Woodward, Michael Clifford; Woodward, Erin
There is limited information describing memory clinics at a national level in Australia. The aim of this study was to gather information about the resourcing, practices and clinical diagnoses of Australian memory clinics. A postal survey was sent to all Australian memory clinics identified by key specialists working in dementia assessment services. Of 23 surveys sent out, 14 were returned. Most clinics are located in Victoria where they receive Victorian state funding. The average clinic has 1.67 effective full time clinical staff including 0.42 medical staff, 0.24 allied health staff, 0.53 clinical nursing staff and 0.48 psychologists. Clinics are open on average twice a week and each half-day clinic has two new and three review patients, seeing new patients twice initially then once more over 12 months. Patients wait 10 weeks for initial assessment with 59% referred by general practitioners. The Mini-mental State Examination and clock drawing are utilized universally. The most common diagnoses are Alzheimer's disease (37.8%) and mild cognitive impairment (19.8%) but 6.9% of patients have no cognitive impairment. This survey has provided useful benchmarking data on Australian memory clinics which can also be used by other countries for comparative analyses.
Mason, David G; Shotton, Hannah; Wilkinson, Kathleen A; Gough, Michael J; Alleway, Robert; Freeth, Heather; Mason, Marisa
To survey clinical practice and opinions of consultant surgeons and anaesthetists caring for children to inform the needs for training, commissioning and management of children's surgery in the UK. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) hosted an online survey to gather data on current clinical practice of UK consultant surgeons and anaesthetists caring for children. The questionnaire was circulated to all hospitals and to Anaesthetic and Surgical Royal Colleges, and relevant specialist societies covering the UK and the Channel Islands and was mainly completed by consultants in District General Hospitals. 555 surgeons and 1561 anaesthetists completed the questionnaire. 32.6% of surgeons and 43.5% of anaesthetists considered that there were deficiencies in their hospital's facilities that potentially compromised delivery of a safe children's surgical service. Almost 10% of all consultants considered that their postgraduate training was insufficient for current paediatric practice and 20% felt that recent Continued Professional Development failed to maintain paediatric expertise. 45.4% of surgeons and 39.2% of anaesthetists considered that the current specialty curriculum should have a larger paediatric component. Consultants in non-specialist paediatric centres were prepared to care for younger children admitted for surgery as emergencies than those admitted electively. Many of the surgeons and anaesthetists had consultant surgeons and anaesthetists providing a competent surgical service for children. Postgraduate curricula must meet the needs of trainees who will be expected to include children in their caseload as consultants. Trusts must ensure appropriate support for consultants to maintain paediatric skills and provide the necessary facilities for a high-quality local surgical service.
Full Text Available Objective. To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia. Methods. Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires. Results. Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard – the systematic reviews of The Cochrane Collaboration – were used less frequently (n=12; 57% than advertising materials from pharmaceutical companies (n=16; 76%. Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project. Conclusion. The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice.
Tilburt, Jon C; Curlin, Farr A; Kaptchuk, Ted J; Clarridge, Brian; Bolcic-Jankovic, Dragana; Emanuel, Ezekiel J; Miller, Franklin G
Little is known about whether federally funded complementary and alternative medicine (CAM) research is translating into clinical practice. We sought to describe the awareness of CAM clinical trials, the ability to interpret research results, the acceptance of research evidence, and the predictors of trial awareness among US clinicians. We conducted a cross-sectional mailed survey of 2400 practicing US acupuncturists, naturopaths, internists, and rheumatologists. A total of 1561 clinicians (65%) responded. Of the respondents, 59% were aware of at least 1 major CAM clinical trial; only 23% were aware of both trials. A minority of acupuncturists (20%), naturopaths (25%), internists (17%), and rheumatologists (33%) were "very confident" in interpreting research results (P research experience (OR, 1.45 [95% CI, 1.13-1.86]), institutional or academic practice setting (ORs, 1.98 [95% CI, 1.01-3.91], and 1.23 [95% CI, 0.73-2.09], respectively), and rating randomized trials as "very useful" (OR, 1.46 [95% CI, 1.12-1.91]) (P clinical decision making were positively associated with CAM trial awareness. Acupuncturists, naturopaths, and internists (ORs, 0.15 [95% CI, 0.10-0.23], 0.15 [95% CI, 0.09-0.24], and 0.18 [95% CI, 0.12-0.28], respectively) were all similarly less aware of CAM trial results compared with rheumatologists. For clinical research in CAM to achieve its social value, concerted efforts must be undertaken to train clinicians and improve the dissemination of research results.
Moon, Woo Kyung; Kim, Tae Jung; Cha, Joo Hee
The goal of this study was to survey the overall quality of mammographic images in Korea. A total of 598 mammographic images collected from 257 hospitals nationwide were reviewed in terms of eight images quality categories, namely positioning, compression, contrast, exposure, sharpness, noise, artifacts, and examination identification, and rated on a five-point scale: (1=severe deficiency, 2=major deficiency, 3=minor deficiency, 4=good, 5=best). Failure was defined as the occurrence of more than four major deficiencies or one severe deficiency (score of 1 or 2). The results were compared among hospitals of varying kinds, and common problems in clinical images quality were identified. Two hundred and seventeen mammographic images (36.3%) failed the evaluation. Poor images were found in descending order of frequency, at The Society for Medical Examination (33/69, 47.8%), non-radiologyclinics (42/88, 47.7%), general hospitals (92/216, 42.6%), radiology clinics (39/102, 38.2%), and university hospitals (11/123, 8.9%) (p<0.01, Chi-square test). Among the 598 images, serious problems which occurred were related to positioning in 23.7% of instances (n=142) (p<0.01, Chi-square test), examination identification in 5.7% (n=34), exposure in 5.4% (n=32), contrast in 4.2% (n=25), sharpness in 2.7% (n=16), compression in 2.5% (n=15), artifacts in 2.5% (n=15), and noise in 0.3% (n=2). This study showed that in Korea, 36.3% of the mammograms examined in this sampling had important image-related defects that might have led to serious errors in patient management. The failure rate was significantly higher in non-radiology clinics and at The Society for Medical Examination than at university hospitals
Hughes, Jan N.; Benson, A. Jerry
Although many school psychology programs use university-based clinics as field placements for school psychology students, there is little information in the literature on how these clinics are organized, administered, and funded or on the nature, duration, and sequencing of clinic field experiences. A national telephone survey of 71 directors of…
Choudhury, Sirazum M; Williams, Emma L; Barnes, Sophie C; Alaghband-Zadeh, Jamshid; Tan, Tricia M; Cegla, Jaimini
Background Using an online survey, we collected data to present a picture of how clinical authorization is performed in the UK. Methods A 21-question survey was uploaded to www.surveymonkey.com , and responses were invited via the mail base of the Association for Clinical Biochemistry and Laboratory Medicine. The questionnaire examined the intensity and function of the duty biochemist role and how different types of authorization are used to handle and release results. Results Of 70 responses received, 60 were suitable for analysis. Responses were received from every region of the UK. A typical duty biochemist shift started on average at 8:50, and finished at 17:25. The mean duration was 8 h 58 min. Clinical scientists are the most abundantly represented group on duty biochemist rotas. Higher banded clinical scientists and chemical pathologists covered out-of-hours shifts. Results were handled differently depending on the level of abnormality and the requesting area. Normal results tended to be released either directly from the analyser or after technical then autoauthorization (90%). A greater preference for clinical authorization was seen for abnormal and critical results originating from outpatients (49% and 69%, respectively) or general practice (51% and 71%) than for inpatients (33% and 53%) or A&E (25% and 37%). Conclusions The handling and authorization of biochemistry results varies greatly between laboratories. The role is clearly heterogeneous in the UK. Guidance from the Association for Clinical Biochemistry and Royal College of Pathologists may help to clarify the essential roles of the duty biochemist.
Cahill, Suzanne; Pierce, Maria; Moore, Vanessa
This national survey investigates the location, resourcing, staff composition, treatments, waiting time, and numbers of patients attending memory clinics (MCs) in the Republic of Ireland. It also explores Directors' attitudes to future service development including their views about the advantages and disadvantages of quality standards for MCs. An audio-taped telephone interview was conducted with the Directors. A total of 14 MCs were identified across the Republic of Ireland, ten of which are hospital-based and most of which offer diagnostic services and are located in Dublin. Nine MCs are medical consultant led and operate under the direction of either Old Age Psychiatrists or Geriatricians. Results show wide variation regarding the location, team size, service availability, and numbers of patients attending. The average number of patients attending in 2011 was 126. Only six clinics employ dedicated Allied Health Professionals. Less than half of the clinics are research active. Whilst most Directors welcomed the availability of national standards, several expressed concern that standards might, in the absence of funding, result in the closure of the most poorly resourced services. This survey provides valuable data on the main characteristics of all of the 14 MCs delivering services in the Republic of Ireland and raises critical and fundamental questions about the goals and outcomes of MC services. The survey data collected can be used by other countries for cross-national comparison.
Brown, Allen W; Watanabe, Thomas K; Hoffman, Jeanne M; Bell, Kathleen R; Lucas, Sylvia; Dikmen, Sureyya
Individuals with headache after traumatic brain injury (TBI) receive care in a wide variety of clinical locations by physicians trained in multiple specialties. To understand current practice patterns and perceptions of treatment issues among clinicians managing headache after TBI. National survey of current clinical practice using a 20-item questionnaire developed by the authors. Survey respondents were members of the Central Nervous System Council list survey of the American Academy of Physical Medicine and Rehabilitation (N = 1782) and the American Headache Society membership (N = 1260). The survey was sent electronically to potential participants and was followed by 2 biweekly reminders. The survey queried the physicians' clinical setting; their use of headache classification systems, headache diaries, checklists, and diagnostic procedures; the pharmacologic and nonpharmacologic treatments prescribed; and headache chronicity and associated symptoms and disorders among their patients with TBI. Completed surveys were received from 193 respondents. The use of standardized classification systems and checklists was commonly reported. Respondents used nonpharmacologic and pharmacologic treatment approaches with similar frequency and modest perceived success rates. A high frequency of headache-associated new sleep and mood disorders was reported. When response differences occurred between practice settings, they reflected a focus on headache diagnosis, classification, and pharmacologic treatment among neurology and specialty headache clinics, whereas a nonpharmacologic approach to management among TBI specialty and general rehabilitation clinicians was more commonly reported. Management strategies for treating headache after TBI vary widely among general and specialty clinical practices. This suggests that additional research is needed that would lead to an increase in the use of established headache classification and the development of standardized management
EPA reports information on the condition of our nation's waters using probabilistic surveys. The National Aquatic Resource Surveys assess the status of and changes in water quality of the nation's coastal waters, lakes, rivers and streams, and wetlands.
Gong, Yanping; Adeli, Khosrow
Notification of critical values to clinical staff is an important post-analytical process in all acute care clinical laboratories. No data are available however on how laboratories obtain or establish critical values, particularly in pediatric settings. This study was designed to examine and compare critical values used for pediatric patients in biochemistry laboratories in Canada and assess potential interlaboratory variability. Fourteen clinical laboratories, including two in pediatric hospitals and twelve in hospitals caring for both children and adults, participated in a survey that included 14 pre-selected STAT chemistry tests and 19 pre-selected therapeutic drug monitoring (TDM) tests. Among fourteen chemistry tests, good agreement was observed for critical values used for sodium and pH at both low and high levels within 14 participant laboratories. Significant interlaboratory variability existed for glucose critical values at the high end, magnesium at high end, and PO2 at the low end. For 19 TDM tests, the majority of laboratories did not have alert values to report values over the therapeutic level but not toxic. For critical values greater than the toxic range, significant variability existed at both trough and peak levels among laboratories surveyed. When asked to provide the source for critical values established at each site, only a limited number of laboratories identified their sources as either internal decision or published references. Although all laboratories have established and routinely use critical values to alert clinical staff, considerable variability exists in both the critical limits reported as well as the source of such values. There is a clear need for new national efforts to standardize pediatric critical value reporting and establish evidence-based critical limits for all medical laboratories across Canada.
U.S. Department of Health & Human Services — The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...
Payne, Thomas J; Chen, Chieh-I; Baker, Christine L; Shah, Sonali N; Pashos, Chris L; Boulanger, Luke
Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use. PsycINFO Database Record (c) 2012 APA, all rights reserved.
Full Text Available Abstract Background Suicide prevention by mental health services requires an awareness of the antecedents of suicide amongst high risk groups such as psychiatric in-patients. The goal of this study was to describe the social and clinical characteristics of people who had absconded from an in-patient psychiatric ward prior to suicide, including aspects of the clinical care they received. Methods We carried out a national clinical survey based on a 10-year (1997-2006 sample of people in England and Wales who had died by suicide. Detailed data were collected on those who had been in contact with mental health services in the year before death. Results There were 1,851 cases of suicide by current psychiatric in-patients, 14% of all patient suicides. 1,292 (70% occurred off the ward. Four hundred and sixty-nine of these patients died after absconding from the ward, representing 25% of all in-patient suicides and 38% of those that occurred off the ward. Absconding suicides were characterised by being young, unemployed and homeless compared to those who were off the ward with staff agreement. Schizophrenia was the most common diagnosis, and rates of previous violence and substance misuse were high. Absconders were proportionally more likely than in-patients on agreed leave to have been legally detained for treatment, non-compliant with medication, and to have died in the first week of admission. Whilst absconding patients were significantly more likely to have been under a high level of observation, clinicians reported more problems in observation due to either the ward design or other patients on the ward. Conclusion Measures that may prevent absconding and subsequent suicide amongst in-patients might include tighter control of ward exits, and more intensive observation of patients, particularly in the early days of admission. Improving the ward environment to provide a supportive and less intimidating experience may contribute to reduced risk.
Full Text Available Abstract Background There has been little systematic research about the extent to which German physicians accept or reject the concept and practice of a clinical practice guidelines (CPG and b evidence based medicine (EBM The aim of this study was to investigate German office-based physicians' perspective on CPGs and EBM and their application in medical practice. Methods Structured national telephone survey of ambulatory care physicians, four thematic blocks with 21 questions (5 point Likert scale. 511 office-based general practitioners and specialists. Main outcome measures were the application of Clinical Practice Guidelines in daily practice, preference for sources of guidelines and degree of knowledge and acceptance of EBM. In the data analysis Pearson's correlation coefficient was used for explorative analysis of correlations. The comparison of groups was performed by Student's t-test. Chi2 test was used to investigate distribution of two or more categorical variables. Results Of the total study population 55.3% of physicians reported already using guidelines in the treatment of patients. Physicians in group practices (GrP as well as general practitioners (GP agreed significantly more with the usefulness of guidelines as a basis for patient care than doctors in single practices (SP or specialists (S (Student's t-test mean GP 2.57, S 2.84, p Conclusion Despite a majority of physicians accepting and applying CPGs a large group remains that is critical and opposed to the utilization of CPGs in daily practice and to the concept of EBM in general. Doctors in single practice and specialists appear to be more critical than physicians in group practices and GPs. Future research is needed to evaluate the willingness to acquire necessary knowledge and skills for the promotion and routine application of CPGs.
Perera-Diltz, Dilani M.; Mason, Kimberly L.
Supervision is vital for personal and professional development of counselors. Practicing school counselors (n = 1557) across the nation were surveyed to explore current supervision practices. Results indicated that 41.1% of school counselors provide supervision. Although 89% receive some type of supervision, only 10.3% of school counselors receive…
C. Scott Hultman, MD, MBA, FACS; Cindy Wu, MD; Michael L. Bentz, MD; Richard J. Redett, MD; R. Bruce Shack, MD; Lisa R. David, MD; Peter J. Taub, MD; Jeffrey E. Janis, MD
Introduction: Resident aesthetic clinics (RACs) have demonstrated good outcomes and acceptable patient satisfaction, but few studies have evaluated their educational, financial, or medicolegal components. We sought to determine RAC best practices. Methods: We surveyed American Council of Academic Plastic Surgeon members (n = 399), focusing on operational details, resident supervision, patient safety, medicolegal history, financial viability, and research opportunities. Of the 96 respondent...
Lefeubvre, C; Viallard, M-L; Schell, M
The need for educational training of healthcare professionals in palliative care is an important issue. Training and practice of pediatric residents in the field of pediatric palliative care (PPC) has never been assessed, although the organization of the medical curriculum in France is currently being revised. This study presents a national survey of pediatric residents, using a computerized anonymous questionnaire. Four different areas were studied: epidemiological data, theoretical and practical knowledge, education, and clinical experience in PPC. The response rate was 39% (n=365/927). Whatever their age or regional location, 25% of residents did not know any details of the French law concerning patients' rights and the end of life. Experience with PPC starts very early since 77% of the first-year pediatric residents experienced at least one child in a palliative care and/or end-of-life situation. During their entire residency, 87% of the residents had experience with PPC and nearly all (96%) end-of-life care. Furthermore, 76% had participated in announcing palliative care (cancer, ICU, etc.) or a serious illness, and 45% had met and discussed with bereaved parents. Furthermore, while 97% of the pediatric residents received training in adult palliative care, mainly before their residency, only 60% received specific PPC training. Ninety-six percent of all French pediatric residents encountered a PPC situation during their residency. That 77% of them had experienced PPC during their first year of residency shows the importance of early training in PPC for pediatric residents. Furthermore, this study points out that there is a significant lack in PPC training since 40% of all residents in the study received no specific PPC training. Progress in education remains insufficient in the dissemination of knowledge on the legal framework and concepts of palliative medicine: while the medical curriculum is being revised, we suggest that training in medical ethics and PPC
Su Jin Shin
Full Text Available Purpose The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. Methods This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. Results First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees’ ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses’ work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. Conclusion In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.
Full Text Available Background: The goals of care for patients with chronic kidney disease (CKD are to delay progression to end stage renal disease, reduce complications, and to ensure timely transition to dialysis or transplantation, while optimizing independence. Recent guidelines recommend that multidisciplinary team based care should be available to patients with CKD. While most provinces fund CKD care, the specific models by which these outcomes are achieved are not known. Funding for clinics is hospital or program based. Objectives: To describe the structure and function of clinics in order to understand the current models of care, inform best practice and potentially standardize models of care. Design: Prospective cross sectional observational survey study. Setting, Patients/Participants: Canadian nephrology programs in all provinces. Methods and Measurements: Using an open-ended semi-structured questionnaire, we surveyed 71 of 84 multidisciplinary adult CKD clinics across Canada, by telephone and with written semi-structured questionnaires; (June 2012 to November 2013. Standardized introductory scripts were used, in both English and French. Results: CKD clinic structure and models of care vary significantly across Canada. Large variation exists in staffing ratios (Nephrologist, dieticians, pharmacists and nurses to patients, and in referral criteria. Dialysis initiation decisions were usually made by MDs. The majority of clinics (57% had a consistent model of care (the same Nephrologist and nurse per patient, while others had patients seeing a different nephrologist and nurses at each clinic visit. Targets for various modality choices varied, as did access to those modalities. No patient or provider educational tools describing the optimal time to start dialysis exist in any of the clinics. Limitations: The surveys rely on self reporting without validation from independent sources, and there was limited involvement of Quebec clinics. These are relative
Laidlaw, Anita; Salisbury, Helen; Doherty, Eva M; Wiskin, Connie
All medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools. The survey was sent via e-mail to communication leads who then were asked to consult with all staff within their medical school involved in the assessment of communication. Results were obtained from 27 out of 33 schools (response rate 82%) and a total of 34 courses. The average number of assessments per year was 2.4 (minimum 0, maximum 10). The Objective Structured Clinical Exam (OSCE) was the most commonly used method of assessment (53%). Other assessments included MCQ and workplace based assessments. Only nine courses used a single method of assessment. Issues raised included, logistics and costs of assessing mainly by OSCE, the robustness and reliability of such exams and integration with other clinical skills. It is encouraging that a variety of assessment methods are being used within UK medical schools and that these methods target different components of clinical communication skills acquisition.
Wang, Wei; Zhong, Kun; Yuan, Shuai; He, Falin; Du, Yuxuan; Hu, Zhehui; Wang, Zhiguo
This survey was initiated to obtain knowledge on the current situation of internal quality control (IQC) practice for tumour markers (TMs) in China. Additionally, we tried to acquire the most appropriate quality specifications. This survey was a current status survey. The IQC information had been collected via online questionnaires. All of 1821 clinical laboratories which participated in the 2016 TMs external quality assessment (EQA) programme had been enrolled. The imprecision evaluation criteria were the minimal, desirable, and optimal allowable imprecisions based on biological variations, and 1/3 total allowable error (TEa) and 1/4 TEa. A total of 1628 laboratories answered the questionnaires (89%). The coefficients of variation (CVs) of the IQC of participant laboratories varied greatly from 1% (5 th percentile) to 13% (95 th percentile). More than 82% (82 - 91%) of participant laboratories two types of CVs met 1/3 TEa except for CA 19-9. The percentiles of current CVs were smaller than cumulative CVs. A number of 1240 laboratories (76%) reported their principles and systems used. The electrochemiluminescence was the most used principle (45%) and had the smallest CVs. The performance of laboratories for TMs IQC has yet to be improved. On the basis of the obtained results, 1/3 TEa would be realistic and attainable quality specification for TMs IQC for clinical laboratories in China.
Jagadeesan, Vikrant S. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Raleigh, David R. [Department of Radiation Oncology, School of Medicine, University of California–San Francisco, San Francisco, California (United States); Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Golden, Daniel W., E-mail: email@example.com [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States)
Purpose: Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. Methods and Materials: An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results: The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank–sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43). Conclusions: Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These
Jagadeesan, Vikrant S.; Raleigh, David R.; Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J.; Golden, Daniel W.
Purpose: Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. Methods and Materials: An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results: The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank–sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43). Conclusions: Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These results
U.S. Department of Health & Human Services — The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States...
The National Nursing Home Survey provides includes characteristics such as size of nursing home facilities, ownership, Medicare/Medicaid certification, occupancy rate, number of days of care provided, and expenses.
Wu, Cindy; Bentz, Michael L.; Redett, Richard J.; Shack, R. Bruce; David, Lisa R.; Taub, Peter J.; Janis, Jeffrey E.
Introduction: Resident aesthetic clinics (RACs) have demonstrated good outcomes and acceptable patient satisfaction, but few studies have evaluated their educational, financial, or medicolegal components. We sought to determine RAC best practices. Methods: We surveyed American Council of Academic Plastic Surgeon members (n = 399), focusing on operational details, resident supervision, patient safety, medicolegal history, financial viability, and research opportunities. Of the 96 respondents, 63 reported having a RAC, and 56% of plastic surgery residency program directors responded. Results: RACs averaged 243 patient encounters and 53.9 procedures annually, having been in existence for 19.6 years (mean). Full-time faculty (73%) supervised chief residents (84%) in all aspects of care (65%). Of the 63 RACs, 45 were accredited, 40 had licensed procedural suites, 28 had inclusion/exclusion criteria, and 31 used anesthesiologists. Seventeen had overnight capability, and 17 had a Life Safety Plan. No cases of malignant hyperthermia occurred, but 1 facility death was reported. Sixteen RACs had been involved in a lawsuit, and 33 respondents reported financial viability of the RACs. Net revenue was transferred to both the residents’ educational fund (41%) and divisional/departmental overhead (37%). Quality measures included case logs (78%), morbidity/mortality conference (62%), resident surveys (52%), and patient satisfaction scores (46%). Of 63 respondents, 14 have presented or published RAC-specific research; 80 of 96 of those who were surveyed believed RACs enhanced education. Conclusions: RACs are an important component of plastic surgery education. Most clinics are financially viable but carry high malpractice risk and consume significant resources. Best practices, to maximize patient safety and optimize resident education, include use of accredited procedural rooms and direct faculty supervision of all components of care. PMID:26146599
Hultman, C Scott; Wu, Cindy; Bentz, Michael L; Redett, Richard J; Shack, R Bruce; David, Lisa R; Taub, Peter J; Janis, Jeffrey E
Resident aesthetic clinics (RACs) have demonstrated good outcomes and acceptable patient satisfaction, but few studies have evaluated their educational, financial, or medicolegal components. We sought to determine RAC best practices. We surveyed American Council of Academic Plastic Surgeon members (n = 399), focusing on operational details, resident supervision, patient safety, medicolegal history, financial viability, and research opportunities. Of the 96 respondents, 63 reported having a RAC, and 56% of plastic surgery residency program directors responded. RACs averaged 243 patient encounters and 53.9 procedures annually, having been in existence for 19.6 years (mean). Full-time faculty (73%) supervised chief residents (84%) in all aspects of care (65%). Of the 63 RACs, 45 were accredited, 40 had licensed procedural suites, 28 had inclusion/exclusion criteria, and 31 used anesthesiologists. Seventeen had overnight capability, and 17 had a Life Safety Plan. No cases of malignant hyperthermia occurred, but 1 facility death was reported. Sixteen RACs had been involved in a lawsuit, and 33 respondents reported financial viability of the RACs. Net revenue was transferred to both the residents' educational fund (41%) and divisional/departmental overhead (37%). Quality measures included case logs (78%), morbidity/mortality conference (62%), resident surveys (52%), and patient satisfaction scores (46%). Of 63 respondents, 14 have presented or published RAC-specific research; 80 of 96 of those who were surveyed believed RACs enhanced education. RACs are an important component of plastic surgery education. Most clinics are financially viable but carry high malpractice risk and consume significant resources. Best practices, to maximize patient safety and optimize resident education, include use of accredited procedural rooms and direct faculty supervision of all components of care.
