; Bednar, Carol

    2006-01-01

    This article describes a case study relating to an internal communication audit conducted in a large academic library that assessed existing information channels during a period of organizational change in order to recommend improvements. A communications task force developed and administered a survey instrument and then analyzed data and reported…

  17. A Communication Audit of a State Mental Health Institution.

    Science.gov (United States)

    Eadie, William F.; And Others

    An adaptation of "communication audit" procedures was used to evaluate the communication patterns at a mental health center (MHC). The evaluation included initial interviews with 28 MHC workers/administrators, a survey of 215 staff members for a communication network analysis, and followup interviews with another 28 persons. The data produced four…

  18. Disease prevalence and the index of detectability: a survey of studies of lung cancer detection by chest radiography

    Science.gov (United States)

    Kundel, Harold L.

    2000-04-01

    A survey of 12 studies of lung cancer detection with cancer prevalence ranging from 0.9 to 476 cancers per 1000 showed that the unit-slope index of detectability, d', decreased from a high value of 3.9 at low prevalence to 1.4 at high prevalence. A proposed explanation is that the readers are operating on an ROC curve with a slope that is less than unity approximating 0.6. On such a curve, a shift to more stringent criteria that occurs with decreasing prevalence in order to minimize false positives, would result in a increased unity- slope d'.

  19. A European survey relating to cancer therapy and neutropenic infections: Nurse and patient viewpoints.

    LENUS (Irish Health Repository)

    Leonard, Kay

    2011-09-25

    PURPOSE: Severe neutropenia and febrile neutropenia (FN) are the major causes of morbidity, treatment interruptions and dose reductions in patients undergoing chemotherapy. The European Oncology Nursing Society (EONS) conducted an European survey to evaluate nurse perspectives on prevention of infection and FN in this setting, and how much they educate their patients about this. A separate survey explored these issues in patients receiving chemotherapy. METHODS: 217 nurse participants were identified by EONS from the membership database and 473 cancer patients who were receiving\\/had received chemotherapy were identified through patient advocacy groups. Questionnaires were completed anonymously online for both surveys. RESULTS: More than 90% of the nurses agreed that preventing infections including FN is extremely\\/very important for a successful chemotherapy outcome and said that they, or other health professionals in their practice, advised patients about these issues. Most (90%) indicated that they favoured giving treatment to protect against FN and infections in chemotherapy patients at risk, rather than treating infection after it develops, but 82% expressed concern over patient concordance with measures employed. A substantial proportion of patients reported emergency room visits, hospitalization and\\/or chemotherapy delays or changes as a result of neutropenia, infection or FN. However, only 44% said that their infection risk was discussed with them before starting chemotherapy. CONCLUSIONS: Our findings indicate that nurses recognise the importance of reducing the risk of infection and FN in patients undergoing chemotherapy, as well as the need to educate patients. However, results of the patient survey suggest a need for better patient education.

  20. Introducing students to clinical audit.

    Science.gov (United States)

    Parkes, Jacqueline; O'Dell, Cindy

    2015-11-01

    It is more than a decade since the UK Central Council for Nursing Midwifery and Health Visiting said that engaging with clinical audit is 'the business of every registered practitioner', yet there appears to be little evidence that nursing has embraced the process. To address this issue, Northampton General Hospital and the University of Northampton implemented a pilot project in which two third-year adult nursing students worked on a 'real life' audit. Supported by the hospital's audit department, and supervised by academic tutors with the relevant experience, the students worked on a pressure-ulcer care audit for their final year dissertation. This article describes the process undertaken by the hospital audit team and the university academic team to develop the pilot project and support the students. Based on the positive evaluations, the university has extended the project to a second phase, incorporating two new partner organisations.

  1. Patterns of practice of regional nodal irradiation in breast cancer: results of the European Organization for Research and Treatment of Cancer (EORTC) NOdal Radiotherapy (NORA) survey

    NARCIS (Netherlands)

    Belkacemi, Y.; Kaidar-Person, O.; Poortmans, P.; Ozsahin, M.; Valli, M.-C.; Russell, N.; Kunkler, I.; Hermans, J.; Kuten, A.; van Tienhoven, G.; Westenberg, H.

    2015-01-01

    Predicting outcome of breast cancer (BC) patients based on sentinel lymph node (SLN) status without axillary lymph node dissection (ALND) is an area of uncertainty. It influences the decision-making for regional nodal irradiation (RNI). The aim of the NORA (NOdal RAdiotherapy) survey was to examine

  2. The cancer awareness assessment project: A small-scale survey across people with different levels of education in Mysore, India.

    Science.gov (United States)

    Sheshachalam, A; Chakravarthy, A R

    2015-01-01

    To assess the cancer awareness in respondents, their knowledge about the nature of cancer as a disease, its diagnosis and treatment, warning signs, environmental risk factors and conceptions of how risk factors work, as well as willingness to participate in screening programs if available. Cancer awareness is an increasingly important issue in light of increasing incidence and associated healthcare costs, as well as the presence of risk management strategies. In this study, 453 people, drawn from several educational institutes/workplaces, were surveyed with respect to cancer awareness. The test sample included pre university students, undergraduates, and postgraduate students/workers. We checked for variations in cancer awareness across multiple educational levels to determine whether there was variation in levels of cancer awareness across educational classes. We found that confidence in perception of cancer awareness, and awareness itself, was not very high, and only postgraduates had a nuanced appreciation of some of the complexities of cancer epidemiology, and even then only moderately. The conclusions of the study point towards the need for optimal policymaking in the development of cancer awareness in the population.

  3. Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey.

    Science.gov (United States)

    Leung, Janni; Atherton, Iain; Kyle, Richard G; Hubbard, Gill; McLaughlin, Deirdre

    2016-04-01

    The aim of this study is to examine the association between optimism and psychological distress in women with breast cancer after taking into account their self-rated general health. Data were aggregated from the Scottish Health Survey (2008 to 2011) to derive a nationally representative sample of 12,255 women (11,960 cancer-free controls, and 295 breast cancer cases identified from linked cancer registry data). The explanatory variables were optimism and general health, and the outcome variable was symptoms of psychological distress. Logistic regression analyses were conducted, with optimism entered in step 1 and general health entered in step 2. In an unadjusted model, higher levels of optimism were associated with lower odds of psychological distress in both the control group (OR = 0. 57, 95 % CI = 0.51-0.60) and breast cancer group (OR = 0. 64, 95 % CI = 0.47-0.88). However, in a model adjusting for general health, optimism was associated with lower odds of psychological distress only in the control group (OR = 0.50, 95 % CI = 0.44-0.57), but not significantly in the breast cancer group (OR = 1.15, 95 % CI = 0.32-4.11). In the breast cancer group, poor general health was a stronger associate of psychological distress (OR = 4. 98, 95 % CI = 1.32-18.75). Results were consistent after adjusting for age, years since breast cancer diagnosis, survey year, socioeconomic status, education, marital status, body mass index, smoking status, and alcohol consumption. This research confirms the value of multicomponent supportive care interventions for women with breast cancer. Specifically, it suggests that following breast cancer diagnosis, health care professionals need to provide advice and signpost to services that assist women to maintain or improve both their psychological and general health.

