WorldWideScience

Sample records for incident database review

  1. The identification of incident cancers in UK primary care databases : a systematic review

    NARCIS (Netherlands)

    Rañopa, Michael; Douglas, Ian; van Staa, Tjeerd; Smeeth, Liam; Klungel, Olaf; Reynolds, Robert; Bhaskaran, Krishnan

    2015-01-01

    PURPOSE: UK primary care databases are frequently used in observational studies with cancer outcomes. We aimed to systematically review methods used by such studies to identify and validate incident cancers of the breast, colorectum, and prostate. METHODS: Medline and Embase (1980-2013) were

  2. Marine Animal Incident Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Large whale stranding, death, ship strike and entanglement incidents are all recorded to monitor the health of each population and track anthropogenic factors that...

  3. Reviewer Database

    OpenAIRE

    Chief Editor

    2016-01-01

    REVIEWER DATABASEA S PaddaAarati KrishnanAarti KapilAbdul JilaniAbhaya JoglekarAbhijit PakhareAbhisek MishraAbhishek ArunAbhishek GuptaAbhishek JadhavAbhishek SinghAditi SinghAdrija RoyAdwitiya MukhopadhyayAhmed MandilA SubramanianAjit SahaiAkanksha GautamAkela MohamedAkhila GopinathanAkshay KumarAlankrata JainAli AbediAlisha SyiemliehAmal BasuAmandeep KaurA ChauhanAmarnath GuptaAmar SinhaAmir M KhanAmit KaushikAmit PawaiyaAmit SinghAmrita KansalAmrita SougaijamA WadheraAnand DixtA Neelakanta...

  4. Reviewer Database

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available REVIEWER DATABASEA S PaddaAarati KrishnanAarti KapilAbdul JilaniAbhaya JoglekarAbhijit PakhareAbhisek MishraAbhishek ArunAbhishek GuptaAbhishek JadhavAbhishek SinghAditi SinghAdrija RoyAdwitiya MukhopadhyayAhmed MandilA SubramanianAjit SahaiAkanksha GautamAkela MohamedAkhila GopinathanAkshay KumarAlankrata JainAli AbediAlisha SyiemliehAmal BasuAmandeep KaurA ChauhanAmarnath GuptaAmar SinhaAmir M KhanAmit KaushikAmit PawaiyaAmit SinghAmrita KansalAmrita SougaijamA WadheraAnand DixtA NeelakantanAnil PurtyAnimesh JainAnisha MohanAnjali AroraAnjan DattaAnju GahlotAnkita BajpaiAnku SaikiaAnmol GoyalAnu AgrawalAnu BhardwajAnuj JangraAnupama AryaA MohokarAnurag ChaudaryA SrivastavaAr BondArnab GhoshArpan YagnikArpit PrajapatiArshad AyubArti RauthanArun SainiArun SharmaArun ShiraliArun SugumaranArun VargheseArun WanjpeArvind NathArvind SinghAsha RAshish ChauhanAshish SinhaAshish SrivastavaAshish YadavAshok BhardwajAshok SrivastavaAshu GroverAshutosh SarwaAshwani SinhaAshwini KumarAthar AnsariAtul PuthiaAustin OkpanmaAvijit DasAvijit SinghaAvinash SunthliaB P MathurB VermaBabu DilipBadri MisraBaridalyne NongkynrihBhaswati SenguptaBhavana PandeyBhavana PantBhola NathBhupinder AnandBhupinder SinghBhuwan SharmaBiju SomanBimlesh KumarBinod KumarBinod PatroBishwas AcharyaBiswajit PaulB ChakravarthyB MannaC M S RawatC P MishraC M SinghChandra PrabhaChibi RushithaChitrangada MistryD SrivastavaDaksh SharmaDaneshwar SinghDanish ImtiazDebabrata RoyDeep ShikhaDeepa NairDeepak ChopraDeepak GuptaDeepak SharmaDeepika MittalNandanwarD SharmaDevi NairDharma BhattaD GahwaiDheeraj SharmaDhiraj SrivastavaDhrubajyotiDileepanDinesh BhatnagarDipanjan DeyDivya RajaseharanEkta GuptaEmanuel CummingsEnakshi GanguliFabrice JotterandFatma KarasuFomboh RichardGagan GargGajendra GuptaGarima MittalG BandyopadhyayGeetanjali KapoorGeetu SinghGhos AhmedGirish ChavanGirjesh YadavGita NegiGmsubba RaoGnanakshiGobezie TemesgenGokul ShindeGouri PadhyKassa GideboGunjan NathH ChopraHameeda Ali

  5. Scopus database: a review.

    Science.gov (United States)

    Burnham, Judy F

    2006-03-08

    The Scopus database provides access to STM journal articles and the references included in those articles, allowing the searcher to search both forward and backward in time. The database can be used for collection development as well as for research. This review provides information on the key points of the database and compares it to Web of Science. Neither database is inclusive, but complements each other. If a library can only afford one, choice must be based in institutional needs.

  6. Scopus database: a review

    OpenAIRE

    Burnham, Judy F

    2006-01-01

    The Scopus database provides access to STM journal articles and the references included in those articles, allowing the searcher to search both forward and backward in time. The database can be used for collection development as well as for research. This review provides information on the key points of the database and compares it to Web of Science. Neither database is inclusive, but complements each other. If a library can only afford one, choice must be based in institutional needs.

  7. E3 Portfolio Review Database

    Data.gov (United States)

    US Agency for International Development — The E3 Portfolio Review Database houses operational and performance data for all activities that the Bureau funds and/or manages. Activity-level data is collected by...

  8. Volcanic disasters and incidents: A new database

    Science.gov (United States)

    Witham, C. S.

    2005-12-01

    A new database on human mortality and morbidity, and civil evacuations arising from volcanic activity is presented. The aim is to quantify the human impacts of volcanic phenomena during the 20th Century. Data include numbers of deaths, injuries, evacuees and people made homeless, and the nature of the associated volcanic phenomena. The database has been compiled from a wide range of sources, and discrepancies between these are indicated where they arise. The quality of the data varies according to the source and the impacts reported. Data for homelessness are particularly poor and effects from ashfall and injuries appear to be under-reported. Of the 491 events included in the database, ˜53% resulted in deaths, although the total death toll of 91,724 is dominated by the disasters at Mt Pelée and Nevado del Ruiz. Pyroclastic density currents account for the largest proportion of deaths, and lahars for the most injuries incurred. The Philippines, Indonesia, and Southeast Asia, as a region, were the worst affected, and middle-income countries experienced greater human impacts than low or high-income countries. Compilation of the database has highlighted a number of problems with the completeness and accuracy of the existing CRED EM-DAT disaster database that includes volcanic events. This database is used by a range of organisations involved with risk management. The new database is intended as a resource for future analysis and will be made available via the Internet. It is hoped that it will be maintained and expanded.

  9. Estimation of National Colorectal-Cancer Incidence Using Claims Databases

    Directory of Open Access Journals (Sweden)

    C. Quantin

    2012-01-01

    Full Text Available Background. The aim of the study was to assess the accuracy of the colorectal-cancer incidence estimated from administrative data. Methods. We selected potential incident colorectal-cancer cases in 2004-2005 French administrative data, using two alternative algorithms. The first was based only on diagnostic and procedure codes, whereas the second considered the past history of the patient. Results of both methods were assessed against two corresponding local cancer registries, acting as “gold standards.” We then constructed a multivariable regression model to estimate the corrected total number of incident colorectal-cancer cases from the whole national administrative database. Results. The first algorithm provided an estimated local incidence very close to that given by the regional registries (646 versus 645 incident cases and had good sensitivity and positive predictive values (about 75% for both. The second algorithm overestimated the incidence by about 50% and had a poor positive predictive value of about 60%. The estimation of national incidence obtained by the first algorithm differed from that observed in 14 registries by only 2.34%. Conclusion. This study shows the usefulness of administrative databases for countries with no national cancer registry and suggests a method for correcting the estimates provided by these data.

  10. Tracking Traffickers. The IAEA Incident and Trafficking Database

    International Nuclear Information System (INIS)

    Webb, Greg

    2013-01-01

    Radioactive material is missing from a hospital. Contaminated metal is found in a scrap yard. Smugglers try to peddle nuclear- weapon-usable material. These different scenarios illustrate the risks that these materials can pose to human safety and security. To assess those risks and to develop strategies to reduce them, States must understand the implications and the scope of such incidents that are occurring around the world. To better understand and respond to these events, the IAEA maintains an Incident and Trafficking Database (ITDB) which collects information from 122 participating States and some select international organizations. They are asked to share data on a voluntary basis about incidents in which nuclear and other radioactive material has fallen ''out of regulatory control.'' This could mean reporting cases of material that has gone missing, or discoveries of material where none was expected. The cases range from the innocent misplacement of industrial radioactive sources to criminal smuggling efforts which could aid terrorist acts. This information is shared among ITDB participants, and IAEA analysts try to identify trends and characteristics that could help prevent the misuse of these potentially dangerous materials. ''The ITDB has become an internationally recognized tool for States to study the extent and nature of these incidents,'' said John Hilliard, head of the Information Management and Coordination Section that administers the database. ''We've learned a lot by studying them, and we hope the information helps us prevent accidents or crimes in the future.'' The IAEA established the database in 1995 after States became alarmed by a growing number of trafficking incidents in the early 1990s. The service was originally operated by the Department of Safeguards, but later moved to the Department of Nuclear Safety and Security, where the Office of Nuclear Security now administers all the data collection and analysis

  11. Online Petroleum Industry Bibliographic Databases: A Review.

    Science.gov (United States)

    Anderson, Margaret B.

    This paper discusses the present status of the bibliographic database industry, reviews the development of online databases of interest to the petroleum industry, and considers future developments in online searching and their effect on libraries and information centers. Three groups of databases are described: (1) databases developed by the…

  12. Serious incidents after death: content analysis of incidents reported to a national database.

    Science.gov (United States)

    Yardley, Iain E; Carson-Stevens, Andrew; Donaldson, Liam J

    2018-02-01

    Objectives To describe serious incidents occurring in the management of patient remains after their death. Design Incidents occurring after patient deaths were analysed using content analysis to determine what happened, why it happened and the outcome. Setting The Strategic Executive Information System database of serious incidents requiring investigation occurring in the National Health Service in England. Participants All cases describing an incident that occurred following death, regardless of the age of the patient. Main outcome measures The nature of the incident, the underlying cause or causes of the incident and the outcome of the incident. Results One hundred and thirty-two incidents were analysed; these related to the storage, management or disposal of deceased patient remains. Fifty-four incidents concerned problems with the storage of bodies or body parts. Forty-three incidents concerned problems with the management of bodies, including 25 errors in postmortem examination, or postmortems on the wrong body. Thirty-one incidents related to the disposal of bodies, 25 bodies were released from the mortuary to undertakers in error; of these, nine were buried or cremated by the wrong family. The reported underlying causes were similar to those known to be associated with safety incidents occurring before death and included weaknesses in or failures to follow protocol and procedure, poor communication and informal working practices. Conclusions Serious incidents in the management of deceased patient remains have significant implications for families, hospitals and the health service more broadly. Safe mortuary care may be improved by applying lessons learned from existing patient safety work.

  13. Grazing incidence diffraction : A review

    Energy Technology Data Exchange (ETDEWEB)

    Gilles, B. [LTPCM, ENSEEG. St. Martin d`Heres. (France)

    1996-09-01

    Different Grazing Incidence Diffraction (GID) methods for the analysis of thin films and multilayer structures are reviewed in three sections: the reflectivity is developed in the first one, which includes the non-specular diffuse scattering. The second one is devoted to the extremely asymmetric Bragg diffraction and the third one to the in-plane Bragg diffraction. Analytical formulations of the scattered intensities are developed for each geometry, in the framework of the kinetical analysis as well as the dynamical theory. Experimental examples are given to illustrate the quantitative possibility of the GID techniques.

  14. Review of natural product databases.

    Science.gov (United States)

    Xie, Tao; Song, Sicheng; Li, Sijia; Ouyang, Liang; Xia, Lin; Huang, Jian

    2015-08-01

    Many natural products have pharmacological or biological activities that can be of therapeutic benefit in treating diseases, and are also an important source of inspiration for development of potential novel drugs. The past few decades have witnessed extensive study of natural products for their promising prospects in application of medicinal chemistry, molecular biology and pharmaceutical sciences. Natural product databases have provided systematic collection of information concerning natural products and their derivatives, including structure, source and mechanisms of action, which significantly support modern drug discovery. Currently, a considerable number of natural product databases, such as TCM Database@Taiwan, TCMID, CEMTDD, SuperToxic and SuperNatural, have been developed, providing data such as integrated medicinal herbs, ingredients, 2D/3D structures of the compounds, related target proteins, relevant diseases, and metabolic toxicity and more. We focus on an analytical overview of current natural product databases, and further discuss the good, bad or imperfection of current ones, in the hope of better integrating existing relevant outcomes, thus providing new routes for future drug discovery. © 2015 John Wiley & Sons Ltd.

  15. NOAA's Office of Response and Restoration: Historical Oil and Chemical Spill Incidents Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Historical Incidents database contains reports and images from oil and chemical spills that occurred between 1968 and 2002. The database includes reports on...

  16. Critical incidents related to cardiac arrests reported to the Danish Patient Safety Database

    DEFF Research Database (Denmark)

    Andersen, Peter Oluf; Maaløe, Rikke; Andersen, Henning Boje

    2010-01-01

    Background Critical incident reports can identify areas for improvement in resuscitation practice. The Danish Patient Safety Database is a mandatory reporting system and receives critical incident reports submitted by hospital personnel. The aim of this study is to identify, analyse and categorize...... critical incidents related to cardiac arrests reported to the Danish Patient Safety Database. Methods The search terms “cardiac arrest” and “resuscitation” were used to identify reports in the Danish Patient Safety Database. Identified critical incidents were then classified into categories. Results One...

  17. Incidence of kidney stones in kidney transplant recipients: A systematic review and meta-analysis

    OpenAIRE

    Cheungpasitporn, Wisit; Thongprayoon, Charat; Mao, Michael A; Kittanamongkolchai, Wonngarm; Jaffer Sathick, Insara J; Dhondup, Tsering; Erickson, Stephen B

    2016-01-01

    AIM To evaluate the incidence and characteristics of kidney stones in kidney transplant recipients. METHODS A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the inception of the databases through March 2016. Studies assessing the incidence of kidney stones in kidney transplant recipients were included. We applied a random-effects model to estimate the incidence of kidney stones. RESULTS Twenty one studies with 64416 kidney transplant pa...

  18. Development of Incident Report Database for Organizational Learning

    Science.gov (United States)

    Otsuka, Yuichi; Abe, Tomotaka; Noguchi, Hiroshi; Makinouchi, Akifumi

    The necessity of an incident reporting system has recently been increasing for hospitals. Japan Council for Quality Health Care (JCQHC) started operating a national incident reporting system to which domestic hospitals would report their incidents. However, the reporting system obtained an additional problem for the hospitals. They managed their own systems which collected reports by papers. The purposes of the reporting systems was to analyze considerable causes involved in incidents to improve the quality of patient safety management. On the contrary, the national reporting system aimed at collecting a statistical tendency of normal incidents. Simultaneously operating the two systems would be too much workload for safety managers. The load may have the managers rest only a short time for summarizing occurrences, not enough for analyzing their causes. However, to the authors' knowledge, there has not been an integrating policy of the two forms to adapt them to practical situations in patient safety management. The scope of this paper is to establish the integrated form in order to use in analyzing the causes of incidents as well as reporting for the national system. We have developed new data base system using XML + XSLT and Java Servlet. The developed system is composed of three computers; DB server , DB client and Data sending server. To investigate usability of the developed system, we conducted a monitoring test by real workers in reporting workplaces. The result of subjective evaluations by examinees was so preferable for the developed system. The results of usability test and the achievement of increasing the number of reports after the introduction can demonstrate the enough effectiveness of the developed system for supporting the activity of patient safety management.

  19. Tuberculosis incidence in prisons: a systematic review.

    Science.gov (United States)

    Baussano, Iacopo; Williams, Brian G; Nunn, Paul; Beggiato, Marta; Fedeli, Ugo; Scano, Fabio

    2010-12-21

    Transmission of tuberculosis (TB) in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI) and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF%) to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR) for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8) and 23.0 (IQR: 11.7-36.1), respectively. The median estimated fraction (PAF%) of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9%) and 6.3% (IQR: 2.7%-17.2%) in high- and middle/low-income countries, respectively. The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.

  20. Review: Childhood and Adolescent Sexual Abuse: Incidence ...

    African Journals Online (AJOL)

    Other complications relate to sexually transmitted diseases, unwanted pregnancy and psychological pathologies such as intense anxiety, anger, depression, mood swings, nightmares, phobias and somatisation. This review discusses the apparent low incidence and of sexual abuse in children and adolescents, ...

  1. Lessons learned from process incident databases and the process safety incident database (PSID) approach sponsored by the Center for Chemical Process Safety

    International Nuclear Information System (INIS)

    Sepeda, Adrian L.

    2006-01-01

    Learning from the experiences of others has long been recognized as a valued and relatively painless process. In the world of process safety, this learning method is an essential tool since industry has neither the time and resources nor the willingness to experience an incident before taking corrective or preventative steps. This paper examines the need for and value of process safety incident databases that collect incidents of high learning value and structure them so that needed information can be easily and quickly extracted. It also explores how they might be used to prevent incidents by increasing awareness and by being a tool for conducting PHAs and incident investigations. The paper then discusses how the CCPS PSID meets those requirements, how PSID is structured and managed, and its attributes and features

  2. Tuberculosis incidence in prisons: a systematic review.

    Directory of Open Access Journals (Sweden)

    Iacopo Baussano

    Full Text Available BACKGROUND: Transmission of tuberculosis (TB in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. METHODS AND FINDINGS: A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF% to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8 and 23.0 (IQR: 11.7-36.1, respectively. The median estimated fraction (PAF% of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9% and 6.3% (IQR: 2.7%-17.2% in high- and middle/low-income countries, respectively. CONCLUSIONS: The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.

  3. Pipework failures - a review of historical incidents

    International Nuclear Information System (INIS)

    Blything, K.W.; Parry, S.T.

    1988-01-01

    A description is presented of the gathering of historical pipework incident data and its analysis to determine the causes and underlying reasons for failure. The following terms of reference were agreed: (a) To review data on failures associated with pipework to establish the principal causes of failure. This should include not only rupture of the pipe itself, but also pipework induced failures, such as severe flange leaks and excessive strains resulting in failure of connected equipment. (b) To suggest an incident classification for pipework systems which will alert design, construction, maintenance, and operating personnel to the need for special care. (c) To advise non-piping specialists of the type of situation which could result in failure if not allowed for in the design, e.g. dynamic and transient conditions. (d) To recommend, possibly as the result of (a) above, areas where present procedures and codes of practice may require amplification. Brief descriptions are given of selected incidents where the consequences are considered to be serious in terms of damage and financial loss. For consequence analysis, the release rate is an important parameter and, where possible, the proportion of incidents in the failure mode categories, leaks, ''ruptures/severances'' are given. Although not one of the agreed objectives, the determination of failure rates was recognised as an important requirement in the risk assessment of pipework systems. The quality of data gathered however was found to be inadequate for any statistical analysis and no failure rate values are given in this report. (author)

  4. Leptospirosis: recent incidents and available diagnostics - a review.

    Science.gov (United States)

    Yuszniahyati, Y; Kenneth, F R; Daisy Vanitha, J

    2015-12-01

    The aim of this article was to review published research articles on leptospirosis, in particular the recent incidence of leptospirosis in Malaysia and the currently available diagnostic methods for the detection of leptospirosis. PubMed, Google Scholar and Google Search databases were searched using the key words Leptospira and leptospirosis. A total of seventy-six references were reviewed including sixty-seven research articles, three annual reports from Ministry of Health and six online newspaper articles. This review includes the following five sub-headings: introduction, leptospirosis transmission, leptospirosis incidents, laboratory diagnosis of leptospirosis and treatment and prevention of leptospirosis. An increase in incidents of leptospirosis cases has been seen in recent years in Malaysia. The recent floods have contributed to the rise in the number of reported cases. Current diagnostic approaches such as dark field microscopy, microscopic agglutination test (MAT), Polymerase chain reaction and serological tests are inadequate as the organism is a slow grower. There is an urgent need to develop newer techniques for rapid detection of leptospirosis. The combination of PCR and ELISA are suggested for rapid and accurate diagnosis of leptospirosis. Studies on the mechanism of pathogenesis of Leptospira are needed for the development of vaccines that are safe for human use.

  5. Patient-safety-related hospital deaths in England: thematic analysis of incidents reported to a national database, 2010-2012.

    Science.gov (United States)

    Donaldson, Liam J; Panesar, Sukhmeet S; Darzi, Ara

    2014-06-01

    Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%), failure of prevention (26%), deficient checking and oversight (11%), dysfunctional patient flow (10%), equipment-related errors (6%), and other (12%). The most common incident types were failure to act on or recognise deterioration (23%), inpatient falls (10%), healthcare-associated infections (10%), unexpected per-operative death (6%), and poor or inadequate handover (5%). Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives.

  6. Patient-safety-related hospital deaths in England: thematic analysis of incidents reported to a national database, 2010-2012.

    Directory of Open Access Journals (Sweden)

    Liam J Donaldson

    2014-06-01

    Full Text Available BACKGROUND: Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. METHODS AND FINDINGS: The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%, failure of prevention (26%, deficient checking and oversight (11%, dysfunctional patient flow (10%, equipment-related errors (6%, and other (12%. The most common incident types were failure to act on or recognise deterioration (23%, inpatient falls (10%, healthcare-associated infections (10%, unexpected per-operative death (6%, and poor or inadequate handover (5%. Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. CONCLUSIONS: Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives.

  7. Comparison of six electronic healthcare databases in Europe using standardized protocols: a descriptive study on the incidence of cancer.

    NARCIS (Netherlands)

    Afonso, A.S.; Groot, M.C.H. de; Ham, R. van den; Bruin, M.L. de; Huerta Alvarez, C.; Gil, M.; Hesse, U.; Ronn, P.F.; Souverein, P.C.; Alvarez, Y.; Slattery, J.; Rottenkolber, M.; Dijk, L. van; Schlienger, R.; Reynolds, R.; Klungel, O.H.; Grimaldi-Bensouda, L.

    2013-01-01

    Background: There are several national cancer registries available across Europe, but information on cancer incidence from routine electronic healthcare record (EHR) databases (DBs), such as General Practitioners (GPs) and comparisons across different databases are rather scarce. It is important to

  8. Comparison of six electronic healthcare databases in Europe using standardized protocols: A descriptive study on the incidence of cancer

    NARCIS (Netherlands)

    Afonso, Ana S.; De Groot, Mark C.H.; Van Den Ham, Rianne; Bruin, Marie L.; Alvarez, Consuelo Huerta; Gil, Miguel; Hesse, Ulrik; Rønn, Pernille F.; Souverein, Patrick C.; Alvarez, Yolanda; Slattery, Jim; Rottenkolber, Marietta; Van Dijk, Liset; Schlienger, Raymond G.; Reynolds, Robert; Klungel, Olaf H.; Grimaldi-Bensouda, Lamiae

    2013-01-01

    Background: There are several national cancer registries available across Europe, but information on cancer incidence from routine electronic healthcare record (EHR) databases (DBs), such as General Practitioners (GPs) and comparisons across different databases are rather scarce. It is important to

  9. Literature review on medical incident command.

    Science.gov (United States)

    Rimstad, Rune; Braut, Geir Sverre

    2015-04-01

    It is not known what constitutes the optimal emergency management system, nor is there a consensus on how effectiveness and efficiency in emergency response should be measured or evaluated. Literature on the role and tasks of commanders in the prehospital emergency services in the setting of mass-casualty incidents has not been summarized and published. This comprehensive literature review addresses some of the needs for future research in emergency management through three research questions: (1) What are the basic assumptions underlying incident command systems (ICSs)? (2) What are the tasks of ambulance and medical commanders in the field? And (3) How can field commanders' performances be measured and assessed? A systematic literature search in MEDLINE, PubMed, PsycINFO, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, ISI Web of Science, Scopus, International Security & Counter Terrorism Reference Center, Current Controlled Trials, and PROSPERO covering January 1, 1990 through March 1, 2014 was conducted. Reference lists of included literature were hand searched. Included papers were analyzed using Framework synthesis. The literature search identified 6,049 unique records, of which, 76 articles and books where included in qualitative synthesis. Most ICSs are described commonly as hierarchical, bureaucratic, and based on military principles. These assumptions are contested strongly, as is the applicability of such systems. Linking of the chains of command in cooperating agencies is a basic difficulty. Incident command systems are flexible in the sense that the organization may be expanded as needed. Commanders may command by direction, by planning, or by influence. Commanders' tasks may be summarized as: conducting scene assessment, developing an action plan, distributing resources, monitoring operations, and making decisions. There is considerable variation between authors in nomenclature and what tasks are included or highlighted

  10. Database selection in systematic reviews: an insight through clinical neurology.

    Science.gov (United States)

    Vassar, Matt; Yerokhin, Vadim; Sinnett, Philip Marcus; Weiher, Matthew; Muckelrath, Halie; Carr, Branden; Varney, Laura; Cook, Gregory

    2017-06-01

    Failure to perform a comprehensive search when designing a systematic review (SR) can lead to bias, reducing the validity of review's conclusions. We examined the frequency and choice of databases used by reviewers in clinical neurology. Ninety-five SRs and/or meta-analyses were located across five prominent neurology journals between 2008 and 2014. Methods sections were reviewed, and all bibliographic databases were coded. On average, 2.59 databases were used in SR searches. Seven reviews included an information specialist, and these reviews reported a greater number of information sources used during the search process. Thirty-nine databases were reported across studies. PubMed/MEDLINE ® and EMBASE were cited most frequently. Searching too few databases may reduce the validity and generalisability of SR results. We found that the majority of systematic reviewers in clinical neurology do not search an adequate number of databases, which may yield a biased sample of primary studies and, thus, may influence the accuracy of summary effects. Systematic reviewers should aim to search a sufficient number of databases to minimise selection bias. Additionally, systematic reviewers should include information specialists in designing SR methodology, as this may improve systematic review quality. © 2017 Health Libraries Group.

  11. The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study.

    Directory of Open Access Journals (Sweden)

    Bo Kyung Koo

    Full Text Available The incidence and prevalence of type 2 diabetes mellitus (T2DM and related macrovascular complications in Korea were estimated using the Health Insurance Review and Assessment (HIRA database from 2007-2011, which covers the claim data of 97.0% of the Korean population.T2DM, coronary artery disease (CAD, cerebrovascular disease (CVD, and peripheral artery disease (PAD were defined according to ICD-10 codes. We used the Healthcare Common Procedure Coding System codes provided by HIRA to identify associated procedures or surgeries. When calculating incidence, we excluded cases with preexisting T2DM within two years before the index year. A Poisson distribution was assumed when calculating 95% confidence intervals for prevalence and incidence rates.The prevalence of T2DM in Korean adults aged 20-89 years was 6.1-6.9% and the annual incidence rates of T2DM ranged from 9.5-9.8/1,000 person-year (PY during the study period. The incidence rates of T2DM in men and women aged 20-49 years showed decreasing patterns from 2009 to 2011 (P<0.001; by contrast, the incidence in subjects aged 70-79 years showed increased patterns from 2009 to 2011 (P<0.001. The incidence rates of CAD and CVD in patients newly diagnosed with T2DM were 18.84/1,000 PY and 11.32/1,000 PY, respectively, in the year of diagnosis. Among newly diagnosed individuals with T2DM who were undergoing treatment for PAD, 14.6% underwent angioplasty for CAD during the same period.Our study measured the national incidences of T2DM, CAD, CVD, and PAD, which are of great concern for public health. We also confirmed the relatively higher risk of CAD and CVD newly detected T2DM patients compared to the general population in Korea.

  12. Similar herpes zoster incidence across Europe: results from a systematic literature review

    OpenAIRE

    Pinchinat, Sybil; Cebri?n-Cuenca, Ana M; Bricout, H?l?ne; Johnson, Robert W

    2013-01-01

    Background Herpes zoster (HZ) is caused by reactivation of the varicella-zoster virus (VZV) and mainly affects individuals aged ?50?years. The forthcoming European launch of a vaccine against HZ (Zostavax?) prompts the need for a better understanding of the epidemiology of HZ in Europe. Therefore the aim of this systematic review was to summarize the available data on HZ incidence in Europe and to describe age-specific incidence. Methods The Medline database of the National Library of Medicin...

  13. Development of a fire incident database for the United States nuclear power industry

    International Nuclear Information System (INIS)

    Wilks, G.

    1998-01-01

    The Nuclear Power Industry in the United States has identified a need to develop and maintain a comprehensive fire events database to support anticipated performance-based or risk-based fire protection programs and regulations. These new programs will require accurate information on the frequency, severity and consequences of fire events. Previous attempts to collect fire incident data had been made over the years for other purposes, but it was recognized that the detail and form of the data collected would be insufficient to support the new initiatives. Weaknesses in the earlier efforts included the inability in some cases to obtain fire incidents reports, inconsistent of incomplete information reported, and the inability to easily retrieve, sort, analyze and trend the data. The critical elements identified for the new data collection efforts included a standardized fire incident report from to assure consistent and accurate information, some mechanism to assure that all fire events are reported, and the ability to easily access the data for trending and analysis. In addition, the database would need to be unbiased and viewed as such by outside agencies. A new database is currently being developed that should meet all of these identified need. (author)

  14. Should we search Chinese biomedical databases when performing systematic reviews?

    OpenAIRE

    Cohen, J?r?mie F; Korevaar, Dani?l A; Wang, Junfeng; Spijker, Ren?; Bossuyt, Patrick M

    2015-01-01

    Background Chinese biomedical databases contain a large number of publications available to systematic reviewers, but it is unclear whether they are used for synthesizing the available evidence. Methods We report a case of two systematic reviews on the accuracy of anti-cyclic citrullinated peptide for diagnosing rheumatoid arthritis. In one of these, the authors did not search Chinese databases; in the other, they did. We additionally assessed the extent to which Cochrane reviewers have searc...

  15. The incidence of complications associated with lip and/or tongue piercings: a systematic review

    NARCIS (Netherlands)

    Hennequin-Hoenderdos, N.L.; Slot, D.E.; Van der Weijden, G.A.

    2016-01-01

    Objective: This review determines the incidence of complications associated with lip and/or tongue piercings based on a systematic evaluation of the available literature. Material and Methods: MEDLINE–PubMed, Cochrane-CENTRAL and EMBASE databases were comprehensively searched through June 2014 to

  16. Incident and Trafficking Database: New Systems for Reporting and Accessing State Information

    International Nuclear Information System (INIS)

    Dimitrovski, D.; Kittley, S.

    2015-01-01

    The IAEA's Incident and Trafficking Database (ITDB) is the Agency's authoritative source for information on incidents in which nuclear and other radioactive material is out of national regulatory control. It was established in 1995 and, as of June 2014, 126 States participate in the ITDB programme. Currently, the database contains over 2500 confirmed incidents, out of which 21% involve nuclear material, 62% radioactive source and 17% radioactively contaminated material. In recent years, the system for States to report incidents to the ITDB has been evolving — moving from fax-based to secure email and most recently to secure on-line reporting. A Beta version of the on-line system was rolled out this June, offering a simple, yet secure, communication channel for member states to provide information. In addition the system serves as a central hub for information related to official communication of the IAEA with Member States so some communication that is traditionally shared by e-mail does not get lost when ITDB counterparts change. In addition the new reporting system incorporates optional features that allow multiple Member State users to collaboratively contribute toward an INF. States are also being given secure on-line access to a streamlined version of the ITDB. This improves States' capabilities to retrieve and analyze information for their own purposes. In addition, on-line access to ITDB statistical information on incidents is available to States through an ITDB Dashboard. The dashboard contains aggregate information on number and types of incidents, material involved, as well some other statistics related to the ITDB that is typically provided in the ITDB Quarterly reports. (author)

  17. Incidence and prevalence rates of diabetes mellitus in Taiwan: Analysis of the 2000–2009 Nationwide Health Insurance database

    Directory of Open Access Journals (Sweden)

    Yi-Der Jiang

    2012-11-01

    Conclusion: The incidence of diabetes, including type 1, remained stable over this 10-year period in Taiwan. However, the incidence rate in men aged 20–59 years was higher than that in age-matched women. With our nationwide database, subgroup analysis of DM incidence can be performed to refine our health policies for the prevention, screening, and treatment of diabetes mellitus.

  18. Incidence and etiology of lumbar spondylolysis: review of the literature.

    Science.gov (United States)

    Sakai, Toshinori; Sairyo, Koichi; Suzue, Naoto; Kosaka, Hirofumi; Yasui, Natsuo

    2010-05-01

    Lumbar spondylolysis is a defect of the pars interarticularis known to occur as a stress fracture. Its incidence varies considerably depending on ethnicity, sex, and sports activity. However, there are few literature reviews describing its incidence in different ethnic groups or in people who engage in different sports. We reviewed the most relevant articles on spondylolysis published in scientific journals. First, we focused on its incidence in various ethnic groups distributed by sex, the familial occurrence, and in patients with relevant diseases. Second, we focused on the incidence of spondylolysis in relation to the sports practiced by the patients. Although placing special emphasis on the incidence of lumbar spondylolysis in the general population in Japan, we also reviewed the Japanese and English literature to investigate its incidence among those who engage in different sports. The incidence of lumbar spondylolysis in the general Japanese population was 5.9%. Most studies report that the incidence in higher in male subjects than in female subjects. We found that Japanese rugby and judo players were prone to suffer lumbar spondylolysis, at an incidence of about 20%. However, the incidence for Japanese professional soccer and baseball players was much higher, at 30%, which was more than five times the incidence in the general Japanese population. The incidence of lumbar spondylolysis varies depending on ethnicity, sex, family history, relevant disease, and sports activity.

  19. Prevalence and incidence of hypoparathyroidism in the United States using a large claims database.

    Science.gov (United States)

    Powers, Julia; Joy, Karen; Ruscio, Aimee; Lagast, Hjalmar

    2013-12-01

    Hypoparathyroidism is a rare endocrine disorder whose incidence and prevalence have not been well defined. This study aimed to 1) estimate the number of insured adult patients with hypoparathyroidism in the United States and 2) obtain physician assessment of disease severity and chronicity. Prevalence was estimated through calculation of diagnoses of hypoparathyroidism in a large proprietary health plan claims database over a 12-month period from October 2007 through September 2008 and projected to the US insured population. Incidence was also calculated from the same database by determining the proportion of total neck surgeries resulting in either transient (≤6 months) or chronic (>6 months) hypoparathyroidism. A physician primary market research study was conducted to assess disease severity and determine the percentage of new nonsurgical patients with hypoparathyroidism. Incidence data were entered into an epidemiologic model to derive an estimate of prevalence. The diagnosis-based prevalence approach estimated 58,793 insured patients with chronic hypoparathyroidism in the United States. The surgical-based incidence approach yielded 117,342 relevant surgeries resulting in 8901 cases over 12 months. Overall, 7.6% of surgeries resulted in hypoparathyroidism (75% transient, 25% chronic). The prevalence of chronic hypoparathyroidism among insured patients included in the surgical database was estimated to be 58,625. The physician survey found that 75% of cases treated over the past 12 months were reported due to surgery and, among all thyroidectomies and parathyroidectomies and neck dissections performed in a year, 26% resulted in transient hypoparathyroidism and 5% progressed to a chronic state. In conclusion, the two claims-based methods yielded similar estimates of the number of insured patients with chronic hypoparathyroidism in the United States (~58,700). The physician survey was consistent with those calculations and confirmed the burden imposed by

  20. Should we search Chinese biomedical databases when performing systematic reviews?

    Science.gov (United States)

    Cohen, Jérémie F; Korevaar, Daniël A; Wang, Junfeng; Spijker, René; Bossuyt, Patrick M

    2015-03-06

    Chinese biomedical databases contain a large number of publications available to systematic reviewers, but it is unclear whether they are used for synthesizing the available evidence. We report a case of two systematic reviews on the accuracy of anti-cyclic citrullinated peptide for diagnosing rheumatoid arthritis. In one of these, the authors did not search Chinese databases; in the other, they did. We additionally assessed the extent to which Cochrane reviewers have searched Chinese databases in a systematic overview of the Cochrane Library (inception to 2014). The two diagnostic reviews included a total of 269 unique studies, but only 4 studies were included in both reviews. The first review included five studies published in the Chinese language (out of 151) while the second included 114 (out of 118). The summary accuracy estimates from the two reviews were comparable. Only 243 of the published 8,680 Cochrane reviews (less than 3%) searched one or more of the five major Chinese databases. These Chinese databases index about 2,500 journals, of which less than 6% are also indexed in MEDLINE. All 243 Cochrane reviews evaluated an intervention, 179 (74%) had at least one author with a Chinese affiliation; 118 (49%) addressed a topic in complementary or alternative medicine. Although searching Chinese databases may lead to the identification of a large amount of additional clinical evidence, Cochrane reviewers have rarely included them in their search strategy. We encourage future initiatives to evaluate more systematically the relevance of searching Chinese databases, as well as collaborative efforts to allow better incorporation of Chinese resources in systematic reviews.

  1. A national database of incidence and treatment outcomes of status epilepticus in Thailand.

    Science.gov (United States)

    Tiamkao, Somsak; Pranbul, Sineenard; Sawanyawisuth, Kittisak; Thepsuthammarat, Kaewjai

    2014-06-01

    Status epilepticus (SE) is a serious neurological condition. The national database of SE in Thailand and other developing countries is limited in terms of incidence and treatment outcomes. This study was conducted on the prevalence of status epilepticus (SE). The study group comprised of adult inpatients (over 18 years old) with SE throughout Thailand. SE patients were diagnosed and searched based on ICD 10 (G41) from the national database. The database used was from reimbursement documents submitted by the hospitals under the three health insurance systems, namely, the universal health coverage insurance, social security, and government health welfare system during the fiscal year 2010. We found 2190 SE patients receiving treatment at hospitals (5.10/100 000 population). The average age was 50.5 years and 1413 patients were males (64.5%). Mortality rate was 0.6 death/100 000 population or 11.96% of total patients. Significant factors associated with death or a nonimproved status at discharge were type of insurance, hospital level, chronic kidney disease, having pneumonia, having shock, on mechanical ventilator, and having cardiopulmonary resuscitation. In conclusion, the incidence of SE in Thailand was 5.10/100 000 population with mortality rate of 0.6/100 000 population.

  2. Incidence of chronic kidney disease among people with diabetes: a systematic review of observational studies.

    Science.gov (United States)

    Koye, D N; Shaw, J E; Reid, C M; Atkins, R C; Reutens, A T; Magliano, D J

    2017-07-01

    The aim was to systematically review published articles that reported the incidence of chronic kidney disease among people with diabetes. A systematic literature search was performed using MEDLINE, Embase and CINAHL databases. The titles and abstracts of all publications identified by the search were reviewed and 10 047 studies were retrieved. A total of 71 studies from 30 different countries with sample sizes ranging from 505 to 211 132 met the inclusion criteria. The annual incidence of microalbuminuria and albuminuria ranged from 1.3% to 3.8% for Type 1 diabetes. For Type 2 diabetes and studies combining both diabetes types, the range was from 3.8% to 12.7%, with four of six studies reporting annual rates between 7.4% and 8.6%. In studies reporting the incidence of eGFR Disease (MDRD) equation, apart from one study which reported an annual incidence of 8.9%, the annual incidence ranged from 1.9% to 4.3%. The annual incidence of end-stage renal disease ranged from 0.04% to 1.8%. The annual incidence of microalbuminuria and albuminuria is ~ 2-3% in Type 1 diabetes, and ~ 8% in Type 2 diabetes or mixed diabetes type. The incidence of developing eGFR kidney disease, there was only modest variation in incidence rates. These findings may be useful in clinical settings to help understand the risk of developing kidney disease among those with diabetes. © 2017 Diabetes UK.

  3. Should we search Chinese biomedical databases when performing systematic reviews?

    NARCIS (Netherlands)

    Cohen, Jérémie F.; Korevaar, Daniël A.; Wang, Junfeng; Spijker, René; Bossuyt, Patrick M.

    2015-01-01

    Chinese biomedical databases contain a large number of publications available to systematic reviewers, but it is unclear whether they are used for synthesizing the available evidence. We report a case of two systematic reviews on the accuracy of anti-cyclic citrullinated peptide for diagnosing

  4. Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry.

    Science.gov (United States)

    Coward, Stephanie; Kareemi, Hashim; Clement, Fiona; Zimmer, Scott; Dixon, Elijah; Ball, Chad G; Heitman, Steven J; Swain, Mark; Ghosh, Subrata; Kaplan, Gilaad G

    2016-01-01

    At the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings. We compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis. We conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008. Two population-based data sources were used to identify cases of appendicitis: 1) a pathology registry (n = 8,822); and 2) a hospital discharge abstract database (n = 10,453). The administrative database was compared to the pathology registry for the following a priori analyses: 1) to calculate the positive predictive value (PPV) of administrative codes; 2) to compare the annual incidence of appendicitis; and 3) to assess differences in temporal trends. Temporal trends were assessed using a generalized linear model that assumed a Poisson distribution and reported as an annual percent change (APC) with 95% confidence intervals (CI). Analyses were stratified by perforated and non-perforated appendicitis. The administrative database (PPV = 83.0%) overestimated the incidence of appendicitis (100.3 per 100,000) when compared to the pathology registry (84.2 per 100,000). Codes for perforated appendicitis were not reliable (PPV = 52.4%) leading to overestimation in the incidence of perforated appendicitis in the administrative database (34.8 per 100,000) as compared to the pathology registry (19.4 per 100,000). The incidence of appendicitis significantly increased over time in both the administrative database (APC = 2.1%; 95% CI: 1.3, 2.8) and pathology registry (APC = 4.1; 95% CI: 3.1, 5.0). The administrative database overestimated the incidence of appendicitis, particularly among perforated appendicitis. Therefore, studies utilizing administrative data to analyze

  5. Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry.

    Directory of Open Access Journals (Sweden)

    Stephanie Coward

    Full Text Available At the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings.We compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis.We conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008.Two population-based data sources were used to identify cases of appendicitis: 1 a pathology registry (n = 8,822; and 2 a hospital discharge abstract database (n = 10,453.The administrative database was compared to the pathology registry for the following a priori analyses: 1 to calculate the positive predictive value (PPV of administrative codes; 2 to compare the annual incidence of appendicitis; and 3 to assess differences in temporal trends. Temporal trends were assessed using a generalized linear model that assumed a Poisson distribution and reported as an annual percent change (APC with 95% confidence intervals (CI. Analyses were stratified by perforated and non-perforated appendicitis.The administrative database (PPV = 83.0% overestimated the incidence of appendicitis (100.3 per 100,000 when compared to the pathology registry (84.2 per 100,000. Codes for perforated appendicitis were not reliable (PPV = 52.4% leading to overestimation in the incidence of perforated appendicitis in the administrative database (34.8 per 100,000 as compared to the pathology registry (19.4 per 100,000. The incidence of appendicitis significantly increased over time in both the administrative database (APC = 2.1%; 95% CI: 1.3, 2.8 and pathology registry (APC = 4.1; 95% CI: 3.1, 5.0.The administrative database overestimated the incidence of appendicitis, particularly among perforated appendicitis. Therefore, studies utilizing administrative data to analyze perforated

  6. Comprehensive metabolomic profiling and incident cardiovascular disease: a systematic review

    Science.gov (United States)

    Background: Metabolomics is a promising tool of cardiovascular biomarker discovery. We systematically reviewed the literature on comprehensive metabolomic profiling in association with incident cardiovascular disease (CVD). Methods and Results: We searched MEDLINE and EMBASE from inception to Janua...

  7. Incidence of Sinusitis Associated With Endotracheal and Nasogastric Tubes: NIS Database.

    Science.gov (United States)

    Metheny, Norma A; Hinyard, Leslie J; Mohammed, Kahee A

    2018-01-01

    Endotracheal and nasogastric tubes are recognized risk factors for nosocomial sinusitis. The extent to which these tubes affect the overall incidence of nosocomial sinusitis in acute care hospitals is unknown. To use data for 2008 through 2013 from the Nationwide Inpatient Sample database to compare the incidence of sinusitis in patients with nasogastric tubes with that in patients with an endotracheal tube alone or with both an endotracheal tube and a nasogastric tube. Patients' data with any of the following International Classification of Disease, Ninth Revision, Clinical Modification codes were abstracted from the database: (1) 96.6, enteral infusion of concentrated nutritional substances; (2) 96.07, insertion of other (naso-)gastric tube; or (3) 96.04, insertion of an endotracheal tube. Sinusitis was defined by the appropriate codes. Weighted and unweighted frequencies and weighted percentages were calculated, categorical comparisons were made by χ 2 test, and logistic regression was used to examine odds of sinusitis development by tube type. Of 1 141 632 included cases, most (68.57%) had an endotracheal tube only, 23.02% had a nasogastric tube only, and 8.41% had both types of tubes. Sinusitis was present in 0.15% of the sample. Compared with patients with only a nasogastric tube, the risk for sinusitis was 41% greater in patients with an endotracheal tube and 200% greater in patients with both tubes. Despite the low incidence of sinusitis, a significant association exists between sinusitis and the presence of an endotracheal tube, especially when a nasogastric tube is also present. ©2018 American Association of Critical-Care Nurses.

  8. Nuclear Energy Infrastructure Database Fitness and Suitability Review

    Energy Technology Data Exchange (ETDEWEB)

    Heidrich, Brenden [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-03-01

    In 2014, the Deputy Assistant Secretary for Science and Technology Innovation (NE-4) initiated the Nuclear Energy-Infrastructure Management Project by tasking the Nuclear Science User Facilities (NSUF) to create a searchable and interactive database of all pertinent NE supported or related infrastructure. This database will be used for analyses to establish needs, redundancies, efficiencies, distributions, etc. in order to best understand the utility of NE’s infrastructure and inform the content of the infrastructure calls. The NSUF developed the database by utilizing data and policy direction from a wide variety of reports from the Department of Energy, the National Research Council, the International Atomic Energy Agency and various other federal and civilian resources. The NEID contains data on 802 R&D instruments housed in 377 facilities at 84 institutions in the US and abroad. A Database Review Panel (DRP) was formed to review and provide advice on the development, implementation and utilization of the NEID. The panel is comprised of five members with expertise in nuclear energy-associated research. It was intended that they represent the major constituencies associated with nuclear energy research: academia, industry, research reactor, national laboratory, and Department of Energy program management. The Nuclear Energy Infrastructure Database Review Panel concludes that the NSUF has succeeded in creating a capability and infrastructure database that identifies and documents the major nuclear energy research and development capabilities across the DOE complex. The effort to maintain and expand the database will be ongoing. Detailed information on many facilities must be gathered from associated institutions added to complete the database. The data must be validated and kept current to capture facility and instrumentation status as well as to cover new acquisitions and retirements.

  9. Incidence of myiasis among humans-a review.

    Science.gov (United States)

    Singh, Amandeep; Singh, Zorawar

    2015-09-01

    Myiasis, the infestation of tissues of live humans and other vertebrate animals with dipteran larvae (maggots), is a phenomenon of widespread occurrence throughout the tropical regions of the world. It is commonly seen in domestic and wild animals but occurs rarely in man also. The tissue invasion in man by maggots is generally a well-recognized complication of neglected wounds. The condition may be asymptomatic but occasionally results in more or less severe problems and even death when larvae invade body cavities or areas that forbid their direct visual examination. Many cases of myiasis, however, usually do not reach the attention of medical practitioners because of the tendency of the mature larvae to migrate out of the lesion for pupation. In the present study, the authors reviewed the past literature describing the cases of human myiasis, causative fly species and predisposing factors for the onset of the same. The aim of the present manuscript is to provide a database for the future reference of medical entomologists, medical practitioners and veterinarians. Review of literature revealed that 37 fly species belonging to ten families were responsible worldwide for the onset of human myiasis. The incidence of myiasis among humans can be correlated to increasing fly populations, poor hygienic conditions and presence of domestic animals in the close vicinity. Other factors responsible for myiasis include neglected open wounds and foul-smelling discharge from natural body openings. Moreover, ignorance plays a key role in its occurrence since people are generally unaware about the actual cause and often correlate the condition to their superstitious beliefs. It is emphasized that the patients should not neglect their wounds and should take proper medical care; otherwise, myiasis may supervene.

  10. Incidence and prevention of osteoradionecrosis after dental extraction in irradiated patients: a systematic review.

    Science.gov (United States)

    Nabil, S; Samman, N

    2011-03-01

    This systematic review aims to identify and review the best available evidence to answer the clinical question 'What are the incidence and the factors influencing the development of osteoradionecrosis after tooth extraction in irradiated patients?'. A systematic review of published articles on post-irradiation extraction was performed via electronic search of the Medline, Ovid, Embase and Cochrane Library databases. Additional studies were identified by manual reference list search. Evaluation and critical appraisal were done in 3 stages by two independent reviewers and any disagreement was resolved by discussion with a third party. 19 articles were selected for the final analysis. The total incidence of osteoradionecrosis after tooth extraction in irradiated patients was 7%. When extractions were performed in conjunction with prophylactic hyperbaric oxygen, the incidence was 4% while extraction in conjunction with antibiotics gave an incidence of 6%. This systematic review found that while the incidence of osteoradionecrosis after post-irradiation tooth extractions is low, the extraction of mandibular teeth within the radiation field in patients who received a radiation dose higher than 60Gy represents the highest risk of developing osteoradionecrosis. Based on weak evidence, prophylactic hyperbaric oxygen is effective in reducing the risk of developing osteoradionecrosis after post-radiation extractions. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Clobazam and clonazepam use in epilepsy: Results from a UK database incident user cohort study.

    Science.gov (United States)

    Brodie, Martin J; Chung, Steve; Wade, Alan; Quelen, Céline; Guiraud-Diawara, Alice; François, Clément; Verpillat, Patrice; Shen, Vivienne; Isojarvi, Jouko

    2016-07-01

    To compare patient characteristics and treatment patterns among clobazam (CLB) and clonazepam (CZP)-treated patients with epilepsy in a longitudinal primary care database. In this pharmacoepidemiological study, real-life usage data from the Clinical Practice Research Database (CPRD) were evaluated. The CPRD collects data from approximately 690 primary care practices throughout the UK. Data included were from patients with ≥1 incident CLB or CZP prescription from 1995 to 2011 and were present in the database for ≥182 days prior to the index date (date patient was first prescribed CLB or CZP within the study period). Of 21,099 patients who met inclusion criteria, 18.4% were receiving CLB and 81.6% were receiving CZP. More patients used CLB for epilepsy than CZP (76.1% vs 8.7%). CLB-treated adults (≤18years) were younger than those treated with CZP (41.0 vs 48.2 years; p<0.001), while CLB-treated children (≤18 years) were older than those treated with CZP (8.8 vs 7.3 years, p<0.001). The median CLB dosage did not change from baseline to last follow-up, while median CZP dosage increased 25% in adults and 50% in children. Median treatment duration, as well as retention rate up to 10 years, was similar between CLB and CZP in each age group. Among adult and pediatric patients in the UK, CLB is more often prescribed for epilepsy than CZP. The median CLB dosage used by both adults and children remained stable over the 16-year study period, while the median CZP dosage increased in both adults and children. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Incidence of kidney stones in kidney transplant recipients: A systematic review and meta-analysis

    Science.gov (United States)

    Cheungpasitporn, Wisit; Thongprayoon, Charat; Mao, Michael A; Kittanamongkolchai, Wonngarm; Jaffer Sathick, Insara J; Dhondup, Tsering; Erickson, Stephen B

    2016-01-01

    AIM To evaluate the incidence and characteristics of kidney stones in kidney transplant recipients. METHODS A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the inception of the databases through March 2016. Studies assessing the incidence of kidney stones in kidney transplant recipients were included. We applied a random-effects model to estimate the incidence of kidney stones. RESULTS Twenty one studies with 64416 kidney transplant patients were included in the analyses to assess the incidence of kidney stones after kidney transplantation. The estimated incidence of kidney stones was 1.0% (95%CI: 0.6%-1.4%). The mean duration to diagnosis of kidney stones after kidney transplantation was 28 ± 22 mo. The mean age of patients with kidney stones was 42 ± 7 years. Within reported studies, approximately 50% of kidney transplant recipients with kidney stones were males. 67% of kidney stones were calcium-based stones (30% mixed CaOx/CaP, 27%CaOx and 10%CaP), followed by struvite stones (20%) and uric acid stones (13%). CONCLUSION The estimated incidence of kidney stones in patients after kidney transplantation is 1.0%. Although calcium based stones are the most common kidney stones after transplantation, struvite stones (also known as “infection stones”) are not uncommon in kidney transplant recipients. These findings may impact the prevention and clinical management of kidney stones after kidney transplantation. PMID:28058231

  13. 2014 Fort Hood, Texas, mass casualty incident: reviews and perspectives

    OpenAIRE

    Strommen, Joshua J.; Waterman, Scott M.; Mitchell, Christopher A.; Grogan, Brian F.

    2015-01-01

    On April 2, 2014, in Fort Hood, Texas, an active shooter incident occurred where four active duty soldiers were tragically killed. Active shooter incidents are becoming alarmingly more frequent over the last decade in the USA. The authors provide a detailed account of the events that occurred within the hospital and an evaluation of the triage decisions made on that day. A detailed review of mass casualty preparedness and the general approach to triage processes are also described.

  14. Incidence of epilepsy: a systematic review and meta-analysis.

    Science.gov (United States)

    Ngugi, Anthony K; Kariuki, S M; Bottomley, C; Kleinschmidt, I; Sander, J W; Newton, C R

    2011-09-06

    To estimate the pooled incidence of epilepsy from published studies and investigate sources of heterogeneity in the estimates. We searched online databases for incidence studies and used meta-analytic methods to analyze the data. Thirty-three articles met the entry criteria. The median incidence of epilepsy was 50.4/100,000/year (interquartile range [IQR] 33.6-75.6), while it was 45.0 (IQR 30.3-66.7) for high-income countries and 81.7 (IQR 28.0-239.5) for low- and middle-income countries. Population-based studies had higher incidence estimates than hospital-based studies (p = 0.02) while retrospective study design was associated with lower estimates than prospective studies (p = 0.04). We provide data that could potentially be used to assess the burden and analyze the trends in incidence of epilepsy. Our results support the need for large population-based incidence studies of epilepsy.

  15. Risk factors for first time incidence sciatica: a systematic review.

    Science.gov (United States)

    Cook, Chad E; Taylor, Jeffrey; Wright, Alexis; Milosavljevic, Steven; Goode, Adam; Whitford, Maureen

    2014-06-01

    Characteristically, sciatica involves radiating leg pain that follows a dermatomal pattern along the distribution of the sciatic nerve. To our knowledge, there are no studies that have investigated risk factors associated with first time incidence sciatica. The purpose of the systematic review was to identify the longitudinal risk factors associated with first time incidence sciatica and to report incidence rates for the condition. For the purposes of this review, first time incidence sciatica was defined as either of the following: 1) no prior history of sciatica or 2) transition from a pain-free state to sciatica. Studies included subjects of any age from longitudinal, observational, cohort designs. The study was a systematic review. Eight of the 239 articles identified by electronic search strategies met the inclusion criteria. Risk factors and their respective effect estimates were reported using descriptive analysis and the preferred reporting items for systematic reviews and meta-analyses guidelines. Modifiable risk factors included smoking, obesity, occupational factors and health status. Non-modifiable factors included age, gender and social class. Incidence rates varied among the included studies, in part reflecting the variability in the operationalized definition of sciatica but ranged from sciatica are modifiable, suggesting the potential benefits of primary prevention. In addition, those risk factors are also associated with unhealthy lifestyles, which may function concomitantly toward the development of sciatica. Sciatica as a diagnosis is inconsistently defined among studies. © 2013 John Wiley & Sons, Ltd.

  16. Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry

    Science.gov (United States)

    Clement, Fiona; Zimmer, Scott; Dixon, Elijah; Ball, Chad G.; Heitman, Steven J.; Swain, Mark; Ghosh, Subrata

    2016-01-01

    Importance At the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings. Objectives We compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis. Design We conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008. Setting & Participants Two population-based data sources were used to identify cases of appendicitis: 1) a pathology registry (n = 8,822); and 2) a hospital discharge abstract database (n = 10,453). Intervention & Main Outcome The administrative database was compared to the pathology registry for the following a priori analyses: 1) to calculate the positive predictive value (PPV) of administrative codes; 2) to compare the annual incidence of appendicitis; and 3) to assess differences in temporal trends. Temporal trends were assessed using a generalized linear model that assumed a Poisson distribution and reported as an annual percent change (APC) with 95% confidence intervals (CI). Analyses were stratified by perforated and non-perforated appendicitis. Results The administrative database (PPV = 83.0%) overestimated the incidence of appendicitis (100.3 per 100,000) when compared to the pathology registry (84.2 per 100,000). Codes for perforated appendicitis were not reliable (PPV = 52.4%) leading to overestimation in the incidence of perforated appendicitis in the administrative database (34.8 per 100,000) as compared to the pathology registry (19.4 per 100,000). The incidence of appendicitis significantly increased over time in both the administrative database (APC = 2.1%; 95% CI: 1.3, 2.8) and pathology registry (APC = 4.1; 95% CI: 3.1, 5.0). Conclusion & Relevance The administrative database overestimated the incidence of appendicitis

  17. Databases

    Digital Repository Service at National Institute of Oceanography (India)

    Kunte, P.D.

    Information on bibliographic as well as numeric/textual databases relevant to coastal geomorphology has been included in a tabular form. Databases cover a broad spectrum of related subjects like coastal environment and population aspects, coastline...

  18. Incidence of type 2 diabetes in Japan: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Atsushi Goto

    Full Text Available The definition of incident type 2 diabetes varies across studies; hence, the actual incidence of type 2 diabetes in Japan is unclear. Here, we reviewed the various definitions of incident type 2 diabetes used in previous epidemiologic studies and estimated the diabetes incidence rate in Japan.We searched for related literature in the MEDLINE, EMBASE, and Ichushi databases through September 2012. Two reviewers selected studies that evaluated incident type 2 diabetes in the Japanese population.From 1824 relevant articles, we included 33 studies with 386,803 participants. The follow-up period ranged from 2.3 to 14 years and the studies were initiated between 1980 and 2003. The random-effects model indicated that the pooled incidence rate of diabetes was 8.8 (95% confidence interval, 7.4-10.4 per 1000 person-years. We observed a high degree of heterogeneity in the results (I(2 = 99.2%; p < 0.001, with incidence rates ranging from 2.3 to 52.6 per 1000 person-years. Three studies based their definition of incident type 2 diabetes on self-reports only, 10 on laboratory data only, and 20 on self-reports and laboratory data. Compared with studies defining diabetes using laboratory data (n = 30; pooled incidence rate = 9.6; 95% confidence interval = 8.3-11.1, studies based on self-reports alone tended to show a lower incidence rate (n = 3; pooled incidence rate = 4.0; 95% confidence interval = 3.2-5.0; p for interaction < 0.001. However, stratified analyses could not entirely explain the heterogeneity in the results.Our systematic review and meta-analysis indicated the presence of a high degree of heterogeneity, which suggests that there is a considerable amount of uncertainty regarding the incidence of type 2 diabetes in Japan. They also suggested that laboratory data may be important for the accurate estimation of the incidence of type 2 diabetes.

  19. Review on hazardous and noxious substances (HNS) involved in marine spill incidents—an online database.

    Science.gov (United States)

    Cunha, Isabel; Moreira, Susana; Santos, Miguel M

    2015-03-21

    In this review, we have collected information on the behavior, fate, weathering, and impact of hazardous and noxious substances (HNS) accidentally spilled at sea on the marine biota. The information was compiled on a datasheet and converted into a database that can be accessed by the general public (www.ciimar.up.pt/hns). Systematization of data is important to assist stakeholders involved in HNS spill preparedness and response, facilitating the incorporation of lessons from past incidents in the decision process. The database contains 184 entries of HNS spilled in 119 incidents in marine waters around the world. Data were analyzed in terms of HNS physical behavior in water according to SEBC (Standard European Behavior Classification) codes. The most common products involved in accidental spills in the marine environment were identified and major lessons highlighted. From the analysis, it was determined that most HNS spills were poorly documented and information was mistreated. In most cases, no monitoring programs were implemented following the incident. This conduct has occurred in 24 out of 119 incidents analyzed and has consequently limited the information on fate, behavior, and weathering of HNS spilled that could have been recovered. Major gaps were identified, and priorities and recommendations were drawn as a step toward improving preparedness and response to HNS spills. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Review of the prevalence and incidence of eating disorders

    NARCIS (Netherlands)

    Hoek, HW; van Hoeken, D

    2003-01-01

    Objective: To review the literature on the incidence and prevalence of eating disorders. Methods: We searched Medline using several key terms relating to epidemiology and eating disorders and we checked the reference lists of the articles that we found. Special attention has been paid to

  1. Incidence of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Nationwide Population-Based Study Using National Health Insurance Database in Korea.

    Science.gov (United States)

    Yang, Min-Suk; Lee, Jin Yong; Kim, Jayeun; Kim, Gun-Woo; Kim, Byung-Keun; Kim, Ju-Young; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

    2016-01-01

    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases; however, it is hard to estimate their incidence due to the rarity of these diseases. We evaluated the incidence of SJS and TEN using a nationwide administrative database. We used a national medical insurance review system (Health Insurance Review and Assessment) database which contained the claim data of the entire nation from 2009 to 2013 to estimate the accurate incidence of SJS and TEN in Korea. The diagnostic codes of L511 (SJS) or L512 (TEN) from the International Classification of Diseases-10th revision were used to define the target study population. We also retrospectively followed up a 2011 SJS and TEN cohort for 24 months in order to assess the in-hospital mortality, related complications and total claims cost due to SJS and TEN. A total of 1,167 (938 SJS and 229 TEN) cases were newly diagnosed from 2010 to 2013. The age- and sex-standardized annual incidences estimated in this study were 3.96 to 5.03 in SJS and 0.94 to 1.45 in TEN per million. There was no significant change in annual incidence throughout the study periods. When analyzed by 10-year age groups, the annual incidence was the lowest in group 20-29 years and the highest in group 70 for both SJS and TEN. Based on the 2011 cohort analysis, the in-hospital mortality were 5.7 and 15.1% for SJS and TEN, respectively. The mortality increased with age, particularly, after 40 years of age. Among the complications related with SJS or TEN, ocular sequelae was the most common (43.1 and 43.4% of SJS and TEN patients, respectively) followed by urethral sequelae (5.7 and 9.4% of SJS and TEN patients, respectively). Overall, our data suggest that SJS, and TEN are infrequent but constantly arise throughout the years.

  2. Quality review of an adverse incident reporting system and root cause analysis of serious adverse surgical incidents in a teaching hospital of Scotland

    Directory of Open Access Journals (Sweden)

    Khorsandi Maziar

    2012-08-01

    Full Text Available Abstract Background A significant proportion of surgical patients are unintentionally harmed during their hospital stay. Root Cause Analysis (RCA aims to determine the aetiology of adverse incidents that lead to patient harm and produce a series of recommendations, which would minimise the risk of recurrence of similar events, if appropriately applied to clinical practice. A review of the quality of the adverse incident reporting system and the RCA of serious adverse incidents at the Department of Surgery of Ninewells hospital, in Dundee, United Kingdom was performed. Methods The Adverse Incident Management (AIM database of the Department of Surgery of Ninewells Hospital was retrospectively reviewed. Details of all serious (red, sentinel incidents recorded between May 2004 and December 2009, including the RCA reports and outcomes, where applicable, were reviewed. Additional related information was gathered by interviewing the involved members of staff. Results The total number of reported surgical incidents was 3142, of which 81 (2.58% cases had been reported as red or sentinel. 19 of the 81 incidents (23.4% had been inappropriately reported as red. In 31 reports (38.2% vital information with regards to the details of the adverse incidents had not been recorded. In 12 cases (14.8% the description of incidents was of poor quality. RCA was performed for 47 cases (58% and only 12 cases (15% received recommendations aiming to improve clinical practice. Conclusion The results of our study demonstrate the need for improvement in the quality of incident reporting. There are enormous benefits to be gained by this time and resource consuming process, however appropriate staff training on the use of this system is a pre-requisite. Furthermore, sufficient support and resources are required for the implementation of RCA recommendations in clinical practice.

  3. Antidepressant Use and Incident Urinary Incontinence: A Literature Review.

    Science.gov (United States)

    Dane, Kathryn E; Gatewood, Sharon B S; Peron, Emily P

    2016-03-01

    To review available data examining antidepressant use and incident urinary incontinence (UI). PubMed was used to conduct the literature search for this review. In the primary search, the term "antidepressive agents" was searched as a medical subject heading, a pharmacological action, and a keyword phrase. This choice was made so that any relevant articles would include complete results for antidepressive agents. "Antidepressive agents" was combined with the key phrase "drug-induced urinary incontinence" to complete this primary search. Relevant articles published in English and examining human subjects were included. The study authors determined appropriateness of articles for inclusion, focusing on those examining antidepressant-associated UI. This literature review identified three cohort studies and 11 case reports examining various associations between antidepressant use and incident UI. All 11 case reports and 1 cohort study reviewed suggest an association between antidepressant use and incident UI. It remains unclear which drugs are most problematic and which patients are at greatest risk, and more data are needed to confirm an association, especially in older adults. Comprehensive medication reviews should be employed by pharmacists to identify potential medication-related causes of UI.

  4. Databases

    Directory of Open Access Journals (Sweden)

    Nick Ryan

    2004-01-01

    Full Text Available Databases are deeply embedded in archaeology, underpinning and supporting many aspects of the subject. However, as well as providing a means for storing, retrieving and modifying data, databases themselves must be a result of a detailed analysis and design process. This article looks at this process, and shows how the characteristics of data models affect the process of database design and implementation. The impact of the Internet on the development of databases is examined, and the article concludes with a discussion of a range of issues associated with the recording and management of archaeological data.