Fitzgerald, J E F; Milburn, J A; Khera, G; Davies, R S M; Hornby, S T; Giddings, C E B
Fellowship posts are increasingly common and offer targeted opportunities for training and personal development. Despite international demand, there is little objective information quantifying this effect or the motivations behind undertaking such a post. The present study investigated surgical trainees' fellowship aims and intentions. An electronic, 38-item, self-administered questionnaire survey was distributed in the United Kingdom via national and regional surgical mailing lists and websites via the Association of Surgeons in Training, Royal Surgical Colleges, and Specialty Associations. In all, 1,581 fully completed surveys were received, and 1,365 were included in the analysis. These represented trainees in core or higher training programs or research from all specialties and training regions: 66 % were male; the mean age was 32 years; 77.6 % intended to or had already completed a fellowship. Plastic surgery (95.2 %) and cardiothoracic (88.6 %) trainees were most likely to undertake a fellowship, with pediatrics (51.2 %), and urology (54.3 %) the least likely. Fellowship uptake increased with seniority (p training does not deliver sufficient levels of competence and confidence merit further investigation.
Yang, Geliang; Lee, Richard; Zhang, Huiqing; Gu, Wei; Yang, Peiying; Ling, Changquan
It is common for cancer patients to use complementary and alternative medicine (CAM). This study was designed to explore China's oncologists' knowledge, attitudes and clinical practices regarding CAM use by their patients. An online survey was conducted of China's oncologists. Among 11,270 participants who completed the online survey, 6,007 (53.3%) were identified as oncologists. Most were men (75.2%), with a mean age of 33.4 (standard deviation: 6.5) years. The 6,007 oncologists discussed with 36.5% of their patients about CAM. Most of them (75.6%) did not want to initiate discussions due to lack of knowledge on CAM. Oncologists estimated that 40.0% of their patients used CAM treatments. Oncologists reported that 28.7% of their patients underwent anticancer therapy with the concurrent use of CAM. Four out of five of the responding oncologists self-reported inadequate knowledge and only 22.0% reported receiving professional education on CAM. Nearly half (44.9%) of the oncologists believed CAM treatment was effective for symptoms and treatment of cancer. Physician factors associated with initiating discussions with patients about CAM use included sex, age (≥ 33 years), medical license for traditional Chinese medicine, enough knowledge and professional education experience. China's oncologists infrequently discussed with their patients about CAM due to lack of knowledge. Most of the oncologists did not encourage CAM use.
Rencic, Joseph; Trowbridge, Robert L; Fagan, Mark; Szauter, Karen; Durning, Steven
Recent reports, including the Institute of Medicine's Improving Diagnosis in Health Care, highlight the pervasiveness and underappreciated harm of diagnostic error, and recommend enhancing health care professional education in diagnostic reasoning. However, little is known about clinical reasoning curricula at US medical schools. To describe clinical reasoning curricula at US medical schools and to determine the attitudes of internal medicine clerkship directors toward teaching of clinical reasoning. Cross-sectional multicenter study. US institutional members of the Clerkship Directors in Internal Medicine (CDIM). Examined responses to a survey that was emailed in May 2015 to CDIM institutional representatives, who reported on their medical school's clinical reasoning curriculum. The response rate was 74% (91/123). Most respondents reported that a structured curriculum in clinical reasoning should be taught in all phases of medical education, including the preclinical years (64/85; 75%), clinical clerkships (76/87; 87%), and the fourth year (75/88; 85%), and that more curricular time should be devoted to the topic. Respondents indicated that most students enter the clerkship with only poor (25/85; 29%) to fair (47/85; 55%) knowledge of key clinical reasoning concepts. Most institutions (52/91; 57%) surveyed lacked sessions dedicated to these topics. Lack of curricular time (59/67, 88%) and faculty expertise in teaching these concepts (53/76, 69%) were identified as barriers. Internal medicine clerkship directors believe that clinical reasoning should be taught throughout the 4 years of medical school, with the greatest emphasis in the clinical years. However, only a minority reported having teaching sessions devoted to clinical reasoning, citing a lack of curricular time and faculty expertise as the largest barriers. Our findings suggest that additional institutional and national resources should be dedicated to developing clinical reasoning curricula to improve
Zhang, Xiaoyan; Fei, Yang; Wang, Wei; Zhao, Haijian; Wang, Minqi; Chen, Bingquan; Zhou, Jie; Wang, Zhiguo
This survey was initiated to estimate the current status of turnaround time (TAT) monitoring of clinical biochemistry in China, provide baseline data for establishment of quality specifications and analyze the impact factors of TAT. 738 laboratories were included. Questionnaires involved general information and data of related indicators of TAT during 1 week were provided to participating laboratories. Nine quality indicators were covered, which were medians, 90th and outlier rates of pre-examination, examination, and post-examination TAT. The 25th percentile, median, and 75th percentile of TATs were calculated as optimum, desirable, and minimum quality specifications. Percentages and sigma values were used to describe the outlier rates. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of TAT. Response rate of this survey was 46.44%. More than 50% of the laboratories indicated they had set up target TATs in three time intervals and monitored TATs generally. The post-examination TAT of most laboratories was 0min, while the pre-examination and examination TAT varied. Sigma values of outlier rates for 45%~60% of laboratories were above 4, while 15%~20% of labs whose sigma values were below 3. Group comparisons suggested nurse or mechanical pipeline transportation, link laboratory information system with hospital information system, and using computer reporting instead of printing report were related to shorter TATs. Despite of the remarkable progresses of TATs in China, there was also room to improve. Laboratories should strengthen the construction of information systems, identify reasons for TAT delay to improve the service quality continuously. © 2017 Wiley Periodicals, Inc.
St Lawrence, Janet S; Montaño, Daniel E; Kasprzyk, Danuta; Phillips, William R; Armstrong, Keira; Leichliter, Jami S
This study presents results from a national survey of US physicians that assessed screening, case reporting, partner management, and clinical practices for syphilis, gonorrhea, chlamydia, and HIV infection. Surveys were mailed to a random sample of 7300 physicians to assess screening, testing, reporting, and partner notification for syphilis, gonorrhea, chlamydia, and HIV. Fewer than one third of physicians routinely screened men or women (pregnant or nonpregnant) for STDs. Case reporting was lowest for chlamydia (37 percent), intermediate for gonorrhea (44 percent), and higher for syphilis, HIV, and AIDS (53 percent-57 percent). Physicians instructed patients to notify their partners (82 percent-89 percent) or the health department (25 percent-34 percent) rather than doing so themselves. STD screening levels are well below practice guidelines for women and virtually nonexistent for men. Case reporting levels are below those legally mandated; physicians rely instead on patients for partner notification. Health departments must increase collaboration with private physicians to improve the quality of STD care.
Kahwaji, I Y; Connuck, D M; Tafari, N; Dahdah, N S
In 1994, the American Heart Association (AHA) published the most recent guidelines for long-term cardiovascular management of Kawasaki disease. Since then, recent publications have shed new light on different diagnostic, prognostic, and management issues. We sought the opinion of pediatric cardiologists practicing in U.S. fellowship programs on the subject by means of a multiple-choice survey. Two questions addressed therapy in the acute phase, each preceded by a statement from related literature. Ten duplicate questions addressed the long-term cardiovascular management in five sets of paired questions; each question was first given in reminiscence of a clinical situation and then preceded by a statement from particular publications representative of new information that has become available since the publication of the 1994 AHA guidelines. All questions were provided in the same mailing. Replies were received from 97 participants practicing at 29 institutions. For the acute illness, 21% of respondents do not use high-dose aspirin, and 50% support reassessment of current guidelines. Universal intravenous immune globulin (IVIG) administration is followed by 97%, among whom 20% agree that evaluation of selection criteria is needed. For long-term management, 60-75% advocate regular follow-up of risk level I patients, and 80% favor periodic follow-up, with stress imaging (34-40%), for risk level II. For risk level IV more respondents favor stress echocardiography as opposed to nuclear imaging, in consonance with recent literature. For risk levels III and IV, 36-40% perform coronary angiography on a regular basis, whereas 60% do so when coronary symptoms are present or when stress imaging suggests myocardial ischemia. Finally, 19-25% of respondents do not routinely advise healthy lifestyle to patients free of coronary artery lesions. In conclusion, the guidelines for conventional therapy in the acute phase and long-term cardiovascular management need to be revised.
Kim, Hyun; Bar Ad, Voichita; McAna, John; Dicker, Adam P
The yearly radiation oncology in-training examination (ITE) by the American College of Radiology is a widely used, norm-referenced educational assessment, with high test reliability and psychometric performance. We distributed a national survey to evaluate the academic radiation oncology community's perception of the ITE. In June 2014, a 7-question online survey was distributed via e-mail to current radiation oncology residents, program directors, and attending physicians who had completed residency in the past 5 years or junior attendings. Survey questions were designed on a 5-point Likert scale. Sign test was performed with P ≤ .05 considered statistically different from neutral. Thirty-one program directors (33.3%), 114 junior attendings (35.4%), and 225 residents (41.2%) responded. Junior attendings and program directors reported that the ITE directly contributed to their preparation for the American Board of Radiology written certification (P = .050 and .004, respectively). Residents did not perceive the examination as an accurate assessment of relevant clinical and scientific knowledge (P quality assurance is insufficient in its current form (P quality assurance and clinical relevance in the ITE. Although the current examination allows limited feedback, establishing a venue for individualized feedback may allow continual and timely improvement of the ITE. Adopting a criterion-referenced examination may further increase resident investment in and utilization of this valuable learning tool. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.
Sterlin, Delphine; Velasco, Guillaume; Moshous, Despina; Touzot, Fabien; Mahlaoui, Nizar; Fischer, Alain; Suarez, Felipe; Francastel, Claire; Picard, Capucine
Autosomal recessive deficiencies of DNMT3B or ZBTB24 account for two-thirds of cases of immunodeficiency, centromeric instability and facial dysmorphism (ICF syndrome). This primary immunodeficiency (PID) is characterized mainly by an antibody deficiency, facial abnormalities and centromeric instability. We analyzed the national cohort of patients with ICF syndrome with the aim of providing a more detailed description of the phenotype and management of patients with ICF syndrome. Demographic, genetic, immunological, and clinical features were recorded for each patient. In the French cohort, seven of the nine patients carried DNMT3B mutations, six of which had never been described before. One patient had compound heterozygous ZBTB24 mutations. All patients were found to lack CD19(+)CD27(+) memory B cells. This feature is a major diagnostic criterion for both ICF1 and ICF2. Patients suffered both bacterial and viral infections, and three patients developed bronchiectasis. Autoimmune manifestations (hepatitis, nephritis and thyroiditis) not previously reported in ICF1 patients were also detected in two of our ICF1 patients. The mode of treatment and outcome of the French patients are reported, by genetic defect, and compared with those for 68 previously reported ICF patients. Immunoglobulin (Ig) replacement treatment was administered to all nine French patients. One ICF1 patient presented severe autoimmune manifestations and pancytopenia and underwent allogeneic hematopoietic stem cell transplantation (HSCT), but she died from unknown causes 6 years post-transplant. Autoimmune signs are uncommon in ICF syndrome, but, when present, they affect patient outcome and require immunosuppressive treatment. The long-term outcome of ICF patients has been improved by the combination of IgG replacement and antibiotic prophylaxis.
Kim, Do Yeun; Lee, Yun Gyoo; Kim, Bong-Seog
This study was conducted to investigate the current role of medical oncologists in cancer care with a focus on increasing the recognition of medical oncology as an independent specialty. Questionnaires modified from the Medical Oncology Status in Europe Survey dealing with oncology structure, resources, research, and patterns of care given by medical oncologists were selected. Several modifications were made to the questionnaire after feedback from the insurance and policy committee of the Korean Association for Clinical Oncology (KACO). The online survey was then sent to KACO members. A total of 214 medical oncologists (45.8% of the total inquiries), including 71 directors of medical oncology institutions, took the survey. Most institutions had various resources, including a medical oncology department (94.1%) and a department of radiation oncology (82.4%). There was an average of four medical oncologists at each institution. Medical oncologists were involved in various treatments from diagnosis to end-of-life care. They were also chemotherapy providers from a wide range of institutions that treated many types of solid cancers. In addition, 86.2% of the institutions conducted research. This is the first national survey in Korea to show that medical oncologists are involved in a wide range of cancer treatments and care. This survey emphasizes the contributions and proper roles of medical oncologists in the evolving health care environment in Korea.
Bickley, Harriet; Kapur, Navneet; Hunt, Isabelle M; Robinson, Jo; Meehan, Janet; Parsons, Rebecca; McCann, Kerry; Flynn, Sandra; Burns, James; Amos, Tim; Shaw, Jenny; Appleby, Louis
Suicide prevention is a health service priority. Homeless mental health patients present a challenge to services because of their complex health and social needs. To establish the numbers of homeless patients in contact with services who die by suicide; to describe their suicide methods and their social and clinical characteristics including aspects of clinical care. A national clinical survey based on a 4-year (1996-2000) sample of people in England and Wales who died by suicide. Detailed data were collected on those who had been in contact with mental health services in the year before death. A total of 131 individuals who died by suicide were reported to have been homeless at the time of death--3% of all suicides by psychiatric patients, over 30 per year. Hanging was the most common cause of death. The most frequent diagnosis was schizophrenia. Around half were in-patients at the time of death. Social and clinical risk factors for suicide were common, including drug and alcohol misuse, and recent suicidal ideas and behaviour. Despite this, their clinical care was characterised by disengagement from services as a result of missed contacts, self-discharge, lack of follow-up and lack of key worker. In order to reduce the number of deaths by suicide in those who are homeless and mentally ill, improvements in in-patient safety and engagement in the community are needed. This may be achieved through assertive community treatment, dual diagnosis services, and dedicated community mental health teams.
Lippi, Giuseppe; Ciaccio, Marcello; Giavarina, Davide
Digital libraries are typically used for retrieving and accessing articles in academic journals and repositories. Previous studies have been published about the performance of various biomedical research platforms, but no information is available about access preferences. A six-question survey was designed by the Italian Society of Clinical Biochemistry and Laboratory Medicine (SIBioC) using the platform Google Drive, and made available for 1 month to the members of the society. The information about the survey was published on the website of SIBioC and also disseminated by two sequential newsletters. Overall, 165 replies were collected throughout the 1-month survey availability. The largest number of replies were provided by laboratory professionals working in the national healthcare system (44.2%), followed by those working in private facilities (13.9%), university professors (12.7%) and specialization training staff (12.7%). The majority of responders published zero to one articles per year (55.2%), followed by two to five articles per year (37.6%), whereas only 7.3% published more than five articles per year. A total of 34.5% of the responders consulted biomedical research platforms on weekly basis, followed by 33.9% who did so on daily basis. PubMed/Medline was the most accessed scientific database, followed by Scopus, ISI Web of Science and Google Scholar. The impact factor was the leading reason when selecting which journal to publish in. The most consulted journals in the field of laboratory medicine were Clinical Chemistry and Laboratory Medicine and Biochimica Clinica. This survey provides useful indications about the personal inclination towards access to scientific information in our country.
Pring, Tim; Flood, Emma; Dodd, Barbara; Joffe, Victoria
Background: The majority of speech and language therapists (SLTs) work with children who have speech, language and communication needs. There is limited information about their working practices and clinical experience and their views of how changes to healthcare may impact upon their practice. Aims: To investigate the working practices and…
C. Scott Hultman, MD, MBA, FACS
Conclusions: RACs are an important component of plastic surgery education. Most clinics are financially viable but carry high malpractice risk and consume significant resources. Best practices, to maximize patient safety and optimize resident education, include use of accredited procedural rooms and direct faculty supervision of all components of care.
... Action Coalition AIM Vaccine Education Center 2012 National Immunization Survey Data Released Recommend on Facebook Tweet Share ... on this page kept for historical reasons. National Immunization Survey (NIS) – Children (19-35 months old) MMWR : ...
Kailainathan, Pungavi; Humble, Stephen; Dawson, Helen; Cameron, Fiona; Gokani, Shyam; Lidder, Gursimren
Inconsistencies in the availability and quality of pain service provision have been noted nationally, as have lengthy waiting times for appointments and lack of awareness of the Pain Clinic role. The 2013 NHS England report stated that specialist pain services must offer multispecialty and multidisciplinary pain clinics. This national survey of multidisciplinary pain service provision in the United Kingdom and Ireland provides a snapshot of pain service provision in order to review and highlight what variations exist in multidisciplinary team (MDT) provision and working patterns. A common perception among clinicians is that financial pressures have led to alternate ways of staff utilisation with variable degrees of success. The survey included 143 pain clinics, focusing principally on MDT working patterns, MDT composition and adoption of the extended role. The results identified that the majority of Pain Clinics utilise the MDT approach. However, provision of critical components such as regular MDT meetings is highly variable as is the composition of the MDT itself and also working patterns of the individual clinicians. The survey reports the successful use of the extended roles for specialist nurses in follow up clinics. In contrast, the survey highlights that a large proportion of clinicians surveyed have reservations about both the effectiveness and the safety of utilising specialist nurses in the extended role to see new referrals of complex pain patients to pain clinics. This survey underlines the essential requirement for incorporation of greater MDT working locally and nationally and allocation of appropriate resources to facilitate this.
Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva
To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.
Fitchett, George; Tartaglia, Alexander; Dodd-McCue, Diane; Murphy, Patricia
There is growing evidence that leaders in professional health care chaplaincy recognize the important role of research. The Standards of Practice recently approved by the Association of Professional Chaplains (APC), and especially the standard about research (Standard 12), provide strong evidence that the profession sees research, and research-literate chaplains, as important for its future. The aim of this study was to identify the extent to which Association for Clinical Pastoral Education, Inc (ACPE) accredited clinical pastoral education (CPE) residency programs are preparing their graduates to be the kind of research-literate chaplains described in these Standards. We interviewed CPE supervisors from 26 randomly-selected CPE residency programs. We found 12% of the programs had intentional and substantive research-related curricula, 27% of the programs offered some limited exposure to research, and 62% of the programs provided no education about research. We found also that supervisors often defined "research education" in terms of actually conducting research projects. CPE residency programs potentially play a central role in educating research-literate chaplains. Future research should examine the incentives and barriers that influence the inclusion of research education in CPE residency programs.
Full Text Available Background and Objective: Evidence supports the use of pulmonary rehabilitation in the treatment of chronic obstructive pulmonary disease (COPD patients both during acute exacerbation and at later stages. It is used in India; but, to date, there has been no study that has investigated the structure of pulmonary rehabilitation programs for COPD patients in India. The recent study aims to determine the current practice patterns of Indian Physiotherapists for COPD patients admitted in Intensive Care Units (ICUs and wards in terms of assessment and treatment. Materials and Methods: A questionnaire-based survey was conducted across India. Questionnaires were distributed to around 800 physiotherapists via E-mail. Physiotherapists with a Master Degree and a specialization in cardiopulmonary science or a minimum of 1 year of experience in treating cardiopulmonary patients were included. The questionnaires addressed assessment measures and treatment techniques given to COPD patients. Results: A total of 342 completed questionnaires were received, yielding a response rate of 43.8%, with a majority of responses from Karnataka, Maharashtra and Gujarat. The assessment and treatment techniques used were almost similar between ICUs and wards. More than 80% of the responders carried out the assessment of certain respiratory impairments in both ICUs and wards. An objective measure of dyspnea was taken by less than 40% of the responders, with little attention given to functional exercise capacity and health-related quality of life. Eighty-five percent of the responders used Dyspnea-relieving strategies and traditional airway clearance techniques in both ICUs and wards. Eighty-three percent of the responders were giving patients in the wards training for upper and lower extremity. Fifty percent were giving strength training in the wards. Conclusion: Whether patients are admitted in ICUs or Wards, the practice pattern adopted by Physiotherapists to treat them vary
Hanna, F W F; Peters, J R; Harlow, J; Jones, P W
There is no UK consensus for screening methodology, diagnosis and management of gestational diabetes mellitus (GDM). To evaluate routine practice for GDM management across the UK. Questionnaires were sent to all members of the Association of British Clinical Diabetologists. They were asked to describe how patients were screened for GDM, the diagnostic criteria and subsequent management and clinical targets. Centres that did not respond were followed up by personal communication. Variability trends within regions were assessed. The response rate averaged 46% nationally (35-67%). Most (85%) units hold a joint clinic, regardless of the size. Most (82%) centres routinely screen for GDM; half universally and half screening high risk pregnancies only. Screening tests, cut-off values, timings and subsequent action vary widely. The first screening test to be used varies, with 40% using glycosuria, followed by random plasma glucose (RPG)(28%), high risk features (11%) then FPG in 6%. Cut-off values for both random and plasma glucose as screening methods also vary. The 75 g oral glucose tolerance test (OGTT) is the most likely confirmatory test to be used if initial screening is positive; however, clinicians rely on different cut-off values and timing. Most (95%) centres routinely assess foetal growth. Postpartum screening is undertaken by 90%, using a 75 g OGTT (93%). Most (90%) centres counsel patients about their high risk for further GDM and type 2 diabetes mellitus. Variability trends in any of the responses could not be detected between different regions in the UK. Standards for GDM screening and management vary significantly across the UK. Although most centres utilize the 75 g OGTT to confirm the diagnosis, there is no consistency in its interpretation. This survey confirms the urgent need for consensus guideline development.
Narcolepsy is characterised by excessive daytime sleepiness and cataplexy and has a prevalence of 25 per 100,000. We suspect this is higher than presently seen in the Republic of Ireland. We aimed to calculate the Irish prevalence of Narcolepsy and to examine current management practices. We conducted an online survey of respiratory physicians, neurologists, paediatric neurologists, and psychiatrists with an interest in sleep disorders (73% response rate). Of this group, a total of 16 physicians managed 180 patients prior to January 2009. A clinical diagnosis alone was reached in 67 (41%) patients, the remainder by polysomnography or multiple sleep latency testing. No patients were diagnosed by cerebro-spinal fluid analysis of hypocretin levels. While 70 (42%) patients received modafanil, only 7 (4%) were treated with sodium oxybate. Even allowing for missing data it is apparent that Narcolepsy is hugely under-diagnosed in Ireland, however, current practises adhere with new international guidelines.
Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…
This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.
Background Since the introduction of bone-anchored hearing aids (BAHAs) in the 1980s, the practices of surgeons who implant these hearing aids have become varied; different indications and surgical techniques are utilized depending on the surgeon and institution. The objective of the current study is to describe the clinical and surgical practices of otolaryngologists in Canada who perform pediatric BAHA operations. Methods A detailed practice questionnaire was devised and sent to all members of the Canadian Society of Otolaryngology-Head and Neck Surgery. Those who performed pediatric BAHA surgeries were asked to participate. Results Twelve responses were received (response rate of 80%). All of the respondents identified congenital aural atresia to be an indication for pediatric BAHAs. Other indications were chronic otitis externa or media with hearing loss (92%), allergic reactions to conventional hearing aids (75%), congenital fixation or anomaly of ossicular chain (67%), and unilateral deafness (25%). Minor complications, such as skin reactions, were reported in 25% of cases, while major complications were very rare. There was great variability with regards to surgical techinque and post-operative management. The extent of financial support for the BAHA hardware and device also varied between provinces, and even within the same province. Conclusion There is a lack of general consensus regarding pediatric BAHA surgeries in Canada. With such a small community of otolaryngologists performing this procedure, we are hopeful that this survey can serve as an impetus for a national collaboration to establish a set of general management principles and inspire multi-site research ventures. PMID:23815797
Walitt, Brian; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick
Objectives Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-p...
U.S. Department of Health & Human Services — The National Survey of Family Growth (NSFG) gathers information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and men's and...
U.S. Department of Health & Human Services — 2013-2014. The National Adult Tobacco Survey (NATS) was created to assess the prevalence of tobacco use, as well as the factors promoting and impeding tobacco use...
U.S. Environmental Protection Agency — Surface water monitoring data from national aquatic surveys (lakes, streams, rivers). This dataset is associated with the following publication: Stoddard , J., J....
Schiekirka-Schwake, S; Anders, S; von Steinbüchel, N; Becker, J C; Raupach, T
Clinical teachers in medical schools are faced with the challenging task of delivering high-quality patient care, producing high-impact research and contributing to undergraduate medical education all at the same time. Little is known on the gap between an 'ideal' environment supporting clinical teachers to provide high quality teaching for their students and the reality of clinical teaching during worktime in the clinical environment. Most quantitative research published so far was done in a wide range of medical educators and did not consider individual academic qualifications. In this study, we wanted to survey clinical teachers in particular and assess the potential impact of individual academic qualification on their perceptions. Based on qualitative data of focus group discussions, we developed a questionnaire which was piloted among 189 clinical teachers. The final web-based questionnaire was completed by clinical teachers at nine German medical schools. A total of 833 clinical teachers (569 junior physicians, 264 assistant professors) participated in the online survey. According to participants, the most important indicator of high quality teaching was "sustained student learning outcome" followed by "stimulation of interest in the subject matter". Lack of time was the main factor impeding effective teaching (78%). Among the factors facilitating high-quality teaching, protected preparation time during working hours (48%) and more recognition of high-quality teaching within medical schools (21%) were perceived as most helpful. Three out of four teachers (76%) were interested in faculty development programmes directed at teaching skills, but 60% stated they had no time to engage in such activities. With regard to evaluation, teachers preferred individual feedback (75%) over global ratings (21%). Differences between assistant professors and junior physicians were found in that the latter group perceived their teaching conditions as more difficult. Lack of time
Williams, Robert L; Romney, Crystal; Kano, Miria; Wright, Randy; Skipper, Betty; Getrich, Christina M; Sussman, Andrew L; Zyzanski, Stephen J
Research suggests stereotyping by clinicians as one contributor to racial and gender-based health disparities. It is necessary to understand the origins of such biases before interventions can be developed to eliminate them. As a first step toward this understanding, we tested for the presence of bias in senior medical students. The purpose of the study was to determine whether bias based on race, gender, or socioeconomic status influenced clinical decision-making among medical students. We surveyed seniors at 84 medical schools, who were required to choose between two clinically equivalent management options for a set of cardiac patient vignettes. We examined variations in student recommendations based on patient race, gender, and socioeconomic status. The study included senior medical students. We investigated the percentage of students selecting cardiac procedural options for vignette patients, analyzed by patient race, gender, and socioeconomic status. Among 4,603 returned surveys, we found no evidence in the overall sample supporting racial or gender bias in student clinical decision-making. Students were slightly more likely to recommend cardiac procedural options for black (43.9 %) vs. white (42 %, p = .03) patients; there was no difference by patient gender. Patient socioeconomic status was the strongest predictor of student recommendations, with patients described as having the highest socioeconomic status most likely to receive procedural care recommendations (50.3 % vs. 43.2 % for those in the lowest socioeconomic status group, p socioeconomic status, geographic variations, and the influence of interactions between patient race and gender on student recommendations.