  4. Facebook Ads Recruit Parents of Children with Cancer for an Online Survey of Web-Based Research Preferences

    Science.gov (United States)

    Akard, Terrah Foster; Wray, Sarah; Gilmer, Mary

    2014-01-01

    Background Studies involving samples of children with life-threatening illnesses and their families face significant challenges, including inadequate sample sizes and limited diversity. Social media recruitment and web-based research methods may help address such challenges yet have not been explored in pediatric cancer populations. Objective This study examined the feasibility of using Facebook ads to recruit parent caregivers of children and teens with cancer. We also explored the feasibility of web-based video recording in pediatric palliative care populations by surveying parents of children with cancer regarding (a) their preferences for research methods and (b) technological capabilities of their computers and phones. Methods Facebook's paid advertising program was used to recruit parent caregivers of children currently living with cancer to complete an electronic survey about research preferences and technological capabilities. Results The advertising campaign generated 3,897,981 impressions which resulted in 1050 clicks at a total cost of $1129.88. Of 284 screened individuals, 106 were eligible. Forty-five caregivers of children with cancer completed the entire electronic survey. Parents preferred and had technological capabilities for web-based and electronic research methods. Participant survey responses are reported. Conclusion Facebook was a useful, cost-effective method to recruit a diverse sample of parent caregivers of children with cancer. Web-based video recording and data collection may be feasible and desirable in samples of children with cancer and their families. Implications for Practice Web-based methods (e.g., Facebook, Skype) may enhance communication and access between nurses and pediatric oncology patients and their families. PMID:24945264

  5. Survey of Usual Practice: Dysphagia Therapy in Head & Neck Cancer Patients

    Science.gov (United States)

    Krisciunas, Gintas P.; Sokoloff, William; Stepas, Katherine; Langmore, Susan E.

    2012-01-01

    There is no standardized dysphagia therapy for head and neck cancer patients and scant evidence to support any particular protocol, leaving institutions and individual speech language pathologists (SLPs) to determine their own protocols based on “typical” practices or anecdotal evidence. To gain an understanding of current usual practices, a national internet-based survey was developed and disseminated to SLPs who treat HNC patients. From a random sample of 4,000 ASHA SID 13 members, 1,931 fit the inclusion criteria, and 759 complete responses were recorded for a 39.3% response rate. Results were analyzed by institution type as well as by individual clinical experience. While some interesting trends emerged from the data, a lack of uniformity and consensus regarding best practices was apparent. This is undoubtedly due to a paucity of research adequately addressing the efficacy of any one therapy for dysphagia in the HNC population. PMID:22456699

  6. [A questionnaire survey about hair loss after chemotherapy for breast cancer].

    Science.gov (United States)

    Oshima, Yukiko; Watanabe, Takanori; Nakagawa, Saki; Endo, Ayako; Shiga, Chizuko

    2012-09-01

    Hair loss is one of the most common side effects of chemotherapies such as FEC and taxane, and it greatly affects quality of life. We conducted a questionnaire survey of breast cancer patients who were treated with adjuvant chemotherapy about their hair loss. Eighty-five patients participated. They all had lost their hair and suffered from persistent changes in their hair condition, ranging from thinning to curly. More than 80% of patients had worn wigs until their hair had grown back. Furthermore, a few patients did not remove their wigs for 2 years after treatment. Unfortunately, there is no prevention or medication to combat hair loss due to chemotherapy at present, so cumulative examinations are awaited. We must provide appropriate information and support to the patient.

  7. Quality audit--a review of the literature concerning delivery of continence care.

    Science.gov (United States)

    Swaffield, J

    1995-09-01

    This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

  8. Comparison of diabetes management status between cancer survivors and the general population: results from a Korean population-based survey.

    Directory of Open Access Journals (Sweden)

    Ji-Yeon Shin

    Full Text Available This study aimed to determine and compare the prevalences of diabetes awareness, treatment, and adequate glycemic control among cancer survivors in a Korean population and two non-cancer control groups, comprising individuals without a history of cancer but with other chronic diseases (non-cancer, chronic disease controls and individuals without a history of cancer or any other chronic disease (non-cancer, non-chronic disease controls.We analyzed data from 2,660 subjects with prevalent diabetes (aged ≥30 years, who had participated in the 2007-2011 Korea National Health and Nutrition Examination Survey. Awareness was defined as a subject having been diagnosed with diabetes by a clinician. Treatment was defined as a subject who was taking anti-diabetic medicine. Adequate glycemic control was defined as a hemoglobin A1c level of <7%. Multivariable logistic regression and predictive margins were used to evaluate whether awareness, treatment, or adequate glycemic control differed among cancer survivors and the two non-cancer control groups.Cancer survivors had greater awareness compared with the non-cancer, chronic disease and non-cancer, non-chronic disease control groups (85.1%, 80.4%, and 60.4%, respectively. Although the prevalences of treatment and adequate glycemic control were higher for survivors compared with the non-cancer, non-chronic disease controls, they were lower compared with the non-cancer, chronic disease controls. The prevalence of diabetes treatment was 67.5% for cancer survivors, 69.5% for non-cancer, chronic disease controls, and 46.7% for non-cancer, non-chronic disease controls; the prevalences of adequate glycemic control in these three groups were 31.7%, 34.6%, and 17.8%, respectively.Cancer survivors were less likely than the non-cancer chronic disease subjects to receive diabetes management and to achieve adequate glycemic targets. Special attention and education are required to ensure that this population receives

  9. Survey of Policies and Guidelines on Antioxidant Use for Cancer Prevention, Treatment, and Survivorship in North American Cancer Centers: What Do Institutions Perceive as Evidence?

    Science.gov (United States)

    Hong, Gyeongyeon; White, Jennifer; Zhong, Lihong; Carlson, Linda E

    2015-07-01

    Health care policies and guidelines that are clear and consistent with research evidence are important for maximizing clinical outcomes. To determine whether cancer centers in Canada and the United States had policies and/or guidelines about antioxidant use, and whether policies were aligned with the evidence base, we reviewed current research evidence in the field, and we undertook a survey of the policies and guidelines on antioxidant use at cancer institutions across North America. A survey of policies and guidelines on antioxidant use and the development and communication of the policies and guidelines was conducted by contacting cancer institutions in North America. We also conducted a Website search for each institution to explore any online resources. Policies and guidelines on antioxidant use were collected from 78 cancer institutions. Few cancer institutions had policies (5%) but most provided guidelines (69%). Antioxidants from diet were generally encouraged at cancer institutions, consistent with the current research evidence. In contrast, specific antioxidant supplements were generally not recommended at cancer institutions. Policies and guidelines were developed using evidence-based methods (53%), by consulting another source (35%), or through discussions/conference (26%), and communicated mainly through online resources (65%) or written handouts (42%). For cancer institutions that had no policy or guideline on antioxidants, lack of information and lack of time were the most frequently cited reasons. Policies and guidelines on antioxidants from diet were largely consistent with the research evidence. Policies and guidelines on antioxidant supplements during treatment were generally more restrictive than the research evidence might suggest, perhaps due to the specificity of results and the inability to generalize findings across antioxidants, adding to the complexity of their optimal and safe use. Improved communication of comprehensive research

  10. Marketingový audit

    OpenAIRE

    Čevelová, Petra

    2007-01-01

    Diplomová práce je zpracování na téma marketingový audit. Jejím cílem provedení marketingového auditu ve firmě XX. Předmětem auditu je jejich nejstarší produkt, a to v plné šíři, tj. celkové zhodnocení marketingové činnosti firmy. Marketingový audit je nástroj analýzy v této diplomové práci. Poznatky shrnuji v analýze SWOT, na jejímž základě jsem vypracovala seznam doporučení s cílem vylepšení fungování marketingových činností, následně jsem sestavila přibližný rozpočet pro tyto kroky, stejně...

  11. Reaktivní audit

    OpenAIRE

    Hlísta, Juraj

    2010-01-01

    Tato diplomová práce se zabývá návrhem a implementací rozšíření auditu v Linuxu, kterým je reaktivní audit. Tento mechanizmus přináší novou funkcionalitu ve formě možnosti spouštění reakcí na určité události generované auditem. Reaktivní audit je implementován jako plugin a jeho použití je volitelné. Tato práce se zabývá také pluginem, který ukládá některé události a na základě jejich analýzy poskytuje časově závislé statistiky pro první plugin. Výsledkem je, že mechanizmus reaktivního auditu...