  5. A Review of Stellar Abundance Databases and the Hypatia Catalog Database

    Science.gov (United States)

    Hinkel, Natalie Rose

    2018-01-01

    The astronomical community is interested in elements from lithium to thorium, from solar twins to peculiarities of stellar evolution, because they give insight into different regimes of star formation and evolution. However, while some trends between elements and other stellar or planetary properties are well known, many other trends are not as obvious and are a point of conflict. For example, stars that host giant planets are found to be consistently enriched in iron, but the same cannot be definitively said for any other element. Therefore, it is time to take advantage of large stellar abundance databases in order to better understand not only the large-scale patterns, but also the more subtle, small-scale trends within the data.In this overview to the special session, I will present a review of large stellar abundance databases that are both currently available (i.e. RAVE, APOGEE) and those that will soon be online (i.e. Gaia-ESO, GALAH). Additionally, I will discuss the Hypatia Catalog Database (www.hypatiacatalog.com) -- which includes abundances from individual literature sources that observed stars within 150pc. The Hypatia Catalog currently contains 72 elements as measured within ~6000 stars, with a total of ~240,000 unique abundance determinations. The online database offers a variety of solar normalizations, stellar properties, and planetary properties (where applicable) that can all be viewed through multiple interactive plotting interfaces as well as in a tabular format. By analyzing stellar abundances for large populations of stars and from a variety of different perspectives, a wealth of information can be revealed on both large and small scales.

  6. Amniotic fluid embolism incidence, risk factors and outcomes: a review and recommendations

    Directory of Open Access Journals (Sweden)

    Knight Marian

    2012-02-01

    Full Text Available Abstract Background Amniotic fluid embolism (AFE is a rare but severe complication of pregnancy. A recent systematic review highlighted apparent differences in the incidence, with studies estimating the incidence of AFE to be more than three times higher in North America than Europe. The aim of this study was to examine population-based regional or national data from five high-resource countries in order to investigate incidence, risk factors and outcomes of AFE and to investigate whether any variation identified could be ascribed to methodological differences between the studies. Methods We reviewed available data sources on the incidence of AFE in Australia, Canada, the Netherlands, the United Kingdom and the USA. Where information was available, the risk factors and outcomes of AFE were examined. Results The reported incidence of AFE ranged from 1.9 cases per 100 000 maternities (UK to 6.1 per 100 000 maternities (Australia. There was a clear distinction between rates estimated using different methodologies. The lowest estimated incidence rates were obtained through validated case identification (range 1.9-2.5 cases per 100 000 maternities; rates obtained from retrospective analysis of population discharge databases were significantly higher (range 5.5-6.1 per 100 000 admissions with delivery diagnosis. Older maternal age and induction of labour were consistently associated with AFE. Conclusions Recommendation 1: Comparisons of AFE incidence estimates should be restricted to studies using similar methodology. The recommended approaches would be either population-based database studies using additional criteria to exclude false positive cases, or tailored data collection using existing specific population-based systems. Recommendation 2: Comparisons of AFE incidence between and within countries would be facilitated by development of an agreed case definition and an agreed set of criteria to minimise inclusion of false positive cases for

  7. The incidence of eating disorders in the UK in 2000-2009: findings from the General Practice Research Database.

    Science.gov (United States)

    Micali, Nadia; Hagberg, Katrina W; Petersen, Irene; Treasure, Janet L

    2013-05-28

    Few studies have investigated the incidence of eating disorders (EDs). Important questions about changes in the incidence of diagnosed disorders in recent years, disorder and gender-specific onset and case detection remain unanswered. Understanding changes in incidence is important for public health, clinical practice and service provision. The aim of this study was to estimate the annual (age-specific, gender-specific and subtype-specific) incidence of diagnosed ED: anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in primary care over a 10-year period in the UK (2000-2009); to examine the changes within the study period; and to describe peak age at diagnosis. Register-based study. Primary care. Data were obtained from a primary care register, the General Practice Research Database, which contains anonymised records representing about 5% of the UK population. All patients with a first-time diagnosis of AN, BN and EDNOS were identified. Annual crude and age-standardised incidence rates were calculated. A total of 9072 patients with a first-time diagnosis of an ED were identified. The age-standardised annual incidence rate of all diagnosed ED for ages 10-49 increased from 32.3 (95% CI 31.7 to 32.9) to 37.2 (95% CI 36.6 to 37.9) per 100 000 between 2000 and 2009. The incidence of AN and BN was stable; however, the incidence of EDNOS increased. The incidence of the diagnosed ED was highest for girls aged 15-19 and for boys aged 10-14. The age-standardised incidence of ED increased in primary care between 2000 and 2009. New diagnoses of EDNOS increased, and EDNOS is the most common ED in primary care.

  8. The incidence of eating disorders in the UK in 2000–2009: findings from the General Practice Research Database

    Science.gov (United States)

    Micali, Nadia; Hagberg, Katrina W; Petersen, Irene; Treasure, Janet L

    2013-01-01

    Objectives Few studies have investigated the incidence of eating disorders (EDs). Important questions about changes in the incidence of diagnosed disorders in recent years, disorder and gender-specific onset and case detection remain unanswered. Understanding changes in incidence is important for public health, clinical practice and service provision. The aim of this study was to estimate the annual (age-specific, gender-specific and subtype-specific) incidence of diagnosed ED: anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in primary care over a 10-year period in the UK (2000–2009); to examine the changes within the study period; and to describe peak age at diagnosis. Design Register-based study. Setting Primary care. Data were obtained from a primary care register, the General Practice Research Database, which contains anonymised records representing about 5% of the UK population. Participants All patients with a first-time diagnosis of AN, BN and EDNOS were identified. Primary outcome Annual crude and age-standardised incidence rates were calculated. Results A total of 9072 patients with a first-time diagnosis of an ED were identified. The age-standardised annual incidence rate of all diagnosed ED for ages 10–49 increased from 32.3 (95% CI 31.7 to 32.9) to 37.2 (95% CI 36.6 to 37.9) per 100 000 between 2000 and 2009. The incidence of AN and BN was stable; however, the incidence of EDNOS increased. The incidence of the diagnosed ED was highest for girls aged 15–19 and for boys aged 10–14. Conclusions The age-standardised incidence of ED increased in primary care between 2000 and 2009. New diagnoses of EDNOS increased, and EDNOS is the most common ED in primary care. PMID:23793681

  9. Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database.

    Science.gov (United States)

    Cooper, Jennifer; Edwards, Adrian; Williams, Huw; Sheikh, Aziz; Parry, Gareth; Hibbert, Peter; Butlin, Amy; Donaldson, Liam; Carson-Stevens, Andrew

    2017-09-01

    A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%-47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others' behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture. © 2017 Annals of Family Medicine, Inc.

  10. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature.

    Science.gov (United States)

    Kilic, O; Maas, M; Verhagen, E; Zwerver, J; Gouttebarge, V

    2017-07-01

    Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies.

  11. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review.

    Science.gov (United States)

    Pereira, D; Peleteiro, B; Araújo, J; Branco, J; Santos, R A; Ramos, E

    2011-11-01

    To understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints. A systematic review was carried out in PUBMED and SCOPUS databases comprising the date of publication period from January 1995 to February 2011. We attempted to summarise data on the incidence and prevalence of OA according to different methods of assessment: self-reported, radiographic and symptomatic OA (clinical plus radiographic). Prevalence estimates were combined through meta-analysis and between-study heterogeneity was quantified. Seventy-two papers were reviewed (nine on incidence and 63 on prevalence). Higher OA prevalences are seen when radiographic OA definition was used for all age groups. Prevalence meta-analysis showed high heterogeneity between studies even in each specific joint and using the same OA definition. Although the knee is the most studied joint, the highest OA prevalence estimates were found in hand joints. OA of the knee tends to be more prevalent in women than in men independently of the OA definition used, but no gender differences were found in hip and hand OA. Insufficient data for incidence studies didn't allow us to make any comparison according to joint site or OA definition. Radiographic case definition of OA presented the highest prevalences. Within each joint site, self-reported and symptomatic OA definitions appear to present similar estimates. The high heterogeneity found in the studies limited further conclusions. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  12. Contributory factors to patient safety incidents in primary care: protocol for a systematic review.

    Science.gov (United States)

    Giles, Sally; Panagioti, Maria; Hernan, Andrea; Cheraghi-Sohi, Sudeh; Lawton, Rebecca

    2015-05-07

    Organisations need to systematically identify contributory factors (or causes) which impact on patient safety in order to effectively learn from error. Investigations of error have tended to focus on taking a reactive approach to learning from error, mainly relying on incident-reporting systems. Existing frameworks which aim to identify latent causes of error rely almost exclusively on evidence from non-healthcare settings. In view of this, the Yorkshire Contributory Factors Framework (YCFF) was developed in the hospital setting. Eighty-five percent of healthcare contacts occur in primary care. As a result, this review will build on the work that produced the YCFF, by examining the empirical evidence that relates to the contributory factors of error within a primary care setting. Four electronic bibliographic databases will be searched: MEDLINE, Embase, PsycInfo and CINAHL. The database search will be supplemented by additional search methodologies including citation searching and snowballing strategies which include reviewing reference lists and reviewing relevant journal table of contents, that is, BMJ Quality and Safety. Our search strategy will include search combinations of three key blocks of terms. Studies will not be excluded based on design. Included studies will be empirical studies conducted in a primary care setting. They will include some description of the factors that contribute to patient safety. One reviewer (SG) will screen all the titles and abstracts, whilst a second reviewer will screen 50% of the abstracts. Two reviewers (SG and AH) will perform study selection, quality assessment and data extraction using standard forms. Disagreements will be resolved through discussion or third party adjudication. Data to be collected include study characteristics (year, objective, research method, setting, country), participant characteristics (number, age, gender, diagnoses), patient safety incident type and characteristics, practice characteristics and

  13. Increased colorectal cancer incidence in Iran: a systematic review and meta-analysis.

    Science.gov (United States)

    Dolatkhah, Roya; Somi, Mohammad Hossein; Kermani, Iraj Asvadi; Ghojazadeh, Morteza; Jafarabadi, Mohamad Asghari; Farassati, Faris; Dastgiri, Saeed

    2015-10-01

    Colorectal cancer is the third most common cancer in Iran. The increasing trend of colorectal cancer incidence in Iran and the close relationship with the geographical location are the underlying reasons for this study. Eleven databases, including MEDLINE, EMBASE, SCOPUS, and four other databases, for articles in Persian were searched from April 2014 to October 2014. Additional data were obtained from an online survey of the Central Library of Tabriz Faculty of Medicine. In this systematic review and meta-analysis, we included studies reporting different measures of incidence, age-standardized incidence rates, and crude incidence rates. All rates (per 100,000 person-years) were standardized to the world standard population. A preliminary review of the title and abstracts of these articles was used to exclude any that were clearly irrelevant. The full text review determined whether the article was relevant to our topic. All the potentially relevant manuscripts were reviewed by two other investigators (S.D., M.G.). A total of 39 studies (10 Persian and 29 English articles) from different provinces and diverse areas of Iran, were analyzed in this study using comprehensive meta-analysis software. For accuracy studies, we used estimated rates for males and females with 95 % confidence intervals. Age-standardized incidence rates were obtained based on the random effects model and were 8.16 (95 % CI: 6.64 to 9.68) and 6.17 (95 % CI: 5.01 to 7.32) for males and females, respectively. The random crude rates were 5.58 (95 % CI: 4.22 to 6.94) for males and 4.01 (95 % CI: 3.06 to 4.97) for females. Colorectal cancer incidence rates rise due to individual and environmental risk factors as well as improvement in the registry system and increase in access to health services. A more executed organized and structured system for collecting cancer data, in all cities and rural areas of the country, is an essential priority.

  14. Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care

    DEFF Research Database (Denmark)

    Thomsen, Linda Aagaard; Winterstein, Almut G; Søndergaard, Birthe

    2007-01-01

    OBJECTIVE: To estimate the incidence and describe characteristics of preventable adverse drug events (pADEs) in ambulatory care. DATA SOURCES: Studies were searched in PubMed (1966-March 2007), International Pharmaceutical Abstracts (1970-December 2006), the Cochrane database of systematic reviews...... (1993-March 2007), EMBASE (1980-February 2007), and Web of Science (1945-March 2007). Key words included medication error, adverse drug reaction, iatrogenic disease, outpatient, ambulatory care, primary health care, general practice, patient admission, hospitalization, observational study, retrospective....../pADE incidence, (2) clinical outcomes, (3) associated drug groups, and/or (4) underlying medication errors were included. Study country, year and design, sample size, follow-up time, ADE/pADE identification method, proportion of ADEs/pADEs and ADEs/pADEs requiring hospital admission, and frequency distribution...

  15. The incidence and prevalence of Huntington's disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Pringsheim, Tamara; Wiltshire, Katie; Day, Lundy; Dykeman, Jonathan; Steeves, Thomas; Jette, Nathalie

    2012-08-01

    Huntington's disease (HD) is a rare, neurodegenerative disorder characterized by chorea, behavioral manifestations, and dementia. The aim of this study was to estimate the incidence and prevalence of HD through a systematic review of the literature. Medline and Embase databases were searched using terms specific to HD as well as studies of incidence, prevalence, and epidemiology. All studies reporting the incidence and/or prevalence of HD were included. Twenty original research articles were included. Eight studies examined incidence, and 17 studies examined prevalence. Meta-analysis of data from four incidence studies revealed an incidence of 0.38 per 100,000 per year (95% confidence interval [CI]: 0.16, 0.94). Lower incidence was reported in the Asian studies (n = 2), compared to the studies performed in Europe, North America, and Australia (n = 6). The worldwide service-based prevalence of HD, based on a meta-analysis (n = 13 studies), was 2.71 per 100,000 (95% CI: 1.55-4.72). Eleven studies were conducted in Europe, North American, and Australia, with an overall prevalence of 5.70 per 100,000 (95% CI: 4.42-7.35). Three studies were conducted in Asia, with an overall prevalence of 0.40 per 100,000 (95% CI: 0.26-0.61). Metaregression revealed a significantly lower prevalence of HD in Asia, compared to European, North American, and Australian populations. HD is a devastating neurodegenerative disorder with a higher prevalence in Europe, North America, and Australia than in Asia. The difference in prevalence of this genetic disorder can be largely explained by huntingtin gene haplotypes. Copyright © 2012 Movement Disorder Society.

  16. Landslide databases review in the Geological Surveys of Europe

    Science.gov (United States)

    Herrera, Gerardo

    2017-04-01

    Landslides are one of the most widespread geohazards in Europe, producing significant social and economic damages. Rapid population growth in urban areas throughout many countries in Europe and extreme climatic scenarios can considerably increase landslide risk in the near future. However, many European countries do not include landslide risk into their legislation. Countries lack official methodological assessment guidelines and knowledge about landslide impacts. Although regional and national landslide databases exist in most countries, they are often not integrated because they are owed by different institutions. Hence, a European Landslides Directive, that provides a common legal framework for dealing with landslides, is necessary. With this long-term goal in mind, we present a review of the landslide databases from the Geological Surveys of Europe focusing on their interoperability. The same landslide classification was used for the 849,543 landslide records from the Geological Surveys, from which 36% are slides, 10 % falls, 20% flows, 11% complex slides and 24% remain either unclassified or correspond to another typology. A landslide density map was produced from the available records of the Geological Surveys of 17 countries showing the variable distribution of landslides. There are 0.2 million km2 of landslide prone areas. The comparison of this map with the European landslide susceptibility map ELSUS v1 was successful for 73% of the predictions, and permitted identification of 25% of susceptible areas where landslide records are not available from the Geological Surveys. Taking these results into account the completeness of these landslide databases was evaluated, revealing different landslide hazard management approaches between surveys and countries.

  17. Persistent postoperative pain after cardiac surgery: a systematic review with meta-analysis regarding incidence and pain intensity.

    Science.gov (United States)

    Guimarães-Pereira, Luís; Reis, Pedro; Abelha, Fernando; Azevedo, Luís Filipe; Castro-Lopes, José Manuel

    2017-10-01

    Persistent postoperative pain (PPP) has been described as a complication of cardiac surgery (CS). We aimed to study PPP after CS (PPPCS) by conducting a systematic review of the literature regarding its incidence, intensity, location, and the presence of neuropathic pain, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The review comprised 3 phases: a methodological assessment of 6 different databases identifying potential articles and screening for inclusion criteria by 2 independent reviewers; data extraction; and study quality assessment. Meta-analysis was used to estimate the pooled incidence rates using a random effects model. We have identified 442 potentially relevant studies through database searching. A total of 23 studies (involving 11,057 patients) met our inclusion criteria. Persistent postoperative pain affects 37% patients in the first 6 months after CS, and it remains present more than 2 years after CS in 17%. The reported incidence of PPP during the first 6 months after CS increased in recent years. Globally, approximately half of the patients with PPPCS reported moderate to severe pain. Chest is the main location of PPPCS followed by the leg; neuropathic pain is present in the majority of the patients. This is the first systematic review and meta-analysis to provide estimates regarding incidence and intensity of PPPCS, which elucidates its relevance. There is an urgent need for adequate treatment and follow-up in patients with PPPCS.

  18. Deaths following prehospital safety incidents: an analysis of a national database.

    Science.gov (United States)

    Yardley, Iain E; Donaldson, Liam J

    2016-10-01

    Ensuring patient safety in the prehospital environment is difficult due to the unpredictable nature of the workload and the uncontrolled situations that care is provided in. Studying previous safety incidents can help understand risks and take action to mitigate them. We present an analysis of safety incidents related to patient deaths in ambulance services in England. All incidents related to a patient death reported to the National Reporting and Learning System from an ambulance service between 1 June 2010 and 31 October 2012 were subjected to thematic analysis to identify the failings that led to the incident. Sixty-nine incidents were analysed, equating to one safety incident-related death per 168 000 calls received. Just three event categories were identified: delayed response (59%, 41/69), shortfalls in clinical care (35%, 24/69) and injury during transit (6%, 4/69). Primary failures differed for the categories: problems with dispatch caused the majority of delays in response, with equipment problems and bad weather accounting for the remainder. Failure to provide necessary care was predominantly caused by clinical misjudgements by ambulance staff and equipment issues underlay incidents that led to a patient injury. Improvements intended to address safety related mortality in the ambulance service should include ensuring adequate equipping and resourcing of ambulance services, improving coordination and decision-making during dispatch and supporting individual staff members in the difficult decisions they are faced with. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Differences in reported sepsis incidence according to study design: a literature review

    Directory of Open Access Journals (Sweden)

    Saga Elise Mariansdatter

    2016-10-01

    Full Text Available Abstract Background Sepsis and severe sepsis are common conditions in hospital settings, and are associated with high rates of morbidity and mortality, but reported incidences vary considerably. In this literature review, we describe the variation in reported population-based incidences of sepsis and severe sepsis. We also examine methodological and demographic differences between studies that may explain this variation. Methods We carried out a literature review searching three major databases and reference lists of relevant articles, to identify all original studies reporting the incidence of sepsis or severe sepsis in the general population. Two authors independently assessed all articles, and the final decision to exclude an article was reached by consensus. We extracted data according to predetermined variables, including study country, sepsis definition, and data source. We then calculated descriptive statistics for the reported incidences of sepsis and severe sepsis. The studies were classified according to the method used to identify cases of sepsis or severe sepsis: chart-based (i.e. review of patient charts or code-based (i.e. predetermined International Classification of Diseases [ICD] codes. Results Among 482 articles initially screened, we identified 23 primary publications reporting incidence of sepsis and/or severe sepsis in the general population. The reported incidences ranged from 74 to 1180 per 100,000 person-years and 3 to 1074 per 100,000 person-years for sepsis and severe sepsis, respectively. Most chart-based studies used the Bone criteria (or a modification hereof and Protein C Worldwide Evaluation in Severe Sepsis (PROWESS study criteria to identify cases of sepsis and severe sepsis. Most code-based studies used ICD-9 codes, but the number of codes used ranged from 1 to more than 1200. We found that the incidence varied according to how sepsis was identified (chart-based vs. code-based, calendar year, data source, and

  20. The Incidence of Injury in Amateur Male Rugby Union: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Yeomans, Caithriona; Kenny, Ian C; Cahalan, Roisin; Warrington, Giles D; Harrison, Andrew J; Hayes, Kevin; Lyons, Mark; Campbell, Mark J; Comyns, Thomas M

    2018-04-01

    Rugby union is a physically demanding, full-contact team sport that has gained worldwide popularity. The incidence of injury in rugby union has been widely reported in the literature. While comprehensive injury surveillance and prevention programmes have been implemented within the professional game, there is a need for similar strategies in the amateur game. Despite recent increases in the volume of research in rugby, there is little consensus regarding the true incidence rate of match and training injuries in senior amateur male rugby union players. The aim of the current review was to systematically review the available evidence on the epidemiology of time-loss injuries in senior amateur male rugby union players and to subsequently conduct a meta-analysis of the findings. A comprehensive search of the PubMed, Scopus, SportDiscus and Google Scholar electronic databases was performed using the following keywords; ('rugby' OR 'rugby union') AND ('amateur' OR 'community') AND ('injur*' OR 'pain*'). Six articles regarding the incidence of injury in senior amateur male rugby union players, in both matches and training, were retrieved and included in the meta-analysis to determine the overall incidence rate of match injury, with descriptive analyses also provided for other reported variables. The overall incidence rate of match injuries within senior amateur rugby union players was 46.8/1000 player hours [95% confidence interval (CI) 34.4-59.2]. Contact events accounted for the majority of injuries, with the tackler more at risk than the player being tackled, and with respective incidence rates of 15.9/1000 player hours (95% CI 12.4-19.5) and 12.2/1000 player hours (95% CI 9.3-15.1). This meta-analysis found that the incidence rate of injury in amateur rugby union players was lower than that in professional players, but higher than the incidences reported in adolescent and youth rugby players. By understanding the true incidence and nature of injuries in rugby, injury

  1. Correlation between weather and incidence of selected ophthalmological diagnoses: a database analysis

    Science.gov (United States)

    Kern, Christoph; Kortüm, Karsten; Müller, Michael; Raabe, Florian; Mayer, Wolfgang Johann; Priglinger, Siegfried; Kreutzer, Thomas Christian

    2016-01-01

    Purpose Our aim was to correlate the overall patient volume and the incidence of several ophthalmological diseases in our emergency department with weather data. Patients and methods For data analysis, we used our clinical data warehouse and weather data. We investigated the weekly overall patient volume and the average weekly incidence of all encoded diagnoses of “conjunctivitis”, “foreign body”, “acute iridocyclitis”, and “corneal abrasion”. A Spearman’s correlation was performed to link these data with the weekly average sunshine duration, temperature, and wind speed. Results We noticed increased patient volume in correlation with increasing sunshine duration and higher temperature. Moreover, we found a positive correlation between the weekly incidences of conjunctivitis and of foreign body and weather data. Conclusion The results of this data analysis reveal the possible influence of external conditions on the health of a population and can be used for weather-dependent resource allocation. PMID:27601872

  2. The incidence of intensive care unit-acquired weakness syndromes: A systematic review.

    Science.gov (United States)

    Appleton, Richard Td; Kinsella, John; Quasim, Tara

    2015-05-01

    We conducted a literature review of the intensive care unit-acquired weakness syndromes (critical illness polyneuropathy, critical illness myopathy and critical illness neuromyopathy) with the primary objective of determining their incidence as a combined group. Studies were identified through MEDLINE, Embase, Cochrane Database and article reference list searches and were included if they evaluated the incidence of one or more of these conditions in an adult intensive care unit population. The incidence of an intensive care unit-acquired weakness syndrome in the included studies was 40% (1080/2686 patients, 95% confidence interval 38-42%). The intensive care unit populations included were heterogeneous though largely included patients receiving mechanical ventilation for seven or more days. Additional prespecified outcomes identified that the incidence of intensive care unit-acquired weakness varied with the diagnostic technique used, being lower with clinical (413/1276, 32%, 95% CI 30-35%) compared to electrophysiological techniques (749/1591, 47%, 95% CI 45-50%). Approximately a quarter of patients were not able to comply with clinical evaluation and this may be responsible for potential underreporting of this condition.

  3. Patient safety incidents from acupuncture treatments: a review of reports to the National Patient Safety Agency.

    Science.gov (United States)

    Wheway, Jayne; Agbabiaka, Taofikat B; Ernst, Edzard

    2012-01-01

    Acupuncture is frequently employed to treat chronic pain syndromes or other chronic conditions. Nevertheless, there is a growing literature on adverse events (AEs) from treatments including pneumothorax, cardiac tamponade and spinal cord injury. Acupuncture is provided in almost all NHS pain clinics and by an increasing number of GP's and physiotherapists. Considering acupuncture's popularity, its safety has become an important public health issue. To evaluate the harm caused to patients through acupuncture treatments within NHS organisations. The National Reporting and Learning System (NRLS) database was searched for incidents reported from 1st January 2009 to 31st December 2011. The free text fields of all reports received from all healthcare settings and specialties were searched for the keyword 'acupuncture'. All relevant incidents were reviewed to provide a qualitative theme of the harm to patients. 468 patient safety incidents were identified; 325 met our inclusion criteria for analysis. Adverse events reported include retained needles (31%), dizziness (30%), loss of consciousness/unresponsive (19%), falls (4%), Bruising or soreness at needle site (2%), Pneumothorax (1%) and other adverse reactions (12%). The majority (95%) of the incidents were categorised as low or no harm. A number of AEs are recorded after acupuncture treatments in the NHS but the majority is not severe. However, miscategorisation and under-reporting may distort the overall picture. Acupuncture practitioners should be aware of, and be prepared to manage, any significant harm from treatments.

  4. Intimate Partner Violence and Incident Depressive Symptoms and Suicide Attempts: A Systematic Review of Longitudinal Studies

    Science.gov (United States)

    Devries, Karen M.; Mak, Joelle Y.; Bacchus, Loraine J.; Child, Jennifer C.; Falder, Gail; Petzold, Max; Astbury, Jill; Watts, Charlotte H.

    2013-01-01

    Background Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV) experience is associated with increased risk of depression, but also that people with mental disorders are at increased risk of violence. We aimed to investigate the extent to which IPV experience is associated with incident depression and suicide attempts, and vice versa, in both women and men. Methods and Findings We conducted a systematic review and meta-analysis of longitudinal studies published before February 1, 2013. More than 22,000 records from 20 databases were searched for studies examining physical and/or sexual intimate partner or dating violence and symptoms of depression, diagnosed major depressive disorder, dysthymia, mild depression, or suicide attempts. Random effects meta-analyses were used to generate pooled odds ratios (ORs). Sixteen studies with 36,163 participants met our inclusion criteria. All studies included female participants; four studies also included male participants. Few controlled for key potential confounders other than demographics. All but one depression study measured only depressive symptoms. For women, there was clear evidence of an association between IPV and incident depressive symptoms, with 12 of 13 studies showing a positive direction of association and 11 reaching statistical significance; pooled OR from six studies = 1.97 (95% CI 1.56–2.48, I 2 = 50.4%, p heterogeneity = 0.073). There was also evidence of an association in the reverse direction between depressive symptoms and incident IPV (pooled OR from four studies = 1.93, 95% CI 1.51–2.48, I 2 = 0%, p = 0.481). IPV was also associated with incident suicide attempts. For men, evidence suggested that IPV was associated with incident depressive symptoms, but there was no clear evidence of an association between IPV and suicide attempts or depression and incident IPV. Conclusions In women, IPV

  5. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies.

    Directory of Open Access Journals (Sweden)

    Karen M Devries

    Full Text Available BACKGROUND: Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV experience is associated with increased risk of depression, but also that people with mental disorders are at increased risk of violence. We aimed to investigate the extent to which IPV experience is associated with incident depression and suicide attempts, and vice versa, in both women and men. METHODS AND FINDINGS: We conducted a systematic review and meta-analysis of longitudinal studies published before February 1, 2013. More than 22,000 records from 20 databases were searched for studies examining physical and/or sexual intimate partner or dating violence and symptoms of depression, diagnosed major depressive disorder, dysthymia, mild depression, or suicide attempts. Random effects meta-analyses were used to generate pooled odds ratios (ORs. Sixteen studies with 36,163 participants met our inclusion criteria. All studies included female participants; four studies also included male participants. Few controlled for key potential confounders other than demographics. All but one depression study measured only depressive symptoms. For women, there was clear evidence of an association between IPV and incident depressive symptoms, with 12 of 13 studies showing a positive direction of association and 11 reaching statistical significance; pooled OR from six studies = 1.97 (95% CI 1.56-2.48, I²  =  50.4%, p(heterogeneity = 0.073. There was also evidence of an association in the reverse direction between depressive symptoms and incident IPV (pooled OR from four studies = 1.93, 95% CI 1.51-2.48, I²  =  0%, p = 0.481. IPV was also associated with incident suicide attempts. For men, evidence suggested that IPV was associated with incident depressive symptoms, but there was no clear evidence of an association between IPV and suicide attempts or depression and incident IPV

  6. MS incidence and prevalence in Africa, Asia, Australia and New Zealand: A systematic review.

    Science.gov (United States)

    Makhani, N; Morrow, S A; Fisk, J; Evans, C; Beland, S G; Kulaga, S; Kingwell, E; Marriott, J J; Dykeman, J; Jetté, N; Pringsheim, T; Wolfson, C; Marrie, R A; Koch, M W

    2014-01-01

    Studies of multiple sclerosis (MS) incidence and prevalence from Africa, Asia, Australia and New Zealand are relatively scarce. We systematically reviewed MS incidence and prevalence in these regions including a standardized evaluation of study quality. We searched MEDLINE and EMBASE databases for studies of MS prevalence or incidence in Africa, Asia, Australia and New Zealand published in English or French between January 1, 1985 and January 31, 2011. Study quality was assessed using a standardized tool. All steps of the review were performed in duplicate. Of 3925 citations identified, 28 studies met inclusion criteria and 21 of these were from Asia. Quality scores ranged from 1/8 to 8/8; the lowest scores were observed in studies from Asia (median 4/8, IQR 3,6). Prevalence was lowest in South African Blacks (0.22/100,000) and highest amongst Australian-born individuals in Australia (125/100,000). Prevalence increased over time in many countries. MS prevalence increased with increasing latitude only in some regions, and prevalence varied significantly with ethnicity. Eight studies reported incidence, which ranged from 0.67/100,000/year in Taiwan to 3.67/100,00/year in Australia. This comprehensive study provides an update of MS epidemiology in Africa, Asia, Australia, and New Zealand. Incidence and prevalence were lowest in Africa and Asia and highest in Australia, but many Asian studies were of poor quality. Use of consistent case ascertainment methods, standardized data collection tools, and similar outcomes would all improve study quality and comparability. The underlying basis of observed ethnic differences is an important area for future study. © 2013 Elsevier B.V. All rights reserved.

  7. Incidence of occult leiomyosarcoma in presumed morcellation cases: a database study.

    Science.gov (United States)

    Rodriguez, Ana M; Asoglu, Mehmet R; Sak, Muhammet Erdal; Tan, Alai; Borahay, Mostafa A; Kilic, Gokhan S

    2016-02-01

    Our objective was to estimate the incidence of uterine leiomyosarcoma in patients with leiomyomas following laparoscopic supracervical hysterectomy and myomectomy procedures. For this study, we analyzed records of 13,964 women aged 25-64 years who underwent laparoscopic supracervical hysterectomies or myomectomies for leiomyomas from 2002 to 2011 using Clinformatics DataMart. Patient records were divided into two groups: history of laparoscopic supracervical hysterectomy and history of myomectomy. Subjects were tracked to identify diagnosis of leiomyosarcoma within 1 year of the procedure. We analyzed data from the 25-39, 40-49, and 50-64 age brackets. Evidence was obtained from a cohort study from national private insurance claims in the US. Our results showed the incidence of occult leiomyosarcoma developing within 1 year following supracervical hysterectomy using a laparoscopic-assisted approach are 9.8, 10.7, and 33.4 per 10,000 for the 25-39, 40-49, and 50-64 age brackets, respectively; the overall incidence rate is 13.1 per 10,000. The incidence rate of occult leiomyosarcoma developing within 1 year following myomectomy using a laparoscopic-assisted approach are 0.0, 33.8, and 90.1 per 10,000 for the 25-39, 40-49, and 50-64 age brackets, respectively; the overall incidence rate is 17.3 per 10,000. Our analysis shows the overall risk of being diagnosed with occult leiomyosarcoma is 12.9 per 10,000 in laparoscopic-assisted supracervical hysterectomy and myomectomy for patients younger than 49. There is no evidence of occult leiomyosarcoma 1 year after operation for patients younger than 40 who underwent laparoscopic myomectomy. Copyright © 2015. Published by Elsevier Ireland Ltd.

  8. Incidence of syphilis seroconversion among HIV-infected persons in Asia: results from the TREAT Asia HIV Observational Database.

    Science.gov (United States)

    Ahn, Jin Young; Boettiger, David; Kiertiburanakul, Sasisopin; Merati, Tuti Parwati; Huy, Bui Vu; Wong, Wing Wai; Ditangco, Rossana; Lee, Man Po; Oka, Shinichi; Durier, Nicolas; Choi, Jun Yong

    2016-01-01

    Outbreaks of syphilis have been described among HIV-infected men who have sex with men (MSM) in Western communities, whereas reports in Asian countries are limited. We aimed to characterize the incidence and temporal trends of syphilis among HIV-infected MSM compared with HIV-infected non-MSM in Asian countries. Patients enrolled in the TREAT Asia HIV Observational Database cohort and with a negative non-treponemal test since enrolment were analyzed. Incidence of syphilis seroconversion, defined as a positive non-treponemal test after previously testing negative, was evaluated among patients at sites performing non-treponemal tests at least annually. Factors associated with syphilis seroconversion were investigated at sites doing non-treponemal testing in all new patients and subsequently testing routinely or when patients were suspected of having syphilis. We included 1010 patients from five sites that performed non-treponemal tests in all new patients; those included had negative non-treponemal test results during enrolment and subsequent follow-ups. Among them, 657 patients were from three sites conducting regular non-treponemal testing. The incidence of syphilis seroconversion was 5.38/100 person-years (PY). Incidence was higher in MSM than non-MSM (7.64/100 PY vs. 2.44/100 PY, psyphilis diagnosis (IRR 5.15, 95% CI 3.69-7.17) and younger age (IRR 0.84 for every additional 10 years, 95% CI 0.706-0.997) were significantly associated with syphilis seroconversion. We observed a higher incidence of syphilis seroconversion among HIV-infected MSM and a trend to increasing annual incidence. Regular screening for syphilis and targeted interventions to limit transmission are needed in this population.

  9. Review article: A systematic review of emergency department incident classification frameworks.

    Science.gov (United States)

    Murray, Matthew; McCarthy, Sally

    2017-10-11

    As in any part of the hospital system, safety incidents can occur in the ED. These incidents arguably have a distinct character, as the ED involves unscheduled flows of urgent patients who require disparate services. To aid understanding of safety issues and support risk management of the ED, a comparison of published ED specific incident classification frameworks was performed. A review of emergency medicine, health management and general medical publications, using Ovid SP to interrogate Medline (1976-2016) was undertaken to identify any type of taxonomy or classification-like framework for ED related incidents. These frameworks were then analysed and compared. The review identified 17 publications containing an incident classification framework. Comparison of factors and themes making up the classification constituent elements revealed some commonality, but no overall consistency, nor evolution towards an ideal framework. Inconsistency arises from differences in the evidential basis and design methodology of classifications, with design itself being an inherently subjective process. It was not possible to identify an 'ideal' incident classification framework for ED risk management, and there is significant variation in the selection of categories used by frameworks. The variation in classification could risk an unbalanced emphasis in findings through application of a particular framework. Design of an ED specific, ideal incident classification framework should be informed by a much wider range of theories of how organisations and systems work, in addition to clinical and human factors. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  10. Correlation between weather and incidence of selected ophthalmological diagnoses: a database analysis

    Directory of Open Access Journals (Sweden)

    Kern C

    2016-08-01

    Full Text Available Christoph Kern, Karsten Kortüm, Michael Müller, Florian Raabe, Wolfgang Johann Mayer, Siegfried Priglinger, Thomas Christian Kreutzer University Eye Hospital Munich, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany Purpose: Our aim was to correlate the overall patient volume and the incidence of several ophthalmological diseases in our emergency department with weather data. Patients and methods: For data analysis, we used our clinical data warehouse and weather data. We investigated the weekly overall patient volume and the average weekly incidence of all encoded diagnoses of “conjunctivitis”, “foreign body”, “acute iridocyclitis”, and “corneal abrasion”. A Spearman’s correlation was performed to link these data with the weekly average sunshine duration, temperature, and wind speed. Results: We noticed increased patient volume in correlation with increasing sunshine duration and higher temperature. Moreover, we found a positive correlation between the weekly incidences of conjunctivitis and of foreign body and weather data. Conclusion: The results of this data analysis reveal the possible influence of external conditions on the health of a population and can be used for weather-dependent resource allocation. Keywords: corneal injury, trauma, uveitis, conjunctivitis, weather

  11. Incidence of subarachnoid haemorrhage : a systematic review with emphasis on region, age, gender and time trends

    NARCIS (Netherlands)

    de Rooij, N. K.; Linn, F. H. H.; van der Plas, J. A.; Algra, A.; Rinkel, G. J. E.

    2007-01-01

    Background and aim: To update our 1996 review on the incidence of subarachnoid haemorrhage (SAH) and assess the relation of incidence with region, age, gender and time period. Methods: We searched for studies on the incidence of SAH published until October 2005. The overall incidences with

  12. The critical incident technique in dental research: A review

    Directory of Open Access Journals (Sweden)

    Binu Santha

    2016-01-01

    Full Text Available Research is a scientific quest to find answers to certain questions. It makes us think with curiosity and wonderment about how to make something better. Research contributes in a major way to the development and maintenance of health and health care systems. Qualitative research is concerned with qualitative phenomena and includes subjective assessment of attitudes, opinions, and behavior. It is especially important in the behavioral sciences where the aim is to discover the underlying motives of human behavior. The critical incident technique (CIT is a well-established qualitative research tool used in many areas of health sciences including nursing, medicine, dentistry, and their respective education systems. This technique is described as consisting of “a set of procedures for collecting direct observations of human behavior in such a way as to facilitate their potential usefulness in solving practical problems.” This review gives a gist of CIT and its application in different aspects of dental research.

  13. Incidence and severity of neck injury in Rugby Union: a systematic review.

    Science.gov (United States)

    Swain, Michael S; Lystad, Reidar P; Pollard, Henry; Bonello, Rod

    2011-09-01

    Objectives. To collate and appraise incidence and severity data for neck injury in Rugby Union. To report risk factors for neck injury in Rugby Union that are supported by incidence and severity data. Design. Systematic review. Methods. Original journal articles were retrieved from electronic searches of AusportMed, AUSPORT, Scopus, Medline (Ovid), CINAHL, Mantis, and Pubmed databases and relevant bibliographic hand searches. Selection criteria were restricted to: (a) prospective study designs including cohort, case-control, and intervention methodologies; (b) populations of Rugby Union players, either male or female of any age; (c) studies must report on neck injury incidence and/or severity specifically; (d) articles with republished neck injury data were excluded. The STROBE Statement was adapted for the quality assessment of included studies and categorised as either poor, moderate or good. Results. Thirty-three original articles met the selection criteria. Wide variation of injury and exposure definitions and population sampling was identified in the included articles. Neck injury incidence ranged between 0.26 (CI: 0.08, 0.93) and 9.17 (CI: 1.89, 26.81) per 1000 player hours for mixed populations that adopted an all inclusive sports injury definition. There is a paucity of severity data and analytical data which evaluates causal roles of risk factors for neck injury in Rugby Union. Conclusions. Meaningful understanding of neck injury incidence and severity in Rugby Union is restricted to a few studies which adopt comparable methodological construct. This paper provides an index for future neck injury studies in Rugby Union. Copyright © 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. A review and discussion of flight management system incidents reported to the Aviation Safety Reporting System

    Science.gov (United States)

    1992-02-01

    This report covers the activities related to the description, classification and : analysis of the types and kinds of flight crew errors, incidents and actions, as : reported to the Aviation Safety Reporting System (ASRS) database, that can occur as ...

  15. Retrospective review of critical incidents in the post-anaesthesia care unit at a major tertiary hospital.

    Science.gov (United States)

    Bruins, Suze Dominique; Leong, Pauline Meng Choo; Ng, Shin Yi

    2017-08-01

    We reviewed patients with critical incidents that occurred in the post-anaesthesia care unit (PACU) at a major tertiary hospital, and assessed the effect of these incidents on PACU length of stay and discharge disposition. A retrospective review was conducted of patients in the PACU over a two-year period from 24 June 2011 to 23 August 2013. Data on critical incidents was recorded in the administrative database using a standardised data form. There were 701 incidents involving 364 patients; 203 (55.8%) patients had American Society of Anesthesiologists (ASA) physical status I or II. The most common critical incidents were cardiovascular-related (n = 293, 41.8%), respiratory (n = 155, 22.1%), neurological (n = 52, 7.4%), surgical (n = 47, 6.7%) and airway-related (n = 34, 4.9%). There were two incidents of cardiac arrest and 25 incidents of unexpected reintubations. Many patients (n = 186, 51.2%) stayed for over four hours in the PACU due to critical incidents and 184 (50.5%) patients required a higher level of care postoperatively than initially planned. Some patients (n = 34, 9.3%) returned to the operation theatre for further management. A proportion of patients (n = 64, 17.6%) had unplanned intensive care unit admissions due to adverse events in the PACU. A wide spectrum of critical incidents occur in the PACU, many of which are related to the cardiovascular and respiratory systems. Critical incidents have a major impact on healthcare utilisation and result in prolonged PACU stays and higher levels of postoperative care than initially anticipated. Copyright: © Singapore Medical Association

  16. [Incidence of surgical site infections in sub-Saharan Africa: systematic review and meta-analysis].

    Science.gov (United States)

    Ngaroua; Ngah, Joseph Eloundou; Bénet, Thomas; Djibrilla, Yaouba

    2016-01-01

    Surgical Site Infections (SSI) cause morbi-mortality and additional healthcare expenditures. Developing countries are the most affected. The objective was to estimate the pooled incidence of SSI in Sub-Saharan Africa and describe its major risk factors. Systematic review and meta-analysis were conducted using the databases of the World Health Organization Regional Office for Africa, PubMed and standard search to select electronic articles published between 2006 and 2015. Only articles investigating SSI impact and risk factors in Sub-Saharan African countries were retained. Out of 95 articles found, 11 met the inclusion criteria. Only 9 countries out of 45 have contributed, with a huge amount of information coming from Nigeria (5 articles out of 11). The impact of SSI ranged from 6.8% to 26% with predominance in general surgery. The pooled incidence of SSI was 14.8% (95% CI: 15,5-16,2%) with significant heterogeneity according to the specialty and the method of monitoring. Most cited risk factors were long procedure length and categories 3 and 4 of Altemeier contamination class. Other factors included hospital environment, inadequate care practices and underlying pathologies. SSI incidence is high in Sub-Saharan Africa. Studies in this area could improve knowledge, prevention and control of these multiple risk factors.

  17. The updated Swedish family-cancer database used to assess familial risks of prostate cancer during rapidly increasing incidence

    Directory of Open Access Journals (Sweden)

    Hemminki Kari

    2006-12-01

    Full Text Available Abstract The Swedish Family-Cancer Database has been used for some 10 years in the study of familial risks at all common sites. In the present paper we describe some of the main features of version VII of this Database, assembled in year 2006. This update included all residents in Sweden born or immigrated in 1932 and later (offspring with their biological parents, a total of 11.5 million individuals. Cancer cases were retrieved from the Swedish Cancer Registry from years 1958 to 2004, including over 1.2 million first and multiple primary cancers and in situ tumours. We show one application of the Database in the study of familial risks in prostate cancer, with special reference to the modification of familial risk at the time of about 50% increase in incidence due to prostate specific antigen (PSA screening. The familial risks for prostate cancer were 1.92 for sons of affected fathers, 3.03 for brothers and 5.44 for men with an affected father and an affected brother. Familial risk for prostate cancer according to the time since the first family member was diagnosed showed significant increases for two family members being diagnosed in the same year compared to 5+ years apart. Increased surveillance and the availability of PSA screening are the likely reasons for the overestimated familial relative risk shortly after the first diagnosis. This lead time bias should be considered in clinical counselling.

  18. Playing-related musculoskeletal disorders in musicians: a systematic review of incidence and prevalence.

    Science.gov (United States)

    Zaza, C

    1998-04-21

    Work-related musculoskeletal disorders cause pain, disability and loss of employment for many workers, including musicians. Although performing arts medicine is a growing field, the health problems of musicians remain under-recognized and under-researched. Therefore, the author undertook a systematic review of published information on the incidence and prevalence of playing-related musculoskeletal disorders (PRMDs) in classical musicians. Seven databases were searched for the period 1980 to 1996. The main textbook and performing arts medicine journals were searched manually, as were reference lists of all relevant papers. The author also contacted individuals familiar with the literature of performing arts medicine. Studies were included for review if they reported PRMD incidence or prevalence in classical musicians. Of the 24 studies identified, 18 cross-sectional surveys and cohort studies were reviewed. The author subjectively assessed the studies using criteria modified from an existing evaluation scale and used 4 criteria for data combination. On the basis of prevalence values from the eligible studies, chi 2 tests for heterogeneity were performed. Only one study estimated PRMD incidence. Ten of the 17 prevalence studies were ineligible for data combination, because of low response rates and other methodological problems. In the 7 eligible studies, PRMD point prevalence ranged from 39% to 87% in adult musicians and from 34% to 62% in secondary school music students. The best estimates of PRMD prevalence were derived from the 3 studies that excluded mild complaints; these studies indicated that PRMD prevalence was 39% and 47% in adults and 17% in secondary school music students respectively. Statistical combination of data across studies within each demographic category was not possible. Available data indicate that the prevalence of PRMD in adult classical musicians is comparable to the prevalence of work-related musculoskeletal disorders reported for other

  19. Panic disorder and incident coronary heart disease: a systematic review and meta-analysis protocol.

    Science.gov (United States)

    Tully, Phillip J; Wittert, Gary A; Turnbull, Deborah A; Beltrame, John F; Horowitz, John D; Cosh, Suzanne; Baumeister, Harald

    2015-03-25

    The clinical presentation of panic disorder and panic attack overlaps many symptoms typically experienced in coronary heart disease (CHD). Etiological links between panic disorder and CHD are controversial and remain largely tenuous. This systematic review aims to pool together data regarding panic disorder with respect to incident CHD or myocardial infarction. Electronic databases (MEDLINE, EMBASE, PsycINFO and SCOPUS) will be searched using a search strategy exploding the topics for CHD and panic disorder. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: persons without CHD who meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms; Comparison: persons without CHD who do not meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms; verified fatal and non-fatal CHD at follow-up; including coronary revascularization procedure, coronary artery disease, and myocardial infarction. Studies adopting self-report CHD will be ineligible. Screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, risk ratios, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the CHD outcomes with Cochrane Review Manager 5.3. This systematic review aims to clarify whether panic disorder is associated with elevated risk for subsequent CHD. An evaluation of the etiological links between panic disorder with incident CHD might inform evidence-based clinical practice and policy concerning triaging chest pain patients, diagnostic assessment, and psychiatric intervention with panic disorder patients. PROSPERO CRD42014014891 .

  20. Incidence and characteristics of kidney stones in patients with horseshoe kidney: A systematic review and meta-analysis

    Science.gov (United States)

    Pawar, Aditya S.; Thongprayoon, Charat; Cheungpasitporn, Wisit; Sakhuja, Ankit; Mao, Michael A.; Erickson, Stephen B.

    2018-01-01

    Introduction: The horseshoe kidney (HSK) is the most common type of renal fusion anomaly. The incidence and characteristics of kidney stones in patients with HSK are not well studied. The aim of this meta-analysis was to evaluate the incidence and types of kidney stones in patients with HSK. Methods: A systematic literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the databases' inception through November 2016. Studies assessing the incidence and types of kidney stones in patients with HSK were included. We applied a random-effects model to estimate the incidence of kidney stones. The study protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42016052037). Results: A total of 14 observational studies with 943 patients (522 adults and 421 pediatric) with HSK were enrolled. The estimated pooled incidence of kidney stones was 36% (95% confidence interval [CI], 15%–59%) in adults with the HSK. Kidney stones were less common in pediatric patients with HSK with an estimated pooled incidence of 3% (95% CI, 2%–5%). The mean age of adult stone formers with HSK was 44.9 ± 6.2 years, and 75% were males. Within reported studies, 89.2% of kidney stones were calcium-based stones (64.2% calcium oxalate [CaOx], 18.8% calcium phosphate [CaP], and 6.2% mixed CaOx/CaP), followed by struvite stones (4.2%), uric acid stones (3.8%), and others (2.8%). Conclusions: Kidney stones are very common in adult patients with HSK with an estimated incidence of 36%. Calcium-based stones are the most prevalent kidney stones in adults with HSKs. These findings may impact the prevention and clinical management of kidney stones in patients with HSK. PMID:29416282

  1. Hyperuricemia and risk of incident hypertension: a systematic review and meta-analysis of observational studies.

    Directory of Open Access Journals (Sweden)

    Ji Wang

    Full Text Available Observational studies of the relationship between hyperuricemia and the incidence of hypertension are controversial. We conducted a systematic review and meta-analysis to assess the association and consistency between uric acid levels and the risk of hypertension development.We searched MEDLINE, EMBASE, CBM (Chinese Biomedicine Database through September 2013 and reference lists of retrieved studies to identify cohort studies and nested case-control studies with uric acid levels as exposure and incident hypertension as outcome variables. Two reviewers independently extracted data and assessed study quality using Newcastle-Ottawa Scale. Extracted information included study design, population, definition of hyperuricemia and hypertension, number of incident hypertension, effect sizes, and adjusted confounders. Pooled relative risks (RRs and corresponding 95% confidence intervals (CIs for the association between hyperuricemia and risk of hypertension were calculated using a random-effects model.We included 25 studies with 97,824 participants assessing the association between uric acid and incident hypertension in our meta-analysis. The quality of included studies is moderate to high. Random-effects meta-analysis showed that hyperuricemia was associated with a higher risk of incident hypertension, regardless of whether the effect size was adjusted or not, whether the data were categorical or continuous as 1 SD/1 mg/dl increase in uric acid level (unadjusted: RR = 1.73, 95% CI 1.46∼2.06 for categorical data, RR = 1.22, 95% CI 1.03∼1.45 for a 1 SD increase; adjusted: RR = 1.48, 95% CI 1.33∼1.65 for categorical data, RR = 1.15, 95% CI 1.06∼1.26 for a 1 mg/dl increase, and the risk is consistent in subgroup analyses and have a dose-response relationship.Hyperuricemia may modestly increase the risk of hypertension incidence, consistent with a dose-response relationship.

  2. Mining the ACCENT database: a review and update.

    Science.gov (United States)

    Renfro, Lindsay A; Shi, Qian; Sargent, Daniel J

    2013-06-01

    The database of the Adjuvant Colon Cancer End Points (ACCENT) Group was assembled to address questions in early stage colon cancer that could be best answered by information pooled across many similar trials. Today, the ACCENT database contains individual patient-level data from over 33,000 patients enrolled onto 25 adjuvant colon cancer trials conducted between 1977 and 2008. Since its flagship analysis of 3-year disease-free survival as a surrogate endpoint for 5-year overall survival in 2005, the ACCENT group has produced many noteworthy scientific findings addressing a variety of clinical questions, which we describe here. Additionally, we provide an overview of the history, collaboration, construction, principles, and future of the ACCENT database, as it has set a precedent for multi-trial database creation in other types of cancer.

  3. Study review : The European Nutrient Database (ENDB) for Nutritional Epidemiology

    NARCIS (Netherlands)

    Charrondiere, U.R.; Vignat, J.; Moller, A.; Ireland, J.; Becker, W.; Church, S.; Farran, A.; Holden, J.; Klemm, C.; Linardou, A.; Mueller, D.; Staveren, van W.A.

    2002-01-01

    Food composition databases (FCDB), as well as standardized calculation procedures are required for international studies on nutrition and disease to calculate nutrient intakes across countries. Comparisons of national FCDBs have shown that major improvements are needed in standardization and

  4. Incidence, treatment and recurrence of endometriosis in a UK-based population analysis using data from The Health Improvement Network and the Hospital Episode Statistics database.

    Science.gov (United States)

    Cea Soriano, Lucia; López-Garcia, Esther; Schulze-Rath, Renate; Garcia Rodríguez, Luis A

    2017-10-01

    This retrospective study used medical records from The Health Improvement Network (THIN) and Hospital Episode Statistics (HES) database to evaluate endometriosis (incidence, treatment and need for recurrent invasive procedures) in the general UK population. Women aged 12-54 years between January 2000 and December 2010, with a Read code for endometriosis, were identified in THIN. Cases were validated by manual review of free-text comments in medical records and responses to physician questionnaires. False-negative cases were identified among women with Read codes for hysterectomy or dysmenorrhea. Prescriptions of medical therapies for endometriosis were identified in THIN. Cases of single and recurrent invasive procedures were identified in women with medical records in both THIN and HES. Overall, 5087 women had a Read code for endometriosis, corresponding to an incidence of 1.02 (95% confidence interval [CI]: 0.99-1.05) per 1000 person-years. After case validation, the estimate was 1.46 (95% CI: 1.43-1.50) per 1000 person-years. Medical therapy was prescribed to 55.5% of women with endometriosis in the first year after diagnosis. In total, 48.3% of women received invasive treatment during the study period; approximately one-fifth of these women required further invasive treatment, mainly in the 3 years after the index procedure. Using Read codes as the only method to identify women with endometriosis underestimates incidence. Over half of women with recorded endometriosis are prescribed medical therapy in the first year after diagnosis. Women with diagnosed endometriosis are at risk of requiring recurrent invasive procedures.

  5. The incidence of complications associated with lip and/or tongue piercings: a systematic review.

    Science.gov (United States)

    Hennequin-Hoenderdos, N L; Slot, D E; Van der Weijden, G A

    2016-02-01

    This review determines the incidence of complications associated with lip and/or tongue piercings based on a systematic evaluation of the available literature. MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were comprehensively searched through June 2014 to identify appropriate studies. The incidence of complications, as established by a dental professional associated with oral and peri-oral piercings, was evaluated in populations with lip and/or tongue piercings. The quality of the case-control studies was assessed using the Newcastle-Ottawa Scale. For case series studies, the risk of bias was assessed using the National Institute for Health and Clinical Excellence scale. An independent screening of 1580 unique titles and abstracts revealed 15 publications that met the eligibility criteria. The incidence of gingival recessions appeared to be 50% in subjects with lip piercings and 44% in subjects with a tongue piercing. Tooth injuries were observed in 26% individuals with lip piercings and in up to 37% of individuals with tongue piercings. Subjects with a lip piercing were 4.14 times (P = 0.005) more likely to develop gingival recession than those without a lip piercing. Subjects with a tongue piercing were more likely than non-pierced subjects to experience gingival recession (relative risk (RR) 2.77; P = 0.00001) and tooth injuries (RR 2.44; P = 0.003). Both lip and tongue piercings are highly associated with the risk of gingival recession, and tongue piercings are also associated with tooth injuries. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis.

    Science.gov (United States)

    Napalkov, Pavel; Felici, Diana M; Chu, Laura K; Jacobs, Joan R; Begelman, Susan M

    2013-10-16

    Central venous catheter (CVC) and hemodialysis (HD) catheter usage are associated with complications that occur during catheter insertion, dwell period, and removal. This study aims to identify and describe the incidence rates of catheter-related complications in a large patient population in a United States-based health care claims database after CVC or HD catheter placement. Patients in the i3 InVision DataMart® health care claims database with at least 1 CVC or HD catheter insertion claim were categorized into CVC or HD cohorts using diagnostic and procedural codes from the US Renal Data System, American College of Surgeons, and American Medical Association's Physician Performance Measures. Catheter-related complications were identified using published diagnostic and procedural codes. Incidence rates (IRs)/1000 catheter-days were calculated for complications including catheter-related bloodstream infections (CRBSIs), thrombosis, embolism, intracranial hemorrhage (ICH), major bleeding (MB), and mechanical catheter-related complications (MCRCs). Thirty percent of the CVC cohort and 54% of the HD cohort had catheter placements lasting <90 days. Catheter-related complications occurred most often during the first 90 days of catheter placement. IRs were highest for CRBSIs in both cohorts (4.0 [95% CI, 3.7-4.3] and 5.1 [95% CI, 4.7-5.6], respectively). Other IRs in CVC and HD cohorts, respectively, were thrombosis, 1.3 and 0.8; MCRCs, 0.6 and 0.7; embolism, 0.4 and 0.5; MB, 0.1 and 0.3; and ICH, 0.1 in both cohorts. Patients with cancer at baseline had significantly higher IRs for CRBSIs and thrombosis than non-cancer patients. CVC or HD catheter-related complications were most frequently seen in patients 16 years or younger. The risk of catheter-related complications is highest during the first 90 days of catheter placement in patients with CVCs and HD catheters and in younger patients (≤16 years of age) with HD catheters. Data provided in this study can be applied

  7. Incidence of HIV-associated tuberculosis among individuals taking combination antiretroviral therapy: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Tendesayi Kufa

    Full Text Available Knowledge of tuberculosis incidence and associated factors is required for the development and evaluation of strategies to reduce the burden of HIV-associated tuberculosis.Systematic literature review and meta-analysis of tuberculosis incidence rates among HIV-infected individuals taking combination antiretroviral therapy.From PubMed, EMBASE and Global Index Medicus databases, 42 papers describing 43 cohorts (32 from high/intermediate and 11 from low tuberculosis burden settings were included in the qualitative review and 33 in the quantitative review. Cohorts from high/intermediate burden settings were smaller in size, had lower median CD4 cell counts at study entry and fewer person-years of follow up. Tuberculosis incidence rates were higher in studies from Sub-Saharan Africa and from World Bank low/middle income countries. Tuberculosis incidence rates decreased with increasing CD4 count at study entry and duration on combination antiretroviral therapy. Summary estimates of tuberculosis incidence among individuals on combination antiretroviral therapy were higher for cohorts from high/intermediate burden settings compared to those from the low tuberculosis burden settings (4.17 per 100 person-years [95% Confidence Interval (CI 3.39-5.14 per 100 person-years] vs. 0.4 per 100 person-years [95% CI 0.23-0.69 per 100 person-years] with significant heterogeneity observed between the studies.Tuberculosis incidence rates were high among individuals on combination antiretroviral therapy in high/intermediate burden settings. Interventions to prevent tuberculosis in this population should address geographical, socioeconomic and individual factors such as low CD4 counts and prior history of tuberculosis.

  8. Incidence and body location of reported acute sport injuries in seven sports using a national insurance database.

    Science.gov (United States)

    Åman, M; Forssblad, M; Larsén, K

    2018-03-01

    Sports with high numbers of athletes and acute injuries are an important target for preventive actions at a national level. Both for the health of the athlete and to reduce costs associated with injury. The aim of this study was to identify injuries where injury prevention should focus, in order to have major impact on decreasing acute injury rates at a national level. All athletes in the seven investigated sport federations (automobile sports, basketball, floorball, football (soccer), handball, ice hockey, and motor sports) were insured by the same insurance company. Using this insurance database, the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), at each body location, was calculated. Comparisons were made between sports, sex, and age. In total, there were 84 754 registered injuries during the study period (year 2006-2013). Athletes in team sports, except in male ice hockey, had the highest risk to sustain an injury and PMI in the lower limb. Females had higher risk of injury and PMI in the lower limb compared to males, in all sports except in ice hockey. This study recommends that injury prevention at national level should particularly focus on lower limb injuries. In ice hockey and motor sports, head/neck and upper limb injuries also need attention. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Stroke in SSA: Review of current literature concerning the incidence ...

    African Journals Online (AJOL)

    2013-11-04

    Nov 4, 2013 ... stroke patients were on average 24 years younger than their HIV-negative counterparts [27]. In the same study HIV-positive patients had a lower incidence of common cardiovascular risk factors, further suggesting the causal link between HIV and ischemic stroke. The. Risk Factors. White. Black. Odds Ratio.

  10. Disparities in incidence of early- and late-onset colorectal cancer between Hispanics and Whites: A 10-year SEER database study.

    Science.gov (United States)

    Koblinski, Jenna; Jandova, Jana; Nfonsam, Valentine

    2018-04-01

    Racial disparities in incidence of colorectal cancer (CRC) exist. In Hispanics, CRC was the second most commonly diagnosed cancer in 2012. We abstracted the national estimates for Hispanics/Whites with CRC using the SEER database between 2000 and 2010. Trends in incidence, mortality, gender and stage of disease were analyzed for early-onset (age50; LO - old) cases. The overall incidence of CRC increased by 48% in Hispanics. 38% increase in incidence of LO CRC and 80% increase in incidence of EO CRC was seen in this ethnic group. Hispanics and Whites showed higher percentage of distant tumors for both age groups. There was no deviation in overall trend between males and females. Although there is an overall decrease in incidence of CRC in Whites increase was seen in Hispanics. While incidence of EO CRC is increasing in both races, LO CRC incidence is increasing in Hispanics not in Whites. This data suggest that disparities in incidence of EO and LO CRC exist between Hispanics and Whites. Published by Elsevier Inc.

  11. A review of accessibility of administrative healthcare databases in the Asia-Pacific region

    Science.gov (United States)

    Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

    2015-01-01

    Objective We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. Methods The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Results Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3–6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but

  12. Incident reviews in UK maternity units: a systematic appraisal of the quality of local guidelines.

    Science.gov (United States)

    Shah, Anjali; Mohamed-Ahmed, Olaa; Peirsegaele, Philippe; McClymont, Charlotte; Knight, Marian

    2015-03-14

    Maternity care is recognised as a particularly high-risk speciality that is subject to investigation and inquiry, and improvements in risk management have been recommended. However, the quality of guidelines for local reviews of maternity incidents is unknown. The aim of the study is to appraise the quality of local guidance on conducting reviews of severe maternity incidents in the National Health Service. Guidelines for incident reviews were requested from all 211 consultant-led maternity units in the UK during 2012. The Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) was used to evaluate the quality of guidelines. The methods used for reviewing an incident, the people involved in the review and the methods for disseminating the outcomes of the reviews were also examined. Guidelines covering 148 (70%) of all NHS maternity units in the UK were received for evaluation. Most guidelines (55%) received were of good or high quality. The median score on 'scope and purpose' (86%), concerned with the aims and target population of the guideline, was higher than for other domains. Median scores were: 'stakeholder involvement' (representation of users' views) 56%, 'rigour of development' (process used to develop guideline) 34%, 'clarity of presentation' 78%, 'applicability' (organisational and cost implications of applying guideline) 56% and 'editorial independence' 0%. Most guidelines (81%) recommended a range of health professionals review serious maternity incidents using root cause analysis. Findings were most often disseminated at meetings, in reports and in newsletters. Many guidelines (69%) stated lessons learnt from incidents would be audited. Overall, local guidance for the review of maternity incidents was mostly of good or high quality. Stakeholder participation in guideline development could be widened, and editorial independence more clearly stated. It was unclear in over a quarter of guidelines whether changes in practice in response

  13. Databases in High Energy Physics a critial review

    CERN Document Server

    Shiers, J D

    2007-01-01

    The year 2000 is marked by a plethora of significant milestones in the history of High Energy Physics. Not only the true numerical end to the second millennium, this watershed year saw the final run of CERN's Large Electron-Positron collider (LEP) - the world-class machine that had been the focus of the lives of many of us for such a long time. It is also closely related to the subject of this chapter in the following respects: - Classified as a nuclear installation, information on the LEP machine must be retained indefinitely. This represents a challenge to the database community that is almost beyond discussion - archiving of data for a relatively small number of years is indeed feasible, but retaining it for centuries, millennia or more is a very different issue; - There are strong scientific arguments as to why the data from the LEP machine should be retained for a short period. However, the complexity of the data itself, the associated metadata and the programs that manipulate it make even this a huge ch...

  14. Concussions and heading in soccer: a review of the evidence of incidence, mechanisms, biomarkers and neurocognitive outcomes.

    Science.gov (United States)

    Maher, Monica E; Hutchison, Michael; Cusimano, Michael; Comper, Paul; Schweizer, Tom A

    2014-01-01

    Soccer is currently the most popular and fastest-growing sport worldwide. Similar to many sports, soccer carries an inherent risk of injury, including concussion. Soccer is also unique in the use of 'heading'. The present paper provides a comprehensive review of the research examining the incidence, mechanisms, biomarkers of injury and neurocognitive outcomes of concussions and heading in soccer. Seven databases were searched for articles from 1806 to 24 May 2013. Articles obtained by the electronic search were reviewed for relevance, with 229 selected for review. Ultimately, 49 articles met criteria for inclusion in the present review. Female soccer players have a higher incidence of concussions than males. The most frequent injury mechanism is player-to-player contact for both genders. Few studies examined the effects of concussion in soccer players; however, neurocognitive outcomes were similar to those reported in the larger sport concussion literature, while the effect of heading is less clear. Despite variation in research designs and study characteristics, the outcomes of concussions in soccer align with the greater concussion literature. This review makes recommendations for future research to increase standardization of research for improved understanding of concussions in soccer as well as the effects of heading.

  15. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature

    NARCIS (Netherlands)

    Kilic, O.; Maas, M.; Verhagen, E.; Zwerver, J.; Gouttebarge, V.

    2017-01-01

    Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific

  16. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball : A systematic review of the literature

    NARCIS (Netherlands)

    Kilic, O.; Maas, M.; Verhagen, E.; Zwerver, J.; Gouttebarge, V.

    2017-01-01

    Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific

  17. A systematic review of the incidence and prevalence of cancer in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    BACKGROUND: Studies of cancer incidence and prevalence in multiple sclerosis (MS) have produced conflicting results. OBJECTIVE: To estimate the incidence and prevalence of cancer in persons with MS and review the quality of included studies. METHODS: We searched the PUBMED, SCOPUS, Web of Knowledge...

  18. Incidence of and risk indicators for vasa praevia : A systematic review

    NARCIS (Netherlands)

    Ruiter, L.; Kok, N.; Limpens, J.; Derks, Jb; de Graaf, Im; Mol, Bwj; Pajkrt, E.