Montero, Javier; Bravo, Manuel; López-Valverde, Antonio; Llodra, Juan-Carlos
Pain and chewing difficulties have been identified as the strongest predictors of oral disadvantage. The aim of this study is to analyze and quantify the sociodemographic, behavioural and clinical factors modulating the oral pain and eating difficulties reported by Spanish adults and elderly Spanish people in the last National Oral Health Survey performed in 2010. Data concerning pain and chewing difficulties were acquired on a Likert‑scale format from a representative sample of the Spanish general population with ages between 35-44 years (n=391) and 65‑74 years (n=405). Risk factors were identified using bivariate analysis, after which the crude association between risk factors (sociodemographic, behavioural and clinical) and outcome variables (pain and eating problems) was assessed by adjusted odds ratios, calculated by means of multivariate logistic regression. Eating problems and oral pain were mainly associated with prosthetic and caries treatment needs as clinical predictors, but female sex was also seen to be a relevant and significant risk factor for suffering pain and eating restrictions. Paradoxically, after taking into account all the aforementioned predictors, the adults had an almost two‑fold higher risk of reporting pain or eating difficulties than the elderly subjects. In agreement with the results from the last national oral health survey, prosthetic and caries treatment needs should be considered key factors in determining the oral well‑being of the Spanish population. In sociodemographic terms, the women and adults were seen to be at a significantly higher risk of suffering pain and eating restrictions.
Mansfield Richard J
Full Text Available Abstract Background Although shoulder pain is a commonly encountered problem in primary care, there are few studies examining its presenting characteristics and clinical management in this setting. Methods We performed secondary data analysis of 692 office visits for shoulder pain collected through the National Ambulatory Medical Care Survey (Survey years 1993–2000. Information on demographic characteristics, history and place of injury, and clinical management (physician order of imaging, physiotherapy, and steroid intraarticular injection were examined. Results Shoulder pain was associated with an injury in one third (33.2% (230/692 of office visits in this population of US primary care physicians. Males, and younger adults (age ≤ 52 more often associated their shoulder pain with previous injury, but there were no racial differences in injury status. Injury-related shoulder pain was related to work in over one-fifth (21.3% (43/202 of visits. An x-ray was performed in 29.0% (164/566 of office visits, a finding that did not differ by gender, race, or by age status. Other imaging (CT scan, MRI, or ultrasound was infrequently performed (6.5%, 37/566. Physiotherapy was ordered in 23.9% (135/566 of visits for shoulder pain. Younger adults and patients with a history of injury more often had physiotherapy ordered, but there was no significant difference in the ordering of physiotherapy by gender or race. Examination of the use of intraarticular injection was not possible with this data set. Conclusion These data from the largest sample of patients with shoulder pain presenting to primary care settings offer insights into the presenting characteristics and clinical management of shoulder pain at the primary care level. The National Ambulatory Medical Care Survey is a useful resource for examining the clinical management of specific symptoms in U.S. primary care offices.
National Oceanic and Atmospheric Administration, Department of Commerce — The National Geodetic Survey (NGS), formerly part of the U.S. Coast and Geodetic Survey, has been performing Aeronautical surveys since the 1920's. NGS, in...
Vlaar, Alexander P J; Wortel, Kim; Binnekade, Jan M; van Oers, Marinus H J; Beckers, Erik; Gajic, Ognjen; Schultz, Marcus J; Juffermans, Nicole P
Transfusion-related acute lung injury (TRALI) is hypothesized to be a "two-hit" entity, in which an inflammatory condition (e.g., sepsis) predisposes to TRALI. TRALI is a clinical diagnosis. Disciplines involved in managing TRALI may differ in decision-making on the reporting of TRALI. A survey was conducted among critical care physicians, hematologists, hemovigilance workers, and transfusion medicine physicians, using case vignettes and a questionnaire. The vignettes varied in patient- and blood product-related factors that may influence the decision to report a TRALI case. Multiple linear regression analysis was performed. A positive beta-coefficient is in favor of reporting. Ninety-two questionnaires were returned (response rate, 68%). For all disciplines, preferences in favor of reporting TRALI were onset of symptoms within 1 hour (beta = 0.4), after transfusion of a single unit of FFP (beta = 0.5), and in the absence of acute lung injury before transfusion (beta = 1.3). An admission diagnosis of sepsis was a negative preference (beta = -0.3). Massive transfusion (6 RBC plus 4 FFP units) was a negative preference for transfusion medicine physicians (beta = -0.3), but a positive preference for the other disciplines. The questionnaire revealed that massive transfusion and the age of blood products were considered relatively more important reasons to report TRALI by critical care physicians compared to the other disciplines (p reporting of a suspected TRALI case. Disciplines involved in managing TRALI differ in decision-making of reporting TRALI, which may contribute to variance in incidence.
Adeli, Khosrow; Higgins, Victoria; Seccombe, David; Collier, Christine P; Balion, Cynthia M; Cembrowski, George; Venner, Allison A; Shaw, Julie
Reference intervals are widely used decision-making tools in laboratory medicine, serving as health-associated standards to interpret laboratory test results. Numerous studies have shown wide variation in reference intervals, even between laboratories using assays from the same manufacturer. Lack of consistency in either sample measurement or reference intervals across laboratories challenges the expectation of standardized patient care regardless of testing location. Here, we present data from a national survey conducted by the Canadian Society of Clinical Chemists (CSCC) Reference Interval Harmonization (hRI) Working Group that examines variation in laboratory reference sample measurements, as well as pediatric and adult reference intervals currently used in clinical practice across Canada. Data on reference intervals currently used by 37 laboratories were collected through a national survey to examine the variation in reference intervals for seven common laboratory tests. Additionally, 40 clinical laboratories participated in a baseline assessment by measuring six analytes in a reference sample. Of the seven analytes examined, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and creatinine reference intervals were most variable. As expected, reference interval variation was more substantial in the pediatric population and varied between laboratories using the same instrumentation. Reference sample results differed between laboratories, particularly for ALT and free thyroxine (FT4). Reference interval variation was greater than test result variation for the majority of analytes. It is evident that there is a critical lack of harmonization in laboratory reference intervals, particularly for the pediatric population. Furthermore, the observed variation in reference intervals across instruments cannot be explained by the bias between the results obtained on instruments by different manufacturers. Copyright © 2017 The Canadian Society of Clinical Chemists
Institute for Intergovernmental Research, Tallahassee, FL. National Youth Gang Center.
The largest and most comprehensive national gang survey to date, the 1997 National Youth Gang Survey, contacted nearly 5,000 law enforcement agencies across the country. To allow for both comparative and trend analysis, the 1997 survey used the same sample as the 1996 survey. Survey results indicate that the percentage of jurisdictions reporting…
U.S. Department of Health & Human Services — The National Ambulatory Medical Care Survey (NAMCS) is a national survey designed to meet the need for objective, reliable information about the provision and use of...
U.S. Department of Health & Human Services — The National Sample Survey of Registered Nurses (NSSRN) Download makes data from the survey readily available to users in a one-stop download. The Survey has been...
Walitt, Brian; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick
Objectives Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. Methods The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Results Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). Conclusions The majority of clinically diagnosed fibromyalgia
Walitt, Brian; Katz, Robert S; Bergman, Martin J; Wolfe, Frederick
Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). The majority of clinically diagnosed fibromyalgia cases in the US do not reach levels of
Full Text Available Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia to persons with and without criteria-positive fibromyalgia.The National Health Interview Survey (NHIS collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD as characterized in the 2011 modified American College of Rheumatology criteria (ACR for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria.Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2 and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81, married (OR 3.27, and white (OR 1.96. In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive fibromyalgia (OR 2.1.The majority of clinically diagnosed fibromyalgia cases in the US do not reach levels
Vlaar, Alexander P.; Wortel, Kim; Binnekade, Jan M.; van Oers, Marinus H. J.; Beckers, Erik; Gajic, Ognjen; Schultz, Marcus J.; Juffermans, Nicole P.
BACKGROUND: Transfusion-related acute lung injury (TRALI) is hypothesized to be a "two-hit" entity, in which an inflammatory condition (e. g., sepsis) predisposes to TRALI. TRALI is a clinical diagnosis. Disciplines involved in managing TRALI may differ in decision-making on the reporting of TRALI.
This survey was conducted to review the current practice regarding frequency of weight measurement in neonatal units in the Republic of Ireland, and whether these practices are in keeping with best practice as described in the literature. There was an 88.5% (23 of 26) response rate to this survey. 6 (26%) units had a written policy, and 16 (70%) had an unwritten agreed practice. In the Vermont Oxford Network\\'s potentially better practices daily weight measurements on newborn infants are recommended until the infant is stable and growing and then alternate day measurements The most common practices in this survey were to weigh infants on alternate days, this occurred in 9 (39%) units, and twice weekly in 6 (26%). Less than 31% of units had a separate policy for those less than 30 weeks, on assisted ventilation, or transitioning to enteral feeds. Most weigh infants on alternate days, and plot weights weekly, which is in keeping with best practice. Few units have separate policies for specific subgroups as is recommended in the limited literature. Consensus guidelines should be developed and promoted nationally.
This survey was conducted to review the current practice regarding frequency of weight measurement in neonatal units in the Republic of Ireland, and whether these practices are in keeping with best practice as described in the literature. There was an 88.5% (23 of 26) response rate to this survey. 6 (26%) units had a written policy, and 16 (70%) had an unwritten agreed practice. In the Vermont Oxford Network\\'s potentially better practices daily weight measurements on newborn infants are recommended until the infant is stable and growing and then alternate day measurements The most common practices in this survey were to weigh infants on alternate days, this occurred in 9 (39%) units, and twice weekly in 6 (26%). Less than 31% of units had a separate policy for those less than 30 weeks, on assisted ventilation, or transitioning to enteral feeds. Most weigh infants on alternate days, and plot weights weekly, which is in keeping with best practice. Few units have separate policies for specific subgroups as is recommended in the limited literature. Consensus guidelines should be developed and promoted nationally.
Yoon, Da Young; Lee, Young Ah; Lee, Jieun; Kim, Jae Hyun; Shin, Choong Ho; Yang, Sei Won
Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) are differentiated by the presence of cardiometabolic risk factors (CMRFs) and insulin resistance (IR). This study aimed to evaluate the prevalence and clinical characteristics of MHO in Korean children and adolescents and to investigate the anthropometric, laboratory, and lifestyle predictors of MHO. This study included data from 530 obese subjects, aged 10-19 years, obtained from the Fourth Korea National Health and Nutrition Examination Survey. Subjects were classified into MHO and MUO groups according to the presence of CMRF (MHO(CMRF)/MUO(CMRF)) and degree of IR (MHO(IR)/MUO(IR)). Demographic, anthropometric, cardiometabolic, and lifestyle factors were compared between the groups. Logistic regression analysis and receiver operating characteristic curve analysis were performed to identify factors that predicted MHO. The prevalence of MHO(CMRF) and MHO(IR) in obese Korean youth was 36.8% (n = 197) and 68.8% (n = 356), respectively. CMRF profiles were significantly less favorable in MUO children. Longer and more vigorous physical activity and less protein intake were associated with MHO(CMRF) phenotype. The best predictors of MHO(CMRF) and MHO(IR) were waist circumference (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.77-0.88; P obesity in youth, the approach to individuals with MHO and MUO should be personalized due to variation in clinical characteristics. Longitudinal studies are needed to evaluate long-term consequences of MHO. © 2017 The Korean Academy of Medical Sciences.
Department of Veterans Affairs — The 2001 National Survey of Veterans (NSV) is the fifth in a series of comprehensivenationwide surveys designed to help the Department of Veterans Affairs (VA) plan...
This study investigated the prevalence of perceived dysphonia and its correlation with the prevalence of clinically diagnosed laryngeal disorders. Subjects were 8713 non-institutionalized civilian adults over the age of 19 (3810 men and 4912 women) who completed the laryngeal examination of the fifth Korea National Health and Nutrition Examination Survey. A Poisson regression was used to examine the association between perceived dysphonia and laryngeal disorders. Adjusting for covariates (age, sex, education level, income, occupation, alcohol drinking, and self-reported health status), those with perceived voice problems were 4.8 times (OR=4.75, 95% CI, 3.77-5.99) more likely to have laryngeal disorders than those without voice problems. In particular, the vocal fold pathology correlated with perceived dysphonia was: vocal fold nodules (OR=5.32, 95% CI, 3.43-8.26), vocal polyps (OR=3.73, 95% CI, 1.57-8.86), vocal cysts (OR=11.97, 95% CI, 1.97-72.72), Reinke's edema (OR=9.27, 95% CI, 4.77-18.00), laryngeal paralysis (OR=3.58, 95% CI, 1.56-8.26), laryngeal granulomas (OR=4.31, 95% CI, 1.01-18.80), epiglottic cyst (OR=2.94, 95% CI, 1.21-7.13), and laryngitis (OR=4.07, 95% CI, 2.91-5.69). People with self-perceived dysphonia had a high risk of laryngeal disorders. © The Author(s) 2015.
U.S. Department of Health & Human Services — 2001 forward. The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are...
De Rosa Marisa
Full Text Available Abstract Background Although interim analysis approaches in clinical trials are widely known, information on current practice of planned monitoring is still scarce. Reports of studies rarely include details on the strategies for both data monitoring and interim analysis. The aim of this project is to investigate the forms of monitoring used in cancer clinical trials and in particular to gather information on the role of interim analyses in the data monitoring process of a clinical trial. This study focused on the prevalence of different types of interim analyses and data monitoring in cancer clinical trials. Methods Source of investigation were the protocols of cancer clinical trials included in the Italian registry of clinical trials from 2000 to 2005. Evaluation was restricted to protocols of randomised studies with a time to event endpoint, such as overall survival (OS or progression free survival (PFS. A template data extraction form was developed and tested in a pilot phase. Selection of relevant protocols and data extraction were performed independently by two evaluators, with differences in the data assessment resolved by consensus with a third reviewer, referring back to the original protocol. Information was obtained on a general characteristics of the protocol b disease localization and patient setting; c study design d interim analyses; e DSMC. Results The analysis of the collected protocols reveals that 70.7% of the protocols incorporate statistical interim analysis plans, but only 56% have also a DSMC and be considered adequately planned. The most concerning cases are related to lack of any form of monitoring (20.0% of the protocols, and the planning of interim analysis, without DSMC (14.7%. Conclusion The results indicate that there is still insufficient attention paid to the implementation of interim analysis.
Ikeda, Takafumi; Sugie, Tomoharu; Shimizu, Akira; Toi, Masakazu
Sentinel lymph node (SLN) biopsy is now accepted as the standard of care for axillary staging in women with node-negative breast cancer. Currently, dye, radioisotope (RI), and fluorescence indocyanine green (fICG) are tracers available. Importance of these three tracers has been recognized for SLN biopsy but the trend for SLN mapping has not been reported. Aim of this national wide survey was to evaluate practice patterns of SLN biopsy in Japan. This survey was conducted to examine the clinical practice of SLN biopsy in centers where one or more Japanese Breast Cancer Society (JBCS) board-certified surgeons practice breast cancer care. Their responses were recorded from 1 to 30 Oct 2014 and received by mail or fax in Japan. The questionnaire included three items: the number of breast cancer patients treated per year, the number of SLN biopsy procedures in a single year, and the methods for SLN detection. A total of 412 responses excluding the 63 centers that do not perform the surgery were analyzed. Out of them, 206 (50 %) centers had a gamma probe, 118 (29 %) had an NIR fluorescence imaging system, and both were available at 49 (12 %) of the centers. Neither RI nor fICG was available in 137 (33 %). The dye method was preferentially used in private hospitals. In 412 centers, a total of 36,221 patients underwent SLN biopsy per year and 23,038 (64 %) received radioactive tracer. fICG was co-applied with RI in 83 and 13 % of patients, respectively. Single mapping with RI alone was used in only 4 % of patients. The non-radioactive method was used for routine SLN biopsy in 13,183 (36 %) patients [8533 (24 %) for dye alone and 4650 (12 %) for fICG alone]. A radioactive tracer was used in 64 % of women with early breast cancer for SLN biopsy while approximately 24 % received dye alone, which was especially prevalent in PHs. The fICG was used in only 12 % as a non-radioactive method but incentive package for fICG by national health insurance plan could
Mortensen, Lene; Malling, Bente; Ringsted, Charlotte Vibeke
Many countries have recently reformed their postgraduate medical education (PGME). New pedagogic initiatives and blueprints have been introduced to improve quality and effectiveness of the education. Yet it is unknown whether these changes improved the daily clinical training. The purpose...... was to examine the impact of a national PGME reform on the daily clinical training practice....
A UK national survey of investigations for beta-lactam hypersensitivity - heterogeneity in practice and a need for national guidelines - on behalf of British Society for Allergy and Clinical Immunology (BSACI).
Richter, A G; Nasser, S M; Krishna, M T
Beta lactams (BL) are the most widely prescribed antibiotics in the UK and the commonest cause of hypersensitivity reactions. There are no UK guidelines for BL testing and the most relevant guidelines were devised by the European Network for Drug Allergy (ENDA) on behalf of the European Academy of Allergy and Clinical Immunology. Delivery of allergy services differs across Europe, so this survey was designed to investigate how closely UK practice adhered to these guidelines. An online survey, using surveymonkey.com software, was sent to all consultants offering an allergy service in the UK and who were members of either BSACI or 'Travellers' (Immunology consultant group). The response rate was 48% (n=81/165) and BL allergy testing was undertaken by 78% of respondents. All responders requested SsIgE, although four responders stated they rarely requested. Skin testing was undertaken by 87% of respondents who perform beta lactam testing with 17% undertaking skin prick testing (SPT) only, 77% SPT followed by intra-dermal testing (IDT) if the former were negative or indeterminate and 6% SPT and IDT in all cases. The drugs, doses and protocols for skin testing varied considerably. Drug provocation testing was undertaken by 87% of respondents who undertake beta lactam testing with significant heterogeneity in protocols. Respondents that investigated ≤ 20 patients per year demonstrated lower adherence to ENDA recommendations compared to those who saw > 20. Following positive testing, 79% advised avoidance of all penicillins only and the remainder advised additional drug avoidance. This survey revealed variation in the investigation and management of BL hypersensitivity in the UK with some centres reporting procedures that could potentially put patients at risk of anaphylaxis if allergy was falsely excluded. This survey highlights an urgent need for evidence based national guidelines and standardisation of practice. © 2013 John Wiley & Sons Ltd.
The American Academy of Clinical Neuropsychology, National Academy of Neuropsychology, and Society for Clinical Neuropsychology (APA Division 40) 2015 TCN Professional Practice and 'Salary Survey': Professional Practices, Beliefs, and Incomes of U.S. Neuropsychologists.
Sweet, Jerry J; Benson, Laura M; Nelson, Nathaniel W; Moberg, Paul J
The current survey updated professional practice and income information pertaining to clinical neuropsychology. Doctoral-level members of the American Academy of Clinical Neuropsychology, Division 40 (Clinical Neuropsychology) of the American Psychological Association, and the National Academy of Neuropsychology and other neuropsychologists, as well as postdoctoral trainees in the Association of Postdoctoral Programs in Clinical Neuropsychology and at other training sites were invited to participate in a web-based survey in early 2015. The sample of 1777 respondents, of whom 1579 were doctoral-level practitioners and 198 were postdoctoral trainees, was larger than the prior 2010 income and practice survey. The substantial proportional change in gender has continued, with women now a clear majority in the postdoctoral trainee sample as well as in the practitioner sample. Dissimilar from the median age trajectory of American Psychological Association members, the median age of clinical neuropsychologists remains essentially unchanged since 1989, indicating a substantial annual influx of young neuropsychologists. The question of whether the Houston Conference training model has become an important influence in the specialty can now be considered settled in the affirmative among postdoctoral trainees and practitioners. Testing assistant usage remains commonplace, and continues to be more common in institutions. The vast majority of clinical neuropsychologists work full-time and very few are unemployed and seeking employment. The numbers of neuropsychologists planning to retire in the coming 5-10 years do not suggest a "baby boomer" effect or an unexpected bolus of planned retirements in the next 10 years that would be large enough to be worrisome. Average length of time reported for evaluations appears to be increasing across time. The most common factors affecting evaluation length were identified, with the top three being: (1) goal of evaluation, (2) stamina
National Academy of Neuropsychology/Division 40 of the American Psychological Association Practice Survey of Clinical Neuropsychology in the United States. Part II: Reimbursement experiences, practice economics, billing practices, and incomes.
Sweet, Jerry J; Peck, Edward A; Abramowitz, Carolyn; Etzweiler, Sharon
Leaders of the National Academy of Neuropsychology and Division 40 (Clinical Neuropsychology) of the American Psychological Association determined that current information on the professional practice of clinical neuropsychology within the United States was needed. These two organizations co-sponsored a national survey of U.S. clinical neuropsychologists that was conducted in September 2000. The primary goal of the survey was to gather information on such topics as: practitioner and practice characteristics, economic variables (e.g., experience with major third party payors, such as Medicare and managed care), practice expenses, billing methods, experiences with Current Procedural Terminology (CPT) codes, time spent on various clinical tasks, use of assistants, and income. In this second of two articles describing the survey results, reimbursement experiences, practice economics, billing practices, and incomes are highlighted. Survey results indicate that neuropsychologists frequently have difficulty gaining access to membership on managed care panels. For those who gain access, managed care companies often limit provision of services; this is quite often perceived as negatively affecting quality of patient care. It is very common for neuropsychologists to feel obligated to provide more services to managed care and Medicare patients than are allowed to be billed to the insurance carrier; these hours are typically "written off." Numerous CPT codes are used to bill the same clinical service. Awareness of Medicare practice and billing expectations is variable among practitioners, as is awareness of public aid/Medicaid billing status. Professional income is influenced by years of licensed practice, practice setting, gender, types and amounts of non-clinical professional activities, and types and amounts of reimbursement sources within one's clinical practice. Income of neuropsychologists has only a minimal relationship to percentage of clinical practice per week
The objective of this survey was to obtain an indication of the size of the methicillin-resistant Staphylococcus aureus (MRSA) problem in Ireland prior to introducing national MRSA control guidelines. A survey of all microbiology laboratories in Ireland was carried out over two weeks in Spring 1995. For patients from whom MRSA was isolated during the study period standard demographic and clinical data were requested and period prevalence\\/1000 discharges was calculated. All 45 microbiology laboratories surveyed responded. MRSA was isolated from 448 patients during the two-week period. The period prevalence of MRSA was 16.5\\/1000 discharges. Males aged > or = 65 had the highest rate (50\\/1000 discharges). Half of all isolates were from patients in surgical or medical wards, but 4% were from community-based sources such as GPs, nursing homes and hospices. Thirty-two percent of MRSA patients were infected rather than colonized. MRSA is clearly a significant problem in Ireland. While it is largely a hospital problem at present, the increasing trend towards day procedures and shorter hospital stay means that infection will increase in the community.
Nguyen Khac Hai
Full Text Available Breach of confidentiality or invasion of privacy from the collection and use of medical records, particularly those of patients with HIV/AIDS or other diseases sensitive to stigmatization, should be prevented by all related stakeholders in healthcare settings. The main focus of this study was to assess practices regarding security and confidentiality of HIV-related information among staff at HIV outpatient clinics (HIV-OPCs in Vietnam.A descriptive cross-sectional study was conducted at all 312 HIV-OPCs across the country using an online survey technique.In general, the staff practices for securing and protecting patient information were at acceptable levels. Most staff had proper measures and practices for maintaining data security; however, the protection of patient confidentiality, particularly for data access, sharing, and transfer still required improvement. Most HIV-OPC staff had good or moderate knowledge and positive perceptions towards security and confidentiality issues. Staff who were not trained in the practice of security measures differed significantly from those who were trained (OR: 3.74; 95%CI: 1.44-9.67; staff needing improved knowledge levels differed significantly from those with good (OR: 5.20; 95%CI: 2.39-11.32 and moderate knowledge levels (OR: 5.10; 95%CI: 2.36-11.00; and staff needing improved perception levels differed significantly from those with good (i.e., with 100% proper practices and moderate perception levels (OR: 5.67; 95%CI: 2.93-10.95. Staff who were not trained in the protection of data confidentiality differed significantly from those who were trained (OR: 2.18; 95%CI: 1.29-3.65.Training is an important factor to help raise the levels of proper practices regarding confidentiality and security, to improve knowledge and raise awareness about change among staff. The operation and management of HIV treatment and care in Vietnam are currently transitioning from separate healthcare clinics (HIV-OPC into units
U.S. Department of Health & Human Services — This data set contains the national average (mean) âtop-boxâ scores of Medicare-certified hospice agencies on Consumer Assessment of Healthcare Providers and...
Social Security Administration — A cross-sectional survey of a nationally representative sample of 4,864 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...
Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...
Social Security Administration — A cross-sectional survey of a nationally representative sample of 6,520 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...
U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...
U.S. Department of Health & Human Services — 1999-2000 forward. The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of...
NSGIC Local Govt | GIS Inventory — This data contains a set of geodetic control stations maintained by the National Geodetic Survey. Each geodetic control station in this dataset has either a precise...
Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...