  12. The internal audit dilemma : The impact of executive directors versus audit committees on internal auditing work

    NARCIS (Netherlands)

    Eulerich, Marc; Henseler, Jörg; Koehler, Annette

    2017-01-01

    Purpose The purpose of this study is to analyze how internal audit function (IAF) activities differ, depending on the impact of executive boards (EBs) and audit committees (ACs). Design/methodology/approach This study is based on data collected from the Common Body of Knowledge (CBOK) study

  13. [UNE-EN-ISO-9001 internal audit program performed by our own personnel: a knowledge management tool].

    Science.gov (United States)

    Rieiro, C Rodríguez; Lucerón, M C Olmedo; Gijón, L Flavia Rodríguez; Mestre, R Plá; Membrilla, I Izquierdo; Ramirez, C Seriña; Pérez, P Rodríguez

    2010-01-01

    The need to maintain a Quality Management System based on the UNE-EN-ISO 9001:2000 standards in 12 Departments of the "Hospital General Universitario Gregorio Marañón" (HGUGM), led us to make the decision to establish an internal audit program using our own personnel as a useful tool for knowledge management and continuous improvement. The Department of "Medicina Preventiva y Gestión de Calidad" developed an Audit Program, which has been implemented in our Hospital during the last three years. We conducted a training program for internal auditors, who then became part of the hospital audit staff. Quality Managers of the accredited departments were consolidated as a group. A procedure for scheduling and coordination of audits was developed. The auditors and those audited were surveyed on the difficulties in conducting audits, including a section for suggestions, and an annual report was drafted with the results of internal and external audits, as well as the improvement areas identified in the whole process. A total of 40 internal audits have been performed in HGUGM since 2007, and 38 people were trained. The Quality Management System improved in terms of the decreasing number of non-conformances (NC) in external audits, and all services have maintained the certification. The perception of auditors and those audited regarding the performing of internal audits by our own personnel is very positive. There were identified improvement areas and common solutions.

  14. Medical auditing of whole-breast screening ultrasonography.

    Science.gov (United States)

    Kim, Min Jung

    2017-07-01

    Since breast ultrasonography (US) has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes.

  15. Medical auditing of whole-breast screening ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Jung [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-07-15

    Since breast ultrasonography (US) has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes.

  16. Clinical audit teaching in record-keeping for dental undergraduates at International Medical University, Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Chong, Jun A; Chew, Jamie K Y; Ravindranath, Sneha; Pau, Allan

    2014-02-01

    This study investigated the impact of clinical audit training on record-keeping behavior of dental students and students' perceptions of the clinical audit training. The training was delivered to Year 4 and Year 5 undergraduates at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It included a practical audit exercise on patient records. The results were presented by the undergraduates, and guidelines were framed from the recommendations proposed. Following this, an audit of Year 4 and Year 5 students' patient records before and after the audit training was carried out. A total of 100 records were audited against a predetermined set of criteria by two examiners. An email survey of the students was also conducted to explore their views of the audit training. Results showed statistically significant improvements in record-keeping following audit training. Responses to the email survey were analyzed qualitatively. Respondents reported that the audit training helped them to identify deficiencies in their record-keeping practice, increased their knowledge in record-keeping, and improved their record-keeping skills. Improvements in clinical audit teaching were also proposed.

  17. Impact of Patient-Provider Race, Ethnicity, and Gender Concordance on Cancer Screening: Findings from Medical Expenditure Panel Survey.

    Science.gov (United States)

    Malhotra, Jyoti; Rotter, David; Tsui, Jennifer; Llanos, Adana A M; Balasubramanian, Bijal A; Demissie, Kitaw

    2017-12-01

    Background: Racial and ethnic minorities experience lower rates of cancer screening compared with non-Hispanic whites (NHWs). Previous studies evaluating the role of patient-provider race, ethnicity, or gender concordance in cancer screening have been inconclusive. Methods: In a cross-sectional analysis using the Medical Expenditure Panel Survey (MEPS), data from 2003 to 2010 were assessed for associations between patient-provider race, ethnicity, and/or gender concordance and, screening (American Cancer Society guidelines) for breast, cervical, and colorectal cancer. Multivariable logistic analyses were conducted to examine associations of interest. Results: Of the 32,041 patient-provider pairs in our analysis, more than 60% of the patients were NHW, 15% were non-Hispanic black (NHB), and 15% were Hispanic. Overall, patients adherent to cancer screening were more likely to be non-Hispanic, better educated, married, wealthier, and privately insured. Patient-provider gender discordance was associated with lower rates of breast [OR, 0.83; 95% confidence interval (CI), 0.76-0.90], cervical (OR, 0.83; 95% CI, 0.76-0.91), and colorectal cancer (OR, 0.84; 95% CI, 0.79-0.90) screening in all patients. This association was also significant after adjusting for racial and/or ethnic concordance. Conversely, among NHWs and NHBs, patient-provider racial and/or ethnic concordance was not associated with screening. Among Hispanics, patient-provider ethnic discordant pairs had higher breast (58% vs. 52%) and colorectal cancer (45% vs. 39%) screening rates compared with concordant pairs. Conclusions: Patient-provider gender concordance positively affected cancer screening. Patient-provider ethnic concordance was inversely associated with receipt of cancer screening among Hispanics. This counter-intuitive finding requires further study. Impact: Our findings highlight the importance of gender concordance in improving cancer screening rates. Cancer Epidemiol Biomarkers Prev; 26

  18. The morbidity and associated risk factors of cancer in chronic liver disease patients with diabetes mellitus: a multicenter field survey.

    Science.gov (United States)

    Kawaguchi, Takumi; Kohjima, Motoyuki; Ichikawa, Tatsuki; Seike, Masataka; Ide, Yasushi; Mizuta, Toshihiko; Honda, Koichi; Nakao, Kazuhiko; Nakamuta, Makoto; Sata, Michio

    2015-03-01

    Diabetes mellitus is associated with various cancers; however, little is known of the relationship between cancer and diabetes in chronic liver disease (CLD) patients. The aim of this study is to investigate the morbidity and associated factors of cancer, including the use of anti-diabetics, in CLD patients with diabetes. We performed a multicenter survey in 2012 and 478 CLD patients with diabetes were enrolled (age 64.3 ± 12.1 years, female/male 187/291). A frequency analysis of cancer and antidiabetic use was performed. Independent factors for cancer were analyzed using logistic regression and decision-tree analysis. The morbidity of cancer was 33.3%. Hepatocellular carcinoma (HCC) and extra-hepatic cancer were diagnosed in 24.7 and 11.3% of enrolled patients, respectively. The frequency of antidiabetic use was 66.5%. Of prescribed antidiabetics, 39% were dipeptidyl-peptidase 4 inhibitors; however, their use was not significantly associated with cancer. In contrast, the use of exogenous insulin (OR 2.21; 95% CI 1.16-4.21, P = 0.0165) and sulfonylurea (OR 2.08; 95% CI 1.05-3.97, P = 0.0353) were independently associated with HCC and extra-hepatic cancer, respectively. In decision-tree analysis, exogenous insulin and sulfonylurea were also identified as a divergence factor for HCC and extra-hepatic cancer, respectively. We found a high morbidity of not only HCC, but also extra-hepatic cancer in CLD patients with diabetes. We also showed a possible association between the use of antidiabetics and the morbidity of cancer. Thus, a large-scale cohort study is needed to establish a therapeutic strategy for diabetes to suppress carcinogenesis in CLD patients.