    Background: Vasa praevia (VP) is a rare phenomenon that is assumed to increase the risk of severe complications, including fetal death. Critical data on its incidence are lacking, so there is no rational basis for prenatal screening. Objectives: To review the literature on the incidence and risk

  19. The Incidence of Postpartum Hemorrhage in Pregnant Women with Placenta Previa: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Fan, Dazhi; Xia, Qing; Liu, Li; Wu, Shuzhen; Tian, Guo; Wang, Wen; Wu, Song; Guo, Xiaoling; Liu, Zhengping

    2017-01-01

    The global burden of postpartum hemorrhage (PPH) in women with placenta previa is a major public health concern. Although there are different reports on the incidence of PPH in different countries, to date, no research has reviewed them. The aim of this study was to calculate the average point incidence of PPH in women with placenta previa. A systematic review and meta-analysis of observational studies estimating PPH in women with placenta previa was conducted through literature searches in four databases in Jul 2016. This study was totally conducted according to the MOOSE guidelines and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard. From 1148 obtained studies, 11 included in the meta-analysis, which involved 5146 unique pregnant women with placenta previa. The overall pooled incidence of PPH was 22.3% (95% CI 15.8-28.7%). In the subgroup, the prevalence was 27.4% in placenta previas, and was 14.5% in low-lying placenta previa; the highest prevalence was estimated in Northern America (26.3%, 95%CI 11.0-41.6%), followed by the Asia (20.7%, 95%CI 12.8-28.6%), Australia (19.2%, 95% CI 17.2-21.1%) and Europe (17.8%, 95% CI, 11.5%-24.0%). The summary estimate of the incidence of PPH among women with placenta previa was considerable in this systematic review. The results will be crucial in prevention, treatment, and identification of PPH among pregnant women with placenta previa and will be contributed to the planning and implantation of relevant public health strategies.

  20. What value is the CINAHL database when searching for systematic reviews of qualitative studies?

    Science.gov (United States)

    Wright, Kath; Golder, Su; Lewis-Light, Kate

    2015-06-26

    The Cumulative Index to Nursing and Allied Health Literature (CINAHL) is generally thought to be a good source to search when conducting a review of qualitative evidence. Case studies have suggested that using CINAHL could be essential for reviews of qualitative studies covering topics in the nursing field, but it is unclear whether this can be extended more generally to reviews of qualitative studies in other topic areas. We carried out a retrospective analysis of a sample of systematic reviews of qualitative studies to investigate CINAHL's potential contribution to identifying the evidence. In particular, we planned to identify the percentage of included studies available in CINAHL and the percentage of the included studies unique to the CINAHL database. After screening 58 qualitative systematic reviews identified from the Database of Abstracts of Reviews of Effects (DARE), we created a sample set of 43 reviews covering a range of topics including patient experience of both illnesses and interventions. For all 43 reviews (21 %) in our sample, we found that some of the included studies were available in CINAHL. For nine of these reviews, all the studies that had been included in the final synthesis were available in the CINAHL database, so it could have been possible to identify all the included studies using just this one database, while for an additional 21 reviews (49 %), 80 % or more of the included studies were available in CINAHL. Consequently, for a total of 30 reviews, or 70 % of our sample, 80 % or more of the studies could be identified using CINAHL alone. 11 reviews, where we were able to recheck all the databases used by the original review authors, had included a study that was uniquely identified from the CINAHL database. The median % of unique studies was 9.09%; while the range had a lowest value of 5.0% to the highest value of 33.0%. [corrected]. Assuming a rigorous search strategy was used and the records sought were accurately indexed, we could

  1. A Review and Database of Snake Venom Proteomes.

    Science.gov (United States)

    Tasoulis, Theo; Isbister, Geoffrey K

    2017-09-18

    Advances in the last decade combining transcriptomics with established proteomics methods have made possible rapid identification and quantification of protein families in snake venoms. Although over 100 studies have been published, the value of this information is increased when it is collated, allowing rapid assimilation and evaluation of evolutionary trends, geographical variation, and possible medical implications. This review brings together all compositional studies of snake venom proteomes published in the last decade. Compositional studies were identified for 132 snake species: 42 from 360 (12%) Elapidae (elapids), 20 from 101 (20%) Viperinae (true vipers), 65 from 239 (27%) Crotalinae (pit vipers), and five species of non-front-fanged snakes. Approximately 90% of their total venom composition consisted of eight protein families for elapids, 11 protein families for viperines and ten protein families for crotalines. There were four dominant protein families: phospholipase A₂s (the most common across all front-fanged snakes), metalloproteases, serine proteases and three-finger toxins. There were six secondary protein families: cysteine-rich secretory proteins, l-amino acid oxidases, kunitz peptides, C-type lectins/snaclecs, disintegrins and natriuretic peptides. Elapid venoms contained mostly three-finger toxins and phospholipase A₂s and viper venoms metalloproteases, phospholipase A₂s and serine proteases. Although 63 protein families were identified, more than half were present in <5% of snake species studied and always in low abundance. The importance of these minor component proteins remains unknown.

  2. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies.

    Science.gov (United States)

    Ferris, Mollie; Quan, Samuel; Kaplan, Belle S; Molodecky, Natalie; Ball, Chad G; Chernoff, Greg W; Bhala, Nij; Ghosh, Subrata; Dixon, Elijah; Ng, Siew; Kaplan, Gilaad G

    2017-08-01

    We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. Population-based studies reported the incidence of appendicitis. We searched MEDLINE and EMBASE databases for population-based studies reporting the incidence of appendicitis or appendectomy. Time trends were explored using Poisson regression and reported as annual percent change (APC) with 95% confidence intervals (CI). APC were stratified by time periods and pooled using random effects models. Incidence since 2000 was pooled for regions in the Western world. The search retrieved 10,247 citations with 120 studies reporting on the incidence of appendicitis or appendectomy. During the 21st century the pooled incidence of appendicitis or appendectomy (in per 100,000 person-years) was 100 (95% CI: 91, 110) in Northern America, and the estimated number of cases in 2015 was 378,614. The pooled incidence ranged from 105 in Eastern Europe to 151 in Western Europe. In Western countries, the incidence of appendectomy steadily decreased since 1990 (APC after 1989=-1.54; 95% CI: -2.22, -0.86), whereas the incidence of appendicitis stabilized (APC=-0.36; 95% CI: -0.97, 0.26) for both perforated (APC=0.95; 95% CI: -0.25, 2.17) and nonperforated appendicitis (APC=0.44; 95% CI: -0.84, 1.73). In the 21st century, the incidence of appendicitis or appendectomy is high in newly industrialized countries in Asia (South Korea pooled: 206), the Middle East (Turkey pooled: 160), and Southern America (Chile: 202). Appendicitis is a global disease. The incidence of appendicitis is stable in most Western countries. Data from newly industrialized countries is sparse, but suggests that appendicitis is rising rapidly.

  3. How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies.

    Science.gov (United States)

    Simpson, Eric L; Keck, Laura E; Chalmers, Joanne R; Williams, Hywel C

    2012-07-01

    Eczema prevention is now an active area of dermatologic and allergy research. Defining an incident case is therefore a prerequisite for such a study. We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. We conducted a systematic review of controlled interventional atopic dermatitis prevention studies by using searches of MEDLINE and Cochrane databases for studies published from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. One hundred two studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  4. The growing incidence of neonatal malaria- A situational review in ...

    African Journals Online (AJOL)

    Abstract. Background: Neonatal malaria was said to be a rare entity. However there are increasing reports from many parts of the world about the occurrence of malaria in the newborn. Methods: A review of the literature on this subject was done with emphasis on developing countries. Literature search was done using ...

  5. A review of PU prevalence and incidence across Scandinavia, Iceland and Ireland (Part I).

    Science.gov (United States)

    Moore, Z; Johanssen, E; van Etten, M

    2013-07-01

    To provide a critical appraisal and synthesis of the published literature pertaining to pressure ulcer (PU) prevalence, incidence and prevention practices from the context of Scandinavia, Iceland and Ireland. An integrative research review following Cooper's five stages. Studies published in peer-reviewed journals, involving any study design, but specifically exploring PU prevalence or incidence in adults or children, in any care setting, were included. Fifty-five papers were data extracted, quality appraised and included in the qualitative synthesis of the review. Mean prevalence in Norway was 17% (4.8-29%) in Ireland was 16% (4-37%), in Denmark was 15% (2.2-35.5%) and in Sweden was 25%, (0.04-42.7%). Prevalence in Iceland was 8.9%. In acute care, mean prevalence was 21% (0-42.7%) and in long stay was 12% (2.4-23.7%). Prevalence among hospice patients was 35.7%, and in community care was 0.04% and 4%. No incidence study from Iceland was identified; the single incidence study from Norway noted a figure of 16.4%. The mean incidence from Ireland was 11% (8-14.4%) from Sweden was 20% (3.1-49%) and Denmark was 1.8% (1.4-2.7%). Mean incidence in acute care setting was 17.6%, (1.4-49%); in long stay was 6.63% (3.1-8.4%). Incidence in the hospice setting was 20.4%. No study reported PU incidence figures from the community setting. Figures for both prevalence and incidence were similar in Ireland and Norway and highest in Sweden, whereas Denmark demonstrated the lowest incidence rates and Iceland demonstrated the lowest prevalence rates. Figures were consistently highest in acute care and hospice settings, and lowest in the care of the older person setting.

  6. A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    disease in MS. METHODS: The PUBMED, EMBASE, SCOPUS and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles were searched, and abstracts were independently screened by two reviewers. The data were abstracted by one reviewer using a standardized data collection form...

  7. Incidence and prevalence of hypercholesterolemia in Portugal: a systemic review. Part II.

    Science.gov (United States)

    Costa, João; Borges, Margarida; Oliveira, Eduardo; Gouveia, Miguel; Carneiro, António Vaz

    2003-05-01

    Over 50% of the mortality and disability caused by ischemic heart disease and stroke could be avoided by controlling individual risk factors (hypertension, hypercholesterolemia, smoking and obesity). The ignorance of the extent and impact of hypercholesterolemia (HC) in Portugal prompted us to undertake this systematic review of the prevalence and incidence of hyperlipidemia in Portugal, based exclusively on work published nationally. We included every study published in the country that could provide data on the prevalence or incidence of hypercholesterolemia. The search strategy included an electronic search of national and international biomedical databases (Medline, Index Revistas Médicas Portuguesas, the Portuguese Directorate-General for Health and the Portuguese National School of Public Health), screening of reference lists from the individual studies, and personal contacts with institutions, groups and authors (such as the Portuguese Foundation of Cardiology). The data--recorded in electronic format--was collected independently by two of the authors (JC and MB), with consensus achieved with a third (AVC) when there were differences in the study coding. We could only identify one paper on the incidence of HC in Portugal, which gave an incidence of 559 new cases per 100,000 inhabitants, increasing with age up to 54 years for men and 64 years for women. There was a higher incidence in men than in women up to the age of 54, but at more advanced ages this relationship was reversed. Prevalence studies on HC included 53,445 individuals overall, with sample size lower than 1000 in most of the individual studies. The most frequently used criterion for HC was > 200 mg/dL, with the mean level being higher in most studies. We calculated the mean prevalence for several cut-off points (190 mg/dL: 63.8%; 200 mg/dL: 56.7%; 240 mg/dL: 31.7%; 250 mg/dL: 21%). Due to the heterogeneity of the data, these results are to be interpreted with caution, even though they are

  8. Incidence and prevalence of hypercholesterolemia in Portugal: a systematic review. Part I.

    Science.gov (United States)

    Costa, João; Borges, Margarida; Oliveira, Eduardo; Gouveia, Miguel; Carneiro, António Vaz

    2003-04-01

    Over 50% of the mortality and disability caused by ischemic heart disease and stroke could be avoided by controlling individual risk factors (hypertension, hypercholesterolemia, smoking and obesity). The ignorance of the extent and impact of hypercholesterolemia (HC) in Portugal prompted us to undertake this systematic review of the prevalence and incidence of hyperlipidemia in Portugal, based exclusively on work published nationally. We included every study published in the country that could provide data on the prevalence or incidence of hypercholesterolemia. The search strategy included an electronic search of national and international biomedical databases (Medline, Index Revistas Médicas Portuguesas, the Portuguese Directorate-General for Health and the Portuguese National School of Public Health), screening of reference lists from the individual studies, and personal contacts with institutions, groups and authors (such as the Portuguese Foundation of Cardiology). The data--recorded in electronic format--was collected independently by two of the authors (JC and MB), with consensus achieved with a third (AVC) when there were differences in the study coding. We could only identify one paper on the incidence of HC in Portugal, which gave an incidence of 559 new cases per 100,000 inhabitants, increasing with age up to 54 years for men and 64 years for women. There was a higher incidence in men than in women up to the age of 54, but at more advanced ages this relationship was reversed. Prevalence studies on HC included 53,445 individuals overall, with sample size lower than 1000 in most of the individual studies. The most frequently used criterion for HC was > 200 mg/dL, with the mean level being higher in most studies. We calculated the mean prevalence for several cut-off points (190 mg/dL: 63.8%; 200 mg/dL: 56.7%; 240 mg/dL: 31.7%; 250 mg/dL: 21%). Due to the heterogeneity of the data, these results are to be interpreted with caution, even though they are

  9. Incidence and prevalence of hypercholesterolemia in Portugal: a systematic review. Part III.

    Science.gov (United States)

    Costa, João; Borges, Margarida; Oliveira, Eduardo; Gouveia, Miguel; Carneiro, António Vaz

    2003-06-01

    Over 50% of the mortality and disability caused by ischemic heart disease and stroke could be avoided by controlling individual risk factors (hypertension, hypercholesterolemia, smoking and obesity). The ignorance of the extent and impact of hypercholesterolemia (HC) in Portugal prompted us to undertake this systematic review of the prevalence and incidence of hyperlipidemia in Portugal, based exclusively on work published nationally. We included every study published in the country that could provide data on the prevalence or incidence of hypercholesterolemia. The search strategy included an electronic search of national and international biomedical databases (Medline, Index Revistas Médicas Portuguesas, the Portuguese Directorate-General for Health and the Portuguese National School of Public Health), screening of reference lists from the individual studies, and personal contacts with institutions, groups and authors (such as the Portuguese Foundation of Cardiology). The data--recorded in electronic format--was collected independently by two of the authors (JC and MB), with consensus achieved with a third (AVC) when there were differences in the study coding. We could only identify one paper on the incidence of HC in Portugal, which gave an incidence of 559 new cases per 100,000 inhabitants, increasing with age up to 54 years for men and 64 years for women. There was a higher incidence in men than in women up to the age of 54, but at more advanced ages this relationship was reversed. Prevalence studies on HC included 53,445 individuals overall, with sample size lower than 1000 in most of the individual studies. The most frequently used criterion for HC was > 200 mg/dL, with the mean level being higher in most studies. We calculated the mean prevalence for several cut-off points (> or = 190 mg/dL: 63.8%; > or = 200 mg/dL: 56.7%; > or = 240 mg/dL; 31.7%; > or 250 mg/d; 21%). Due to the heterogeneity of the data, these results are to be interpreted with caution

  10. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review

    Science.gov (United States)

    van Gent, R N; Siem, D; van Middelkoop, M; van Os, A G; Bierma‐Zeinstra, S M A; Koes, B W

    2007-01-01

    The purpose of this study was to present a systematic overview of published reports on the incidence and associated potential risk factors of lower extremity running injuries in long distance runners. An electronic database search was conducted using the PubMed–Medline database. Two observers independently assessed the quality of the studies and a best evidence synthesis was used to summarise the results. The incidence of lower extremity running injuries ranged from 19.4% to 79.3%. The predominant site of these injuries was the knee. There was strong evidence that a long training distance per week in male runners and a history of previous injuries were risk factors for injuries, and that an increase in training distance per week was a protective factor for knee injuries. PMID:17473005

  11. Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl; Gøtzsche, Peter C

    2009-01-01

    . DATA SOURCES: PubMed (April 2007), reference lists, and authors. Review methods One author extracted data on incidence of breast cancer (including carcinoma in situ), population size, screening uptake, time periods, and age groups, which were checked independently by the other author. Linear regression......OBJECTIVE: To estimate the extent of overdiagnosis (the detection of cancers that will not cause death or symptoms) in publicly organised screening programmes. DESIGN: Systematic review of published trends in incidence of breast cancer before and after the introduction of mammography screening...... was used to estimate trends in incidence before and after the introduction of screening and in older, previously screened women. Meta-analysis was used to estimate the extent of overdiagnosis. RESULTS: Incidence data covering at least seven years before screening and seven years after screening had been...

  12. Pediatric immunization-related safety incidents in primary care: A mixed methods analysis of a national database.

    Science.gov (United States)

    Rees, Philippa; Edwards, Adrian; Powell, Colin; Evans, Huw Prosser; Carter, Ben; Hibbert, Peter; Makeham, Meredith; Sheikh, Aziz; Donaldson, Liam; Carson-Stevens, Andrew

    2015-07-31

    Children are scheduled to receive 18-20 immunizations before their 18th birthday in England and Wales; this approximates to 13 million vaccines administered per annum. Each immunization represents a potential opportunity for immunization-related error and effective immunization is imperative to maintain the public health benefit from immunization. Using data from a national reporting system, this study aimed to characterize pediatric immunization-related safety incident reports from primary care in England and Wales between 2002 and 2013. A cross-sectional mixed methods study was undertaken. This comprised reading the free-text of incident reports and applying codes to describe incident type, potential contributory factors, harm severity, and incident outcomes. A subsequent thematic analysis was undertaken to interpret the most commonly occurring codes, such as those describing the incident, events leading up to it and reported contributory factors, within the contexts they were described. We identified 1745 reports and most (n=1077, 61.7%) described harm outcomes including three deaths, 67 reports of moderate harm and 1007 reports of low harm. Failure of timely vaccination was the potential cause of three child deaths from meningitis and pneumonia, and described in a further 113 reports. Vaccine administration incidents included the wrong number of doses (n=476, 27.3%), wrong timing (n=294, 16.8%), and wrong vaccine (n=249, 14.3%). Documentation failures were frequently implicated. Socially and medically vulnerable children were commonly described. This is the largest examination of reported contributory factors for immunization-related patient safety incidents in children. Our findings suggest investments in IT infrastructure to support data linkage and identification of risk predictors, development of consultation models that promote the role of parents in mitigating safety incidents, and improvement efforts to adapt and adopt best practices from elsewhere, are

  13. The use of intelligent database systems in acute pancreatitis--a systematic review.

    Science.gov (United States)

    van den Heever, Marc; Mittal, Anubhav; Haydock, Matthew; Windsor, John

    2014-01-01

    Acute pancreatitis (AP) is a complex disease with multiple aetiological factors, wide ranging severity, and multiple challenges to effective triage and management. Databases, data mining and machine learning algorithms (MLAs), including artificial neural networks (ANNs), may assist by storing and interpreting data from multiple sources, potentially improving clinical decision-making. 1) Identify database technologies used to store AP data, 2) collate and categorise variables stored in AP databases, 3) identify the MLA technologies, including ANNs, used to analyse AP data, and 4) identify clinical and non-clinical benefits and obstacles in establishing a national or international AP database. Comprehensive systematic search of online reference databases. The predetermined inclusion criteria were all papers discussing 1) databases, 2) data mining or 3) MLAs, pertaining to AP, independently assessed by two reviewers with conflicts resolved by a third author. Forty-three papers were included. Three data mining technologies and five ANN methodologies were reported in the literature. There were 187 collected variables identified. ANNs increase accuracy of severity prediction, one study showed ANNs had a sensitivity of 0.89 and specificity of 0.96 six hours after admission--compare APACHE II (cutoff score ≥8) with 0.80 and 0.85 respectively. Problems with databases were incomplete data, lack of clinical data, diagnostic reliability and missing clinical data. This is the first systematic review examining the use of databases, MLAs and ANNs in the management of AP. The clinical benefits these technologies have over current systems and other advantages to adopting them are identified. Copyright © 2013 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  14. The Nordic prescription databases as a resource for pharmacoepidemiological research-a literature review

    DEFF Research Database (Denmark)

    Wettermark, Bjørn; Wallach-Kildemoes, Helle

    2013-01-01

    PURPOSE: All five Nordic countries have nationwide prescription databases covering all dispensed drugs, with potential for linkage to outcomes. The aim of this review is to present an overview of therapeutic areas studied and methods applied in pharmacoepidemiologic studies using data from...... these databases. METHODS: The study consists of a Medline-based structured literature review of scientific papers published during 2005-2010 using data from the prescription databases in Denmark, Finland, Iceland, Norway, and Sweden, covering 25 million inhabitants. Relevant studies were analyzed in terms...... of pharmacological group, study population, outcomes examined, type of study (drug utilization vs. effect of drug therapy), country of origin, and extent of cross-national collaboration. RESULTS: A total of 515 studies were identified. Of these, 262 were conducted in Denmark, 97 in Finland, 4 in Iceland, 87...

  15. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies.

    Science.gov (United States)

    Fiest, Kirsten M; Sauro, Khara M; Wiebe, Samuel; Patten, Scott B; Kwon, Churl-Su; Dykeman, Jonathan; Pringsheim, Tamara; Lorenzetti, Diane L; Jetté, Nathalie

    2017-01-17

    To review population-based studies of the prevalence and incidence of epilepsy worldwide and use meta-analytic techniques to explore factors that may explain heterogeneity between estimates. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed. We searched MEDLINE and EMBASE for articles published on the prevalence or incidence of epilepsy since 1985. Abstract, full-text review, and data abstraction were conducted in duplicate. Meta-analyses and meta-regressions were used to explore the association between prevalence or incidence, age group, sex, country level income, and study quality. A total of 222 studies were included (197 on prevalence, 48 on incidence). The point prevalence of active epilepsy was 6.38 per 1,000 persons (95% confidence interval [95% CI] 5.57-7.30), while the lifetime prevalence was 7.60 per 1,000 persons (95% CI 6.17-9.38). The annual cumulative incidence of epilepsy was 67.77 per 100,000 persons (95% CI 56.69-81.03) while the incidence rate was 61.44 per 100,000 person-years (95% CI 50.75-74.38). The prevalence of epilepsy did not differ by age group, sex, or study quality. The active annual period prevalence, lifetime prevalence, and incidence rate of epilepsy were higher in low to middle income countries. Epilepsies of unknown etiology and those with generalized seizures had the highest prevalence. This study provides a comprehensive synthesis of the prevalence and incidence of epilepsy from published international studies and offers insight into factors that contribute to heterogeneity between estimates. Significant gaps (e.g., lack of incidence studies, stratification by age groups) were identified. Standardized reporting of future epidemiologic studies of epilepsy is needed. © 2016 American Academy of Neurology.

  16. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  17. HIV incidence in Asia: a review of available data and assessment of the epidemic.

    Science.gov (United States)

    Dokubo, E Kainne; Kim, Andrea A; Le, Linh-Vi; Nadol, Patrick J; Prybylski, Dimitri; Wolfe, Mitchell I

    2013-01-01

    Rates of new HIV infections in Asia are poorly characterized, likely resulting in knowledge gaps about infection trends and the most important areas to target for interventions. We conducted a systematic review of peer-reviewed English language publications and conference abstracts on HIV incidence in thirteen countries - Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Taiwan, Thailand, and Vietnam. We obtained data on HIV incidence rate, incidence estimation method, population, and risk factors for incident infection. Our search yielded 338 unique incidence estimates from 70 published articles and 41 conference abstracts for eight countries. A total of 138 (41%) were obtained from prospective cohort studies and 106 (31%) were from antibody-based tests for recent infection. High HIV incidence rates were observed among commercial sex workers (0.4-27.8 per 100 person-years), people who inject drugs (0.0-43.6 per 100 person-years) and men who have sex with men (0.7-15.0 per 100 person-years). Risk factors for incident HIV infection include brothel-based sex work and cervicitis among commercial sex workers; young age, frequent injection use and sharing needles or syringes among people who inject drugs; multiple male sexual partners, receptive anal intercourse and syphilis infection among men who have sex with men. In the countries with available data, incidence rates were highest in key populations and varied widely by incidence estimation method. Established surveillance systems that routinely monitor trends in HIV incidence are needed to inform prevention planning, prioritize resources, measure impact, and improve the HIV response in Asia.

  18. The IAEA Illicit Trafficking Database Programme: Operations and Structure

    International Nuclear Information System (INIS)

    2010-01-01

    the IAEA I TDB currently has 90 states participating voluntarily to the database. Information on about 827 incidents of which 500 involved radioactive sources has been reported. States provide information by submitting an Information Notification Form. The incident is assigned an identification number and entered in the database. Information from open sources is collected daily and reviewed. If the information warrants it a new incident is created in the database.

  19. Searching Harvard Business Review Online. . . Lessons in Searching a Full Text Database.

    Science.gov (United States)

    Tenopir, Carol

    1985-01-01

    This article examines the Harvard Business Review Online (HBRO) database (bibliographic description fields, abstracts, extracted information, full text, subject descriptors) and reports on 31 sample HBRO searches conducted in Bibliographic Retrieval Services to test differences between searching full text and searching bibliographic record. Sample…

  20. Review of acute chemical incidents as a first step in evaluating the usefulness of physiologically based pharmacokinetic models in such incidents

    NARCIS (Netherlands)

    Hunault, C. C.; Boerleider, R. Z.; Hof, B. G H; Kliest, J. J G; Meijer, M.; Nijhuis, N. J.; De Vries, I.; Meulenbelt, J.

    2014-01-01

    Context. Acute chemical incidents can have substantial public health consequences in terms of morbidity and mortality. Objective. We aimed to characterize acute chemical incidents and near-misses in the Netherlands and compare the results with previous studies. This review is a first step in

  1. Incidence and predictors of oral feeding intolerance in acute pancreatitis: A systematic review, meta-analysis, and meta-regression.

    Science.gov (United States)

    Bevan, Melody G; Asrani, Varsha M; Bharmal, Sakina; Wu, Landy M; Windsor, John A; Petrov, Maxim S

    2017-06-01

    Tolerance of oral food is an important criterion for hospital discharge in patients with acute pancreatitis. Patients who develop oral feeding intolerance have prolonged hospitalisation, use additional healthcare resources, and have impaired quality of life. This study aimed to quantify the incidence of oral feeding intolerance, the effect of confounders, and determine the best predictors of oral feeding intolerance. Clinical studies indexed in three electronic databases (EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials) were reviewed. Incidence and predictor data were meta-analysed and possible confounders were investigated by meta-regression analysis. A total of 22 studies with 2024 patients met the inclusion criteria, 17 of which (with 1550 patients) were suitable for meta-analysis. The incidence of oral feeding intolerance was 16.3%, and was not affected by WHO region, age, sex, or aetiology of acute pancreatitis. Nine of the 22 studies investigated a total of 62 different predictors of oral feeding intolerance. Serum lipase level prior to refeeding, pleural effusions, (peri)pancreatic collections, Ranson score, and Balthazar score were found to be statistically significant in meta-analyses. Oral feeding intolerance affects approximately 1 in 6 patients with acute pancreatitis. Serum lipase levels of more than 2.5 times the upper limit of normal prior to refeeding is a potentially useful threshold to identify patients at high risk of developing oral feeding intolerance. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. The incidence of Kawasaki disease after vaccination within the UK pre-school National Immunisation Programme: an observational THIN database study.

    Science.gov (United States)

    Hall, Gillian C; Tulloh, Robert Mr; Tulloh, Louise E

    2016-11-01

    To provide expected incidence rates of Kawasaki disease after vaccination in routine clinical practice and as recommended within a pre-school National Immunisation Programme (NIP). A post-immunisation risk period when Kawasaki disease onset might be associated with vaccination was defined as 28 days. Immunisation records for children under 6 years were identified from The Health Improvement Network (THIN) database of electronic UK primary health care records (2008-2012) and linked to previously validated cases of Kawasaki disease with an assigned date of onset. Kawasaki disease incidence in the risk period after a complete NIP recommended set of vaccinations was estimated for five vaccination stages individually and in total. A total of 642 170 complete pre-school immunisation stages from 275 986 children were included. Six cases of Kawasaki disease had onset in the risk period after any NIP stage providing an incidence of 12.8 per 100 000 person years (95%CI 5.7, 28.4). The incidence after any single immunisation stage ranged from 0 to 27.4 (95%CI 8.8, 84.8) per 100 000 person years. There were few cases of Kawasaki disease in the risk period after any NIP vaccination combination. The incidence rates will aid in the interpretation of clinical trials and post-marketing surveillance of new vaccines. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Review of patient safety incidents submitted from Critical Care Units in England & Wales to the UK National Patient Safety Agency.

    Science.gov (United States)

    Thomas, A N; Panchagnula, U; Taylor, R J

    2009-11-01

    We reviewed and classified all patient safety incidents submitted from critical care units in England and Wales to the National Patient Safety Agency for the first quarter of 2008. A total of 6649 incidents were submitted from 141 organisations (median (range) 23 (1-268 incidents)); 786 were unrelated to the critical care episode and 248 were repeat entries. Of the remaining 5615 incidents, 1726 occurred in neonates or babies, 1298 were associated with temporary harm, 15 with permanent harm and 59 required interventions to maintain life or may have contributed to the patient's death. The most common main incident groups were medication (1450 incidents), infrastructure and staffing (1289 incidents) and implementation of care (1047 incidents). There were 2789 incidents classified to more than one main group. The incident analysis highlights ways to improve patient safety and to improve the classification of incidents.

  4. The incidence of adjacent segment disease requiring surgery after anterior cervical diskectomy and fusion: estimation using an 11-year comprehensive nationwide database in Taiwan.

    Science.gov (United States)

    Wu, Jau-Ching; Liu, Laura; Wen-Cheng, Huang; Chen, Yu-Chun; Ko, Chin-Chu; Wu, Ching-Lan; Chen, Tzeng-Ji; Cheng, Henrich; Su, Tung-Ping

    2012-03-01

    The incidence of symptomatic adjacent segment disease (ASD) after anterior cervical diskectomy and fusion (ACDF) was reported as 2.9%/y in a previous cohort of 374 patients. Few other data corroborate the incidence and natural history of ASD. To calculate the incidence of ASD after ACDF that required secondary fusion surgery. The retrospective study used an 11-year nationwide database to analyze the incidences. All patients who underwent ACDF for cervical disk diseases were identified through diagnostic and procedure codes. Kaplan-Meier and Cox regression analyses were performed. From 1997 to 2007, covering 241 800 725.8 person-years, 19 385 patients received ACDF and 568 had ≥ 2 ACDF operations. The incidence of secondary ACDF operations was 7.6 per 1000 person-years. At the end of the 10-year cohort, 94.4% of patients who had received 1 ACDF remained free from secondary ACDF. The average time interval between the first and second ACDF was 23.3 months. After adjustment for comorbidities and socioeconomic status, secondary ACDF operations were more likely performed on male patients (hazard ratio = 1.27; P = .008) 15 to 39 years of age (hazard ratio = 1.45; P = .009) and 40 to 59 years of age (hazard ratio = 1.41, P = .002, respectively). Repeat ACDF surgery for ASD cumulated steadily in an annual incidence of approximately 0.8%, much lower than the reported incidence of symptomatic ASD. However, at the end of this 10-year cohort, a considerable portion of patients (5.6%) received a second operation. Younger and male patients are more likely to receive such second operations.

  5. A review of the anterolateral ligament of the knee: current knowledge regarding its incidence, anatomy, biomechanics, and surgical dissection.

    Science.gov (United States)

    Pomajzl, Ryan; Maerz, Tristan; Shams, Christienne; Guettler, Joseph; Bicos, James

    2015-03-01

    To systematically review current literature on the anterolateral ligament (ALL) of the knee. We searched the PubMed/Medline database for publications specifically addressing the ALL. We excluded studies not written in English, studies not using human cadavers or subjects, and studies not specifically addressing the ALL. Data extraction related to the incidence, anatomy, morphometry, biomechanics, and histology of the ALL and its relation to the Segond fracture was performed. The incidence of the ALL ranged from 83% to 100%, and this range occurs because of small discrepancies in the definition of the ALL's bony insertions. The ALL originates anterior and distal to the femoral attachment of the lateral collateral ligament. It spans the joint in an oblique fashion and inserts between the fibular head and Gerdy tubercle on the tibia. Exact anatomic and morphometric descriptions vary in the literature, and there are discrepancies regarding the ALL's attachment to the capsule and lateral meniscus. The ALL is a contributor to tibial internal rotation stability, and histologically, it exhibits parallel, crimped fibers consistent with a ligamentous microstructure. The footprint of the ALL has been shown to be at the exact location of the Segond fracture. The ALL is a distinct ligamentous structure at the anterolateral aspect of the knee, and it is likely involved in tibial internal rotation stability and the Segond fracture. Level IV, systematic review of anatomic and imaging studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies.

    Science.gov (United States)

    Doherty, Cailbhe; Delahunt, Eamonn; Caulfield, Brian; Hertel, Jay; Ryan, John; Bleakley, Chris

    2014-01-01

    Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with

  7. Incidence of constipation in stroke patients: A systematic review and meta-analysis.

    Science.gov (United States)

    Li, Jianxiang; Yuan, Mengguo; Liu, Yunfang; Zhao, Yang; Wang, Jingqing; Guo, Weifeng

    2017-06-01

    There is growing awareness of a link between the gut and cardiovascular disease. Constipation is common among individuals who have had a stroke, and it negatively affects social functioning and quality of life. However, no systematic study on the incidence of constipation in stroke patients has been reported.We selected studies included in Medline, Embase, Cochrane database, and Web of Science. Studies were included if they reported the incidence in stroke patients. Two authors selected the studies, extracted the data independently, and assessed these. Subgroup analyses were conducted according to the stroke subtype and stage of stroke.After detailed evaluations, 8 studies (n  =  1385 participants) were found that contained data that were suitable for meta-analytic synthesis. A forest plot showed that the incidence of constipation was 48% (95% confidence interval [CI]  =  33%-63%). In the analysis of the type of stroke subgroup, the incidence of constipation in patients who had had a hemorrhagic stroke (66% [95% CI  =  40-91%]) was higher than that in patients who had experienced an ischemic stroke (51% [95% CI  =  27%-75%]). The incidence in the acute stage (45% [95% CI  =  36%-54%]) was lower than that in the rehabilitation stage (48% [95% CI  =  23%-73%]).Constipation after a stroke event occurs frequently. This finding may raise awareness about bowel complications to allow correct evaluation and proper management.

  8. 7 Mass casualty incidents: a review of triage severity planning assumptions.

    Science.gov (United States)

    Hunt, Paul

    2017-12-01

    Recent events involving a significant number of casualties have emphasised the importance of appropriate preparation for receiving hospitals, especially Emergency Departments, during the initial response phase of a major incident. Development of a mass casualty resilience and response framework in the Northern Trauma Network included a review of existing planning assumptions in order to ensure effective resource allocation, both in local receiving hospitals and system-wide.Existing planning assumptions regarding categorisation by triage level are generally stated as a ratio for P1:P2:P3 of 25%:25%:50% of the total number of injured survivors. This may significantly over-, or underestimate, the number in each level of severity in the case of a large-scale incident. A pilot literature review was conducted of the available evidence from historical incidents in order to gather data regarding the confirmed number of overall casualties, 'critical' cases, admitted cases, and non-urgent or discharged cases. This data was collated and grouped by mechanism in order to calculate an appropriate severity ratio for each incident type. 12 articles regarding mass casualty incidents from the last two decades were identified covering three main incident types: (1) Mass transportation crash, (2) Building fire, and (3) Bomb and related terrorist attacks and involving a total of 3615 injured casualties. The overall mortality rate was calculated as 12.3%. Table 1 summarises the available patient casualty data from each of the specific incidents reported and calculated proportions of critical ('P1'), admitted ('P2'), and non-urgent or ambulatory cases ('P3'). Despite the heterogeneity of data and range of incident type there is sufficient evidence to suggest that current planning assumptions are incorrect and a more refined model is required. An important finding is the variation in proportion of critical cases depending upon the mechanism. For example, a greater than expected proportion

  9. Effect of Toothbrushing Frequency on Incidence and Increment of Dental Caries: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kumar, S; Tadakamadla, J; Johnson, N W

    2016-10-01

    Toothbrushing is considered fundamental self-care behavior for maintenance of oral health, and brushing twice a day has become a social norm, but the evidence base for this frequency is weak. This systematic review and meta-analysis aims to assess the effect of toothbrushing frequency on the incidence and increment of carious lesions. Medline, Embase, Cinahl, and Cochrane databases were searched. Screening and quality assessment were performed by 2 independent reviewers. Three different meta-analyses were conducted: 2 based on the caries outcome reported in the studies (incidence and increment) with subgroup analyses of categories of toothbrushing frequency; another included all studies irrespective of the caries outcome reported with the type of dentition as subgroups. Meta-regression was conducted to assess the influence of sample size, follow-up period, diagnosis level for carious lesions, and methodological quality of the articles on the effect estimate. Searches retrieved 5,494 titles: after removing duplicates, 4,305 remained. Of these, 74 were reviewed in full, but only 33 were eligible for inclusion. Self-reported infrequent brushers demonstrated higher incidence (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.34 to 1.69) and increment (standardized mean difference [SMD], 0.28; 95% CI: 0.13 to 0.44) of carious lesions than frequent brushers. The odds of having carious lesions differed little when subgroup analysis was conducted to compare the incidence between ≥2 times/d vs <2 times/d (OR: 1.45; 95% CI: 1.21 to 1.74) and ≥1 time/d vs <1 time/d brushers (OR: 1.56; 95% CI: 1.37 to 1.78). When meta-analysis was conducted with the type of dentition as subgroups, the effect of infrequent brushing on incidence and increment of carious lesions was higher in deciduous (OR: 1.75; 95% CI: 1.49 to 2.06) than permanent dentition (OR: 1.39; 95% CI: 1.29 to 1.49). Findings from meta-regression indicated that none of the included variables influenced the

  10. Sensitivity of routine system for reporting patient safety incidents in an NHS hospital: retrospective patient case note review.

    Science.gov (United States)

    Sari, Ali Baba-Akbari; Sheldon, Trevor A; Cracknell, Alison; Turnbull, Alastair

    2007-01-13

    To evaluate the performance of a routine incident reporting system in identifying patient safety incidents. Two stage retrospective review of patients' case notes and analysis of data submitted to the routine incident reporting system on the same patients. A large NHS hospital in England. 1006 hospital admissions between January and May 2004: surgery (n=311), general medicine (n=251), elderly care (n=184), orthopaedics (n=131), urology (n=61), and three other specialties (n=68). Proportion of admissions with at least one patient safety incident; proportion and type of patient safety incidents missed by routine incident reporting and case note review methods. 324 patient safety incidents were identified in 230/1006 admissions (22.9%; 95% confidence interval 20.3% to 25.5%). 270 (83%) patient safety incidents were identified by case note review only, 21 (7%) by the routine reporting system only, and 33 (10%) by both methods. 110 admissions (10.9%; 9.0% to 12.8%) had at least one patient safety incident resulting in patient harm, all of which were detected by the case note review and six (5%) by the reporting system. The routine incident reporting system may be poor at identifying patient safety incidents, particularly those resulting in harm. Structured case note review may have a useful role in surveillance of routine incident reporting and associated quality improvement programmes.

  11. Adherence to Mediterranean Diet Reduces Incident Frailty Risk: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kojima, Gotaro; Avgerinou, Christina; Iliffe, Steve; Walters, Kate

    2018-01-11

    To conduct a systematic review of the literature on prospective cohort studies examining associations between adherence to a Mediterranean diet and incident frailty and to perform a meta-analysis to synthesize the pooled risk estimates. Systematic review and meta-analysis. Embase, MEDLINE, CINAHL, PsycINFO, and Cochrane Library were systematically searched on September 14, 2017. We reviewed references of included studies and relevant review papers and performed forward citation tracking for additional studies. Corresponding authors were contacted for additional data necessary for a meta-analysis. Community-dwelling older adults (mean age ≥60). Incident frailty risk according to adherence to a Mediterranean diet. Two reviewers independently screened the title, abstract, and full text to ascertain the eligibility of 125 studies that the systematic search of the literature identified, and four studies were included (5,789 older people with mean follow-up of 3.9 years). Two reviewers extracted data from the studies independently. All four studies provided adjusted odds ratios (ORs) of incident frailty risk according to three Mediterranean diet score (MDS) groups (0-3, 4-5, and 6-9). Greater adherence to a Mediterranean diet was associated with significantly lower incident frailty risk (pooled OR = 0.62, 95% CI = 0.47-0.82, P = .001 for MDS 4-5; pooled OR = 0.44, 95% CI = 0.31-0.64, P Mediterranean diet is associated with significantly lower risk of incident frailty in community-dwelling older people. Future studies should confirm these findings and evaluate whether adherence to a Mediterranean diet can reduce the risk of frailty, including in non-Mediterranean populations. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  12. Critical incidents related to opioid infusions in children: a five-year review and analysis.

    Science.gov (United States)

    West, Nicholas; Nilforushan, Vahid; Stinson, Jonathan; Ansermino, J Mark; Lauder, Gillian

    2014-04-01

    Opioids have a narrow therapeutic index and have the potential to cause significant harm. Developmental and pharmacogenetic factors put children, and especially infants, at increased risk of complications. We performed a retrospective root cause analysis to identify the factors associated with critical incidents in children receiving opioid infusions in a tertiary care children's hospital. Following institutional ethical approval, we identified potential critical incidents during 2004 to 2009 from patient safety and pharmacy data. Patients' medical charts were reviewed and a timeline of events that occurred before, during, and following each incident was generated. A safety assessment code score was assigned to each incident according to its severity and probability of recurrence, and incidents with a score ≥ 8 were selected for root cause analysis. Root causes were identified and classified, formal causal statements were written, and action plans were recommended. One hundred and sixty-six medical charts were reviewed, and 58 of these included one (45/58) or more (13/58) relevant critical incidents. The resulting harms were of minor to moderate severity. Fourteen incidents were submitted for detailed analysis, from which 31 root causes were identified. The most frequent and significant root causes involved defects in pre-printed order sheets, lack of a nursing guidelines for infusions (rate, adjustment, weaning), and inadequate guidelines for monitoring and recording pain, vital signs, and arousal scores. The root causes of a range of critical incidents have been identified, and these have been used to generate recommendations for improving both patient safety and quality of analgesia for children receiving opioid infusions for acute pain management.

  13. Searching for evidence or approval? A commentary on database search in systematic reviews and alternative information retrieval methodologies

    NARCIS (Netherlands)

    Delaney, Aogán; Tamás, Peter A.

    2017-01-01

    Despite recognition that database search alone is inadequate even within the health sciences, it appears that reviewers in fields that have adopted systematic review are choosing to rely primarily, or only, on database search for information retrieval. This commentary reminds readers of factors that

  14. Guarding the Precious Smile: Incidence and Prevention of Injury in Sports: A Review

    OpenAIRE

    Dhillon, Bikramjit Singh; Sood, Nikhil; Sood, Niti; Sah, Nupur; Arora, Dhruv; Mahendra, Ashish

    2014-01-01

    The paper provides a review about the orofacial injuries sustained during sports and the options available to the athletes for their prevention. It was done with a purpose to determine three different aspects incidence of dental injury during sporting activities, role of mouthguards in preventing sports injury, types of mouthguards and their properties. From this review, it is clear that sports carry a considerable risk of injury, this is not only true for the contact sports such as rugby or ...

  15. Incidence of acute kidney injury among patients with chronic kidney disease: a single-center retrospective database analysis.

    Science.gov (United States)

    Hatakeyama, Yutaka; Horino, Taro; Kataoka, Hiromi; Matsumoto, Tatsuki; Ode, Kazu; Shimamura, Yoshiko; Ogata, Koji; Inoue, Kosuke; Taniguchi, Yoshinori; Terada, Yoshio; Okuhara, Yoshiyasu

    2017-02-01

    Acute kidney injury (AKI) is a serious complication among hospitalized individuals and is closely associated with chronic kidney disease (CKD). This retrospective cohort study evaluated the incidences of AKI according to CKD stage at Kochi Medical School hospital during 1981-2011. AKI was defined and staged according to the kidney disease improving global outcomes criteria, using serum creatinine levels. We analyzed data from 122,653 Japanese patients (57,105 men, 46.6 %). The incidence of AKI was 7.8 % (95 % confidence interval 7.7-8.0 %). Compared to non-AKI patients, patients with stage 1-2 AKI were more likely to be men. Patients with stage 1-2 AKI were significantly older than non-AKI or stage 3 AKI patients. The incidences of AKI were 6.7, 5.9, 10.4, 18.4, 30.0, and 48.8 % among individuals with estimated glomerular filtration rates of ≥90, 60-89, 45-59, 30-44, 15-29, and kidney function, and the proportions among outpatients exhibited step-wise increases with milder pre-existing reduced kidney function. CKD was a risk factor for AKI, and the incidence of AKI was positively associated with pre-existing reduced kidney function (CKD stage). We also found that the prevalence of AKI at early-stage CKD among outpatients was higher than expected. We suggest that outpatients should be monitored for AKI, given its unexpected incidence in that population.

  16. Incidence of influenza and associated illness in children aged 0-19 years : a systematic review

    NARCIS (Netherlands)

    Bueving, HJ; van der Wouden, JC; Berger, MY; Thomas, S

    2005-01-01

    A systematic review was conducted to estimate the incidence of influenza and concomitant morbidity and mortality in children from 0 to 19 years (0-19 years). Medline was searched for observational studies and placebo or non-treated arms of experimental studies providing occurrence rates of

  17. Incidence and risk of cardiotoxicity associated with bortezomib in the treatment of cancer: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yi Xiao

    Full Text Available BACKGROUND: We conducted a systematic review and meta-analysis to clarify the incidence and risk of cardiotoxicity associated with bortezomib in cancer patients. METHODS: Databases from PubMed, Web of Science and abstracts presented at ASCO meeting up to July 31, 2013 were searched to identify relevant studies. Eligible studies included prospective phase II and III trials evaluating bortezomib in cancer patients with adequate data on cardiotoxicity. Statistical analyses were conducted to calculate the summary incidence, odds ratio (OR and 95% confidence intervals (CIs by using either random effects or fixed effect models according to the heterogeneity of included studies. RESULTS: A total of 5718 patients with a variety of malignancies from 25 clinical trials were included in our analysis. The incidence of all-grade and high-grade cardiotoxicity associated with bortezomib was 3.8% (95%CI: 2.6-5.6% and 2.3% (1.6-3.5%, with a mortality of 3.0% (1.4-6.5%. Patients treated with bortezomib did not significantly increase the risk of all-grade (OR 1.15, 95%CI: 0.82-1.62, p=0.41 and high-grade (OR 1.13, 95%CI: 0.58-2.24, p=0.72 cardiotoxicity compared with patients treated with control medication. Sub-group analysis showed that the incidence of cardiotoxicity varied with tumor types, treatment regimens and phases of trials. No evidence of publication bias was observed. CONCLUSIONS: The use of bortezomib does not significantly increase the risk of cardiotoxicity compared to control patients. Further studies are recommended to investigate this association and risk differences among different tumor types, treatment regimens and phases of trials.

  18. 34 A systematic literature review of the pre-hospital lessons identified following mass casualty deliberate bombing incidents.

    Science.gov (United States)

    Cooke, Thomas; Chesters, Adam; Grier, Gareth

    2017-12-01

    Since the end of World War II, there has been an emergence of explosives used amongst civilian populations resulting in mass-casualty incidents. The development of pre-hospital medical systems, worldwide, has resulted in an increased response at these incidents. However, information about the pre-hospital medical response is sparse and not collated. This review aimed to collect and appraise the literature on the pre-hospital management of mass-casualty bombing incidents. The primary objective was to identify and discuss the common themes highlighted as problems in the pre-hospital medical response. The secondary objectives reviewed the injury patterns in victims and psychological impacts on pre-hospital responders. A systematic literature search on the PubMed, SCOPUS and Web of Science databases took place. It included literature published from the 1 st of January 2000 to April 3rd 2017, with the last search performed on April 3rd 2017. Literature was included if it offered description, analysis, reflection or review of the bombing incidents.emermed;34/12/A884-a/F1F1F1Figure 1The minimum number of recorded deaths and injuries from 11 deliberate mass casualty bombing incidents (note: two simultaneous marauding terrorist firearm attack and bombing incidents excluded)emermed;34/12/A884-a/F2F2F2Figure 2Percentage of included literature identifying the following themes as problems in the pre-hospitals medical response RESULTS: 1345 articles were found, with 54 included in analysis. 13 mass-casualty bombing incidents were described. Two of these included marauding terrorist firearm attacks (MTFA). In the 11 bombing-only incidents the death of 592-642 people and injury of 3,842-5229 more is described, with a further 301 deaths and 604 injuries from bombings with MTFA attacks. Quality appraisal showed a variation in reporting among incidents and a lack of uniform reporting. Functioning and reliable communication, alongside regular training exercises with other emergency

  19. A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

    Directory of Open Access Journals (Sweden)

    Duncan KJ

    2016-01-01

    Full Text Available Koji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA. The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods: Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results: Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11. Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations: This review was not registered through PROSPERO. Conclusion: The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing

  20. Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature.

    Science.gov (United States)

    Thompson, Julian; Rehn, Marius; Lossius, Hans Morten; Lockey, David

    2014-09-24

    As the threat of international terrorism rises, there is an increasing requirement to provide evidence-based information and training for the emergency personnel who will respond to terrorist incidents. Current major incident training advises that emergency responders prioritize their own personal safety above that of the 'scene and survivors'. However, there is limited information available on the nature of these threats and how they may be accurately evaluated. This study reviews the published medical literature to identify the hazards experienced by emergency responders who have attended previous terrorist incidents. A PubMed literature search identified 10,894 articles on the subject of 'terrorism', and there was a dramatic increase in publications after the 9/11 attacks in 2001. There is heterogeneity in the focus and quality of this literature, and 307 articles addressing the subject of scene safety were assessed for information regarding the threats encountered at terrorist incidents. These articles demonstrate that emergency responders have been exposed to both direct terrorist threats and environmental scene hazards, including airborne particles, structural collapse, fire, and psychological stress. The emphasis of training and preparedness for terrorist incidents has been primarily on the direct threats, but the published literature suggests that the dominant causes of mortality and morbidity in responders after such incidents are the indirect environmental hazards. If the medical response to terrorist incidents is to be based on evidence rather than anecdote, analysis of the current literature should be incorporated into major incident training, and consistent collection of key data from future incidents is required.

  1. Pediatric immunization-related safety incidents in primary care: A mixed methods analysis of a national database

    OpenAIRE

    Rees, Philippa; Edwards, Adrian; Powell, Colin; Evans, Huw Prosser; Carter, Ben; Hibbert, Peter; Makeham, Meredith; Sheikh, Aziz; Donaldson, Liam; Carson-Stevens, Andrew

    2015-01-01

    Background\\ud \\ud Children are scheduled to receive 18–20 immunizations before their 18th birthday in England and Wales; this approximates to 13 million vaccines administered per annum. Each immunization represents a potential opportunity for immunization-related error and effective immunization is imperative to maintain the public health benefit from immunization. Using data from a national reporting system, this study aimed to characterize pediatric immunization-related safety incident repo...

  2. Genealogical databases as a tool for extending follow-up in clinical reviews.

    Science.gov (United States)

    Ho, Thuy-Van; Chowdhury, Naweed; Kandl, Christopher; Hoover, Cindy; Robinson, Ann; Hoover, Larry

    2016-08-01

    Long-term follow-up in clinical reviews often presents significant difficulty with conventional medical records alone. Publicly accessible genealogical databases such as Ancestry.com provide another avenue for obtaining extended follow-up and added outcome information. No previous studies have described the use of genealogical databases in the follow-up of individual patients. Ancestry.com, the largest genealogical database in the United States, houses extensive demographic data on an increasing number of Americans. In a recent retrospective review of esthesioneuroblastoma patients treated at our institution, we used this resource to ascertain the outcomes of patients otherwise lost to follow-up. Additional information such as quality of life and supplemental treatments the patient may have received at home was obtained through direct contact with living relatives. The use of Ancestry.com resulted in a 25% increase (20 months) in follow-up duration as well as incorporation of an additional 7 patients in our study (18%) who would otherwise not have had adequate hospital chart data for inclusion. Many patients within this subset had more advanced disease or were remotely located from our institution. As such, exclusion of these outliers can impact the quality of subsequent outcome analysis. Online genealogical databases provide a unique resource of public information that is acceptable to institutional review boards for patient follow-up in clinical reviews. Utilization of Ancestry.com data led to significant improvement in follow-up duration and increased the number of patients with sufficient data that could be included in our retrospective study. © 2016 ARS-AAOA, LLC.

  3. A Systematic Review of Coding Systems Used in Pharmacoepidemiology and Database Research.

    Science.gov (United States)

    Chen, Yong; Zivkovic, Marko; Wang, Tongtong; Su, Su; Lee, Jianyi; Bortnichak, Edward A

    2018-02-01

    Clinical coding systems have been developed to translate real-world healthcare information such as prescriptions, diagnoses and procedures into standardized codes appropriate for use in large healthcare datasets. Due to the lack of information on coding system characteristics and insufficient uniformity in coding practices, there is a growing need for better understanding of coding systems and their use in pharmacoepidemiology and observational real world data research. To determine: 1) the number of available coding systems and their characteristics, 2) which pharmacoepidemiology databases are they adopted in, 3) what outcomes and exposures can be identified from each coding system, and 4) how robust they are with respect to consistency and validity in pharmacoepidemiology and observational database studies. Electronic literature database and unpublished literature searches, as well as hand searching of relevant journals were conducted to identify eligible articles discussing characteristics and applications of coding systems in use and published in the English language between 1986 and 2016. Characteristics considered included type of information captured by codes, clinical setting(s) of use, adoption by a pharmacoepidemiology database, region, and available mappings. Applications articles describing the use and validity of specific codes, code lists, or algorithms were also included. Data extraction was performed independently by two reviewers and a narrative synthesis was performed. A total of 897 unique articles and 57 coding systems were identified, 17% of which included country-specific modifications or multiple versions. Procedures (55%), diagnoses (36%), drugs (38%), and site of disease (39%) were most commonly and directly captured by these coding systems. The systems were used to capture information from the following clinical settings: inpatient (63%), ambulatory (55%), emergency department (ED, 34%), and pharmacy (13%). More than half of all coding

  4. An analysis of dental patient safety incidents in a patient complaint and healthcare supervisory database in Finland.

    Science.gov (United States)

    Hiivala, Nora; Mussalo-Rauhamaa, Helena; Tefke, Hanna-Leena; Murtomaa, Heikki

    2016-01-01

    Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland. The sample included all available fully resolved dental cases (n = 948) during 2000-2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases. Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications. Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods.

  5. A systematic review describing incidence rate and prevalence of dysvascular partial foot amputation; how both have changed over time and compare to transtibial amputation

    Directory of Open Access Journals (Sweden)

    Michael P Dillon

    2017-11-01

    Full Text Available Abstract Background Partial foot amputation (PFA is a common consequence of advanced peripheral vascular disease. Given the different ways incidence rate and prevalence data have been measured and reported, it is difficult to synthesize data and reconcile variation between studies. As such, there is uncertainty in whether the incidence rates and prevalence of PFA have increased over time compared to the decline in transtibial amputation (TTA. The aims of this systematic review were to describe the incidence rate and prevalence of dysvascular PFA over time, and how these compare to TTA. Method Databases (i.e., MEDLINE, EMBASE, psychINFO, AMED, CINAHL, ProQuest Nursing and Allied Health were searched using MeSH terms and keywords related to amputation level and incidence rate or prevalence. Original research published in English from 1 January 2000 to 31 December 2015 were independently appraised, and data extracted, by two reviewers. The McMaster Critical Review Forms were used to assess methodological quality and bias. Results were reported as narrative summaries given heterogeneity of the literature and included the weighted mean annual incidence rate and 95% confidence interval. Results Twenty two cohort studies met the inclusion criteria. Twenty one reported incidence rate data for some level of PFA; four also included a TTA cohort. One study reported prevalence data for a cohort with toe(s amputation. Samples were typically older, male and included people with diabetes among other comorbidities. Incidence rates were reported using a myriad of denominators and strata such as diabetes type or initial/recurrent amputation. Conclusion When appropriately grouped by denominator and strata, incidence rates were more homogenous than might be expected. Variation between studies did not necessarily reduce confidence in the conclusion; for example, incidence rate of PFA were many times larger in cohorts with diabetes (94.24 per 100,000 people with

  6. Incidence and prevalence of idiopathic pulmonary fibrosis: review of the literature

    Directory of Open Access Journals (Sweden)

    Luba Nalysnyk

    2012-12-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF is a chronic, progressive, fibrosing interstitial pneumonia of unknown aetiology. It is a rare disease, and its incidence and prevalence are not clear. Therefore, we sought to review the published evidence on the global epidemiology of IPF. A comprehensive review of English language literature was performed by searching Medline and EMBASE for studies on IPF epidemiology published between January 1990 and August 2011. Studies providing quantitative data on IPF incidence and/or prevalence were identified and key data collected. 15 studies reporting on the incidence and/or prevalence of IPF were identified and summarised. IPF prevalence estimates in the USA varied between 14 and 27.9 cases per 100,000 population using narrow case definitions, and 42.7 and 63 per 100,000 population using broad case definitions. In Europe, IPF prevalence ranged from 1.25 to 23.4 cases per 100,000 population. The annual incidence of IPF in the USA was estimated at 6.8–8.8 per 100,000 population using narrow case definitions and 16.3–17.4 per 100,000 population using broad case definitions. In Europe, the annual incidence ranged between 0.22 and 7.4 per 100,000 population. IPF prevalence and incidence increase with age, are higher among males and appear to be on the increase in recent years. IPF is an orphan disease that affects a potentially increasing number of people in Europe and the USA. The observed variability in IPF incidence and prevalence may be explained by the differences in diagnostic criteria used, case definition, study population and study design.

  7. Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Panagioti, Maria; Stokes, Jonathan; Esmail, Aneez; Coventry, Peter; Cheraghi-Sohi, Sudeh; Alam, Rahul; Bower, Peter

    2015-01-01

    Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care. We followed our published protocol (PROSPERO registration number: CRD42014007434). Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR) and 95% confidence intervals (95% CIs) were calculated for the associations between multimorbidity and two categories of patient safety outcomes: 'active patient safety incidents' (such as adverse drug events and medical complications) and 'precursors of safety incidents' (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors). Meta-analyses using random effects models were undertaken. Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for 'active patient safety incidents' (OR = 2.39, 95% CI = 1.40 to 3.38) and 'precursors of safety incidents' (OR = 1.69, 95% CI = 1.36 to 2.03). Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80) but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13). Statistical heterogeneity was high and the methodological quality of the studies was generally low. The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity involving mental health may be a key driver of safety

  8. Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Maria Panagioti

    Full Text Available Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care.We followed our published protocol (PROSPERO registration number: CRD42014007434. Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR and 95% confidence intervals (95% CIs were calculated for the associations between multimorbidity and two categories of patient safety outcomes: 'active patient safety incidents' (such as adverse drug events and medical complications and 'precursors of safety incidents' (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors. Meta-analyses using random effects models were undertaken.Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for 'active patient safety incidents' (OR = 2.39, 95% CI = 1.40 to 3.38 and 'precursors of safety incidents' (OR = 1.69, 95% CI = 1.36 to 2.03. Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80 but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13. Statistical heterogeneity was high and the methodological quality of the studies was generally low.The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity involving mental health may be a key driver of

  9. Cardiovascular risk factors and incident Alzheimer disease: a systematic review of the literature.

    Science.gov (United States)

    Purnell, Christianna; Gao, Sujuan; Callahan, Christopher M; Hendrie, Hugh C

    2009-01-01

    The purpose of this study was to conduct a systematic review of the literature of cardiovascular factors pertaining to incident Alzheimer disease (AD). A systematic literature review was conducted of all studies of cardiovascular risk factors for incident AD listed in PubMed in English from 2000 to 2007. Risk factors included hypertension, diabetes, exercise, alcohol intake, smoking, B complex vitamins, homocysteine, stroke, atrial fibrillation, apolipoprotein E (APOE), lipids, and diet. Inclusion criteria consisted of diagnoses of incident AD and longitudinal studies with cohorts of 500 or more. Individual clinically defined risk factors such as hypertension and diabetes were not significantly associated with increased risk for AD. The strength of the association for hypertension could be considerably strengthened by changing criteria such as midlife measurements or using higher cutoffs for systolic blood pressure. APOE epsilon4 was the most consistent risk factor. Interactions between risk factors modify risk particularly for hypertension and diabetes. Interactions modifying risk were also found for exercise and physical function, APOE epsilon4, diabetes, and cholesterol. In this review, the evidence that single clinically defined cardiovascular risk factors are significantly associated with incident AD is inconsistent at best. The strength of the association of cardiovascular risk factors and AD can be influenced greatly by changing the parameters of measurement of risk factors and by identifying interactions between the factors.

  10. A Systematic Review of Cervical Cancer Incidence and Mortality in the Pacific Region

    DEFF Research Database (Denmark)

    Obel, Josephine; Souares, Y; Hoy, D

    2014-01-01

    This study provides the first systematic literature review of cervical cancer incidence and mortality as well as human papillomavirus (HPV) genotype prevalence among women with cervical cancer in the Pacific Island countries and territories. The cervical cancer burden in the Pacific Region...... is substantial, with age standardized incidence rates ranging from 8.2 to 50.7 and age standardized mortality rate from 2.7 to 23.9 per 100,000 women per year. The HPV genotype distribution suggests that 70-80% of these cancers could be preventable by the currently available bi- or quadrivalent HPV vaccines...

  11. Apneic oxygenation reduces the incidence of hypoxemia during emergency intubation: A systematic review and meta-analysis.

    Science.gov (United States)

    Pavlov, Ivan; Medrano, Sofia; Weingart, Scott

    2017-08-01

    Apneic oxygenation has been advocated for the prevention of hypoxemia during emergency endotracheal intubation. Because of conflicting results from recent trials, the efficacy of apneic oxygenation remains unclear. We performed a systematic review and meta-analysis to investigate the effect of apneic oxygenation on the incidence of clinically significant hypoxemia during emergency endotracheal intubation. MEDLINE, EMBASE, and PubMed databases were searched without language and time restrictions for studies of apneic oxygenation performed in a critical care setting. Meta-analysis was conducted with a random-effect model, and according to intention-to-treat allocation wherever applicable. Subgroup analyses were performed to ensure the robustness of findings across various clinical outcomes. Eight studies (n=1953) were included in the meta-analysis. The pooled absolute risk of clinically significant hypoxemia was 27.6% in the usual care group and 19.1% in the apneic oxygenation group, without any heterogeneity across studies (I 2 =0%; p=0.42). Apneic oxygenation reduced the relative risk of hypoxemia by 30% (95% confidence interval 0.59 to 0.82). There was a trend toward lower mortality in the apneic oxygenation group (relative risk of death 0.77; 95% confidence interval 0.59 to 1.02). Apneic oxygenation significantly reduces the incidence of hypoxemia during emergency endotracheal intubation. These findings support the inclusion of apneic oxygenation in everyday clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. HIV incidence in sub-Saharan Africa: a review of available data with implications for surveillance and prevention planning

    NARCIS (Netherlands)

    Braunstein, Sarah L.; van de Wijgert, Janneke H. H. M.; Nash, Denis

    2009-01-01

    HIV incidence estimation is increasingly being incorporated into HIV/AIDS surveillance activities in both resource-rich and developing countries. We conducted a systematic review to assess the availability of HIV incidence data from sub-Saharan Africa. We examined peer-reviewed articles, conference

  13. The contribution of databases to the results of systematic reviews: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Lisa Hartling

    2016-09-01

    Full Text Available Abstract Background One of the best sources for high quality information about healthcare interventions is a systematic review. A well-conducted systematic review includes a comprehensive literature search. There is limited empiric evidence to guide the extent of searching, in particular the number of electronic databases that should be searched. We conducted a cross-sectional quantitative analysis to examine the potential impact of selective database searching on results of meta-analyses. Methods Our sample included systematic reviews (SRs with at least one meta-analysis from three Cochrane Review Groups: Acute Respiratory Infections (ARI, Infectious Diseases (ID, Developmental Psychosocial and Learning Problems (DPLP (n = 129. Outcomes included: 1 proportion of relevant studies indexed in each of 10 databases; and 2 changes in results and statistical significance of primary meta-analysis for studies identified in Medline only and in Medline plus each of the other databases. Results Due to variation across topics, we present results by group (ARI n = 57, ID n = 38, DPLP n = 34. For ARI, identification of relevant studies was highest for Medline (85 % and Embase (80 %. Restricting meta-analyses to trials that appeared in Medline + Embase yielded fewest changes in statistical significance: 53/55 meta-analyses showed no change. Point estimates changed in 12 cases; in 7 the change was less than 20 %. For ID, yield was highest for Medline (92 %, Embase (81 %, and BIOSIS (67 %. Restricting meta-analyses to trials that appeared in Medline + BIOSIS yielded fewest changes with 1 meta-analysis changing in statistical significance. Point estimates changed in 8 of 31 meta-analyses; change less than 20 % in all cases. For DPLP, identification of relevant studies was highest for Medline (75 % and Embase (62 %. Restricting meta-analyses to trials that appeared in Medline + PsycINFO resulted in only one change in

  14. Identifying incident colorectal and lung cancer cases in health service utilisation databases in Australia: a validation study.