Hess, Sonja Y
Information is needed on the national prevalence of zinc deficiency to guide program development and evaluation. To summarize results of national surveys that assessed plasma or serum zinc concentrations (PZC) and compare the prevalence of low PZC with other methods used to estimate countries' risk of zinc deficiency. National surveys that included PZC were identified through Internet searches and personal contacts. A survey was eligible if a nationally representative sampling scheme was used, PZC was analyzed, and the survey was implemented in a low- or middle-income country. Twenty surveys were eligible; 19 countries assessed PZC in young children and 14 in women of reproductive age. In 13 of the 19 surveys, the prevalence of low PZC in children was >20%. Only Afghanistan, Azerbaijan, Nigeria, the Republic of Maldives, Sri Lanka, and China found a low prevalence of inadequate PZC among children. Some of these conclusions may be due to the lower than recommended cutoff that was used. Similarly, in 13 of 14 surveys, the prevalence of low PZC in women was >20%. Estimates of percentage population with inadequate dietary zinc intake based on food balance sheets underestimate the risk of zinc deficiency. The national stunting prevalence seems to be a useful proxy, as both indicators categorized countries similarly into high versus low risk of zinc deficiency, with some exceptions. Results from 20 countries suggest that zinc deficiency is a public health concern in the majority of these countries and zinc intervention strategies should be considered.
Institute for Intergovernmental Research, Tallahassee, FL. National Youth Gang Center.
The 1996 National Youth Gang Survey was the largest of its type ever conducted, and the results are representative of the United States as a whole. Almost 5,000 law enforcement agencies were surveyed, and more than 80% of the sample responded. Agencies in all large cities, and a random sample of smaller cities were included, as were suburban…
National Academy of Neuropsychology/Division 40 of the American Psychological Association practice survey of clinical neuropsychology in the United States, Part I: practitioner and practice characteristics, professional activities, and time requirements.
Sweet, Jerry J; Peck, Edward A; Abramowitz, Carolyn; Etzweiler, Sharon
Leaders of the National Academy of Neuropsychology and Division 40 (Clinical Neuropsychology) of the American Psychological Association determined that current information on the professional practice of clinical neuropsychology within the United States (U.S.) was needed. These two organizations co-sponsored a national survey of U.S. clinical neuropsychologists that was conducted in September 2000. The primary goal of the survey was to gather information on such topics as: practitioner and practice characteristics, economic variables (e.g., experience with major third party payors, such as Medicare and managed care), practice expenses, billing methods, experiences with Current Procedural Terminology (CPT) codes, time spent on various clinical tasks, use of assistants, and income. The adjusted return rate of 33.5% (n = 1,406) reflects the number of surveys returned with sufficient data by licensed doctoral level clinicians with membership in one or both sponsoring organizations. In this first of two articles describing the survey results, characteristics of practitioners and practices, various types of professional activities, and time requirements for clinical tasks are presented and discussed. It was noted that the proportion of women in the field is increasing rapidly. Private practice is the predominant employment setting. Findings also document that members of the two sponsoring organizations are very similar with regard to employment setting, professional characteristics, and weekly activities. That is, involvement in clinical practice and research, as well as private practice versus institutional employment, was very similar between organizations. However, across organizations, work setting (private practice vs. institution) was associated with significant and meaningful differences. Private practitioners have a more diverse set of weekly clinical activities, are less likely to use assistants, and engage in more forensic activities. Across work setting, with
Gaunaurd, Ignacio; Spaulding, Susan E; Amtmann, Dagmar; Salem, Rana; Gailey, Robert; Morgan, Sara J; Hafner, Brian J
Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists' ability to use outcome measures are needed to facilitate their adoption in routine practice. To assess prosthetists' use of outcome measures and evaluate the effects of training on their confidence in administering performance-based measures. Cross-sectional and single-group pretest-posttest survey. Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. The majority of prosthetists (62%) were classified as non-routine outcome measure users. Confidence administering the Timed Up and Go and Amputee Mobility Predictor prior to training was low-to-moderate across the study sample. Training significantly (p confidence in administering both instruments. Prosthetists in this study reported limited use of and confidence with standardized outcome measures. Interactive training resulted in a statistically significant increase of prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor and may facilitate use of outcome measures in clinical practice. Frequency of outcome measure use in the care of persons with limb loss has not been studied. Study results suggest that prosthetists may not regularly use standardized outcome measures and report limited confidence in administering them. Training enhances confidence and may encourage use of outcome measures in clinical practice. © The International Society for Prosthetics and Orthotics 2014.
A project is described in which the Epidemiologic Studies Branch, DBE, is cooperating with the National Center for Health Statistics in a National Natality Survey and a National Fetal Mortality Survey of a sample of live births and of late fetal deaths (28 or more weeks gestation) in 1979. Questionnaires will be sent to a sample of mothers who had a live born infant or late fetal death in 1979, to hospitals in which the deliveries took place, to attending physicians, and all other possible sources of health care. The survey will provide quantitative information regarding use of ionizing and nonionizing radiation, including ultrasound, during pregnancy and possible associations between radiation and late fetal mortality. Specifically the study will provide information on the demographic and socioeconomic characteristics of the mothers and complications of pregnancy, labor, and delivery. The physical condition of the infant at birth is also included. This is one of many health surveys conducted routinely by the NCHS under the National Health Survey program
Institute for Intergovernmental Research, Tallahassee, FL. National Youth Gang Center.
This summary provides results from the 1998 National Youth Gang Survey, administered to a representative sample of city and county police and sheriff's departments nationwide. Results indicate that the percentage of jurisdictions reporting active youth gangs decreased from 51 percent in 1997 to 48 percent in 1998. About 780,200 gang members were…
The release of the Doll report in the UK, and its reported association between prolonged exposures to higher levels of power frequency magnetic fields and a small risk of leukaemia in children, has heightened community concerns. This disquiet among the general public has prompted the possibility of a national survey of residential magnetic field exposures to be implemented. Measurement methodologies were reviewed by the author and long-term measurements made by a logger placed in the living room for a 24-hour period were chosen as a surrogate measurement for the evaluation of exposure. An international comparison of similar surveys is presented, showing great deficiency, with the exception of Schuz et al and the UKCCS, in the number of homes surveyed. Factors influencing the selection of residences in the survey sample are elucidated and a range of sample sizes is presented with varying precision and confidence levels. Finally a feasible sample of 1,000 homes is chosen and a cost estimate is calculated with extra options for the measurement of the child's bedroom, a schools' survey and child personal exposure measurements included in the outlay. The purpose of the proposed national survey is to determine the proportion of Australian homes that are exposed to fields greater than 0.4 μT and the influence of proximity to powerlines as a cause. The study would also enable an interstate and international comparison of exposures to be made. Copyright (2002) Australasian Radiation Protection Society Inc
Full Text Available Shih-Lung Cheng,1,2 Ming-Cheng Chan,3 Chin-Chou Wang,4 Ching-Hsiung Lin,5 Hao-Chien Wang,6 Jeng-Yuan Hsu,3 Liang-Wen Hang,7,8 Chee-Jen Chang,9 Diahn-Warng Perng,10,* Chong-Jen Yu6,* On behalf of the Taiwan COPD Consortium 1Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 2Department of Chemical Engineering and Materials Science, Yuan Ze University, Chung-Li City, Taoyuan County, 3Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, 4Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 5Division of Chest Medicine, Changhua Christian Hospital, Changhua City, Changhua County, 6Department of Internal Medicine, National Taiwan University Hospital, Taipei, 7Department of Pulmonary and Critical Care Medicine, Sleep Medicine Center, China Medical University Hospital, 8Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, 9Biostatistical Center for Clinical Research, Chang Gung Memorial Hospital, Linkou Branch, Guishan Township, Taoyuan County, 10Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China *These authors contributed equally to this work Objectives: To determine the prevalence of COPD in Taiwan and to document the disease characteristics and associated risk factors.Methods: We conducted a random cross-sectional national survey of adults older than 40 years in Taiwan. Respiratory health screening questions identified subjects with diagnosed COPD or whose reported symptoms also fulfilled an epidemiological case definition; these were eligible to complete the survey, which also included indices of symptom severity and disability and questions on comorbidities, medical treatments, smoking habits, and occupations potentially harmful to respiratory health. Subjects with diagnosed COPD were subdivided by smoking status. Subjects who fulfilled the case definition
Pedersen, Torben Bach; Jensen, Christian Søndergaard
quality and reduce costs. Adoption of data warehousing in health care has been slowed by lack of understanding of the benefits offered by the technology. This paper contributes by providing needed understanding, by introducing the opportunities offered by data warehousing, describing current efforts......In this article we present the concept of data warehousing, and its use in the clinical area. Clinical data warehousing will become very important in the near future, as healthcare enterprises need to gain more information from their clinical, administrative, and financial data, in order to improve...
Gorman, Mark; Coelho, James; Gujral, Sameer; McKay, Alastair
Introduction. “See and treat” one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times. Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented. We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK. Methods. The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction. Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery. Results. The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average. Department capacity increased 15%. 95% of patients were highly satisfied with and preferred the OSC to a conventional service. Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use. Conclusions. OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit. This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction. We offer our considerations and local experience instituting an OSC service. PMID:26236502
Christensen, Linda; Sobrino Vázquez, Natalia
Look-up tables are collected and analysed for 12 European National Travel Surveys (NTS) in a harmonized way covering the age group 13-84 year. Travel behaviour measured as kilometres, time use and trips per traveller is compared. Trips per traveller are very similar over the countries whereas...... of walking trips rather similar with a higher level of cycling in the Netherlands, more public transport in Switzerland, and more air traffic in Sweden. Normally kilometres per respondent / inhabitant is used for national planning purpose and this is very affected by the share of mobile travellers...
Li, Tingting; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo
This study aimed to evaluate whether the quality performance of clinical laboratories in China has been greatly improved and whether Internal Quality Control (IQC) practice of HbA1c has also been changed since National Center for Clinical Laboratories (NCCL) of China organized laboratories to report IQC data for HbA1c in 2012. Internal Quality Control information of 306 External Quality Assessment (EQA) participant laboratories which kept reporting IQC data in February from 2012 to 2016 were collected by Web-based EQA system. Then percentages of laboratories meeting four different imprecision specifications for current coefficient of variations (CVs) of HbA1c measurements were calculated. Finally, we comprehensively analyzed analytical systems and IQC practice of HbA1c measurements. The current CVs of HbA1c tests have decreased significantly from 2012 to 2016. And percentages of laboratories meeting four imprecision specifications for CVs all showed the increasing tendency year by year. As for analytical system, 52.1% (159/306) laboratories changed their systems with the change in principle of assay. And many laboratories began to use cation exchange high-performance liquid chromatography (CE-HPLC) instead of Immunoturbidimetry, because CE-HPLC owed a lower intra-laboratory CVs. The data of IQC practice, such as IQC rules and frequency, also showed significant variability among years with overall tendency of meeting requirements. The imprecision performance of HbA1c tests has been improved in these 5 years with the change in IQC practice, but it is still disappointing in China. Therefore, laboratories should actively find existing problems and take action to promote performance of HbA1c measurements. © 2016 Wiley Periodicals, Inc.
Gibbs, S; Waters, W E; George, C F
Three thousand four hundred and ten patients recruited at 254 pharmacies took part in a national postal survey of the effect of prescription information leaflets. The patients had been prescribed penicillins, non-steroidal anti-inflammatory drugs (NSAIDs) or beta-adrenoceptor antagonists. The 1809 patients who received leaflets knew more about their medicines, especially the side effects and were significantly more satisfied than the 1601 patients who were not given additional written informa...
Full Text Available Abstract Background Clinical practice guidelines (CPGs have become a very popular tool for decision making in healthcare. While there is some evidence that CPGs improve outcomes, there are numerous factors that influence their acceptability and use by healthcare providers. While evidence of clinicians' knowledge, perceptions and attitudes toward CPGs is extensive, results are still disperse and not conclusive. Our study will evaluate these issues in a large and representative sample of clinicians in Spain. Methods/Design A mixed-method design combining qualitative and quantitative research techniques will evaluate general practitioners (GPs and hospital-based specialists in Spain with the objective of exploring attitudes and perceptions about CPGs and evidence grading systems. The project will consist of two phases: during the first phase, group discussions will be carried out to gain insight into perceptions and attitudes of the participants, and during the second phase, this information will be completed by means of a survey, reaching a greater number of clinicians. We will explore these issues in GPs and hospital-based practitioners, with or without previous experience in guideline development. Discussion Our study will identify and gain insight into the perceived problems and barriers of Spanish practitioners in relation to guideline knowledge and use. The study will also explore beliefs and attitudes of clinicians towards CPGs and evidence grading systems used to rate the quality of the evidence and the strength of recommendations. Our results will provide guidance to healthcare researchers and healthcare decision makers to improve the use of guidelines in Spain and elsewhere.
Hu, Patricia S [ORNL; Reuscher, Tim [ORNL; Schmoyer, Richard L [ORNL; Chin, Shih-Miao [ORNL
Policy makers rely on transportation statistics, including data on personal travel behavior, to formulate strategic transportation policies, and to improve the safety and efficiency of the U.S. transportation system. Data on personal travel trends are needed to examine the reliability, efficiency, capacity, and flexibility of the Nation's transportation system to meet current demands and to accommodate future demand. These data are also needed to assess the feasibility and efficiency of alternative congestion-mitigating technologies (e.g., high-speed rail, magnetically levitated trains, and intelligent vehicle and highway systems); to evaluate the merits of alternative transportation investment programs; and to assess the energy-use and air-quality impacts of various policies. To address these data needs, the U.S. Department of Transportation (USDOT) initiated an effort in 1969 to collect detailed data on personal travel. The 1969 survey was the first Nationwide Personal Transportation Survey (NPTS). The survey was conducted again in 1977, 1983, 1990, 1995, and 2001. Data on daily travel were collected in 1969, 1977, 1983, 1990 and 1995. In 2001, the survey was renamed the National Household Travel Survey (NHTS) and it collected both daily and long-distance trips. The 2001 survey was sponsored by three USDOT agencies: Federal Highway Administration (FHWA), Bureau of Transportation Statistics (BTS), and National Highway Traffic Safety Administration (NHTSA). The primary objective of the survey was to collect trip-based data on the nature and characteristics of personal travel so that the relationships between the characteristics of personal travel and the demographics of the traveler can be established. Commercial and institutional travel were not part of the survey. Due to the survey's design, data in the NHTS survey series were not recommended for estimating travel statistics for categories smaller than the combination of Census division (e.g., New
...] National Contact Center; Information Collection; National Contact Center Customer Evaluation Survey AGENCY... National Contact Center customer evaluation surveys. In this request, the previously approved surveys have... several months. These temporary surveys will allow the National Contact Center to compare its customer...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...
U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...
U.S. Department of Health & Human Services — The National Intimate Partner and Sexual Violence Survey (NISVS) is an ongoing, nationally representative survey to assess experiences of intimate partner violence,...
Takada, Tsuyoshi; Hatano, Koji; Satoh, Mototaka; Tsujimoto, Yuichi; Honda, Masahito; Matsumiya, Kiyomi; Fujioka, Hideki
Treatment trends and outcomes for prostate cancer in our hospital were reported. A total of 482 patients with prostate cancer treated in our hospital between January, 1990 and December, 2004. The age distribution was from 51 to 99 years-old, with the mean age of 72.9 years-old at onset. The number of prostate cancer patients, especially asymptomatic patients with prostatic specific antigen (PSA) elevation, have increased recently. As for the clinical stage, 92 cases (19.1%), 238 cases (49.4%), 48 cases (10.0%) and 104 cases (21.6%) were stage A, B, C and D, respectively. 425 cases (88.2%) received some form of endocrine therapy. Retropubic prostatectomy or external beam radiation therapy was performed in 77 and 57 cases, respectively all cases. The cause-specific 5-year survival rate of the 482 cases was 79.7%, comprising 100% for stage A1, 96.8% for stage A2, 89.4% for stage B, 79.9% for stage C and 42.9% for stage D. The cause-specific 5-year survival was significantly better in the latter patients (1997-2004) than the former patients (1990-1996) in stage C (p=0.0226), D (p=0.0448). In stage C patients, the retropubic prostatectomy (with endocrine therapy) group, increased in the latter period and showed longer cause-specific 5-year survival than the endocrine therapy group (p=0.0027). In stage D2 patients, chemo-endocrine therapy with etoposide (VP-16), adriamycin (ADM) and cisplatin (CDDP) refractory and cause-specific 5-year survival was longer than endocrine therapy alone (p=0.0467, P=0.0381). Our results suggest that retropubic prostatectomy with endocrine therapy and chemo-endocrine therapy are useful for stage C and D prostate cancer patients, respectively. (author)
Dela Cruz, Fe M.; Garcia, Teofilo Y.; Palad, Lorna Jean H.; Cobar, Ma. Lucia C.; Duran, Emerenciana B.
This paper presents the results of the first national survey of indoor radon concentrations in different types of Filipino houses throughout the Philippines. Measurements were carried out using 2,626 CR-39 alpha track detectors that were deployed in selected houses for a period of six months. Results of analyses showed that indoor radon concentration in Filipino houses ranged from 1.4 to 57.6 Bq/m 3 with a mean value of 21.4 ± 9.2 Bq/m 3 . This leads to an estimated annual average effective dose equivalent of 0.4 mSv. There are slight differences in the mean concentrations of radon in different types of houses, which ranged from 19.4 to 25.3 Bq/m 3 . Highest mean radon concentrations were observed in houses made of concrete with a mean radon value of 25.3 ± 10.1 Bq/m 3 . Radon concentrations in the houses surveyed were below the action limits of 200 Bq/m 3 set by the National Radiological Protection Board (NRPB) and do not pose any hazard to the health of the occupants. (author)
Full Text Available In the age of digital technology, as teens seem to be constantly connected online, via social media, and through mobile applications, it is no surprise that they increasingly turn to digital media to answer their health questions. This study is the first of its kind to survey a large, nationally-representative sample of teens to investigate how they use the newest digital technologies, including mobile apps, social networking sites, electronic gaming and wearable devices, to explore health topics. The survey covered the types of health topics teens most frequently search for, which technologies they are most likely to use and how they use them, and whether they report having changed their behaviors due to digital health information. In addition, this survey explores how the digital divide continues to impact adolescents. Results of this study indicate that teens are concerned about many health issues, ranging from fitness, sexual activity, drugs, hygiene as well as mental health and stress. As teens virtually always have a digital device at their fingertips, it is clear that public health interventions and informational campaigns must be tailored to reflect the ways that teens currently navigate digital health information and the health challenges that concern them most.
Mortensen, Lene Sundahl; Malling, Bente Vigh; Ringsted, Charlotte Vibeke
Many countries have recently reformed their postgraduate medical education (PGME). New pedagogic initiatives and blueprints have been introduced to improve quality and effectiveness of the education. Yet it is unknown whether these changes improved the daily clinical training. The purpose...
The USGS, in collaboration with other federal and state government agencies, industry, and academia, is conducting the National Geochemical Survey (NGS) to produce a body of geochemical data for the United States based primarily on stream sediments, analyzed using a consistent set of methods. These data will compose a complete, national-scale geochemical coverage of the US, and will enable construction of geochemical maps, refine estimates of baseline concentrations of chemical elements in the sampled media, and provide context for a wide variety of studies in the geological and environmental sciences. The goal of the NGS is to analyze at least one stream-sediment sample in every 289 km2 area by a single set of analytical methods across the entire nation, with other solid sample media substituted where necessary. The NGS incorporates geochemical data from a variety of sources, including existing analyses in USGS databases, reanalyses of samples in USGS archives, and analyses of newly collected samples. At the present time, the NGS includes data covering ~71% of the land area of the US, including samples in all 50 states. This version of the online report provides complete access to NGS data, describes the history of the project, the methodology used, and presents preliminary geochemical maps for all analyzed elements. Future editions of this and other related reports will include the results of analysis of variance studies, as well as interpretive products related to the NGS data.
The National Highway Traffic Safety Administration (NHTSA) conducted a national Customer Satisfaction Survey in response to the requirements of the National Performance Review and Executive Order 12862. An independent research organization, Schulman,...
Full Text Available Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort with variable frequency. The goal of the present study was to obtain information on the workload entailed by patients with constipation and associated abdominal complaints, predominant clinical behaviors, education needs, and potential daily practice aids both in Primary Care and gastroenterology settings. The clinical behavior of doctors is generally similar at both levels, despite differences in healthcare approach: use of empiric therapies and clinically guided diagnostic tests, with some differences in colonoscopy use (not always directly accessible from Primary Care. Regarding perceptions, general support and osmotic laxatives are most valued by PC doctors, whereas osmotic laxatives, combined laxatives, and linaclotide are most valued by GE specialists. Furthermore, over half of respondents considered differentiating both diagnoses as challenging. Finally, considerable education needs are self-acknowledged at both levels, as is a demand for guidelines and protocols to help in managing this issue in clinical practice. A strength of this study is its providing a joint photograph of the medical approach and the perceptions of constipation with abdominal discomfort from a medical standpoint. Weaknesses include self-declaration (no formal validation and a response rate potentially biased by professional motivation.
Full Text Available Lina Sun,* Yahong Chen,* Rui Wu, Ming Lu, Wanzhen Yao Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China *These authors contributed equally to this work Purpose: To investigate how the changes of definition in assessment of Global Initiative for Chronic Obstructive Lung Disease (GOLD stratification 2017 lead to changes of chronic obstructive pulmonary disease (COPD patient clinical characteristics across categories in China.Patients and methods: COPD patients from 11 medical centers in China were stratified into old and new groups A–D twice according to the GOLD 2011 and 2017 comprehensive assessment. Demography and clinical characteristics were compared between old and new groups A–D.Results: In 1,532 COPD patients, the distribution from group A to D was 330 (21.5%, 132 (8.6%, 411 (26.8%, 659 (43.0% and 557 (36.4%, 405 (26.4%, 184 (12.0%, 386 (25.2%, respectively according to GOLD 2011 and 2017. 46.7% (500/1,070 patients in high-risk groups were regrouped to low-risk groups. Compared to the old groups A and B, the new groups A and B had a higher proportion of males, lower body mass index, higher modified Medical Research Council (mMRC grade, poor pulmonary function, more patients with chronic bronchitis, and fewer patients with coronary heart disease and hypertension disease. Compared to the old groups C and D, the new groups C and D had older patients, fewer men, better pulmonary functions, frequent acute exacerbations in the previous year, and more patients with chronic bronchitis, coronary heart disease, or diabetes mellitus. The new group D had more patients with stroke than the old group D.Conclusion: In China, GOLD 2017 shifted the overall COPD comprehensive assessments distribution to more low-risk groups. The new high-risk groups had more characteristics associated with high risk of acute exacerbation and mortality. Some of the changes in demography and clinical characteristics of
Chandesris, Marie-Olivia; Melki, Isabelle; Natividad, Angels; Puel, Anne; Fieschi, Claire; Yun, Ling; Thumerelle, Caroline; Oksenhendler, Eric; Boutboul, David; Thomas, Caroline; Hoarau, Cyrille; Lebranchu, Yvon; Stephan, Jean-Louis; Cazorla, Celine; Aladjidi, Nathalie; Micheau, Marguerite; Tron, Fran[cedil]cois; Baruchel, Andre; Barlogis, Vincent; Palenzuela, Gilles; Mathey, Catherine; Dominique, Stephane; Body, Gerard; Munzer, Martine; Fouyssac, Fanny; Jaussaud, Rolland; Bader-Meunier, Brigitte; Mahlaoui, Nizar; Blanche, Stephane; Debre, Marianne; Le Bourgeois, Muriel; Gandemer, Virginie; Lambert, Nathalie; Grandin, Virginie; Ndaga, Stephanie; Jacques, Corinne; Harre, Chantal; Forveille, Monique; Alyanakian, Marie-Alexandra; Durandy, Anne; Bodemer, Christine; Suarez, Felipe; Hermine, Olivier; Lortholary, Olivier; Casanova, Jean-Laurent; Fischer, Alain; Picard, Capucine
Autosomal dominant deficiency of signal transducer and activator of transcription 3 (STAT3) is the main genetic etiology of hyper-immunoglobulin (Ig) E syndrome. We documented the molecular, cellular, and clinical features of 60 patients with heterozygous STAT3 mutations from 47 kindreds followed in France. We identified 11 known and 13 new mutations of STAT3. Low levels of interleukin (IL)-6-dependent phosphorylation and nuclear translocation (or accumulation) of STAT3 were observed in Epstein-Barr virus-transformed B lymphocytes (EBV-B cells) from all STAT3-deficient patients tested. The immunologic phenotype was characterized by high serum IgE levels (96% of the patients), memory B-cell lymphopenia (94.5%), and hypereosinophilia (80%). A low proportion of IL-17A-producing circulating T cells was found in 14 of the 15 patients tested. Mucocutaneous infections were the most frequent, typically caused by Staphylococcus aureus (all patients) and Candida albicans (85%). Up to 90% of the patients had pneumonia, mostly caused by Staph. aureus (31%) or Streptococcus pneumoniae (30%). Recurrent pneumonia was associated with secondary bronchiectasis and pneumatocele (67%), as well as secondary aspergillosis (22%). Up to 92% of the patients had dermatitis and connective tissue abnormalities, with facial dysmorphism (95%), retention of decidual teeth (65%), osteopenia (50%), and hyperextensibility (50%). Four patients developed non-Hodgkin lymphoma. The clinical outcome was favorable, with 56 patients, including 43 adults, still alive at the end of study (mean age, 21 yr; range, 1 mo to 46 yr). Only 4 patients died, 3 from severe bacterial infection (aged 1, 15, and 29 yr, respectively). Antibiotic prophylaxis (90% of patients), antifungal prophylaxis (50%), and IgG infusions (53%) improved patient health, as demonstrated by the large decrease in pneumonia recurrence. Overall, the prognosis of STAT3 deficiency may be considered good, provided that multiple prophylactic
Pediatric Chest Pain-Low-Probability Referral: A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®), the Pediatric Health Information Systems Database, and the National Ambulatory Medical Care Survey.