  19. Can virtual streetscape audits reliably replace physical streetscape audits?

    Science.gov (United States)

    Badland, Hannah M; Opit, Simon; Witten, Karen; Kearns, Robin A; Mavoa, Suzanne

    2010-12-01

    There is increasing recognition that the neighborhood-built environment influences health outcomes, such as physical activity behaviors, and technological advancements now provide opportunities to examine the neighborhood streetscape remotely. Accordingly, the aims of this methodological study are to: (1) compare the efficiencies of physically and virtually conducting a streetscape audit within the neighborhood context, and (2) assess the level of agreement between the physical (criterion) and virtual (test) audits. Built environment attributes associated with walking and cycling were audited using the New Zealand Systematic Pedestrian and Cycling Environment Scan (NZ-SPACES) in 48 street segments drawn from four neighborhoods in Auckland, New Zealand. Audits were conducted physically (on-site) and remotely (using Google Street View) in January and February 2010. Time taken to complete the audits, travel mileage, and Internet bandwidth used were also measured. It was quicker to conduct the virtual audits when compared with the physical audits (χ = 115.3 min (virtual), χ = 148.5 min (physical)). In the majority of cases, the physical and virtual audits were within the acceptable levels of agreement (ICC ≥  0.70) for the variables being assessed. The methodological implication of this study is that Google Street View is a potentially valuable data source for measuring the contextual features of neighborhood streets that likely impact on health outcomes. Overall, Google Street View provided a resource-efficient and reliable alternative to physically auditing the attributes of neighborhood streetscapes associated with walking and cycling. Supplementary data derived from other sources (e.g., Geographical Information Systems) could be used to assess the less reliable streetscape variables.

  20. Survey on changes of breast cancer radiotherapy in four hospitals within southeast coastal region of China

    International Nuclear Information System (INIS)

    Ji Yongling; Liu Jingjie; Tian Ye; Li Xianming; Zhu Yaqun; Yu De; Du Xianghui

    2010-01-01

    Objective: to explore the changes and the tendency of breast cancer radiotherapy in China within the past decade. Methods: A survey on breast cancer radiotherapy in 1999 and 2006 was conducted in 4 hospitals located within the southeast coastal region of China, including patients' clinical characteristics, the purpose of radiotherapy and its techniques. Results: The percentage of breast conservative treatment (BCT) increased from 3% in 1999 to 13% in 2006. For radiotherapy techniques in 2066 compared with 1999, the growth trend was found in use of breast immobilization devices (80% vs. 46%), treatment planning system (70% vs. 23%), and CT simulation (14% vs. 0). The frequency was increased in the chest wall irradiation after mastectomy (90% vs. 67%), but decreased in internal mammary region (30% vs. 76%) and axilla (37% vs. 69%) treatment. There were no differences in total dose and fractionation prescription. Conclusions: BCT was performed more frequently, but post-mastectomy radiotherapy was still essential option in China at present. Although some advanced techniques were applied frequently in clinical practice. Simulation, treatment planning, and irradiation target design were urgent for improvement and standardization. (authors)

  1. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Mohan Roy Gopalan

    2016-01-01

    Full Text Available Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above, having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7% had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6% of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

  2. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

    Science.gov (United States)

    Gopalan, Mohan Roy; Karunakaran, Vidhukumar; Prabhakaran, Anil; Jayakumar, Krishnannair Lalithamma

    2016-01-01

    Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients. PMID:28066004

  3. The impact of an ostomy on older colorectal cancer patients: a cross-sectional survey.

    Science.gov (United States)

    Verweij, N M; Hamaker, M E; Zimmerman, D D E; van Loon, Y T; van den Bos, F; Pronk, A; Borel Rinkes, I H M; Schiphorst, A H W

    2017-01-01

    Ostomies are being placed in 35 % of patients after colorectal cancer surgery. As decision-making regarding colorectal surgery is challenging in the older patients, it is important to have insight in the potential impact due to ostomies. An internet-based survey was sent to all members with registered email addresses of the Dutch Ostomy Patient Association. The response rate was 49 %; 932 cases were included of whom 526 were aged Ostomy-related limitations were similar in the different age groups, just as uncertainty (8-10 %) and dependency (18-22 %) due to the ostomy. A reduced quality of life was experienced least in the oldest old group (24 % vs 37 % of the elderly and 46 % of the younger respondents, p ostomy was observed. Older ostomates do not experience more limitations or psychosocial impact due to the ostomy compared to their younger counterparts. Over the years, impact becomes less distinct. Treatment decision-making is challenging in the older colorectal cancer patients but ostomy placement should not be withheld based on age alone.

  4. Descriptive survey about causes of illness given by the parents of children with cancer.

    Science.gov (United States)

    Matteo, Bernardi; Pierluigi, Badon

    2008-04-01

    When a doctor diagnoses a child's illness as cancer, parents very often react by creating wrong and unrealistic theories about the origins of their child's illness which in turn generates self-blame in the parents, who take responsibility for the disease. To find what are the parents' beliefs about the origins of their children's illness. Descriptive study. Seventy-two couples of parents whose children with cancer are under treatment in the haemato-oncology paediatric ward of the Padova hospital. They have been collected by a no probabilistic method of sampling. A questionnaire was used, based on current literature, which investigates the beliefs of the parents as to what are the causes of illness, whether the parents research information about the illness and the origins of cancer and what are the information sources they use in order to establish if there is a connection between these factors. Eighty-seven percent of the sample group thinks that there is a specific origin of their child's illness: 27% believes the cause is environmental pollution, 26% believes it is due to radiation emissions, 26% believes it is due to genetic factors and 8% believes it is due to other causes. Eighty six percent and 70% of the sample search for information about the illness and its causes; 64% of the parents state that the first meeting with the medical staff, in which the illness is explained and they are informed that there are no known causes that produce it, does not clarify their doubts. The sources more often used to search for more information and explanations are the physicians in the ward, internet and medical books. This survey confirms the importance of an "advocacy" role of the nurse in educating the caregiver and the need to create instruments which guide the parents in the informative process and the research for good information. Nurses need to be cognizant that their care is crucial not just for the child, but for the entire family.

  5. Treatment choices for patients with invasive lobular breast cancer: a doctor survey.

    Science.gov (United States)

    Jacobs, Carmel; Ibrahim, Mohamed F K; Clemons, Mark; Hutton, Brian; Simos, Demetrios; Caudrelier, Jean-Michel; Graham, Ian D; Smith, Stephanie; Addison, Christina; Arnaout, Angel

    2015-08-01

    Invasive lobular breast cancer (ILC) has distinct features that present challenges for management. We surveyed doctors regarding management approaches, opinions on quality of evidence supporting their practice, and future research needs. An online questionnaire was developed and circulated to breast cancer surgical, radiation and medical oncologists. The questionnaire was completed by 88/428 doctors (20.6%); 22/56 (39.3%) surgeons, 21/64 (32.8%) radiation oncologists and 45/308 (14.6%) medical oncologists. The majority (65%) of surgeons were comfortable treating ILC patients using the same surgical management as patients with invasive ductal cancers (IDC). Furthermore, 25% would perform a similar surgery but would obtain larger gross margins. There was equipoise for radiation oncologists regarding whether or not ILC was an independent risk factor for local-regional recurrence after either breast-conserving surgery or mastectomy. Of those radiation oncologists who believe ILC is an independent risk factor for recurrence after mastectomy, 44.4% would offer radiation in the absence of usual indications. Medical oncologists approached systemic therapy for ILC patients similarly to those with comparable IDCs. Areas identified as most controversial and requiring future research were preoperative magnetic resonance imaging, radiotherapy post-mastectomy and the responsiveness of ILC to adjuvant chemotherapy compared with endocrine therapy. There is a variation in doctors' beliefs, management and opinions regarding the quality of evidence for the management of ILC. Clinical trials specifically assessing the management of ILC are required to guide clinical practice. © 2015 John Wiley & Sons, Ltd.

  6. Systematic follow-up after curative surgery for colorectal cancer in Norway: a population-based audit of effectiveness, costs, and compliance.