    Science.gov (United States)

    Goldsbury, David; Weber, Marianne; Yap, Sarsha; Banks, Emily; O'Connell, Dianne L; Canfell, Karen

    2017-02-27

    Data from centralised, population-based statutory cancer registries are generally considered the 'gold standard' for confirming incident cases of cancer. When these are not available, or more current information is needed, hospital or other routinely collected population-level data may be feasible alternative sources. We aimed to determine the validity of various methods using routinely collected administrative health data for ascertaining incident cases of colorectal or lung cancer in participants from the 45 and Up Study in New South Wales (NSW), Australia. For 266,844 participants in the 45 and Up Study (recruited 2006-2009) ascertainment of incident colorectal or lung cancers was assessed using diagnosis and treatment records in linked administrative health datasets (hospital, emergency department, Medicare and pharmaceutical claims, death records). This was compared with ascertainment via the NSW Cancer Registry (NSWCR, the 'gold standard') for a period for which both data sources were available for participants. A total of 2253 colorectal and 1019 lung cancers were recorded for study participants in the NSWCR over the period 2006-2010. A diagnosis of primary cancer recorded in the statewide Admitted Patient Data Collection identified the majority of NSWCR colorectal and lung cancers, with sensitivities and positive predictive values (PPV) of 95% and 91% for colorectal cancer and 81% and 85% for lung cancer, respectively. Using additional information on lung cancer deaths from death records increased sensitivity to 84% (PPV 83%) for lung cancer, but did not improve ascertainment of colorectal cancers. Hospital procedure codes for colorectal cancer surgery identified cases with sensitivity 81% and PPV 54%. No other individual indicator had sensitivity >50% or PPV >65% for either cancer type and no combination of indicators increased both the sensitivity and PPV above that achieved using the hospital cancer diagnosis data. All specificities were close to 100

  15. Prevalence and incidence of attention-deficit/hyperactivity disorder in Slovenian children and adolescents: a database study from a national perspective.

    Science.gov (United States)

    Štuhec, Matej; Švab, Vesna; Locatelli, Igor

    2015-04-01

    To estimate prevalence and incidence of attention deficit hyperactivity disorder (ADHD) in children and adolescents in Slovenia using different epidemiological models. Data from the National Institute of Public Health of the Republic of Slovenia for the period 1997-2012 were analyzed. The database includes the annual number of newly diagnosed outpatients with ADHD in Slovenia. The evaluation for ADHD diagnoses was done in accordance with the Tenth Revision of the International Classification of Diseases (ICD-10) outpatient data codes. In model 1, a linear increase was proposed to fit the data in the period from 1997 to 2003 in order to extrapolate the data before 1997. In model 2 and 3, an exponential increase in the annual incidence rate was proposed. The incidence rate of ADHD diagnosis in 1997 was 0.032% and in 2012 it increased to 0.082%. Mean prevalence rate was 750 (95% confidence interval: 660-840) per 100 000 children and adolescents. It was estimated that the prevalence rate in 2020 would be 1% (95% confidence interval: 0.875-1.125), which is 6.3-fold higher than in 1997. ADHD is a common mental health disorder among Slovenian children and adolescents, but it remained underdiagnosed compared with Western countries. Our results indicated a need for improved timely interventions in Slovenia, not only in child and adolescent psychiatry but also in primary settings and adult psychiatry, where ADHD should be more efficiently recognized.

  16. Incidence of Herpes Simplex Virus Type 2 Infections in Africa: A Systematic Review

    Science.gov (United States)

    Rajagopal, Sharanya; Magaret, Amalia; Mugo, Nelly; Wald, Anna

    2014-01-01

    The burden of HSV type 2 varies substantially by region, with the highest incidence and prevalence in sub-Saharan Africa. We undertook a systematic review to identify studies reporting prospective data on incidence rates in men and women in Africa. Of 18 eligible studies, 7 were conducted in high-risk populations. Among women, incidence rates appeared to be higher in those with high-risk sexual behavior, with rates ranging from 3 to 23 per 100 person-years. In contrast, incidence rates in men appeared to be lower, ranging from 1 to 12 per 100 person-years. Risk factors for HSV-2 in women included prevalent human immunodeficiency virus (HIV) infection, younger age at sexual initiation, and sexual activity. Among men, condom use and circumcision had a protective effect, whereas prevalent HIV increased the risk of HSV-2 acquisition. This review draws attention to the high HSV-2 acquisition rates reported in Africa, thereby identifying an efficient setting for preventative HSV-2 vaccine trials. PMID:25734115

  17. The incidence of concussion in youth sports: a systematic review and meta-analysis.

    Science.gov (United States)

    Pfister, Ted; Pfister, Ken; Hagel, Brent; Ghali, William A; Ronksley, Paul E

    2016-03-01

    To conduct a comprehensive systematic review and meta-analysis of studies assessing the incidence of concussion in youth athletes. Specifically, we estimate the overall risk of concussion in youth sports and compare sport-specific estimates of concussion risk. Systemic review and meta-analysis. A search of Medline, Embase (1980 through September 2014), and SportDiscus (1985 through September 2014) supplemented by manual searches of bibliographies and conference proceedings. We included studies if they met the inclusion criteria of study design (prospective cohort study), relevant sports identified from the literature (eg, American football, rugby, hockey, lacrosse, soccer/football, basketball, baseball, softball, wrestling, field hockey, track, taekwondo, volleyball and cheerleading), population (males and females ≤18 years old), and outcome (concussion). Of the 698 studies reviewed for eligibility, 23 articles were accepted for systematic review and 13 of which were included in a meta-analysis. Random effects models were used to pool overall and sport-specific concussion incidence rates per 1000 athlete exposures (AEs). The overall risk of concussion was estimated at 0.23 (95% CI 0.19 to 0.28). The three sports with the highest incidence rates were rugby, hockey and American football at 4.18, 1.20 and 0.53, respectively. Lowest incidence rates per 1000 AEs occurred in volleyball, baseball and cheerleading at 0.03, 0.06 and 0.07, respectively. Quality of the included studies varied, with the majority of studies not reporting age and gender-specific incidence rates or an operational definition for concussion. There are striking differences in the rates of incident youth concussion across 12 sports. This systematic review and meta-analysis can serve as the current sport-specific baseline risk of concussion among youth athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Risk factors associated with unintentional house fire incidents, injuries and deaths in high-income countries: a systematic review.

    Science.gov (United States)

    Turner, Samantha L; Johnson, Rhodri D; Weightman, Alison L; Rodgers, Sarah E; Arthur, Geri; Bailey, Rowena; Lyons, Ronan A

    2017-04-01

    To identify the distinguishing risk factors associated with unintentional house fire incidents, injuries and deaths. Systematic review. A range of bibliographical databases and grey literature were searched from their earliest records to January 2016. To ensure the magnitude of risk could be quantified, only those study types which contained a control group, and undertook appropriate statistical analyses were included. A best evidence synthesis was conducted instead of a meta-analysis due to study heterogeneity. Eleven studies investigating a variety of risk factors and outcomes were identified. Studies ranged from medium to low quality with no high quality studies identified. Characteristics commonly associated with increased risk of house fire incidents, injuries and fatalities included: higher numbers of residents, male, children under the age of 5 years, non-working households, smoking, low income, non-privately owned properties, apartments and buildings in poor condition. Several risk factors were only associated with one outcome (eg, living alone was only associated with increased risk of injurious fires), and households with older residents were at increased risk of injurious fires, but significantly less likely to experience a house fire in the first place. This best evidence synthesis indicates that several resident and property characteristics are associated with risk of experiencing house fire incidents, injuries or death. These findings should be considered by the Fire and Rescue Services and others with a role in fire prevention. Future research should adopt robust, standardised study designs to permit meta-analyses and enable stronger conclusions to be drawn. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Outcomes after bariatric surgery according to large databases: a systematic review.

    Science.gov (United States)

    Balla, Andrea; Batista Rodríguez, Gabriela; Corradetti, Santiago; Balagué, Carmen; Fernández-Ananín, Sonia; Targarona, Eduard M

    2017-09-01

    The rapid development of technological tools to record data allows storage of enormous datasets, often termed "big data". In the USA, three large databases have been developed to store data regarding surgical outcomes: the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) and the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). We aimed to evaluate the clinical impact of studies found in these databases concerning outcomes of bariatric surgery. We performed a systematic review using the Meta-analysis of Observational Studies in Epidemiology guidelines. Research carried out using the PubMed database identified 362 papers. All outcomes related to bariatric surgery were analysed. Fifty-four studies, published between 2005 and February 2017, were included. These articles were divided into (1) outcomes related to surgical techniques (12 articles), (2) morbidity and mortality (12), (3) 30-day hospital readmission (10), (4) outcomes related to specific diseases (11), (5) training (2) and (6) socio-economic and ethnic observations in bariatric surgery (7). Forty-two papers were based on data from ACS-NSQIP, nine on data from NIS and three on data from MBSAQIP. This review provides an overview of surgical management and outcomes of bariatric surgery in the USA. Large databases offer useful complementary information that could be considered external validation when strong evidence-based medicine data are lacking. They also allow us to evaluate infrequent situations for which randomized control trials are not feasible and add specific information that can complement the quality of surgical knowledge.

  20. Review article: the prevalence of Helicobacter pylori and the incidence of gastric cancer across Europe.

    Science.gov (United States)

    Roberts, S E; Morrison-Rees, S; Samuel, D G; Thorne, K; Akbari, A; Williams, J G

    2016-02-01

    There is little up-to-date review evidence on the prevalence of Helicobacter pylori across Europe. To establish regional and national patterns in H. pylori prevalence across Europe. Secondly, to establish trends over time in H. pylori prevalence and gastric cancer incidence and, thirdly, to report on the relationship between H. pylori prevalence and age group across Europe. A review of H. pylori prevalence from unselected surveys of adult or general populations across 35 European countries and four European regions since 1990. Secondly, an analysis of trends over time in H. pylori prevalence and in gastric cancer incidence from cancer registry data. Helicobacter pylori prevalence was lower in northern and western Europe than in eastern and southern Europe (P Europe from 1993 to 2007 was 2.1% with little variation regionally across Europe (north 2.2%, west 2.3%, east 1.9% and south 2.0%). Sharp increases in age-related prevalence of H. pylori often levelled off for middle age groups of about 50 years onwards, especially in areas with high prevalence. This review shows that H. pylori prevalence is much higher in less affluent regions of Europe and that age-related increases in prevalence are confined to younger age groups in some areas. There were sharp reductions in both H. pylori prevalence and gastric cancer incidence throughout Europe. © 2015 John Wiley & Sons Ltd.

  1. Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis.

    Science.gov (United States)

    Prioreschi, A; Munthali, R J; Soepnel, L; Goldstein, J A; Micklesfield, L K; Aronoff, D M; Norris, S A

    2017-03-29

    This systematic review aims to investigate the incidence and prevalence of type 2 diabetes mellitus (T2DM) in patients with HIV infection in African populations. Only studies reporting data from Africa were included. A systematic search was conducted using four databases for articles referring to HIV infection and antiretroviral therapy, and T2DM in Africa. Articles were excluded if they reported data on children, animals or type 1 diabetes exclusively. Incidence of T2DM and prevalence of T2DM. Risk ratios were generated for pooled data using random effects models. Bias was assessed using an adapted Cochrane Collaboration bias assessment tool. Of 1056 references that were screened, only 20 were selected for inclusion. Seven reported the incidence of T2DM in patients with HIV infection, eight reported the prevalence of T2DM in HIV-infected versus uninfected individuals and five reported prevalence of T2DM in HIV-treated versus untreated patients. Incidence rates ranged from 4 to 59 per 1000 person years. Meta-analysis showed no significant differences between T2DM prevalence in HIV-infected individuals versus uninfected individuals (risk ratio (RR) =1.61, 95% CI 0.62 to 4.21, p=0.33), or between HIV-treated patients versus untreated patients (RR=1.38, 95% CI 0.66 to 2.87, p=0.39), and heterogeneity was high in both meta-analyses (I 2 =87% and 52%, respectively). Meta-analysis showed no association between T2DM prevalence and HIV infection or antiretroviral therapy; however, these results are limited by the high heterogeneity of the included studies and moderate-to-high risk of bias, as well as, the small number of studies included. There is a need for well-designed prospective longitudinal studies with larger population sizes to better assess incidence and prevalence of T2DM in African patients with HIV. Furthermore, screening for T2DM using gold standard methods in this population is necessary. PROSPERO42016038689. Published by the BMJ Publishing Group Limited. For

  2. Catastrophic Outcomes in Free Tissue Transfer: A Six-Year Review of the NSQIP Database

    Directory of Open Access Journals (Sweden)

    David W. Grant

    2014-01-01

    Full Text Available Background. No studies report robust data on the national incidence and risk factors associated with catastrophic medical outcomes following free tissue transfer. Methods. The American College of Surgeons (ACS multicenter, prospective National Surgical Quality Improvement Program (NSQIP database was used to identify patients who underwent free tissue transfer between 2006 and 2011. Multivariable logistic regression was used for statistical analysis. Results. Over the 6-year study period 2,349 patients in the NSQIP database underwent a free tissue transfer procedure. One hundred and twenty-two patients had at least one catastrophic medical outcome (5.2%. These 122 patients had 151 catastrophic medical outcomes, including 93 postoperative respiratory failure events (4.0%, 14 pulmonary emboli (0.6%, 13 septic shock events (0.5%, 12 myocardial infarctions (0.5%, 6 cardiac arrests (0.3%, 4 strokes (0.2%, 1 coma (0.0%, and 8 deaths (0.3%. Total length of hospital stay was on average 14.7 days longer for patients who suffered a catastrophic medical complication (P<0.001. Independent risk factors were identified. Conclusions. Free tissue transfer is a proven and safe technique. Catastrophic medical complications were infrequent but added significantly to length of hospital stay and patient morbidity.

  3. The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

    2015-08-01

    Percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) are minimally invasive and effective vertebral augmentation techniques for managing osteoporotic vertebral compression fractures (OVCFs). Recent meta-analyses have compared the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques or conservative treatment; however, the inclusions were not thorough and rigorous enough, and the effects of each technique on the incidence of secondary vertebral fractures remain unclear. To perform an updated systematic review and meta-analysis of the studies with more rigorous inclusion criteria on the effects of vertebral augmentation techniques and conservative treatment for OVCF on the incidence of secondary vertebral fractures. PubMed, MEDLINE, EMBASE, SpringerLink, Web of Science, and the Cochrane Library database were searched for relevant original articles comparing the incidence of secondary vertebral fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (NRCTs) were identified. The methodological qualities of the studies were evaluated, relevant data were extracted and recorded, and an appropriate meta-analysis was conducted. A total of 13 articles were included. The pooled results from included studies showed no statistically significant differences in the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques and conservative treatment. Subgroup analysis comparing different study designs, durations of symptoms, follow-up times, races of patients, and techniques were conducted, and no significant differences in the incidence of secondary fractures were identified (P > 0.05). No obvious publication bias was detected by either Begg's test (P = 0.360 > 0.05) or Egger's test (P = 0.373 > 0.05). Despite current thinking in the

  4. Insulin, hospitals and harm: a review of patient safety incidents reported to the National Patient Safety Agency.

    Science.gov (United States)

    Cousins, David; Rosario, Catherine; Scarpello, John

    2011-02-01

    Patient safety incidents involving insulin are frequent and cause considerable distress to people with diabetes and anxieties to their families and carers. This article describes an analysis of the National Reporting and Learning System database of patient safety incidents concerning insulin reported from NHS providers in England and Wales over six years. The main causes are discussed and the ongoing developments by the National Patient Safety Agency and partner organisations to reduce insulin errors are described.

  5. Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis

    Science.gov (United States)

    Carter, Holly; Amlôt, Richard

    2016-01-01

    Introduction: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents. The review focuses on five psychosocial aspects of incident management: likely public behaviour; responder management style; communication strategy; privacy/ modesty concerns; and vulnerable groups. Methods: Two structured literature reviews were carried out; one to identify decontamination guidance documents for first responders, and another to identify evidence which is relevant to the understanding of the psychosocial aspects of mass decontamination.  The guidance documents and relevant research were reviewed to identify whether the guidance documents contain information relating to psychosocial issues and where it exists, that the guidance is consistent with the existing evidence-base. Results: Psychosocial aspects of incident management receive limited attention in current decontamination guidance.  In addition, our review has identified a number of gaps and inconsistencies between guidance and research evidence.  For each of the five areas we identify: what is currently presented in guidance documents, to what extent this is consistent with the existing research evidence and where it diverges.  We present a series of evidence-based recommendations for updating decontamination guidance to address the psychosocial aspects of mass decontamination. Conclusions: Effective communication and respect for casualties’ needs are critical in ensuring

  6. Wheelchair incidents

    NARCIS (Netherlands)

    Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

    2002-01-01

    This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

  7. Systematic review of paediatric studies of adverse drug reactions from pharmacovigilance databases.

    Science.gov (United States)

    Cliff-Eribo, Kennedy Obebi; Sammons, Helen; Choonara, Imti

    2016-10-01

    To perform a systematic review of studies describing paediatric adverse drug reactions (ADRs) conducted from national pharmacovigilance databases. A systematic literature search of studies describing results for paediatric ADRs from national pharmacovigilance databases was performed. PubMed database, Embase and MEDLINE were searched up to March 2015. The descriptive studies included were analysed for country of origin, reporters, and ADR reporting rate, drugs, ADRs and number of fatalities. 20 studies were identified. Doctors were the largest group of reporters in all the studies, and with more consumer reports seen in USA. The studies ranged from 3 - 37 years. The highest ADR reporting rate was 1458 reports per year per million children in Cuba. Antibiotics and vaccines were the most frequently reported drugs, in almost all the studies. The most frequent ADRs were skin and nervous system disorders. The highest proportion of fatalities and serious reports was from North America. Drugs used for treating attention deficit hyperactivity disorders (ADHD) and isotretinoin were the most frequently reported drugs for ADRs in North America. There were geographical differences in drugs responsible for ADRs and their seriousness, especially in North America. Very few studies were conducted in Asia and Latin America, none were found from Africa.

  8. Incidence of Bladder Cancer in Sri Lanka: Analysis of the Cancer Registry Data and Review of the Incidence of Bladder Cancer in the South Asian Population

    Science.gov (United States)

    De Silva, Daswin; De Silva, M.V.C.; Ranasinghe, Tamra I J; Lawrentschuk, Nathan; Bolton, Damien; Persad, Raj

    2012-01-01

    Purpose To investigate the incidence of bladder cancer (BC) in Sri Lanka and to compare risk factors and outcomes with those of other South Asian nations and South Asian migrants to the United Kingdom (UK) and the United States (US). Materials and Methods The incidence of BC in Sri Lanka was examined by using two separate cancer registry databases over a 5-year period. Smoking rates were compiled by using a population-based survey from 2001 to 2009 and the relative risk was calculated by using published data. Results A total of 637 new cases of BC were diagnosed over the 5-year period. Sri Lankan BC incidence increased from 1985 but remained low (1.36 and 0.3 per 100,000 in males and females) and was similar to the incidence in other South Asian countries. The incidence was lower, however, than in migrant populations in the US and the UK. In densely populated districts of Sri Lanka, these rates almost doubled. Urothelial carcinoma accounted for 72%. The prevalence of male smokers in Sri Lanka was 39%, whereas Pakistan had higher smoking rates with a 6-fold increase in BC. Conclusions Sri Lankan BC incidence was low, similar to other South Asian countries (apart from Pakistan), but the actual incidence is likely higher than the cancer registry rates. Smoking is likely to be the main risk factor for BC. Possible under-reporting in rural areas could account for the low rates of BC in Sri Lanka. Any genetic or environmental protective effects of BC in South Asians seem to be lost on migration to the UK or the US and with higher levels of smoking, as seen in Pakistan. PMID:22670188

  9. Incidence, Risk Factors, and Trends of Motor Peripheral Nerve Injury After Colorectal Surgery: Analysis of the National Surgical Quality Improvement Program Database.

    Science.gov (United States)

    Al-Temimi, Mohammed H; Chandrasekaran, Bindupriya; Phelan, Michael J; Pigazzi, Alessio; Mills, Steven D; Stamos, Michael J; Carmichael, Joseph C

    2017-03-01

    Motor peripheral nerve injury is a rare but serious event after colorectal surgery, and a nationwide study of this complication is lacking. The purpose of this study was to report the incidence, trends, and risk factors of motor peripheral nerve injury during colorectal surgery. The National Surgical Quality Improvement Program database was surveyed for motor peripheral nerve injury complicating colorectal procedures. Risk factors for this complication were identified using logistic regression analysis. The study used a national database. Patients undergoing colorectal resection between 2005 and 2013 were included. The incidence, trends, and risk factors for motor peripheral nerve injury complicating colorectal procedures were measured. We identified 186,936 colorectal cases, of which 50,470 (27%) were performed laparoscopically. Motor peripheral nerve injury occurred in 122 patients (0.065%). Injury rates declined over the study period, from 0.025% in 2006 to nerve injury were younger (mean ± SD; 54.02 ± 15.41 y vs 61.56 ± 15.95 y; p Nerve injury was also associated with longer operative times (277.16 ± 169.79 min vs 176.69 ± 104.80 min; p nerve injury (OR = 1.04 (95% CI, 1.03-1.04)), whereas increasing age was associated with a protective effect (OR = 0.80 (95% CI, 0.71-0.90)). This study was limited by its retrospective nature. Motor peripheral nerve injury during colorectal procedures is uncommon (0.065%), and its rate declined significantly over the study period. Prolonged operative time is the strongest predictor of motor peripheral nerve injury during colorectal procedures. Instituting and documenting measures to prevent nerve injury is imperative; however, special attention to this complication is necessary when surgeons contemplate long colorectal procedures.

  10. Oral human papillomavirus infection incidence and clearance: a systematic review of the literature.

    Science.gov (United States)

    Wood, Zoe C; Bain, Christopher J; Smith, David D; Whiteman, David C; Antonsson, Annika

    2017-04-01

    Subclinical oral human papillomavirus (HPV) infection that persists for decades is likely to precede an HPV-driven squamous cell carcinoma of the head and neck, but little is known about the natural history of oral HPV. We systematically reviewed and abstracted data from nine manuscripts that examined human immunodeficiency virus-negative and cancer-free subjects for oral HPV DNA to determine the pooled baseline prevalence and incidence of newly acquired oral HPV infections, and specifically for HPV-16. We also documented the clearance rate and the median time to clearance, where data existed. Of 3762 individuals, 7.5 % had an oral infection with any HPV type (1.6 % for HPV-16). Meta-regression analysis estimated the 12-month cumulative incidence to be 4.8 % (95 % confidence interval 3.2-7.3 %). The overall oral HPV clearance was reported to be 0-80 % between studies, and the median time to clearance from 6.5 to 18 months. Oral HPV-16 clearance was 43-83 %, and median time to clearance for HPV-16 was 7-22 months. Oral HPV prevalence, incidence and clearance vary considerably between published studies from different geographical regions. Further research is required to identify predictors of persistent oral HPV infection. Measurable baseline prevalence was observed in all studies, as well as non-trivial incidence of newly acquired oral HPV infections and incomplete clearance.

  11. Pesticide Poisoning of Honeybees: A Review of Symptoms, Incident Classification, and Causes of Poisoning

    Directory of Open Access Journals (Sweden)

    Kiljanek Tomasz

    2016-12-01

    Full Text Available During the 2000s, the problem of pesticide poisoning of honeybees seemed to be almost solved. The number of cases has decreased in comparison to the 1970s. The problem of acute honeybee poisoning, however, has not disappeared, but instead has transformed into a problem of poisoning from ‘traditional’ pesticides like organophosphorus pesticides or pyrethroids, to poisoning from additional sources of ‘modern’ systemic neonicotinoids and fipronil. In this article, the biological activity of pesticides was reviewed. The poisoning symptoms, incident definitions, and monitoring systems, as well as the interpretation of the analytical results, were also reviewed. The range of pesticides, and the detected concentrations of pesticides in poisoned honeybee samples, were reviewed. And, for the first time, cases of poisoning related to neonicotinoids were reviewed. The latter especially is of practical importance and could be helpful to analysts and investigators of honeybee poisoning incidents. It is assumed that secondary poisoning induced by plant collected materials contaminated with systemic pesticides occurs. Food stored in a hive and contaminated with systemic pesticides consumed continuously by the same generation of winter bees, may result in sub-lethal intoxication. This leads to abnormal behaviour identified during acute intoxication. The final result is that the bees discontinue their social role in the honeybee colony super organism, and colony collapse disorder (CCD takes place. The process described above refers primarily to robust and strong colonies that were able to collect plenty of food due to effective plant protection.

  12. Validity of Health Administrative Database Definitions for Hypertension: A Systematic Review.

    Science.gov (United States)

    Pace, Romina; Peters, Tricia; Rahme, Elham; Dasgupta, Kaberi

    2017-08-01

    Health administrative data are frequently used for hypertension surveillance. The aim of this systematic review was to determine the sensitivity and specificity of the commonly used hypertension case definition of 2 physician outpatient claims within a 2-year period or 1 hospital discharge abstract record. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE (from 1946) and EMBASE (from 1947) for relevant studies through September 2016 (keywords: "hypertension," "administrative databases," "validation studies"). Data with standardized forms and assessed quality using Quality Assessment of Diagnostic Accuracy Studies criteria were reviewed by 2 reviewers. Pooled sensitivity and specificity were estimated using a generalized linear-model approach to random-effects bivariate regression meta-analysis. The search strategy identified 1732 abstracts, among which 3 articles were deemed relevant. One of the articles incorporated 2 studies with differing reference standards and study populations; thus, we considered each separately. The quality scores of the retained studies ranged from 10-12 of a maximum 14. The sensitivity of the definition investigated to identify hypertension using administrative health databases was 71.2% (95% confidence interval [CI], 68.3-73.7) and the specificity was 94.5% (95% CI, 93.2-95.6) when compared with surveys or medical records. The 2 physician outpatient claims within a 2-year period or 1 hospital discharge abstract record hypertension case definition accurately classifies individuals as hypertensive in approximately 70% of cases and correctly identifies persons as nonhypertensive in approximately 95% of cases. This is likely sufficiently sensitive and specific for most research and surveillance purposes. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  13. Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Panagioti, Maria; Stokes, Jonathan; Esmail, Aneez; Coventry, Peter; Cheraghi-Sohi, Sudeh; Alam, Rahul; Bower, Peter

    2015-01-01

    Background Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care. Methods We followed our published protocol (PROSPERO registration number: CRD42014007434). Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR) and 95% confidence intervals (95% CIs) were calculated for the associations between multimorbidity and two categories of patient safety outcomes: ‘active patient safety incidents’ (such as adverse drug events and medical complications) and ‘precursors of safety incidents’ (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors). Meta-analyses using random effects models were undertaken. Results Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for ‘active patient safety incidents’ (OR = 2.39, 95% CI = 1.40 to 3.38) and ‘precursors of safety incidents’ (OR = 1.69, 95% CI = 1.36 to 2.03). Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80) but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13). Statistical heterogeneity was high and the methodological quality of the studies was generally low. Conclusions The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity

  14. Whistleblowing: An integrative literature review of data-based studies involving nurses.

    Science.gov (United States)

    Jackson, Debra; Hickman, Louise D; Hutchinson, Marie; Andrew, Sharon; Smith, James; Potgieter, Ingrid; Cleary, Michelle; Peters, Kath

    2014-01-01

    Abstract Aim: To summarise and critique the research literature about whistleblowing and nurses. Whistleblowing is identified as a crucial issue in maintenance of healthcare standards and nurses are frequently involved in whistleblowing events. Despite the importance of this issue, to our knowledge an evaluation of this body of the data-based literature has not been undertaken. An integrative literature review approach was used to summarise and critique the research literature. A comprehensive search of five databases including Medline, CINAHL, PubMed and Health Science: Nursing/Academic Edition, and Google, were searched using terms including: 'Whistleblow*,' 'nurs*.' In addition, relevant journals were examined, as well as reference lists of retrieved papers. Papers published during the years 2007-2013 were selected for inclusion. Fifteen papers were identified, capturing data from nurses in seven countries. The findings in this review demonstrate a growing body of research for the nursing profession at large to engage and respond appropriately to issues involving suboptimal patient care or organisational wrongdoing. Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

  15. Risk Factors Associated with Injury and Mortality from Paediatric Low Speed Vehicle Incidents: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Anne Paul Anthikkat

    2013-01-01

    Full Text Available Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover (LSVRO incidents involving children aged 0–15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries from the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study inclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk factors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5 years, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies identified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with LSVRO injury. Vehicles were most commonly driven by a family member, predominantly a parent. Conclusion. There are a number of modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been identified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance systems, housing design (physical separation of driveway and play areas, and behaviour (driver behaviour, supervision of young children are discussed.

  16. Use of External Beam Radiotherapy Is Associated With Reduced Incidence of Second Primary Head and Neck Cancer: A SEER Database Analysis

    International Nuclear Information System (INIS)

    Rusthoven, Kyle; Chen Changhu; Raben, David; Kavanagh, Brian

    2008-01-01

    Purpose: Patients with head and neck cancer have a significant risk of developing a second primary cancer of the head and neck. We hypothesized that treatment with external beam radiotherapy (RT) might reduce this risk, because RT can eradicate occult foci of second head and neck cancer (HNCA). Methods and Materials: The data of patients with Surveillance, Epidemiology, and End Results Historic Stage A localized squamous cell carcinoma of the oral cavity, larynx, and pharynx were queried using the Surveillance, Epidemiology, and End Results database. For patients treated with or without RT, the incidence of second HNCA was determined and compared using the log-rank method. Cox proportional hazards analysis was performed for each site, evaluating the influence of covariates on the risk of second HNCA. Results: Between 1973 and 1997, 27,985 patients were entered with localized HNCA. Of these patients, 44% had received RT and 56% had not. The 15-year incidence of second HNCA was 7.7% with RT vs. 10.5% without RT (hazard ratio 0.71, p <0.0001). The effect of RT was more profound in patients diagnosed between 1988 and 1997 (hazard ratio 0.53, p <0.0001) and those with pharynx primaries (hazard ratio 0.47, p <0.0001). On multivariate analysis, RT was associated with a reduced risk of second HNCA for pharynx (p <0.0001) and larynx (p = 0.04) tumors. For oral cavity primaries, RT was associated with an increased risk of second HNCA in patients treated before 1988 (p <0.001), but had no influence on patients treated between 1988 and 1997 (p = 0.91). Conclusion: For localized HNCA, RT is associated with a reduced incidence of second HNCA. These observations are consistent with the eradication of microscopic foci of second HNCA with external beam RT

  17. A review of fatal accident incidence rate trends in fishing international

    DEFF Research Database (Denmark)

    Jensen, Olaf; Pétursdóttir, G; Abrahamsen, Annbjørg

    2014-01-01

    Background. Injury prevention in fishing is one of the most important occupational health challenges. The aim was to describe and compare internationally the trends of the fatal injury incidence rates and to discuss the impact of the implemented safety programs. Methods. The review is based...... on journal articles and reports from the maritime authorities in Poland, UK, Norway, Iceland, Denmark, US and Alaska and Canada. The original incidence rates were recalculated as per 1000 person-years for international comparison of the trends. Results. The risk of fatal accidents in fishing in the northern...... countries has been reduced by around 50% to an average of about 1 per 1000 person-years. Norway and Canada keep the lowest rates with around 0.5 and 0.25 per 1000 person-years. About half of the fatal injuries are related to vessel disasters and drowning. The safety programs seem to have good effects still...

  18. The prophylactic effect of Lactobacillus rhamnosus GG on incidence of acute rotavirus diarrhea in children: a systematic review; randomized double-blind placebo-controlled trials

    Directory of Open Access Journals (Sweden)

    Elaheh Ahmadi

    2014-07-01

    Full Text Available otavirus is one of the most common etiologic agent of severe acute diarrhea in infants and children which results in high mortality and morbidity globally. Prophylactic strategies are required to prevent acute rotavirus diarrhea. Recently, the beneficial effect of probiotic therapy in control of rotavirus diarrhea was noted in many investigations. This systematic review investigated the prophylactic effect of Lactobacillus rhamnosus GG on the incidence of acute rotavirus diarrhea in infants and children. Databases including PubMed, Cochrane Controlled Trial Register (CCTR, Google Scholar, Science direct and Ovid (Wolters Kluwer health were searched for articles and reviews from 1980–2013. Reviewers selected randomized clinical trials that met the study inclusion criteria. The outcome measures included incidence of rotavirus diarrhea, duration of diarrhea, and hospital stay. The search results included three trials with 1043 eligible patients. The results indicated that the use of Lactobacillus rhamnosus GG compared with placebo significantly affected the incidence of rotavirus diarrhea without influencing the duration of hospital stay. Some studies signified the role of Lactobacillus rhamnosus GG in preventing acute rotavirus diarrhea; however we did not find sufficient trials with certain method to evaluate this influence.

  19. Pregnancy incidence and risk factors among women participating in vaginal microbicide trials for HIV prevention: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alfred Musekiwa

    Full Text Available INTRODUCTION: Pregnancy is contraindicated in vaginal microbicide trials for the prevention of HIV infection in women due to the unknown maternal and fetal safety of the microbicides. Women who become pregnant are taken off the microbicide during pregnancy period but this result in reduction of the power of the trials. Strategies to reduce the pregnancy rates require an understanding of the incidence and associated risk factors of pregnancy in microbicide trials. This systematic review estimates the overall incidence rate of pregnancy in microbicide trials and describes the associated risk factors. METHODS: A comprehensive literature search was carried out to identify eligible studies from electronic databases and other sources. Two review authors independently selected studies and extracted relevant data from included studies. Meta-analysis of incidence rates of pregnancy was carried out and risk factors of pregnancy were reported narratively. RESULTS: Fifteen studies reporting data from 10 microbicide trials (N=27,384 participants were included. A total of 4,107 participants (15.0% fell pregnant and a meta-analysis of incidence rates of pregnancy from 8 microbicide trials (N=25,551 yielded an overall incidence rate of 23.37 (95%CI: 17.78 to 28.96 pregnancies per 100 woman-years. However, significant heterogeneity was detected. Hormonal injectable, intra-uterine device (IUD or implants or sterilization, older age, more years of education and condom use were associated with lower pregnancy. On the other hand, living with a man, history of pregnancy, self and partner desire for future baby, oral contraceptive use, increased number of unprotected sexual acts and inconsistent use of condoms were associated with higher pregnancy. CONCLUSIONS: The incidence rate of pregnancy in microbicide trials is high and strategies for its reduction are urgently required in order to improve the sample size and power of these trials.

  20. The incidence of pregnancy-related stroke: A systematic review and meta-analysis.

    Science.gov (United States)

    Swartz, Richard H; Cayley, Megan L; Foley, Norine; Ladhani, Noor Niyar N; Leffert, Lisa; Bushnell, Cheryl; McClure, J A; Lindsay, M Patrice

    2017-10-01

    Background Stroke risk is increased during pregnancy, but estimates of pregnancy-related stroke incidence vary widely. Aims A systematic review and meta-analysis was conducted to assess the incidence of stroke during pregnancy and the puerperium. Ovid Medline, EMBASE, and ISI Web of Science were searched for studies published between 1990 and January 2017 reporting stroke incidence during pregnancy and postpartum, from defined pregnancy populations. Pooled analyses were conducted using a random effects approach and expressed as an incidence rate per 100,000 pregnancies, with 95% confidence intervals. Subgroup analyses of stroke type and timing were conducted. Summary of review Eleven studies met inclusion criteria. Variation in estimated rates was noted based on geography and study methodology. The pooled crude rate of pregnancy-related stroke was 30.0 per 100,000 pregnancies (95% confidence interval 18.8-47.9). The pooled crude rates from nonhemorrhagic stroke (arterial and cerebral venous sinus thrombosis) were 19.9 (95% confidence interval 10.7-36.9) and from hemorrhage 12.2 (95% confidence interval 6.4-23.2) per 100,000 pregnancies. For studies separately reporting cerebral venous sinus thrombosis, the rates were roughly equal between ischemic stroke (12.2, 95% confidence interval 6.7-22.2), cerebral venous sinus thrombosis (9.1, 95% confidence interval 4.3-18.9), and hemorrhage (12.2, 95% confidence interval 6.4-23.2). The crude stroke rate for antenatal/perinatal stroke was 18.3 (95% confidence interval 11.9-28.2), and for postpartum stroke was 14.7 (95% confidence interval 8.3-26.1). Conclusions Stroke affects 30.0 per 100,000 pregnancies, with ischemia, cerebral venous sinus thrombosis, and hemorrhage causing roughly equal numbers and with highest risk peripartum and postpartum. Organized approaches to the management of this high-risk population, informed by existing evidence from stroke and obstetrical care are needed.

  1. Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review.

    Science.gov (United States)

    Pfirrmann, Daniel; Herbst, Mark; Ingelfinger, Patrick; Simon, Perikles; Tug, Suzan

    2016-05-01

    The incidence of injury for elite youth and professional adult soccer players is an important concern, but the risk factors for these groups are different. To summarize and compare the injury incidences and injury characteristics of male professional adult and elite youth soccer players. We searched MEDLINE and Web of Science using the search terms elite, international, European, soccer, football, injury, injuries, epidemiology, incidence, prevalence, not female, not American football, and not rugby. We also used the search terms professional for studies on professional adult soccer players and high-level, soccer academy, youth, adolescent, and young for studies on elite youth soccer players. Eligible studies were published in English, had a prospective cohort design, and had a minimum study period of 6 months. To ensure that injury data were assessed in relationship to the athlete's individual exposure, we included only studies that reported on injuries and documented exposure volume. Two independent reviewers applied the selection criteria and assessed the quality of the studies. A total of 676 studies were retrieved from the literature search. Eighteen articles met the inclusion criteria: 6 for elite youth and 12 for professional adult soccer players. Injury rates were higher for matches than for training for both youth and adult players. Youth players had a higher incidence of training injuries than professionals. Efforts must be made to reduce the overall injury rate in matches. Therefore, preventive interventions, such as adequately enforcing rules and focusing on fair play, must be analyzed and developed to reduce match-related injury incidences. Reducing training injuries should be a particular focus for youth soccer players.

  2. Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review

    Science.gov (United States)

    Pfirrmann, Daniel; Herbst, Mark; Ingelfinger, Patrick; Simon, Perikles; Tug, Suzan

    2016-01-01

    Context:  The incidence of injury for elite youth and professional adult soccer players is an important concern, but the risk factors for these groups are different. Objective:  To summarize and compare the injury incidences and injury characteristics of male professional adult and elite youth soccer players. Data Sources:  We searched MEDLINE and Web of Science using the search terms elite, international, European, soccer, football, injury, injuries, epidemiology, incidence, prevalence, not female, not American football, and not rugby. We also used the search terms professional for studies on professional adult soccer players and high-level, soccer academy, youth, adolescent, and young for studies on elite youth soccer players. Study Selection:  Eligible studies were published in English, had a prospective cohort design, and had a minimum study period of 6 months. To ensure that injury data were assessed in relationship to the athlete's individual exposure, we included only studies that reported on injuries and documented exposure volume. Data Extraction:  Two independent reviewers applied the selection criteria and assessed the quality of the studies. Data Synthesis:  A total of 676 studies were retrieved from the literature search. Eighteen articles met the inclusion criteria: 6 for elite youth and 12 for professional adult soccer players. Conclusions:  Injury rates were higher for matches than for training for both youth and adult players. Youth players had a higher incidence of training injuries than professionals. Efforts must be made to reduce the overall injury rate in matches. Therefore, preventive interventions, such as adequately enforcing rules and focusing on fair play, must be analyzed and developed to reduce match-related injury incidences. Reducing training injuries should be a particular focus for youth soccer players. PMID:27244125

  3. Impact of Persistent Antiphospholipid Antibodies on Risk of Incident Symptomatic Thromboembolism in Children : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Kenet, Gili; Aronis, Sofia; Berkun, Yackov; Bonduel, Mariana; Chan, Anthony; Goldenberg, Neil A.; Holzhauer, Susanne; Iorio, Alfonso; Journeycake, Janna; Junker, Ralf; Male, Christoph; Manco-Johnson, Marilyn; Massicotte, Patti; Mesters, Rolf; Monagle, Paul; van Ommen, Heleen; Rafini, Leslie; Simioni, Paolo; Young, Guy; Nowak-Goettl, Ulrike

    2011-01-01

    The aim of this study was to estimate the impact of antiphospholipid (aPL) antibodies on the risk of incident thromboembolism (TE; arterial and venous) in children via meta-analysis of published observational studies. A systematic search of electronic databases (Medline, EMBASE, OVID, Web of

  4. Prevalence, incidence and risk factors for overuse injuries of the wrist in young athletes: a systematic review

    NARCIS (Netherlands)

    Kox, Laura S.; Kuijer, P. Paul F. M.; Kerkhoffs, Gino M. M. J.; Maas, Mario; Frings-Dresen, Monique H. W.

    2015-01-01

    Overuse wrist injuries can cause long-term symptoms in young athletes performing wrist-loading sports. Information on the prevalence, incidence and associated risk factors is required. We aimed to review the prevalence and incidence of overuse wrist injuries in young athletes and to identify

  5. [A SYSTEMATIC REVIEW ON THE PREVALENCE AND INCIDENCE OF LATENT TUBERCULOSIS INFECTION AMONG PRISON POPULATION].

    Science.gov (United States)

    Kawatsu, Lisa; Uchimura, Kazuhiro; Izumi, Kiyohiko; Ohkado, Akihiro

    2016-04-01

    We conducted a systematic review of literatures on the prevalence and incidence of latent tuberculosis infection in correctional settings, with the aim of offering one of the resources to guide establishment of policies on screening for and treating LTBI among prisoners in Japan. Using the keywords "latent tuberculosis AND (prison OR jail OR correctional)" and "tuberculosis infection AND (prison OR jail OR correctional)", we conducted a systematic review of relevant literatures on PubMed and secondary searches from the reference list of primary sources. We limited our search to those original articles published since 1980, and in English. 55 articles were identified, and 15 were subject to the systematic review. Of the 12 articles on prevalence of LTBI, 5 were from middle and high-burden and 7 from low-burden countries. The average prevalence of LTBI among middle and high-burden countries was 73.0%, and among low-burden countries, 40.3%. "Duration of incarceration" and "history of previous incarceration" were identified as risk factors for high LTBI prevalence which were specific to the prison population. Incidence of LTBI among the high-burden country was 61.8 per 100 person years, while 5.9 and 6.3 in the two reports from low-burden countries. Prevalence and incidence of LTBI were higher than the general population, both in middle/high- and low-burden countries. The fact that "duration of incarceration" and "history of previous incarceration" were identified as risk factors indicate that high prevalence of LTBI among prison population is not just attributable to the characteristics of prisoners themselves, but also to the possibility of TB infection occurring in prison settings.

  6. How to minimise the incidence of transport-related problem behaviours in horses: a review.

    Science.gov (United States)

    York, Amanda; Matusiewicz, Judith; Padalino, Barbara

    2017-01-01

    This review aims to provide practical outcomes on how to minimise the incidence of transport-related problem behaviours (TRPBs) in horses. TRPBs are unwanted behaviours occurring during different phases of transport, most commonly, a reluctance to load and scrambling during travelling. TRPBs can result in injuries to horses and horse handlers, horse trailer accidents, disruption of time schedules, inability to attend competitions, and poor performance following travel. Therefore, TRPBs are recognised as both a horse-related risk to humans and a human-related risk to horses. From the literature, it is apparent that TRPBs are common throughout the entire equine industry, and a YouTube keyword search of 'horse trailer loading' produced over 67,000 results, demonstrating considerable interest in this topic and the variety of solutions suggested. Drawing upon articles published over the last 35 years, this review summarises current knowledge on TRPBs and provides recommendations on their identification, management, and prevention. It appears that a positive human-horse relationship, in-hand pre-training, systematic training for loading and travelling, appropriate horse handling, and the vehicle driving skills of the transporters are crucial to minimise the incidence of TRPBs. In-hand pre-training based on correct application of the principles of learning for horses and horse handlers, habituation to loading and travelling, and self-loading appear to minimise the risk of TRPBs and are therefore strongly recommended to safeguard horse and horse-handler health and welfare. This review indicates that further research and education with respect to transport management are essential to substantially decrease the incidence of TRPBs in horses.

  7. Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Minsu Ock

    2017-03-01

    Full Text Available Objectives We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. Results There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. Conclusions The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.

  8. Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review.

    Science.gov (United States)

    Ock, Minsu; Lim, So Yun; Jo, Min-Woo; Lee, Sang-Il

    2017-03-01

    We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.

  9. HIV and tuberculosis co-infection among migrants in Europe: A systematic review on the prevalence, incidence and mortality.

    Science.gov (United States)

    Tavares, Ana Maria; Fronteira, Inês; Couto, Isabel; Machado, Diana; Viveiros, Miguel; Abecasis, Ana B; Dias, Sónia

    2017-01-01

    International human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and migration could be one of the potential driving forces. This systematic review aims to improve the understanding on the burden of HIV-TB co-infection among migrants in Europe and to assess whether these populations are particularly vulnerable to this co-infection compared to nationals. MEDLINE®, Web of Science® and Scopus® databases were searched from March to April 2016 using combinations of keywords. Titles and abstracts were screened and studies meeting the inclusion criteria proceeded for full-text revision. These articles were then selected for data extraction on the prevalence, incidence and mortality. The majority of HIV-TB prevalence data reported in the analysed studies, including extrapulmonary/disseminated TB forms, was higher among migrant vs. nationals, some of the studies even showing increasing trends over time. Additionally, while HIV-TB incidence rates have decreased among migrants and nationals, migrants are still at a higher risk for this co-infection. Migrants with HIV-TB co-infection were also more prone to unsuccessful treatment outcomes, death and drug resistant TB. However, contradicting results also showed lower mortality compared to nationals. Overall, a disproportionate vulnerability of migrants to acquire the HIV-TB co-infection was observed across studies. Such vulnerability has been associated to low socioeconomic status, poor living conditions and limited access to healthcare. Adequate social support, early detection, appropriate treatment, and adequate access to healthcare are key improvements to tackle HIV-TB co-infection among these populations.

  10. Searching for evidence or approval? A commentary on database search in systematic reviews and alternative information retrieval methodologies.

    Science.gov (United States)

    Delaney, Aogán; Tamás, Peter A

    2018-03-01

    Despite recognition that database search alone is inadequate even within the health sciences, it appears that reviewers in fields that have adopted systematic review are choosing to rely primarily, or only, on database search for information retrieval. This commentary reminds readers of factors that call into question the appropriateness of default reliance on database searches particularly as systematic review is adapted for use in new and lower consensus fields. It then discusses alternative methods for information retrieval that require development, formalisation, and evaluation. Our goals are to encourage reviewers to reflect critically and transparently on their choice of information retrieval methods and to encourage investment in research on alternatives. Copyright © 2017 John Wiley & Sons, Ltd.

  11. A review of clinical trials in dietary interventions to decrease the incidence of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Miettinen Tatu A

    2001-04-01

    Full Text Available Abstract Of the associations between dietary elements and coronary artery disease (CAD, the greatest body of evidence deals with the beneficial effect of reducing the dietary intake of saturated fatty acids and cholesterol. Furthermore, it is well established, on the basis of convincing evidence, that reduction in serum total cholesterol results in reduction in coronary morbidity and mortality, as well as in regression of other atherosclerotic manifestations.In fact, dietary intervention studies revealed that it is possible to reduce the incidence of coronary death and nonfatal myocardial infarction, as well as manifestations of atherosclerosis in cerebral and peripheral arteries, by reducing dietary intake of saturated fat and cholesterol. In two recently reported dietary interventions the incidence of coronary events, especially coronary mortality, and total mortality were reduced by increased intake of n-3 long-chain polyunsaturated fatty acids and by a modification of the diet toward a Mediterranean-type diet (rich in α-linolenic acid. In addition to those findings, the potential efficacy of the dietary newcomers phytostanol and phytosterol esters on reducing coronary incidence is discussed in the present review.

  12. Guarding the precious smile: incidence and prevention of injury in sports: a review.

    Science.gov (United States)

    Dhillon, Bikramjit Singh; Sood, Nikhil; Sood, Niti; Sah, Nupur; Arora, Dhruv; Mahendra, Ashish

    2014-07-01

    The paper provides a review about the orofacial injuries sustained during sports and the options available to the athletes for their prevention. It was done with a purpose to determine three different aspects incidence of dental injury during sporting activities, role of mouthguards in preventing sports injury, types of mouthguards and their properties. From this review, it is clear that sports carry a considerable risk of injury, this is not only true for the contact sports such as rugby or kickboxing, but also for seemingly less dangerous sports such as football. Amongst the different types of mouthguards, the most acceptable and safe ones are the custom-fabricated mouthguards, in particular the pressure-laminated ones. In general, mouthguard usage is less than the dental profession would recommend. As much of progress has been made in this area, need for the use of mouthguard needs to be emphasized and promoted by the dental profession.

  13. Interval breast cancers: Absolute and proportional incidence and blinded review in a community mammographic screening program

    Energy Technology Data Exchange (ETDEWEB)

    Carbonaro, Luca A., E-mail: luca.carbonaro@gmail.com [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Azzarone, Antonio [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Paskeh, Bijan Babaei [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Brambilla, Giorgio [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Brunelli, Silvia [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Calori, Anna [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Caumo, Francesca [Centro di Prevenzione Senologica, ULSS 20, Piazza Lambranzi, Verona 37034 (Italy); Malerba, Paolo [Dipartimento di Radiologia, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzano (Mi) 20089 (Italy); Menicagli, Laura [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Sconfienza, Luca M. [Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese (Mi) 20097 (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano (Italy); Vadalà, Giuseppe [Servizio di Radiologia, Azienda Ospedaliera Circolo di Melegnano, Via Pandina 1, Vizzolo Predabissi (Mi) 20070 (Italy); Brambilla, Gelma; Fantini, Luigi [Servizio di Medicina Preventiva delle Comunità, ASL Milano 2, Via Friuli 2, Lacchiarella (Mi) 20084 (Italy); Ciatto, Stefano [Screening Program, ULSS 16, Padova (Italy); and others

    2014-02-15

    Purpose: To evaluate the performance of the first years since the beginning of a mammographic population-based screening program. Materials and methods: Women aged 49–69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records. The proportional incidence of IC was determined considering breast cancers expected without screening. Three offsite radiologists experienced in breast cancer screening blindly evaluated mammograms prior to diagnosis, randomly mixed with negative mammograms (1:2 ratio). Cases unrecalled at review were considered as true ICs, those recalled by only one reviewer as minimal signs, and those recalled by two or three reviewers as missed cancers. T and N stage of the reviewed ICs were evaluated and compared. Results: A total of 86,276 first level mammograms were performed. Mean recall rate was 6.8% at first and 4.6% at repeat screening. We had 476 screen-detected cancers and 145 ICs (10 of them ductal carcinomas in situ). Absolute incidence was 17 per 10,000 screening examinations. Invasive proportional incidence was 19% (44/234) in the first year, 39% (91/234) in the second year, and 29% (135/468) in the two-year interval. Of 145 ICs, 130 (90%) were reviewed mixed with 287 negative controls: 55% (71/130) resulted to be true ICs, 24% (31/130) minimal signs, and 22% (28/130) missed cancers. The rate of ICs diagnosed in the first year interval was 21% (15/71) for true ICs, 46% (13/28) for missed cancers, and 39% (12/31) for minimal signs, with a significant difference of true ICs rate compared to missed cancers rate (p = 0.012). A higher rate of T3 and T4 stages was found for missed cancers (18%, 5/28) compared to minimal signs (6%, 2/31) or true ICs (8%, 6/71), while the rate of N2 and N3 stage for both minimal signs (19%, 6/31) or missed cancers (25

  14. Post-operative adhesions after digestive surgery: their incidence and prevention: review of the literature.

    Science.gov (United States)

    Ouaïssi, M; Gaujoux, S; Veyrie, N; Denève, E; Brigand, C; Castel, B; Duron, J J; Rault, A; Slim, K; Nocca, D

    2012-04-01

    Post-operative adhesions after gastrointestinal surgery are responsible for significant morbidity and constitute an important public health problem. The aim of this study was to review the surgical literature to determine the incidence, consequences and the variety of possible countermeasures to prevent adhesion formation. A systematic review of English and French language surgical literature published between 1995 and 2009 was performed using the keywords "adhesion" and "surgery". Peritoneal adhesions are reported as the cause of 32% of acute intestinal obstruction and 65-75% of all small bowel obstructions. It is estimated that peritoneal adhesions develop after 93-100% of upper abdominal laparotomies and after 67-93% of lower abdominal laparotomies. Nevertheless, only 15-18% of these adhesions require surgical re-intervention. The need for re-intervention for adhesion-related complications varies depending on the initial type of surgery, the postoperative course and the type of incision. The laparoscopic approach appears to decrease the risk of adhesion formation by 45% and the need for adhesion-related re-intervention to 0.8% after appendectomy and to 2.5% after colorectal surgery. At the present time, only one product consisting of hyaluronic acid applied to a layer of carboxymethylcellulose (Seprafilm(®)) has been shown to significantly reduce the incidence of postoperative adhesion formation; but this product is also associated with a significant increase in the incidence of anastomotic leakage when the membrane is applied in direct contact with the anastomosis. The use of this product has not been shown to decrease the risk of re-intervention for bowel obstruction. The prevention of postoperative adhesions is an important public health goal, particularly in light of the frequency of this complication. The routine use of anti-adhesion products is not recommended given the lack of studies with a high level of evidence concerning their efficacy and safety of

  15. Incidence of neoplasms in the most prevalent autoimmune rheumatic diseases: a systematic review.

    Science.gov (United States)

    Machado, Roberta Ismael Lacerda; Braz, Alessandra de Sousa; Freire, Eutilia Andrade Medeiros

    2014-01-01

    This article is a systematic review of the literature about the coexistence of cancer and autoimmune rheumatic diseases, their main associations, cancers and possible risk factors associated, with emphasis on existing population-based studies, besides checking the relation of this occur with the use of the drugs used in the treatment of autoimmune diseases. A search was conducted of scientific articles indexed in the Cochrane / BVS, Pubmed / Medline and Scielo / Lilacs in the period from 2002 to 2012. Also consulted was the IB-ICT (Brazilian digital library of theses and Masters), with descriptors in Portuguese and English for "Systemic sclerosis", "Rheumatoid Arthritis", " Systemic Lupus Erythematosus" and "Sjögren's syndrome", correlating each one with the descriptor AND "neoplasms". The results showed that in the database IBICT a thesis and a dissertation for the descriptor SLE met the inclusion criteria, none met RA one thesis to SS. Lilacs in the database/Scielo found two articles on "Rheumatoid Arthritis" AND "neoplasms". In Pubmed/Medline the inicial search resulted in 118 articles, and 41 were selected. The review noted the relationship between cancer and autoimmune rheumatic diseases, as well as a risk factor for protection, although the pathophysiological mechanisms are not known.

  16. A multi-institutional evaluation of antibody-mediated rejection utilizing the Pediatric Heart Transplant Study database: Incidence, therapies and outcomes.

    Science.gov (United States)

    Thrush, Philip T; Pahl, Elfriede; Naftel, David C; Pruitt, Elizabeth; Everitt, Melanie D; Missler, Heather; Zangwill, Steven; Burch, Michael; Hoffman, Timothy M; Butts, Ryan; Mahle, William T

    2016-12-01

    Current knowledge of antibody-mediated rejection (AMR) after heart transplantation (HT) stems largely from adult data. Using the Pediatric Heart Transplant Study (PHTS) database, we report the incidence of AMR, describe treatment, and evaluate outcomes for treated AMR in children after HT. We queried the PHTS database for patients <18 years of age undergoing primary HT between January 2010 and December 2014. An AMR episode was defined as either a biopsy consistent with pathologic AMR or a rejection event based on immunotherapy augmentation directed against antibody production. Biopsy data, treatment strategies and survival were analyzed. An episode of AMR was identified in 179 of 1,596 (11%) HT recipients and in 246 of 705 (35%) rejection episodes. AMR was diagnosed by biopsy in 182 of 246 episodes and by immunotherapy in 64 of 179 episodes. Mixed rejection was identified in 179. Freedom from AMR was 88% and 82% at 1 and 3 years, respectively. AMR therapies included intravenous immunoglobulin (IVIg) (58%), plasmapheresis (40%), rituximab (40%), bortezomib (11%) and eculizumab (0.4%). The most commonly used combination therapies included IVIg/plasmapheresis/rituximab (13%). Thirty-three patients (16%) died after developing AMR. Patient and graft survival were lower for the AMR + group. One- and 3-year survival after initial AMR diagnosis was 88% and 77%, respectively. In his study we report the largest experience of AMR in pediatric HT recipients. AMR was common and often occurred concurrently with acute cellular rejection. There is wide variability in the treatment of AMR. Short-term patient and graft outcomes were worse for those with treated AMR. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  17. SU-E-T-310: Targeting Safety Improvements Through Analysis of Near-Miss Error Detection Points in An Incident Learning Database

    Energy Technology Data Exchange (ETDEWEB)

    Novak, A; Nyflot, M; Sponseller, P; Howard, J; Logan, W; Holland, L; Jordan, L; Carlson, J; Ermoian, R; Kane, G; Ford, E; Zeng, J [University of Washington, Seattle, WA (United States)

    2014-06-01

    Purpose: Radiation treatment planning involves a complex workflow that can make safety improvement efforts challenging. This study utilizes an incident reporting system to identify detection points of near-miss errors, in order to guide our departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or their patterns. Methods: 1377 incidents were analyzed from a departmental nearmiss error reporting system from 3/2012–10/2013. All incidents were prospectively reviewed weekly by a multi-disciplinary team, and assigned a near-miss severity score ranging from 0–4 reflecting potential harm (no harm to critical). A 98-step consensus workflow was used to determine origination and detection points of near-miss errors, categorized into 7 major steps (patient assessment/orders, simulation, contouring/treatment planning, pre-treatment plan checks, therapist/on-treatment review, post-treatment checks, and equipment issues). Categories were compared using ANOVA. Results: In the 7-step workflow, 23% of near-miss errors were detected within the same step in the workflow, while an additional 37% were detected by the next step in the workflow, and 23% were detected two steps downstream. Errors detected further from origination were more severe (p<.001; Figure 1). The most common source of near-miss errors was treatment planning/contouring, with 476 near misses (35%). Of those 476, only 72(15%) were found before leaving treatment planning, 213(45%) were found at physics plan checks, and 191(40%) were caught at the therapist pre-treatment chart review or on portal imaging. Errors that passed through physics plan checks and were detected by therapists were more severe than other errors originating in contouring/treatment planning (1.81 vs 1.33, p<0.001). Conclusion: Errors caught by radiation treatment therapists tend to be more severe than errors caught earlier in the workflow, highlighting the importance of safety

  18. Bisphosphonate adverse effects, lessons from large databases

    DEFF Research Database (Denmark)

    Abrahamsen, Bo

    2010-01-01

    To review the latest findings on bisphosphonate safety from health databases, in particular sources that can provide incidence rates for stress fractures, osteonecrosis of the jaw (ONJ), atrial fibrillation and gastrointestinal lesions including esophageal cancer. The main focus is on bisphosphon......To review the latest findings on bisphosphonate safety from health databases, in particular sources that can provide incidence rates for stress fractures, osteonecrosis of the jaw (ONJ), atrial fibrillation and gastrointestinal lesions including esophageal cancer. The main focus...... is on bisphosphonates used for osteoporosis....

  19. Discerning molecular interactions: A comprehensive review on biomolecular interaction databases and network analysis tools.

    Science.gov (United States)

    Miryala, Sravan Kumar; Anbarasu, Anand; Ramaiah, Sudha

    2018-02-05

    Computational analysis of biomolecular interaction networks is now gaining a lot of importance to understand the functions of novel genes/proteins. Gene interaction (GI) network analysis and protein-protein interaction (PPI) network analysis play a major role in predicting the functionality of interacting genes or proteins and gives an insight into the functional relationships and evolutionary conservation of interactions among the genes. An interaction network is a graphical representation of gene/protein interactome, where each gene/protein is a node, and interaction between gene/protein is an edge. In this review, we discuss the popular open source databases that serve as data repositories to search and collect protein/gene interaction data, and also tools available for the generation of interaction network, visualization and network analysis. Also, various network analysis approaches like topological approach and clustering approach to study the network properties and functional enrichment server which illustrates the functions and pathway of the genes and proteins has been discussed. Hence the distinctive attribute mentioned in this review is not only to provide an overview of tools and web servers for gene and protein-protein interaction (PPI) network analysis but also to extract useful and meaningful information from the interaction networks. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. [Systematic review of studies on quality of life indexed on the SciELO database].

    Science.gov (United States)

    Landeiro, Graziela Macedo Bastos; Pedrozo, Celine Cristina Raimundo; Gomes, Maria José; Oliveira, Elizabete Regina de Araújo

    2011-10-01

    Interest in the quality of life construct has increased in the same proportion as the output of instruments to measure it. In order to analyze the scientific literature on the subject to provide a reflection on this construct in Brazil, a systematic review of the SciELO database covering the period from January 2001 to December 2006 was conducted. It was divided into 3 phases: the first involving 180 publications, the second 124, and the third 10. Of the 180 publications, 77.4% consisted of production in the last three years, with growth of 32.4% from 2001 to 2006. Of these, 124 were selected for methodological analysis in accordance with the category of the study: 79 (63.9%) instrument application articles; 25 (20.1%) translation, validation, adaptation and construction of a QOL instrument; 10 (8%) qualitative studies on QOL; 5 (4%) bibliographical review, 5 (4%) on the quality of life concept. The next stage involved the use of questionnaires and/or interview scripts in order to obtain a broader consensus on perceived quality of life from the interviewees. It was seen that there was significant scientific output in the period under scrutiny, with diversification of approaches and methodologies, highlighting the complexity of the quality of life construct.

  1. Socioeconomic inequalities in breast cancer incidence and mortality in Europe-a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Lundqvist, Adam; Andersson, Emelie; Ahlberg, Ida

    2016-01-01

    literature review and meta-analysis on studies on association between socioeconomic status and breast cancer outcomes in Europe, with a focus on effects of confounding factors. Summary relative risks (SRRs) were calculated. RESULTS: The systematic review included 25 articles of which 8 studied incidence, 10...

  2. Review of Spatial-Database System Usability: Recommendations for the ADDNS Project

    National Research Council Canada - National Science Library

    Abdalla, R. M; Niall, K. K

    2007-01-01

    ...) and three-dimensional (3D) visualizations. This report presents an overview of the basic concepts of GIS and spatial databases, provides an analytical usability evaluation and critically analyses different spatial- database applications...

  3. A systematic review of the incidence and prevalence of cardiac, cerebrovascular, and peripheral vascular disease in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    the quality of the included studies. METHODS: The PubMed, EMBASE, SCOPUS and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles were searched. One reviewer abstracted data using a standardized data collection form, while the second reviewer verified the abstraction...

  4. Incident myocardial infarction associated with major types of arthritis in the general population: a systematic review and meta-analysis.

    Science.gov (United States)

    Schieir, Orit; Tosevski, Cedomir; Glazier, Richard H; Hogg-Johnson, Sheilah; Badley, Elizabeth M

    2017-08-01

    To synthesise, quantify and compare risks for incident myocardial infarction (MI) across five major types of arthritis in population-based studies. A systematic search was performed in MEDLINE, EMBASE and CINAHL databases with additional manual/hand searches for population-based cohort or case-control studies published in English of French between January 1980 and January 2015 with a measure of effect and variance for associations between incident MI and five major types of arthritis: rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), gout or osteoarthritis (OA), adjusted for at least age and sex. All search screening, data abstraction quality appraisals were performed independently by two reviewers. Where appropriate, random-effects meta-analysis was used to pool results from studies with a minimum of 10 events. We identified a total of 4, 285 articles; 27 met review criteria and 25 criteria for meta-analyses. In studies adjusting for age and sex, MI risk was significantly increased in RA (pooled relative risk (RR): 1.69, 95% CI 1.50 to 1.90), gout (pooled RR: 1.47, 95% CI 1.24 to 1.73), PsA (pooled RR: 1.41, 95% CI 1.17 to 1.69), OA (pooled RR: 1.31, 95% CI 1.01 to 1.71) and tended towards increased risk in AS (pooled RR: 1.24, 95% CI 0.93 to 1.65). Traditional risk factors were more prevalent in all types of arthritis. MI risk was attenuated for each type of arthritis in studies adjusting for traditional risk factors and remained significantly increased in RA, PsA and gout. MI risk was consistently increased in multiple types of arthritis in population-based studies, and was partially explained by a higher prevalence of traditional risk factors in all types of arthritis. Findings support more integrated cardiovascular (CV) prevention strategies for arthritis populations that target both reducing inflammation and enhancing management of traditional CV risk factors. Published by the BMJ Publishing Group Limited. For permission to

  5. 77 FR 39269 - Submission for OMB Review, Comment Request, Proposed Collection: IMLS Museum Web Database...

    Science.gov (United States)

    2012-07-02

    ..., Proposed Collection: IMLS Museum Web Database: MuseumsCount.gov AGENCY: Institute of Museum and Library... database of museums for use by museums, museum professionals, IMLS, policy makers, researchers, and the... subject of this notice, would establish a comprehensive, reliable database about the size, distribution...

  6. Incidence and preventability of adverse events requiring intensive care admission: a systematic review.

    Science.gov (United States)

    Vlayen, Annemie; Verelst, Sandra; Bekkering, Geertruida E; Schrooten, Ward; Hellings, Johan; Claes, Neree

    2012-04-01

    Adverse events are unintended patient injuries or complications that arise from health care management resulting in death, disability or prolonged hospital stay. Adverse events that require critical care are a considerable financial burden to the health care system, but also their global impact on patients and society is probably underestimated. The objectives of this systematic review were to synthesize the best available evidence regarding the estimates of the incidence and preventability of adverse events that necessitate intensive care admission, to determine the type and consequences [mortality, length of intensive care unit (ICU) stay and costs] of these adverse events. MEDLINE (from 1966 to present), EMBASE (from 1974 to present) and CENTRAL (version 1-2010) were searched for studies reporting on unplanned admissions on ICUs. Several other sources were searched for additional studies. Only quantitative studies that used chart review for the detection of adverse events requiring intensive care admission were considered for eligibility. For the purposes of this systematic review, ICUs were defined as specialized hospital facilities which provide continuous monitoring and intensive care for acutely ill patients. Studies that were published in the English, Dutch, German, French or Spanish language were eligible for inclusion. Two reviewers independently extracted data and assessed the methodological quality of the included studies. A total of 27 studies were reviewed. Meta-analysis of the data was not appropriate because of methodological and statistical heterogeneity between studies; therefore, results are presented in a descriptive way. The percentage of surgical and medical adverse events that required ICU admission ranged from 1.1% to 37.2%. ICU readmissions varied from 0% to 18.3%. Preventability of the adverse events varied from 17% to 76.5%. Preventable adverse events are further synthesized by type of event. Consequences of the adverse events included a

  7. Incidence and Management of Thrombotic and Thromboembolic Complications Following the Norwood Procedure: A Systematic Review.