Harahsheh, Ashraf S; O'Byrne, Michael L; Pastor, Bill; Graham, Dionne A; Fulton, David R
We conducted a study to assess test characteristics of red-flag criteria for identifying cardiac disease causing chest pain and technical charges of low-probability referrals. Accuracy of red-flag criteria was ascertained through study of chest pain Standardized Clinical Assessment and Management Plans (SCAMPs®) data. Patients were divided into 2 groups: Group1 (concerning clinical elements) and Group2 (without). We compared incidence of cardiac disease causing chest pain between these 2 groups. Technical charges of Group 2 were analyzed using the Pediatric Health Information System database. Potential savings for the US population was estimated using National Ambulatory Medical Care Survey data. Fifty-two percent of subjects formed Group 1. Cardiac disease causing chest pain was identified in 8/1656 (0.48%). No heart disease was identified in patients in Group 2 ( P = .03). Applying red-flags in determining need for referral identified patients with cardiac disease causing chest pain with 100% sensitivity. Median technical charges for Group 2, over a 4-year period, were US2014$775 559. Eliminating cardiac testing of low-probability referrals would save US2014$3 775 182 in technical charges annually. Red-flag criteria were an effective screen for children with chest pain. Eliminating cardiac testing in children without red-flags for referral has significant technical charge savings.
U.S. Department of Health & Human Services — Youth data for the fourth wave of the National Youth Survey are contained in this data collection. The first wave of this survey was conducted in 1976, the second...
U.S. Department of Health & Human Services — Youth data for the fifth wave of the National Youth Survey are contained in this collection. The first wave of this survey was conducted in 1976, the second wave in...
U.S. Department of Health & Human Services — The National Household Survey on Drug Abuse (NHSDA) series measures the prevalence and correlates of drug use in the United States. The surveys are designed to...
U.S. Department of Health & Human Services — The National Household Survey on Drug Abuse (NHSDA) series measures the prevalence and correlates of drug use in the United States. The surveys are designed to...
U.S. Department of Health & Human Services — The National Household Survey on Drug Abuse (NHSDA) series measures the prevalence and correlates of drug use in the United States. The surveys are designed to...
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
Critchley, Christine R; Nicol, Dianne; Otlowski, Margaret F A; Stranger, Mark J A
The success of human population biobanks are dependent on the publics' willingness to participate. This research aimed to determine those factors important in determining the public's intention to donate a biological sample to a publicly funded biobank, and allow that sample to be linked with medical records. A national sample of 1000 Australians was surveyed via telephonic interviews. Questions included the reported likelihood that respondents would participate in biobank research, ratings of trust in biobanks, beliefs that biobank research will lead to improved health care and general ratings of comfort with blood taking and DNA analysis. The sample reported a high level of trust in university biobanks, a strong belief that biobank research will lead to improved health care and a strong willingness to participate in biobank research. Using structural equation modelling, trust in the biobank was found to be the most important determinant of intention to participate in biobank research, followed by general comfort with blood taking and DNA analysis, belief in health-care benefits and higher education. Gender, age, parental status and experience of genetic conditions were not significantly associated with intention to participate. Australians are generally willing to participate in biobank research, and this is strongly determined by trust. While benefit beliefs and comfort with research are also relevant, higher trust was associated with intention regardless of these factors, suggesting reasons other than concern for improved health care are important in determining the publics' willingness to participate in biobank research.
The National Aquatic Resource Surveys (NARS) data are being used and applied above and beyond the regional and national assessments. This page includes a list of recent journal articles that reference NARS data.
In 1995, the National Highway Traffic Safety Administration (NHTSA) conducted its first Customer Satisfaction Survey in response to the requirements of the National Performance Review and Executive Order 12862. An independent research organization, S...
Creswell, John W.; And Others
It is proposed that numerous national surveys of faculty since the late 1960s provide institutional researchers and others with rich sources of descriptive data to help address the shifting national issues and institutional concerns related to faculty resources. An annotated list of 12 major faculty surveys is appended. (MSE)
Hupkens, C.L.H.; Berg, J. van den; Zee, J. van der
In order to study the value of national health interview surveys for national and international research and policy activities, this paper examines the existence and content of recent and future health interview surveys in the 15 member states of the European Union (EU), Norway, Iceland and
Torreggiani, W.C.; Nicolaou, S.; Lyburn, I.D.; Harris, A.C.; Buckley, A.R.
To document the existing radiology services available to emergency physicians in hospitals across Canada and to preview future trends and needs. Questionnaires (n = 130) regarding the type, availability and satisfaction with radiology services were distributed to radiologists and emergency physicians at 65 hospitals across Canada. Fifty-three (41%) questionnaires were returned, and 45 (35%) completed questionnaires from 35 hospitals were used for analysis (24 from radiologists and 21 from emergency physicians). Plain radiographs were available in all hospitals at all times. Ultrasonography, intravenous pyleograms and computed tomography (CT) were available in all departments during normal working hours; after hours, CT was unavailable in 1 hospital and ultrasonography was unavailable in 2. Focused assessment with sonography for trauma (FAST) was routinely performed for blunt abdominal trauma in 6 centres, and 10 centres had teleradiology services. Regarding the quality of emergency service, 7 of 45 responded 'poor,' 4 'average,' 14 'good,' and 17 of 45 rated service 'excellent.' Interestingly, most radiologists answered 'good' or 'excellent,' and most of the 'poor' responses came from emergency physicians. Regarding staff coverage after 5 pm, 34 hospitals provided CT services, 20 had ultrasonography staff available, and there was radiology nursing coverage in 14 hospitals. Clinical details on requisitions were generally rated 'adequate' or 'poor.' Although most radiograph reports were available within 48 hours, some took longer. Hot-seat reporting was available in 11 centres. During normal working hours, radiologists were the first to read films in 5 of 35 hospitals. After hours, emergency physicians were the first to read films in all hospitals, but only 14 hospitals indicated they were 'formally' trained to do so. This survey documents the strengths and weaknesses of the radiology services available to emergency physicians. The perceptions of emergency physicians
National Oceanic and Atmospheric Administration, Department of Commerce — Marine recreational fishing is a popular pastime across the United States that generates significant economic impacts to both local economies and to the nation. In...
National Oceanic and Atmospheric Administration, Department of Commerce — Marine recreational fishing is a popular pastime across the United States that generates significant economic impacts to both local economies and to the nation. In...
The basic aim of TU is to survey the transport behaviour of Danes residing in Denmark. The survey is managed by DTU Transport on behalf of a group of Danish authorities and organisa-tions. Thus, we focus on the needs arising from this group: • A stable, continuous, operational, reliable, easy-to-...
Lam, N P; Lê, P D; Crawford, S Y; Patel, S
To determine the rationale for using stress ulcer prophylaxis (SUP) among clinicians; to assess criteria used to define failure of SUP; and to evaluate the decision-making process in the selection of a prophylactic agent. A cross-sectional national mail survey. Random sample of the members of the Society of Critical Care Medicine who identified anesthesiology, surgery, or internal medicine as their primary specialty area. None. None. Questionnaires consisting of multiple-choice and short-answer questions were sent to a simple random sample of 1,268 physicians to assess the current practice of SUP. A total of 328 usable questions were returned, resulting in a response rate of 26%. All percentages reported in the results are based on the total number of responses. The risk factors for SUP that were most commonly identified were burns (91%), shock (90%), and sepsis (88%). These were also risk factors for which the respondents most commonly started SUP. Histamine-2-receptor (H2)-antagonists as a class, were the most commonly used prophylactic agents (67%). The most commonly used agents for SUP were ranitidine (31%), famotidine (24%), sucralfate (24%), and cimetidine (12%). Most respondents selected ranitidine for ease of administration, famotidine because of formulary availability, sucralfate for a better side effects profile, and cimetidine for cost-effectiveness. Eighty-two percent of respondents considered the presence of bright red blood in the nasogastric tube as failure of SUP. In cases where SUP failed, most respondents would add a second agent from a different therapeutic class. Of those respondents who used an H2-antagonist initially, 48% would add sucralfate, 36% would add antacid, and 13% would add omeprazole. Of those respondents who used sucralfate, 77% would add an H2-antagonist when SUP failed. For those respondents who would switch to another agent when the H2-antagonist failed, 52% would change to omeprazole, whereas 67% would change to an H2
The National Wetland Condition Assessment 2011: A Collaborative Survey presents the results of an unprecedented assessment of the nation’s wetlands. This report is part of the National Aquatic Resource Surveys, a series of statistically based surveys designed to provide the publi...
Kenney, A M
On October 9-12, 1985, 250 health personnel, educators, and social service workers attended the 2nd national conference on school based clinics in the US. The conference, held in Chicago, was sponsored jointly by the Center for Population Options (CPO), a Washington based organization which provides technical assistance to groups interested in establishing school clinics, and the Ounce of Prevention Fund, a group of funding agencies in Illinois which works in cooperation with the state government to provide funds for school clinics in Illinois. The growth and accomplishments of the school based clinic movement in the US was reviewed in opening remarks made by the chairperson of the CPO. In 1984, at the time of the 1st national conference, there were clinics in only about 12 communities throughout the nation. Currently, there are clinics in about 50 communities located in 26 states. The clinics provide primary health care, including physical exams, immunizations, treatment for minor illnesses, counseling, nutrition assistance, gynecological exams, and family planning counseling. Some of the clinics dispense contraceptives. Most of the clinics do not provide abortion referrals. The clinics are generally operated by groups outside the educational system, e.g., hospitals, health departments, and nonprofit organizations. The schools furnish space for the clinics. Clinics are usually staffed by a nurse practitioner and a social worker with a backup physician. Topics discussed by the conference participants included strategies for establishing clinics and for gaining community and student acceptance, clinic evaluation, and funding issues. Controversy frequently accompanies the establishment of new clinics. Participants tended to agree that an essential element in launching a successful program is the establishment of a community advisory committee. A concerted effort must be made to address all community concerns about the clinic. Participants noted that it was best to
Boster, Jamie B.; McCarthy, John W.
The Internet is a source of many resources for graduate speech-language pathology (SLP) students. It is important to understand the resources students are aware of, which they use, and why they are being chosen as sources of information for therapy activities. A national online survey of graduate SLP students was conducted to assess their…
A cross-sectional survey was undertaken with the European Union (EU) Member States and Norway and Iceland to describe seasonal influenza immunisation in the 2006-7 season, in particular to identify country-specific recommendations for risk groups, obtain vaccine uptake information and allow comparison with global recommendations. A standardised questionnaire was completed electronically by each country\\'s project gatekeeper. Of the 29 countries surveyed, 28 recommended seasonal influenza vaccination for older age groups (22 for those aged > 65 years), and in one country vaccine was recommended for all age groups. All countries recommended vaccinating patients with chronic pulmonary and cardiovascular diseases and most countries advised to immunise patients with haematologic or metabolic disorders (n=28), immunologic disorders (n=27) and renal disease (n=27), as well as residents of long-term care facilities (n=24). Most countries recommended vaccination for staff in hospitals (n=25), long-term care facilities (n=25) and outpatient clinics (n=23), and one-third had such recommendations for workers in essential (n=10), military (n=10) and veterinary services (n=10) and poultry industry (n=13). Eight countries recommended vaccine for pregnant women; and five advised to vaccinate children (with age limits ranging from 6 months to 5 years). Twenty countries measured influenza vaccine uptake among those aged > 65 years (range 1.8%-82.1%), seven reported uptake in healthcare workers (range 14%-48%) and seven assessed coverage in persons with underlying medical conditions (range 27.6%-75.2%). The data provided by this study can assist EU states to assess and compare their influenza vaccination programme performance with other countries. The information provides a comprehensive overview of policies and programmes and their outcomes and can be used to inform joint discussions on how the national policies in the EU might be standardised in the future to achieve optimal
Full Text Available Objective. To estimate calendar of sexual debut in Mexico and its trends using national representative household surveys. Materials and methods. Analysis of five birth cohorts extracted from four national population based household surveys in Mexico (National Health Survey 2000, National Survey on Demographic Dynamics 2009, National Youth Survey 2010, and National Health and Nutrition Survey 2012, using as outcome the proportion of individuals that reported sexual debut before the age of 16 and before the age of 20. Results. Overall, the four analyzed surveys produce consistent results, although some differences were found. While a larger proportion among younger cohorts reported sexual debut before the age of 20, that was not the case for sexual debut before 16 years. Conclusions. While data seems to reflect a relative stable age of sexual debut in Mexico, there is a recent trend to prepone sexual initiation that highlights the need to strengthen comprehensive sexual education and the supply of sexual and reproductive health services that are accessible and friendly to adolescents thus responding to the growing demand from this age group.
La Porte, Angela M.; Speirs, Peg; Young, Bernard
This article is the result of an empirical study that attempts to discern the extent to which certain factors might influence current curriculum content taught by K-12 art teachers in the United States with 0 to 7 years of teaching experience. Data were collected from a sample of 437 art teachers' completion of a survey instrument with…
Arrigoni, C; Grugnetti, A M; Caruso, R; Gallotti, M L; Borrelli, P; Puci, M
Developing clearly defined competencies and identifying strategies for their measurement remain unfortunately a critical aspect of nursing training. In the current international context, which continues to be characterised by deep economic crisis, universities have a fundamental role to play in redefining the educational goals to respond to the expectations of certain geographical areas of interest, as underscored in the Bologna Process (Joint Declaration of the European Ministers of Education Convened in Bologna 19 June 1999). The aim of this observational study was to examine the clinical learning context of nursing students using a tool developed by a team of teachers for the analysis of clinical learning. Redefinition of the clinical learning objectives with reference to the competencies set out in the questionnaire validated by Venturini et al. (2012) and the subsequent use of the tool created by the team of teachers for students in the first, second and third-year courses of the 2013/14 academic year, covering all the internships called for in those years. All nursing students enrolled in the first, second and third year of the nursing undergraduate degree program at the University of Pavia (no. 471) participated in this survey. A total of 1,758 clinical internships were carried out: 461 for the first year, 471 for the second year and 826 for the third year. Setting objectives, beginning with the educational offerings in the several clinical contexts, represents a strong point for this process. The results highlight a level of heterogeneity and complexity intrinsic to the University of Pavia educational system, characterized by clinical settings with different clinical levels (Research hospital and other traditional hospitals) that offering different levels of training. The use of the self-evaluation form for clinical learning made it possible to perform real-time observations of the training activities of the entire student body. An educational model
U.S. Department of Health & Human Services — Youth data for the third wave of the National Youth Survey are contained in this data collection, which includes data for youth interviewed in 1979 about events and...
U.S. Department of Health & Human Services — Youth data for the second wave of the National Youth Survey are contained in this data collection. The first wave was conducted in 1976. Youths were interviewed in...
U.S. Department of Health & Human Services — The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in...
U.S. Department of Health & Human Services — Youth data for the seventh wave of the National Youth Survey are contained in this collection. This research project, designed to gain a better understanding of both...
U.S. Department of Health & Human Services — This dataset contains parent and youth data for the National Youth Survey. Youths and one of their parents or legal guardians were interviewed in early 1977 about...
U.S. Department of Health & Human Services — Youth data for the sixth wave of the National Youth Survey are contained in this collection. This research project, which was designed to gain a better understanding...
U.S. Department of Health & Human Services — This dataset includes breastfeeding data from the National Immunization Survey (NIS). This data is used for DNPAO's Data, Trends, and Maps database, which provides...
Iowa State University GIS Support and Research Facility — The United States Geological Survey (USGS), in collaboration with other state and federal agencies, industry, and academia, is conducting a National Geochemical...
Ahlmark, Nanna; Algren, Maria Holst; Holmberg, Teresa
and incentives to participation. Design. This was a mixed-method study. Logistic regression was used to analyze nonresponse using data from DNHS (N = 177,639 and chi-square tests in item nonresponse analyses. We explored barriers and incentives regarding participation through focus groups and cognitive...... the questionnaire and the cover letter. The sender and setting in which to receive the questionnaire also influenced answering incentives. We observed differences in barriers and incentives between immigrants and descendants. Conclusions. Nonresponse appears related to linguistic and/or educational limitations......, to alienation generated by the questions' focus on disease and cultural assumptions, or mistrust regarding anonymity. Ethnic minorities seem particularly affected by such barriers. To increase survey participation, questions could be sensitized to reflect multicultural traditions, and the impact of sender...
Full Text Available Mariam Gangat,1 Genna W Klein,1 Hillel W Cohen,2 Rubina A Heptulla1 1Division of Pediatric Endocrinology and Diabetes, The Children's Hospital at Montefiore, 2Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA Background: A national online survey was conducted to evaluate pediatric subspecialty fellow satisfaction regarding continuity clinic experience. Methods: An anonymous online survey (SurveyMonkey™ was developed to evaluate demographics of the program, clinic organization, and patient and preceptor characteristics, and to compare fellow satisfaction when fellows were the primary providers with faculty supervision versus attending-run clinics assisted by fellows or a combination of the two models. Pediatric subspecialty fellows in a 3-year Accreditation Council for Graduate Medical Education accredited program in the United States (excluding emergency medicine, neonatology, and critical care were invited to participate. Results: There were 644 respondents and nearly half (54% of these had fellow-run clinics. Eighty-six percent of fellows responded that they would prefer to have their own continuity clinics. Higher satisfaction ratings on maintaining continuity of care, being perceived as the primary provider, and feeling that they had greater autonomy in patient management were associated with being part of a fellow-run clinic experience (all P < 0.001. Additionally, fellow-run clinics were associated with a feeling of increased involvement in designing a treatment plan based on their differential diagnosis (P < 0.001. There were no significant associations with patient or preceptor characteristics. Conclusion: Fellow-run continuity clinics provide fellows with a greater sense of satisfaction and independence in management plans. Keywords: resident education/training, workforce, pediatric, patient-provider relationship, pediatric outpatient clinic
Kantrowitz-Gordon, Ira; Adriane Ellis, Simon; McFarlane, Ann
Midwifery in the United States suffers from a lack of diversity. More than 91% of midwives are white, and more than 98% are women. Little research has explored the experiences of midwives who are men or transgender. Invitation to an Internet survey was sent to the membership of the American College of Nurse-Midwives. Thirty-one participants who identified as men or transgender completed the survey, which included quantitative and open-ended questions about the impact of gender on education and practice. Data analysis of qualitative responses used qualitative description methodology to identify common themes. Four themes described participating men's experiences of education and practice of midwifery. Challenges included feeling singled out as different and being excluded. Supportive factors came from the social support of family, friends, colleagues, and patients, as well as from taking pride in one's work as a midwife. Midwives who identify as transgender described the challenges of others' confusion about their gender, having to hide their true gender identity, and struggling with the resulting loneliness. This survey highlights the challenges faced by midwives who are men or transgender in education and practice. Midwifery values of respect and acceptance for all women and families need to be applied internally to all members of the profession. This will support increased diversity and openness in midwifery. © 2014 by the American College of Nurse‐Midwives.
Martín Romero-Martínez; Teresa Shamah-Levy; Lucia Cuevas-Nasu; Ignacio Méndez Gómez-Humarán; Elsa Berenice Gaona-Pineda; Luz María Gómez-Acosta; Juan Ángel Rivera-Dommarco; Mauricio Hernández-Ávila
Objective. Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. Materials and methods. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organizat...
Aronson, Jeffrey K
Since the discipline expanded during 1970-1990, the number of UK consultant clinical pharmacologists has fallen. This paper describes the results of a questionnaire survey of the work patterns of 53 UK consultant clinical pharmacologists, including 35 (66%) employed by universities and 13 (25%) employed by the National Health Service (NHS). The range of activities undertaken includes: teaching medical students and others the principles of clinical pharmacology and practical therapeutics; research in a wide range of pharmacological and therapeutic areas; patient care, mostly in acute and general hospital medicine and in out-patient clinics; service both locally and nationally on a wide range of committees related to drug therapy; editorial work on learned journals and preparation of written teaching materials, including journal articles, didactic textbooks, reference books, and e-learning materials. The median amount of time that a UK consultant clinical pharmacologist spends on these activities is 50 hours per week; several work more than that. The time is spent as follows: teaching 10%; research 40%; clinical work 30%; policy and administration 12%; editorial work and writing 8%. The numbers of physicians who have been newly registered with the General Medical Council as clinical pharmacologists each year has so far been undiminished, but the number of consultant posts has fallen in 1990-2010. Many trainees therefore leave the discipline when they become consultants. © 2011 The Author. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.
Lovato, C Y; Shoveller, J A; Peters, L; Rivers, J K
This article describes the methods used for the 1996 Canadian National Survey on Sun Exposure & Protective Behaviours. A 55-item random-digit-dialling telephone household survey of people 15 years of age or more was completed in 1996. Items assessed were daily sun exposure and protective behaviours, as well as other sun-related behaviours and attitudes. Data were collected regarding sun-related behaviours during leisure, work time and winter holidays, as well as for children 12 years of age or less (as reported by parents). To test for an effect on the survey response rate, a letter of introduction was sent to 40% of the households. The survey response rate was 69% (4023 successfully completed surveys out of 5847 households included in the sample). The response rate achieved in the subset that received the introductory letter was 75%. This survey is the first to establish national population estimates for sun exposure and protective behaviours in Canada.
Ramesh Ghimire; Ken Cordell; Alan Watson; Chad Dawson; Gary T. Green
A national survey of managers was developed to support interagency wilderness strategic planning. The focus was on major challenges, perceived needs for science and training, and accomplishments of 1995 Strategic Plan objectives. The survey was administered to managers at the four federal agencies with wilderness management responsibilities: the Bureau of Land...
Objective: To determine factors associated with male condom use in Tanzania. Methods: Data from the 1996 Tanzania Demographic and Health Survey (TDHS) was used. In this survey, a national representative sample of sexually active men (N= 1898) and women (N=7027) were interviewed to obtain information about ...
Egley, Jr., Arlen; O'Donnell, Christina E.
This report presents findings from the 2007 National Youth Gang Survey. Data on the number of gangs, gang members, and gang-related homicides in larger cities, suburban counties, smaller cities, and rural counties are provided to accurately reflect youth gang activity in the United States. Based on survey results, it is estimated that nearly 3,550…
Crisp-Han, Holly; Chambliss, R. Bryan; Coverdale, John
Objective: Because there have been no previously published national surveys on teaching psychiatry residents about how to teach, the authors surveyed United States psychiatry program directors on what and how residents are taught about teaching. Methods: All psychiatry training programs across the United States were mailed a semistructured…
This report presents the preliminary findings of the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Argonne National Laboratory (ANL), conducted June 15 through 26, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. The team includes outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with ANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ANL, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S ampersand A) Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The S ampersand A Plan will be executed by the Oak Ridge National Laboratory (ORNL). When completed, the S ampersand A results will be incorporated into the Argonne National Laboratory Environmental Survey findings for inclusion in the Environmental Survey Summary Report. 75 refs., 24 figs., 60 tabs
This report presents the preliminary findings of the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Argonne National Laboratory (ANL), conducted June 15 through 26, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. The team includes outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with ANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ANL, and interviews with site personnel. The Survey team developed a Sampling and Analysis (S A) Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The S A Plan will be executed by the Oak Ridge National Laboratory (ORNL). When completed, the S A results will be incorporated into the Argonne National Laboratory Environmental Survey findings for inclusion in the Environmental Survey Summary Report. 75 refs., 24 figs., 60 tabs.
Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J
Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.
Cheffins, Richard H. A.
National bibliographies of 62 countries are examined, and standardized information on each is presented together with summary tables in this country-by-country analysis. It is based on, and aims to extend and update, Gerhard Pomassl's "Survey of National Bibliographies, 1975" and "Synoptic Tables Concerning the Current National…
A cross-sectional, national household-based survey was conducted using second-generation surveillance procedures. A complex multistage sampling technique was used to create a master sample of 1 000 census enumerator areas out of a total of 86 000 nationally. Aerial photographs were taken and used to randomly ...
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Fermi National Accelerator Laboratory (Fermilab), conducted September 14 through 25, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual participants for the Survey team are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Fermilab. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at Fermilab, and interviews with site personnel. 110 refs., 26 figs., 41 tabs
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Fermi National Accelerator Laboratory (Fermilab), conducted September 14 through 25, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual participants for the Survey team are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Fermilab. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at Fermilab, and interviews with site personnel. 110 refs., 26 figs., 41 tabs.
Huon, Leh-Kiong; Wang, Ting-Chuan; Fang, Te-Yung; Chuang, Li-Ju; Wang, Pa-Chun
To investigate the association between vertigo and stroke in Taiwan using the Bureau of National Health Insurance research database. Information on adult patients with an index vertigo attack in 2006 was retrieved from Bureau of National Health Insurance research database. All patients with specific diagnostic codes for vertigo were included. Occurrence of stroke during a 1-year follow-up period was identified. Risk factors for stroke were examined. Using χ test, t test, and a multilevel logistic regression model, patients with vertigo were categorized into stroke and nonstroke groups for comparative analyses. An age- and sex- matched control cohort was prepared for comparison. Patients with vertigo (n = 527,807) (mean age, 55.1 yr) accounted for 3.1% of the general Taiwanese adult population. The prevalence of stroke among vertigo patients of 0.5% (mean age, 67.8 yr) was slightly higher than that of the control group (0.3%; mean age, 72.3 yr; p vertigo had higher prevalence of comorbid conditions (p diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, or atrial fibrillation had a higher prevalence of stroke (p vertigo had higher chance to develop stroke than the control group. Some strokes may initially manifest as peripheral vertigo, and some central vertigo may eventually evolve into a stroke. Middle aged male, diabetes, hypertension, dyslipidemia, coronary artery disease, and atrial fibrillation are risk factors for subsequent stroke in vertigo patients.