    Science.gov (United States)

    Körner, Hartwig; Söreide, Kjetil; Stokkeland, Pål J; Söreide, Jon Arne

    2005-03-01

    In this study, we analyzed the Norwegian guidelines for systematic follow-up after curative colorectal cancer surgery in a large single institution. Three hundred fourteen consecutive unselected patients undergoing curative surgery for colorectal cancer between 1996 and 1999 were studied with regard to asymptomatic curable recurrence, compliance with the program, and cost. Follow-up included carcinoembryonic antigen (CEA) interval measurements, colonoscopy, ultrasonography of the liver, and radiography of the chest. In 194 (62%) of the patients, follow-up was conducted according to the Norwegian guidelines. Twenty-one patients (11%) were operated on for curable recurrence, and 18 patients (9%) were disease free after curative surgery for recurrence at evaluation. Four metachronous tumors (2%) were found. CEA interval measurement had to be made most frequently (534 tests needed) to detect one asymptomatic curable recurrence. Follow-up program did not influence cancer-specific survival. Overall compliance with the surveillance program was 66%, being lowest for colonoscopy (55%) and highest for ultrasonography of the liver (85%). The total program cost was 228,117 euro (US 280,994 dollars), translating into 20,530 euro (US 25,289 dollars) for one surviving patient after surgery for recurrence. The total diagnosis yield with regard to disease-free survival after surgery for recurrence was 9%. Compliance was moderate. Whether the continuing implementation of such program and cost are justified should be debated.

  7. Psychosocial standards of care for children with cancer and their families: A national survey of pediatric oncology social workers.

    Science.gov (United States)

    Jones, Barbara; Currin-Mcculloch, Jennifer; Pelletier, Wendy; Sardi-Brown, Vicki; Brown, Peter; Wiener, Lori

    2018-04-01

    In 2015, an interdisciplinary group of psychosocial experts developed The Standards of Psychosocial Care for Children with Cancer and Their Families. This paper presents data from a national survey of pediatric oncology social workers and their experiences in delivering psychosocial care to children and families. In total, 107 social workers from 81 cancer institutions participated in a 25-item online survey that mirrored the 15 Standards for Psychosocial Care. Both closed and open-ended questions were included. Social work participants reported that psychosocial support is being provided at most cancer centers surveyed, primarily by social workers and child life specialists, addressing adaptation to the cancer diagnosis, treatment, and transitions into survivorship or end-of-life care and bereavement. While social workers reported offering comprehensive services throughout the cancer trajectory, many of the 2015 Standards are not being systematically implemented. Areas for improvement include funding for psychosocial support staff and programs, incorporation of standardized assessment measures, assessment for financial burden throughout treatment and beyond, consistent access to psychology and psychiatry, integrated care for parents and siblings, and more inclusion of palliative care services from time of diagnosis.

  8. 76 FR 58520 - Proposed Collection; Comment Request; Cancer Risk in U.S. Radiologic Technologists: Fourth Survey...

    Science.gov (United States)

    2011-09-21

    ... carcinogenesis in women. The fourth survey will be administered by mail to approximately 93,000 living and... new cancers and other disease outcomes, detailed work patterns and practices from technologists who... following points: (1) Whether the proposed collection of information is necessary for the proper performance...

  9. Four Years Analysis of Cancer Genetic Clinics Activity in France from 1994 to 1997: A Survey on 801 Patients

    Directory of Open Access Journals (Sweden)

    Hagay Sobol

    1999-01-01

    Full Text Available AIM: In order to evaluate the characteristics and the evolution of cancer genetics activity in France, a survey was conducted at the national level during a period of 4 years from 1994 to 1997 through the French Cooperative Network, a multidisciplinary group formed to investigate inherited tumors.

  10. The Strategic Options of Supreme Audit Institutions

    DEFF Research Database (Denmark)

    Klarskov Jeppesen, Kim; Carrington, Thomas; Catasús, Bino

    2017-01-01

    Based on the theory of professional competition, this paper identifies and investigates four strategic options of supreme audit institutions (SAIs) through a case study of four Nordic national audit offices: a performance auditing strategy; a financial auditing strategy; a portfolio strategy...

  11. 7 CFR 1948.96 - Audit requirements.

    Science.gov (United States)

    2010-01-01

    ... Program § 1948.96 Audit requirements. (a) Audit requirements for Site Development and Acquisition Grants will be made in accordance with FmHA Instruction 1942-G. (b) Audits for planning grants made in... 7 Agriculture 13 2010-01-01 2009-01-01 true Audit requirements. 1948.96 Section 1948.96...

  12. 7 CFR 3052.230 - Audit costs.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit costs. 3052.230 Section 3052.230 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.230 Audit costs...

  13. 29 CFR 99.200 - Audit requirements.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirements. 99.200 Section 99.200 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.... Guidance on determining Federal awards expended is provided in § 99.205. (b) Single audit. Non-Federal...

  14. 29 CFR 99.510 - Audit findings.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit... schedule of prior audit findings prepared by the auditee in accordance with § 99.315(b) materially...

  15. Factors Affecting the Internal Audit Effectiveness

    OpenAIRE

    Mustika, Adhista Cahya

    2015-01-01

    This study tests the factors that influence the internal audit effectiveness, including internal auditor competencies, internal auditor independence, auditee support to internal audit activity, and the internal and external auditor relationship. Using the internal auditor inspectorate in Java Province, Indonesia, we found that the internal audit effectiveness can be attained through increase internal audit competence, independence and strong relationship between internal and external auditor....

  16. 20 CFR 655.180 - Audit.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit. 655.180 Section 655.180 Employees... United States (H-2A Workers) Integrity Measures § 655.180 Audit. The CO may conduct audits of applications for which certifications have been granted. (a) Discretion. The applications selected for audit...

  17. 38 CFR 41.230 - Audit costs.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit costs. 41.230 Section 41.230 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.230 Audit costs. (a) Allowable...

  18. 9 CFR 149.4 - Spot audit.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Spot audit. 149.4 Section 149.4... LIVESTOCK IMPROVEMENT VOLUNTARY TRICHINAE CERTIFICATION PROGRAM § 149.4 Spot audit. (a) In addition to regularly scheduled site audits, certified production sites will be subject to spot audits. (1) Random spot...

  19. 24 CFR 236.901 - Audit.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Audit. 236.901 Section 236.901... AND INTEREST REDUCTION PAYMENT FOR RENTAL PROJECTS Audits § 236.901 Audit. Where a State or local... mortgagor of a mortgage insured or held by the Commissioner under this part, it shall conduct audits in...

  20. On the nature of auditing: The audit partner effect : Research on the effect of individual audit partners on audit quality and the information dynamics of accounting data

    NARCIS (Netherlands)

    Buuren, van J.P.

    2009-01-01

    This doctoral thesis is about whether auditing is ‘static and mechanic’ of nature or the opposite: ‘dynamic and organic’. If auditing is considered ‘static and mechanic’ of nature, this implies that standard audit solutions are available and can uniformly be applied by the audit partners. Moreover,

  1. 28 CFR 33.51 - Audit.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Audit. 33.51 Section 33.51 Judicial... Additional Requirements § 33.51 Audit. Pursuant to Office of Management and Budget Circular A-128 “Audits of State and Local Governments,” all grantees and subgrantees must provide for an independent audit of...

  2. Towards a framework for auditing environmental reports

    NARCIS (Netherlands)

    Kamp, A.E.M.

    2002-01-01

    Audits of environmental reports first appeared about ten years ago. Both the number of environmental reports and the audit of these reports is still increasing. Audit firms perform a major part of these audits, but other professionals are also active in this field. Even today there are still

  3. Annexing new audit spaces: challenges and adaptations

    NARCIS (Netherlands)

    Andon, P.; Free, C.; O'Dwyer, B.

    2015-01-01

    Purpose - The purpose of this paper is to examine attempts at jurisdictional expansion in the audit field. Specifically, the authors critically analyse the professional implications of "new audit spaces", that is, novel auditing and assurance services that have emerged at intersections between audit

  4. 21 CFR 820.22 - Quality audit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality audit. 820.22 Section 820.22 Food and... QUALITY SYSTEM REGULATION Quality System Requirements § 820.22 Quality audit. Each manufacturer shall establish procedures for quality audits and conduct such audits to assure that the quality system is in...