    Science.gov (United States)

    Agarwal, Arnav; Firdouse, Mohammed; Brar, Nishaan; Yang, Andy; Lambiris, Panos; Chan, Anthony K; Mondal, Tapas K

    2017-11-01

    The stage 1 Norwood procedure and its variants represent the first step of palliation for hypoplastic left heart syndrome. Although appropriate postoperative thromboprophylaxis is integral, significant variance remains across institutional practices. The purpose of this systematic review is to estimate the incidence of thrombosis and thromboembolism following the Norwood or modified Blalock-Taussig shunt procedure and examine current thromboprophylaxis regimens. Ovid MEDLINE and Embase were searched from January 2000 to June 2016 for primary studies explicitly reporting incidence of thrombosis, thromboembolism (strokes and pulmonary embolisms), or shunt occlusion in neonates, infants, and children undergoing the Norwood procedure or any variant. All-cause mortality was a secondary outcome of interest. Of 887 identified articles, 15 cohort studies were deemed eligible, the majority including modified Blalock-Taussig shunt patients. Reported incidence of thrombosis ranged from 0% to 40%; thromboembolic events were rarely reported. Overall mortality ranged from 4.5% to 31.3% across studies. Although most studies involved the long-term acetylsalicylic acid use, thromboprophylaxis strategies varied across studies. Due to substantial variability in event rates, no correlation was identified with thrombotic complications. Clinical practice guidelines recommend that patients receive intraoperative unfractionated heparin therapy and either aspirin or no antithrombotic therapy postoperatively. Our findings suggest a substantial risk of thrombosis and thromboembolism and demonstrate substantial variation in thromboprophylaxis practices. Although postoperative thromboprophylaxis seems optimal, it remains controversial whether the long-term aspirin use is most effective. Our findings highlight the lack of a gold-standard thromboprophylaxis strategy and emphasize the need for more consistency.

  8. Prevalence, incidence, and mortality of stroke in the chinese island populations: a systematic review.

    Directory of Open Access Journals (Sweden)

    Xiaomei Wu

    Full Text Available BACKGROUND: In China, there are 2.5 million new stroke cases each year and 7.5 million stroke survivors. However, stroke incidence in some island populations is obviously lower compared with inland regions, perhaps due to differences in diet and lifestyle. As the lifestyle in China has changed significantly, along with dramatic transformations in social, economic and environmental conditions, such changes have also been seen in island regions. Thus, we analyzed stroke in the Chinese island regions over the past 30 years. METHODS: We conducted a systematic review to identify reliable and comparable epidemiologic evidence about stroke in the Chinese island regions between 1980 and 2013. Two authors independently assessed the eligibility and the quality of the articles and disagreement was resolved by discussion. Owing to the great heterogeneity among individual study estimates, a random-effects or fixed-effects model was used to incorporate the heterogeneity among records into a pooled estimate for age-standardized rates. Age-standardized rates were calculated by the direct method with the 2000 world population if included records provided the necessary information. RESULTS: During the past three decades, the overall pooled age-standardized prevalence of stroke is 6.17 per 1000 (95% CI 4.56-7.78, an increase from 5.54 per 1000 (95% CI 3.88-7.20 prior to 2000 to 8.34 per 1000 (95% CI 5.98-10.69 after 2000. However, this difference was not found to be statistically significant. The overall pooled age-standardized incidence of stroke is 120.42 per 100,000 person years (95% CI 26.17-214.67. Between 1982 and 2008, the incidence of stroke increased and mortality declined over time. CONCLUSIONS: Effective intervention and specific policy recommendations on stroke prevention should be required, and formulated in a timely fashion to effectively curb the increased trend of stroke in Chinese island regions.

  9. Prevalence, incidence, and mortality of stroke in the chinese island populations: a systematic review.

    Science.gov (United States)

    Wu, Xiaomei; Zhu, Bo; Fu, Lingyu; Wang, Hailong; Zhou, Bo; Zou, Safeng; Shi, Jingpu

    2013-01-01

    In China, there are 2.5 million new stroke cases each year and 7.5 million stroke survivors. However, stroke incidence in some island populations is obviously lower compared with inland regions, perhaps due to differences in diet and lifestyle. As the lifestyle in China has changed significantly, along with dramatic transformations in social, economic and environmental conditions, such changes have also been seen in island regions. Thus, we analyzed stroke in the Chinese island regions over the past 30 years. We conducted a systematic review to identify reliable and comparable epidemiologic evidence about stroke in the Chinese island regions between 1980 and 2013. Two authors independently assessed the eligibility and the quality of the articles and disagreement was resolved by discussion. Owing to the great heterogeneity among individual study estimates, a random-effects or fixed-effects model was used to incorporate the heterogeneity among records into a pooled estimate for age-standardized rates. Age-standardized rates were calculated by the direct method with the 2000 world population if included records provided the necessary information. During the past three decades, the overall pooled age-standardized prevalence of stroke is 6.17 per 1000 (95% CI 4.56-7.78), an increase from 5.54 per 1000 (95% CI 3.88-7.20) prior to 2000 to 8.34 per 1000 (95% CI 5.98-10.69) after 2000. However, this difference was not found to be statistically significant. The overall pooled age-standardized incidence of stroke is 120.42 per 100,000 person years (95% CI 26.17-214.67). Between 1982 and 2008, the incidence of stroke increased and mortality declined over time. Effective intervention and specific policy recommendations on stroke prevention should be required, and formulated in a timely fashion to effectively curb the increased trend of stroke in Chinese island regions.

  10. Sleep and circadian disruption and incident breast cancer risk: An evidence-based and theoretical review.

    Science.gov (United States)

    Samuelsson, Laura B; Bovbjerg, Dana H; Roecklein, Kathryn A; Hall, Martica H

    2018-01-01

    Opportunities for restorative sleep and optimal sleep-wake schedules are becoming luxuries in industrialized cultures, yet accumulating research has revealed multiple adverse health effects of disruptions in sleep and circadian rhythms, including increased risk of breast cancer. The literature on breast cancer risk has focused largely on adverse effects of night shift work and exposure to light at night (LAN), without considering potential effects of associated sleep disruptions. As it stands, studies on breast cancer risk have not considered the impact of both sleep and circadian disruption, and the possible interaction of the two through bidirectional pathways, on breast cancer risk in the population at large. We review and synthesize this literature, including: 1) studies of circadian disruption and incident breast cancer; 2) evidence for bidirectional interactions between sleep and circadian systems; 3) studies of sleep and incident breast cancer; and 4) potential mechanistic pathways by which interrelated sleep and circadian disruption may contribute to the etiology of breast cancer. Copyright © 2017. Published by Elsevier Ltd.

  11. IAEA expert review mission completes assessment of fuel cleaning incident at Paks Nuclear Power Plant

    International Nuclear Information System (INIS)

    2003-01-01

    Full text: The IAEA today completed its expert review mission to investigate the 10 April fuel cleaning incident at the Paks nuclear power plant in Hungary. The mission was requested by the Hungarian Government to provide an independent assessment of the causes and actions taken by the plant and Hungarian authorities. The team was composed of nuclear and radiation experts from the IAEA, Austria, Canada, Finland, Slovakia, the United Kingdom and the United States. In a press conference, team leader Miroslav Lipar highlighted the team's findings in five areas: On management, the team concluded that the Hungarian Atomic Energy Authority and Paks are committed to improving the safety of the plant. They noted that as a result of steam generator decontamination in previous years, deposits became attached to the fuel assemblies. A decision was made to clean the fuel and contract an outside company to develop and operate a fuel cleaning process. The team found that the design and operation of the fuel cleaning tank and system was not accomplished in the manner prescribed by the IAEA Safety Standards. Neither the Hungarian Atomic Energy Authority nor Paks used conservative decision-making in their safety assessments for this unproven fuel cleaning system. The team determined that there was an over-reliance on the contractor that had been selected for the design, management and operation of the fuel cleaning system. Time pressure related to a prescribed fuel outage schedule, combined with confidence generated by previous successful fuel cleaning operations, contributed to a weak assessment of a new design and operation, which involved fuel directly removed from the reactor following a planned shutdown. On regulatory oversight, the IAEA team concluded that the Hungarian Atomic Energy Authority underestimated the safety significance of the proposed designs for the fuel cleaning system, which resulted in a less than rigorous review and assessment than should have been necessary

  12.  Patient safety in orthopedic surgery: prioritizing key areas of iatrogenic harm through an analysis of 48,095 incidents reported to a national database of errors

    Directory of Open Access Journals (Sweden)

    Panesar SS

    2013-03-01

    Full Text Available  Sukhmeet S Panesar,1 Andrew Carson-Stevens,2 Sarah A Salvilla,1 Bhavesh Patel,3 Saqeb B Mirza,4 Bhupinder Mann51Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK; 2Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK; 3National Patient Safety Agency, London, UK; 4Department of Trauma and Orthopaedic Surgery, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, Hampshire, UK; 5Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury, UKBackground: With scientific and technological advances, the practice of orthopedic surgery has transformed the lives of millions worldwide. Such successes however have a downside; not only is the provision of comprehensive orthopedic care becoming a fiscal challenge to policy-makers and funders, concerns are also being raised about the extent of the associated iatrogenic harm. The National Reporting and Learning System (NRLS in England and Wales is an underused resource which collects intelligence from reports about health care error.Methods: Using methods akin to case-control methodology, we have identified a method of prioritizing the areas of a national database of errors that have the greatest propensity for harm. Our findings are presented using odds ratios (ORs and 95% confidence intervals (CIs.Results: The largest proportion of surgical patient safety incidents reported to the NRLS was from the trauma and orthopedics specialty, 48,095/163,595 (29.4%. Of those, 14,482/48,095 (30.1% resulted in iatrogenic harm to the patient and 71/48,095 (0.15% resulted in death. The leading types of errors associated with harm involved the implementation of care and on-going monitoring (OR 5.94, 95% CI 5.53, 6.38; self-harming behavior of patients in hospitals (OR 2.14, 95% CI 1.45, 3.18; and infection control (OR 1.91, 95% CI 1.69, 2.17. We analyze these data to quantify the extent and type of iatrogenic

  13. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law

  14. Road traffic incidents in Uganda: a systematic review of a five-year trend

    Science.gov (United States)

    Balikuddembe, Joseph Kimuli; Ardalan, Ali; Khorasani-Zavareh, Davoud; Nejati, Amir; Munanura, Kasiima Stephen

    2017-01-01

    Abstract: Background: Over the years, Uganda has been one of the low and middle-income countries bearing the heaviest burden of road traffic incidents (RTI). Since the proclamation of the United Nations Decade of Action for Road Safety 2011 – 2020, a number of measures have been taken to reduce the burden. However, they ought to be premised on existing evidence-based research; therefore, the present review ventures to report the most recent five-year trend of RTI in Uganda. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-Data Analysis (PRISMA) guidelines, a systematic review was employed. Using a thematic analysis, the articles were grouped into: trauma etiology, trauma care, mortality, cost, trauma registry and communication, intervention and treatment for final analysis. Results: Of the nineteen articles that were identified to be relevant to the study, the etiology of RTI was inevitably observed to be an important cause of injuries in Uganda. The risk factors cut across: the crash type, injury physiology, cause, victims, setting, age, economic status, and gender. All studies that were reviewed have advanced varying recommendations aimed at responding to the trend of RTIs in Uganda, of which some are in tandem with the five pillars of the United Nations Decade of Action for Road Safety 2011 – 2020. Conclusions: Peripheral measures of the burden of RTIs in Uganda were undertaken within a five-year timeframe (2011-2015) of implementing the United Nations Decade of Action for Road Safety. The measures however, ought to be scaled-up on robust evidence based research available from all the concerned stakeholders beyond Kampala or central region to other parts of Uganda. PMID:28039687

  15. Can patients report patient safety incidents in a hospital setting? A systematic review.

    Science.gov (United States)

    Ward, Jane K; Armitage, Gerry

    2012-08-01

    Patients are increasingly being thought of as central to patient safety. A small but growing body of work suggests that patients may have a role in reporting patient safety problems within a hospital setting. This review considers this disparate body of work, aiming to establish a collective view on hospital-based patient reporting. This review asks: (a) What can patients report? (b) In what settings can they report? (c) At what times have patients been asked to report? (d) How have patients been asked to report? 5 databases (MEDLINE, EMBASE, CINAHL, (Kings Fund) HMIC and PsycINFO) were searched for published literature on patient reporting of patient safety 'problems' (a number of search terms were utilised) within a hospital setting. In addition, reference lists of all included papers were checked for relevant literature. 13 papers were included within this review. All included papers were quality assessed using a framework for comparing both qualitative and quantitative designs, and reviewed in line with the study objectives. Patients are clearly in a position to report on patient safety, but included papers varied considerably in focus, design and analysis, with all papers lacking a theoretical underpinning. In all papers, reports were actively solicited from patients, with no evidence currently supporting spontaneous reporting. The impact of timing upon accuracy of information has yet to be established, and many vulnerable patients are not currently being included in patient reporting studies, potentially introducing bias and underestimating the scale of patient reporting. The future of patient reporting may well be as part of an 'error detection jigsaw' used alongside other methods as part of a quality improvement toolkit.

  16. A risk score to predict the incidence of prolonged air leak after video-assisted thoracoscopic lobectomy: An analysis from the European Society of Thoracic Surgeons database.

    Science.gov (United States)

    Pompili, Cecilia; Falcoz, Pierre Emmanuel; Salati, Michele; Szanto, Zalan; Brunelli, Alessandro

    2017-04-01

    The study objective was to develop an aggregate risk score for predicting the occurrence of prolonged air leak after video-assisted thoracoscopic lobectomy from patients registered in the European Society of Thoracic Surgeons database. A total of 5069 patients who underwent video-assisted thoracoscopic lobectomy (July 2007 to August 2015) were analyzed. Exclusion criteria included sublobar resections or pneumonectomies, lung resection associated with chest wall or diaphragm resections, sleeve resections, and need for postoperative assisted mechanical ventilation. Prolonged air leak was defined as an air leak more than 5 days. Several baseline and surgical variables were tested for a possible association with prolonged air leak using univariable and logistic regression analyses, determined by bootstrap resampling. Predictors were proportionally weighed according to their regression estimates (assigning 1 point to the smallest coefficient). Prolonged air leak was observed in 504 patients (9.9%). Three variables were found associated with prolonged air leak after logistic regression: male gender (P classes with an incremental risk of prolonged air leak (P class A (score 0 points, 1493 patients) 6.3% with prolonged air leak, class B (score 1 point, 2240 patients) 10% with prolonged air leak, class C (score 2 points, 1219 patients) 13% with prolonged air leak, and class D (score >2 points, 117 patients) 25% with prolonged air leak. An aggregate risk score was created to stratify the incidence of prolonged air leak after video-assisted thoracoscopic lobectomy. The score can be used for patient counseling and to identify those patients who can benefit from additional intraoperative preventative measures. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  17. Patient safety in orthopedic surgery: prioritizing key areas of iatrogenic harm through an analysis of 48,095 incidents reported to a national database of errors.

    Science.gov (United States)

    Panesar, Sukhmeet S; Carson-Stevens, Andrew; Salvilla, Sarah A; Patel, Bhavesh; Mirza, Saqeb B; Mann, Bhupinder

    2013-01-01

    With scientific and technological advances, the practice of orthopedic surgery has transformed the lives of millions worldwide. Such successes however have a downside; not only is the provision of comprehensive orthopedic care becoming a fiscal challenge to policy-makers and funders, concerns are also being raised about the extent of the associated iatrogenic harm. The National Reporting and Learning System (NRLS) in England and Wales is an underused resource which collects intelligence from reports about health care error. Using methods akin to case-control methodology, we have identified a method of prioritizing the areas of a national database of errors that have the greatest propensity for harm. Our findings are presented using odds ratios (ORs) and 95% confidence intervals (CIs). The largest proportion of surgical patient safety incidents reported to the NRLS was from the trauma and orthopedics specialty, 48,095/163,595 (29.4%). Of those, 14,482/48,095 (30.1%) resulted in iatrogenic harm to the patient and 71/48,095 (0.15%) resulted in death. The leading types of errors associated with harm involved the implementation of care and on-going monitoring (OR 5.94, 95% CI 5.53, 6.38); self-harming behavior of patients in hospitals (OR 2.14, 95% CI 1.45, 3.18); and infection control (OR 1.91, 95% CI 1.69, 2.17). We analyze these data to quantify the extent and type of iatrogenic harm in the specialty, and make suggestions on the way forward. CONCLUSION AND LEVEL OF EVIDENCE: Despite the limitations of such analyses, it is clear that there are many proven interventions which can improve patient safety and need to be implemented. Avoidable errors must be prevented, lest we be accused of contravening our fundamental duty of primum non nocere. This is a level III evidence-based study.

  18. Body Mass Index, Abdominal Fatness, and Heart Failure Incidence and Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.

    Science.gov (United States)

    Aune, Dagfinn; Sen, Abhijit; Norat, Teresa; Janszky, Imre; Romundstad, Pål; Tonstad, Serena; Vatten, Lars J

    2016-02-16

    Obesity has been associated with increased risk of heart failure, but whether overweight also increases risk is unclear. It is also unclear whether abdominal adiposity is more strongly associated with heart failure risk than general adiposity. We conducted a systematic review and meta-analysis of prospective studies to clarify the strength and shape of the dose-response relationship between general and abdominal adiposity and the risk of heart failure. PubMed and Embase databases were searched up to October 10, 2014. Summary relative risks were calculated using random-effects models. A total of 28 studies (27 publications) were included. Twenty-three prospective studies with >15 905 incident cases among 647 388 participants were included in the analysis of body mass index and heart failure incidence, and 4 studies were included for heart failure mortality. The summary relative risk for a 5-unit increment in body mass index was 1.41 (95% confidence interval, 1.34-1.47; I(2)=83%) for heart failure incidence and 1.26 (95% confidence interval, 0.85-1.87; I(2)=95%) heart failure mortality. Although the test for nonlinearity was significant (Pfailure. © 2016 American Heart Association, Inc.

  19. There Is a Significant Discrepancy Between "Big Data" Database and Original Research Publications on Hip Arthroscopy Outcomes: A Systematic Review.

    Science.gov (United States)

    Sochacki, Kyle R; Jack, Robert A; Safran, Marc R; Nho, Shane J; Harris, Joshua D

    2018-02-21

    The purpose of this study was to compare (1) major complication, (2) revision, and (3) conversion to arthroplasty rates following hip arthroscopy between database studies and original research peer-reviewed publications. A systematic review was performed using PRISMA guidelines. PubMed, SCOPUS, SportDiscus, and Cochrane Central Register of Controlled Trials were searched for studies that investigated major complication (dislocation, femoral neck fracture, avascular necrosis, fluid extravasation, septic arthritis, death), revision, and hip arthroplasty conversion rates following hip arthroscopy. Major complication, revision, and conversion to hip arthroplasty rates were compared between original research (single- or multicenter therapeutic studies) and database (insurance database using ICD-9/10 and/or current procedural terminology coding terminology) publishing studies. Two hundred seven studies (201 original research publications [15,780 subjects; 54% female] and 6 database studies [20,825 subjects; 60% female]) were analyzed (mean age, 38.2 ± 11.6 years old; mean follow-up, 2.7 ± 2.9 years). The database studies had a significantly higher age (40.6 + 2.8 vs 35.4 ± 11.6), body mass index (27.4 ± 5.6 vs 24.9 ± 3.1), percentage of females (60.1% vs 53.8%), and longer follow-up (3.1 ± 1.6 vs 2.7 ± 3.0) compared with original research (P database studies (P = .029; relative risk [RR], 1.3). There was a significantly higher rate of femoral neck fracture (0.24% vs 0.03%; P database studies. Reoperations occurred at a significantly higher rate in the database studies (11.1% vs 7.3%; P database studies (8.0% vs 3.7%; P Database studies report significantly increased major complication, revision, and conversion to hip arthroplasty rates compared with original research investigations of hip arthroscopy outcomes. Level IV, systematic review of Level I-IV studies. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights

  20. Validity of heart failure diagnoses in administrative databases: a systematic review and meta-analysis.

    Science.gov (United States)

    McCormick, Natalie; Lacaille, Diane; Bhole, Vidula; Avina-Zubieta, J Antonio

    2014-01-01

    Heart failure (HF) is an important covariate and outcome in studies of elderly populations and cardiovascular disease cohorts, among others. Administrative data is increasingly being used for long-term clinical research in these populations. We aimed to conduct the first systematic review and meta-analysis of studies reporting on the validity of diagnostic codes for identifying HF in administrative data. MEDLINE and EMBASE were searched (inception to November 2010) for studies: (a) Using administrative data to identify HF; or (b) Evaluating the validity of HF codes in administrative data; and (c) Reporting validation statistics (sensitivity, specificity, positive predictive value [PPV], negative predictive value, or Kappa scores) for HF, or data sufficient for their calculation. Additional articles were located by hand search (up to February 2011) of original papers. Data were extracted by two independent reviewers; article quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Using a random-effects model, pooled sensitivity and specificity values were produced, along with estimates of the positive (LR+) and negative (LR-) likelihood ratios, and diagnostic odds ratios (DOR = LR+/LR-) of HF codes. Nineteen studies published from 1999-2009 were included in the qualitative review. Specificity was ≥95% in all studies and PPV was ≥87% in the majority, but sensitivity was lower (≥69% in ≥50% of studies). In a meta-analysis of the 11 studies reporting sensitivity and specificity values, the pooled sensitivity was 75.3% (95% CI: 74.7-75.9) and specificity was 96.8% (95% CI: 96.8-96.9). The pooled LR+ was 51.9 (20.5-131.6), the LR- was 0.27 (0.20-0.37), and the DOR was 186.5 (96.8-359.2). While most HF diagnoses in administrative databases do correspond to true HF cases, about one-quarter of HF cases are not captured. The use of broader search parameters, along with laboratory and prescription medication data, may help identify

  1. BADERI: an online database to coordinate handsearching activities of controlled clinical trials for their potential inclusion in systematic reviews.

    Science.gov (United States)

    Pardo-Hernandez, Hector; Urrútia, Gerard; Barajas-Nava, Leticia A; Buitrago-Garcia, Diana; Garzón, Julieth Vanessa; Martínez-Zapata, María José; Bonfill, Xavier

    2017-06-13

    Systematic reviews provide the best evidence on the effect of health care interventions. They rely on comprehensive access to the available scientific literature. Electronic search strategies alone may not suffice, requiring the implementation of a handsearching approach. We have developed a database to provide an Internet-based platform from which handsearching activities can be coordinated, including a procedure to streamline the submission of these references into CENTRAL, the Cochrane Collaboration Central Register of Controlled Trials. We developed a database and a descriptive analysis. Through brainstorming and discussion among stakeholders involved in handsearching projects, we designed a database that met identified needs that had to be addressed in order to ensure the viability of handsearching activities. Three handsearching teams pilot tested the proposed database. Once the final version of the database was approved, we proceeded to train the staff involved in handsearching. The proposed database is called BADERI (Database of Iberoamerican Clinical Trials and Journals, by its initials in Spanish). BADERI was officially launched in October 2015, and it can be accessed at www.baderi.com/login.php free of cost. BADERI has an administration subsection, from which the roles of users are managed; a references subsection, where information associated to identified controlled clinical trials (CCTs) can be entered; a reports subsection, from which reports can be generated to track and analyse the results of handsearching activities; and a built-in free text search engine. BADERI allows all references to be exported in ProCite files that can be directly uploaded into CENTRAL. To date, 6284 references to CCTs have been uploaded to BADERI and sent to CENTRAL. The identified CCTs were published in a total of 420 journals related to 46 medical specialties. The year of publication ranged between 1957 and 2016. BADERI allows the efficient management of handsearching

  2. Interstitial lung disease induced by fluoxetine: Systematic review of literature and analysis of Vigiaccess, Eudravigilance and a national pharmacovigilance database.

    Science.gov (United States)

    Deidda, Arianna; Pisanu, Claudia; Micheletto, Laura; Bocchetta, Alberto; Del Zompo, Maria; Stochino, Maria Erminia

    2017-06-01

    We investigated a pulmonary adverse drug reaction possibly induced by fluoxetine, the Interstitial Lung Disease, by performing a systematic review of published case reports on this subject, a review of the World Health Organization VigiAccess database, of the European EudraVigilance database and of a national Pharmacovigilance database (Italian Pharmacovigilance Network). The research found a total of seven cases linking fluoxetine to Interstitial Lung Disease in the literature. 36 cases of interstitial lung disease related to fluoxetine were retrieved from the VigiAccess database (updated to July 2016), and 36 reports were found in EudraVigilance database (updated to June 2016). In the Italian Pharmacovigilance database (updated to August 2016), we found only one case of Interstitial Lung Disease, codified as "pulmonary disease". Our investigation shows that fluoxetine might be considered as a possible cause of Interstitial Lung Disease. In particular, although here we do not discuss the assessment of benefits and harms of fluoxetine, since this antidepressant is widely used, our review suggests that fluoxetine-induced Interstitial Lung Disease should be considered in patients with dyspnea, associated or not with dry cough, who are treated with this drug. An early withdrawn of fluoxetine could be useful to obtain a complete remission of this adverse drug reaction and special attention should be particularly devoted to long-term therapy, and to female and elderly patients. Although the spontaneous reporting system is affected by important limitations, drug post- marketing surveillance represents an important tool to evaluate the real world effectiveness and safety of drugs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Review and Comparison of the Search Effectiveness and User Interface of Three Major Online Chemical Databases

    Science.gov (United States)

    Bharti, Neelam; Leonard, Michelle; Singh, Shailendra

    2016-01-01

    Online chemical databases are the largest source of chemical information and, therefore, the main resource for retrieving results from published journals, books, patents, conference abstracts, and other relevant sources. Various commercial, as well as free, chemical databases are available. SciFinder, Reaxys, and Web of Science are three major…

  4. Databases and Associated Bioinformatic Tools in Studies of Food Allergens, Epitopes and Haptens – a Review

    Directory of Open Access Journals (Sweden)

    Bucholska Justyna

    2018-06-01

    Full Text Available Allergies and/or food intolerances are a growing problem of the modern world. Diffi culties associated with the correct diagnosis of food allergies result in the need to classify the factors causing allergies and allergens themselves. Therefore, internet databases and other bioinformatic tools play a special role in deepening knowledge of biologically-important compounds. Internet repositories, as a source of information on different chemical compounds, including those related to allergy and intolerance, are increasingly being used by scientists. Bioinformatic methods play a signifi cant role in biological and medical sciences, and their importance in food science is increasing. This study aimed at presenting selected databases and tools of bioinformatic analysis useful in research on food allergies, allergens (11 databases, epitopes (7 databases, and haptens (2 databases. It also presents examples of the application of computer methods in studies related to allergies.

  5. Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis.

    Science.gov (United States)

    Baur, David; Gladstone, Beryl Primrose; Burkert, Francesco; Carrara, Elena; Foschi, Federico; Döbele, Stefanie; Tacconelli, Evelina

    2017-09-01

    Antibiotic stewardship programmes have been shown to reduce antibiotic use and hospital costs. We aimed to evaluate evidence of the effect of antibiotic stewardship on the incidence of infections and colonisation with antibiotic-resistant bacteria. For this systematic review and meta-analysis, we searched PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published from Jan 1, 1960, to May 31, 2016, that analysed the effect of antibiotic stewardship programmes on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infections in hospital inpatients. Two authors independently assessed the eligibility of trials and extracted data. Studies involving long-term care facilities were excluded. The main outcomes were incidence ratios (IRs) of target infections and colonisation per 1000 patient-days before and after implementation of antibiotic stewardship. Meta-analyses were done with random-effect models and heterogeneity was calculated with the I 2 method. We included 32 studies in the meta-analysis, comprising 9 056 241 patient-days and 159 estimates of IRs. Antibiotic stewardship programmes reduced the incidence of infections and colonisation with multidrug-resistant Gram-negative bacteria (51% reduction; IR 0·49, 95% CI 0·35-0·68; pbacteria (48%; 0·52, 0·27-0·98; p=0·0428), and meticillin-resistant Staphylococcus aureus (37%; 0·63, 0·45-0·88; p=0·0065), as well as the incidence of C difficile infections (32%; 0·68, 0·53-0·88; p=0·0029). Antibiotic stewardship programmes were more effective when implemented with infection control measures (IR 0·69, 0·54-0·88; p=0·0030), especially hand-hygiene interventions (0·34, 0·21-0·54; pAntibiotic stewardship did not affect the IRs of vancomycin-resistant enterococci and quinolone-resistant and aminoglycoside-resistant Gram-negative bacteria. Significant heterogeneity

  6. The incidence of intraabdominal abscess formation following laparoscopic appendicectomy in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Nataraja, Ramesh M; Loukogeorgakis, Stavros P; Sherwood, William J; Clarke, Simon A; Haddad, Munther J

    2013-09-01

    Recent systematic reviews have suggested an increased incidence of intraabdominal abscess (IAA) formation following laparoscopic appendicectomy (LA) compared with the open approach (OA). As the majority of these analyses have focused on appendicectomy in adults, our aim was to review the evidence base for pediatric patients. We performed a comprehensive review of relevant studies published between 1990 and 2012. Specific inclusion and exclusion criteria were used to identify studies that investigated the incidence of IAA following LA and OA in pediatric patients. The primary outcome measure in the present meta-analysis was IAA formation, and secondary outcomes included wound infection (WI) and incidence of postoperative small bowel obstruction (SBO). Sixty-six studies with a total of 22,060 pediatric patients were included: 56.5% OA and 43.5% LA. There was no overall difference in the incidence of IAA formation: 2.7% for OA (333/12,460) versus 2.9% for LA (282/9600) (P=.25). However, OA patients had a higher incidence of wound infection: 3.7% for OA (337/9228) versus 2.2% for LA (183/8154) (PLA: 0.4% LA (86/5767) versus 1.5% (29/6840) (PLA versus OA in pediatric patients. LA confers a significantly lower risk of other postoperative complications, including WI and SBO.

  7. What evidence exists for initiatives to reduce risk and incidence of sexual violence in armed conflict and other humanitarian crises? A systematic review.

    Directory of Open Access Journals (Sweden)

    Jo Spangaro

    Full Text Available Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i survivor care; ii livelihood initiatives; iii community mobilisation; iv personnel initiatives; v systems and security responses; vi legal interventions and vii multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms

  8. What evidence exists for initiatives to reduce risk and incidence of sexual violence in armed conflict and other humanitarian crises? A systematic review.

    Science.gov (United States)

    Spangaro, Jo; Adogu, Chinelo; Ranmuthugala, Geetha; Powell Davies, Gawaine; Steinacker, Léa; Zwi, Anthony

    2013-01-01

    Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings

  9. Comparison of the prevalence and characteristics of inpatient adverse events using medical records review and incident reporting.

    Science.gov (United States)

    Macharia, W M; Muteshi, C M; Wanyonyi, S Z; Mukaindo, A M; Ismail, A; Ekea, H; Abdallah, A; Tole, J M; Ngugi, A K

    2016-09-08

    Information on adverse events (AEs) in hospitalised patients in developing countries is scanty. To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting. Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence. An AE was defined as an unexpected clinical event (UE) associated with death, disability or prolonged hospitalisation not explained by the disease condition. The kappa statistic was used to estimate inter-rater agreement, and analysis was done using logistic regression. The study identified 53 UEs from 2 000 randomly selected medical records and 33 reported UEs from 23 026 admissions in the index year. The prevalences of AEs from medical records review and incident reports were 1.4% (95% confidence interval (CI) 0.9 - 2.0) and 0.03% (95% CI 0.012 - 0.063), respectively. Compared with incident reporting, review of medical records identified more disability (13.2% v. 0%; p=0.03) and prolonged hospital stays (43.4% v. 18.2%; p=0.02). Review of medical records is preferable to incident reporting in determining the prevalence of AEs in health facilities with limited inpatient quality improvement experience. Further research is needed to determine whether staff education and a positive culture change through promotion of non-punitive UE reporting or a combination of approaches would improve the comprehensiveness of AE reporting.

  10. Validity of peptic ulcer disease and upper gastrointestinal bleeding diagnoses in administrative databases: a systematic review protocol.

    Science.gov (United States)

    Montedori, Alessandro; Abraha, Iosief; Chiatti, Carlos; Cozzolino, Francesco; Orso, Massimiliano; Luchetta, Maria Laura; Rimland, Joseph M; Ambrosio, Giuseppe

    2016-09-15

    Administrative healthcare databases are useful to investigate the epidemiology, health outcomes, quality indicators and healthcare utilisation concerning peptic ulcers and gastrointestinal bleeding, but the databases need to be validated in order to be a reliable source for research. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases, 9th Revision and 10th version (ICD-9 and ICD-10) codes for peptic ulcer and upper gastrointestinal bleeding diagnoses. MEDLINE, EMBASE, Web of Science and the Cochrane Library databases will be searched, using appropriate search strategies. We will include validation studies that used administrative data to identify peptic ulcer disease and upper gastrointestinal bleeding diagnoses or studies that evaluated the validity of peptic ulcer and upper gastrointestinal bleeding codes in administrative data. The following inclusion criteria will be used: (a) the presence of a reference standard case definition for the diseases of interest; (b) the presence of at least one test measure (eg, sensitivity, etc) and (c) the use of an administrative database as a source of data. Pairs of reviewers will independently abstract data using standardised forms and will evaluate quality using the checklist of the Standards for Reporting of Diagnostic Accuracy (STARD) criteria. This systematic review protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) 2015 statement. Ethics approval is not required given that this is a protocol for a systematic review. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide for researchers validating administrative healthcare databases to determine appropriate case definitions for peptic ulcer disease and upper gastrointestinal bleeding, as well as to perform outcome research using

  11. Incidence, prognostic factors and impact of postoperative delirium after major vascular surgery: A meta-analysis and systematic review.

    Science.gov (United States)

    Aitken, Sarah Joy; Blyth, Fiona M; Naganathan, Vasi

    2017-10-01

    Although postoperative delirium is a common complication and increases patient care needs, little is known about the predictors and outcomes of delirium in patients having vascular surgery. This review aimed to determine the incidence, prognostic factors and impact of postoperative delirium in vascular surgical patients. MEDLINE and EMBASE were systematically searched for articles published between January 2000 and January 2016 on delirium after vascular surgery. The primary outcome was the incidence of delirium. Secondary outcomes were contributing prognostic factors and impact of delirium. Study quality and risk of bias was assessed using the QUIPS tool for systematic reviews of prognostic studies, and MOOSE guidelines for reviews of observational studies. Quantitative analyses of extracted data were conducted using meta-analysis where possible to determine incidence of delirium and prognostic factors. A qualitative review of outcomes was performed. Fifteen articles were eligible for inclusion. Delirium incidence ranged between 5% and 39%. Meta-analysis found that patients with delirium were older than those without delirium (OR 3.6, pdelirium included increased age (OR 1.04, pdelirium. Data were limited on the impact of procedure complexity, endovascular compared to open surgery or type of anaesthetic. Postoperative delirium occurs frequently, resulting in major morbidity for vascular patients. Improved quality of prognostic studies may identify modifiable peri-operative factors to improve quality of care for vascular surgical patients.

  12. Redefining the Practice of Peer Review Through Intelligent Automation Part 1: Creation of a Standardized Methodology and Referenceable Database.

    Science.gov (United States)

    Reiner, Bruce I

    2017-10-01

    Conventional peer review practice is compromised by a number of well-documented biases, which in turn limit standard of care analysis, which is fundamental to determination of medical malpractice. In addition to these intrinsic biases, other existing deficiencies exist in current peer review including the lack of standardization, objectivity, retrospective practice, and automation. An alternative model to address these deficiencies would be one which is completely blinded to the peer reviewer, requires independent reporting from both parties, utilizes automated data mining techniques for neutral and objective report analysis, and provides data reconciliation for resolution of finding-specific report differences. If properly implemented, this peer review model could result in creation of a standardized referenceable peer review database which could further assist in customizable education, technology refinement, and implementation of real-time context and user-specific decision support.

  13. Brain Metastasis in Bone and Soft Tissue Cancers: A Review of Incidence, Interventions, and Outcomes

    Directory of Open Access Journals (Sweden)

    Faris Shweikeh

    2014-01-01

    Full Text Available Bone and soft tissue malignancies account for a small portion of brain metastases. In this review, we characterize their incidence, treatments, and prognosis. Most of the data in the literature is based on case reports and small case series. Less than 5% of brain metastases are from bone and soft tissue sarcomas, occurring most commonly in Ewing’s sarcoma, malignant fibrous tumors, and osteosarcoma. Mean interval from initial cancer diagnosis to brain metastasis is in the range of 20–30 months, with most being detected before 24 months (osteosarcoma, Ewing sarcoma, chordoma, angiosarcoma, and rhabdomyosarcoma, some at 24–36 months (malignant fibrous tumors, malignant peripheral nerve sheath tumors, and alveolar soft part sarcoma, and a few after 36 months (chondrosarcoma and liposarcoma. Overall mean survival ranges between 7 and 16 months, with the majority surviving < 12 months (Ewing’s sarcoma, liposarcoma, malignant fibrous tumors, malignant peripheral nerve sheath tumors, angiosarcoma and chordomas. Management is heterogeneous involving surgery, radiosurgery, radiotherapy, and chemotherapy. While a survival advantage may exist for those given aggressive treatment involving surgical resection, such patients tended to have a favorable preoperative performance status and minimal systemic disease.

  14. Gender difference of childhood overweight and obesity in predicting the risk of incident asthma: a systematic review and meta-analysis.

    Science.gov (United States)

    Chen, Y C; Dong, G H; Lin, K C; Lee, Y L

    2013-03-01

    The aims of our meta-analysis were (i) to quantify the predictability of childhood overweight and obesity on the risk of incident asthma; and (ii) to evaluate the gender difference on this relationship. The selection criteria included prospective cohort paediatric studies which use age- and sex-specific body mass index (BMI) as a measure of childhood overweight and the primary outcome of incident asthma. A total of 1,027 studies were initially identified through online database searches, and finally 6 studies met the inclusion criteria. The combined result of reported relative risk from the 6 included studies revealed that overweight children conferred increased risks of incident asthma as compared with non-overweight children (relative risk, 1.19; 95% confidence interval [CI], 1.03-1.37). The relationship was further elevated for obesity vs. non-obesity (relative risk, 2.02; 95% CI, 1.16-3.50). A dose-responsiveness of elevated BMI on asthma incidence was observed (P for trend, 0.004). Obese boys had a significantly larger effect than obese girls (relative risk, boys: 2.47; 95% CI, 1.57-3.87; girls: 1.25; 95% CI, 0.51-3.03), with significant dose-dependent effect. Proposed mechanisms of gender difference could be through pulmonary mechanics, sleep disordered breathing and leptin. Further research might be needed to better understand the exact mechanism of gender difference on the obesity-asthma relationship. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

  15. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records.

    Science.gov (United States)

    Cashmore, Aaron W; Indig, Devon; Hampton, Stephen E; Hegney, Desley G; Jalaludin, Bin B

    2012-08-09

    Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as 'high risk' work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury - there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical abuse. The most incidents of workplace

  16. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Directory of Open Access Journals (Sweden)

    Cashmore Aaron W

    2012-08-01

    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  17. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Science.gov (United States)

    2012-01-01

    Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical

  18. The incidence and prevalence of hepatitis C in prisons and other closed settings: Results of a systematic review and meta-analysis

    Science.gov (United States)

    Larney, Sarah; Kopinski, Hannah; Beckwith, Curt G.; Zaller, Nickolas D.; Jarlais, Don Des; Hagan, Holly; Rich, Josiah D.; van den Bergh, Brenda J.; Degenhardt, Louisa

    2013-01-01

    People detained in prisons and other closed settings are at elevated risk of infection with hepatitis C virus (HCV). We undertook a systematic review and meta-analysis with the aim of determining the rate of incident HCV infection and the prevalence of anti-HCV among detainees of closed settings. We systematically searched databases of peer-reviewed literature and widely distributed a call for unpublished data. We calculated summary estimates of incidence and prevalence among general population detainees and detainees with a history of injecting drug use (IDU), and explored heterogeneity through stratification and meta-regression. The summary prevalence estimates were used to estimate the number of anti-HCV positive prisoners globally. HCV incidence among general detainees was 1·4 per 100 person-years (py; 95% CI: 0·1, 2·7; k=4), and 16·4 per 100py (95% CI: 0·8, 32·1; k=3) among detainees with a history of IDU. The summary prevalence estimate of anti-HCV in general detainees was 26% (95% CI: 23%, 29%; k=93), and in detainees with a history of IDU, 64% (95% CI: 58%, 70%; k=51). The regions of highest prevalence were Central Asia (38%; 95% CI 32%, 43%; k=1) and Australasia (35%; 95% CI: 28%, 43%; k=9). We estimate that 2·2 million (range: 1·4 million – 2·9 million) detainees globally are anti-HCV positive, with the largest populations in North America (668,500; range: 553,500–784,000) and East and Southeast Asia (638,000; range: 332,000–970,000). Conclusion HCV is a significant concern in detained populations, with one in four detainees anti-HCV positive. Epidemiological data on the extent of HCV infection in detained populations is lacking in many countries. Greater attention towards prevention, diagnosis and treatment of HCV infection among detained populations is urgently required. PMID:23504650

  19. The Effect of Head Positioning and Head Tilting on the Incidence of Intraventricular Hemorrhage in Very Preterm Infants: A Systematic Review.

    Science.gov (United States)

    de Bijl-Marcus, Karen A; Brouwer, Annemieke J; de Vries, Linda S; van Wezel-Meijler, Gerda

    2017-01-01

    Despite advances in neonatal intensive care, germinal matrix-intraventricular hemorrhage (GMH-IVH) remains a frequent, serious complication of premature birth. Neutral head position and head tilting have been suggested to reduce the risk of GMH-IVH in preterm infants during the first 72 h of life. The aim of this study was to provide a systematic review of the effect of neutral head positioning and head tilting on the incidence of GMH-IVH in very preterm infants (gestational age ≤30 weeks). In addition, we reviewed their effect on cerebral hemodynamics and oxygenation. Literature was searched (June 2016) in the following electronic databases: CINAHL, Embase, Medline, SCOPUS, and several trial registers. One underpowered trial studied the effect of head positioning on the incidence of GMH-IVH. This randomized controlled trial enrolled 48 preterm infants and found no effect on the occurrence of GMH-IVH. Three observational studies investigated the effect of head rotation and/or tilting on cerebral oxygenation in 68 preterm infants in total. Their results suggest that cerebral oxygenation is not significantly affected by changes in head positioning. The effect of head positioning and/or tilting on cerebral hemodynamics was described in 2 observational studies of 28 preterm infants and found no significant effect. There is insufficient evidence regarding the effect of head positioning and tilting on the incidence of GMH-IVH and cerebral hemodynamics and oxygenation in preterm infants. We recommend further research in this field, especially in extremely preterm and clinically unstable infants during the first postnatal days. © 2016 S. Karger AG, Basel.

  20. [Hyponatremia associated with SSRI/NRSI: Descriptive and comparative epidemiological study of the incidence rates of the notified cases from the data of the French National Pharmacovigilance Database and the French National Health Insurance].

    Science.gov (United States)

    Revol, R; Rault, C; Polard, E; Bellet, F; Guy, C

    2017-12-14

    Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are frequently prescribed. These antidepressants can potentially induce serious hyponatremia through the SIADH syndrome. That seems to concern all molecules of these classes but the individual risk of each molecule is not well known. The aims of the study were to compare the incidence rate of each molecule in order to identify the existence of molecules more at risk of inducing hyponatremia and to characterize a profile of patients at risk for hyponatremia during a treatment with a SSRI or a SNRI. The cases of hyponatremia under SSRI/SNRI were extracted from the French pharmacovigilance database (BPNV). The exposition to the different SSRIs/SNRIs in the French population was estimated from the French National Health Insurance database (SNIIRAM) using a sampled database (Echantillon Généralistes des Bénéficiaires). The study ran from 01/01/2011 to 31/12/2013. The primary study endpoint was the incidence rate of notifications of the hyponatremia cases in patients treated by SSRI/SNRI and recorded into the BNPV database, related to the average annual number of corresponding treatments initiated during the same period. The number of cases of hyponatremia included in the study was 169 for 3 749 800 adult patients initiating treatment. The incidence rate of cases was 1.64 for 100 000 persons per year (PY). The standardized incidence rates between the different molecules showed no difference except for duloxetine (2.79/100 000 PY p > 0.03). Identified risk factors were age, with a large increase of incidence rate from 75 years old (incidence 12.5 higher) and female gender. Comparison of the incidence rates from spontaneous reports indicates a greater risk of hyponatremia for duloxetine for 2011-2013. This result needs to be confirmed by other studies. The advanced age and female sex are risk factors, irrespective of the molecule. Copyright © 2017 L

  1. Searching the Literatura Latino Americana e do Caribe em Ciencias da Saude (LILACS) database improves systematic reviews

    OpenAIRE

    Clark, Otávio Augusto Câmara [UNIFESP; Castro, Aldemar Araujo [UNIFESP

    2002-01-01

    Background An unbiased systematic review (SR) should analyse as many articles as possible in order to provide the best evidence available. However, many SR use only databases with high English-language content as sources for articles. Literatura Latino Americana e do Caribe em Ciencias da Saude (LILACS) indexes 670 journals from the Latin American and Caribbean health literature but is seldom used in these SR. Our objective is to evaluate if LILACS should be used as a routine source of articl...

  2. Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study

    Directory of Open Access Journals (Sweden)

    van Weel Chris

    2011-04-01

    Full Text Available Abstract Background Patient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to show areas where potential improvements could be implemented. Methods We conducted a retrospective review of patient records in Dutch general practice. A random sample of 1,000 patients from 20 general practices was obtained. The number of patient safety incidents that occurred in a one-year period, their perceived underlying causes, and impact on patients' health were recorded. Results We identified 211 patient safety incidents across a period of one year (95% CI: 185 until 241. A variety of types of incidents, perceived causes and consequences were found. A total of 58 patient safety incidents affected patients; seven were associated with hospital admission; none resulted in permanent disability or death. Conclusions Although this large audit of medical records in general practices identified many patient safety incidents, only a few had a major impact on patients' health. Improving patient safety in this low-risk environment poses specific challenges, given the high numbers of patients and contacts in general practice.

  3. Trend in the Age-Adjusted Incidence of Hip Fractures in South Korea: Systematic Review.

    Science.gov (United States)

    Lee, Young-Kyun; Kim, Jin Woo; Lee, Myung Ho; Moon, Kyung Ho; Koo, Kyung-Hoi

    2017-12-01

    The incidence of hip fractures has been reported to vary geographically, and its trend has also varied widely. However, the trend in the age-adjusted incidence of hip fractures has not been well studied in Korea. After we identified eligible studies presenting multiple age-adjusted incidences of hip fractures in the Korean population in PubMed, we evaluated changes in the absolute number of occurrence and calculated the annual percentage change (APC) of age-adjusted incidences of hip fractures. We have searched PubMed for the original and English-language literature on the incidence of hip fractures in the Korean population published since 2000. The studies presenting multiple age-adjusted incidences of hip fractures were selected. We evaluated the change in the absolute number of hip fractures and calculated the APC of age-adjusted incidences of hip fractures for each study. Three eligible articles were identified. The absolute number of hip fractures for both genders increased over time in all three studies although the operational definition of hip fracture differed from one another. The APC of the age-adjusted incidence of hip fractures was positive for women and negative for men. However, the change was not statistically significant in both genders during each study period (2001-2004, 2005-2008, and 2006-2010, respectively). The age-adjusted incidence of hip fractures was stable among men and women, while the absolute number of hip fractures increased for both genders in Korea. Further studies with longer study periods on age-adjusted incidences are required to better determine the trend in the incidence of hip fractures in Korea.

  4. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology

    Directory of Open Access Journals (Sweden)

    El Saadi Ossama

    2004-04-01

    Full Text Available Abstract Background Understanding variations in the incidence of schizophrenia is a crucial step in unravelling the aetiology of this group of disorders. The aims of this review are to systematically identify studies related to the incidence of schizophrenia, to describe the key features of these studies, and to explore the distribution of rates derived from these studies. Methods Studies with original data related to the incidence of schizophrenia (published 1965–2001 were identified via searching electronic databases, reviewing citations and writing to authors. These studies were divided into core studies, migrant studies, cohort studies and studies based on Other Special Groups. Between- and within-study filters were applied in order to identify discrete rates. Cumulative plots of these rates were made and these distributions were compared when the underlying rates were sorted according to sex, urbanicity, migrant status and various methodological features. Results We identified 100 core studies, 24 migrant studies, 23 cohort studies and 14 studies based on Other Special Groups. These studies, which were drawn from 33 countries, generated a total of 1,458 rates. Based on discrete core data for persons (55 studies and 170 rates, the distribution of rates was asymmetric and had a median value (10%–90% quantile of 15.2 (7.7–43.0 per 100,000. The distribution of rates was significantly higher in males compared to females; the male/female rate ratio median (10%–90% quantile was 1.40 (0.9–2.4. Those studies conducted in urban versus mixed urban-rural catchment areas generated significantly higher rate distributions. The distribution of rates in migrants was significantly higher compared to native-born; the migrant/native-born rate ratio median (10%–90% quantile was 4.6 (1.0–12.8. Apart from the finding that older studies reported higher rates, other study features were not associated with significantly different rate distributions (e

  5. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology.

    Science.gov (United States)

    McGrath, John; Saha, Sukanta; Welham, Joy; El Saadi, Ossama; MacCauley, Clare; Chant, David

    2004-04-28

    Understanding variations in the incidence of schizophrenia is a crucial step in unravelling the aetiology of this group of disorders. The aims of this review are to systematically identify studies related to the incidence of schizophrenia, to describe the key features of these studies, and to explore the distribution of rates derived from these studies. Studies with original data related to the incidence of schizophrenia (published 1965-2001) were identified via searching electronic databases, reviewing citations and writing to authors. These studies were divided into core studies, migrant studies, cohort studies and studies based on Other Special Groups. Between- and within-study filters were applied in order to identify discrete rates. Cumulative plots of these rates were made and these distributions were compared when the underlying rates were sorted according to sex, urbanicity, migrant status and various methodological features. We identified 100 core studies, 24 migrant studies, 23 cohort studies and 14 studies based on Other Special Groups. These studies, which were drawn from 33 countries, generated a total of 1,458 rates. Based on discrete core data for persons (55 studies and 170 rates), the distribution of rates was asymmetric and had a median value (10%-90% quantile) of 15.2 (7.7-43.0) per 100,000. The distribution of rates was significantly higher in males compared to females; the male/female rate ratio median (10%-90% quantile) was 1.40 (0.9-2.4). Those studies conducted in urban versus mixed urban-rural catchment areas generated significantly higher rate distributions. The distribution of rates in migrants was significantly higher compared to native-born; the migrant/native-born rate ratio median (10%-90% quantile) was 4.6 (1.0-12.8). Apart from the finding that older studies reported higher rates, other study features were not associated with significantly different rate distributions (e.g. overall quality, methods related to case finding

  6. Assessment of Primary Cancer Incidence in Growth Hormone-Treated Children: Comparison of a Multinational Prospective Observational Study with Population Databases.

    Science.gov (United States)

    Child, Christopher J; Zimmermann, Alan G; Jia, Nan; Robison, Leslie L; Brämswig, Jürgen H; Blum, Werner F

    2016-01-01

    Although results of the majority of clinical studies have shown no association between growth hormone (GH) treatment in childhood and risk of primary cancer, concerns remain regarding the potential influence of GH therapy on neoplastic cell growth. This study evaluated the incidence of primary malignancies in a large observational study of paediatric GH treatment. Primary cancer incidence was assessed in a cohort of 19,054 GH-treated children without a reported prestudy history of malignancy in the observational Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS). The standardised incidence ratio (SIR) for primary cancer in GH-treated children was determined by comparing cancer incidence in the GeNeSIS study population with incidence rates for country-, age-, and sex-matched cohorts of the general population. During a mean follow-up of 3.4 years in GeNeSIS (64,705 person-years), 13 incident potential primary cancers were identified in GH-treated patients. The SIR (95% confidence interval) for all observed cancers was 1.02 (0.54-1.75), and the crude incidence was 20.1 (10.7-34.4) cases per 100,000 person-years. Acknowledging the relatively short follow-up in our study, GH-treated children without a history of previous malignancy did not have a higher risk of all-site primary cancer during the study when compared to general-population cancer registries. © 2016 S. Karger AG, Basel.

  7. A Database for Reviewing and Selecting Radioactive Waste Treatment Technologies and Vendors

    International Nuclear Information System (INIS)

    P. C. Marushia; W. E. Schwinkendorf

    1999-01-01

    Several attempts have been made in past years to collate and present waste management technologies and solutions to waste generators. These efforts have been manifested as reports, buyers' guides, and databases. While this information is helpful at the time it is assembled, the principal weakness is maintaining the timeliness and accuracy of the information over time. In many cases, updates have to be published or developed as soon as the product is disseminated. The recently developed National Low-Level Waste Management Program's Technologies Database is a vendor-updated Internet based database designed to overcome this problem. The National Low-Level Waste Management Program's Technologies Database contains information about waste types, treatment technologies, and vendor information. Information is presented about waste types, typical treatments, and the vendors who provide those treatment methods. The vendors who provide services update their own contact information, their treatment processes, and the types of wastes for which their treatment process is applicable. This information is queriable by a generator of low-level or mixed low-level radioactive waste who is seeking information on waste treatment methods and the vendors who provide them. Timeliness of the information in the database is assured using time clocks and automated messaging to remind featured vendors to keep their information current. Failure to keep the entries current results in a vendor being warned and then ultimately dropped from the database. This assures that the user is dealing with the most current information available and the vendors who are active in reaching and serving their market

  8. Proteomic biomarkers of preterm birth risk in women with polycystic ovary syndrome (PCOS: a systematic review and biomarker database integration.

    Directory of Open Access Journals (Sweden)

    Nicolas Galazis

    Full Text Available BACKGROUND: Preterm Birth (PTB is a major cause of neonatal mortality and morbidity. Women with Polycystic Ovary Syndrome (PCOS are at high risk of PTB. There is a need for research studies to investigate the mechanisms linking PCOS and PTB, to facilitate screening, and develop novel preventative strategies. OBJECTIVE: To list all the proteomic biomarkers of PTB and integrate this list with the PCOS biomarker database to identify commonly expressed biomarkers of the two conditions. SEARCH STRATEGY: A systematic review of PTB biomarkers and update of PCOS biomarker database. All eligible published studies on proteomic biomarkers for PTB and PCOS identified through various databases were evaluated. SELECTION CRITERIA: For the identification of the relevant studies, the following search terms were used: "proteomics", "proteomic", "preterm birth", "preterm labour", "proteomic biomarker" and "polycystic ovary syndrome". This search was restricted to humans only DATA COLLECTION AND ANALYSIS: A database on proteomic biomarkers for PTB was created while an already existing PCOS biomarker database was updated. The two databases were integrated and biomarkers that were co-expressed in both women with PCOS and PTB were identified and investigated. RESULTS: A panel of six proteomic biomarkers was similarly differentially expressed in women with PTB and women with PCOS compared to their respective controls (normal age-matched women in the case of PCOS studies and women with term pregnancy in the case of PTB studies. These biomarkers include Pyruvate kinase M1/M2, Vimentin, Fructose bisphosphonate aldolase A, Heat shock protein beta-1, Peroxiredoxin-1 and Transferrin. CONCLUSIONS: These proteomic biomarkers (Pyruvate kinase M1/M2, Vimentin, Fructose bisphosphonate aldolase A, Heat shock protein beta-1, Peroxiredoxin-1 and Transferrin can be potentially used to better understand the pathophysiological mechanisms linking PCOS and PTB. This would help to

  9. Pleasing some of the people some of the time: How authors, subjects, and readers assess "Audience" in wildland fire incident reviews

    Science.gov (United States)

    Jennifer A. Ziegler; Anne E. Black

    2012-01-01

    When unexpected outcomes occur in wildland fire, reports from incident reviews carry a symbolic value beyond the factual information they contain. Popular perception of incident reviews is that the organization has identified the root cause with an eye toward system change, and that the final report chronicles "the" final, definitive, and authoritative...

  10. Pleasing some of the people some of the time: How authors, subjects, and readers assess the complex landscape of "audience" in wildland fire incident reviews (Abstract)

    Science.gov (United States)

    Jennifer Ziegler; Anne E. Black

    2012-01-01

    When unexpected outcomes occur in wildland fire, reports from incident reviews carry a symbolic value beyond the factual information they contain. Popular perception of incident reviews is that the organization has identified the root cause with an eye toward system change, and that the final report chronicles "the" final, definitive, and authoritative...

  11. Incidence and prevalence of non-melanoma skin cancer in Australia: A systematic review.

    Science.gov (United States)

    Perera, Eshini; Gnaneswaran, Neiraja; Staines, Carolyn; Win, Aung Ko; Sinclair, Rod

    2015-11-01

    Non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common cancer occurring in people with fair skin. Australia has been reported to have the highest incidence of NMSC in the world. Using a systematic search of the literature in EMBASE and Medline, we identified 21 studies that investigated the incidence or prevalence of NMSC in Australia. Studies published between 1948 and 2011 were identified and included in the analysis. There were six studies that were conducted on national level, two at state level and 13 at the regional level. Overall, the incidence of NMSC had steadily increased over calendar-years in Australia. The incidence of NMSC per 100,000 person-years was estimated to be 555 in 1985; 977 in 1990; 1109 in 1995; 1170 in 2002 and 2448 in 2011. The incidence was higher for men than women and higher for BCC than SCC. Incidence varied across the states of Australia, with the highest in Queensland. The prevalence of NMSC was estimated to be 2% in Australia in 2002. The incidence and prevalence of NMSC still need to be accurately established at both national and state levels to determine the costs and burden of the disease on the public health system in Australia. © 2015 The Australasian College of Dermatologists.

  12. Population incidence of Guillain-Barré syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Sejvar, James J; Baughman, Andrew L; Wise, Matthew; Morgan, Oliver W

    2011-01-01

    Population incidence of Guillain-Barré syndrome (GBS) is required to assess changes in GBS epidemiology, but published estimates of GBS incidence vary greatly depending on case ascertainment, definitions, and sample size. We performed a meta-analysis of articles on GBS incidence by searching Medline (1966-2009), Embase (1988-2009), Cinahl (1981-2009) and CABI (1973-2009) as well as article bibliographies. We included studies from North America and Europe with at least 20 cases, and used population-based data, subject matter experts to confirm GBS diagnosis, and an accepted GBS case definition. With these data, we fitted a random-effects negative binomial regression model to estimate age-specific GBS incidence. Of 1,683 nonduplicate citations, 16 met the inclusion criteria, which produced 1,643 cases and 152.7 million person-years of follow-up. GBS incidence increased by 20% for every 10-year increase in age; the risk of GBS was higher for males than females. The regression equation for calculating the average GBS rate per 100,000 person-years as a function of age in years was exp[-12.0771 + 0.01813(age in years)] × 100,000. Our findings provide a robust estimate of background GBS incidence in Western countries. Our regression model may be used in comparable populations to estimate the background age-specific rate of GBS incidence for future studies. Copyright © 2011 S. Karger AG, Basel.

  13. 77 FR 66622 - Submission for OMB Review; Comment Request: National Database for Autism Research (NDAR) Data...

    Science.gov (United States)

    2012-11-06

    ...) Data Access Request. Type of Information Collection Request: 0925-NEW. Need and Use of Information Collection: The NDAR Data Access Request form is necessary for ``Recipient'' Principal Investigators and... well as to notify interested recipients of updates, corrections or other changes to the database...

  14. Worldwide Incidence of Colorectal Cancer, Leukemia, and Lymphoma in Inflammatory Bowel Disease: An Updated Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Chelle L. Wheat

    2016-01-01

    Full Text Available Background/Aims. Inflammatory bowel disease (IBD is associated with an increased risk of colorectal cancer (CRC. In addition, there may be an association between leukemia and lymphoma and IBD. We conducted a systematic review and meta-analysis of the IBD literature to estimate the incidence of CRC, leukemia, and lymphoma in adult IBD patients. Methods. Studies were identified by a literature search of PubMed, Cochrane Library, Medline, Web of Science, Scopus, EMBASE, and ProQuest Dissertations and Theses. Pooled incidence rates (per 100,000 person-years [py] were calculated through use of a random effects model, unless substantial heterogeneity prevented pooling of estimates. Several stratified analyses and metaregression were performed to explore potential study heterogeneity and bias. Results. Thirty-six articles fulfilled the inclusion criteria. For CRC, the pooled incidence rate in CD was 53.3/100,000 py (95% CI 46.3–60.3/100,000. The incidence of leukemia was 1.5/100,000 py (95% CI −0.06–3.0/100,000 in IBD, 0.3/100,000 py (95% CI −1.0–1.6/100,000 in CD, and 13.0/100,000 py (95% CI 5.8–20.3/100,000 in UC. For lymphoma, the pooled incidence rate in CD was 0.8/100,000 py (95% CI −0.4–2.1/100,000. Substantial heterogeneity prevented the pooling of other incidence estimates. Conclusion. The incidence of CRC, leukemia, and lymphoma in IBD is low.

  15. Epidemiology of Trichomoniasis in South Korea and Increasing Trend in Incidence, Health Insurance Review and Assessment 2009-2014.

    Science.gov (United States)

    Joo, So-Young; Goo, Youn-Kyoung; Ryu, Jae-Sook; Lee, Sang-Eun; Lee, Won Kee; Chung, Dong-Il; Hong, Yeonchul

    2016-01-01

    Trichomoniasis, which is caused by Trichomonas vaginalis, is one of the most common non-viral sexually transmitted infections; however, limited population-based data are available that describe patterns and trends of the disease. We summarized insurance claims of trichomoniasis cases reported during 2009-2014 to South Korea Health Insurance Review and Assessment Service. The average annual incidence in South Korea was 276.8 persons per 100,000 population, and a substantial sex-associated variation was observed. The incidence rate among female subjects trended upward over 6 years, that is, it increased from 501 in 2009 to 625.8 in 2014 per 100,000 female population, which indicates a 25% overall increase. This trend was sharpest in the ≥60 years group of female population. However, a 66% decrease in incidence rates was observed among male subjects (23.7 in 2009 to 15.7 in 2014 per 100,000 male population). Further, substantial decrease was observed in the ≥40 years groups of male population. The incidence of trichomoniasis varied across regions and was the highest in Jeju province of South Korea. Overall, as the incidence of trichomoniasis appears to have increased in South Korea during 2009-2014, the disease burden is increasing; hence, there is a need to better understand the disease transmission.

  16. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  17. Lead exposure in US worksites: A literature review and development of an occupational lead exposure database from the published literature

    Science.gov (United States)

    Koh, Dong-Hee; Locke, Sarah J.; Chen, Yu-Cheng; Purdue, Mark P.; Friesen, Melissa C.

    2016-01-01

    Background Retrospective exposure assessment of occupational lead exposure in population-based studies requires historical exposure information from many occupations and industries. Methods We reviewed published US exposure monitoring studies to identify lead exposure measurement data. We developed an occupational lead exposure database from the 175 identified papers containing 1,111 sets of lead concentration summary statistics (21% area air, 47% personal air, 32% blood). We also extracted ancillary exposure-related information, including job, industry, task/location, year collected, sampling strategy, control measures in place, and sampling and analytical methods. Results Measurements were published between 1940 and 2010 and represented 27 2-digit standardized industry classification codes. The majority of the measurements were related to lead-based paint work, joining or cutting metal using heat, primary and secondary metal manufacturing, and lead acid battery manufacturing. Conclusions This database can be used in future statistical analyses to characterize differences in lead exposure across time, jobs, and industries. PMID:25968240

  18. Effects of gastrocnemius recession on ankle motion, strength, and functional outcomes: a systematic review and national healthcare database analysis.

    Science.gov (United States)

    Gianakos, Arianna; Yasui, Youichi; Murawski, Christopher D; Kennedy, John G

    2016-04-01

    The purpose of this systematic review was to report the effects of gastrocnemius recession on ankle dorsiflexion range of motion, function, and push-off power. The MEDLINE and EMBASE databases were reviewed with terms "gastrocnemius recession". The inclusion criteria were: (1) clinical studies, (2) published in a peer-reviewed journal within the past 10 years, and (3) published in English. Excluded were: (1) review articles, (2) cadaveric studies, (3) studies including patients under the age of 18 years, (4) studies evaluating a neurologic condition, (5) level of evidence 5, and (6) Quality of Evidence Score trends. The PearlDiver Database was also used to review de-identified patient information retrospectively between 2007 and 2011. Full-text review yielded 23 articles that fit the inclusion criteria. Twenty-one of 23 (91%) and 2/23 (9%) studies were level of evidence 4 and 3, respectively. Twelve of 23 (52%) studies reported follow-up assessment between 12 and 36 months, and no studies reported longer-term follow-up. Twelve of 12 (100%) studies reported improved dorsiflexion range of motion 9/9 (100%) reported improved AOFAS, and 11/11 (100%) reported improved VAS. Five of 23 (22%) studies reported strength in a measured and controlled fashion with variable results, but of these, no study reported a return to normal power. The mean complication rate was 14%. The available evidence supports that GR improves functional outcomes and increases dorsiflexion range of motion. Furthermore, GR affects gait kinematics, which may cause compensatory effects at the knee, ankle, and subtalar joints. Evidence has shown that power does not return to normal levels. Clinicians may utilize these data clinically to determine whether patients may benefit from GR or not. IV.

  19. Incidence of Acute Complications Following Surgery for Syndactyly and Polydactyly: An Analysis of the National Surgical Quality Improvement Program Database from 2012 to 2014.