Ling, Pamela M; Neilands, Torsten B; Glantz, Stanton A
Young adults have the highest smoking rate of any age group in the U.S., and new strategies to decrease young adult smoking are needed. The objective of the current study was to identify psychographic and demographic factors associated with current smoking and quitting behaviors among young adults. Attitudes, social groups, and self-descriptors, including supporting action against the tobacco industry, advertising receptivity, depression, alcohol use, and other factors associated with smoking were tested for associations with smoking behaviors in a 2005 cross-sectional survey of 1528 young adults (aged 18-25 years) from a web-enabled panel. Analyses were conducted in 2007. Being older was associated with current smoking, whereas having some higher education and being African American or Hispanic were negatively associated with smoking. Supporting action against the tobacco industry was negatively associated with smoking (AOR=0.34 [95% CI=0.22, 0.52]). Perceived usefulness of smoking, exposure to smokers, increased perceived smoking prevalence, receptivity to tobacco advertising, binge drinking, and exposure to tobacco advertising in bars and clubs were associated with smoking. Supporting action against the tobacco industry was associated with intentions to quit smoking (AOR=4.43 [95% CI=2.18, 8.60]). Young adults are vulnerable to tobacco-industry advertising. Media campaigns that denormalize the tobacco industry and appeal to young adults appear to be a powerful intervention to decrease young adult smoking.
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Brookhaven National Laboratory (BNL) conducted April 6 through 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with BNL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at BNL, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing specific environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by Oak Ridge National Laboratory. When completed, the results will be incorporated into the BNL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the BNL Survey. 80 refs., 24 figs., 48 tabs.
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Brookhaven National Laboratory (BNL) conducted April 6 through 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with BNL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at BNL, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing specific environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by Oak Ridge National Laboratory. When completed, the results will be incorporated into the BNL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the BNL Survey. 80 refs., 24 figs., 48 tabs
Probst, Charlotte; Shuper, Paul A; Rehm, Jürgen
Evidence suggests that adult per-capita alcohol consumption, as estimated from self-reports of nationally representative surveys, underestimates 'true' consumption, as measured as the sum of recorded and unrecorded consumption. The proportion of total adult alcohol per capita reported in representative surveys is usually labelled 'coverage'. The aim of the present paper was to estimate coverage for South Africa under different scenarios of alcohol use assessment and 'true' consumption. Five nationally representative surveys from South Africa were used to estimate the prevalence of drinking and the grams per day among current drinkers. All surveys used a complex multi-stage sampling frame that was accounted for by using survey weights. The total (recorded and unrecorded), the recorded and the adjusted total adult per-capita alcohol consumption in South Africa served as different estimates of the 'true' consumption. South Africa. Alcohol use information was assessed on a total of 8115, 16 398 and 13 181 adults (15 years or older) in surveys from the years 2003, 2005 and 2008, respectively. Two surveys in 2012 included 27 070 and 18 688 adults. Coverage of the alcohol use reported in the surveys was calculated, compared with the 'true' adult per-capita alcohol. The survey data covered between 11.8% [2005; 95% uncertainty interval (UI) = 9.3-16.2%)] and 19.4% (2003; 95% UI = 14.9-24.2%) of the total alcohol used per capita. The highest coverage of 27.9% (95% UI = 22.4-36.8%) was observed when looking only at recorded alcohol in 2003. Evidence from five nationally representative surveys assessing alcohol use suggests that less than 20% of the total adult per-capita alcohol consumption in South Africa is reported in surveys. © 2016 Society for the Study of Addiction.
Full Text Available A survey was mailed to all institutions in Canada licensed to use radiopharmaceuticals. Questions addressed meal type; mode of preparation; and means, ranges and SD of emptying times. Seventy-eight per cent of 222 facilities responded, including all 55 teaching centres. Eighty-five per cent of teaching and 56% of nonteaching centres perform solid phase gastric emptying studies (GES. The majority use 99mTc sulphur colloid (Tc-SC added to eggs before cooking as the standard meal. Twenty-five per cent of teaching and 21% of nonteaching centres perform liquid phase GES. Most use a watery solution of 111In-diethylenetriamine pentaacetic acid. Gastric emptying for solid phase GES, expressed as time for 50% emptying (mean t½, varied from 42 to 105 mins for centres using the Tc-SC egg meal. Twenty-eight per cent of teaching centres used ±2 SD to define their normal range, 26% used ±1 SD, 6% used ±1.5 SD, and 40% did not know the number of SD used. Twenty per cent of non-teaching centres used ±2 SD, 12% used ±1 SD and 68% did not know how many SD were used. For liquid phase GES, mean t½ varied from 20 to 60 mins. Eighteen per cent of centres used healthy volunteers to establish or validate normal ranges. There is substantial variability among the normal ranges for radionuclide solid and liquid phase GES in both teaching and nonteaching centres across Canada. A minority of facilities have established or validated their own normal ranges in healthy volunteers. There is a need for a more standardized protocol and range of normal, with internal validation by each institution.
Hawes, Catherine; Phillips, Charles D; Rose, Miriam; Holan, Scott; Sherman, Michael
Throughout the 1990s, assisted living was the most rapidly growing form of senior housing. The purpose of this paper is to describe the existing supply of assisted living facilities (ALFs) and examine the extent to which they matched the philosophy of assisted living. The study involved a multistage sample design to produce nationally representative estimates for the ALF industry. Administrators of nearly 1,500 eligible ALFs were interviewed by telephone. As of 1998, there were an estimated 11,459 ALFs nationwide, with 611,300 beds and 521,500 residents. Nearly 60% offered a combination of low services and low or minimal privacy, whereas only 11% offered relatively high services and high privacy. Seventy-three percent of the resident rooms or apartments were private. Aging-in-place was limited by discharge policies in most ALFs for residents who needed help with transfers, had moderate to severe cognitive impairment, had any behavioral symptoms, or needed nursing care. The industry is largely private pay and unaffordable for low- or moderate-income persons aged >/=75 unless they use assets as well as income to pay. ALFs differed widely in ownership, size, policies, and the degree to which they manifested the philosophy of assisted living. This diversity represents a challenge for consumers in terms of selecting an appropriate facility and for policy makers in terms of deciding what role they want assisted living to play in long-term care.
This report presents the preliminary findings from the first phase of the Environmental Survey of the Department of Energy (DOE) Lawrence Livermore National Laboratory (LLNL), conducted December 1 through 19, 1986. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with LLNL. The Survey covers all environmental media all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations performed at LLNL, and interviews with site personnel. A Sampling and Analysis Plan was developed to assist in further assessing certain of the environmental problems identified during performance of on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory. When completed, the results will be incorporated into the LLNL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the LLNL Survey. 70 refs., 58 figs., 52 tabs.,
Frazier, Benjamin W.; Betts, Gilbert L.; Greenleaf, Walter J.; Waples, Douglas; Dearborn, Ned H.; Carney, Mabel; Alexander, Thomas
The Seventy-first Congress authorized a survey of the education of teachers on a Nation-wide scope, conducted during the last 3 years. After the work of the survey was organized it was apparent that only a limited number of studies could be undertaken with the time and funds available. It was decided, therefore, to cooperate whenever possible with…
Jaana, Mirou; Ward, Marcia M.; Bahensky, James A.
Purpose: Present an overview of clinical information systems (IS) in hospitals and analyze the level of electronic medical records (EMR) implementation in relation to clinical IS capabilities and organizational characteristics. Methods: We developed a survey instrument measuring clinical IS implementation and classified clinical IS across 5 EMR…
Elmore, Leisha C; Jeffe, Donna B; Jin, Linda; Awad, Michael M; Turnbull, Isaiah R
Background Burnout is a complex syndrome of emotional distress that can disproportionately affect individuals who work in healthcare professions. Study Design For a national survey of burnout in US general surgery residents, we asked all Accreditation Council for Graduate Medical Education-accredited general surgery program directors to email their general surgery residents an invitation to complete an anonymous, online survey. Burnout was assessed with the Maslach Burnout Inventory; total scores for Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) subscales were calculated. Burnout was defined as having a score in the highest tertile for EE or DP or lowest tertile for PA. Chi-square tests and one-way analyses of variance were used to test associations between burnout tertiles for each subscale and various resident and training-program characteristics as appropriate. Results From April–December, 2014, 665 residents actively engaged in clinical training had data for analysis; 69% met the criterion for burnout on at least one subscale. Higher burnout on each subscale was reported by residents planning private practice compared with academic careers. A greater proportion of women than men reported burnout on EE and PA. Higher burnout on EE and DP was associated with greater work hours per week. Having a structured mentoring program was associated with lower burnout on each subscale. Conclusions The high rates of burnout among general surgery residents are concerning given the potential impact of burnout on the quality of patient care. Efforts to identify at-risk populations and to design targeted interventions to mitigate burnout in surgical trainees are warranted. PMID:27238875
Paul A Bourne
Full Text Available Paul A Bourne1, Christopher AD Charles2,3, Neva South-Bourne4, Chloe Morris1, Denise Eldemire-Shearer1, Maureen D Kerr-Campbell51Department of Community Health and Psychiatry, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica; 2King Graduate School, Monroe College, Bronx, New York, USA; 3Center for Victim Support, Harlem Hospital Center, New York, USA; 4Research assistant for Paul A Bourne; 5Systems Development Unit, Main Library, Faculty of Humanities and Education, University of the West Indies, Mona, Kingston, JamaicaBackground: In Jamaica, population census began in 1844, and many intercensal ratios obtained from the census data showed that there is a general high degree of accuracy of the data. However, statistics from the Jamaican Ministry of Health showed that there are inaccuracies in health data collected from males using sample surveys.Objectives: The objectives of the present research are to 1 investigate the accuracy of a national sample survey, 2 explore the feasibility and quality of using a subnational sample survey to represent a national survey, 3 aid other scholars in understanding the probability of using national sample surveys and subnational sample surveys, 4 assess older men’s evaluation of their health status, and 5 determine whether dichotomization changes self-evaluated health status.Methods: For the current study, the data used in the analysis were originally collected from 2 different sources: 1 the Jamaica Survey of Living Conditions (JSLC and 2 Survey of Older Men (SOM. Cross validation of self-evaluated data of men in Jamaica was done with comparable samples of the complete JSLC data and the SOM data, where men older than 55 years were selected from each sample.Results: In study 1, 50.2% of respondents indicated at least good self-evaluated health status compared with 74.0% in study 2. Statistical associations were found between health status and survey sample (Χ2 [df = 5
U.S. Environmental Protection Agency — The National Aquatic Resource Survey (NARS) findings for nutrients in streams and lakes highlight that nutrient pollution is widespread across the United States and...
Cropsey, Karen L.; Wexler, Harry K.; Melnick, Gerald; Taxman, Faye S.; Young, Douglas W.
Findings from the National Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) National Criminal Justice Treatment Practices survey are examined to describe types of services provided by three types of prisons: those that serve a cross-section of offenders, those that specialize in serving offenders with special psychosocial and medical needs, and those that specialize in serving legal status or gender specific populations. Information is presented on the prevalence and type of specialize...
... Questions to Ask about Your Treatment Research Cancer Clinical Trials at the National Institutes of Health Clinical Center ... they are eligible for a clinical trial . NCI Clinical Trials at the NIH Clinical Center Cancer research at ...
Brown, James; Ryan, Christopher; Harris, Anthony
Doctors are uncertain of their ethical and legal obligations when communicating with patients online. Professional guidelines for patient-doctor interaction online have been written with limited quantitative data about doctors' current usage and attitudes toward the medium. Further research into these trends will help to inform more focused policy and guidelines for doctors communicating with patients online. The intent of the study was to provide the first national profile of Australian doctors' attitudes toward and use of online social media. The study involved a quantitative, cross-sectional online survey of Australian doctors using a random sample from a large representative database. Of the 1500 doctors approached, 187 participated (12.47%). Most participants used social media privately, with only one-quarter not using any social media websites at all (48/187, 25.7%). One in five participants (30/155, 19.4%) had received a "friend request" from a patient. There was limited use of online communication in clinical practice: only 30.5% (57/187) had communicated with a patient through email and fewer than half (89/185, 48.1%) could offer their patients electronic forms of information if that were the patients' preference. Three in five participants (110/181, 60.8%) reported not being uncomfortable about interacting with patients who had accessed personal information about them online, prior to the consultation. Most of the participants (119/181, 65.8%) were hesitant to immerse themselves more fully in social media and online communication due to worries about public access and legal concerns. Doctors have different practices and views regarding whether or how to communicate appropriately with patients on the Internet, despite online and social media becoming an increasingly common feature of clinical practice. Additional training would assist doctors in protecting their personal information online, integrating online communication in patient care, and guidance on
Dietsch, Alia M.; Sexton, Natalie R.; Koontz, Lynne M.; Conk, Shannon J.
The National Wildlife Refuge System (Refuge System), established in 1903 and managed by the U.S. Fish and Wildlife Service (Service), is the leading network of protected lands and waters in the world dedicated to the conservation of fish, wildlife and their habitats. There are 560 national wildlife refuges and 38 wetland management districts nationwide, encompassing more than 150 million acres. The Refuge System attracts nearly 45 million visitors annually, including 34.8 million people who observe and photograph wildlife, 9.6 million who hunt and fish, and nearly 675,000 teachers and students who use refuges as outdoor classrooms. Understanding visitor perceptions of refuges and characterizing their experiences on refuges are critical elements of managing these lands and meeting the goals of the Refuge System. The Service collaborated with the U.S. Geological Survey to conduct a national survey of visitors regarding their experiences on national wildlife refuges. The purpose of the survey was to better understand visitor experiences and trip characteristics, to gauge visitors’ levels of satisfaction with existing recreational opportunities, and to garner feedback to inform the design of programs and facilities. The survey results will inform performance, planning, budget, and communications goals. Results will also inform Comprehensive Conservation Plans (CCPs), visitor services, and transportation planning processes. This Data Series consists of 25 separate data files. Each file describes the results of the survey for an individual refuge and contains the following information: • Introduction: An overview of the Refuge System and the goals of the national surveying effort. • Methods: The procedures for the national surveying effort, including selecting refuges, developing the survey instrument, contacting visitors, and guidance for interpreting the results.• Refuge Description: A brief description of the refuge location, acreage, purpose, recreational
Ilyas, S.; Beatie, A.; Pettet, G.; Kharay, A.; Hedayati, V.; Hameed, S.; McCleery, M.A.; Papadakos, N.; Chari, B.
Aim: To gather information in order to highlight areas within training that could be improved and share ideas of good practice and, in addition, to compare national results with those of local training schemes. Materials and methods: A request to participate in the survey was emailed to 1158 radiology trainees across 36 UK training schemes in October 2012. The electronic replies were anonymous. The survey remained active for 6 weeks. The data were collated and analysed by members of the JRF. The survey itself was divided into seven sections, covering a diverse range of topics. Results: Six hundred and four trainees from 36 UK training schemes completed the survey, resulting in a response rate of 52%. - Highlights: • First Radiology specific national survey, written by trainees. • Training schemes can benchmark their performance against a national average. • Also can share areas of good practice; and highlight those that need improvement. • Summary of the results, highlighting the most pertinent findings from each section
Kingery, Paul M.; Coggeshall, Mark B.; Alford, Aaron A.
Reviews data from four surveys using national samples that include questions about violence that were administered to school-aged youth. Assesses risk factors for weapon-carrying and the level of the school violence program. Results show that students' involvement with violence in the community, both as perpetrator and victim, is the most…
Busacca, Louis A.; Beebe, Ronald S.; Toman, Sarah M.
This national web-based study used the Schwartz Value Survey (Schwartz, 1994) and Super's Work Values Inventory-Revised (Zytowski, n.d.) to identify general life and work value orientations of 674 female and male entry-level counselor trainees residing in 27 states. In general, trainees emphasized benevolence, self-direction, and achievement and…
The perception exists that laparoscopic training in South Africa has been unplanned and under-resourced. This study set out to assess the opinions of surgeons and surgical trainees with regard to the various facets of laparoscopic surgical training. Methods. A national survey was conducted, using a questionnaire ...
Panjwani, Aliza A.; Gurung, Regan A. R.; Revenson, Tracey A.
We conducted an online national survey to examine how undergraduate health psychology is taught, offer information about course design and content, and provide a needs analysis. Health psychology instructors (N = 126) answered questions about course format, teaching tools, importance of covering specific topics, and needed resources. A principal…
National Survey on Blindness, Low Vision and Trachoma in Ethiopia: Methods and Study Clusters Profile. Y Berhane, A Worku, A Bejiga, L Adamu, W Alemayehu, A Bedri, Z Haile, A Ayalew, W Adamu, T Gebre, T D Kebede, E West, S West ...
Catechis, Christopher Spyros
Sandia National Laboratories, Environmental Programs completed an environmental baseline survey (EBS) of 12.6 acres located at Sandia National Laboratories/California (SNL/CA) in support of the proposed Collaboration in Research and Engineering for Advanced Technology and Education (CREATE) Facility. The survey area is comprised of several parcels of land within SNL/CA, County of Alameda, California. The survey area is located within T 3S, R 2E, Section 13. The purpose of this EBS is to document the nature, magnitude, and extent of any environmental contamination of the property; identify potential environmental contamination liabilities associated with the property; develop sufficient information to assess the health and safety risks; and ensure adequate protection for human health and the environment related to a specific property.
Van Horn, Pamela S.; Green, Kathy E.; Martinussen, Monica
This article reports results of a meta-analysis of survey response rates in published research in counseling and clinical psychology over a 20-year span and describes reported survey administration procedures in those fields. Results of 308 survey administrations showed a weighted average response rate of 49.6%. Among possible moderators, response…
Liau, Adrian; Havidich, Jeana E; Onega, Tracy; Dutton, Richard P
The Anesthesia Quality Institute (AQI) was chartered in 2008 by the American Society of Anesthesiologists to develop the National Anesthesia Clinical Outcomes Registry (NACOR). In this Technical Communication, we will describe how data enter NACOR, how they are authenticated, and how they are analyzed and reported. NACOR accepts case-level administrative, clinical, and quality capture data from voluntarily participating anesthesia practices and health care facilities in the United States. All data are transmitted to the AQI in summary electronic files generated by billing, quality capture, and electronic health care record software, typically on a monthly basis. All data elements are mapped to fields in the NACOR schema in accordance with a publicly available data dictionary. Incoming data are loaded into NACOR by AQI technologists and are subject to both manual and automated review to identify systematically missing elements, miscoding, and inadvertent corruption. Data are deidentified in compliance with Health Insurance Portability and Accountability Act regulations. The database server of AQI, which houses the NACOR database, is protected by 2 firewalls within the American Society of Anesthesiologists' network infrastructure; this system has not been breached. The NACOR Participant User File, a deidentified case-level dataset of information from NACOR, is available to researchers at participating institutions. NACOR architecture and the nature of the Participant User File include both strengths and weaknesses.
Food consumption surveys are performed in many countries. Comparison of results from those surveys across nations is difficult because of differences in methodological approaches. While consensus about the preferred methodology associated with national food consumption surveys is increasing, no in...
In 2012, NHTSA conducted a national telephone survey to obtain a status report on attitudes, knowledge, and behavior related to outdoor walking and bicycling. This study updates national telephone survey data collected by NHTSA in 2002. The survey ad...
Kaaijk, Paul; Durand, Yvonnick
The objective of Task 1 of the IEA Photovoltaic Power Systems Program is to promote and facilitate the exchange and dissemination of information on the technical, economic, environmental and social aspects of PV power systems. Task 1 activities support the broader PVPS objectives: to contribute to cost reduction of PV power applications, to increase awareness of the potential and value of PV power systems, to foster the removal of both technical and non-technical barriers and to enhance technology co-operation. An important deliverable of Task 1 is the annual report Trends in Photovoltaic Applications. In parallel, National Survey Reports are produced annually by each Task 1 participant. The PVPS web site www.iea-pvps.org also plays an important role in disseminating information arising from the program, including national information. This document is the French National Survey Report on photovoltaics for the year 2015
Kaaijk, Paul; Durand, Yvonnick
The objective of Task 1 of the IEA Photovoltaic Power Systems Program is to promote and facilitate the exchange and dissemination of information on the technical, economic, environmental and social aspects of PV power systems. Task 1 activities support the broader PVPS objectives: to contribute to cost reduction of PV power applications, to increase awareness of the potential and value of PV power systems, to foster the removal of both technical and non-technical barriers and to enhance technology co-operation. An important deliverable of Task 1 is the annual Trends in photovoltaic applications report. In parallel, National Survey Reports are produced annually by each Task 1 participant. The PVPS web site www.iea-pvps.org also plays an important role in disseminating information arising from the program, including national information. This document is the French National Survey Report on photovoltaics for the year 2014
Natarajan, Pradeep; Oelschlager, Ashley; Agah, Arvin; Pohl, Patricia S; Ahmad, S Omar; Liu, Wen
This study was aimed at understanding the current physical and occupational therapy practices in stroke rehabilitation in the Midwest. The insights gained from this pilot study will be used in a future study aimed at understanding stroke rehabilitation practices across the nation. Researchers and clinicians in the field of stroke rehabilitation were interviewed, and past studies in the literature were analyzed. Through these activities, we developed a 37-item questionnaire that was sent to occupational and physical therapists practicing in Kansas and Missouri who focus on the care of people who have had a stroke (n = 320). A total of 107 respondents returned a com pleted questionnaire, which gives a response rate of about 36%. The majority of respondents had more than 12 years of experience treating patients with stroke. Consensus of 70% or more was found for 80% of the items. The preferred approaches for the rehabilitation of people who have had a stroke are the Bobath and Brunnstrom methods, which are being used by 93% and 85% of the physical and occupational therapists, respectively. Even though some variability existed in certain parts of the survey, in general clinicians agreed on different treatment approaches in issues dealing with muscle tone, weakness, and limited range of motion in stroke rehabilitation. Some newer treatment approaches that have been proven to be effective are practiced only by a minority of clinicians. The uncertainty among clinicians in some sections of the survey reveals that more evidence on clinical approaches is needed to ensure efficacious treatments.
This report contains the preliminary findings based on the first phase of an Environmental Survey at the Department of Energy (DOE) Sandia National Laboratories Livermore (SNLL), located at Livermore, California. The Survey is being conducted by DOE's Office of Environment, Safety and Health. The SNLL Survey is a portion of the larger, comprehensive DOE Environmental Survey encompassing all major operating facilities of DOE. The DOE Environmental Survey is one of a series of initiatives announced on September 18, 1985, by Secretary of Energy, John S. Herrington, to strengthen the environmental, safety, and health programs and activities within DOE. The purpose of the Environmental Survey is to identify, via a no fault'' baseline Survey of all the Department's major operating facilities, environmental problems and areas of environmental risk. The identified problem areas will be prioritized on a Department-wide basis in order of importance in 1989. The findings in this report are subject to modification based on the results from the Sampling and Analysis Phase of the Survey. The findings are also subject to modification based on comments from the Albuquerque Operations Office concerning the technical accuracy of the findings. The modified preliminary findings and any other appropriate changes will be incorporated into an Interim Report. The Interim Report will serve as the site-specific source for environmental information generated by the Survey, and ultimately as the primary source of information for the DOE-wide prioritization of environmental problems in the Survey Summary Report. 43 refs., 21 figs., 24 tabs.
The 2012 National Survey of Bicyclist and Pedestrian Attitudes and Behavior is the second survey on this topic conducted for the National Highway Traffic Safety Administration (NHTSA). Data collection was conducted by Abt SRBI, Inc, a national resear...
This report presents the first national prevalence estimates for drug-involved driving derived from the recently : completed 2007 National Roadside Survey (NRS). The NRS is a national field survey of alcohol- and drug-involved : driving conducted pri...
Borges, Guilherme; Medina-Mora, Maria Elena; Lown, Anne; Ye, Yu; Robertson, Marjorie J.; Cherpitel, Cheryl; Greenfield, Tom
The authors show associations between immigration and alcohol disorders using data from the 1995 and 2000 U.S. National Alcohol Surveys and the 1998 Mexico National Household Survey on Addictions. The prevalence of alcohol dependence was 4.8% for the Mexicans, 4.2% for the Mexico-born immigrants, and 6.6% for the U.S.-born Mexican Americans. They…
Wang, Hong-Ying; Petersen, Poul Erik; Bian, Jin-You
OBJECTIVES: To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience. DESIGN: Cross-sectional study, oral epidemiological survey based on WHO methodology, clinical examinations....... SETTING: National survey by National Committee for Oral Health. SUBJECTS: Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5,12,15,18, 35-44 and 65-74. Each age group consisted of 23,452 participants, i.e. total of 140,712 individuals. RESULTS: At age 5...... prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old-age people of rural areas. At national level, changes in dental caries prevalence of 12- and 15-year-olds were small. However, some provinces...
Sugarbaker, Larry; Coray, Kevin E.; Poore, Barbara
The purpose of this study was to receive customer feedback and to understand data and information requirements for The National Map. This report provides results and findings from interviews and surveys and will guide policy and operations decisions about data and information requirements leading to the development of a 5-year strategic plan for the National Geospatial Program. These findings are based on feedback from approximately 2,200 customers between February and August 2008. The U.S. Geological Survey (USGS) conducted more than 160 interviews with 200 individuals. The American Society for Photogrammetry and Remote Sensing (ASPRS) and the International Map Trade Association (IMTA) surveyed their memberships and received feedback from over 400 members. The Environmental Systems Research Institute (ESRI) received feedback from over 1,600 of its U.S.-based software users through an online survey sent to customers attending the ESRI International User Conference in the summer of 2008. The results of these surveys were shared with the USGS and have been included in this report.
Gómez-Restrepo, Carlos; de Santacruz, Cecilia; Rodriguez, María Nelcy; Rodriguez, Viviana; Tamayo Martínez, Nathalie; Matallana, Diana; Gonzalez, Lina M
The 2015 National Mental Health Survey (NMHS) is the fourth mental survey conducted in Colombia, and is part of the National System of Surveys and Population Studies for health. A narrative description is used to explain the background, references, the preparation, and characteristics of the 2015 NMHS. The 2015 NMHS and its protocol emerge from the requirements that support the national and international policies related to mental health. Together with the Ministry of Health and Social Protection, the objectives, the collection tools, the sample, and the operational plan are defined. The main objective was to obtain updated information about the mental health, mental problems and disorders, accessibility to health services, and an evaluation of health conditions. Participants were inhabitants from both urban and rural areas, over 7 years old, and in whom the comprehension of social determinants and equity were privileged. An observational cross-sectional design with national, regional and age group representativity, was used. The age groups selected were 7-11, 12-17, and over 18 years old. The regions considered were Central, Orient, Atlantic, Pacific, and Bogota. The calculated sample had a minimum of 12,080 and a maximum of 14,496 participants. A brief summary of the protocol of the 2015 NMHS is presented. The full document with all the collection tools can be consulted on the Health Ministry webpage. Copyright © 2016. Publicado por Elsevier España.