  5. Pengaruh Struktur Organisasi Terhadapkomunikasi dalam Tim Audit

    OpenAIRE

    Muhammad, Rifqi

    2009-01-01

    Some audit researchers suggest that high levels of audit team structure may encumber communication within audit teams by impeding information-gathering activities. Others suggest that structure benefits communication by coordinating controlling information flows. This study evaluated these arguments by examining the relationship between the structure of audit teams and selected communication variables (information overload, boundary spanning, satisfaction with supervision, and accuracy of inf...

  6. Increased auditor independence by external rotation and separating audit and non audit duties? - A note on the European audit regulation

    OpenAIRE

    Patrick Velte; Marc Eulerich

    2015-01-01

    The European audit reform contains the implementation of an external mandatory auditor rotation (audit firm rotation) and a separation of audit and non audit duties to increase auditor independence. The central question is, whether these regulation measures are connected with an increased accounting and audit quality. First, this article presents an agency theoretical foundation of auditor independence. Then, a state of the art analysis of empirical research illustrates these ambivalent resul...

  7. Lung cancer specialist physicians' attitudes towards e-cigarettes: A nationwide survey.

    Science.gov (United States)

    Shin, Dong Wook; Kim, Young Il; Kim, Seung Joon; Kim, Jung Soo; Chong, SeMin; Park, Young Sik; Song, Sang-Yun; Lee, Jin Han; Ahn, Hee Kyung; Kim, Eun Young; Yang, Sei Hoon; Lee, Myoung Kyu; Cho, Deog Gon; Jang, Tae Won; Son, Ji Woong; Ryu, Jeong-Seon; Cho, Moon-June

    2017-01-01

    Despite a sharp increase in e-cigarette use, there is debate about whether e-cigarettes are a viable alternative for harm reduction, and the forms that regulation should take. Healthcare providers can be effective in offering guidance to patients and their families and shaping regulatory policy. We described lung cancer specialists' attitudes toward e-cigarettes and its regulation. We undertook a nationwide survey of pulmonologists, thoracic surgeons, medical and radiological oncologists who are members of Korean Association for Lung Cancer. Survey items included beliefs and attitudes toward e-cigarettes, attitudes toward e-cigarette regulation and preparedness on discussing e-cigarettes with their patients. Most respondents believed that e-cigarettes are not safer than conventional tobacco cigarettes (75.7%) or smokeless tobacco (83.2%), and feared that discussing e-cigarettes with the patients would encourage use (65.4%). They did not consider it a smoking cessation treatment (78.3%), and thus would not recommend it to smokers who do not want to quit (82.2%) or who failed to quit with conventional smoking cessation treatment (74.1%). Most respondents supported all examples of e-cigarette regulations, including the safety and quality check (97.8%), warning label (97.8%), advertisement ban (95.1%), restriction of flavoring (78.4%), minimum purchasing age (99.5%), and restriction of indoor use (94.6%). Most learned about e-cigarettes from media and advertisements, or conversation with patients rather than through professional scientific resources, and reported discomfort when discussing e-cigarette with patients. Lung cancer specialist physicians in Korea doubt the safety of e-cigarette and use of e-cigarette as smoking cessation treatment, and supported strict regulation. However, only 20% reported that they obtained information on e-cigarettes from the scientific literature and many lacked adequate knowledge based on scientific evidence, suggesting the need for

  8. International Brachytherapy Practice Patterns: A Survey of the Gynecologic Cancer Intergroup (GCIG)

    Energy Technology Data Exchange (ETDEWEB)

    Viswanathan, Akila N., E-mail: aviswanathan@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA (United States); Creutzberg, Carien L. [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Craighead, Peter [Tom Baker Cancer Centre, Calgary, Alberta (Canada); McCormack, Mary [Department of Oncology, University College London Hospital, London (United Kingdom); Toita, Takafumi [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa (Japan); Narayan, Kailash [Division of Radiation Oncology, Peter MacCallum Cancer Centre and Department of Obstetrics and Gynecology, University of Melbourne, Melbourne (Australia); Reed, Nicholas [Beatson Oncology Centre, Glasgow, Scotland (United Kingdom); Long, Harry [Division of Medical Oncology, Department of Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States); Kim, Hak-Jae [Department of Oncology, Seoul National University Hospital, Seoul (Korea, Republic of); Marth, Christian [Medical University Innsbruck, Innsbruck (Austria); Lindegaard, Jacob C. [Aarhus University Hospital, Aarhus (Denmark); Cerrotta, Annmarie [Department of Radiation Therapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano (Italy); Small, William [The Robert H. Lurie Comprehensive Cancer of Northwestern University, Chicago, IL (United States); Trimble, Edward [National Cancer Institute, Bethesda, MD (United States)

    2012-01-01

    Purpose: To determine current practice patterns with regard to gynecologic high-dose-rate (HDR) brachytherapy among international members of the Gynecologic Cancer Intergroup (GCIG) in Japan/Korea (Asia), Australia/New Zealand (ANZ), Europe (E), and North America (NAm). Methods and Materials: A 32-item survey was developed requesting information on brachytherapy practice patterns and standard management for Stage IB-IVA cervical cancer. The chair of each GCIG member cooperative group selected radiation oncology members to receive the survey. Results: A total of 72 responses were analyzed; 61 respondents (85%) used HDR. The three most common HDR brachytherapy fractionation regimens for Stage IB-IIA patients were 6 Gy for five fractions (18%), 6 Gy for four fractions (15%), and 7 Gy for three fractions (11%); for Stage IIB-IVA patients they were 6 Gy for five fractions (19%), 7 Gy for four fractions (8%), and 7 Gy for three fractions (8%). Overall, the mean combined external-beam and brachytherapy equivalent dose (EQD2) was 81.1 (standard deviation [SD] 10.16). The mean EQD2 recommended for Stage IB-IIA patients was 78.9 Gy (SD 10.7) and for Stage IIB-IVA was 83.3 Gy (SD 11.2) (p = 0.02). By region, the mean combined EQD2 was as follows: Asia, 71.2 Gy (SD 12.65); ANZ, 81.18 (SD 4.96); E, 83.24 (SD 10.75); and NAm, 81.66 (SD, 6.05; p = 0.02 for Asia vs. other regions).The ratio of brachytherapy to total prescribed dose was significantly higher for Japan (p = 0.0002). Conclusion: Although fractionation patterns may vary, the overall mean doses administered for cervical cancer are similar in Australia/New Zealand, Europe, and North America, with practitioners in Japan administering a significantly lower external-beam dose but higher brachytherapy dose to the cervix. Given common goals, standardization should be possible in future clinical trials.

  9. A Guide to Energy Audits

    Energy Technology Data Exchange (ETDEWEB)

    Baechler, Michael C.

    2011-09-01

    Energy audits are a powerful tool for uncovering operational and equipment improvements that will save energy, reduce energy costs, and lead to higher performance. Energy audits can be done as a stand-alone effort or as part of a larger analysis across a group of facilities, or across an owner's portfolio. The purpose of an energy audit (sometimes called an 'energy assessment' or 'energy study') is to determine where, when, why and how energy is used in a facility, and to identify opportunities to improve efficiency. Energy auditing services are offered by energy services companies (ESCOs), energy consultants and engineering firms. The energy auditor leads the audit process but works closely with building owners, staff and other key participants throughout to ensure accuracy of data collection and appropriateness of energy efficiency recommendation. The audit typically begins with a review of historical and current utility data and benchmarking of your building's energy use against similar buildings. This sets the stage for an onsite inspection of the physical building. The main outcome of an energy audit is a list of recommended energy efficiency measures (EEMs), their associated energy savings potential, and an assessment of whether EEM installation costs are a good financial investment.