    Science.gov (United States)

    McQuillan, Thomas J; Hawkins, Jessica E; Ladd, Amy L

    2017-09-01

    Congenital hand differences are infrequent phenomena, and their treatment represents a relatively small fraction of cases performed by hand surgeons. Little is known about the incidence of wound complications and acute postoperative problems given the relative rarity of these procedures. This study sought to characterize the incidence of complications within 30 days of surgery for congenital hand differences. The National Surgical Quality Improvement Program (NSQIP) contains prospective data regarding 30-day morbidity from 64 pediatric centers across the United States. Data from all available years (2012-2014) were queried for Current Procedural Terminology (CPT) codes pertinent to the treatment of congenital hand differences. Bivariate statistics, Fisher exact tests and Poisson 95% confidence intervals (95% CI) were used to assess the incidence of complications and examine risk factors for these outcomes. We identified a total of 1,656 congenital hand cases that represented 4 different CPT codes, including surgery for simple syndactyly, complex syndactyly, and polydactyly. The overall incidence of complications was 2.2% (95% CI, 1.6%-3.1%; n = 37) with the most common complication being superficial surgical site infection (1.7%; 95% CI, 1.1%-2.4%) followed by related readmission (0.3%; 95% CI, 0.1%-0.7%). There was a higher incidence of complications observed in patients undergoing complex syndactyly repair (5.2% for complex syndactyly repair vs 2.3% for all others). The rate of acute complications following procedures to correct syndactyly and polydactyly is low, the most common of which is superficial surgical site infection. The incidence of acute complications may be helpful in counseling patients and families. We suggest that further research must prioritize collecting data on long-term functional outcomes. Therapeutic II. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. DMPD: Cellular reprogramming by gram-positive bacterial components: a review. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 16885502 Cellular reprogramming by gram-positive bacterial components: a review. Bu...(.csml) Show Cellular reprogramming by gram-positive bacterial components: a review. PubmedID 16885502 Title Cellular reprogramming...ckley JM, Wang JH, Redmond HP. J Leukoc Biol. 2006 Oct;80(4):731-41. Epub 2006 Aug 2. (.png) (.svg) (.html)

  1. Prevalence, Cumulative Incidence, Monotherapy and Combination Therapy, and Treatment Duration of Frequently Prescribed Psychoactive Medications in the Netherlands : Retrospective Database Analysis for the Years 2000 to 2005

    NARCIS (Netherlands)

    Ravera, Silvia; Visser, Sipke T.; de Gier, Johan J.; den Berg, Lolkje T. W. de Jong-van

    2010-01-01

    Background: Psychoactive drugs have been reported to impair daily activities (eg, driving), but data regarding the use of such drugs in the Netherlands are lacking. Objective: The aim of this work was to examine the prevalence, cumulative incidence, use of monotherapy and combination therapy, and

  2. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  3. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

  4. Towards optimising local reviews of severe incidents in maternity care: messages from a comparison of local and external reviews.

    Science.gov (United States)

    Shah, Anjali; Kemp, Bryn; Sellers, Susan; Hinton, Lisa; O'Connor, Melanie; Brocklehurst, Peter; Kurinczuk, Jenny; Knight, Marian

    2017-04-01

    Detailed local case review is commonly used as a strategy to improve care. However, recent reports have highlighted concerns over quality of local reviews in maternity care. The aim of this project was to describe the methods used for conducting local reviews of care of women with severe maternal morbidity, and to compare lessons identified for future care through external and local reviews. Thirty-three anonymised clinical records from women with severe maternal morbidities were obtained, together with the report of the local review of their care. The methodology used for the local reviews was described, including specific tools used, team members involved, their disciplines, report format and whether an action plan with recommendations for audit was produced. Multidisciplinary external reviewers considered the records using a standard confidential enquiry approach. A thematic analysis of lessons learned from the two approaches was undertaken. A formal report of the local review was produced for 11/33 cases; 4 of these used root cause analysis. A further 12 local reviews consisted of a group discussion with output noted in a spreadsheet; 5 consisted of a timeline with good practice points and 5 had no formal review. Patients were involved in five local reviews; only one was multidisciplinary. Action plans were recorded in 14 local reviews; 3 of these included a recommendation to audit the proposed changes. External reviews identified additional messages for care and highlighted aspects of good care in every case, whereas only 55% (n=18) of local reviews identified good care (previews can clearly be improved. Very few of the reviews involved patients. Local reviews should be multidisciplinary, generate an action plan, and the implementation of recommendations should be audited. Improvements in local reviews may be achieved by standardised training or development of national protocols. Published by the BMJ Publishing Group Limited. For permission to use (where not

  5. Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review.

    Science.gov (United States)

    Artico, Marco; Dante, Angelo; D'Angelo, Daniela; Lamarca, Luciano; Mastroianni, Chiara; Petitti, Tommasangelo; Piredda, Michela; De Marinis, Maria Grazia

    2018-01-01

    Terminally ill patients are at high risk of pressure ulcers, which have a negative impact on quality of life. Data about pressure ulcers' prevalence, incidence and associated factors are largely insufficient. To document the point prevalence at admission and the cumulative incidence of pressure ulcers in terminally ill patients admitted to an Italian home palliative care unit, and to analyse the patients' and caregivers' characteristics associated with their occurrence. Retrospective chart review. Patients ( n = 574) with a life expectancy ⩽6 months admitted to a palliative home care service were included in this study. The prevalence and incidence rates were 13.1% and 13.0%, respectively. The logistic regression models showed body mass index ( p 70 and >1 caregiver at home as the dichotomous variables predictors of presenting with a pressure ulcer at time of admission and during home palliative care. The notable pressure ulcers' incidence and prevalence rates suggest the need to include this issue among the main outcomes to pursue during home palliative care. The accuracy of body mass index, Braden Scale and Karnofsky Performance Scale in predicting the pressure ulcers risk is confirmed. Therefore, they appear as essential tools, in combination with nurses' clinical judgment, for a structured approach to pressure ulcers prevention. Further research is needed to explore the home caregivers' characteristics and attitudes associated with the occurrence of pressure ulcers and the relations between their strategies for pressure ulcer prevention and gender-related patient's needs.

  6. Mass Casualty Incidents in the Underground Mining Industry: Applying the Haddon Matrix on an Integrative Literature Review.

    Science.gov (United States)

    Engström, Karl Gunnar; Angrén, John; Björnstig, Ulf; Saveman, Britt-Inger

    2018-02-01

    Underground mining is associated with obvious risks that can lead to mass casualty incidents. Information about such incidents was analyzed in an integrated literature review. A literature search (1980-2015) identified 564 modern-era underground mining reports from countries sharing similar occupational health legislation. These reports were condensed to 31 reports after consideration of quality grading and appropriateness to the aim. The Haddon matrix was used for structure, separating human factors from technical and environmental details, and timing. Most of the reports were descriptive regarding injury-creating technical and environmental factors. The influence of rock characteristics was an important pre-event environmental factor. The organic nature of coal adds risks not shared in hard-rock mines. A sequence of mechanisms is commonly described, often initiated by a human factor in interaction with technology and step-wise escalation to involve environmental circumstances. Socioeconomic factors introduce heterogeneity. In the Haddon matrix, emergency medical services are mainly a post-event environmental issue, which were not well described in the available literature. The US Quecreek Coal Mine incident of 2002 stands out as a well-planned rescue mission. Evaluation of the preparedness to handle underground mining incidents deserves further scientific attention. Preparedness must include the medical aspects of rescue operations. (Disaster Med Public Health Preparedness. 2018;12:138-146).

  7. Patient record review of the incidence, consequences, and causes of diagnostic adverse events

    NARCIS (Netherlands)

    Zwaan, L.; de Bruijne, M.; Wagner, C.; Thijs, A.; Smits, M.; van der Wal, G.; Timmermans, D.R.M.

    2010-01-01

    Background: Diagnostic errors often result in patient harm. Previous studies have shown that there is large variability in results in different medical specialties. The present study explored diagnostic adverse events (DAEs) across all medical specialties to determine their incidence and to gain

  8. Patient record review of the incidence, consequences, and causes of diagnostic adverse events.

    NARCIS (Netherlands)

    Zwaan, L.; Bruijne, M. de; Wagner, C.; Thijs, A.; Smits, M.; Wal, G. van der; Timmermans, D.R.M.

    2010-01-01

    Background: Diagnostic errors often result in patient harm. Previous studies have shown that there is large variability in results in different medical specialties. The present study explored diagnostic adverse events (DAEs) across all medical specialties to determine their incidence and to gain

  9. A review of the incidence and survival of childhood and adolescent ...

    African Journals Online (AJOL)

    cancer incidence. The age range for adolescence for the purpose of scientific reporting has been set at 15 - 19 years.6 More recently the concept of 'young adult oncology' has referred to a larger group of young people ... Testicular cancer is the commonest ... In general the alkylating agents interact with DNA, preventing.

  10. Towards optimising local reviews of severe incidents in maternity care: messages from a comparison of local and external reviews

    OpenAIRE

    Shah, Anjali; Kemp, Bryn; Sellers, Susan; Hinton, Lisa; O'Connor, Melanie; Brocklehurst, Peter; Kurinczuk, Jenny; Knight, Marian

    2016-01-01

    ABSTRACT Background Detailed local case review is commonly used as a strategy to improve care. However, recent reports have highlighted concerns over quality of local reviews in maternity care. The aim of this project was to describe the methods used for conducting local reviews of care of women with severe maternal morbidity, and to compare lessons identified for future care through external and local reviews. Methods Thirty-three anonymised clinical records ...

  11. Incidence, prevalence and genetic determinants of neonatal diabetes mellitus: a systematic review and meta-analysis protocol.

    Science.gov (United States)

    Nansseu, Jobert Richie N; Ngo-Um, Suzanne S; Balti, Eric V

    2016-11-10

    In the absence of existing data, the present review intends to determine the incidence, prevalence and/or genetic determinants of neonatal diabetes mellitus (NDM), with expected contribution to disease characterization. We will include cross-sectional, cohort or case-control studies which have reported the incidence, prevalence and/or genetic determinants of NDM between January 01, 2000 and May 31, 2016, published in English or French languages and without any geographical limitation. PubMed and EMBASE will be extensively screened to identify potentially eligible studies, completed by manual search. Two authors will independently screen, select studies, extract data, and assess the risk of bias; disagreements will be resolved by consensus. Clinical heterogeneity will be investigated by examining the design and setting (including geographic region), procedure used for genetic testing, calculation of incidence or prevalence, and outcomes in each study. Studies found to be clinically homogeneous will be pooled together through a random effects meta-analysis. Statistical heterogeneity will be assessed using the chi-square test of homogeneity and quantified using the I 2 statistic. In case of substantial heterogeneity, subgroup analyses will be undertaken. Publication bias will be assessed with funnel plots, complemented with the use of Egger's test of bias. This systematic review and meta-analysis is expected to draw a clear picture of phenotypic and genotypic presentations of NDM in order to better understand the condition and adequately address challenges in respect with its management. PROSPERO CRD42016039765.

  12. Systematic Review and Meta-Analysis on Incidence of Altered Sensation of Mandibular Implant Surgery

    Science.gov (United States)

    Lin, Chia-Shu; Wu, Shih-Yun; Huang, Hsin-Yi; Lai, Yu-Lin

    2016-01-01

    Altered sensation (including paresthesia, dysesthesia and hypoesthesia) after mandibular implant surgery may indicate transient or permanent injury of the inferior alveolar nerve and the mental branch, and considerably lower patients’ satisfaction about the therapy. Previous studies have shown a great degree of variability on the incidence of altered sensation. We here reported the incidence of altered sensation after mandibular implant surgery based on a meta-analysis of 26 articles published between 1990.1.1 and 2016.1.1. Study quality and risk of bias was assessed and the studies with a lower score were excluded in the meta-analysis. Data synthesis was performed using the logistic-normal random-effect model. The meta-analyses revealed that the short-term (10 days after implant placement) and long-term (1 year after implant placement) incidence was 13% (95% CI, 6%-25%) and 3% (95% CI, 1%-7%), respectively. (2) For the patients who initially reported altered sensation, 80% (95% CI, 52%-94%) of them would return to normal sensation within 6 months after surgery, and 91% (95% CI, 78%-96%) of them would return to normal sensation one year after surgery. We concluded that dentist-patient communication about the risk of altered sensation is critical to treatment planning, since the short-term incidence of altered sensation is substantial (13%). When a patient reports altered sensation, regular assessment for 6 months would help tracing the changes of symptoms. In terms of long-term follow-up (1 year after surgery), the incidence is much lower (3%) and most patients (91%) would return to normal sensation. PMID:27100832

  13. Proportional incidence and radiological review of large (T2+) breast cancers as surrogate indicators of screening programme performance

    International Nuclear Information System (INIS)

    Ciatto, S.; Bernardi, D.; Pellegrini, M.; Borsato, G.; Peterlongo, P.; Gentilini, M.A.; Caumo, F.; Frigerio, A.; Houssami, N.

    2012-01-01

    Surrogate measures of screening performance [e.g. interval cancer (IC) proportional incidence] allow timely monitoring of sensitivity and quality. This study explored measures using large (T2+) breast cancers as potential indicators of screening performance. The proportional incidence of T2+ cancers (observed/expected cases) in a population-based screening programme (Trento, 2001-2009) was estimated. A parallel review of 'negative' preceding mammograms for screen-detected T2+ and for all ICs, using 'blinded' independent readings and case-mixes (54 T2+, 50 ICs, 170 controls) was also performed. T2+ cancers were observed in 168 screening participants: 48 at first screen, 67 at repeat screening and 53 ICs. The T2+ estimated proportional incidence was 68% (observed/expected = 168/247), corresponding to an estimated 32% reduction in the rate of T2+ cancers in screening participants relative to that expected without screening. Majority review classified 27.8% (15/54) of T2+ and 28% (14/50) of ICs as screening error (P = 0.84), with variable recall rates amongst radiologists (8.8-15.2%). T2+ review could be integrated as part of quality monitoring and potentially prove more feasible than IC review for some screening services. circle Interval breast cancers, assumed as screening failures, are monitored to estimate screening performance circle Large (T2+) cancers at screening may also represent failed prior screening detection circle Analysis of T2+ lesions may be more feasible than assessing interval cancers circle Analysis of T2+ cancers is a potential further measure of screening performance. (orig.)

  14. Proportional incidence and radiological review of large (T2+) breast cancers as surrogate indicators of screening programme performance

    Energy Technology Data Exchange (ETDEWEB)

    Ciatto, S.; Bernardi, D.; Pellegrini, M.; Borsato, G.; Peterlongo, P. [APSS, U.O. Senologia Clinica e Screening Mammografico, Dipartimento di Radiodiagnostica, Trento (Italy); Gentilini, M.A. [APSS, Servizio Osservatorio Epidemiologico, Direzione promozione ed educazione alla salute, Trento (Italy); Caumo, F. [Centro di Prevenzione Senologica, Verona (Italy); Frigerio, A. [CRR, Centro di Riferimento Regionale per lo Screening Mammografico, Torino (Italy); Houssami, N. [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney (Australia)

    2012-06-15

    Surrogate measures of screening performance [e.g. interval cancer (IC) proportional incidence] allow timely monitoring of sensitivity and quality. This study explored measures using large (T2+) breast cancers as potential indicators of screening performance. The proportional incidence of T2+ cancers (observed/expected cases) in a population-based screening programme (Trento, 2001-2009) was estimated. A parallel review of 'negative' preceding mammograms for screen-detected T2+ and for all ICs, using 'blinded' independent readings and case-mixes (54 T2+, 50 ICs, 170 controls) was also performed. T2+ cancers were observed in 168 screening participants: 48 at first screen, 67 at repeat screening and 53 ICs. The T2+ estimated proportional incidence was 68% (observed/expected = 168/247), corresponding to an estimated 32% reduction in the rate of T2+ cancers in screening participants relative to that expected without screening. Majority review classified 27.8% (15/54) of T2+ and 28% (14/50) of ICs as screening error (P = 0.84), with variable recall rates amongst radiologists (8.8-15.2%). T2+ review could be integrated as part of quality monitoring and potentially prove more feasible than IC review for some screening services. circle Interval breast cancers, assumed as screening failures, are monitored to estimate screening performance circle Large (T2+) cancers at screening may also represent failed prior screening detection circle Analysis of T2+ lesions may be more feasible than assessing interval cancers circle Analysis of T2+ cancers is a potential further measure of screening performance. (orig.)

  15. Incidence and natural history of intravenous immunoglobulin-induced aseptic meningitis: a retrospective review at a single tertiary care center.

    Science.gov (United States)

    Bharath, Vighnesh; Eckert, Kathleen; Kang, Matthew; Chin-Yee, Ian H; Hsia, Cyrus C

    2015-11-01

    Aseptic meningitis is a rare but significant complication of intravenous immunoglobulin (IVIG) therapy. The majority of literature is limited to case reports, so the true incidence of this complication is uncertain. A retrospective review of all cases of IVIG-associated adverse transfusion reactions was performed at London Health Sciences Centre (LHSC) from January 1, 2008, to December 31, 2013. All reported transfusion reactions were evaluated to identify cases of aseptic meningitis due to IVIG. All documented IVIG infusions and lumbar punctures performed during the study period were reviewed; patients with both interventions were identified and further chart review was performed to identify aseptic meningitis. During our study period, 1324 unique patients received a total of 11,907 IVIG infusions (554,566 g) for various conditions. Eight cases of aseptic meningitis were identified, suggesting an overall incidence of 0.60% for all patients and 0.067% for all IVIG infusions. Patients presented with symptoms within 24 to 48 hours of the infusion and were treated with antibiotics initially. The reactions were self-limited, as symptoms self-resolved within 5 to 7 days. Treatment was supportive, with subsequent IVIG infusions likely requiring preinfusion medication or possibly a switch in product formulation. This review of IVIG-induced aseptic meningitis over a 6-year period identifies a more robust estimate of incidence and risk of 0.60% and 0.067% for all patients and infusions, respectively. Given that this complication can mimic infectious meningitis and cause considerable morbidity, physicians need to be aware of this rare but important condition. © 2015 AABB.

  16. Establishment of database and network for research of stream generator and state of the art technology review

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jae Bong; Hur, Nam Su; Moon, Seong In; Seo, Hyeong Won; Park, Bo Kyu; Park, Sung Ho; Kim, Hyung Geun [Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2004-02-15

    A significant number of steam generator tubes are defective and are removed from service or repaired world widely. This wide spread damage has been caused by diverse degradation mechanisms, some of which are difficult to detect and predict. Regarding domestic nuclear power plants, also, the increase of number of operating nuclear power plants and operating periods may result in the increase of steam generator tube failure. So, it is important to carry out the integrity evaluation process to prevent the steam generator tube damage. There are two objectives of this research. The one is to make database for the research of steam generator at domestic research institution. It will increase the efficiency and capability of limited domestic research resources by sharing data and information through network organization. Also, it will enhance the current standard of integrity evaluation procedure that is considerably conservative but can be more reasonable. The second objective is to establish the standard integrity evaluation procedure for steam generator tube by reviewing state of the art technology. The research resources related to steam generator tubes are managed by the established web-based database system. The following topics are covered in this project: development of web-based network for research on steam generator tubes review of state of the art technology.

  17. Incidence of schizophrenia and other psychoses in England, 1950-2009: a systematic review and meta-analyses.

    Directory of Open Access Journals (Sweden)

    James B Kirkbride

    Full Text Available We conducted a systematic review of incidence rates in England over a sixty-year period to determine the extent to which rates varied along accepted (age, sex and less-accepted epidemiological gradients (ethnicity, migration and place of birth and upbringing, time.To determine variation in incidence of several psychotic disorders as above.Published and grey literature searches (MEDLINE, PSycINFO, EMBASE, CINAHL, ASSIA, HMIC, and identification of unpublished data through bibliographic searches and author communication.Published 1950-2009; conducted wholly or partially in England; original data on incidence of non-organic adult-onset psychosis or one or more factor(s pertaining to incidence.People, 16-64 years, with first -onset psychosis, including non-affective psychoses, schizophrenia, bipolar disorder, psychotic depression and substance-induced psychosis.Title, abstract and full-text review by two independent raters to identify suitable citations. Data were extracted to a standardized extraction form. Descriptive appraisals of variation in rates, including tables and forest plots, and where suitable, random-effects meta-analyses and meta-regressions to test specific hypotheses; rate heterogeneity was assessed by the I²-statistic.83 citations met inclusion. Pooled incidence of all psychoses (N = 9 was 31.7 per 100,000 person-years (95%CI: 24.6-40.9, 23.2 (95%CI: 18.3-29.5 for non-affective psychoses (N = 8, 15.2 (95%CI: 11.9-19.5 for schizophrenia (N = 15 and 12.4 (95%CI: 9.0-17.1 for affective psychoses (N = 7. This masked rate heterogeneity (I²: 0.54-0.97, possibly explained by socio-environmental factors; our review confirmed (via meta-regression the typical age-sex interaction in psychosis risk, including secondary peak onset in women after 45 years. Rates of most disorders were elevated in several ethnic minority groups compared with the white (British population. For example, for schizophrenia: black Caribbean (pooled

  18. Incidence rate and prevalence of major risk factors for ectopic pregnancy in the Pakistani population: mini-review

    Directory of Open Access Journals (Sweden)

    Sabira Sultana

    2015-05-01

    Full Text Available Ectopic pregnancy is the complication of pregnancy in which the product of conception implants outside the uterine cavity i.e. in the uterine tubes, cervix, ovaries and abdomen. It is lifethreatening emergency and a major cause of maternal morbidity and mortality. The incidence rate is 0.5%-1.5% of all pregnancies. Even though its incidence rate is drop off when compared with earlier decades, it is still the foremost causes of maternal morbidity and mortality in the first trimester of pregnancy, especially in developing countries. In Pakistan, it varies from 1:1 124 to 1:130 pregnancies. Risk factors associated to ectopic pregnancy are pelvic inflammatory disease, past history of miscarriages, age, parity, infertility, previous ectopic pregnancy, induction of ovulation and intrauterine device usage. The aim of this study is to review the published literature concerning the disease knowledge and major risk factors associated to ectopic pregnancy in Pakistan.

  19. Zofenopril and incidence of cough: a review of published and unpublished data

    Directory of Open Access Journals (Sweden)

    Omboni S

    2011-11-01

    Full Text Available Stefano Omboni1, Claudio Borghi21Italian Institute of Telemedicine, Varese, Italy; 2Department of Internal Medicine, Aging, and Kidney Diseases, University Hospital of Bologna, Bologna, ItalyObjective: Cough is a typical side effect of angiotensin-converting enzyme (ACE inhibitors, though its frequency quantitatively varies among the different compounds. Data on the incidence of cough with the lipophilic third-generation ACE inhibitor zofenopril are scanty and never systematically analyzed. The purpose of this paper is to give an overview on the epidemiology, pathophysiology, and treatment of ACE inhibitor-induced cough and to assess the incidence of cough induced by zofenopril treatment.Methods: Published and unpublished data from randomized and postmarketing zofenopril trials were merged together and analyzed.Results: Twenty-three studies including 5794 hypertensive patients and three studies including 1455 postmyocardial infarction patients exposed for a median follow-up time of 3 months to zofenopril at doses of 7.5–60 mg once-daily were analyzed. The incidence of zofenopril-induced cough was 2.6% (range 0%–4.2%: 2.4% in the hypertension trials (2.4% in the double-blind randomized studies and 2.4% in the open-label postmarketing studies and 3.6% in the double-blind randomized postmyocardial infarction trials. Zofenopril-induced cough was generally of a mild to moderate intensity, occurred significantly (P < 0.001 more frequently in the first 3–6 months of treatment (3.0% vs 0.2% 9–12 months, and always resolved or improved upon therapy discontinuation. Zofenopril doses of 30 mg and 60 mg resulted in significantly (P = 0.042 greater rate of cough (2.1% and 2.6%, respectively than doses of 7.5 mg and 15 mg (0.4% and 0.7%, respectively. In direct comparison trials (enalapril and lisinopril, incidence of cough was not significantly different between zofenopril and other ACE inhibitors (2.4% vs 2.7%.Conclusion: Evidence from a limited

  20. Development of a theoretical framework of factors affecting patient safety incident reporting: a theoretical review of the literature.

    Science.gov (United States)

    Archer, Stephanie; Hull, Louise; Soukup, Tayana; Mayer, Erik; Athanasiou, Thanos; Sevdalis, Nick; Darzi, Ara

    2017-12-27

    The development and implementation of incident reporting systems within healthcare continues to be a fundamental strategy to reduce preventable patient harm and improve the quality and safety of healthcare. We sought to identify factors contributing to patient safety incident reporting. To facilitate improvements in incident reporting, a theoretical framework, encompassing factors that act as barriers and enablers ofreporting, was developed. Embase, Ovid MEDLINE(R) and PsycINFO were searched to identify relevant articles published between January 1980 and May 2014. A comprehensive search strategy including MeSH terms and keywords was developed to identify relevant articles. Data were extracted by three independent researchers; to ensure the accuracy of data extraction, all studies eligible for inclusion were rescreened by two reviewers. The literature search identified 3049 potentially eligible articles; of these, 110 articles, including >29 726 participants, met the inclusion criteria. In total, 748 barriers were identified (frequency count) across the 110 articles. In comparison, 372 facilitators to incident reporting and 118 negative cases were identified. The top two barriers cited were fear of adverse consequences (161, representing 21.52% of barriers) and process and systems of reporting (110, representing 14.71% of barriers). In comparison, the top two facilitators were organisational (97, representing 26.08% of facilitators) and process and systems of reporting (75, representing 20.16% of facilitators). A wide range of factors contributing to engagement in incident reporting exist. Efforts that address the current tendency to under-report must consider the full range of factors in order to develop interventions as well as a strategic policy approach for improvement. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Incidence and risk of QTc interval prolongation among cancer patients treated with vandetanib: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jiajie Zang

    Full Text Available Vandetanib is a multikinase inhibitor that is under assessment for the treatment of various cancers. QTc interval prolongation is one of the major adverse effects of this drug, but the reported incidence varies substantially among clinical trials. We performed a systematic review and meta-analysis to obtain a better understanding in the risk of QTc interval prolongation among cancer patients administered vandetanib.Eligible studies were phase II and III prospective clinical trials that involved cancer patients who were prescribed vandetanib 300 mg/d and that included data on QTc interval prolongation. The overall incidence and risk of QTc interval prolongation were calculated using random-effects or fixed-effects models, depending on the heterogeneity of the included studies. Nine trials with 2,188 patients were included for the meta-analysis. The overall incidence of all-grade and high-grade QTc interval prolongation was 16.4% (95% CI, 8.1-30.4% and 3.7% (8.1-30.4%, respectively, among non-thyroid cancer patients, and 18.0% (10.7-28.6% and 12.0% (4.5-28.0%, respectively, among thyroid cancer patients. Patients with thyroid cancer who had longer treatment duration also had a higher incidence of high-grade events, with a relative risk of 3.24 (1.57-6.71, than patients who had non-thyroid cancer. Vandetanib was associated with a significantly increased risk of all-grade QTc interval prolongation with overall Peto odds ratios of 7.26 (4.36-12.09 and 5.70 (3.09-10.53 among patients with non-thyroid cancer and thyroid cancer, respectively, compared to the controls.Treatment with vandetanib is associated with a significant increase in the overall incidence and risk of QTc interval prolongation. Different cancer types and treatment durations may affect the risk of developing high-grade QTc interval prolongation.

  2. [Evidence-based medicine in surgical practice - locating clinical studies and systematic reviews by searching the Medline database].

    Science.gov (United States)

    Grummich, K; Jensen, K; Obst, O; Seiler, C M; Diener, M K

    2014-12-01

    Every day approximately 75 clinical trials and 11 systematic reviews are published in the health-care intervention and medical field. Due to this growing number of publications it is a challenge for every practicing clinician to keep track with the latest research. The implementation of new and effective diagnostic and therapeutic interventions into daily clinical routine may thus be delayed. Conversely, ineffective or even harmful interventions might still be in use. Decision-making in evidence-based medicine (EBM) requires consideration of the most recent high quality evidence. Randomised controlled trials (RCTs) are regarded as the "gold standard" to prove the efficacy of surgical interventions in patient-oriented research. Systematic reviews combine results from RCTs by summarising single RCTs which answer a particular clinical question. Some basic knowledge in systematic literature searching is required and helpful for detecting relevant publications. This article shows various possibilities for locating clinical studies and systematic reviews in the database Medline on the basis of illustrative step-by-step instructions. RESULTS AND CONCLUSION. Depending on the aim and topic of the literature search, the time required for the task may vary. In routine practice, a systematic literature search is unrealistic in most cases. Clinicians in need of a quick update of current evidence on a certain clinical topic may make use of up-to-date systematic reviews. During a systematic literature search, different approaches and strategies might be necessary. Georg Thieme Verlag KG Stuttgart · New York.

  3. Sugar Alcohols, Caries Incidence, and Remineralization of Caries Lesions: A Literature Review

    Directory of Open Access Journals (Sweden)

    Kauko K. Mäkinen

    2010-01-01

    Full Text Available Remineralization of minor enamel defects is a normal physiological process that is well known to clinicians and researchers in dentistry and oral biology. This process can be facilitated by various dietary and oral hygiene procedures and may also concern dentin caries lesions. Dental caries is reversible if detected and treated sufficiently early. Habitual use of xylitol, a sugar alcohol of the pentitol type, can be associated with significant reduction in caries incidence and with tooth remineralization. Other dietary polyols that can remarkably lower the incidence of caries include erythritol which is a tetritol-type alditol. Based on known molecular parameters of simple dietary alditols, it is conceivable to predict that their efficacy in caries prevention will follow the homologous series, that is, that the number of OH-groups present in the alditol molecule will determine the efficacy as follows: erythritol≥xylitol>sorbitol. The possible difference between erythritol and xylitol must be confirmed in future clinical trials.

  4. Equity in Health Care Financing in Low- and Middle-Income Countries: A Systematic Review of Evidence from Studies Using Benefit and Financing Incidence Analyses.

    Science.gov (United States)

    Asante, Augustine; Price, Jennifer; Hayen, Andrew; Jan, Stephen; Wiseman, Virginia

    2016-01-01

    Health financing reforms in low- and middle- income countries (LMICs) over the past decades have focused on achieving equity in financing of health care delivery through universal health coverage. Benefit and financing incidence analyses are two analytical methods for comprehensively evaluating how well health systems perform on these objectives. This systematic review assesses progress towards equity in health care financing in LMICs through the use of BIA and FIA. Key electronic databases including Medline, Embase, Scopus, Global Health, CinAHL, EconLit and Business Source Premier were searched. We also searched the grey literature, specifically websites of leading organizations supporting health care in LMICs. Only studies using benefit incidence analysis (BIA) and/or financing incidence analysis (FIA) as explicit methodology were included. A total of 512 records were obtained from the various sources. The full texts of 87 references were assessed against the selection criteria and 24 were judged appropriate for inclusion. Twelve of the 24 studies originated from sub-Saharan Africa, nine from the Asia-Pacific region, two from Latin America and one from the Middle East. The evidence points to a pro-rich distribution of total health care benefits and progressive financing in both sub-Saharan Africa and Asia-Pacific. In the majority of cases, the distribution of benefits at the primary health care level favoured the poor while hospital level services benefit the better-off. A few Asian countries, namely Thailand, Malaysia and Sri Lanka, maintained a pro-poor distribution of health care benefits and progressive financing. Studies evaluated in this systematic review indicate that health care financing in LMICs benefits the rich more than the poor but the burden of financing also falls more on the rich. There is some evidence that primary health care is pro-poor suggesting a greater investment in such services and removal of barriers to care can enhance equity. The

  5. Equity in Health Care Financing in Low- and Middle-Income Countries: A Systematic Review of Evidence from Studies Using Benefit and Financing Incidence Analyses.

    Directory of Open Access Journals (Sweden)

    Augustine Asante

    Full Text Available Health financing reforms in low- and middle- income countries (LMICs over the past decades have focused on achieving equity in financing of health care delivery through universal health coverage. Benefit and financing incidence analyses are two analytical methods for comprehensively evaluating how well health systems perform on these objectives. This systematic review assesses progress towards equity in health care financing in LMICs through the use of BIA and FIA.Key electronic databases including Medline, Embase, Scopus, Global Health, CinAHL, EconLit and Business Source Premier were searched. We also searched the grey literature, specifically websites of leading organizations supporting health care in LMICs. Only studies using benefit incidence analysis (BIA and/or financing incidence analysis (FIA as explicit methodology were included. A total of 512 records were obtained from the various sources. The full texts of 87 references were assessed against the selection criteria and 24 were judged appropriate for inclusion. Twelve of the 24 studies originated from sub-Saharan Africa, nine from the Asia-Pacific region, two from Latin America and one from the Middle East. The evidence points to a pro-rich distribution of total health care benefits and progressive financing in both sub-Saharan Africa and Asia-Pacific. In the majority of cases, the distribution of benefits at the primary health care level favoured the poor while hospital level services benefit the better-off. A few Asian countries, namely Thailand, Malaysia and Sri Lanka, maintained a pro-poor distribution of health care benefits and progressive financing.Studies evaluated in this systematic review indicate that health care financing in LMICs benefits the rich more than the poor but the burden of financing also falls more on the rich. There is some evidence that primary health care is pro-poor suggesting a greater investment in such services and removal of barriers to care can enhance

  6. Equity in Health Care Financing in Low- and Middle-Income Countries: A Systematic Review of Evidence from Studies Using Benefit and Financing Incidence Analyses

    Science.gov (United States)

    Price, Jennifer; Hayen, Andrew; Jan, Stephen; Wiseman, Virginia

    2016-01-01

    Introduction Health financing reforms in low- and middle- income countries (LMICs) over the past decades have focused on achieving equity in financing of health care delivery through universal health coverage. Benefit and financing incidence analyses are two analytical methods for comprehensively evaluating how well health systems perform on these objectives. This systematic review assesses progress towards equity in health care financing in LMICs through the use of BIA and FIA. Methods and Findings Key electronic databases including Medline, Embase, Scopus, Global Health, CinAHL, EconLit and Business Source Premier were searched. We also searched the grey literature, specifically websites of leading organizations supporting health care in LMICs. Only studies using benefit incidence analysis (BIA) and/or financing incidence analysis (FIA) as explicit methodology were included. A total of 512 records were obtained from the various sources. The full texts of 87 references were assessed against the selection criteria and 24 were judged appropriate for inclusion. Twelve of the 24 studies originated from sub-Saharan Africa, nine from the Asia-Pacific region, two from Latin America and one from the Middle East. The evidence points to a pro-rich distribution of total health care benefits and progressive financing in both sub-Saharan Africa and Asia-Pacific. In the majority of cases, the distribution of benefits at the primary health care level favoured the poor while hospital level services benefit the better-off. A few Asian countries, namely Thailand, Malaysia and Sri Lanka, maintained a pro-poor distribution of health care benefits and progressive financing. Conclusion Studies evaluated in this systematic review indicate that health care financing in LMICs benefits the rich more than the poor but the burden of financing also falls more on the rich. There is some evidence that primary health care is pro-poor suggesting a greater investment in such services and removal

  7. A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Cohen, Jeffrey; Stuve, Olaf

    2015-01-01

    approach. We quantitatively assessed population-based studies using the I² statistic, and conducted random-effects meta-analyses. RESULTS: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting...... about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population....

  8. Strategies to alleviate the incidence of ascites in broilers: a review

    Directory of Open Access Journals (Sweden)

    U Aftab

    2005-12-01

    Full Text Available Ascites is a complex problem caused by many interacting factors such as genetics, environment and management. Many nutritional, medicinal and management strategies have been proposed to alleviate the problem. Higher levels of dietary vitamin C and E along with selenium yeast might be beneficial, presumably because of their role in improving cellular integrity. Oils rich in n-3 fatty acids have been shown to reduce pulmonary hypertension and, consequently, ascites incidence. The potential use of flax oil has already been demonstrated, whereas the effects of other oils rich in n-3 fatty acids (fish, linseed and canola oils remain to be investigated. The assessment of the effects of dietary electrolyte balance on ascites incidence seems to be a promising field of research in broiler nutrition. In general, reducing the dietary level of salt (NaCl and adding bicarbonates to the diet and drinking water have been proposed as potential "cost-effective" methods to reduce ascites incidence. The use of nutrients/drug agents that increase the vascular capacity of the lungs or decrease the pulmonary vascular resistance may help to alleviate the problem, but economic and local feed regulations might restrict such use. Diuretics have also shown positive effects, presumably because there is a reduction of sodium and fluid retention in the body; litter humidity however must be closely monitored if diuretics are continuously administered. As the high metabolic rate (fast growth is a major factor contributing to the susceptibility of broilers to ascites, early-age feed or nutrient restriction (qualitative or quantitative or light restriction in order to slow down the growth rate seem practically viable methods, since final body weight is not compromised. Optimization of the house temperature and ventilation in cold weather seem helpful practices to decrease ascites incidence. Under practical conditions, it might be interesting to test the additive effects of

  9. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Birmingham C Laird

    2009-03-01

    Full Text Available Abstract Background Overweight and obese persons are at risk of a number of medical conditions which can lead to further morbidity and mortality. The primary objective of this study is to provide an estimate of the incidence of each co-morbidity related to obesity and overweight using a meta-analysis. Methods A literature search for the twenty co-morbidities identified in a preliminary search was conducted in Medline and Embase (Jan 2007. Studies meeting the inclusion criteria (prospective cohort studies of sufficient size reporting risk estimate based on the incidence of disease were extracted. Study-specific unadjusted relative risks (RRs on the log scale comparing overweight with normal and obese with normal were weighted by the inverse of their corresponding variances to obtain a pooled RR with 95% confidence intervals (CI. Results A total of 89 relevant studies were identified. The review found evidence for 18 co-morbidities which met the inclusion criteria. The meta-analysis determined statistically significant associations for overweight with the incidence of type II diabetes, all cancers except esophageal (female, pancreatic and prostate cancer, all cardiovascular diseases (except congestive heart failure, asthma, gallbladder disease, osteoarthritis and chronic back pain. We noted the strongest association between overweight defined by body mass index (BMI and the incidence of type II diabetes in females (RR = 3.92 (95% CI: 3.10–4.97. Statistically significant associations with obesity were found with the incidence of type II diabetes, all cancers except esophageal and prostate cancer, all cardiovascular diseases, asthma, gallbladder disease, osteoarthritis and chronic back pain. Obesity defined by BMI was also most strongly associated with the incidence of type II diabetes in females (12.41 (9.03–17.06. Conclusion Both overweight and obesity are associated with the incidence of multiple co-morbidities including type II diabetes

  10. Customer focused incident monitoring in anaesthesia.

    Science.gov (United States)

    Khan, F A; Khimani, S

    2007-06-01

    The database of incident forms relating to anaesthesia services in an institutional risk management programme were reviewed for 2003-2005, the aim being to identify any recurring patterns. Incidents were prospectively categorised as relating to attitude/behaviour, communication breakdown, delay in service, or were related to care, cost, environment, equipment, security, administrative process, quality of service or miscellaneous. The total number of anaesthesia-related incidents reported during the period was 287, which related to 0.44% of the total number of anaesthetics administered during the time period. In all, 170 incidents were reported by the department, 96 by internal customers and 21 by external customers. Only 30% of the complaints came from the operating room. Thirty-four per cent of all incidents related to communication, behaviour and delay in service. A requirement to teach communication skills and stress handling formally in anaesthesia training programmes, and at the time of induction of staff into the department, has been identified.

  11. Risk factors, incidence, consequences and prevention strategies for falls and fall-injury within older indigenous populations: a systematic review.

    Science.gov (United States)

    Lukaszyk, Caroline; Harvey, Lara; Sherrington, Cathie; Keay, Lisa; Tiedemann, Anne; Coombes, Julieann; Clemson, Lindy; Ivers, Rebecca

    2016-12-01

    To examine the risk factors, incidence, consequences and existing prevention strategies for falls and fall-related injury in older indigenous people. Relevant literature was identified through searching 14 electronic databases, a range of institutional websites, online search engines and government databases, using search terms pertaining to indigenous status, injury and ageing. Thirteen studies from Australia, the United States, Central America and Canada were identified. Few studies reported on fall rates but two reported that around 30% of indigenous people aged 45 years and above experienced at least one fall during the past year. The most common hospitalised fall injuries among older indigenous people were hip fracture and head injury. Risk factors significantly associated with falls within indigenous populations included poor mobility, a history of stroke, epilepsy, head injury, poor hearing and urinary incontinence. No formally evaluated, indigenous-specific fall prevention interventions were identified. Falls are a significant and growing health issue for older indigenous people worldwide that can lead to severe health consequences and even death. No fully-evaluated, indigenous-specific fall prevention programs were identified. Implications for Public Health: Research into fall patterns and fall-related injury among indigenous people is necessary for the development of appropriate fall prevention interventions. © 2016 Public Health Association of Australia.

  12. In 'big bang' major incidents do triage tools accurately predict clinical priority?: a systematic review of the literature.

    Science.gov (United States)

    Kilner, T M; Brace, S J; Cooke, M W; Stallard, N; Bleetman, A; Perkins, G D

    2011-05-01

    The term "big bang" major incidents is used to describe sudden, usually traumatic,catastrophic events, involving relatively large numbers of injured individuals, where demands on clinical services rapidly outstrip the available resources. Triage tools support the pre-hospital provider to prioritise which patients to treat and/or transport first based upon clinical need. The aim of this review is to identify existing triage tools and to determine the extent to which their reliability and validity have been assessed. A systematic review of the literature was conducted to identify and evaluate published data validating the efficacy of the triage tools. Studies using data from trauma patients that report on the derivation, validation and/or reliability of the specific pre-hospital triage tools were eligible for inclusion.Purely descriptive studies, reviews, exercises or reports (without supporting data) were excluded. The search yielded 1982 papers. After initial scrutiny of title and abstract, 181 papers were deemed potentially applicable and from these 11 were identified as relevant to this review (in first figure). There were two level of evidence one studies, three level of evidence two studies and six level of evidence three studies. The two level of evidence one studies were prospective validations of Clinical Decision Rules (CDR's) in children in South Africa, all the other studies were retrospective CDR derivation, validation or cohort studies. The quality of the papers was rated as good (n=3), fair (n=7), poor (n=1). There is limited evidence for the validity of existing triage tools in big bang major incidents.Where evidence does exist it focuses on sensitivity and specificity in relation to prediction of trauma death or severity of injury based on data from single or small number patient incidents. The Sacco system is unique in combining survivability modelling with the degree by which the system is overwhelmed in the triage decision system. The

  13. Epidemiological trends among preterm infants with apnea. A twelve-year database review.

    Science.gov (United States)

    Regenbogen, Elliot; Zhang, Shouling; Yang, Jie; Shroyer, Annie; Zhu, Chencan; DeCristofaro, Joseph

    2018-04-01

    This study sought to characterize trends in the diagnosis of apnea, associated comorbidities and complications, and 30-day readmission rates in preterm singleton infants. The study design was a retrospective, longitudinal, observational study. 2003-2014 New York State Statewide Planning and Research Cooperative System and New York City Vital Statistics databases were merged identifying preterm live singleton births. Hospitalizations of preterm newborns with and without apnea were compared; multivariable logistic regression and log-linear Poisson regression models applied. Of 1,384,013 singleton births, 7.5% were identified as preterm. While relative risk of preterm birth rates declined (RR = 0.987, 95% CI = 0.982-0.991), the diagnosis of apnea increased significantly (RR = 1.069, 95% CI = 1.049-1.089). Multivariable analysis identified two apnea predictors, gastric reflux (OR = 3.19, 95% CI = 2.80-3.63) and early gestational age (OR = 0.83 for 1 week GA increase, 95% CI = 0.82-0.84). Preterm newborns with apnea were more likely to be readmitted within the first 30 days and total charges were 5.4 times higher. While the preterm birth rate has declined the rate of diagnosis of apnea with associated comorbidities and complications has increased. Given the additional findings of higher 30-day readmission rates and charges, more multidisciplinary research appears warranted to identify ways to optimize the quality of high risk newborn care. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

    Directory of Open Access Journals (Sweden)

    M. Riga

    2011-01-01

    Full Text Available Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies. Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library. Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms. Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients.

  15. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review

    International Nuclear Information System (INIS)

    Trotti, Andy; Bellm, Lisa A.; Epstein, Joel B.; Frame, Diana; Fuchs, Henry J.; Gwede, Clement K.; Komaroff, Eugene; Nalysnyk, Luba; Zilberberg, Marya D.

    2003-01-01

    Background and purpose: To determine the frequency of mucositis and associated outcomes in patients receiving radiotherapy (RT) for head and neck cancer through a systematic review of recently published literature. Materials and methods: According to the study protocol, databases were searched for randomized clinical trials (English only, 1996-1999) of patients with head and neck cancer receiving RT with or without chemotherapy that reported one or more outcomes of interest. Results: Thirty-three studies (n=6181 patients) met inclusion criteria. Mucositis was defined using a variety of scoring systems. The mean incidence was 80%. Over one-half of patients (56%) who received altered fractionation RT (RT-AF) experienced severe mucositis (grades 3-4) compared to 34% of patients who received conventional RT. Rates of hospitalization due to mucositis, reported in three studies (n=700), were 16% overall and 32% for RT-AF patients. Eleven percent of patients had RT regimens interrupted or modified because of mucositis in five studies (n=1267) reporting this outcome. Data insufficiency or heterogeneity prohibited analysis of mucositis severity and other associated outcomes, such as oral pain, dysphagia and opioid use. Conclusions: Mucositis is a frequent, severe toxicity in patients treated with RT for head and neck cancer. While it appears that mucositis may lead to hospitalization and treatment interruptions, its overall impact on outcomes has not been adequately investigated

  16. A selective review of knowledge-based approaches to database design

    Directory of Open Access Journals (Sweden)

    Shahrul Azman Noah

    1995-01-01

    Full Text Available The inclusion of real world knowledge or specialised knowledge has not been addressed by the majority of the systems reviewed. ODA has real world knowledge provided by using a thesaurus-type structure to represent generic models. Only NITDT includes the specialised knowledge in its knowledge base. NITDT classified its knowledge into application specific, domain specific and general knowledge. However the literature does not discuss in detail how this knowledge is applied during the design session. One of the key factors that distinguish computer-based expert systems from human experts is that the latter apply not only their specialised expertise to a problem but also their general knowledge of the world. NITDT is the only system reviewed here that holds any form of internal domain specific knowledge, which can be easily augmented, enriched and updated, as required. This knowledge allows the designer to be an active participant along with the user in the design process and significantly eases the user task. The inclusion of real world knowledge and specialised knowledge is an area that must be further addressed before intelligent tools are able to offer a realistic level of assistance to the human designers.

  17. Incidence of Augmentation in Primary Restless Legs Syndrome Patients May Not Be That High: Evidence From A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Liu, Guang Jian; Wu, Lang; Wang, Song Lin; Ding, Li; Xu, Li Li; Wang, Yun Fu; Chang, Li Ying

    2016-01-01

    Abstract Augmentation is a common complication of primary restless legs syndrome (RLS) during treatment; however, its incidence rate remains unclear. The aim of this study is investigate the rate of augmentation during RLS treatment. We searched 6 databases, including PubMed, OVID, Embase, Wiley citations, Web of Science research platform (including SciELO Citation Index, Medline, KCI Korean Journal Database, the Web of Science™ Core Collection), and the Cochrane library, and screened the reference lists of the included trials and recently published reviews. Randomized controlled trials and observational studies that reported augmentation events during RLS treatment. Primary RLS patients older than 18 years. No restrictions regarding intervention types were applied. Three investigators independently extracted and pooled the data to analyze the augmentation rate of the total sample and of patient subgroups with different interventions, treatment durations and drug regimens and different geographic origins. Fixed-effects or random-effects model was used for pooled analysis. A total of 60 studies involving 11,543 participants suggested an overall augmentation rate of 5.6% (95% confidence intervals (CI), 4.0–7.7). The augmentation incidence was 6.1% (95% CI, 4.1–9.1) for long-term treatment and 3.3% (95% CI, 1.4–7.3) for short-term treatment. In addition, 27.1% (95% CI, 12.3–49.5) of the levodopa-treated patients, 6.0% (95% CI, 4.1–8.8) of the patients treated with dopamine agonists, and 0.9% (95% CI, 0.2–3.3) of the patients taking pregabalin or gabapentin developed augmentation. Augmentation occurred in 7.2% (95% CI, 5.0–10.3) of the patients taking immediate-release drugs and in 1.7% (95% CI, 0.6–5.0) of the patients taking transdermal application. The main limitations are that the augmentation rates were not evaluated according to drug dosage, gender, and age and symptom severity. Approximately 5 to 6 in 100 RLS patients developed augmentation

  18. Hiccups in Parkinson's disease: an analysis of cases reported in the European pharmacovigilance database and a review of the literature.

    Science.gov (United States)

    Lertxundi, U; Marquínez, A C; Domingo-Echaburu, S; Solinís, M Á; Calvo, B; Del Pozo-Rodríguez, A; García, M; Aguirre, C; Isla, A

    2017-09-01

    Some reports have suggested an association between dopamine agonists and hiccups, involuntary contractions that merit full clinical attention because they can be very debilitating. Many drugs frequently used to treat hiccups are formally contraindicated in Parkinson's disease due to their liability to worsen motor symptoms, making the treatment of hiccups problematic in this disease. The objective of the present study was to analyze all spontaneous reports of hiccups from the European Pharmacovigilance Database in patients with Parkinson's disease and/or on dopaminergic drugs. Finally, we sought to identify evidence-based recommendations on the management of hiccups in Parkinson's disease. We searched for all reports of hiccups in the European Pharmacovigilance Database (EudraVigilance) and calculated proportional reporting ratios for dopamine agonists and hiccups. We reviewed the literature on Parkinson's disease, dopamine agonists, and hiccups, searching for specific treatment recommendations for hiccups in this disease. Both rotigotine and pramipexole fulfilled the criteria to generate a safety signal. We found 32 and 13 cases of hiccups associated with dopamine agonists in EudraVigilance and the literature, respectively. There were no specific recommendations for the management of hiccups in Parkinson's disease in the clinical guidelines consulted. We have found evidence that rotigotine and pramipexole are associated with the appearance of hiccups and that this adverse reaction occurs predominantly in males. Given the scarce information available, specific recommendations are needed in clinical guidelines for the adequate management of hiccups in Parkinson's disease.

  19. Incidence of sternal wound infection after tracheostomy in patients undergoing cardiac surgery: A systematic review and meta-analysis.

    Science.gov (United States)

    Toeg, Hadi; French, Daniel; Gilbert, Sebastien; Rubens, Fraser

    2017-06-01

    This systematic review and meta-analysis was performed to determine whether timing or type of tracheostomy was associated with superficial or deep sternal wound infections after cardiac surgery. All studies reporting the incidence of sternal wound infection after tracheostomy in patients undergoing cardiac surgery were collected and analyzed. Subgroup analyses determined a priori included timing of tracheostomy and type of procedure (open vs percutaneous). All analyses used the random effects model. A meta-regression analysis was performed on the proportion of sternal wound infection and number of days between tracheostomy and initial cardiac surgery. A total of 13 studies met inclusion criteria. The incidence of sternal wound infection across all studies reported was 7% (95% confidence interval [CI], 4-10). The percutaneous tracheostomy group had a sternal wound infection proportion of 3% (95% CI, 1-8), and the open tracheostomy group had a sternal wound infection proportion of 9% (95% CI, 5-14). The incidence of sternal wound infection with early (<14 days) (7%; 95% CI, 3-11) versus late (≥14 days) (7%; 95% CI, 4-10) tracheostomy was similar. Meta-regression demonstrated no significant relationship between incidence of sternal wound infection and number of days between tracheostomy and initial cardiac surgery (R 2  = 6.13%, P = .72). Reported secondary outcomes included 30-day and 1-year mortality, which were high at 23% (95% CI, 19-28) and 63% (95% CI, 43-80), respectively. The incidence of sternal wound infection after tracheostomy in patients undergoing cardiac surgery remains high at 7% (95% CI, 4-10). Open or percutaneous tracheostomy after cardiac surgery is a feasible option because the incidence of sternal wound infection and short-term mortality are comparable. Moreover, the timing of tracheostomy (early or late) had comparable rates of sternal wound infection and short-term mortality. Copyright © 2016 The American Association for Thoracic

  20. Risk Prediction Models for Incident Heart Failure: A Systematic Review of Methodology and Model Performance.

    Science.gov (United States)

    Sahle, Berhe W; Owen, Alice J; Chin, Ken Lee; Reid, Christopher M

    2017-09-01

    Numerous models predicting the risk of incident heart failure (HF) have been developed; however, evidence of their methodological rigor and reporting remains unclear. This study critically appraises the methods underpinning incident HF risk prediction models. EMBASE and PubMed were searched for articles published between 1990 and June 2016 that reported at least 1 multivariable model for prediction of HF. Model development information, including study design, variable coding, missing data, and predictor selection, was extracted. Nineteen studies reporting 40 risk prediction models were included. Existing models have acceptable discriminative ability (C-statistics > 0.70), although only 6 models were externally validated. Candidate variable selection was based on statistical significance from a univariate screening in 11 models, whereas it was unclear in 12 models. Continuous predictors were retained in 16 models, whereas it was unclear how continuous variables were handled in 16 models. Missing values were excluded in 19 of 23 models that reported missing data, and the number of events per variable was models. Only 2 models presented recommended regression equations. There was significant heterogeneity in discriminative ability of models with respect to age (P prediction models that had sufficient discriminative ability, although few are externally validated. Methods not recommended for the conduct and reporting of risk prediction modeling were frequently used, and resulting algorithms should be applied with caution. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Global trends in incidence of lower limb amputation: a review of the literature

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    L. Godlwana

    2008-01-01

    Full Text Available The aim of this paper was to compile a literature report on the global epidemiology of lower limb amputations. Specifically it aimed at capturing information on the incidence of traumatic and non-traumatic lowerlimb amputations throughout the world, to identify the etiology including diseases and lifestyle habits associated with lower limb amputees (LLA in boththe developed and the developing countries, to identify the demographiccharacteristics, age, sex, race, geographical location of the people undergoing LLA including the levels of amputation as pointed out by the literature. Aliterature search was conducted. Different keyword combinations were used togather as much literature on the subject as possible. The authors systemicallyreviewed literature from some parts of Europe, Asia, North and South America and South Africa. The data was analyzed and presented under various themes. The existing literature shows that diabetes is the leading cause of LLA and trauma accounts for the minority of these cases. The incidence of LLA can be predicted by gender, age, maritalstatus, level of education and socio-economic status. Information on LLA in South Africa is almost absent.

  2. Isolated hemihyperplasia (hemihypertrophy): report of a prospective multicenter study of the incidence of neoplasia and review.

    Science.gov (United States)

    Hoyme, H E; Seaver, L H; Jones, K L; Procopio, F; Crooks, W; Feingold, M

    1998-10-02

    Hemihyperplasia is characterized by asymmetric growth of cranium, face, trunk, limbs, and/or digits, with or without visceral involvement. It may be an isolated finding in an otherwise normal individual, or it may occur in several syndromes. Although isolated hemihyperplasia (IHH) is of unknown cause, it may represent one end of the clinical spectrum of the Wiedemann-Beckwith syndrome (WBS). Uniparental paternal disomy of 11p15.5 or altered expression of insulin-like growth factor 2 (IGF2) from the normally silent maternal allele have been implicated as causes of some cases of WBS. IHH and other mild manifestations of WBS may represent patchy overexpression of the IGF2 gene following defective imprinting in a mosaic fashion. The natural history of IHH varies markedly. An association among many overgrowth syndromes and a predisposition to neoplasia is well recognized. Heretofore the risk for tumor development in children with IHH was unknown. We report on the results of a prospective multicenter clinical study of the incidence and nature of neoplasia in children evaluated because of IHH. One hundred sixty-eight patients were ascertained. A total of 10 tumors developed in nine patients, for an overall incidence of 5.9%. Tumors were of embryonal origin (similar to those noted in other overgrowth disorders), including Wilms tumor, hepatoblastoma, adrenal cell carcinoma, and leiomyosarcoma of the small bowel in one case. These data support a tumor surveillance protocol for children with IHH similar to that performed in other syndromes associated with overgrowth.

  3. Incident Cardiovascular Events and Death in Individuals With Restless Legs Syndrome or Periodic Limb Movements in Sleep: A Systematic Review.

    Science.gov (United States)

    Kendzerska, Tetyana; Kamra, Maneesha; Murray, Brian J; Boulos, Mark I

    2017-03-01

    To systematically review the current evidence examining restless legs syndrome (RLS) and periodic limb movements in sleep (PLMS) as prognostic factors for all-cause mortality and incident cardiovascular events (CVE) in longitudinal studies published in the adult population. All English language studies (from 1947 to 2016) found through Medline and Embase, as well as bibliographies of identified articles, were considered eligible. Quality was evaluated using published guidelines. Among 18 cohorts (reported in 13 manuscripts), 15 evaluated the association between RLS and incident CVE and/or all-cause mortality and 3 between PLMS and CVE and mortality. The follow-up periods ranged from 2 to 20 years. A significant relationship between RLS and CVE was reported in four cohorts with a greater risk suggested for severe RLS with longer duration and secondary forms of RLS. Although a significant association between RLS and all-cause mortality was reported in three cohorts, a meta-analysis we conducted of the four studies of highest quality found no association (pooled hazard ratio = 1.09, 95% confidence interval: 0.80-1.78). A positive association between PLMS and CVE and/or mortality was demonstrated in all included studies with a greater risk attributed to PLMS with arousals. The available evidence on RLS as a prognostic factor for incident CVE and all-cause mortality was limited and inconclusive; RLS duration, severity, and secondary manifestations may be important in understanding a possible relationship. Although very limited, the current evidence suggests that PLMS may be a prognostic factor for incident CVE and mortality. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  4. Independent Review of Mitigating System Performance Indicator Reporting in the EPIX Database

    Energy Technology Data Exchange (ETDEWEB)

    Wierman, Thomas Edward [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2009-05-01

    This report summarizes work done to verify the component, failure mode, and method of detection information provided in the Equipment Performance Information Exchange (EPIX) to support implementation of Mitigating Systems Performance Indices. This task is to select reports from EPIX and determine if their categorization as MSPI or non-MSPI failures is consistent with the development of unreliability baseline failure rates, and whether this significantly affects estimates of plant risk. This review is of all MSPI devices in EPIX that were reported as failures. The components include emergency generators; motor-driven, turbine-driven, and enginedriven pumps; and air and motor-operated valves. The date range for this report includes all MSPI device reported failures from 2003 to the most current EPIX data at the INL (up to the 3rd quarter 2008).

  5. Database Survey of Anti-Inflammatory Plants in South America: A Review

    Directory of Open Access Journals (Sweden)

    Leônia Maria Batista

    2011-04-01

    Full Text Available Inflammation is a complex event linked to tissue damage whether by bacteria, physical trauma, chemical, heat or any other phenomenon. This physiological response is coordinated largely by a variety of chemical mediators that are released from the epithelium, the immunocytes and nerves of the lamina propria. However, if the factor that triggers the inflammation persists, the inflammation can become relentless, leading to an intensification of the lesion. The present work is a literature survey of plant extracts from the South American continent that have been reported to show anti-inflammatory activity. This review refers to 63 bacterial families of which the following stood out: Asteraceae, Fabaceae, Euphorbiaceae, Apocynaceae and Celastraceae, with their countries, parts used, types of extract used, model bioassays, organisms tested and their activity.

  6. Database Survey of Anti-Inflammatory Plants in South America: A Review

    Science.gov (United States)

    de Morais Lima, Gedson Rodrigues; de Albuquerque Montenegro, Camila; de Almeida, Cynthia Layse Ferreira; de Athayde-Filho, Petrônio Filgueiras; Barbosa-Filho, José Maria; Batista, Leônia Maria

    2011-01-01

    Inflammation is a complex event linked to tissue damage whether by bacteria, physical trauma, chemical, heat or any other phenomenon. This physiological response is coordinated largely by a variety of chemical mediators that are released from the epithelium, the immunocytes and nerves of the lamina propria. However, if the factor that triggers the inflammation persists, the inflammation can become relentless, leading to an intensification of the lesion. The present work is a literature survey of plant extracts from the South American continent that have been reported to show anti-inflammatory activity. This review refers to 63 bacterial families of which the following stood out: Asteraceae, Fabaceae, Euphorbiaceae, Apocynaceae and Celastraceae, with their countries, parts used, types of extract used, model bioassays, organisms tested and their activity. PMID:21731467

  7. Testing search strategies for systematic reviews in the Medline literature database through PubMed.

    Science.gov (United States)

    Volpato, Enilze S N; Betini, Marluci; El Dib, Regina

    2014-04-01

    A high-quality electronic search is essential in ensuring accuracy and completeness in retrieved records for the conducting of a systematic review. We analysed the available sample of search strategies to identify the best method for searching in Medline through PubMed, considering the use or not of parenthesis, double quotation marks, truncation and use of a simple search or search history. In our cross-sectional study of search strategies, we selected and analysed the available searches performed during evidence-based medicine classes and in systematic reviews conducted in the Botucatu Medical School, UNESP, Brazil. We analysed 120 search strategies. With regard to the use of phrase searches with parenthesis, there was no difference between the results with and without parenthesis and simple searches or search history tools in 100% of the sample analysed (P = 1.0). The number of results retrieved by the searches analysed was smaller using double quotations marks and using truncation compared with the standard strategy (P = 0.04 and P = 0.08, respectively). There is no need to use phrase-searching parenthesis to retrieve studies; however, we recommend the use of double quotation marks when an investigator attempts to retrieve articles in which a term appears to be exactly the same as what was proposed in the search form. Furthermore, we do not recommend the use of truncation in search strategies in the Medline via PubMed. Although the results of simple searches or search history tools were the same, we recommend using the latter.

  8. Biomechanics of subdural hemorrhage in American football: review of the literature in response to rise in incidence.

    Science.gov (United States)

    Forbes, Jonathan A; Zuckerman, Scott; Abla, Adib A; Mocco, J; Bode, Ken; Eads, Todd

    2014-02-01

    The number of catastrophic head injuries recorded during the 2011 football season was the highest since data collection began in 1984--the vast majority of these cases were secondary to subdural hemorrhage (SDH). The incidence of catastrophic head injury continues to rise: the average yearly incidence from 2008 to 2012 was 238% that of the average yearly incidence from 1998 to 2002. Greater than 95% of the football players who suffered catastrophic head injury during this period were age 18 or younger. Currently, the helmet industry utilizes a standard based on data obtained at Wayne State University approximately 50 years ago that seeks to limit severity index--a surrogate marker of translational acceleration. In this manuscript, we utilize a focused review of the literature to better characterize the biomechanical factors associated with SDH following collisions in American football and discuss these data in the context of current helmet standard. Review of the literature indicates the rotational acceleration (RA) threshold above which the risk of SDH becomes appreciable is approximately 5,000 rad/s(2). This value is not infrequently surmounted in typical high school football games. In contrast, translational accelerations (TAs) experienced during even elite-level impacts in football are not of sufficient magnitude to result in SDH. This information raises important questions about the current helmet standard--in which the sole objective is limitation of TA. Further studies will be necessary to better define whether helmet constructs and quality assurance standards designed to limit RA will also help to decrease the risk of catastrophic head injury in American football.

  9. Classifying injury narratives of large administrative databases for surveillance-A practical approach combining machine learning ensembles and human review.

    Science.gov (United States)

    Marucci-Wellman, Helen R; Corns, Helen L; Lehto, Mark R

    2017-01-01

    Injury narratives are now available real time and include useful information for injury surveillance and prevention. However, manual classification of the cause or events leading to injury found in large batches of narratives, such as workers compensation claims databases, can be prohibitive. In this study we compare the utility of four machine learning algorithms (Naïve Bayes, Single word and Bi-gram models, Support Vector Machine and Logistic Regression) for classifying narratives into Bureau of Labor Statistics Occupational Injury and Illness event leading to injury classifications for a large workers compensation database. These algorithms are known to do well classifying narrative text and are fairly easy to implement with off-the-shelf software packages such as Python. We propose human-machine learning ensemble approaches which maximize the power and accuracy of the algorithms for machine-assigned codes and allow for strategic filtering of rare, emerging or ambiguous narratives for manual review. We compare human-machine approaches based on filtering on the prediction strength of the classifier vs. agreement between algorithms. Regularized Logistic Regression (LR) was the best performing algorithm alone. Using this algorithm and filtering out the bottom 30% of predictions for manual review resulted in high accuracy (overall sensitivity/positive predictive value of 0.89) of the final machine-human coded dataset. The best pairings of algorithms included Naïve Bayes with Support Vector Machine whereby the triple ensemble NB SW =NB BI-GRAM =SVM had very high performance (0.93 overall sensitivity/positive predictive value and high accuracy (i.e. high sensitivity and positive predictive values)) across both large and small categories leaving 41% of the narratives for manual review. Integrating LR into this ensemble mix improved performance only slightly. For large administrative datasets we propose incorporation of methods based on human-machine pairings such as

  10. “You can know an analysis by the source of its data”. A conceptual and methodological review of databases on armed conflict in Colombia

    Directory of Open Access Journals (Sweden)

    Nicolás Espinosa M

    2011-07-01

    Full Text Available In Colombia, there are quantitative databases on armed conflict, some of them public and open-access. This paper reviews the main theoretical and methodological traits in some of those databases and their main features when defining and measuring political violence. Based on the results of a research performed in a Colombian region, several methodological issues will be presented in order to process —statistically, spatially and cartographically― the information delivered by those databases. After the exposition, several procedures are described, which allowed to measure differences among databases. Those contents are addressed aiming to show the consequences that using one or another database has in the quantitative analysis of armed conflict, since the results of those analyses will depend on the source used.