Mindell, Jennifer S; Giampaoli, Simona; Goesswald, Antje; Kamtsiuris, Panagiotis; Mann, Charlotte; Männistö, Satu; Morgan, Karen; Shelton, Nicola J; Verschuren, W M Monique; Tolonen, Hanna
Health examination surveys (HESs), carried out in Europe since the 1950's, provide valuable information about the general population's health for health monitoring, policy making, and research. Survey participation rates, important for representativeness, have been falling. International comparisons are hampered by differing exclusion criteria and definitions for non-response. Information was collected about seven national HESs in Europe conducted in 2007-2012. These surveys can be classified into household and individual-based surveys, depending on the sampling frames used. Participation rates of randomly selected adult samples were calculated for four survey modules using standardised definitions and compared by sex, age-group, geographical areas within countries, and over time, where possible. All surveys covered residents not just citizens; three countries excluded those in institutions. In two surveys, physical examinations and blood sample collection were conducted at the participants' home; the others occurred at examination clinics. Recruitment processes varied considerably between surveys. Monetary incentives were used in four surveys. Initial participation rates aged 35-64 were 45% in the Netherlands (phase II), 54% in Germany (new and previous participants combined), 55% in Italy, and 65% in Finland. In Ireland, England and Scotland, household participation rates were 66%, 66% and 63% respectively. Participation rates were generally higher in women and increased with age. Almost all participants attending an examination centre agreed to all modules but surveys conducted in the participants' home had falling responses to each stage. Participation rates in most primate cities were substantially lower than the national average. Age-standardized response rates to blood pressure measurement among those aged 35-64 in Finland, Germany and England fell by 0.7-1.5 percentage points p.a. between 1998-2002 and 2010-2012. Longer trends in some countries show a more
Gardner, Glenn; Duffield, Christine; Doubrovsky, Anna; Adams, Margaret
The size and flexibility of the nursing workforce has positioned nursing as central to the goals of health service improvement. Nursing's response to meeting these goals has resulted in proliferation of advanced practice nursing with a confusing array of practice profiles, titles and roles. Whilst numerous models and definitions of advanced practice nursing have been developed there is scant published research of significant scope that supports these models. Consequently there is an ongoing call in the literature for clarity and stability in nomenclature, and confusion in the health industry on how to optimise the utility of advanced practice nursing. To identify and delineate advanced practice from other levels of nursing practice through examination of a national nursing workforce. A cross-sectional electronic survey of nurses using the validated Advanced Practice Role Delineation tool based on the Strong Model of Advanced Practice. Study participants were registered nurses employed in a clinical service environment across all states and territories of Australia. A sample of 5662 registered nurses participated in the study. Domain means for each participant were calculated then means for nursing position titles were calculated. Position titles were grouped by delineation and were compared with one-way analysis of variance on domain means. The alpha for all tests was set at 0.05. Significant effects were examined with Scheffe post hoc comparisons to control for Type 1 error. The survey tool was able to identify position titles where nurses were practicing at an advanced level and to delineate this cohort from other levels of nursing practice, including nurse practitioner. The results show that nurses who practice at an advanced level are characterised by high mean scores across all Domains of the Strong Model of Advanced Practice. The mean scores of advanced practice nurses were significantly different from nurse practitioners in the Direct Care Domain and
Carvalho, J C; Declerck, D; De Vos, E; Kellen, J; Van Nieuwenhuysen, J P; Vanobbergen, J; Bottenberg, P; Declerck, C
The aims of the present study were to incorporate and to validate the electronic capture of participant-related outcomes into the Oral Survey-B System, which was originally developed for the electronic capture of clinical data. The validation process compared the performances of electronic and handwritten data captures. The hypothesis of noninferiority would be established if participants performed electronic data capture of the questionnaire survey with an effectiveness of at least 95% of that of handwritten data capture. In this multicenter, randomized, one-period crossover study design, participants (n = 261) were allocated to start with either electronic or handwritten data capture. The incorporation of the electronic self-completed questionnaire into the Oral Survey-B System was successful. The validation of the electronic questionnaire was performed by participants aged from 18 to 75 years. The interrater reliability of participants performing electronic and handwritten data capture of nonclinical assessments per questionnaire and per entry showed a kappa value of 0.72 (95% CI: 0.53-0.94). The noninferiority of electronic data capture in relation to that of the handwritten data capture and transfer was shown (p capture of participant-related outcomes with the Oral Survey-B System, originally designed for capture of clinical data, was validated. The electronic data capture was accurate and limited the number of errors. The participants were able to perform electronic data capture effectively, supporting its implementation in further National Oral Health Surveys. With the consideration of participant preference and time savings, this could lead to the implementation of electronic data capture worldwide in National Oral Health Surveys. © 2016 S. Karger AG, Basel.
Ferguson, T S; Tulloch-Reid, M K; Gordon-Strachan, G; Hamilton, P; Wilks, R J
Over the last six decades, comprehensive national health surveys have become important data-gathering mechanisms to inform countries on their health status and provide information for health policy and programme planning. Developing countries have only recently begun such surveys and Jamaica has been at the forefront of this effort. Jamaica's Reproductive Health Surveys and programme response to their findings have resulted in an almost 50% reduction infertility rates over three decades as well as a 40% reduction in unmet contraceptive needs and a 40% reduction in unplanned pregnancies over the last two decades. The Jamaica Health and Lifestyle Surveys have served to reinforce the major burden that non-communicable diseases place on the society and the extent to which these are driven by unhealthy lifestyles. These surveys have shown that obesity, hypertension, diabetes and dyslipidaemia affect approximately 50%, 25%, 10% and 10% of the adult population, respectively. These surveys have documented low rates of treatment and control for these chronic non-communicable diseases despite two major policy initiatives, the National Programme for the Promotion of Healthy Lifestyles and the creation of the National Health Fund which subsidizes healthcare provision for chronic diseases. In order to maximize the uptake of the findings of future surveys into effective health policy, there will need to be effective collaborations between academia, policy-makers, regional and international health agencies, non-government organizations and civil society. Such collaborations should take into account the social, political and economic issues, thus ensuring a more comprehensive approach to health policy and result in improvement of the nation's health status and by extension national development.
Romero-Martínez, Martín; Shamah-Levy, Teresa; Cuevas-Nasu, Lucía; Gómez-Humarán, Ignacio Méndez; Gaona-Pineda, Elsa Berenice; Gómez-Acosta, Luz María; Rivera-Dommarco, Juan Ángel; Hernández-Ávila, Mauricio
Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC) 2016. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.
Kaaijk, Paul; Mehl, Celine; Carrere, Tristan
The objective of Task 1 of the IEA Photovoltaic Power Systems Program is to promote and facilitate the exchange and dissemination of information on the technical, economic, environmental and social aspects of PV power systems. Task 1 activities support the broader PVPS objectives: to contribute to cost reduction of PV power applications, to increase awareness of the potential and value of PV power systems, to foster the removal of both technical and non-technical barriers and to enhance technology co-operation. An important deliverable of Task 1 is the annual 'Trends in photovoltaic applications' report. In parallel, National Survey Reports are produced annually by each Task 1 participant. This document is France National Survey Report for the year 2016. Information from this document will be used as input to IEA's annual Trends in photovoltaic applications report
Jayaraman, Sudha P; Ayzengart, Alexander L; Goetz, Laura H; Ozgediz, Doruk; Farmer, Diana L
Interest in global health during postgraduate training is increasing across disciplines. There are limited data from surgery residency programs on their attitudes and scope of activities in this area. This study aims to understand how global health education fits into postgraduate surgical training in the US. In 2007 to 2008, we conducted a nationwide survey of program directors at all 253 US general surgery residencies using a Web-based questionnaire modified from a previously published survey. The goals of global health activities, type of activity (ie, clinical versus research), and challenges to establishing these programs were analyzed. Seventy-three programs responded to the survey (29%). Of the respondents, 23 (33%) offered educational activities in global health and 86% (n = 18) of these offered clinical rotations abroad. The primary goals of these activities were to prepare residents for a career in global health and to improve resident recruitment. The greatest barriers to establishing these activities were time constraints for faculty and residents, lack of approval from the Accreditation Council for Graduate Medical Education and Residency Review Committee, and funding concerns. Lack of interest at the institution level was listed by only 5% of program directors. Of the 47 programs not offering such activities, 57% (n = 27) were interested in establishing them. Few general surgery residency programs currently offer clinical or other educational opportunities in global health. Most residencies that responded to our survey are interested in such activities but face many barriers, including time constraints, Residency Review Committee restrictions, and funding.
Penaherrera S, P.; Echeverria T, F.; Buitron S, S.; Yela de Chacon, L.
The Ecuadorian Atomic Energy Commission elaborated a Radiation Protection Regulation for Ecuador. In order to implement it, a national survey of radiodiagnostic services was implemented with the following objectives: a) Statistics of Radiodiagnostic services related to geography and population ulation density, b) To establish general patterns for X-Ray control and calibration, c) Evaluation of the professional and technical work in this field. (Author)
Costich, Julia F; Honoré, Peggy A; Scutchfield, F Douglas
The work reported here builds on the identification of public health financial management practice competencies by a national expert panel. The next logical step was to provide a validity check for the competencies and identify priority areas for educational programming. We developed a survey for local public health finance officers based on the public health finance competencies and field tested it with a convenience sample of officials. We asked respondents to indicate the importance of each competency area and the need for training to improve performance; we also requested information regarding respondent education, jurisdiction size, and additional comments. Our local agency survey sample drew on the respondent list from the National Association of County and City Health Officials 2005 local health department survey, stratified by agency size and limited to jurisdiction populations of 25,000 to 1,000,000. Identifying appropriate respondents was a major challenge. The survey was fielded electronically, yielding 112 responses from 30 states. The areas identified as most important and needing most additional training were knowledge of budget activities, financial data interpretation and communication, and ability to assess and correct the organization's financial status. The majority of respondents had some postbaccalaureate education. Many provided additional comments and recommendations. Health department finance officers demonstrated a high level of general agreement regarding the importance of finance competencies in public health and the need for training. The findings point to a critical need for additional training opportunities that are accessible, cost-effective, and targeted to individual needs.
Griffey, Susan; Piccinino, Linda; Gallivan, Joanne; Lotenberg, Lynne Doner; Tuncer, Diane
Since the 1970s, the federal government has spearheaded major national education programs to reduce the burden of chronic diseases in the United States. These prevention and disease management programs communicate critical information to the public, those affected by the disease, and health care providers. The National Diabetes Education Program (NDEP), the leading federal program on diabetes sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), uses primary and secondary quantitative data and qualitative audience research to guide program planning and evaluation. Since 2006, the NDEP has filled the gaps in existing quantitative data sources by conducting its own population-based survey, the NDEP National Diabetes Survey (NNDS). The NNDS is conducted every 2–3 years and tracks changes in knowledge, attitudes and practice indicators in key target audiences. This article describes how the NDEP has used the NNDS as a key component of its evaluation framework and how it applies the survey results for strategic planning and program improvement. The NDEP's use of the NNDS illustrates how a program evaluation framework that includes periodic population-based surveys can serve as an evaluation model for similar national health education programs.
Every year hundreds of patients voluntarily participate in clinical trials across Ireland. However, little research has been done as to how patients find the experience. This survey was conducted in an attempt to ascertain clinical trial participants\\' views on their experience of participating in a clinical trial and to see and how clinical trial participation can be improved. One hundred and sixty-six clinical trial participants who had recently completed a global phase IV cardiovascular endpoint clinical trial were sent a 3-page questionnaire. Ninety-one (91%) respondents found the experience of participating in a clinical trial a good one with 85 (84.16%) respondents saying they would recommend participating in a clinical trial to a friend or relative and eighty-five (87.63%) respondents feeling they received better healthcare because they had participated in a clinical trial.
Rudnick, P.A.; Anderson, P.S. Jr.
Data from this study are in agreement with the general observations that diabetes is not uncommon in Japan. In an adult study population in Hiroshima 108 patients with diabetes were detected, yielding the prevalence rate of 3.02 percent. Nearly one-half of the patients were diagnosed initially as a result of the routine detection program. Although in females a trend with exposure is suggested by the raw data no statistically significant differences could be demonstrated. However, the size of the sample involved does not permit confident negative conclusions. Additional clinical and laboratory observations were completed in order to characterize the manifestation of diabetes in these subjects. Late manifestations of diabetes frequently were found, but atherosclerotic complications were nonexistent. This is considered to be related to the low fat, high carbohydrate diet of the Japanese. The lack of ketosis, apparently low prevalence rate for juveniles, and male preponderance suggest that diabetes in Japan differs from the disease found in many Western countries. 69 references, 1 figure, 9 tables.
Labadarios, D; Steyn, N P; Maunder, E; MacIntryre, U; Gericke, G; Swart, R; Huskisson, J; Dannhauser, A; Vorster, H H; Nesmvuni, A E; Nel, J H
The aim of the National Food Consumption Survey (NFCS) in South Africa was to determine the nutrient intakes and anthropometric status of children (1-9 years old), as well as factors that influence their dietary intake. This was a cross-sectional survey of a nationally representative sample of all children aged 1-9 years in South Africa. A nationally representative sample with provincial representation was selected using 1996 Census information. Of the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%. The sociodemographic status of each household was assessed by a questionnaire. Dietary intake was assessed by means of a 24-hour recall and a food-frequency questionnaire from the caregivers of the children. Food purchasing practices were determined by means of a food procurement questionnaire. Hunger was assessed by a modified hunger scale questionnaire. Nutritional status was determined by means of anthropometric measurements: height, weight, head circumference and arm circumference. At the national level, stunting (height-for-age below minus two standard deviations (calcium, iron, zinc, selenium, vitamins A, D, C and E, riboflavin, niacin, vitamin B6 and folic acid were below two-thirds of the Recommended Dietary Allowances. At the national level, data from the 24-hour recalls indicated that the most commonly consumed food items were maize, sugar, tea, whole milk and brown bread. For South African children overall, one in two households (52%) experienced hunger, one in four (23%) were at risk of hunger and only one in four households (25%) appeared food-secure. The NFCS indicated that a large majority of households were food-insecure and that energy deficit and micronutrient deficiencies were common, resulting in a high prevalence of stunting. These results were used as motivation for the introduction of mandatory fortification in South Africa.
Biró, Lajos; Zajkás, Gábor; Greiner, Erika; Szórád, Ildikó; Varga, Anna; Domonkos, Andrea; Agoston, Helga; Balázs, Anikó; Mozsáry, Erzsébet; Vitrai, József; Hermann, Dóra; Boros, Julianna; Németh, Renáta; Kéki, Zsuzsanna; Martos, Eva
In the course of the 3rd national nutritional survey data were collected in 2003, and the paper on the energy and nutrition intake of a sample group consisting of 1179 people all aged above 19, was published in the Hungarian Medical Journal (Vol. 146, No. 34, 2005). The present paper focuses on one group of micronutrients, namely the minerals' intake. The authors evaluated the results mainly in comparison with the data of the two previous Hungarian national surveys, and the international and national recommendations. The average magnesium intake was considered adequate in both sexes, while iron, zinc and copper intakes also met the recommended level in men. On the other hand, the insufficient calcium and the excessive phosphorus intakes, as well as the disproportionate calcium-phosphorus ratio in both sexes are unfavourable facts. The adverse results include insufficient iron, zinc and copper intake in women and the excessive sodium intake in both sexes, as well. The authors emphasize the importance of spreading the principles of healthy nutrition as well as co-operating with the food industry in order to prevent the occurrence of mineral nutrients deficiency.
Torke, Alexia M.; Holtz, Laura R.; Hui, Siu; Castelluccio, Peter; Connor, Stephen; Eaton, Matthew A.; Sachs, Greg A.
OBJECTIVES To determine the extent to which hospice and nonhospice palliative care (PC) programs provide services to patients with dementia and to describe barriers and facilitators to providing nonhospice PC. DESIGN Telephone and Web-based surveys. SETTING U.S. hospice and PC programs from the National Hospice and Palliative Care Organization’s program list. PARTICIPANTS Executive directors of 240 hospice programs, 173 programs providing hospice and nonhospice PC, and 13 programs providing nonhospice PC. MEASUREMENTS A telephone survey of hospice and PC providers followed by an online survey of programs providing nonhospice PC. RESULTS Ninety-four percent of hospices and 72% of PC programs had served at least one patient with a primary diagnosis of dementia within the past year. Based on 80 responses to the online survey, the most highly rated barriers to providing PC were lack of awareness of PC by families and referring providers, need for respite services, and reimbursement policies. Highly rated needs were family information, assistance with caregiver burden, and behavioral symptoms. Strategies critical for success were an interdisciplinary team, collaboration with community organizations, and alternatives to aggressive end-of-life care. CONCLUSION Almost all hospices and a majority of nonhospice PC programs serve patients with dementia. Education and policy efforts should focus on education for families and providers, support for caregivers, and reforming reimbursement structures to provide coverage for interdisciplinary PC earlier in the disease, when patients have high needs but are not hospice eligible. PMID:21054292
Barazza, Fabio Daniel; Murith, Christophe; Palacios, Martha; Gfeller, Walther; Christen, Emanuel
We present and discuss the results of a national survey on radon remediation. The main purpose of the survey was the evaluation of the rate of radon remediation in Switzerland and to identify the main reasons for not taking action in cases of high radon levels. Switzerland is strongly affected by the radon problem and extensive efforts have been made to map the radon potential and to investigate the most effective methods to reduce radon levels in different buildings. However, since the radon remediation of buildings has been given over to experts in the private sector and since there is no obligation to report a finished remediation to the authorities, it is difficult for the Federal Office for Public Health (FOPH) to track the activities in this field. In order to improve this situation, the FOPH has launched a survey. We find a rate of radon remediation of 46%. The most often applied method is the aeration of the cellar and the improvement of the tightness of the floor slab. The respondents indicate that the most important reason for not taking action is the concern about the financial and/or invasive magnitude of the work. We discuss the different outcomes of the survey in the three linguistic regions in Switzerland and identify aspects of our communication with the public, which should be improved in view of our findings. © 2017 IOP Publishing Ltd.
This report presents the details of the methodology used for the 2008 National Survey of Drinking and Driving Attitudes and Behaviors conducted by Gallup, Inc. for : the National Highway Traffic Safety Administration (NHTSA). This survey represents t...
Dossett, Michelle L; Davis, Roger B; Kaptchuk, Ted J; Yeh, Gloria Y
We used the 2012 National Health Interview Survey to compare homeopathy users with supplement users and those using other forms of complementary and integrative medicine. Among US adults, 2.1% used homeopathy within the past 12 months. Respiratory and otorhinolaryngology complaints were most commonly treated (18.5%). Homeopathy users were more likely to use multiple complementary and integrative medicine therapies and to perceive the therapy as helpful than were supplement users. US homeopathy use remains uncommon; however, users perceive it as helpful.
McGarry, A.T.; Fennell, S.G.; Mackin, G.M.; Madden, J.S.; O'Colmain, M.
This report presents the results of the final phase of the National Radon Survey carried out by the Radiological Protection Institute of Ireland. The counties included in this phase are Galway and Mayo. The average radon concentrations for the houses measured in these counties were 112 Bq/m 3 and 100 Bq/m 3 , respectively. The measurement data were grouped on the basis of the 10 km grid squares of the Irish National Grid System and used to predict the percentage of dwellings in each grid square which exceeds the Reference Level of 200 Bq/m 3 . Grid squares where this percentage is predicted to be 10% or higher are designated High Radon Areas. The health effects of exposure to high radon levels are discussed and recommendations are made regarding both new and existing dwellings. (author)
McGarry, A.T.; Fennell, S.G.; Mackin, G.M.; Madden, J.S.
This report presents the results of the third phase of the National Radon Survey carried out by the Radiological Protection Institute of Ireland. The counties included in this phase are Cork and Kerry. The average radon concentrations for the houses measured in these counties were 76 Bq/m 3 and 70 Bq/m 3 . The measurement data were grouped on the basis of the 10 km grid squares of the Irish National Grid System and used to predict the percentage of dwellings in each grid square which exceeds the Reference Level of 200 Bq/m 3 . Grid squares where this percentage is predicted to be 10% or higher are designated High Radon Areas. The health effects of exposure to high radon levels are discussed and recommendations are made regarding both new and existing dwellings. (author)
Prevalence and determinants of metabolic syndrome: a cross-sectional survey of general medical outpatient clinics using National Cholesterol Education Program-Adult Treatment Panel III criteria in Botswana.
Omech, Bernard; Tshikuka, Jose-Gaby; Mwita, Julius C; Tsima, Billy; Nkomazana, Oathokwa; Amone-P'Olak, Kennedy
Low- and middle-income countries, including Botswana, are facing rising prevalence of obesity and obesity-related cardiometabolic complications. Very little information is known about clustering of cardiovascular risk factors in the outpatient setting during routine visits. We aimed to assess the prevalence and identify the determinants of metabolic syndrome among the general outpatients' attendances in Botswana. A cross-sectional study was conducted from August to October 2014 involving outpatients aged ≥20 years without diagnosis of diabetes mellitus. A precoded questionnaire was used to collect data on participants' sociodemographics, risk factors, and anthropometric indices. Fasting blood samples were drawn and analyzed for glucose and lipid profile. Metabolic syndrome was assessed using National Cholesterol Education Program-Adult Treatment Panel III criteria. In total, 291 participants were analyzed, of whom 216 (74.2%) were females. The mean age of the total population was 50.1 (±11) years. The overall prevalence of metabolic syndrome was 27.1% (n=79), with no significant difference between the sexes (female =29.6%, males =20%, P=0.11). A triad of central obesity, low high-density lipoprotein-cholesterol, and elevated blood pressure constituted the largest proportion (38 [13.1%]) of cases of metabolic syndrome, followed by a combination of low high-density lipoprotein, elevated triglycerides, central obesity, and elevated blood pressure, with 17 (5.8%) cases. Independent determinants of metabolic syndrome were antihypertensive use and increased waist circumference. Metabolic syndrome is highly prevalent in the general medical outpatients clinics. Proactive approaches are needed to screen and manage cases targeting its most important predictors.
Chamness, Michele A.; Perry, Christopher; Downs, Janelle L.; Powell, Sylvia D.
The U.S. Department of Energy (DOE) Pacific Northwest Site Office (PNSO) oversees and manages the DOE contract for the Pacific Northwest National Laboratory (PNNL), a DOE Office of Science multi-program laboratory located in Richland, Washington. PNSO is responsible for ensuring that all activities conducted on the PNNL Site comply with applicable laws, policies, and DOE orders. The DOE Pacific Northwest Site Office Cultural and Biological Resources Management Plan (DOE/PNSO 2008) addresses the requirement for annual surveys and monitoring for species of concern and to identify and map invasive species. In addition to the requirement for an annual survey, proposed project activities must be reviewed to assess any potential environmental consequences of conducting the project. The assessment process requires a thorough understanding of the resources present, the potential impacts of a proposed action to those resources, and the ultimate consequences of those actions. The PNNL Site is situated on the southeastern corner of the DOE Hanford Site, located at the north end of the city of Richland in south-central Washington. The site is bordered on the east by the Columbia River, on the west by Stevens Drive, and on the north by the Hanford Site 300 Area (Figure 1). The environmental setting of the PNNL Site is described in Larson and Downs (2009). There are currently two facilities on the PNNL Site: the William R. Wiley Environmental Molecular Sciences Laboratory (EMSL), and the recently completed Physical Sciences Facility (PSF). This report describes the results of the annual survey of the biological resources found on the undeveloped portions of the PNNL Site in 2010. A brief description of the methods PNNL ecologists used to conduct the surveys and the results of the surveys are presented. Actions taken to fully delineate noxious weed populations discovered in 2009 and efforts in 2010 to control those weeds also are described. Appendix A provides a list of plant and
Desselle, Shane P; Holmes, Erin R
The results of the 2015 National Certified Pharmacy Technician Workforce Survey are described. A survey was e-mailed to a randomized sample of 5,000 certified pharmacy technicians (CPhTs) throughout the United States, with response reminders employed. Survey items eliciting demographic and work characteristics and work life attitudes were generated from the literature and qualitative interviews. This study aimed to describe job satisfaction, sources of stress, profession and employer commitment, education and training, and reasons for entry into the profession among CPhTs and determine relationships between those variables and CPhTs' level of involvement in various work activities, with particular attention paid to differences in practice setting. Frequency statistics, correlation analysis, and means testing were used to meet study objectives and identify significant differences. A total of 516 CPhTs currently working as a pharmacy technician responded to the survey. The CPhTs reported high levels of involvement in more traditional activities but less involvement in those that involve greater cognitive load. Respondents reported moderate levels of job satisfaction and commitment and somewhat high levels of stress overall. Most CPhTs chose to be a pharmacy technician because they desired to enter a healthcare field and help people and were recruited. CPhTs derived benefit from all aspects of education and training evaluated and most from on-the-job training. Perceived value of education and training was associated with higher satisfaction and commitment and with lower stress. There were a number of differences in these work life attitudes across practice settings and by involvement in various job functions. The results of the survey indicated that job satisfaction and commitment were moderate and that stress levels were somewhat high among CPhTs. There were a number of differences in work life attitudes across practice settings and by involvement in various job
Department of Veterans Affairs — The 2010 National Survey of Veterans (NSV) is the sixth in a series of comprehensive nationwide surveys designed to help the Department of Veterans Affairs (VA) plan...
Nielsen Louise Hjort
Full Text Available With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Broset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.