  10. Archaeology audit program final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-04-15

    In order to review oil and gas companies' archaeological management systems, the British Columbia Oil and Gas Commission (OGC) introduced its archaeology audit program (AAP) in April 2008. As part of this audit, twenty six oil and gas companies were selected for an office documentation review and a corresponding field audit. This document presented and described these audit results. The purpose of the final audit report was to provide information to assist oil and gas companies to improve their management systems by increasing the emphasis of the preservation of cultural resources. This report presented an overview of the AAP scope and methodology and provided examples from the audit of both good management practices encountered and practices in which opportunities for improvement to archaeological management systems could be implemented. Recommendations to address improvement opportunities were also discussed. It was concluded that the oil and gas companies subject to the audit were found to have met or exceeded OGC expectations for maintaining archaeological management systems. 2 tabs., 7 figs.

  11. Public awareness of risk factors for cancer among the Japanese general population: A population-based survey

    Directory of Open Access Journals (Sweden)

    Sasazuki Shizuka

    2006-01-01

    Full Text Available Abstract Background The present study aimed to provide information on awareness of the attributable fraction of cancer causes among the Japanese general population. Methods A nationwide representative sample of 2,000 Japanese aged 20 or older was asked about their perception and level of concern about various environmental and genetic risk factors in relation to cancer prevention, as a part of an Omnibus Survey. Interviews were conducted with 1,355 subjects (609 men and 746 women. Results Among 12 risk factor candidates, the attributable fraction of cancer-causing viral and bacterial infection was considered highest (51%, followed by that of tobacco smoking (43%, stress (39%, and endocrine-disrupting chemicals (37%. On the other hand, the attributable fractions of cancer by charred fish and meat (21% and alcohol drinking (22% were considered low compared with other risk factor candidates. For most risk factors, attributable fraction responses were higher in women than in men. As a whole, the subjects tended to respond with higher values than those estimated by epidemiologic evidence in the West. The attributable fraction of cancer speculated to be genetically determined was 32%, while 36% of cancer was considered preventable by improving lifestyle. Conclusion Our results suggest that awareness of the attributable fraction of cancer causes in the Japanese general population tends to be dominated by cancer-causing infection, occupational exposure, air pollution and food additives rather than major lifestyle factors such as diet.

  12. Auditing as method of QA programme evaluation

    International Nuclear Information System (INIS)

    Wilhelm, H.

    1980-01-01

    The status and adequacy of a quality assurance programme should be regularly reviewed by the cognizant management. The programme audit is an independent review to determine the compliance with respective quality assurance requirements and to determine the effectiveness of that programme. This lecture gives an introduction of the method to perform audits under the following topics: 1. Definition and purpose of quality audits. 2. Organization of the quality audit function. 3. Unique requirements for auditors. 4. Audit preparation and planning. 5. Conduct of the audit. 6. Reporting the audit results. 7. Follow-up activities. (RW)

  13. Incidence and identification of risk factors for trastuzumab-induced cardiotoxicity in breast cancer patients: an audit of a single "real-world" setting.

    Science.gov (United States)

    Tang, Grace H; Acuna, Sergio A; Sevick, Laura; Yan, Andrew T; Brezden-Masley, Christine

    2017-09-01

    Management of human epidermal growth factor receptor-2-positive (HER2+) breast cancer patients includes the combination of adjuvant chemotherapy and trastuzumab. A meta-analysis reported that risk factors associated with TIC among less selected patients. A retrospective cohort study was carried out in 160 HER2+ breast cancer patients who received adjuvant chemotherapy with trastuzumab from January 2006 to June 2014 at St. Michael's Hospital, Toronto, Canada. Patient demographics, cardiovascular history, and TIC were recorded. TIC was defined as symptomatic (heart failure) or asymptomatic [decline in left ventricular ejection fraction (LVEF) by ≥10% or LVEF ≤ 50%]. Of the 160 patients [median age 52 (IQR 45-60), 48.1% on anthracycline-based chemotherapy], 34 patients (21.3%) experienced TIC (median follow-up 55.4 months). The median time to development of TIC was 28.5 weeks during trastuzumab therapy. Those with TIC were more likely to have undergone a mastectomy (52.9 vs. 33.3%, p = 0.04). However, after adjusting for anthracycline-based chemotherapy, and radiotherapy, mastectomy was not independently associated with TIC (HR 2.02; 95% CI 0.88-4.63). The incidence of TIC is higher in our "real-world" population compared to clinical trial data. The median time to development of TIC was 28 weeks after trastuzumab initiation, approximately the 10th treatment of trastuzumab. Timely identification and management of patients is important to avoid irreversible cardiac toxicity and improve breast cancer survival.

  14. A pan-European survey of research in end-of-life cancer care.

    Science.gov (United States)

    Sigurdardottir, Katrin Ruth; Haugen, Dagny Faksvåg; Bausewein, Claudia; Higginson, Irene J; Harding, Richard; Rosland, Jan Henrik; Kaasa, Stein

    2012-01-01

    To date, there is no coordinated strategy for end-of-life (EOL) cancer care research in Europe. The PRISMA (Reflecting the Positive Diversities of European Priorities for Research and Measurement in End-of-life Care) project is aiming to develop a programme integrating research and measurement in EOL care. This survey aimed to map and describe present EOL cancer care research in Europe and to identify priorities and barriers. A questionnaire of 62 questions was developed and 201 researchers in 41 European countries were invited to complete it online in May 2009. An open invitation to participate was posted on the internet. Invited contacts in 36 countries sent 127 replies; eight additional responses came through websites. A total of 127 responses were eligible for analysis. Respondents were 69 male and 58 female, mean age 49 (28-74) years; 85% of the scientific team leaders were physicians. Seventy-one of 127 research groups were located in a teaching hospital or cancer centre. Forty-five percent of the groups had only one to five members and 28% six to ten members. Sixty-three of 92 groups reported specific funding for EOL care research. Seventy-five percent of the groups had published papers in journals with impact factor ≤ 5 in the last 3 years; 8% had published in journals with impact factor >10. Forty-four out of 90 groups reported at least one completed Ph.D. in the last 3 years. The most frequently reported active research areas were pain, assessment and measurement tools, and last days of life and quality of death. Very similar areas--last days of life and quality of death, pain, fatigue and cachexia, and assessment and measurement tools--were ranked as the most important research priorities. The most important research barriers were lack of funding, lack of time, and insufficient knowledge/expertise. Most research groups in EOL care are small. The few large groups (14%) had almost half of the reported publications, and more than half of the current Ph

  15. Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey.

    Science.gov (United States)

    Constantinou, Panayotis; Dray-Spira, Rosemary; Menvielle, Gwenn

    2016-03-31

    Comorbidity at the time of diagnosis is an independent prognostic factor for survival among women suffering from cervical or breast cancer. Although cancer screening practices have proven their efficacy for mortality reduction, little is known about adherence to screening recommendations for women suffering from chronic conditions. We investigated the association between eleven chronic conditions and adherence to cervical and breast cancer screening recommendations in France. Using data from a cross-sectional national health survey conducted in 2008, we analyzed screening participation taking into account self-reported: inflammatory systemic disease, cancer, cardiovascular disease, chronic respiratory disease, depression, diabetes, dyslipidemia, hypertension, obesity, osteoarthritis and thyroid disorders. We first computed age-standardized screening rates among women who reported each condition. We then estimated the effect of having reported each condition on adherence to screening recommendations in logistic regression models, with adjustment for sociodemographic characteristics, socioeconomic position, health behaviours, healthcare access and healthcare use. Finally, we investigated the association between chronic conditions and opportunistic versus organized breast cancer screening using multinomial logistic regression. The analyses were conducted among 4226 women for cervical cancer screening and 2056 women for breast cancer screening. Most conditions studied were not associated with screening participation. Adherence to cervical cancer screening recommendations was higher for cancer survivors (OR = 1.73 [0.98-3.05]) and lower for obese women (OR = 0.73 [0.57-0.93]), when accounting for our complete range of screening determinants. Women reporting chronic respiratory disease or diabetes participated less in cervical cancer screening, except when adjusting for socioeconomic characteristics. Adherence to breast cancer screening recommendations was lower for