  11. Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Zhao, Jia-Guo; Zeng, Xian-Tie; Wang, Jia; Liu, Lin

    2017-12-26

    The increased social and economic burdens for osteoporosis-related fractures worldwide make the prevention of such injuries a major public health goal. Previous studies have reached mixed conclusions regarding the association between calcium, vitamin D, or combined calcium and vitamin D supplements and fracture incidence in older adults. To investigate whether calcium, vitamin D, or combined calcium and vitamin D supplements are associated with a lower fracture incidence in community-dwelling older adults. The PubMed, Cochrane library, and EMBASE databases were systematically searched from the inception dates to December 24, 2016, using the keywords calcium, vitamin D, and fracture to identify systematic reviews or meta-analyses. The primary randomized clinical trials included in systematic reviews or meta-analyses were identified, and an additional search for recently published randomized trials was performed from July 16, 2012, to July 16, 2017. Randomized clinical trials comparing calcium, vitamin D, or combined calcium and vitamin D supplements with a placebo or no treatment for fracture incidence in community-dwelling adults older than 50 years. Two independent reviewers performed the data extraction and assessed study quality. A meta-analysis was performed to calculate risk ratios (RRs), absolute risk differences (ARDs), and 95% CIs using random-effects models. Hip fracture was defined as the primary outcome. Secondary outcomes were nonvertebral fracture, vertebral fracture, and total fracture. A total of 33 randomized trials involving 51 145 participants fulfilled the inclusion criteria. There was no significant association of calcium or vitamin D with risk of hip fracture compared with placebo or no treatment (calcium: RR, 1.53 [95% CI, 0.97 to 2.42]; ARD, 0.01 [95% CI, 0.00 to 0.01]; vitamin D: RR, 1.21 [95% CI, 0.99 to 1.47]; ARD, 0.00 [95% CI, -0.00 to 0.01]. There was no significant association of combined calcium and vitamin D with hip fracture

  12. Validity of Diagnostic Codes for Acute Stroke in Administrative Databases: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Natalie McCormick

    Full Text Available To conduct a systematic review of studies reporting on the validity of International Classification of Diseases (ICD codes for identifying stroke in administrative data.MEDLINE and EMBASE were searched (inception to February 2015 for studies: (a Using administrative data to identify stroke; or (b Evaluating the validity of stroke codes in administrative data; and (c Reporting validation statistics (sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV, or Kappa scores for stroke, or data sufficient for their calculation. Additional articles were located by hand search (up to February 2015 of original papers. Studies solely evaluating codes for transient ischaemic attack were excluded. Data were extracted by two independent reviewers; article quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool.Seventy-seven studies published from 1976-2015 were included. The sensitivity of ICD-9 430-438/ICD-10 I60-I69 for any cerebrovascular disease was ≥ 82% in most [≥ 50%] studies, and specificity and NPV were both ≥ 95%. The PPV of these codes for any cerebrovascular disease was ≥ 81% in most studies, while the PPV specifically for acute stroke was ≤ 68%. In at least 50% of studies, PPVs were ≥ 93% for subarachnoid haemorrhage (ICD-9 430/ICD-10 I60, 89% for intracerebral haemorrhage (ICD-9 431/ICD-10 I61, and 82% for ischaemic stroke (ICD-9 434/ICD-10 I63 or ICD-9 434&436. For in-hospital deaths, sensitivity was 55%. For cerebrovascular disease or acute stroke as a cause-of-death on death certificates, sensitivity was ≤ 71% in most studies while PPV was ≥ 87%.While most cases of prevalent cerebrovascular disease can be detected using 430-438/I60-I69 collectively, acute stroke must be defined using more specific codes. Most in-hospital deaths and death certificates with stroke as a cause-of-death correspond to true stroke deaths. Linking vital statistics and hospitalization

  13. Cancer incidence in the Republic of Mauritius- 5 Years Review 1997 to 2001

    Directory of Open Access Journals (Sweden)

    Mr. P Burhoo

    2006-01-01

    Full Text Available 6484 new cases of cancer have been registered in Mauritius during 1997-2001 corresponding to Age-Standardized Incidence Rates (ASR world of 99.9 per 100,000 in men and 121.1 per 100,000 in women. The commonest sites of cancer in men were colo-rectal cancer (9.5% followed closely by oral cavity & pharynx (9.4% and prostate (8.8%. In women breast cancer was, by far, the main site (28%, ASR 31.7 ahead of cervical cancer (11.7% and colorectal (5.7% and leukaemias (4.7%. Comparisons with figures from neighboring countries show much lower rates in Mauritius for both sexes.

  14. Incidence and clinical relevance of cage subsidence in anterior cervical discectomy and fusion: a systematic review.

    Science.gov (United States)

    Noordhoek, Iris; Koning, Marvyn T; Jacobs, Wilco C H; Vleggeert-Lankamp, Carmen L A

    2018-04-01

    The placement of intervertebral cages in anterior cervical discectomy (ACDF) supposedly maintains foraminal height. The most commonly reported cage-related complication is subsidence, although it is unknown whether a correlation between subsidence and clinical outcome exists. To assess the incidence and relevance of subsidence. Literature searches were performed in PubMed, MEDLINE, Embase, Web of Science, COCHRANE, and CENTRAL. The inclusion criteria were as follows: ≥ 20 patients, ADCF with cage, subsidence assessed, and primary data. Risk of bias was assessed using adjusted Cochrane checklists. Seventy-one studies, comprising 4784 patients, were included. Subsidence was generally defined as ≥ 3-mm loss of height comparing postoperative intervertebral heights with heights at last follow-up. Mean incidence of subsidence was 21% (range 0-83%). Of all patients, 46% of patients received polyether-ether-ketone (PEEK) cages, 31% received titanium cages, 18% received cage-screw-combinations, and 5% received polymethyl-methacrylate (PMMA) cages. Patients treated with cage-screw-combinations had significantly less subsidence than patients treated with PEEK, titanium, or PMMA cages (15.1% vs. 23.5% vs. 24.9% vs. 30.2%; p subsidence; the majority did not find a significant correlation. Only four studies correlated subsidence to cage size and/or height; no correlation was established. Subsidence in ACDF with cages occurs in 21% of patients. The risk for subsidence seems lower using PEEK or titanium cages or adding screws. Whether subsidence affects clinical outcome is not satisfactorily evaluated in the available literature. Future studies on this correlation are warranted in order to establish the additional value of the interposition of a cage in ACDF.

  15. Google Scholar as a source for scholarly evaluation: a bibliographic review of database errors

    Directory of Open Access Journals (Sweden)

    Enrique Orduna-Malea

    2017-11-01

    Full Text Available Google Scholar (GS is an academic search engine and discovery tool launched by Google (now Alphabet in November 2004. The fact that GS provides the number of citations received by each article from all other indexed articles (regardless of their source has led to its use in bibliometric analysis and academic assessment tasks, especially in social sciences and humanities. However, the existence of errors, sometimes of great magnitude, has provoked criticism from the academic community. The aim of this article is to carry out an exhaustive bibliographical review of all studies that provide either specific or incidental empirical evidence of the errors found in Google Scholar. The results indicate that the bibliographic corpus dedicated to errors in Google Scholar is still very limited (n= 49, excessively fragmented, and diffuse; the findings have not been based on any systematic methodology or on units that are comparable to each other, so they cannot be quantified, or their impact analysed, with any precision. Certain limitations of the search engine itself (time required for data cleaning, limit on citations per search result and hits per query may be the cause of this absence of empirical studies.

  16. Review of renal biopsy database: a single centre south Indian study

    Directory of Open Access Journals (Sweden)

    : Clement Wilfred Devadass, Vijaya Mysorekar V, Gireesh MS, Mahesh E, Gurudev KC, Radhika K

    2014-11-01

    Full Text Available Background: The epidemiology of biopsy- proven renal disease (BPRD provides information that is useful for clinical practice and investigation. India lacks a national renal data registry system and there is a scarcity of information on the pattern of BPRD in South India. Objectives: To determine the occurrence and analyse the epidemiology of BPRD in our local (South Indian population. Material and Methods: A retrospective review of reports of native renal biopsies performed on patients at a tertiary care hospital in South India, from 2008 to 2013 was undertaken. All renal biopsies were studied by light and immunofluorescence microscopy and were classified into primary glomerulonephritis (PGN, secondary glomerulonephritis (SGN, tubulointerstitial nephritis, vascular nephropathy, hereditary nephritis, end stage renal disease and biopsies exhibiting no significant pathology. Results: A total of 661 cases were included in the study. The most common clinical syndrome as an indication for renal biopsy was NS (29%. PGN was the most common BPRD, accounting for 42.3 % of the cases. Minimal change disease (33.6% was the commonest PGN followed by membranous nephropathy (15.7% and focal segmental glomerulosclerosis (12.6%. Diabetic nephropathy (76.9% was the commonest SGN (14.7% followed by lupus nephritis. Conclusion: Our study represents an important contribution to understanding the epidemiology of renal disease in South India. The distribution pattern of PGN largely corresponds to the distribution pattern described in other South Indian studies. However, there is a wide variation of major histologic patterns of PGN across the world.

  17. Potential protective effect of lactation against incidence of type 2 diabetes mellitus in women with previous gestational diabetes mellitus: A systematic review and meta-analysis.

    Science.gov (United States)

    Tanase-Nakao, Kanako; Arata, Naoko; Kawasaki, Maki; Yasuhi, Ichiro; Sone, Hirohito; Mori, Rintaro; Ota, Erika

    2017-05-01

    Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, ranging from null to beneficial. We aimed to conduct a systematic review to gather available evidence. Databases MEDLINE, CINAHL, PubMed, and EMBASE were searched on December 15, 2015, without restriction of language or publication year. A manual search was also conducted. We included observational studies (cross-sectional, case-control, and cohort study) with information on lactation and type 2 diabetes mellitus incidence among women with previous GDM. We excluded case studies without control data. Data synthesis was conducted by random-effect meta-analysis. Fourteen reports of 9 studies were included. Overall risk of bias using RoBANS ranged from low to unclear. Longer lactation for more than 4 to 12 weeks postpartum had risk reduction of type 2 diabetes mellitus compared with shorter lactation (OR 0.77, 95% CI 0.01-55.86; OR 0.56, 95% CI 0.35-0.89; OR 0.22, 95% CI 0.13-0.36; type 2 diabetes mellitus evaluation time 2 y, 2-5 y, and >5 y, respectively). Exclusive lactation for more than 6 to 9 weeks postpartum also had lower risk of type 2 diabetes mellitus compared with exclusive formula (OR 0.42, 95% CI 0.22-0.81). The findings support the evidence that longer and exclusive lactation may be beneficial for type 2 diabetes mellitus prevention in women with previous GDM. However, the evidence relies only on observational studies. Therefore, further studies are required to address the true causal effect. © 2017 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.

  18. Data from Telecommunication Networks for Incident Management: An Exploratory Review on Transport Safety and Security

    NARCIS (Netherlands)

    Steenbruggen, J.G.M.; Borzacchiello, M.T.; Nijkamp, P.; Scholten, H.J.

    2013-01-01

    Problems such as traffic congestion and environmental sustainability are forcing us to review our long-term plans for transport, whose aim should be to develop and improve safety, security and effectiveness of the transportation systems. The consequences of traffic accidents are not only limited to

  19. Essay-Writing Interventions for Adolescents with High Incidence Disabilities: A Review of Research

    Science.gov (United States)

    Valasa, Lauren L.; Mason, Linda H.; Hughes, Charles

    2014-01-01

    Many students with disabilities have written language production deficits. As a result, these students are failing to meet the demands of government-initiated standards, higher education, and employment. In this review, quantitative experimental intervention studies for improving persuasive, narrative, and expository compositions for adolescents,…

  20. Reviewing trends in the incidence of cancrum oris in Ibadan, Nigeria ...

    African Journals Online (AJOL)

    Records of children aged 1 to 16 years diagnosed as having cancrum oris between 1st of January 1986 to 31st December, 2000 were reviewed. ... des enfants atteints de cette maladie tous les cinq ans pendant la durée de cet étude, quoique la sous-alimentation soit encore une facteur fréquente chez tous les enfants.

  1. Glomerular diseases in a Hispanic population: review of a regional renal biopsy database

    Directory of Open Access Journals (Sweden)

    Luis Fernando Arias

    Full Text Available CONTEXT AND OBJECTIVE: Epidemiological data provide useful information for clinical practice and investigations. This study aimed to determine glomerular disease frequencies in a region of Colombia and it represents the basis for future studies. DESIGN AND SETTING: Single-center retrospective analysis at the University of Antioquia, Colombia. METHODS: All native renal biopsies (July 1998 to December 2007 were reviewed, but only glomerular diseases were analyzed. The diagnosis of each case was based on histological, immunopathological and clinical features. RESULTS: A total of 1,040 biopsies were included. In 302 cases (29.0%, the patient's age was < 15 years. Primary glomerular diseases were diagnosed in 828 biopsies (79.6% and secondary in 212 (20.4%. The most common primary diseases were focal and segmental glomerulosclerosis (FSGS (34.8%, immunoglobulin A (IgA nephropathy (IgAN (11.8%, membranous glomerulonephritis (MGN (10.6%, minimal change disease (MCD (10.6%, crescentic glomerulonephritis (GN (5.6%, and non-IgA mesangial proliferative GN (5.6%. Postinfectious GN represented 10.7% of the diagnoses if included as primary GN. Lupus nephritis corresponded to 17.8% of the entire series. In adults, the order of the most frequent primary diseases was: FSGS, IgAN, MGN, crescentic GN and MCD. In children (< 15 years, the most frequent were: FSGS, postinfectious GN, MCD, non-IgA mesangial proliferative GN, endocapillary diffuse GN and IgAN. CONCLUSIONS: As among Afro-Americans, FSGS is the most frequent type of glomerulopathy in our population, but in our group, there are more cases of IgAN. The reasons for these findings are unclear. This information is an important contribution towards understanding the prevalence of renal diseases in Latin America.

  2. The management of difficult intubation in infants: a retrospective review of anesthesia record database.

    Science.gov (United States)

    Aida, Junko; Oda, Yutaka; Kasagi, Yoshihiro; Ueda, Mami; Nakada, Kazuo; Okutani, Ryu

    2015-01-01

    We retrospectively reviewed the anesthesia records of infants  10 min for tracheal intubation) or records of Cormack-Lehane grade were included. Demographic data are median age 5 (range, 0-11) months, height 61 (33-84) cm, body weight 6.0 (1.1 - 11.8) kg. The number of cases with ASA physical status I, II, III and IV was 182 (36.6 %), 135 (27.3 %), 177 (35.5 %) and 3 (0.6 %), respectively. Cormack-Lehane grade 1, 2, 3 and 4 was seen in 450 (90.5 %), 32 (6.4 %), 6 (1.2 %) and 6 (1.2 %) cases, respectively. Document of difficult intubation was found in 12 cases (2.4 %, 10 different infants) with a lack of record of Cormack-Lehane grade in 3 cases. Of these 10 infants, nine had multiple congenital anomalies including heart diseases and cleft palate. Without premedication, general anesthesia was induced with intravenous midazolam or sevoflurane in the 12 cases. Tracheal intubation was performed after disappearance of spontaneous respiration except three cases who were intubated in the awake state or under sedation. Elapsed time from induction of anesthesia to intubation was 17 (14-29) min. Although mask ventilation was adequate in all cases, two cases (one infant) developed hypoxia and bradycardia during tracheal intubation. No remarkable decrease of SpO 2 or bradycardia less than 100 bpm was detected in other cases. In conclusion, we found difficult intubation in 2.4 % of infants undergoing general anesthesia. Although muscle relaxants are useful for facilitating tracheal intubation, it should be carefully used with the preparation of other airway devices in infants with predicted difficult intubation.

  3. Dose-Response Association Between Physical Activity and Incident Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Liu, Xuejiao; Zhang, Dongdong; Liu, Yu; Sun, Xizhuo; Han, Chengyi; Wang, Bingyuan; Ren, Yongcheng; Zhou, Junmei; Zhao, Yang; Shi, Yuanyuan; Hu, Dongsheng; Zhang, Ming

    2017-05-01

    Despite the inverse association between physical activity (PA) and incident hypertension, a comprehensive assessment of the quantitative dose-response association between PA and hypertension has not been reported. We performed a meta-analysis, including dose-response analysis, to quantitatively evaluate this association. We searched PubMed and Embase databases for articles published up to November 1, 2016. Random effects generalized least squares regression models were used to assess the quantitative association between PA and hypertension risk across studies. Restricted cubic splines were used to model the dose-response association. We identified 22 articles (29 studies) investigating the risk of hypertension with leisure-time PA or total PA, including 330 222 individuals and 67 698 incident cases of hypertension. The risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.96) with each 10 metabolic equivalent of task h/wk increment of leisure-time PA. We found no evidence of a nonlinear dose-response association of PA and hypertension ( P nonlinearity =0.094 for leisure-time PA and 0.771 for total PA). With the linear cubic spline model, when compared with inactive individuals, for those who met the guidelines recommended minimum level of moderate PA (10 metabolic equivalent of task h/wk), the risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.97). This meta-analysis suggests that additional benefits for hypertension prevention occur as the amount of PA increases. © 2017 American Heart Association, Inc.

  4. Mapping African ethical review committee activity onto capacity needs: the MARC initiative and HRWeb's interactive database of RECs in Africa.

    Science.gov (United States)

    IJsselmuiden, Carel; Marais, Debbie; Wassenaar, Douglas; Mokgatla-Moipolai, Boitumelo

    2012-08-01

    Health research initiatives worldwide are growing in scope and complexity, particularly as they move into the developing world. Expanding health research activity in low- and middle-income countries has resulted in a commensurate rise in the need for sound ethical review structures and functions in the form of Research Ethics Committees (RECs). Yet these seem to be lagging behind as a result of the enormous challenges facing these countries, including poor resource availability and lack of capacity. There is thus an urgent need for ongoing capacity and resource development in these regions in general, and in Africa in particular. Similarly, there is a need for research and initiatives that can identify existing capacity and funding and indicate the areas where this needs to be developed. This discussion paper argues that the Mapping African Research Ethics Capacity (MARC) project is a timely initiative aimed at identifying existing capacity. MARC provides a platform and tool on the Council on Health Research for Development's (COHRED) Health Research website (HRWeb), which can be used by RECs and key stakeholders in health research in Africa to identify capacity, constraints and development needs. MARC intends to provide the first comprehensive interactive database of RECs in Africa, which will allow for the identification of key relationships and analyses of capacity. The potential of MARC lies in the mapping of current ethical review activity onto capacity needs. This paper serves as a starting point by providing a descriptive illustration of the current state of RECs in Africa. © 2012 Blackwell Publishing Ltd.

  5. Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates

    OpenAIRE

    Smink, Frédérique R. E.; van Hoeken, Daphne; Hoek, Hans W.

    2012-01-01

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increas...

  6. Database thinking development in Context of School Education

    OpenAIRE

    Panský, Mikoláš

    2011-01-01

    The term database thinking is understood as group of Competencies that enables working with Database System. Database thinking development is targeted educational incidence to student with the expected outcome ability working with Database system. Thesis is focused on problematic of purposes, content and methods of database thinking development. Experimental part proposes quantitative metrics for database thinking development. KEYWORDS: Education, Database, Database thinking, Structured Query...

  7. Incidence and outcome from adult cardiac arrest occurring in the intensive care unit: a systematic review of the literature.

    Science.gov (United States)

    Efendijev, Ilmar; Nurmi, Jouni; Castrén, Maaret; Skrifvars, Markus B

    2014-04-01

    Significant amount of data on the incidence and outcome of out-of-hospital and in-hospital cardiac arrest have been published. Cardiac arrest occurring in the intensive care unit has received less attention. To evaluate and summarize current knowledge of intensive care unit cardiac arrest including quality of data, and results focusing on incidence and patient outcome. We conducted a literature search of the PubMed, CINAHL and Cochrane databases with the following search terms (medical subheadings): heart arrest AND intensive care unit OR critical care OR critical care nursing OR monitored bed OR monitored ward OR monitored patient. We included articles published from the 1st of January 1990 till 31st of December 2012. After exclusion of all duplicates and irrelevant articles we evaluated quality of studies using a predefined quality assessment score and summarized outcome data. The initial search yielded 794 articles of which 780 were excluded. Three papers were added after a manual search of the eligible studies' references. One paper was identified manually from the literature published after our initial search was completed, thus the final sample consisted of 18 papers. Of the studies included thirteen were retrospective, two based on prospective registries and three were focused prospective studies. All except two studies were from a single institution. Six studies reported the incidence of intensive care unit cardiac arrest, which varied from 5.6 to 78.1 cardiac arrests per 1000 intensive care unit admissions. The most frequently reported initial cardiac arrest rhythms were non-shockable. Patient outcome was variable with survival to hospital discharge being in the range of 0-79% and long-term survival ranging from 1 to 69%. Nine studies reported neurological status of survivors, which was mostly favorable, either no neurological sequelae or cerebral performance score mostly of 1-2. Studies focusing on post cardiac surgery patients reported the best long

  8. A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil.

    Science.gov (United States)

    Saffier, Igor Pedrosa; Kawa, Hélia; Harling, Guy

    2017-10-11

    Despite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil. We searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any time in the HIV epidemic which provided estimates specific to ages 10-25 (or some subset of this age range) for Brazilians on either: (a) HIV prevalence or incidence; or (b) the association between HIV and socio-demographic or behavioral risk factors. Forty eight publications met the inclusion criteria: 44 cross-sectional, two case-control, two cohort. Four studies analysed national data. Forty seven studies provided HIV prevalence estimates, largely for six population subgroups: Counselling and Testing Center attendees; blood donors; pregnant women; institutional individuals; men-who-have-sex-with-men (MSM) and female sex workers (FSW); four provided HIV incidence estimates. Twelve studies showed HIV status to be associated with a wide range of risk factors, including age, sexual and reproductive history, infection history, substance use, geography, marital status, mental health and socioeconomic status. Few published studies have examined HIV amongst young people in Brazil, and those published have been largely cross-sectional and focused on traditional risk groups and the south of the country. Despite these limitations, the literature shows raised HIV prevalence amongst MSM and FSW, as well as amongst those using drugs. Time trends are harder to identify, although rates appear to be falling for pregnant women, possibly reversing an earlier de-masculinization of the epidemic. Improved surveillance of HIV incidence, prevalence and risk factors is a key component of efforts to eliminate HIV in

  9. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M; Hoffmann, Barbara; Esmail, Aneez

    2015-09-01

    Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety. To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary care. A literature review looking at the purpose, design and requirements of an incident reporting system (IRS) was used to update an existing incident reporting system, widely used in Germany. Then, an international expert panel with knowledge on IRS developed the criteria for the design of a new web-based incident reporting system for European primary care. A small demonstration project was used to create a web-based reporting system, to be made freely available for practitioners and researchers. The expert group compiled recommendations regarding the desirable features of an incident reporting system for European primary care. These features covered the purpose of reporting, who should be involved in reporting, the mode of reporting, design considerations, feedback mechanisms and preconditions necessary for the implementation of an IRS. A freely available web-based reporting form was developed, based on these criteria. It can be modified for local contexts. Practitioners and researchers can use this system as a means of recording patient safety incidents in their locality and use it as a basis for learning from errors. The LINNEAUS collaboration has provided a freely available incident reporting system that can be modified for a local context and used throughout Europe.

  10. Describing individual incidents of sexual abuse: a review of research on the effects of multiple sources of information on children's reports.

    Science.gov (United States)

    Roberts, K P; Powell, M B

    2001-12-01

    For successful prosecution of child sexual abuse, children are often required to provide reports about individual, alleged incidents. Although verbally or mentally rehearsing memory of an incident can strengthen memories, children's report of individual incidents can also be contaminated when they experience other events related to the individual incidents (e.g., informal interviews, dreams of the incident) and/or when they have similar, repeated experiences of an incident, as in cases of multiple abuse. Research is reviewed on the positive and negative effects of these related experiences on the length, accuracy, and structure of children's reports of a particular incident. Children's memories of a particular incident can be strengthened when exposed to information that does not contradict what they have experienced, thus promoting accurate recall and resistance to false, suggestive influences. When the encountered information differs from children's experiences of the target incident, however, children can become confused between their experiences-they may remember the content but not the source of their experiences. We discuss the implications of this research for interviewing children in sexual abuse investigations and provide a set of research-based recommendations for investigative interviewers.

  11. A MiniReview of the Use of Hospital-based Databases in Observational Inpatient Studies of Drugs

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Cars, Thomas; Hallas, Jesper

    2013-01-01

    inpatient databases in Asia, the United States and Europe were found. Most databases were automatically collected from claims data or generated from electronic medical records. The contents of the databases varied as well as the potential for linkage with other data sources such as laboratory and outpatient...

  12. Bioadhesive chlorhexidine gel for reduction of alveolar osteitis incidence: Systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Mahmood Reza Kalantar Motamedi

    2014-01-01

    Full Text Available Introduction: Alveolar osteitis (AO creates severe and self-limiting pain, which needs to be treated with several postoperative visits, leading to increases in patient′s morbidity and costs. Hence, the most basic and best treatment could be prevention. The aim of this study was to investigate the efficacy of bioadhesive chlorhexidine (CHX gel in reducing AO occurrence with published studies. Materials and Methods: Medline/PubMed, Scopus, EBSCO, Ovid and Cochrane central registry for control trial were searched up to 28 February 2014 using "alveolar osteitis" and "chlorhexidine" as key words for systematic review and meta-analysis. Inclusion criteria were prospective and randomized controlled trials (RCTs published on this topic. From the chosen studies, the eligible articles were reviewed. Data were analyzed using Review Manager 5.2 software. Results: Out of 43 studies, seven eligible trials with 593 participants were selected. Bioadhesive 0.2% CHX gel prevented approximately 72% of AO (Odd ratio (OR = 0.28, 95% confidence Interval (CI: 0.18-0.44; P < 0.001. Conclusion: Bioadhesive 0.2% CHX gel may be effective as a post-medication to reduce incidence of AO.

  13. Aspirin effect on the incidence of major adverse cardiovascular events in patients with diabetes mellitus: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ghali William A

    2011-04-01

    Full Text Available Abstract Background Aspirin has been recommended for the prevention of major adverse cardiovascular events (MACE, composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death in diabetic patients without previous cardiovascular disease. However, recent meta-analyses have prompted re-evaluation of this practice. The study objective was to evaluate the relative and absolute benefits and harms of aspirin for the prevention of incident MACE in patients with diabetes. Methods We performed a systematic review and meta-analysis on seven studies (N = 11,618 reporting on the use of aspirin for the primary prevention of MACE in patients with diabetes. Two reviewers conducted a systematic search of electronic databases (MEDLINE, EMBASE, the Cochrane Library, and BIOSIS and hand searched bibliographies and clinical trial registries. Reviewers extracted data in duplicate, evaluated the quality of the trials, and calculated pooled estimates. Results A total of 11,618 participants were included in the analysis. The overall risk ratio (RR for MACE was 0.91 (95% confidence intervals, CI, 0.82-1.00 with little heterogeneity among trials (I2 0.0%. Secondary outcomes of interest included myocardial infarction (RR, 0.85; 95% CI, 0.66-1.10, stroke (RR, 0.84; 95% CI, 0.64-1.11, cardiovascular death (RR, 0.95; 95% CI, 0.71-1.27, and all-cause mortality (RR, 0.95; 95% CI, 0.85-1.06. There were higher rates of hemorrhagic and gastrointestinal events. In absolute terms, these relative risks indicate that for every 10,000 diabetic patients treated with aspirin, 109 MACE may be prevented at the expense of 19 major bleeding events (with the caveat that the relative risk for the latter is not statistically significant. Conclusions The studies reviewed suggest that aspirin reduces the risk of MACE in patients with diabetes without cardiovascular disease, while also causing a trend toward higher rates of bleeding and gastrointestinal complications

  14. A critical review of literature on-the-job training’s incidence and its effects in Company

    Directory of Open Access Journals (Sweden)

    Lorena Alikaj

    2017-03-01

    Full Text Available This theoretical article aims to collect and review critically some empirical findings and researches on the incidence of employer training and the economic effects of it on company. It’s aimed to clarify the type of training that companies ensure on the work place, the frequency of training. Is it true that after training, employees have higher chances of promotion and mobility? What are the benefits from the point of view of the companies for them? Is it measurable this investment in human capital? Knowing correctly the literature related to the questions above, it helps the policymakers to formulate the right policies for equality of earnings and accessing on-the-job training, decrease chances for gender discrimination and increase the long run return of the company that makes training among employees. There is a higher interest studying the incidence, determinants, and effects of company training, supported by more reliable data and sophisticated research techniques and instruments. On the other hand, as the interest for the topic increases, so the confusion surrounding this literature does. There are a few empirical articles for the case of Albania. Identifying the right literature and developments on the topic should help the other researchers to explore the field and to contribute with updated findings for Albania’s job market.

  15. Incidence of narcolepsy after H1N1 influenza and vaccinations: Systematic review and meta-analysis.

    Science.gov (United States)

    Sarkanen, Tomi O; Alakuijala, Anniina P E; Dauvilliers, Yves A; Partinen, Markku M

    2018-04-01

    An increased incidence of narcolepsy was seen in many countries after the pandemic H1N1 influenza vaccination campaign in 2009-2010. The H1N1 vaccine - narcolepsy connection is based on observational studies that are prone to various biases, e.g., confounding by H1N1 infection, and ascertainment, recall and selection biases. A direct pathogenic link has, however, remained elusive. We conducted a systematic review and meta-analysis to analyze the magnitude of H1N1 vaccination related risk and to examine if there was any association with H1N1 infection itself. We searched all articles from PubMed, Web of Science and Scopus, and other relevant sources reporting the incidence and risk of post-vaccine narcolepsy. In our paper, we show that the risk appears to be limited to only one vaccine (Pandemrix ® ). During the first year after vaccination, the relative risk of narcolepsy was increased 5 to 14-fold in children and adolescents and 2 to 7-fold in adults. The vaccine attributable risk in children and adolescents was around 1 per 18,400 vaccine doses. Studies from Finland and Sweden also appear to demonstrate an extended risk of narcolepsy into the second year following vaccination, but such conclusions should be interpreted with a word of caution due to possible biases. Benefits of immunization outweigh the risk of vaccination-associated narcolepsy, which remains a rare disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    BACKGROUND: Several studies have suggested that comorbid neurologic disorders are more common than expected in multiple sclerosis (MS). OBJECTIVE: To estimate the incidence and prevalence of comorbid seizure disorders and sleep disorders in persons with MS and to evaluate the quality of studies...... was 3.09% (95% CI: 2.01-4.16%). For sleep disorders we evaluated 18 studies; none were population-based. The prevalence ranged from 0-1.6% for narcolepsy, 14.4-57.5% for restless legs syndrome, 2.22-3.2% for REM behavior disorder, and 7.14-58.1% for obstructive sleep apnea. CONCLUSION: This review...... suggests that seizure disorders and sleep disorders are common in MS, but highlights gaps in the epidemiological knowledge of these conditions in MS worldwide. Other than central-western Europe and North America, most regions are understudied....

  17. Epidemiology of Eating Disorders : Incidence, Prevalence and Mortality Rates

    NARCIS (Netherlands)

    Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.

    Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms

  18. Developing a patient safety incident classification system for primary care. A literature review and Delphi-survey by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Klemp, Kerstin; Dovey, Susan; Valderas, Jose M; Rohe, Julia; Godycki-Cwirko, Maciek; Elliott, Phillip; Beyer, Martin; Gerlach, Ferdin M; Hoffmann, Barbara

    2015-09-01

    Despite awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there has been little effort to establish an incident classification system that is generally applicable to patient safety data in European primary care. To describe the development of a patient safety incident classification system for primary care. A systematic review was followed by an expert group discussion and a modified Delphi survey, to provide consensus statements. We developed a classification system providing a mechanism for classifying patient safety incidents across Europe, taking into account the varying organizational arrangements that exist for primary care. It takes into account organizational processes and outcomes related to patient safety incidents and can supplement existing classification systems. Classification systems are key tools in the analysis of patient safety incidents. A system that has relevance for primary care is now available.

  19. Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: Review of technical incidents and morbidity after 5 years of use

    OpenAIRE

    RIPERT, Thomas; AZEMAR, Marie Dominique; MENARD, Johann; BAYOUD, Younes; MESSAOUDI, Rabah; DUVAL, François; STAERMAN, Frédéric

    2010-01-01

    Abstract OBJECTIVE To report on technical incidents, and early and late complications, occurring on high-intensity focused ultrasound (HIFU) treatment of patients with localized prostate cancer. PATIENTS AND METHODS We performed a retrospective review of patients who were treated by Ablatherm? in our centre. We recorded all technical incidents, treatment discontinuations, and early (< 1 month) and late complications. RESULTS A total of 74 HIFU procedures were perfor...

  20. Developing a patient safety incident classification system for primary care. A literature review and Delphi-survey by the LINNEAUS collaboration on patient safety in primary care

    OpenAIRE

    Klemp, Kerstin; Dovey, Susan; Valderas, Jose M; Rohe, Julia; Godycki-Cwirko, Maciek; Elliott, Phillip; Beyer, Martin; Gerlach, Ferdin M.; Hoffmann, Barbara

    2015-01-01

    ABSTRACT Background: Despite awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there has been little effort to establish an incident classification system that is generally applicable to patient safety data in European primary care. Objective: To describe the development of a patient safety incident classification system for primary care. Methods: A systematic review was followed by an expert group discussion and a modified Delp...

  1. A review of factors influencing the incidence and severity of plaque-induced gingivitis.

    Science.gov (United States)

    Trombelli, L; Farina, R

    2013-06-01

    An individual variation in the gingival inflammatory response to the dental biofilm has been demonstrated. This variability can be observed between individuals with neither quantitative nor qualitative differences in plaque accumulation. The reported significant differences in gingival inflammatory response under quantitatively and/or qualitatively almost identical bacterial challenge suggest that the gingival response to plaque accumulation may be an individual trait, possibly genetic in origin. The most recent classification of periodontal diseases acknowledges that the clinical expression of plaque-induced gingival inflammation can be substantially modified by systemic factors, either inherent to the host or related to environmental influences. The aim of the present literature review is to describe (i) the factors influencing the development of plaque-induced gingivitis as well as (ii) those metabolic, environmental and systemic factors which have a direct impact on the etiopathogenetic pathway of plaque-induced gingivitis, thus altering the nature or course of the gingival inflammatory response to dental biofilm.

  2. Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice.

    Science.gov (United States)

    Booth, C M A; Moore, C E; Eddleston, J; Sharman, M; Atkinson, D; Moore, J A

    2011-10-01

    The incidence and prevalence of obesity are increasing world wide. In the UK, obesity governmental strategy has primarily focused on prevention measures, with less focus on the demands of treating obese patients in hospital. Increasing service demand by obese patients coupled with a lack of adequate provision for care of these patients may lead to an increase in patient safety incidents. By classifying patient safety incidents associated with obesity reported to the National Patient Safety Agency, this report aims to identify areas for improvement in the quality and safety of care of the obese patient. A search of the National Reporting and Learning System database was conducted for all incidents caused by or relating to obesity for the period 1 January 2005 to 31 August 2008. The keywords 'obesity', 'overweight', 'BMI' (body mass index), and 'bariatric' were used. The relevant free text fields of the resulting set of incidents were then searched for the terms designed to isolate incidents occurring in anaesthesia, critical care, and surgery. Reported incidents were analysed and subsequently categorised to identify incident themes. Levels of harm were also established. 555 patient safety incidents were identified; 388 met inclusion criteria for analysis. 148 incidents were related to assessment, diagnosis or treatment, 213 related to infrastructure and 27 related to staffing. The majority of incidents were classified as no or low harm. Three deaths were reported, all within the domain of anaesthesia. This report identifies that the majority of safety incidents associated with obesity were related to infrastructure, suggesting that there is inadequate provision in place for the care of obese patients. While levels of harm were mostly low, the occurrence of incidents resulting in severe harm or death highlights the specific dangers associated with the care of the obese patient. A global approach to improving the safety of care delivery for obese patients is

  3. A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the Food and Drug Administration database.

    Science.gov (United States)

    Carter, John D; Ladhani, Anil; Ricca, Louis R; Valeriano, Joanne; Vasey, Frank B

    2009-03-01

    To present any congenital anomalies with respect to tumor necrosis factor (TNF) antagonists reported to the US Food and Drug Administration (FDA) to determine if there are common findings. A review of the FDA database of reported adverse events with etanercept, infliximab, and adalimumab from 1999 through December of 2005 was performed. Key words for congenital anomalies were employed as search tools. Duplicate reports were eliminated. Any concomitant medicines were recorded. Our review of > 120,000 adverse events revealed a total of 61 congenital anomalies in 41 children born to mothers taking a TNF antagonist. Of these mothers, 22 took etanercept and 19 took infliximab. There were no reports in women taking adalimumab. The most common reported congenital anomaly was some form of heart defect. Twenty-four of the 41 (59%) children had one or more congenital anomalies that are part of vertebral abnormalities, anal atresia, cardiac defect, tracheoesophageal, renal, and limp abnormalities (VACTERL) association. There were 34 specific types of congenital anomalies in total, and 19 (56%) of those are part of the VACTERL spectrum. Nine of these 19 (47%) types of VACTERL anomalies were observed statistically significantly more than historical controls (p < 0.01); in 4 of these 9 the p value was < or = 0.0001. Thirteen (32%) of the children had more than one congenital anomaly; 7 of these 13 children had 2 defects that are part of the VACTERL spectrum. However, only 1 child was diagnosed with VACTERL. In 24/41 cases (59%) the mother was taking no other concomitant medications. A seemingly high number of congenital anomalies that are part of the VACTERL spectrum have been reported. These congenital anomalies are occurring at a rate higher than historical controls. This commonality raises concerns of a possible causative effect of the TNF antagonists.

  4. New trends on mobile learning area: The review of published articles on mobile learning in science direct database

    Directory of Open Access Journals (Sweden)

    Emrah Soykan

    2015-03-01

    Full Text Available Articles published in Science Direct between 2009 and 2014 (May were screened in this research. This is because of its respectable position in the field of technology and peer-reviewed secured structure of this database. From a total of 161 articles within the scope of the screening 156 articles were included in the study. Through this research, new trends in mobile learning activities in recent years will be determined and a new way will be shown for researchers . "Mobile learning" keywords used during researching process and all the articles with "mobile learning" keywords were included in this study. As a result of this research, it is determined that the most studies in the field of mobile learning were published in 2013 in Malaysia, UK and Taiwan. Particularly undergraduate students was selected as the sample group of the researches. It is emerged that, experimental research was used maximum as a research model. Quantitative data collection tools were used most as a means of data collection. It was emerged that foreign language education is the most widely used field in mobile learning. It is seen that smart phones as mobile learning devices and IOS operating system as an operating system were used in the most researches. Mobile-based method is seen to be used as the teaching method in the present study.

  5. Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review.

    Science.gov (United States)

    Sanfilippo, Filippo; Noto, Alberto; Foresta, Grazia; Santonocito, Cristina; Palumbo, Gaetano J; Arcadipane, Antonio; Maybauer, Dirk M; Maybauer, Marc O

    2017-01-01

    Burnout syndrome has reached epidemic levels among physicians (reported around 50%). Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. We conducted a systematic review (MEDLINE up to 30.06.2017). We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors). All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%-41% high risk, up to 59% at least moderate risk). Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field.

  6. Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review

    Science.gov (United States)

    Sanfilippo, Filippo; Noto, Alberto; Foresta, Grazia; Santonocito, Cristina; Palumbo, Gaetano J.; Arcadipane, Antonio; Maybauer, Dirk M.

    2017-01-01

    Background Burnout syndrome has reached epidemic levels among physicians (reported around 50%). Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. Methods We conducted a systematic review (MEDLINE up to 30.06.2017). We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Results Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors). All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%–41% high risk, up to 59% at least moderate risk). Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Conclusions Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field. PMID:29318155

  7. Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Filippo Sanfilippo

    2017-01-01

    Full Text Available Background. Burnout syndrome has reached epidemic levels among physicians (reported around 50%. Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. Methods. We conducted a systematic review (MEDLINE up to 30.06.2017. We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Results. Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors. All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%–41% high risk, up to 59% at least moderate risk. Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Conclusions. Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field.

  8. Systemic Vulnerabilities to Suicide among Veterans from the Iraq and Afghanistan Conflicts: Review of Case Reports from a National Veterans Affairs Database

    Science.gov (United States)

    Mills, Peter D.; Huber, Samuel J.; Watts, Bradley Vince; Bagian, James P.

    2011-01-01

    While suicide among recently returned veterans is of great concern, it is a relatively rare occurrence within individual hospitals and clinics. Root cause analysis (RCA) generates a detailed case report that can be used to identify system-based vulnerabilities following an adverse event. Review of a national database of RCA reports may identify…

  9. Systematic Review and Meta-Analysis of Association of Smokeless Tobacco and of Betel Quid without Tobacco with Incidence of Oral Cancer in South Asia and the Pacific

    Science.gov (United States)

    Gupta, Bhawna; Johnson, Newell W.

    2014-01-01

    Aim This systematic review and meta-analysis aimed to critically appraised data from comparable studies leading to quantitative assessment of any independent association between use of oral smokeless tobacco in any form, of betel quid without tobacco and of areca nut with incidence of oral cancer in South Asia and the Pacific. Methods Studies (case control and/or cohort) were identified by searching Pub Med, CINAHL and Cochrane databases through June 2013 using the keywords oral cancer: chewing tobacco; smokeless tobacco; betel quid; betel quid without tobacco; areca nut; Asia, the Pacific and the reference lists of retrieved articles. A random effects model was used to compute adjusted summary ORRE for the main effect of these habits along with their corresponding 95% confidence intervals. To quantify the impact of between-study heterogeneity on adjusted main-effect summary ORRE, Higgins' H and I2 statistics along with their 95% uncertainty intervals were used. Funnel plots and Egger's test were used to evaluate publication bias. Results Meta-analysis of fifteen case–control studies (4,553 cases; 8,632 controls) and four cohort studies (15,342) which met our inclusion criteria showed that chewing tobacco is significantly and independently associated with an increased risk of squamous-cell carcinoma of the oral cavity (adjusted main-effect summary for case- control studies ORRE = 7.46; 95% CI = 5.86–9.50, Poral cancer, with OR = 2.82 (95% CI = 2.35–3.40, Poral cancer in these populations. However, studies with better separation of the types of tobacco and the ways in which it is used, and studies with sufficient power to quantify dose-response relationships are still needed. PMID:25411778

  10. A review of recent analyses of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS

    Directory of Open Access Journals (Sweden)

    D. Potter

    2015-01-01

    Full Text Available Introduction: The objective of this analysis is to identify, assess the quality and summarize the findings of peer-reviewed articles that used data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS published since November 2011 and data from provincial oversamples of the CIS as well as to illustrate evolving uses of these datasets. Methods: Articles were identified from the Public Health Agency of Canada's data request records tracking access to CIS data and publications produced from that data. At least two raters independently reviewed and appraised the quality of each article. Results: A total of 32 articles were included. Common strengths of articles included clearly stated research aims, appropriate control variables and analyses, sufficient sample sizes, appropriate conclusions and relevance to practice or policy. Common problem areas of articles included unclear definitions for variables and inclusion criteria of cases. Articles frequently measured the associations between maltreatment, child, caregiver, household and agency/referral characteristics and investigative outcomes such as opening cases for ongoing services and placement. Conclusion: Articles using CIS data were rated positively on most quality indicators. Researchers have recently focussed on inadequately studied categories of maltreatment (exposure to intimate partner violence [IPV], neglect and emotional maltreatment and examined factors specific to First Nations children. Data from the CIS oversamples have been underutilized. The use of multivariate analysis techniques has increased.

  11. A review and additional post-hoc analyses of the incidence and impact of constipation observed in darifenacin clinical trials

    Directory of Open Access Journals (Sweden)

    Tack J

    2012-09-01

    Full Text Available Jan Tack,1 Jean-Jacques Wyndaele,2 Greg Ligozio,3 Mathias Egermark41University of Leuven, Gastroenterology Section, Leuven, 2University of Antwerp, Department of Urology, Antwerp, Belgium; 3Novartis Pharmaceuticals Corporation, NJ, USA; 4Roche Diagnostics Scandinavia AB, Bromma, Sweden and formerly of Novartis Pharma AG, Basel, SwitzerlandBackground: Constipation is a common side effect of antimuscarinic treatment for overactive bladder (OAB. This review evaluates the incidence and impact of constipation on the lives of patients with OAB being treated with darifenacin.Methods: Constipation data from published Phase III and Phase IIIb/IV darifenacin studies were reviewed and analyzed. Over 4000 patients with OAB (aged 18–89 years; ≥80% female enrolled in nine studies (three Phase III [data from these fixed-dose studies were pooled and provide the primary focus for this review], three Phase IIIb, and three Phase IV. The impact of constipation was assessed by discontinuations, use of concomitant laxatives, patient-reported perception of treatment, and a bowel habit questionnaire.Results: In the pooled Phase III trials, 14.8% (50/337 of patients on darifenacin 7.5 mg/day and 21.3% (71/334 on 15 mg/day experienced constipation compared with 12.6% (28/223 and 6.2% (24/388 with tolterodine and placebo, respectively. In addition, a few patients discontinued treatment due to constipation (0.6% [2/337], 1.2% [4/334], 1.8% [4/223], and 0.3% [1/388] in the darifenacin 7.5 mg/day or 15 mg/day, tolterodine, and placebo groups, respectively, or required concomitant laxatives (3.3% [11/337], 6.6% [22/334], 7.2% [16/223], and 1.5% [6/388] in the darifenacin 7.5 mg/day or 15 mg/day, tolterodine, and placebo groups, respectively. Patient-reported perception of treatment quality was observed to be similar between patients who experienced constipation and those who did not. During the long-term extension study, a bowel habit questionnaire showed only small

  12. Incidentes transfusionais imediatos: revisão integrativa da literatura Incidentes transfusionales inmediatos: revisión integrativa de la literatura Immediate transfusion incidents: an integrative literature review

    Directory of Open Access Journals (Sweden)

    Adriana Lemos de Sousa Neto

    2012-01-01

    hemolítica y alérgica, avance en acciones de hemovigilancia y mayor preocupación por la calidad de la asistencia hemoterápica.This integrative literature review had the objective of analyzing research on the occurrence of immediate transfusion incidents and implemented hemovigilance actions. Data were obtained through database searches of LILACS, MEDLINE and PubMed, for the period of 1980 to 2009, in the Portuguese, English and Spanish languages. We identified 1382 articles, of which 29 met the established inclusion criteria. Of these articles, 20 (69.0% were retrospective transveral, 8 (27.5% were prospective, and one (3.5% was a case control study. In regard to approach, the studies were classified into two thematic foci: types of immediate transfusion incidents, and implemented hemovigilance actions associated with the types of immediate transfusion incidents. The analysis of this work highlighted the higher incidence of febrile nonhemolytic reactions and allergic reactions, the advancement in hemovigilance actions, and greater concern with the quality of care in hemotherapy.

  13. Device-Related Adverse Events During Percutaneous Nephrolithotomy: Review of the Manufacturer and User Facility Device Experience Database.

    Science.gov (United States)

    Patel, Neel H; Schulman, Ariel A; Bloom, Jonathan B; Uppaluri, Nikil; Phillips, John L; Konno, Sensuke; Choudhury, Muhammad; Eshghi, Majid

    2017-10-01

    Percutaneous nephrolithotomy (PCNL) is an established technique for removal of large stones from the upper urinary tract. It is a complex multistep procedure requiring several classes of instruments that are subject to operator misuse and device malfunction. We report device-related adverse events during PCNL from the Manufacturer and User Facility Device Experience (MAUDE) database using a recently developed standardized classification system. The MAUDE database was queried for "percutaneous nephrolithotomy" from 2006 to 2016. The circumstances and patient complications associated with classes of devices used during PCNL were identified. We then utilized a novel MAUDE classification system to categorize clinical events. Logistic regression analysis was performed to identify associations between device classes and severe adverse events. A total of 218 device-related events were reported. The most common classes included: lithotripter 53 (24.3%), wires 43 (19.7%), balloon dilators 30 (13.8%), and occlusion balloons 28 (12.8%). Reported patient complications included need for a second procedure 12 (28.6%), bleeding 8 (19.0%), retained fragments 7 (16.7%), prolonged procedure 4 (9.5%), ureteral injury 2 (4.8%), and conversion to an open procedure 3 (7.1%). Using a MAUDE classification system, 176 complications (81%) were Level I (mild/none), 26 (12%) were Level II (moderate), 15 (7%) were Level III (severe), and 1 (0.5%) was Level IV (life threatening). On univariate analysis, balloon dilators had the highest risk of Level II-IV complications compared with the other device classes [odds ratio: 4.33, confidence interval: 1.978, 9.493, p < 0.001]. The device was evaluated by the manufacturer in 93 (42.7%) cases, with 54.8% of reviewed cases listing the source of malfunction as misuse by the operator. PCNL is subject to a wide range of device-related adverse events. A MAUDE classification system is useful for standardized, clinically-relevant reporting of events. Our

  14. Collection of scribe databases compiled in response to the Deepwater Horizon oil spill incident in the Gulf of Mexico from 04/23/2010 to 11/08/2011 (NODC Accession 0086261)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Scribe Database Collection includes 14 databases containing data from the Deepwater Horizon (DWH) Oil Spill Event Response Phase. These databases are the work of...

  15. Post-event reviews: Using a quantitative approach for analysing incident response to demonstrate the value of business continuity programmes and increase planning efficiency.

    Science.gov (United States)

    Vaidyanathan, Karthik

    2017-01-01

    Business continuity management is often thought of as a proactive planning process for minimising impact from large-scale incidents and disasters. While this is true, and it is critical to plan for the worst, consistently validating plan effectiveness against smaller disruptions can enable an organisation to gain key insights about its business continuity readiness, drive programme improvements, reduce costs and provide an opportunity to quantitatively demonstrate the value of the programme to management. This paper describes a post mortem framework which is used as a continuous improvement mechanism for tracking, reviewing and learning from real-world events at Microsoft Customer Service & Support. This approach was developed and adopted because conducting regular business continuity exercises proved difficult and expensive in a complex and distributed operations environment with high availability requirements. Using a quantitative approach to measure response to incidents, and categorising outcomes based on such responses, enables business continuity teams to provide data-driven insights to leadership, change perceptions of incident root cause, and instil a higher level of confidence towards disaster response readiness and incident management. The scope of the framework discussed here is specific to reviewing and driving improvements from operational incidents. However, the concept can be extended to learning and evolving readiness plans for other types of incidents.

  16. Incidence of hepatitis C in HIV positive and negative men who have sex with men 2000-2016: a systematic review and meta-analysis.

    Science.gov (United States)

    Ghisla, Virginia; Scherrer, Alexandra U; Nicca, Dunja; Braun, Dominique L; Fehr, Jan S

    2017-06-01

    There is a need for systematic reviews and meta-analyses to synthesize the epidemiology, and the riskfactors for hepatitis C virus (HCV) among HIV-coinfected and HIV negative men who have sex with men (MSM). A meta-analysis of 28 studies was carried out by pooling HCV incidence data of HIV-coinfected and HIV negative MSM. Differences in incidence outcome depending on the prospective or retrospective nature of the individual studies were investigated. The pooled incidence of HCV in MSM was 6.3 per 1000 person-years (95% CI 5.0-7.5). The overall estimated incidence was 19-fold higher in HIV positive compared to HIV negative MSM living in resource-rich countries. This result was confirmed when the analysis was restricted to high-quality studies. Factors associated with an increased risk for incident HCV included behavioural factors (sexual risk behaviour and recreational drug use) as well as biological characteristics (HIV coinfection and a recent history of syphilis). In conclusion, incident HCV predominantly affects HIV positive MSM. The incidence rate varied largely between studies, factors such as study design might play an important role.

  17. Overlap of proteomics biomarkers between women with pre-eclampsia and PCOS: a systematic review and biomarker database integration.

    Science.gov (United States)

    Khan, Gulafshana Hafeez; Galazis, Nicolas; Docheva, Nikolina; Layfield, Robert; Atiomo, William

    2015-01-01

    Do any proteomic biomarkers previously identified for pre-eclampsia (PE) overlap with those identified in women with polycystic ovary syndrome (PCOS). Five previously identified proteomic biomarkers were found to be common in women with PE and PCOS when compared with controls. Various studies have indicated an association between PCOS and PE; however, the pathophysiological mechanisms supporting this association are not known. A systematic review and update of our PCOS proteomic biomarker database was performed, along with a parallel review of PE biomarkers. The study included papers from 1980 to December 2013. In all the studies analysed, there were a total of 1423 patients and controls. The number of proteomic biomarkers that were catalogued for PE was 192. Five proteomic biomarkers were shown to be differentially expressed in women with PE and PCOS when compared with controls: transferrin, fibrinogen α, β and γ chain variants, kininogen-1, annexin 2 and peroxiredoxin 2. In PE, the biomarkers were identified in serum, plasma and placenta and in PCOS, the biomarkers were identified in serum, follicular fluid, and ovarian and omental biopsies. The techniques employed to detect proteomics have limited ability in identifying proteins that are of low abundance, some of which may have a diagnostic potential. The sample sizes and number of biomarkers identified from these studies do not exclude the risk of false positives, a limitation of all biomarker studies. The biomarkers common to PE and PCOS were identified from proteomic analyses of different tissues. This data amalgamation of the proteomic studies in PE and in PCOS, for the first time, discovered a panel of five biomarkers for PE which are common to women with PCOS, including transferrin, fibrinogen α, β and γ chain variants, kininogen-1, annexin 2 and peroxiredoxin 2. If validated, these biomarkers could provide a useful framework for the knowledge infrastructure in this area. To accomplish this goal, a

  18. A global database and "state of the field" review of research into ecosystem engineering by land animals.

    Science.gov (United States)

    Coggan, Nicole V; Hayward, Matthew W; Gibb, Heloise

    2018-02-28

    Ecosystem engineers have been widely studied for terrestrial systems, but global trends in research encompassing the range of taxa and functions have not previously been synthesised. We reviewed contemporary understanding of engineer fauna in terrestrial habitats and assessed the methods used to document patterns and processes, asking: (a) which species act as ecosystem engineers and with whom do they interact? (b) What are the impacts of ecosystem engineers in terrestrial habitats and how are they distributed? (c) What are the primary methods used to examine engineer effects and how have these developed over time? We considered the strengths, weaknesses and gaps in knowledge related to each of these questions and suggested a conceptual framework to delineate "significant impacts" of engineering interactions for all terrestrial animals. We collected peer-reviewed publications examining ecosystem engineer impacts and created a database of engineer species to assess experimental approaches and any additional covariates that influenced the magnitude of engineer impacts. One hundred and twenty-two species from 28 orders were identified as ecosystem engineers, performing five ecological functions. Burrowing mammals were the most researched group (27%). Half of all studies occurred in dry/arid habitats. Mensurative studies comparing sites with and without engineers (80%) were more common than manipulative studies (20%). These provided a broad framework for predicting engineer impacts upon abundance and species diversity. However, the roles of confounding factors, processes driving these patterns and the consequences of experimentally adjusting variables, such as engineer density, have been neglected. True spatial and temporal replication has also been limited, particularly for emerging studies of engineer reintroductions. Climate change and habitat modification will challenge the roles that engineers play in regulating ecosystems, and these will become important avenues

  19. A literature review and update on the incidence and microbiology spectrum of postcataract surgery endophthalmitis over past two decades in India.

    Science.gov (United States)

    Lalitha, Prajna; Sengupta, Sabyasachi; Ravindran, Ravilla D; Sharma, Savitri; Joseph, Joveeta; Ambiya, Vikas; Das, Taraprasad

    2017-08-01

    The purpose of this study was to review the incidence and microbiology of acute postcataract surgery endophthalmitis in India. Systematic review of English-language PubMed referenced articles on endophthalmitis in India published in the past 21 years (January 1992-December 2012), and retrospective chart review of 2 major eye care facilities in India in the past 5 years (January 2010-December 2014) were done. The incidence data were collected from articles that described "in-house" endophthalmitis and the microbiology data were collected from all articles. Both incidence and microbiological data of endophthalmitis were collected from two large eye care facilities. Case reports were excluded, except for the articles on cluster infection. Six of 99 published articles reported the incidence of "in-house" acute postcataract surgery endophthalmitis, 8 articles reported the microbiology spectrum, and 11 articles described cluster infection. The clinical endophthalmitis incidence was between 0.04% and 0.15%. In two large eye care facilities, the clinical endophthalmitis incidence was 0.08% and 0.16%; the culture proven endophthalmitis was 0.02% and 0.08%. Gram-positive cocci (44%-64.8%; commonly, Staphylococcus species), and Gram-negative bacilli (26.2%-43%; commonly Pseudomonas species) were common bacteria in south India. Fungi (16.7%-70%; commonly Aspergillus flavus) were the common organisms in north India. Pseudomonas aeruginosa (73.3%) was the major organism in cluster infections. The incidence of postcataract surgery clinical endophthalmitis in India is nearly similar to the world literature. There is a regional difference in microbiological spectrum. A registry with regular and uniform national reporting will help formulate region specific management guidelines.

  20. Incidence, Carriage and Case-Carrier Ratios for Meningococcal Meningitis in the African Meningitis Belt: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Koutangni, Thibaut; Boubacar Maïnassara, Halima; Mueller, Judith E.

    2015-01-01

    Background To facilitate the interpretation of meningococcal meningitis epidemiology in the “African meningitis belt”, we aimed at obtaining serogroup-specific pooled estimates of incidence, carriage and case-carrier ratios for meningococcal meningitis in the African meningitis belt and describe their variations across the endemic, hyperendemic and epidemic context. Methods We conducted a systematic review and meta-analysis of studies reporting serogroup-specific meningococcal meningitis monthly incidence and carriage in the same population and time period. Epidemiological contexts were defined as endemic (wet season, no epidemic), hyperendemic (dry season, no epidemic), and epidemic (dry season, epidemic). Findings Eight studies reporting a total of eighty pairs of serogroup-specific meningococcal meningitis incidence and carriage estimates were included in this review. For serogroup A, changes associated with the transition from endemic to hyperendemic incidence and from hyperendemic to epidemic incidence were 15-fold and 120-fold respectively. Changes in carriage prevalence associated with both transitions were 1-fold and 30-fold respectively. 
For serogroup W and X, the transition from endemic to hyperendemic incidence involved a 4-fold and 1•1-fold increase respectively. Increases in carriage prevalence for the later transition were 7-fold and 1•7-fold respectively. No data were available for the hyperendemic-epidemic transition for these serogroups. Our findings suggested that the regular seasonal variation in serogroup A meningococcal meningitis incidence between the rainy and the dry season could be mainly driven by seasonal change in the ratio of clinical cases to subclinical infections. In contrast appearance of epidemic incidences is related to a substantial increase in transmission and colonisation and to lesser extent with changes in the case-carrier ratio. Conclusion Seasonal change in the rate of progression to disease given carriage

  1. Relational databases

    CERN Document Server

    Bell, D A

    1986-01-01

    Relational Databases explores the major advances in relational databases and provides a balanced analysis of the state of the art in relational databases. Topics covered include capture and analysis of data placement requirements; distributed relational database systems; data dependency manipulation in database schemata; and relational database support for computer graphics and computer aided design. This book is divided into three sections and begins with an overview of the theory and practice of distributed systems, using the example of INGRES from Relational Technology as illustration. The

  2. Effectiveness of interventions for diagnosis and treatment of tuberculosis in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review

    NARCIS (Netherlands)

    Heuvelings, Charlotte C.; de Vries, Sophia G.; Greve, Patrick F.; Visser, Benjamin J.; Bélard, Sabine; Janssen, Saskia; Cremers, Anne L.; Spijker, René; Shaw, Beth; Hill, Ruaraidh A.; Zumla, Alimuddin; Sandgren, Andreas; van der Werf, Marieke J.; Grobusch, Martin P.

    2017-01-01

    Tuberculosis is over-represented in hard-to-reach (underserved) populations in high-income countries of low tuberculosis incidence. The mainstay of tuberculosis care is early detection of active tuberculosis (case finding), contact tracing, and treatment completion. We did a systematic review with a

  3. Review of the Methods to Obtain Paediatric Drug Safety Information: Spontaneous Reporting and Healthcare Databases, Active Surveillance Programmes, Systematic Reviews and Meta-analyses

    Science.gov (United States)

    Gentili, Marta; Pozzi, Marco; Peeters, Gabrielle; Radice, Sonia; Carnovale, Carla

    2018-02-06

    Knowledge of drugs safety collected during the pre-marketing phase is inevitably limited because the randomized clinical trials (RCTs) are rarely designed to evaluate safety. The small and selective groups of enrolled individuals and the limited duration of trials may hamper the ability to characterize fully the safety profiles of drugs. Additionally, information about rare adverse drug reactions (ADRs) in special groups is often incomplete or not available for most of the drugs commonly used in the daily clinical practice. In the paediatric setting several highimpact safety issues have emerged. Hence, in recent years, there has been a call for improved post-marketing pharmacoepidemiological studies, in which cohorts of patients are monitored for sufficient time in order to determine the precise risk-benefit ratio. In this review, we discuss the current available strategies enhancing the post-marketing monitoring activities of the drugs in the paediatric setting and define criteria whereby they can provide valuable information to improve the management of therapy in daily clinical practice including both safety and efficacy aspects. The strategies we cover include the signal detection using international pharmacovigilance and/or healthcare databases, the promotion of active surveillance initiatives which can generate complete, informative data sets for the signal detection and systematic review/meta-analysis. Together, these methods provide a comprehensive picture of causality and risk improving the management of therapy in a paediatric setting and they should be considered as a unique tool to be integrated with post-marketing activities. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. Work-Related Stress in the Banking Sector: A Review of Incidence, Correlated Factors, and Major Consequences.

    Science.gov (United States)

    Giorgi, Gabriele; Arcangeli, Giulio; Perminiene, Milda; Lorini, Chiara; Ariza-Montes, Antonio; Fiz-Perez, Javier; Di Fabio, Annamaria; Mucci, Nicola

    2017-01-01

    For a number of years now, banks have been going through enormous changes in organization and structure. New technology and new ways of structuring the operation have left their mark on the working conditions and daily lives of employees. Deregulation of labor markets, emerging technologies and new types of jobs have significantly reshaping working lives by continuous changes on employment and working conditions. Such a scenario has a relevant impact not only on companies' organization but also on working population's health. The banking sector is particularly well-deserved of a specific and thorough analysis, in view of the recent increase in psycho-social disorders of employees. This may be related to the major organizational changes affecting this sector and, in particular, to the restructuring processes resulting from the global economic crisis. Our aim is to assess the scale of the phenomenon and how far it relates specifically to the processes of bank organization. With this in mind, through a review of the literature, we selected the main studies dealing with work-related stress in banking, so that we could reach a better understanding of the phenomenon as it relates specifically to this set of workers. The search took place on the MEDLINE® database; in total 20 articles were chosen. There was uniform agreement among the studies that stress in the banking workplace is now at critical levels, and that it can have deleterious psychological effects on workers, and on their physical health, and that organizations, too, are affected. Most studies showed that mental health problems had increased in the banking sector, and that they were stress-related. Examples began with anxiety and depression, carried on through maladaptive behaviors, and ended in job burnout. The reviewed studies' limitations were then discussed, and possible ways forward considered.

  5. Work-Related Stress in the Banking Sector: A Review of Incidence, Correlated Factors, and Major Consequences

    Directory of Open Access Journals (Sweden)

    Gabriele Giorgi

    2017-12-01

    Full Text Available For a number of years now, banks have been going through enormous changes in organization and structure. New technology and new ways of structuring the operation have left their mark on the working conditions and daily lives of employees. Deregulation of labor markets, emerging technologies and new types of jobs have significantly reshaping working lives by continuous changes on employment and working conditions. Such a scenario has a relevant impact not only on companies' organization but also on working population's health. The banking sector is particularly well-deserved of a specific and thorough analysis, in view of the recent increase in psycho-social disorders of employees. This may be related to the major organizational changes affecting this sector and, in particular, to the restructuring processes resulting from the global economic crisis. Our aim is to assess the scale of the phenomenon and how far it relates specifically to the processes of bank organization. With this in mind, through a review of the literature, we selected the main studies dealing with work-related stress in banking, so that we could reach a better understanding of the phenomenon as it relates specifically to this set of workers. The search took place on the MEDLINE® database; in total 20 articles were chosen. There was uniform agreement among the studies that stress in the banking workplace is now at critical levels, and that it can have deleterious psychological effects on workers, and on their physical health, and that organizations, too, are affected. Most studies showed that mental health problems had increased in the banking sector, and that they were stress-related. Examples began with anxiety and depression, carried on through maladaptive behaviors, and ended in job burnout. The reviewed studies' limitations were then discussed, and possible ways forward considered.

  6. Systematic review on the incidence of bisphosphonate related osteonecrosis of the jaw in children diagnosed with osteogenesis imperfecta.

    Science.gov (United States)

    Hennedige, Anusha Adeline; Jayasinghe, Jap; Khajeh, Janette; Macfarlane, Tatiana V

    2013-10-01

    To conduct a systematic review of epidemiological literature to determine the incidence of bisphosphonate related osteonecrosis of the jaw occurring either spontaneously or after dental surgery, in children and adolescents diagnosed with osteogenesis imperfecta. MEDLINE, HMIC and EMBASE were used to search for English-language articles published from 1946 - 2013. Inclusion criteria consisted of population based studies of children and adolescents (24 years and younger) diagnosed with osteogenesis imperfecta, only studies which included a dental examination, and patients treated with intravenous bisphosphonates were included. Articles were excluded if patients had any other co-morbidity which could affect osteonecrosis of the jaw, and those which treated patients with oral bisphosphonates only. Five studies consisting of four retrospective cohort studies and one case series were identified. Study populations ranged from 15 to 278 patients and number of subjects with osteogenesis imperfecta ranged from 15 to 221. Mean duration of intravenous bisphosphonate use ranged from 4.5 to 6.8 years. All patients were clinically examined and no patients were found to have osteonecrosis of the jaw. There is no evidence to support hypothesis of causal relationship between bisphosphonates and osteonecrosis of the jaw in children and adolescents with osteogenesis imperfecta. More prospective studies on bisphosphonate use in osteogenesis imperfecta needs to be carried out.

  7. Incidence of Opportunistic Infections and the Impact of Antiretroviral Therapy Among HIV-Infected Adults in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Low, Andrea; Gavriilidis, Georgios; Larke, Natasha; B-Lajoie, Marie-Renee; Drouin, Olivier; Stover, John; Muhe, Lulu; Easterbrook, Philippa

    2016-06-15

    To understand regional burdens and inform delivery of health services, we conducted a systematic review and meta-analysis to evaluate the effect of antiretroviral therapy (ART) on incidence of key opportunistic infections (OIs) in human immunodeficiency virus (HIV)-infected adults in low- and middle-income countries (LMICs). Eligible studies describing the cumulative incidence of OIs and proportion on ART from 1990 to November 2013 were identified using multiple databases. Summary incident risks for the ART-naive period, and during and after the first year of ART, were calculated using random-effects meta-analyses. Summary estimates from ART subgroups were compared using meta-regression. The number of OI cases and associated costs averted if ART was initiated at a CD4 count ≥200 cells/µL were estimated using Joint United Nations Programme on HIV/AIDS (UNAIDS) country estimates and global average OI treatment cost per case. We identified 7965 citations, and included 126 studies describing 491 608 HIV-infected persons. In ART-naive patients, summary risk was highest (>5%) for oral candidiasis, tuberculosis, herpes zoster, and bacterial pneumonia. The reduction in incidence was greatest for all OIs during the first 12 months of ART (range, 57%-91%) except for tuberculosis, and was largest for oral candidiasis, Pneumocystis pneumonia, and toxoplasmosis. Earlier ART was estimated to have averted 857 828 cases in 2013 (95% confidence interval [CI], 828 032-874 853), with cost savings of $46.7 million (95% CI, $43.8-$49.4 million). There was a major reduction in risk for most OIs with ART use in LMICs, with the greatest effect seen in the first year of treatment. ART has resulted in substantial cost savings from OIs averted. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

  8. Community Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This excel spreadsheet is the result of merging at the port level of several of the in-house fisheries databases in combination with other demographic databases such...

  9. Biofuel Database

    Science.gov (United States)

    Biofuel Database (Web, free access)   This database brings together structural, biological, and thermodynamic data for enzymes that are either in current use or are being considered for use in the production of biofuels.

  10. Visualization of multidimensional database

    Science.gov (United States)

    Lee, Chung

    2008-01-01

    The concept of multidimensional databases has been extensively researched and wildly used in actual database application. It plays an important role in contemporary information technology, but due to the complexity of its inner structure, the database design is a complicated process and users are having a hard time fully understanding and using the database. An effective visualization tool for higher dimensional information system helps database designers and users alike. Most visualization techniques focus on displaying dimensional data using spreadsheets and charts. This may be sufficient for the databases having three or fewer dimensions but for higher dimensions, various combinations of projection operations are needed and a full grasp of total database architecture is very difficult. This study reviews existing visualization techniques for multidimensional database and then proposes an alternate approach to visualize a database of any dimension by adopting the tool proposed by Kiviat for software engineering processes. In this diagramming method, each dimension is represented by one branch of concentric spikes. This paper documents a C++ based visualization tool with extensive use of OpenGL graphics library and GUI functions. Detailed examples of actual databases demonstrate the feasibility and effectiveness in visualizing multidimensional databases.

  11. The Relational Database Dictionary

    CERN Document Server

    J, C

    2006-01-01

    Avoid misunderstandings that can affect the design, programming, and use of database systems. Whether you're using Oracle, DB2, SQL Server, MySQL, or PostgreSQL, The Relational Database Dictionary will prevent confusion about the precise meaning of database-related terms (e.g., attribute, 3NF, one-to-many correspondence, predicate, repeating group, join dependency), helping to ensure the success of your database projects. Carefully reviewed for clarity, accuracy, and completeness, this authoritative and comprehensive quick-reference contains more than 600 terms, many with examples, covering i

  12. Database Administrator

    Science.gov (United States)

    Moore, Pam

    2010-01-01

    The Internet and electronic commerce (e-commerce) generate lots of data. Data must be stored, organized, and managed. Database administrators, or DBAs, work with database software to find ways to do this. They identify user needs, set up computer databases, and test systems. They ensure that systems perform as they should and add people to the…

  13. Hydrogen Leak Detection Sensor Database

    Science.gov (United States)

    Baker, Barton D.

    2010-01-01

    This slide presentation reviews the characteristics of the Hydrogen Sensor database. The database is the result of NASA's continuing interest in and improvement of its ability to detect and assess gas leaks in space applications. The database specifics and a snapshot of an entry in the database are reviewed. Attempts were made to determine the applicability of each of the 65 sensors for ground and/or vehicle use.

  14. Elevation of serum uric acid and incidence of type 2 diabetes: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yi-Li Xu

    2016-06-01

    Full Text Available Objective: Recently, several cohort studies suggested a positive relationship between serum uric acid (SUA and type 2 diabetes mellitus (T2DM, which is inconsistent with the results of functional research. Our aim was to further evaluate this correlation by conducting a systematic review. Methods: Computerized literature searches of the Medline database, EMBASE database, and PubMed were used to evaluate the relationship between SUA and T2DM in cohort studies. Cochran's Q and I2 statistics were used to evaluate heterogeneity among studies, and pooled relative risk (RR and odds ratio (OR with 95% confidence intervals (CIs were calculated using random-effects and fixed-effects models. The summary RR and OR of per 1 mg/ml-SUA increase were calculated separately because of their different epidemiological implications and calculation methods. Additionally, sensitivity analysis, stratified analysis, meta-regression, and multiple meta-regression were applied to investigate the heterogeneity among studies. Results: A total of 970 articles were retrieved from the searches. Sixteen publications of cohort studies containing 61,714 participants were included. The pooled RR was 1.131 (95% CI: 1.084–1.179 with significant heterogeneity among studies (I2 = 51.9%, P = 0.018. Adjusted RR to evaluate the stability of the relationship between SUA and T2DM in the sensitivity analysis was similar (RR = 1.140, 95% CI: 1.087–1.197, with statistically significant heterogeneity (I2 = 54.5%, P = 0.015. Stratified analysis and meta-regression showed that the positive relationship remained irrespective of age, sex, region, and adjustment for confounding factors including body mass index, fasting blood glucose, systolic blood pressure, diastolic blood pressure, alcohol consumption, smoking, blood cholesterol, waist circumference, fatty liver, and drugs affecting SUA. Conclusion: Although SUA is independently associated with

  15. Retrospective and emergency dosimetry in response to radiological incidents and nuclear mass-casualty events: A review

    International Nuclear Information System (INIS)

    Bailiff, I.K.; Sholom, S.; McKeever, S.W.S.

    2016-01-01

    of a radiation incident. Hence attention has focused on biological or physical materials they may have in their possession that could be used as surrogate dosimeters. For EPR measurements, in particular, this includes material within the body (such as bone or tooth biopsy) requiring invasive procedures, but also materials collected non-invasively (such as clippings taken from finger- or toenails) and artefacts within their personal belongings (such as electronic devices of which smart phones are the most common). For luminescence measurements, attention has also focused on components within electronic devices, including smartphones, and a wide range of other personal belongings such as paper and other polymer-based materials (including currency, clothing, bank cards, etc.). The paper reviews progress made using both EPR and luminescence techniques, along with their current limitations. For the longer-established approach of retrospective dosimetry, luminescence has been the most extensively applied method and, by employing minerals found in construction materials, it consequently is employed in dosimetry using structures within the environment. Recent developments in its application to large-scale radiation releases are discussed, including the atomic bomb detonations at Hiroshima and Nagasaki, fallout from the Chernobyl reactor and atmospheric nuclear bomb tests within the Semipalatinsk Nuclear Test Site and fluvially transported pollution within the Techa River basin due to releases from the Mayak facility. The developments made in applying OSL and TL techniques are discussed in the context of these applications. EPR measurements with teeth have also provided benchmark values to test the dosimetry models used for Chernobyl liquidators (clean-up workers), residents of Semipalatinsk Nuclear Tests Sites and inhabitants of the Techa River basin. For both emergency and retrospective dosimetry applications, computational techniques employing radiation transport

  16. C2-Related Incidents Reported by UAS Pilots

    Science.gov (United States)

    Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

    2016-01-01

    It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. This presentation focuses on incidents that involved the management of the command and control (C2) link. The identified issues include loss of link, interference from undesired transmissions, voice latency, accidental control transfer, and the use of the lost link timer, or lost link OK features.

  17. Incidence of marine debris in cetaceans stranded and bycaught in Ireland: Recent findings and a review of historical knowledge.

    Science.gov (United States)

    Lusher, Amy L; Hernandez-Milian, Gema; Berrow, Simon; Rogan, Emer; O'Connor, Ian

    2018-01-01

    Interactions between marine mammals and plastic debris have been the focus of studies for many years. Examples of interactions include entanglement in discarded fishing items or the presence of ingested debris in digestive tracts. Plastics, including microplastics, are a form of marine debris globally distributed in coastal areas, oceanic waters and deep seas. Cetaceans which strand along the coast present a unique opportunity to study interactions between animals with macro- and microplastics. A combination of novel techniques and a review of historical data was used to complete an extensive study of cetaceans interacting with marine debris within Irish waters. Of the 25 species of marine mammals reported in Irish waters, at least 19 species were reported stranded between 1990 and 2015 (n = 2934). Two hundred and forty-one of the stranded cetaceans presented signs of possible entanglement or interactions with fisheries. Of this number, 52.7% were positively identified as bycatch or as entangled in fisheries items, 26.6% were classified as mutilated and 20.7% could not be related to fisheries but showed signs of entanglement. In addition, 274 cetaceans were recorded as by-catch during observer programmes targeting albacore tuna. Post-mortem examinations were carried out on a total of 528 stranded and bycaught individuals and 45 (8.5%) had marine debris in their digestive tracts: 21 contained macrodebris, 21 contained microdebris and three had both macro- and microdebris. Forty percent of the ingested debris were fisheries related items. All 21 individuals investigated with the novel method for microplastics contained microplastics, composed of fibres (83.6%) and fragments (16.4%). Deep diving species presented more incidences of macrodebris ingestion but it was not possible to investigate this relationship to ecological habitat. More research on the plastic implications to higher trophic level organisms is required to understand the effects of these pollutants

  18. Incidence and Determinants of Dental Implant Failure: A Review of Electronic Health Records in a U.S. Dental School.

    Science.gov (United States)

    Hickin, Matthew Parker; Shariff, Jaffer A; Jennette, Philip J; Finkelstein, Joseph; Papapanou, Panos N

    2017-10-01

    The aim of this study was to use electronic health care records (EHRs) to examine retrospectively the incidence of and attributes associated with dental implant failures necessitating implant removal in a large cohort of patients treated in the student clinics of a U.S. dental school over three and a half years. EHRs were searched for all patients who received dental implants between July 1, 2011, and December 31, 2014. Characteristics of patients and implants that were actively removed due to irrevocable failure of any etiology ("failure cohort") during this period were compared to those of all other patients who received dental implants during the same time frame ("reference cohort"). Differences in the frequency distribution of various characteristics between the failure and reference cohorts were compared. Of a total 6,129 implants placed in 2,127 patients during the study period, 179 implants (2.9%) in 120 patients (5.6%) were removed. In the multivariate analysis, presence of a removable (OR=2.86) or fixed temporary prosthesis (OR=3.71) was statistically significantly associated with increased risk for implant failure. In contrast, antibiotic coverage (pre- and post-surgery OR=0.16; post-surgery only OR=0.38) and implants of certain manufacturers were associated with lower risk of implant failure. In this sizeable cohort of patients receiving care in dental student clinics, the review of EHRs facilitated identification of multiple variables associated with implant failure resulting in removal; however, these findings do not suggest causative relationships. The adopted analytical approach can enhance quality assurance measures and may contribute to the identification of true risk factors for dental implant failure.

  19. The Risk for Lung Cancer Incidence with Calcium Channel Blockers: A Systematic Review and Meta-Analysis of Observational Studies.

    Science.gov (United States)

    Rotshild, Victoria; Azoulay, Laurent; Zarifeh, Majd; Masarwa, Reem; Hirsh-Raccah, Bruria; Perlman, Amichai; Muszkat, Mordechai; Matok, Ilan

    2018-02-26

    There are conflicting findings regarding the association between the use of calcium channel blockers (CCBs) and the risk of lung cancer. Considering the public health importance of lung cancer prevention, and emerging evidence of a significant biologic role of calcium channel regulation in the development of lung cancer, we conducted a meta-analysis to assess the risk of lung cancer in CCB users compared with non-CCB users. We conducted a comprehensive systematic search of leading medical databases for observational studies published up to December 2017 that examined CCB use and the risk of lung cancer. We used random-effects models to pool results. The impact of duration of CCB use on the estimated effect size was explored using random effects meta-regression. Ten studies (six cohort and four case-control studies) that evaluated the overall cancer risk among 38,758 CCB users were included in the analysis. Overall risk ratio (RR) for CCB use and lung cancer was 1.15 (95% confidence interval [CI] 1.01-1.32). Subgroup analysis by duration of CCB use suggested that the observed increase in lung cancer risk was driven by the results of five studies with prolonged (≥ 4 years) exposure (RR 1.18; 95% CI 1.08-1.30). Our analysis suggests exposure to CCBs is associated with an increased risk of lung cancer. Considering their widespread use, and the paucity of data on the long-term effects of chronic exposure to CCBs, these results are reason for concern and warrant further investigation. The protocol for this study was registered at the PROSPERO registry of systematic reviews (registry number: CRD42017056362).

  20. Incidence of retinal detachment associated with atopic dermatitis in Japan: review of cases from 1992 to 2011

    Directory of Open Access Journals (Sweden)

    Sasoh M

    2015-06-01

    Full Text Available Mikio Sasoh,1,2 Hitoshi Mizutani,3 Hisashi Matsubara,1 Motoyasu Furuta,4 Yoshitsugu Matsui,1 Kei-ichi Yamanaka,3 Mineo Kondo11Department of Ophthalmology, Graduate School of Medicine, Mie University, Tsu, 2Local Independent Administrative Institution, Mie Prefectural General Medical Center, Yokkaichi, 3Department of Dermatology, Graduate School of Medicine, Mie University, Tsu, 4Japanese Red Cross Ise Hospital, Ise, Mie, JapanPurpose: The present study aims to investigate the number and characteristics of retinal detachment with atopic dermatitis (AD in these 20 years, and the number of the first visit AD outpatients in almost the same period.Methods: A retrospective review of 101 consecutive surgically treated retinal detachments with AD patients from 1992 to 2011 was conducted. Retinal detachments were divided into two groups: eyes operated on from 1992 to 2001 (former AD group, n=63 and eyes operated on from 2002 to 2011 (recent AD group, n=38. We also reviewed the records of the first visit AD outpatients from 1993 to 2011 except 1998.Results: The percentage of bilateral detachment was significantly higher in the former AD group (14/63 than that in the recent AD group (0/38 (P=0.0002. In addition, patients in the recent AD group were significantly older than those in the former AD group (P=0.0084. The annual cases with non-AD retinal detachment remained invariant for 20 years. The ratio of the retinal detachment with AD for the total retinal detachment was significantly lower in the recent (38/847 AD group than that in the former (63/796 AD group (P=0.0038. The number of the first visit AD outpatients linearly decreased in these 19 years (153 cases in 1993 and 65 cases in 2011.Conclusion: Our study indicates an apparent decrease in retinal detachment with AD in the recent 10 years, and might suggest the importance of dermatitis control for prevention of retinal detachment with AD.Keywords: atopic dermatitis, incidence, ocular

  1. Fish Consumption and Age-Related Macular Degeneration Incidence: A Meta-Analysis and Systematic Review of Prospective Cohort Studies

    Directory of Open Access Journals (Sweden)

    Wei Zhu

    2016-11-01

    Full Text Available The association between fish consumption and risk of age-related macular degeneration (AMD is still unclear. The aim of the current meta-analysis and systematic review was to quantitatively evaluate findings from observational studies on fish consumption and the risk of AMD. Relevant studies were identified by searching electronic databases (Medline and EMBASE and reviewing the reference lists of relevant articles up to August, 2016. Prospective cohort studies that reported relative risks (RRs and 95% confidence intervals (CIs for the link between fish consumption and risk of AMD were included. A total of 4202 cases with 128,988 individuals from eight cohort studies were identified in the current meta-analysis. The meta-analyzed RR was 0.76 (95% CI, 0.65–0.90 when any AMD was considered. Subgroup analyses by AMD stages showed that fish consumption would reduce the risk of both early (RR, 0.83; 95% CI, 0.72–0.96 and late (RR; 0.76; 95% CI, 0.60–0.97 AMD. When stratified by the follow-up duration, fish consumption was a protective factor of AMD in both over 10 years (n = 5; RR, 0.81; 95% CI, 0.67–0.97 and less than 10 years (n = 3; RR, 0.70; 95% CI, 0.51 to 0.97 follow-up duration. Stratified analyses by fish type demonstrated that dark meat fish (RR, 0.68, 95% CI, 0.46–0.99, especially tuna fish (RR, 0.58; 95% CI, 95% CI, 0.47–0.71 intake was associated with reduced AMD risk. Evidence of a linear association between dose of fish consumption and risk of AMD was demonstrated. The results of this meta-analysis demonstrated that fish consumption can reduce AMD risk. Advanced, well-designed, randomized clinical trials are required in order to validate the conclusions in this study.

  2. A systematic review and meta-analysis of nut consumption and incident risk of CVD and all-cause mortality.

    Science.gov (United States)

    Mayhew, Alexandra J; de Souza, Russell J; Meyre, David; Anand, Sonia S; Mente, Andrew

    2016-01-28

    Dietary patterns containing nuts are associated with a lower risk of CVD mortality, and increased nut consumption has been shown to have beneficial effects on CVD risk factors including serum lipid levels. Recent studies have reported on the relationship between nut intake and CVD outcomes and mortality. Our objective was to systematically review the literature and quantify associations between nut consumption and CVD outcomes and all-cause mortality. Five electronic databases (through July 2015), previous reviews and bibliographies of qualifying articles were searched. In the twenty included prospective cohort studies (n 467 389), nut consumption was significantly associated with a lower risk of all-cause mortality (ten studies; risk ratio (RR) 0·81; 95 % CI 0·77, 0·85 for highest v. lowest quantile of intake, P het=0·04, I 2=43 %), CVD mortality (five studies; RR 0·73; 95 % CI 0·68, 0·78; P het=0·31, I 2=16 %), all CHD (three studies; RR 0·66; 95 % CI 0·48, 0·91; P het=0·0002, I 2=88 %) and CHD mortality (seven studies; RR 0·70; 95 % CI 0·64, 0·76; P het=0·65, I 2=0 %), as well as a statistically non-significant reduction in the risk of non-fatal CHD (three studies; RR 0·71; 95 % CI 0·49, 1·03; P het=0·03, I 2=72 %) and stroke mortality (three studies; RR 0·83; 95 % CI 0·69, 1·00; P het=0·54, I 2=0 %). No evidence of association was found for total stroke (two studies; RR 1·05; 95 % CI 0·69, 1·61; P het=0·04, I 2=77 %). Data on total CVD and sudden cardiac death were available from one cohort study, and they were significantly inversely associated with nut consumption. In conclusion, we found that higher nut consumption is associated with a lower risk of all-cause mortality, total CVD, CVD mortality, total CHD, CHD mortality and sudden cardiac death.

  3. Systematic review and meta-analysis of association of smokeless tobacco and of betel quid without tobacco with incidence of oral cancer in South Asia and the Pacific.

    Directory of Open Access Journals (Sweden)

    Bhawna Gupta

    Full Text Available This systematic review and meta-analysis aimed to critically appraised data from comparable studies leading to quantitative assessment of any independent association between use of oral smokeless tobacco in any form, of betel quid without tobacco and of areca nut with incidence of oral cancer in South Asia and the Pacific.Studies (case control and/or cohort were identified by searching Pub Med, CINAHL and Cochrane databases through June 2013 using the keywords oral cancer: chewing tobacco; smokeless tobacco; betel quid; betel quid without tobacco; areca nut; Asia, the Pacific and the reference lists of retrieved articles. A random effects model was used to compute adjusted summary OR(RE for the main effect of these habits along with their corresponding 95% confidence intervals. To quantify the impact of between-study heterogeneity on adjusted main-effect summary OR(RE, Higgins' H and I2 statistics along with their 95% uncertainty intervals were used. Funnel plots and Egger's test were used to evaluate publication bias.Meta-analysis of fifteen case-control studies (4,553 cases; 8,632 controls and four cohort studies (15,342 which met our inclusion criteria showed that chewing tobacco is significantly and independently associated with an increased risk of squamous-cell carcinoma of the oral cavity (adjusted main-effect summary for case- control studies OR(RE = 7.46; 95% CI = 5.86-9.50, P<0.001, (adjusted main-effect summary for cohort studies RR = 5.48; 95% CI = 2.56-11.71, P<0.001. Furthermore, meta-analysis of fifteen case control studies (4,648 cases; 7,847 controls has shown betel quid without tobacco to have an independent positive association with oral cancer, with OR = 2.82 (95% CI = 2.35-3.40, P<0.001. This is presumably due to the carcinogenicity of areca nut. There was no significant publication bias.There is convincing evidence that smokeless (aka chewing tobacco, often used as a component of betel quid, and betel quid without tobacco

  4. Pre-entry screening programmes for tuberculosis in migrants to low-incidence countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Aldridge, Robert W; Yates, Tom A; Zenner, Dominik; White, Peter J; Abubakar, Ibrahim; Hayward, Andrew C

    2014-12-01

    Several high-income countries have pre-entry screening programmes for tuberculosis. We aimed to establish the yield of pre-entry screening programmes to inform evidence-based policy for migrant health screening. We searched six bibliographic databases for experimental or observational studies and systematic reviews, which reported data on migrant screening for active or latent tuberculosis by any method before migration to a low-incidence country. Primary outcomes were principal reported screening yield of active tuberculosis, yield of culture-confirmed cases, and yield of sputum smear for acid-fast bacilli cases. Where appropriate, fixed-effects models were used to summarise the yield of pre-entry screening across included studies. We identified 15 unique studies with data for 3 739 266 migrants screened pre-entry for tuberculosis between 1982 and 2010. Heterogeneity was high for all primary outcomes. After stratification by prevalence in country of origin, heterogeneity was reduced for culture-confirmed and smear-confirmed cases. Yield of culture-confirmed cases increased with prevalence in the country of origin, and summary estimates ranged from 19·7 (95% CI 10·3-31·5) cases identified per 100 000 individuals screened in countries with a prevalence of 50-149 cases per 100 000 population to 335·9 (283·0-393·2) per 100 000 in countries with a prevalence of greater than 350 per 100 000 population. Targeting high-prevalence countries could result in the highest yield for active disease. Pre-entry screening should be considered as part of a broad package of measures to ensure early diagnosis and effective management of migrants with active tuberculosis, and be integrated with initiatives that address the health needs of migrants. Wellcome Trust, UK National Institute for Health Research, Medical Research Council, Public Health England. Copyright © 2014 Aldridge et al. Open Access article distributed under the terms of CC BY. Published by Elsevier

  5. Literature Review and Database of Relations Between Salinity and Aquatic Biota: Applications to Bowdoin National Wildlife Refuge, Montana

    Science.gov (United States)

    Gleason, Robert A.; Tangen, Brian A.; Laubhan, Murray K.; Finocchiaro, Raymond G.; Stamm, John F.

    2009-01-01

    Long-term accumulation of salts in wetlands at Bowdoin National Wildlife Refuge (NWR), Mont., has raised concern among wetland managers that increasing salinity may threaten plant and invertebrate communities that provide important habitat and food resources for migratory waterfowl. Currently, the U.S. Fish and Wildlife Service (USFWS) is evaluating various water management strategies to help maintain suitable ranges of salinity to sustain plant and invertebrate resources of importance to wildlife. To support this evaluation, the USFWS requested that the U.S. Geological Survey (USGS) provide information on salinity ranges of water and soil for common plants and invertebrates on Bowdoin NWR lands. To address this need, we conducted a search of the literature on occurrences of plants and invertebrates in relation to salinity and pH of the water and soil. The compiled literature was used to (1) provide a general overview of salinity concepts, (2) document published tolerances and adaptations of biota to salinity, (3) develop databases that the USFWS can use to summarize the range of reported salinity values associated with plant and invertebrate taxa, and (4) perform database summaries that describe reported salinity ranges associated with plants and invertebrates at Bowdoin NWR. The purpose of this report is to synthesize information to facilitate a better understanding of the ecological relations between salinity and flora and fauna when developing wetland management strategies. A primary focus of this report is to provide information to help evaluate and address salinity issues at Bowdoin NWR; however, the accompanying databases, as well as concepts and information discussed, are applicable to other areas or refuges. The accompanying databases include salinity values reported for 411 plant taxa and 330 invertebrate taxa. The databases are available in Microsoft Excel version 2007 (http://pubs.usgs.gov/sir/2009/5098/downloads/databases_21april2009.xls) and contain

  6. Database Replication

    Directory of Open Access Journals (Sweden)

    Marius Cristian MAZILU

    2010-12-01

    Full Text Available For someone who has worked in an environment in which the same database is used for data entry and reporting, or perhaps managed a single database server that was utilized by too many users, the advantages brought by data replication are clear. The main purpose of this paper is to emphasize those advantages as well as presenting the different types of Database Replication and the cases in which their use is recommended.

  7. Improving freight crash incident management.

    Science.gov (United States)

    2015-06-01

    The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

  8. Application of the intelligent techniques in transplantation databases: a review of articles published in 2009 and 2010.

    Science.gov (United States)

    Sousa, F S; Hummel, A D; Maciel, R F; Cohrs, F M; Falcão, A E J; Teixeira, F; Baptista, R; Mancini, F; da Costa, T M; Alves, D; Pisa, I T

    2011-05-01

    The replacement of defective organs with healthy ones is an old problem, but only a few years ago was this issue put into practice. Improvements in the whole transplantation process have been increasingly important in clinical practice. In this context are clinical decision support systems (CDSSs), which have reflected a significant amount of work to use mathematical and intelligent techniques. The aim of this article was to present consideration of intelligent techniques used in recent years (2009 and 2010) to analyze organ transplant databases. To this end, we performed a search of the PubMed and Institute for Scientific Information (ISI) Web of Knowledge databases to find articles published in 2009 and 2010 about intelligent techniques applied to transplantation databases. Among 69 retrieved articles, we chose according to inclusion and exclusion criteria. The main techniques were: Artificial Neural Networks (ANN), Logistic Regression (LR), Decision Trees (DT), Markov Models (MM), and Bayesian Networks (BN). Most articles used ANN. Some publications described comparisons between techniques or the use of various techniques together. The use of intelligent techniques to extract knowledge from databases of healthcare is increasingly common. Although authors preferred to use ANN, statistical techniques were equally effective for this enterprise. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Incidence Proportion of Acute Cor Pulmonale in Patients with Acute Respiratory Distress Syndrome Subjected to Lung Protective Ventilation: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Das, Saurabh Kumar; Choupoo, Nang Sujali; Saikia, Priyam; Lahkar, Amitabh

    2017-06-01

    Reported incidence of acute cor pulmonale (ACP) in patients with acute respiratory distress syndrome (ARDS) varies from 10% to 84%, despite being subjected to lung protective ventilation according to the current guidelines. The objective of this review is to find pooled cumulative incidence of ACP in patients with ARDS undergoing lung protective ventilation. We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILACS, and WHO Clinical Trial Registry. Cross-sectional or cohort studies were included if they reported or provided data that could be used to calculate the incidence proportion of ACP. Inverse variance heterogeneity (IVhet) and random effect model were used for the main outcome and measures. We included 16 studies encompassing 1661 patients. The cumulative incidence of ACP using IVhet analysis was 23% (95% confidence interval [CI] = 18%-28%) over 3 days of lung protective ventilation. Random effect analysis of 7 studies (1250 patients) revealed pooled odd ratio of mortality of 1.16 (95% CI = 0.80-1.67, P = 0.44) due to ACP. Patients with ARDS have a 23% risk of developing ACP with lung protective ventilation. Findings of this review indicate the need of updating existing guidelines for ventilating ARDS patients to incorporate right ventricle protective strategy.

  10. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alison L Drake

    2014-02-01

    Full Text Available Women may have persistent risk of HIV acquisition during pregnancy and postpartum. Estimating risk of HIV during these periods is important to inform optimal prevention approaches. We performed a systematic review and meta-analysis to estimate maternal HIV incidence during pregnancy/postpartum and to compare mother-to-child HIV transmission (MTCT risk among women with incident versus chronic infection.We searched PubMed, Embase, and AIDS-related conference abstracts between January 1, 1980, and October 31, 2013, for articles and abstracts describing HIV acquisition during pregnancy/postpartum. The inclusion criterion was studies with data on recent HIV during pregnancy/postpartum. Random effects models were constructed to pool HIV incidence rates, cumulative HIV incidence, hazard ratios (HRs, or odds ratios (ORs summarizing the association between pregnancy/postpartum status and HIV incidence, and MTCT risk and rates. Overall, 1,176 studies met the search criteria, of which 78 met the inclusion criterion, and 47 contributed data. Using data from 19 cohorts representing 22,803 total person-years, the pooled HIV incidence rate during pregnancy/postpartum was 3.8/100 person-years (95% CI 3.0-4.6: 4.7/100 person-years during pregnancy and 2.9/100 person-years postpartum (p = 0.18. Pooled cumulative HIV incidence was significantly higher in African than non-African countries (3.6% versus 0.3%, respectively; p<0.001. Risk of HIV was not significantly higher among pregnant (HR 1.3, 95% CI 0.5-2.1 or postpartum women (HR 1.1, 95% CI 0.6-1.6 than among non-pregnant/non-postpartum women in five studies with available data. In African cohorts, MTCT risk was significantly higher among women with incident versus chronic HIV infection in the postpartum period (OR 2.9, 95% CI 2.2-3.9 or in pregnancy/postpartum periods combined (OR 2.3, 95% CI 1.2-4.4. However, the small number of studies limited power to detect associations and sources of heterogeneity

  11. Incidence and Prevalence of Opportunistic and Other Infections and the Impact of Antiretroviral Therapy Among HIV-infected Children in Low- and Middle-income Countries: A Systematic Review and Meta-analysis

    Science.gov (United States)

    B-Lajoie, Marie-Renée; Drouin, Olivier; Bartlett, Gillian; Nguyen, Quynh; Low, Andrea; Gavriilidis, Georgios; Easterbrook, Philippa; Muhe, Lulu

    2016-01-01

    Background. We conducted a systematic review and meta-analysis to evaluate the incidence and prevalence of 14 opportunistic infections (OIs) and other infections as well as the impact of antiretroviral therapy (ART) among human immunodeficiency virus (HIV)–infected children (aged Literatura Latino Americana em Ciências da Saúde databases. Summary incident risk (IR) and prevalent risk for each OI in ART-naive and ART-exposed children were calculated, and unadjusted odds ratios calculated for impact of ART. The number of OI cases and associated costs averted were estimated using the AIDS impact model. Results. We identified 4542 citations, and 88 studies were included, comprising 55 679 HIV-infected children. Bacterial pneumonia and tuberculosis were the most common incident and prevalent infections in both ART-naive and ART-exposed children. There was a significant reduction in IR with ART for the majority of OIs. There was a smaller impact on bacterial sepsis and pneumonia, and an increase observed for varicella zoster. ART initiation based on 2010 World Health Organization guidelines criteria for ART initiation in children was estimated to potentially avert >161 000 OIs (2013 UNAIDS data) with estimated cost savings of at least US$17 million per year. Conclusions. There is a decrease in the risk of most OIs with ART use in HIV-infected children in LMICs, and estimated large potential cost savings in OIs averted with ART use, although there are greater uncertainties in pediatric data compared with that of adults. PMID:27001796

  12. Obstetric fistula in low-resource countries: an under-valued and under-studied problem ? systematic review of its incidence, prevalence, and association with stillbirth

    OpenAIRE

    Cowgill, Karen D.; Bishop, Jennifer; Norgaard, Amanda K.; Rubens, Craig E.; Gravett, Michael G.

    2015-01-01

    Background Obstetric fistula (OF) is a serious consequence of prolonged, obstructed labor in settings where emergency obstetric care is limited, but there are few reliable, population-based estimates of the rate of OF. Stillbirth (SB) is another serious consequence of prolonged, obstructed labor, yet the frequency of SB in women with OF is poorly described. Here, we review these data. Methods We searched electronic databases and grey literature for articles on OF in low-resource countries pub...

  13. The incidence of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by microsurgical clipping versus endovascular coiling: a systematic review

    OpenAIRE

    Qing-guo LIU; Zhi-bin SONG; Jian-wei GAO; Xu-guang LI; Yun-li WU; Long WANG; Bing GUO

    2016-01-01

    Objective To systematically review the risk of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by microsurgical clipping versus endovascular coiling.  Methods A comprehensive literature search from January 1990 to September 2015 was conducted in electronic databases, such as PubMed, EMBASE/SCOPUS, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI) and Wanfang data, for randomized controlled trials (R...

  14. Federal databases

    International Nuclear Information System (INIS)

    Welch, M.J.; Welles, B.W.

    1988-01-01

    Accident statistics on all modes of transportation are available as risk assessment analytical tools through several federal agencies. This paper reports on the examination of the accident databases by personal contact with the federal staff responsible for administration of the database programs. This activity, sponsored by the Department of Energy through Sandia National Laboratories, is an overview of the national accident data on highway, rail, air, and marine shipping. For each mode, the definition or reporting requirements of an accident are determined and the method of entering the accident data into the database is established. Availability of the database to others, ease of access, costs, and who to contact were prime questions to each of the database program managers. Additionally, how the agency uses the accident data was of major interest

  15. A Review of Published Articles in the Field of Biomedical Nanotechnology in Medline Database during 2000-2010

    OpenAIRE

    Peyman Sheikhzade

    2015-01-01

    Background and objectives : Nanotechnology is a new technology which is increasingly used over the past decade. Due to its great significance, governments are tending to invest greatly on the research and development on nanotechnology in various sectors and aspects. The purpose of this study was to determine the status of biomedical nanotechnology publications over the past ten years (2010-2000) in Medline/ PubMed. Material and Methods : This was a descriptive study. The Medline database wa...

  16. review of the archaeological evidence for food plants from the British Isles: an example of the use of the Archaeobotanical Computer Database (ABCD

    Directory of Open Access Journals (Sweden)

    Philippa Tomlinson

    1996-09-01

    Full Text Available The Archaeobotanical Computer Database is an electronic compilation of information about remains of plants from archaeological deposits throughout the British Isles. For the first time, this wealth of published data, much of it post-dating Godwin's (1975 History of the British Flora has been brought together in a form in which the user can explore the history of a particular species or group of plants, or investigate the flora and vegetation of a particular archaeological period or part of the British Isles. The database contains information about the sites, deposits and samples from which the remains in question have been recovered, together with details of the plant parts identified and their mode of preservation. It also provides some interpretative guidance concerning the integrity of contexts and the reliability of dating as an aid to judging the quality of the data available. In this paper the compilers of the ABCD make use of the database in order to review the archaeological evidence for food plants in the British Isles. The paper begins with a definition of its scope, examining the concept of a "food plant" and the taphonomy of plant remains on British archaeological sites. It then summarises the principal changes in food plants from the prehistoric period to post-medieval times. The body of the paper is a detailed discussion of the evidence for the use of berries, other fruits, vegetables, pulses, herbs and flavourings, oil plants, cereals and nuts. Finally, the paper compares the archaeological evidence with that known from documentary sources. Readers will be able to view the archaeological evidence as distribution maps and will be able to explore aspects of the database online, enabling queries by taxa, site or worker. Instructions on obtaining electronic copies of the database tables and registering as an ABCD user are also included.

  17. Review of 130 years of research on cyanobacteria in aquatic ecosystems in Serbia presented in a Serbian Cyanobacterial Database

    Directory of Open Access Journals (Sweden)

    Zorica Svirčev

    2017-05-01

    Full Text Available The presence of toxic cyanobacteria in aquatic ecosystems in the territory of the Republic of Serbia was surveyed over a period of several decades. Increasing attention is being paid to some negative consequences that may be caused by these microorganisms. Information from available literary sources regarding the distribution and frequency of cyanobacteria and their toxins over a period of 130 years, together with the effects on humans and wildlife in aquatic ecosystems, were gathered and incorporated into a Serbian Cyanobacterial Database created for the CYANOCOST Action. This database encompasses information on 65 aquatic ecosystems, including rivers, lakes, ponds, canals, irrigation reservoirs, reservoirs used for drinking water supply and reservoirs used for other purposes. Cyanobacterial blooms were found in almost 80% of the investigated aquatic ecosystems. The analysis of the research showed the presence of more than 70 species, including blooms of 24 species from 13 genera. Five species of cyanobacteria: Microcystis aeruginosa, Aphanizomenon flos-aquae, Planktothrix agardhii, Microcystis flos-aquae and Planktothrix rubescens frequently formed blooms in the investigated waterbodies and cyanotoxins were also detected in some of them, which had certain negative effects. Here, we present an overview of data contained in the Serbian Cyanobacterial Database, concerning cyanobacterial distribution, cyanotoxin production and associated biological effects in different types of water bodies from the Republic of Serbia. Also, recent important and major cases of cyanobacterial blooming in reservoirs used for drinking water supply: at Vrutci and Ćelije, the Aleksandrovac irrigation reservoir, the Ponjavica River and Lake Palić, including systematic research on the Lake Ludoš and few fishponds are further described. It can be concluded that cyanobacteria and cyanotoxins are omnipresent in different water bodies throughout the Republic of Serbia

  18. HIV and Hepatitis B and C incidence rates in US correctional populations and high risk groups: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Hook Edward W

    2010-12-01

    Full Text Available Abstract Background High Human Immunodeficiency Virus (HIV prevalence and high risk behaviors have been well documented within United States (US correctional systems. However, uncertainty remains regarding the extent to which placing people in prison or jail increases their risk of HIV infection, and regarding which inmate populations experience an increased incidence of HIV. Describing these dynamics more clearly is essential to understanding how inmates and former detainees may be a source for further spread of HIV to the general US population. Methods The authors conducted a systematic review and meta-analysis of studies describing HIV incidence in US correctional facility residents and, for comparison, in high risk groups for HIV infection, such as non-incarcerated intravenous drug users (IVDU and men who have sex with men (MSM in the US. HIV incidence rates were further compared with Hepatitis B and Hepatitis C Virus rates in these same populations. Results Thirty-six predominantly prospective cohort studies were included. Across all infection outcomes, continuously incarcerated inmates and treatment recruited IVDU showed the lowest incidence, while MSM and street recruited IVDU showed the highest. HIV incidence was highest among inmates released and re-incarcerated. Possible sources of heterogeneity identified among HIV studies were risk population and race. Conclusions Although important literature gaps were found, current evidence suggests that policies and interventions for HIV prevention in correctional populations should prioritize curtailing risk of infection during the post-release period. Future research should evaluate HIV incidence rates in inmate populations, accounting for proportion of high risk sub-groups.

  19. Review of events occurring during the transport of radioactive material for the period 1984-1993. A report on the IAEA's EVTRAM database

    International Nuclear Information System (INIS)

    1997-09-01

    In 1988 the International Atomic Energy Agency initiated data collecting activities for accidents and incidents (EVTRAM), shipments (SHIPTRAM) and radiation exposure (EXTRAM) in connection with radioactive material transport. This publication reports on the data made available for the EVTRAM database by ten Member States regarding events occurring during the transport of radioactive material during the period 1984-1993. The main objectives of the EVATRAM database are to provide information to support evaluations of the effectiveness of the IAEA's Regulations for the Safe Transport of Radioactive Material and provide a means of information exchange for any lessons learned. Member States providing data do so on a voluntary basis an report only those events that involve the safety features of packages being transported. The tables presented in this report are based solely on the data provided regarding 128 valid cases. Where it is meaningful to relate frequency tables this has been done in the section containing cross-tabulations; otherwise, the frequency tables are to be considered individually. Because it is neither complete nor comprehensive the data has severely limited uses for establishing trends or drawing conclusions. The statistical analyses performed are to be considered only in this light. Neither the data nor the tables may be cited as the basis for general, conclusive statements about radioactive material transport events. 4 refs, 5 tabs

  20. Investigating the Link between self-citation and authors’ co-incidence with journal impact factors in Iran: Case study of Economic Journals indexed in Islamic Science Citation Database

    Directory of Open Access Journals (Sweden)

    Hashem Attapour

    2010-03-01

    Full Text Available   The present paper examines the links between self-citation and authors’ co-incidence with impact factors of economic journals indexed in ISC. It is essentially a scientometric research employing citation analysis and literature survey. Data was collected by querying ISC and leafing through the journals studied. Self-citation, authors’ co-incidence and impact factor of the journal studied formed the variables. Correlation analysis indicated that there is a significance between authors’ self-citations and co-incidence with impact factor of the journals studied. Significance was also found between authors’ co-incidence and self-citation of the journals studied.

  1. Database Replication

    CERN Document Server

    Kemme, Bettina

    2010-01-01

    Database replication is widely used for fault-tolerance, scalability and performance. The failure of one database replica does not stop the system from working as available replicas can take over the tasks of the failed replica. Scalability can be achieved by distributing the load across all replicas, and adding new replicas should the load increase. Finally, database replication can provide fast local access, even if clients are geographically distributed clients, if data copies are located close to clients. Despite its advantages, replication is not a straightforward technique to apply, and

  2. Refactoring databases evolutionary database design

    CERN Document Server

    Ambler, Scott W

    2006-01-01

    Refactoring has proven its value in a wide range of development projects–helping software professionals improve system designs, maintainability, extensibility, and performance. Now, for the first time, leading agile methodologist Scott Ambler and renowned consultant Pramodkumar Sadalage introduce powerful refactoring techniques specifically designed for database systems. Ambler and Sadalage demonstrate how small changes to table structures, data, stored procedures, and triggers can significantly enhance virtually any database design–without changing semantics. You’ll learn how to evolve database schemas in step with source code–and become far more effective in projects relying on iterative, agile methodologies. This comprehensive guide and reference helps you overcome the practical obstacles to refactoring real-world databases by covering every fundamental concept underlying database refactoring. Using start-to-finish examples, the authors walk you through refactoring simple standalone databas...

  3. Directory of IAEA databases

    International Nuclear Information System (INIS)

    1992-12-01

    This second edition of the Directory of IAEA Databases has been prepared within the Division of Scientific and Technical Information (NESI). Its main objective is to describe the computerized information sources available to staff members. This directory contains all databases produced at the IAEA, including databases stored on the mainframe, LAN's and PC's. All IAEA Division Directors have been requested to register the existence of their databases with NESI. For the second edition database owners were requested to review the existing entries for their databases and answer four additional questions. The four additional questions concerned the type of database (e.g. Bibliographic, Text, Statistical etc.), the category of database (e.g. Administrative, Nuclear Data etc.), the available documentation and the type of media used for distribution. In the individual entries on the following pages the answers to the first two questions (type and category) is always listed, but the answers to the second two questions (documentation and media) is only listed when information has been made available

  4. Dealer Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The dealer reporting databases contain the primary data reported by federally permitted seafood dealers in the northeast. Electronic reporting was implemented May 1,...

  5. RDD Databases

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This database was established to oversee documents issued in support of fishery research activities including experimental fishing permits (EFP), letters of...

  6. Snowstorm Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Snowstorm Database is a collection of over 500 snowstorms dating back to 1900 and updated operationally. Only storms having large areas of heavy snowfall (10-20...

  7. National database

    DEFF Research Database (Denmark)

    Kristensen, Helen Grundtvig; Stjernø, Henrik

    1995-01-01

    Artikel om national database for sygeplejeforskning oprettet på Dansk Institut for Sundheds- og Sygeplejeforskning. Det er målet med databasen at samle viden om forsknings- og udviklingsaktiviteter inden for sygeplejen.......Artikel om national database for sygeplejeforskning oprettet på Dansk Institut for Sundheds- og Sygeplejeforskning. Det er målet med databasen at samle viden om forsknings- og udviklingsaktiviteter inden for sygeplejen....

  8. Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study

    NARCIS (Netherlands)

    Gaal, S.; Verstappen, W.H.J.M.; Wolters, R.J.; Lankveld, H.; Weel, C. van; Wensing, M.J.P.

    2011-01-01

    BACKGROUND: Patient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to

  9. Impacto do sistema de aspiração traqueal aberto e fechado na incidência de pneumonia associada à ventilação mecânica: revisão de literatura Impact of the open and closed tracheal suctioning system on the incidence of mechanical ventilation associated pneumonia: literature review

    Directory of Open Access Journals (Sweden)

    Fernanda Maia Lopes

    2009-03-01

    systems on the incidence of ventilation-associated pneumonia. A search in the Pubmed database was performed to identify randomized controlled trials, published from 1990 to November 2008. Nine studies were included. Of the studies reviewed, seven did not disclose any significant advantages of using the closed system when compared to th e open, whereas two reported that use of the closed system increased colonization rates but not incidence of ventilation-associated pneumonia and one observed that use of the closed system did not increase colonization of the respiratory tract but reduced the spread of infection resulting in decreased sepsis rates. Only two studies found a reduction in the incidence of ventilation-associated pneumonia with use of the closed system, and one revealed a 3.5 times greater risk of developing this infection with the open system. Results suggest that the impact of the open and closed tracheal suction system is similar on development of ventilation-associated pneumonia, choice of the suction system should therefore be based on other parameters. While the closed system increases risk of colonization of the respiratory tract, but has the advantages of continuing mechanical ventilation and lessening hemodynamic impairment.

  10. Risk factors for radiotherapy incidents and impact of an online electronic reporting system

    International Nuclear Information System (INIS)

    Chang, David W.; Cheetham, Lynn; Marvelde, Luc te; Bressel, Mathias; Kron, Tomas; Gill, Suki; Tai, Keen Hun; Ball, David; Rose, William; Silva, Linas; Foroudi, Farshad

    2014-01-01

    Background and purpose: To ascertain the rate, type, significance, trends and the potential risk factors associated with radiotherapy incidents in a large academic department. Materials and methods: Data for all radiotherapy activities from July 2001 to January 2011 were reviewed from radiotherapy incident reporting forms. Patient and treatment data were obtained from the radiotherapy record and verification database (MOSAIQ) and the patient database (HOSPRO). Logistic regression analyses were performed to determine variables associated with radiotherapy incidents. Results: In that time, 65,376 courses of radiotherapy were delivered with a reported incident rate of 2.64 per 100 courses. The rate of incidents per course increased (1.96 per 100 courses to 3.52 per 100 courses, p < 0.001) whereas the proportion of reported incidents resulting in >5% deviation in dose (10.50 to 2.75%, p < 0.001) had decreased after the introduction of an online electronic reporting system. The following variables were associated with an increased rate of incidents: afternoon treatment time, paediatric patients, males, inpatients, palliative plans, head-and-neck, skin, sarcoma and haematological malignancies. In general, complex plans were associated with higher incidence rates. Conclusion: Radiotherapy incidents were infrequent and most did not result in significant dose deviation. A number of risk factors were identified and these could be used to highlight high-risk cases in the future. Introduction of an online electronic reporting system resulted in a significant increase in the number of incidents being reported

  11. Identifying the incidence of rash, Stevens-Johnson syndrome and toxic epidermal necrolysis in patients taking lamotrigine: a systematic review of 122 randomized controlled trials.

    Science.gov (United States)

    Bloom, Romi; Amber, Kyle T

    2017-01-01

    Lamotrigine is an antiepileptic drug used for the treatment of epilepsy, bipolar disorder and numerous off-label uses. The development of rash significantly affects its use. The most concerning of these adverse reactions is Stevens-Johnson syndrome/toxic epidermal necrolysis. We performed a systematic review of randomized controlled trials using lamotrigine as a monotherapy to quantify the incidence of cutaneous reactions, particularly Stevens-Johnson syndrome/toxic epidermal necrolysis. Of a total of 4,364 papers regarding lamotrigine, 122 studies met our inclusion and exclusion criteria. In total, 18,698 patients were included with 1,570 (8.3%) of patients experiencing an adverse dermatologic reaction. The incidence of Stevens-Johnson syndrome/toxic epidermal necrolysis was 0.04%.

  12. Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

    Directory of Open Access Journals (Sweden)

    Greenblatt JM

    2011-09-01

    Full Text Available James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a referenced electroencephalographic (EEG database analysis to help guide medication selection.Method: We examined 33 charts for patients with the primary psychiatric diagnosis of an eating disorder and comorbid major depressive disorder or bipolar disorder who underwent a quantitative EEG database assessment to provide additional information for choices of medication. The current analysis includes data from 22 subjects who accepted treatments based on information from the referenced-EEG medication database. Hamilton Depression Rating Scale, Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and hospitalization data were examined for these patients.Results: Patients whose EEG data was used for clinical treatment reported significant decreases in associated depressive symptoms (HDRS scores, overall severity of illness (Clinical Global Impression-Severity, and overall clinical global improvement (Clinical Global Impression-Improvement. This cohort also reported fewer inpatient, residential, and partial hospitalization program days following referenced-EEG compared with the two-year period prior to treatment.Conclusion: These findings are consistent with previously reported data for patients with eating disorders and suggest the need for future studies using EEG data correlated with those from other patients with similar quantitative EEG features.Keywords: eating disorders, anorexia, bulimia, depression, referenced-EEG, chart review

  13. Panic disorder and incident coronary heart disease: a systematic review and meta-regression in 1131612 persons and 58111 cardiac events.

    Science.gov (United States)

    Tully, P J; Turnbull, D A; Beltrame, J; Horowitz, J; Cosh, S; Baumeister, H; Wittert, G A

    2015-10-01

    Substantial healthcare resources are devoted to panic disorder (PD) and coronary heart disease (CHD); however, the association between these conditions remains controversial. Our objective was to conduct a systematic review of studies assessing the association between PD, related syndromes, and incident CHD. Relevant studies were retrieved from Medline, EMBASE, SCOPUS and PsycINFO without restrictions from inception to January 2015 supplemented with hand-searching. We included studies that reported hazard ratios (HR) or sufficient data to calculate the risk ratio and 95% confidence interval (CI) which were pooled using a random-effects model. Studies utilizing self-reported CHD were ineligible. Twelve studies were included comprising 1 131 612 persons and 58 111 incident CHD cases. PD was associated with the primary incident CHD endpoint [adjusted HR (aHR) 1.47, 95% CI 1.24-1.74, p < 0.00001] even after excluding angina (aHR 1.49, 95% CI 1.22-1.81, p < 0.00001). High to moderate quality evidence suggested an association with incident major adverse cardiac events (MACE; aHR 1.40, 95% CI 1.16-1.69, p = 0.0004) and myocardial infarction (aHR 1.36, 95% CI 1.12-1.66, p = 0.002). The risk for CHD was significant after excluding depression (aHR 1.64, 95% CI 1.45-1.85) and after depression adjustment (aHR 1.38, 95% CI 1.03-1.87). Age, sex, length of follow-up, socioeconomic status and diabetes were sources of heterogeneity in the primary endpoint. Meta-analysis showed that PD was independently associated with incident CHD, myocardial infarction and MACE; however, reverse causality cannot be ruled out and there was evidence of heterogeneity.

  14. Experiment Databases

    Science.gov (United States)

    Vanschoren, Joaquin; Blockeel, Hendrik

    Next to running machine learning algorithms based on inductive queries, much can be learned by immediately querying the combined results of many prior studies. Indeed, all around the globe, thousands of machine learning experiments are being executed on a daily basis, generating a constant stream of empirical information on machine learning techniques. While the information contained in these experiments might have many uses beyond their original intent, results are typically described very concisely in papers and discarded afterwards. If we properly store and organize these results in central databases, they can be immediately reused for further analysis, thus boosting future research. In this chapter, we propose the use of experiment databases: databases designed to collect all the necessary details of these experiments, and to intelligently organize them in online repositories to enable fast and thorough analysis of a myriad of collected results. They constitute an additional, queriable source of empirical meta-data based on principled descriptions of algorithm executions, without reimplementing the algorithms in an inductive database. As such, they engender a very dynamic, collaborative approach to experimentation, in which experiments can be freely shared, linked together, and immediately reused by researchers all over the world. They can be set up for personal use, to share results within a lab or to create open, community-wide repositories. Here, we provide a high-level overview of their design, and use an existing experiment database to answer various interesting research questions about machine learning algorithms and to verify a number of recent studies.

  15. Etiology of Fall-Related Injuries in the Army: Review of Narrative Incident Reports, January to December 2011

    Science.gov (United States)

    2015-12-01

    Processing System (DCIPS). These data are routinely collected for casualty tracking and mortuary affairs for various deployment operations and...evacuation, and casualty tracking databases to elicit a more complete picture of documented Army Active Duty personnel fall, slip, and trip injuries...privately operated vehicles (POVs), bicycles (not used for sports/training), and other/unspecified. Public Health Report No. S.0032427 18 6 Results

  16. Serum Uric Acid Increases Risk of Cancer Incidence and Mortality: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Shushan Yan

    2015-01-01

    Full Text Available SUA is a potent antioxidant and thus may play a protective role against cancer. Many epidemiological studies have investigated this hypothesis but provided inconsistent and inconclusive findings. We aimed to precisely elucidate the association between SUA levels and cancer by pooling all available publications. Totally, 5 independent studies with 456,053 subjects and 12 with 632,472 subjects were identified after a comprehensive literature screening from PubMed, Embase, and Web of Science. The pooled RRs showed that individuals with high SUA levels were at an increased risk of total cancer incidence (RR=1.03, 95% CI 1.01–1.05, P=0.007. Positive association between high SUA levels and total cancer incidence was observed in males but not females (for men: RR=1.05, 95% CI 1.02–1.08, P=0.002; for women, RR=1.01, 95% CI 0.98–1.04, P=0.512. Besides, high SUA levels were associated with an elevated risk of total cancer mortality (RR=1.17, 95% CI 1.04–1.32, P=0.010, particularly in females (RR=1.25, 95% CI 1.07–1.45, P=0.004. The study suggests that high SUA levels increase the risk of total cancer incidence and mortality. The data do not support the hypothesis of a protective role of SUA in cancer.

  17. Solubility Database

    Science.gov (United States)

    SRD 106 IUPAC-NIST Solubility Database (Web, free access)   These solubilities are compiled from 18 volumes (Click here for List) of the International Union for Pure and Applied Chemistry(IUPAC)-NIST Solubility Data Series. The database includes liquid-liquid, solid-liquid, and gas-liquid systems. Typical solvents and solutes include water, seawater, heavy water, inorganic compounds, and a variety of organic compounds such as hydrocarbons, halogenated hydrocarbons, alcohols, acids, esters and nitrogen compounds. There are over 67,500 solubility measurements and over 1800 references.

  18. Database and Expert Systems Applications

    DEFF Research Database (Denmark)

    Viborg Andersen, Kim; Debenham, John; Wagner, Roland

    submissions. The papers are organized in topical sections on workflow automation, database queries, data classification and recommendation systems, information retrieval in multimedia databases, Web applications, implementational aspects of databases, multimedia databases, XML processing, security, XML......This book constitutes the refereed proceedings of the 16th International Conference on Database and Expert Systems Applications, DEXA 2005, held in Copenhagen, Denmark, in August 2005.The 92 revised full papers presented together with 2 invited papers were carefully reviewed and selected from 390...... schemata, query evaluation, semantic processing, information retrieval, temporal and spatial databases, querying XML, organisational aspects of databases, natural language processing, ontologies, Web data extraction, semantic Web, data stream management, data extraction, distributed database systems...

  19. Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 1. rationale, methods and database description.

    Science.gov (United States)

    Perry, Henry B; Rassekh, Bahie M; Gupta, Sundeep; Wilhelm, Jess; Freeman, Paul A

    2017-06-01

    Community-based primary health care (CBPHC) is an approach used by health programs to extend preventive and curative health services beyond health facilities into communities and even down to households. Evidence of the effectiveness of CBPHC in improving maternal, neonatal and child health (MNCH) has been summarized by others, but our review gives particular attention to not only the effectiveness of specific interventions but also their delivery strategies at the community level along with their equity effects. This is the first article in a series that summarizes and analyzes the assessments of programs, projects, and research studies (referred to collectively as projects) that used CBPHC to improve MNCH in low- and middle-income countries. The review addresses the following questions: (1) What kinds of projects were implemented? (2) What were the outcomes of these projects? (3) What kinds of implementation strategies were used? (4) What are the implications of these findings? 12 166 reports were identified through a search of articles in the National Library of Medicine database (PubMed). In addition, reports in the gray literature (available online but not published in a peer-reviewed journal) were also reviewed. Reports that describe the implementation of one or more community-based interventions or an integrated project in which an assessment of the effectiveness of the project was carried out qualified for inclusion in the review. Outcome measures that qualified for inclusion in the review were population-based indicators that defined some aspect of health status: changes in population coverage of evidence-based interventions or changes in serious morbidity, in nutritional status, or in mortality. 700 assessments qualified for inclusion in the review. Two independent reviewers completed a data extraction form for each assessment. A third reviewer compared the two data extraction forms and resolved any differences. The maternal interventions assessed

  20. Trends in incidence, survival, and management of uveal melanoma: a population-based study of 7,516 patients from the Surveillance, Epidemiology, and End Results database (1973–2012

    Directory of Open Access Journals (Sweden)

    Mahendraraj K

    2016-10-01

    Full Text Available Krishnaraj Mahendraraj,1 Christine SM Lau,1,2 Injoon Lee,2 Ronald S Chamberlain1–3 1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; 2St George’s University School of Medicine, Grenada, West Indies; 3Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA Introduction: Uveal melanoma (UM is the most common primary intraocular malignancy, despite comprising <5% of all melanomas. To date, relatively few case series of UM have been published. Moreover, the factors influencing survival remain largely unknown. This study sought to analyze the impact of demographics, histology, clinical presentation, and treatments on the clinical outcomes of UM in a large modern nationwide patient cohort.Methods: Demographics and clinical data were abstracted on 277,120 histologically confirmed melanoma patients from the Surveillance, Epidemiology, and End Results database between 1973 and 2012.Results: A total of 7,516 cases of UM represented 3.2% of all recorded cases of melanoma. The mean age-adjusted incidence was 5.1 per million (95% CI 4.2–6.1 and was higher in males (5.9, CI =4.4–7.6 compared to females (4.5, CI =3.3–5.8, P<0.001. UM occurred most commonly in the sixth decade of life (61.4±15 and among Caucasians (94.7%. A total of 52.3% of cases were reported in the Western US (35.7% in California. The initial diagnoses in 65.2% of cases were by histopathology, followed by clinical diagnosis (18.8% and radiographic imaging (16.0%. The percentage of UM cases managed by surgery alone decreased by 69.4% between the 1973–1977 and 2006–2012 time periods, concomitant with a 62% increase in primary radiotherapy, P<0.001. The UM mean overall and cancer-specific 5-year relative survival rates were 79.8%±5.8% and 76%±5.3%, respectively. The mean 5-year cancer-specific survival rate (76% remained stable during the study period between 1973 and 2012. The mean survival for patients treated with

  1. Skin cancer in the military: a systematic review of melanoma and non-melanoma skin cancer incidence, prevention, and screening among active duty and veteran personnel.

    Science.gov (United States)

    Riemenschneider, Kelsie; Liu, Jesse; Powers, Jennifer G

    2017-12-29

    Occupational sun exposure is a well-studied risk factor for skin cancer development, but more work is needed to assess melanoma and non-melanoma skin cancer risk among U.S. military personnel to improve education and screening efforts in this population. To conduct an extensive review of skin cancer risks for U.S. military personnel to inform preventative education, diagnosis, and treatment efforts to better protect these individuals from future skin cancer development. A systematic review of published studies on the subject of melanoma and non-melanoma skin cancer in military personnel was conducted. Nine studies describing skin cancer incidence in the United States military were identified, with four studies specific to melanoma. The study findings reveal an increased risk of melanoma associated with service in the military or prisoner of war status. Service in tropical environments was associated with an increased incidence of both melanoma and non-melanoma skin cancer among World War II soldiers. Two studies found that increased melanoma risk was also branch-dependent, with the highest rates among the United States Air Force (USAF) branch. Several of the reviewed studies implicated increased sun exposure during military service and lack of sufficient sun protection as the causes of higher rates of skin cancer among U.S. military and veteran populations as compared to the non-military population in the US. The reviewed articles have variable results; a prospective randomized controlled trial would be helpful to develop interventions that mitigate skin cancer risk in the U.S. military. This review identifies an abundance of evidence for an increased risk of skin cancer development among U.S. active duty and veteran populations. Copyright © 2017. Published by Elsevier Inc.

  2. Identifying gaps for research prioritisation: Global burden of external causes of injury as reflected in the Cochrane Database of Systematic Reviews.

    Science.gov (United States)

    Karimkhani, Chante; Trikha, Ritika; Aksut, Baran; Jones, Trevor; Boyers, Lindsay N; Schlichte, Megan; Pederson, Hannah; Okland, Tyler; DiGuiseppi, Carolyn; Nasser, Mona; Naghavi, Mohsen; Vos, Theo; Yoong, Sze Lin; Wolfenden, Luke; Murray, Christopher J L; Dellavalle, Robert P

    2016-05-01

    Burden of disease should impact research prioritisation. To analyse the Cochrane Database of Systematic Reviews (CDSR) and determine whether systematic reviews and protocols accurately represent disease burden, as measured by disability-adjusted life years (DALYs) from the Global Burden of Disease (GBD) 2010 Study. Two investigators collected GBD disability metrics for 12 external causes of injury in the GBD 2010 Study. These external causes were then assessed for systematic review and protocol representation in CDSR. Data was collected during the month of April 2015. There were no study participants aside from the researchers. Percentage of total 2010 DALYs, 2010 DALY rank, and median DALY percent change from 1990 to 2010 of the 12 external causes of injury were compared with CDSR representation of systematic reviews and protocols. Data were analysed for correlation using Spearman rank correlation. Eleven of the 12 causes were represented by at least one systematic review or protocol in CDSR; the category collective violence and legal intervention had no representation in CDSR. Correlation testing revealed a strong positive correlation that was statistically significant. Representation of road injury; interpersonal violence; fire, heat, and hot substances; mechanical forces; poisonings, adverse effect of medical treatment, and animal contact was well aligned with respect to DALY. Representation of falls was greater compared to DALY, while self-harm, exposure to forces of nature, and other transport injury representation was lower compared to DALY. CDSR representation of external causes of injury strongly correlates with disease burden. The number of systematic reviews and protocols was well aligned for seven out of 12 causes of injury. These results provide high-quality and transparent data that may guide future prioritisation decisions. Published by Elsevier Ltd.

  3. Searching the Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) database improves systematic reviews.

    Science.gov (United States)

    Clark, Otavio Augusto Camara; Castro, Aldemar Araujo

    2002-02-01

    An unbiased systematic review (SR) should analyse as many articles as possible in order to provide the best evidence available. However, many SR use only databases with high English-language content as sources for articles. Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) indexes 670 journals from the Latin American and Caribbean health literature but is seldom used in these SR. Our objective is to evaluate if LILACS should be used as a routine source of articles for SR. First we identified SR published in 1997 in five medical journals with a high impact factor. Then we searched LILACS for articles that could match the inclusion criteria of these SR. We also checked if the authors had already identified these articles located in LILACS. In all, 64 SR were identified. Two had already searched LILACS and were excluded. In 39 of 62 (63%) SR a LILACS search identified articles that matched the inclusion criteria. In 5 (8%) our search was inconclusive and in 18 (29%) no articles were found in LILACS. Therefore, in 71% (44/72) of cases, a LILACS search could have been useful to the authors. This proportion remains the same if we consider only the 37 SR that performed a meta-analysis. In only one case had the article identified in LILACS already been located elsewhere by the authors' strategy. LILACS is an under-explored and unique source of articles whose use can improve the quality of systematic reviews. This database should be used as a routine source to identify studies for systematic reviews.

  4. Antibiotic distribution channels in Thailand: results of key-informant interviews, reviews of drug regulations and database searches.

    Science.gov (United States)

    Sommanustweechai, Angkana; Chanvatik, Sunicha; Sermsinsiri, Varavoot; Sivilaikul, Somsajee; Patcharanarumol, Walaiporn; Yeung, Shunmay; Tangcharoensathien, Viroj

    2018-02-01

    To analyse how antibiotics are imported, manufactured, distributed and regulated in Thailand. We gathered information, on antibiotic distribution in Thailand, in in-depth interviews - with 43 key informants from farms, health facilities, pharmaceutical and animal feed industries, private pharmacies and regulators- and in database and literature searches. In 2016-2017, licensed antibiotic distribution in Thailand involves over 700 importers and about 24 000 distributors - e.g. retail pharmacies and wholesalers. Thailand imports antibiotics and active pharmaceutical ingredients. There is no system for monitoring the distribution of active ingredients, some of which are used directly on farms, without being processed. Most antibiotics can be bought from pharmacies, for home or farm use, without a prescription. Although the 1987 Drug Act classified most antibiotics as "dangerous drugs", it only classified a few of them as prescription-only medicines and placed no restrictions on the quantities of antibiotics that could be sold to any individual. Pharmacists working in pharmacies are covered by some of the Act's regulations, but the quality of their dispensing and prescribing appears to be largely reliant on their competences. In Thailand, most antibiotics are easily and widely available from retail pharmacies, without a prescription. If the inappropriate use of active pharmaceutical ingredients and antibiotics is to be reduced, we need to reclassify and restrict access to certain antibiotics and to develop systems to audit the dispensing of antibiotics in the retail sector and track the movements of active ingredients.

  5. Use of a German longitudinal prescription database (LRx) in pharmacoepidemiology

    Science.gov (United States)

    Richter, Hartmut; Dombrowski, Silvia; Hamer, Hajo; Hadji, Peyman; Kostev, Karel

    2015-01-01

    Large epidemiological databases are often used to examine matters pertaining to drug utilization, health services, and drug safety. The major strength of such databases is that they include large sample sizes, which allow precise estimates to be made. The IMS® LRx database has in recent years been used as a data source for epidemiological research. The aim of this paper is to review a number of recent studies published with the aid of this database and compare these with the results of similar studies using independent data published in the literature. In spite of being somewhat limited to studies for which comparative independent results were available, it was possible to include a wide range of possible uses of the LRx database in a variety of therapeutic fields: prevalence/incidence rate determination (diabetes, epilepsy), persistence analyses (diabetes, osteoporosis), use of comedication (diabetes), drug utilization (G-CSF market) and treatment costs (diabetes, G-CSF market). In general, the results of the LRx studies were found to be clearly in line with previously published reports. In some cases, noticeable discrepancies between the LRx results and the literature data were found (e.g. prevalence in epilepsy, persistence in osteoporosis) and these were discussed and possible reasons presented. Overall, it was concluded that the IMS® LRx database forms a suitable database for pharmacoepidemiological studies. PMID:26339224

  6. Use of a German longitudinal prescription database (LRx in pharmacoepidemiology

    Directory of Open Access Journals (Sweden)

    Richter, Hartmut

    2015-08-01

    Full Text Available Large epidemiological databases are often used to examine