  16. Cervical and breast cancer screening participation for women with chronic conditions in France: results from a national health survey

    International Nuclear Information System (INIS)

    Constantinou, Panayotis; Dray-Spira, Rosemary; Menvielle, Gwenn

    2016-01-01

    Comorbidity at the time of diagnosis is an independent prognostic factor for survival among women suffering from cervical or breast cancer. Although cancer screening practices have proven their efficacy for mortality reduction, little is known about adherence to screening recommendations for women suffering from chronic conditions. We investigated the association between eleven chronic conditions and adherence to cervical and breast cancer screening recommendations in France. Using data from a cross-sectional national health survey conducted in 2008, we analyzed screening participation taking into account self-reported: inflammatory systemic disease, cancer, cardiovascular disease, chronic respiratory disease, depression, diabetes, dyslipidemia, hypertension, obesity, osteoarthritis and thyroid disorders. We first computed age-standardized screening rates among women who reported each condition. We then estimated the effect of having reported each condition on adherence to screening recommendations in logistic regression models, with adjustment for sociodemographic characteristics, socioeconomic position, health behaviours, healthcare access and healthcare use. Finally, we investigated the association between chronic conditions and opportunistic versus organized breast cancer screening using multinomial logistic regression. The analyses were conducted among 4226 women for cervical cancer screening and 2056 women for breast cancer screening. Most conditions studied were not associated with screening participation. Adherence to cervical cancer screening recommendations was higher for cancer survivors (OR = 1.73 [0.98–3.05]) and lower for obese women (OR = 0.73 [0.57–0.93]), when accounting for our complete range of screening determinants. Women reporting chronic respiratory disease or diabetes participated less in cervical cancer screening, except when adjusting for socioeconomic characteristics. Adherence to breast cancer screening recommendations was lower for

  17. Auditor's Guide to IT Auditing

    CERN Document Server

    Cascarino, Richard E

    2012-01-01

    Step-by-step guide to successful implementation and control of IT systems—including the Cloud Many auditors are unfamiliar with the techniques they need to know to efficiently and effectively determine whether information systems are adequately protected. Now in a Second Edition, Auditor's Guide to IT Auditing presents an easy, practical guide for auditors that can be applied to all computing environments.Follows the approach used by the Information System Audit and Control Association's model curriculum, making this book a practical approach to IS auditingServes as an excellent study gu

  18. Human Papillomavirus-mediated cervical cancer awareness and Gardasil vaccination: a pilot survey among North Indian women.

    Science.gov (United States)

    Pandey, Saumya; Chandravati

    2013-10-01

    Human Papillomavirus (HPV)-mediated cervical cancer is a leading cause of morbidity and mortality in women worldwide, including Indian women. Cervical cancer control and prevention strategies are being adopted in developing nations to reduce the increasing burden of HPV infection in the vaccine era. The present study, therefore, aimed to evaluate cervical cancer awareness and knowledge of Gardasil vaccination in North Indian women. A pilot survey was conducted among 103 women of North Indian ethnicity residing in Lucknow/adjoining areas in state of Uttar Pradesh, during routine screening/clinic visits from June 2012 to December 2012. The study subjects were interviewed in either Hindi or English; subsequently the awareness of HPV-mediated cervical cancer and knowledge of Gardasil vaccination was assessed in terms of "yes", "no" and "no response". The study was approved by the Institutional Review Board. Written informed consent was taken from the participants. Overall, the response of participants (n = 103) in our single-centre survey-based pilot study was well-defined. The response regarding HPV-mediated cervical cancer awareness in terms of "yes", "no" and "no response" among the study subjects was 43.7, 44.7 and 11.6 %, respectively. Furthermore, in response to knowledge of HPV vaccine Gardasil, out of 103 subjects, 28.1 % answered "yes" while 37.9 and 34.0 % stated "no" and "no response", respectively. Our pilot survey may help in assessing knowledge of HPV-mediated cervical cancer and Gardasil vaccination awareness in women, and accordingly develop cost-effective cervical cancer control and prevention/public health counseling sessions in a clinical setting.

  19. Twitter Social Media is an Effective Tool for Breast Cancer Patient Education and Support: Patient-Reported Outcomes by Survey.

    Science.gov (United States)

    Attai, Deanna J; Cowher, Michael S; Al-Hamadani, Mohammed; Schoger, Jody M; Staley, Alicia C; Landercasper, Jeffrey

    2015-07-30

    Despite reported benefits, many women do not attend breast cancer support groups. Abundant online resources for support exist, but information regarding the effectiveness of participation is lacking. We report the results of a Twitter breast cancer support community participant survey. The aim was to determine the effectiveness of social media as a tool for breast cancer patient education and decreasing anxiety. The Breast Cancer Social Media Twitter support community (#BCSM) began in July 2011. Institutional review board approval with a waiver of informed consent was obtained for a deidentified survey that was posted for 2 weeks on Twitter and on the #BCSM blog and Facebook page. There were 206 respondents to the survey. In all, 92.7% (191/206) were female. Respondents reported increased knowledge about breast cancer in the following domains: overall knowledge (80.9%, 153/189), survivorship (85.7%, 162/189), metastatic breast cancer (79.4%, 150/189), cancer types and biology (70.9%, 134/189), clinical trials and research (66.1%, 125/189), treatment options (55.6%, 105/189), breast imaging (56.6%, 107/189), genetic testing and risk assessment (53.9%, 102/189), and radiotherapy (43.4%, 82/189). Participation led 31.2% (59/189) to seek a second opinion or bring additional information to the attention of their treatment team and 71.9% (136/189) reported plans to increase their outreach and advocacy efforts as a result of participation. Levels of reported anxiety before and after participation were analyzed: 29 of 43 (67%) patients who initially reported "high or extreme" anxiety reported "low or no" anxiety after participation (Psocial media support group.

  20. Questionnaire based survey of general population to assess their views about disclosure of cancer diagnosis and review of literature

    International Nuclear Information System (INIS)

    Jawaid, M.; Afsar, S.; Jawaid, S.A.

    2003-01-01

    Objective: To ascertain people's views regarding disclosure of cancer diagnosis and whether they would like to share this information with their family. The study also looked at whether if their parents were diagnosed to be suffering from cancer, would they like this information to be communicated to them. Results: The total number of persons surveyed were 520. Fifteen persons refused to participate in the survey, hence they were excluded and 505 respondents 299 male and 206 female were analyzed. Ages of the respondents were between 18 to 80 years. The study population belonged to different socio-economic groups in the society. Three hundred ninety-one (77.4%) responded positively that they would like to know if they ever suffer from cancer, while 112 (22.1%) said No and 2 (0.39%) said it doesn't matter. Three hundred seventeen (62.7%) wanted their family to be informed while 187 (37.%) said No and the attitude of 1 (0.19%) was Indifferent. One hundred seventy (33.6% responded positively that if their parents were diagnosed to be suffering from cancer they should be told about it, whereas 334 (66.1%) did not wish their parents to be informed and 1 (0.19%) was indecisive. All those who were indifferent were elderly, above the age of seventy yeas. Majority 326 (82.6%) who wanted to know the cancer diagnoses were literate and interestingly 57 (50.8%) who didn't wish to be informed were also literate. Conclusions: Most of the people in the survey 391 (77.4%) wanted to now the diagnosis, if they ever suffered from cancer. Again 317 (62.7%) wished this to be disclosed to their family. Only a small percentage 170 (33.6%), wanted to tell the bad news of cancer diagnosis to their parents if they ever suffered. (author)