Kealy, David; Halli, Priyanka; Ogrodniczuk, John S; Hadjipavlou, George
Burnout is a serious problem for health care providers that has implications for clinical practice and personal health. While burnout is known to affect residents, no studies have examined the prevalence or impact of burnout among Canadian psychiatry residents. Residents in all Canadian psychiatry training programs were surveyed between May 1, 2014, and July 1, 2014. The survey included a well-validated, single-item measure to assess symptoms of burnout, several demographic questions, and Likert-scale items to assess residents' appraisals of empathic functioning and strategies for coping with stress from patient encounters. Responses were obtained from 400 residents, for a response rate of 48%. Twenty-one percent (N = 84) of residents reported symptoms of burnout. Burnout was reported more frequently by residents in postgraduate year 2 than by those in other years and was associated with engagement in personal psychotherapy during residency. No association was found between burnout and age, gender, or location of residency program. Residents who endorsed symptoms of burnout reported higher levels of compromised empathic functioning, were less likely to consult with supervisors about stressful clinical experiences, and were more likely to engage in unhealthy coping strategies. Symptoms of burnout affect one-fifth of Canadian psychiatry residents. The associations between burnout symptoms and problematic clinical and personal functioning suggest areas of concern for those involved in the training of Canadian psychiatry residents. © The Author(s) 2016.
Halli, Priyanka; Ogrodniczuk, John S.; Hadjipavlou, George
Objective: Burnout is a serious problem for health care providers that has implications for clinical practice and personal health. While burnout is known to affect residents, no studies have examined the prevalence or impact of burnout among Canadian psychiatry residents. Method: Residents in all Canadian psychiatry training programs were surveyed between May 1, 2014, and July 1, 2014. The survey included a well-validated, single-item measure to assess symptoms of burnout, several demographic questions, and Likert-scale items to assess residents’ appraisals of empathic functioning and strategies for coping with stress from patient encounters. Results: Responses were obtained from 400 residents, for a response rate of 48%. Twenty-one percent (N = 84) of residents reported symptoms of burnout. Burnout was reported more frequently by residents in postgraduate year 2 than by those in other years and was associated with engagement in personal psychotherapy during residency. No association was found between burnout and age, gender, or location of residency program. Residents who endorsed symptoms of burnout reported higher levels of compromised empathic functioning, were less likely to consult with supervisors about stressful clinical experiences, and were more likely to engage in unhealthy coping strategies. Conclusions: Symptoms of burnout affect one-fifth of Canadian psychiatry residents. The associations between burnout symptoms and problematic clinical and personal functioning suggest areas of concern for those involved in the training of Canadian psychiatry residents. PMID:27310237
Becker, James M.; Chamness, Michele A.
The U.S. Department of Energy (DOE) Pacific Northwest Site Office (PNSO) oversees and manages the DOE contract for the Pacific Northwest National Laboratory (PNNL), a DOE Office of Science multi-program laboratory located in Richland, Washington. PNSO is responsible for ensuring that all activities conducted on the PNNL site comply with applicable laws, policies, and DOE Orders. The DOE Pacific Northwest Site Office Cultural and Biological Resources Management Plan (DOE/PNSO 2008) addresses the requirement for annual surveys and monitoring for species of concern and to identify and map invasive species. In addition to the requirement for an annual survey, proposed project activities must be reviewed to assess any potential environmental consequences of conducting the project. The assessment process requires a thorough understanding of the resources present, the potential impacts of a proposed action to those resources, and the ultimate consequences of those actions. The PNNL site is situated on the southeastern corner of the DOE Hanford Site, located at the north end of the city of Richland in south-central Washington. The site is bordered on the east by the Columbia River, on the west by Stevens Drive, and on the north by the Hanford Site 300 Area (Figure 1). The environmental setting of the PNNL site is described in Larson and Downs (2009). There are currently two facilities on the PNNL site: the William R. Wiley Environmental Molecular Sciences Laboratory and the Physical Sciences Facility. This report describes the annual survey of biological resources found on the undeveloped upland portions of the PNNL site. The annual survey is comprised of a series of individual field surveys conducted on various days in late May and throughout June 2011. A brief description of the methods PNNL ecologists used to conduct the baseline surveys and a summary of the results of the surveys are presented. Appendix A provides a list of plant and animal species identified in the
Full Text Available Objective. Describe the design methodology of the halfway health and nutrition national survey (Ensanut-MC 2016. Materials and methods. The Ensanut-MC is a national probabilistic survey whose objective population are the inhabitants of private households in Mexico. The sample size was determined to make inferences on the urban and rural areas in four regions. Describes main design elements: target population, topics of study, sampling procedure, measurement procedure and logistics organization. Results. A final sample of 9 479 completed household interviews, and a sample of 16 591 individual interviews. The response rate for households was 77.9%, and the response rate for individuals was 91.9%. Conclusions. The Ensanut-MC probabilistic design allows valid statistical inferences about interest parameters for Mexico´s public health and nutrition, specifically on overweight, obesity and diabetes mellitus. Updated information also supports the monitoring, updating and formulation of new policies and priority programs.
Torok, Valeria; Hodgson, Kate; McLeod, Catherine; Tan, Jessica; Malhi, Navreet; Turnbull, Alison
Internationally human enteric viruses, such as norovirus (NoV) and hepatitis A virus (HAV), are frequently associated with shellfish related foodborne disease outbreaks, and it has been suggested that acceptable NoV limits based on end-point testing be established for this high risk food group. Currently, shellfish safety is generally managed through the use of indicators of faecal contamination. Between July 2014 and August 2015, a national prevalence survey for NoV and HAV was done in Australian oysters suitable for harvest. Two sampling rounds were undertaken to determine baseline levels of these viruses. Commercial Australian growing areas, represented by 33 oyster production regions in New South Wales, South Australia, Tasmania and Queensland, were included in the survey. A total of 149 and 148 samples were collected during round one and two of sampling, respectively, and tested for NoV and HAV by quantitative RT-PCR. NoV and HAV were not detected in oysters collected in either sampling round, indicating an estimated prevalence for these viruses in Australian oysters of viruses in Australian oysters was consistent with epidemiological evidence, with no oyster-related foodborne viral illness reported during the survey period. Copyright © 2017 Elsevier Ltd. All rights reserved.
This article will describe a survey carried out in February 2004, the aim of which was to summarize the form and content of clinical librarian (CL) and other similar outreach information services to UK health professionals in the acute (secondary or tertiary) sector. (i) To survey the activities and views of UK information professionals offering information services involving the librarians' presence in the clinical setting, (ii) to develop a tool to explore critical aspects of this form of information work, (iii) to create a contacts database for UK CLs, to be made available on the Internet. All known information specialists/librarians offering CL or similar services were surveyed. The semi-structured questionnaire was piloted. Respondents were asked to consider their activity over a period of 4 weeks. Twenty-six people responded to the invitation to take part and met the inclusion criteria. A summary of a 'typical' clinical librarian revealed by this survey is given, with a major conclusion that there is a very mixed picture of activity. Opinion on how far CLs should go in fully appraising search results is uncertain. The survey suggests reasons for this and the developments that may influence change are discussed. Recommendations for future research and development are offered.
Yamada, Yukio; Nomiya, Akira; Niimi, Aya; Igawa, Yasuhiko; Ito, Takaaki; Tomoe, Hikaru; Takei, Mineo; Ueda, Tomohiro
Background To explore the real-life practice of clinical management of interstitial cystitis (IC) in Japan. Methods A questionnaire on the number of IC patients, cystoscopic findings, diagnostic methods, and the treatment modalities was sent via e-mail to 114 medical institutions belonging to the Society of Interstitial Cystitis of Japan (SICJ). Results Completed questionnaires were returned from 62 institutions (20 university hospitals, 26 general hospitals and 16 clinics), with a response rate of 54%. The median of patient number per institution was 20 and the national number of IC patients was counted as 4,531 in Japan. The number of new patients in 2013 was 7 (median) per institution and calculated as 1,214 in total. The case volume per institution distributed broadly and skewed to a lower volume. The patients were categorized according to cystoscopic findings as either Hunner type IC with Hunner lesions (n=2,066, 45%), non-Hunner type IC with glomerulations on hydrodistension (n=1,720, 38%) or hypersensitive bladder without endoscopic abnormalities (n=304, 7%), excluding unknown (n=441, 10%). The proportion of Hunner type IC was highly variable among the institutions, ranging from 0% to 100% with a median of 29%. As for evaluation, symptom and quality of life (QOL) assessment by questionnaires, frequency volume chart, urinalysis, urine cytology, urine culture, post-void residual measurement, uroflowmetry, ultrasound and cystoscopy were widely adapted. Administration of oral medicines and intravesical instillation therapy were undertaken at 98% and 63% of institutions, respectively. Hydrodistension was commonly performed, totaling in 812 procedures at 53 institutions, while only five cystectomies were reported from four institutions. Conclusions The survey estimated about 4,500 IC patients and 2,000 Hunner type IC patients in Japan. It also revealed a wide range of case volume, acceptable adherence to clinical guidelines, and high variability in the proportion
LaVange, L M; Koch, G G; Schwartz, T A
This paper outlines the utility of statistical methods for sample surveys in analysing clinical trials data. Sample survey statisticians face a variety of complex data analysis issues deriving from the use of multi-stage probability sampling from finite populations. One such issue is that of clustering of observations at the various stages of sampling. Survey data analysis approaches developed to accommodate clustering in the sample design have more general application to clinical studies in which repeated measures structures are encountered. Situations where these methods are of interest include multi-visit studies where responses are observed at two or more time points for each patient, multi-period cross-over studies, and epidemiological studies for repeated occurrences of adverse events or illnesses. We describe statistical procedures for fitting multiple regression models to sample survey data that are more effective for repeated measures studies with complicated data structures than the more traditional approaches of multivariate repeated measures analysis. In this setting, one can specify a primary sampling unit within which repeated measures have intraclass correlation. This intraclass correlation is taken into account by sample survey regression methods through robust estimates of the standard errors of the regression coefficients. Regression estimates are obtained from model fitting estimation equations which ignore the correlation structure of the data (that is, computing procedures which assume that all observational units are independent or are from simple random samples). The analytic approach is straightforward to apply with logistic models for dichotomous data, proportional odds models for ordinal data, and linear models for continuously scaled data, and results are interpretable in terms of population average parameters. Through the features summarized here, the sample survey regression methods have many similarities to the broader family of
A survey of pregnant and postnatal women, clinic attendees and maternity staff regarding the presence of birth companions during labour and delivery. ... Conclusion: The involvement of birth companions supporting women during childbirth could be promoted as a low cost preventive intervention to improve maternal and ...
Li, Qian; Su, Yun-Ai; Xiang, Yu-Tao; Shu, Liang; Yu, Xin; Ungvari, Gabor S; Seiner, Stephen J; Chiu, Helen F K; Ning, Yu-Ping; Wang, Gao-Hua; Zhang, Ke-Rang; Li, Tao; Sun, Li-Zhong; Shi, Jian-Guo; Chen, Xian-Sheng; Mei, Qi-Yi; Li, Ke-Qing; Si, Tian-Mei
Little is known about electroconvulsive therapy (ECT) use in the treatment of schizophrenia in China. This study examined the frequency of ECT use, its trend between 2006 and 2012, and its independent demographic and clinical correlates in a nationwide survey in China. A total of 5162 inpatients in 45 Chinese psychiatric hospitals/centers were interviewed (2696 in 2006 and 2466 in 2012). Patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Electroconvulsive therapy was used in 6.1% of the whole sample; 4.7% in 2006 and 7.7% in 2012 (P Electroconvulsive therapy for schizophrenia has increased between 2006 and 2012 in China. Its percentage was higher than the figures reported in most other countries. Reasons for the substantial variations in the frequency of ECT across different provinces in China require further investigations.
Best, Simon R; Mohr, Michael; Zur, Karen B
Aggressive laryngeal, tracheal, and pulmonary papilloma is an extremely challenging clinical problem without proven treatment options. A recent German report documented promising results with systemic bevacizumab. The objective of this study is to report the initial experience of this novel treatment in the United States for recurrent respiratory papillomatosis (RRP). Cases series. Electronic survey of the RRP Task Force of the American Society of Pediatric Otolaryngology, American Broncho-Esophagological Association, and physicians known to the authors to have used systemic bevacizumab for RRP. Eleven completed surveys were obtained. In three cases, systemic bevacizumab was considered clinically but not administered. Eight patients were treated with systemic bevacizumab, all for aggressive papillomatosis uncontrolled by surgical and adjuvant therapy, including seven of eight with pulmonary disease. Treatment dosing ranged from 5 to 10 mg/kg every 2 to 4 weeks, with all patients responding (7/8 partial response, 1/8 complete response). In four patients who had postbevacizumab chest imaging, three demonstrated improvement of disease and one stabilization. Treatment interval could be lengthened in seven patients and clinical response maintained. One patient with long-standing pulmonary disease (>10 years) was diagnosed with malignant transformation while on treatment, and bevacizumab was discontinued in lieu of other chemotherapeutic agents. All other patients continue on systemic bevacizumab with minimal complications (hemoptysis n = 1, proteinuria n = 1). Systemic bevacizumab appears to have significant promise in the most treatment-resistant and aggressive forms of papillomatosis with a low complication profile. These results suggest bevacizumab should be studied in a formal clinical trial for RRP. 4. Laryngoscope, 127:2225-2229, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Graham, James; Shirm, Steve; Liggin, Rebecca; Aitken, Mary E; Dick, Rhonda
Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the chi2 test was used to compare urban versus rural preparedness. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.
Karlsen, Kristine A; Trautman, Michael; Price-Douglas, Webra; Smith, Sandra
Neonatal transport in the United States is a complex process; however, little is known about the neonatal transport team (NTT) workforce. The purpose of this national study was to describe the US NTT workforce. An exploratory, descriptive design that used a Web-based survey questionnaire was used. We identified 398 NTTs, and 345 (86.7%) were enrolled. One survey was completed per team. Ten NTTs did not complete the survey (response rate: 84.2%). Of the 335 completed surveys, 229 (68.4%) were from unit-based teams and 106 (31.6%) were from dedicated teams. Twenty-six different NTT compositions were used. All except 1 (n = 334) had a registered nurse or a neonatal nurse practitioner as a team member. A registered nurse-respiratory therapist team composition was the most common for unit-based (40.2%) and dedicated (44.3%) teams. Dedicated teams used rotor and fixed-wing modes of travel more frequently, transported further distances, and had higher transport volumes than unit-based teams. The median transport volumes reported suggest that as many as 68 797 critically ill neonates are transported each year. There is wide variation in many aspects of neonatal transport, including orientation, determination of readiness for independent transport, use of protocols to guide transport care, and quality assurance activities. These results will be useful for (1) evaluating existing transport services, (2) guiding necessary changes in training or services, and (3) aiding programs that seek to develop a neonatal transport program.
Frye, Mark A; Doederlein, Allen; Koenig, Barbara; McElroy, Susan L; Nassan, Malik; Seymour, Lisa R; Biernacka, Joanna M; Daniels, Allen S
The aim of the present study was to engage a national advocacy group and local stakeholders for guidance in developing a bipolar disorder biobank through a web-based survey and a community advisory board. The Depression and Bipolar Support Alliance and the Mayo Clinic Bipolar Biobank conducted a national web-based survey inquiring about interest in participating in a biobank (i.e., giving DNA and clinical information). A community advisory board was convened to guide establishment of the biobank and identify key deliverables from the research project and for the community. Among 385 survey respondents, funding source (87%), professional opinion (76%), mental health consumer opinion (79%), and return of research results (91%) were believed to be important for considering study participation. Significantly more patients were willing to participate in a biobank managed by a university or clinic (78.2%) than one managed by government (63.4%) or industry (58.2%; both p bipolar disorder developing in a child of an affected parent and which medications to avoid. The advisory board endorsed the use of a comprehension questionnaire to evaluate participants' understanding of the study (e.g., longevity of DNA specimens, right to remove samples, accessing medical records) as a means to strengthen the informed consent process. These national survey and community advisory data support the merit of establishing a biobank to enable studies of disease risk, provided that health records and research results are adequately protected. The goals of earlier diagnosis and individualized treatment of bipolar disorder were endorsed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
The National Highway Traffic Safety Administration's National Occupant Protection Use Survey (NOPUS) expanded its data collection protocols during October and November 2000 to obtain national estimates of driver cell phone use. The results of NOPUS f...
National Oceanic and Atmospheric Administration, Department of Commerce — These data were collected by the National Oceanic Atmospheric Administration National Geodetic Survey Remote Sensing Division using a Riegl Q680i-D system. The data...
National Oceanic and Atmospheric Administration, Department of Commerce — These data were collected by the National Oceanic Atmospheric Administration National Geodetic Survey Remote Sensing Division using a Riegl Q680i-D system. The data...
Hampton, N.L.; Rope, R.C.; Glennon, J.M.; Moor, K.S.
Approximately 135 areas within the boundaries of the Idaho National Engineering Laboratory (INEL) have been mapped as wetland habitat as part of the United States Fish and Wildlife Service (FWS) National Wetlands Inventory (NWI). A preliminary survey of these wetlands was conducted to examine their general characteristics and status, to provide an estimation of relative ecological importance, to identify additional information needed to complete ecological characterization of important INEL wetlands, and to identify high priority wetland areas on the INEL. The purpose of the survey was to provide information to support the preparation of the Environmental Restoration and Waste Management (ER ampersand WM) Environmental Impact Statement (EIS). Information characterizing general vegetation, hydrology, wildlife use, and archaeology was collected at 105 sample sites on the INEL. Sites representing NWI palustrine, lacustrine, and riverine wetlands (including manmade), and areas unmapped or unclassified by the NWI were included in the sample. The field information was used to develop a preliminary ranking of relative ecological importance for each wetland visited during this survey. Survey limitations are identified
Hampton, N.L.; Rope, R.C.; Glennon, J.M.; Moor, K.S.
Approximately 135 areas within the boundaries of the Idaho National Engineering Laboratory (INEL) have been mapped as wetland habitat as part of the United States Fish and Wildlife Service (FWS) National Wetlands Inventory (NWI). A preliminary survey of these wetlands was conducted to examine their general characteristics and status, to provide an estimation of relative ecological importance, to identify additional information needed to complete ecological characterization of important INEL wetlands, and to identify high priority wetland areas on the INEL. The purpose of the survey was to provide information to support the preparation of the Environmental Restoration and Waste Management (ER&WM) Environmental Impact Statement (EIS). Information characterizing general vegetation, hydrology, wildlife use, and archaeology was collected at 105 sample sites on the INEL. Sites representing NWI palustrine, lacustrine, and riverine wetlands (including manmade), and areas unmapped or unclassified by the NWI were included in the sample. The field information was used to develop a preliminary ranking of relative ecological importance for each wetland visited during this survey. Survey limitations are identified.
Kumar Benera Sudhir
Full Text Available Research questions: How well a post survey sample check of NFHS correlates with the findings of NFHS? Objective: Post survey check of National Family Health Survey carried out in 1992-93. Study design: Multistage sampling method with 5 percent sample of original NFHS sample. Setting: Study covered 5 percent sample of original NFHS sample. Subjects: Five percent household sample (1093 members of original NFHS sample was studied and compared with NFHS data. Method: Information from five percent house-holds of NFHS in which either there likely to be no change was likely to be only in one direction such as age group, sex-ratio, literacy, family planning knowledge and adoption etc. were collected in a predesigned questionnaire and compared with NFHS data. Results: The demographic characteristics were similar to those of NFHS. TFR and number of children ever borne were also found to be same. The awareness of FP methods and its uses were within acceptable margin of error. Thus on comparison of data of post survey check and NFHS sample error was within acceptable margin.
Dreyfus, Isabelle; Pauwels, Céline; Bourrat, Emmanuelle; Bursztejn, Anne-Claire; Maruani, Annabel; Chiaverini, Christine; Maza, Aude; Mallet, Stéphanie; Bessis, Didier; Barbarot, Sébastien; Ezzedine, Khaled; Vabres, Pierre; Mazereeuw-Hautier, Juliette
Moderate to severe ichthyosis is known to have a significant impact on quality of life. A French national survey was performed to describe in more detail how ichthyosis impacts the patients' lives. A questionnaire specifically dedicated to ichthyosis was distributed to patients followed in hospital expert centres or members of the French association of patients. A total of 241 questionnaires were completed and returned (response ratio: 29% for children and 71% for adults). A negative impact of ichthyosis was obvious in terms of domestic life (skin care, housework, clothing, etc.), educational/professional lives (rejections by other children, workplace discrimination, absenteeism, etc) and for leisures/sports activities. The patient's economical resources were also heavily impacted by ichthyosis with important out-of-pocket expenses.
Responses to the second worldwide survey of 80 nations on their population policy can be divided into 3 categories. First are countries with large official programs of family planning in existence: Egypt, Kenya, Tunisia, Barbados, Colombia, Panama, Trinidad and Tobago, China, India, Iran, Japan, Nepal, Pakistan, Philippines, Republic of Viet-nam, Singapore, Sri Lanka, Thailand, Turkey, Denmark, Netherlands, United Kingdom, Yugoslavia, Canada, and Fiji. Madagascar and New Zealand are starting programs. The second category is countries that encourage private family planning programs: Tanzania, Mexico, Israel, Cambodia, Bahrain, Jordan, Laos, Syria, Austria, France, West Germany, Finland, and Norway. Third are listed countries that do not officially support, or that forbid contraception: Gabon, Malawi, Zambia, Greece, Italy, and Spain. Thus Asia and North Africa have the most ambitious programs, but Europe and North America practice contraception universally.
Martínez Álvarez, J R; García Alcón, R; Villarino Marín, A; Serrano Morago, L; Marrodán Serrano, Ma D
It is well known that to improve the feeding of the students it would improve its health and wellbeing, contributing to the reduction of the risk of chronic diseases in adults. In Spain, this is especially important considering the data of prevalence of infantile obesity. To know the number of users of school cafeterias in Spain as well as different considerations on its management, nutritional supervision and the number of special diets served to students with specific requirements due to pathologies or other causes. The II national Survey has been realized on school cafeterias: 7,710 used daily by 678,587 users. They provide near the 2.8% of special diets (allergies 38.9%, other pathologies 23.2%, religious causes 26.7% causes and celiac disease 11.1%). The numbers of prevalence of obesity and infantile overweight indicate that it is necessary to improve the diet of the students.
Andzik, Natalie R; Schaefer, John M; Nichols, Robert T; Chung, Yun-Ching
Research literature has yet to quantify and describe how students with complex communication needs are supported in the classroom and how special educators are being prepared to offer support. This study sought out special educators to complete a survey about their students with complex communication needs. Over 4,000 teachers representing 50 states reported on the communicative and behavioral characteristics of 15,643 students. Teachers described the training they have received and instructional approaches they used. The majority of students were reported to use speech as their primary communication mode. Over half of students utilizing alternative and augmentative communication (AAC) were reported to have non-proficient communication. Teacher training varied across respondents as well as the supports they used to support these students in the classroom. The majority of students with disabilities using AAC when communicating across the nation are not proficiently communicating. Implications and recommendations will be discussed.
Kass, William G.; Dulaney, Robert L.; Griffiths, Jake; Hilla, Stephen; Ray, Jim; Rohde, James
NOAA’s National Geodetic Survey (NGS) has been one of the Analysis Centers (ACs) of the International GNSS Service (IGS) since its inception in 1994. Solutions for daily GPS orbits and Earth orientation parameters are regularly contributed to the IGS Rapid and Final products, as well as solutions of weekly station positions. These solutions are combined with those of the other ACs and then the resultant IGS products are distributed to users. To perform these tasks, NGS has developed and refined the Program for the Adjustment of GPS EphemerideS (PAGES) software. Although PAGES has continuously evolved over the past 15 years, recent efforts have focused mostly on updating models and procedures to conform more closely to IGS and the International Earth Rotation Service (IERS) conventions. Details of our processing updates and demonstrations of the improvements will be provided.
Radeloff, D; Lempp, T; Herrmann, E; Kettner, M; Bennefeld-Kersten, K; Freitag, C M
Incarcerated adolescents are a high-risk group for suicidal behaviour, but data on completed suicide are scarce in this population. The present study aimed at calculating relative risks (RR) of suicide in detention and identifying age-related risk factors. We compared data of a German national total survey of completed suicide of young detainees (14 to suicide deaths in non-incarcerated adolescents (N = 3,484) and incarcerated adults (N = 781). Prison suicide accounted for 2.3% of all suicide deaths in adolescents, but only 0.1% of this age group was detained. The RR = 23.0 for adolescent suicide in detention exceeded the RR = 7.7 of adults by far. In adults, suicide rates in pre-trial detention was fivefold higher than in criminal detention; suicide rates were more balanced in adolescent detainees. Our results underline the need for age-specific suicide prevention strategies in detention.
Salmoni, A W; Rogers, R J
Past and current National Alpine Ski Team (NAST) members were surveyed via a mailed questionnaire regarding their educational progress and attainment, career path, parental education and income, as well as their perceptions as to the effect of skiing on dimensions of personal development. The questionnaire was completed by 86% of the total possible (64 of 74) respondents. Although it was found that educational progress was retarded by involvement in elite level skiing, this conclusion could only be drawn if it was assumed that in skiers between 13 and 21 years of age, each one year change in chronological age is 'normally' accompanied by similar academic progress. It was found that upon retirement from NAST 78% of the skiers continued their formal education, with a high level of success. These results were compared to other studies concerning educational attainment.
Sirirassamee, Tawima; Sirirassamee, Buppha
This study aims to establish the prevalence of risky health behaviors among Thai youth and to characterize the prevalence of these behaviors by gender, age group, educational status, and region. We analyzed data from a population-based, nationally representative, cross-sectional survey of 938 youth aged between 13 and 24 years, sampled from Bangkok and 4 regions of Thailand. The 2011 Youth Risk Behavior Surveillance System questionnaire was used to measure youth risk behaviors. This study finds that 15.9% of respondents had engaged in physical fights, and 8.1% had been cyber bullied. The prevalence of current cigarette smoking, alcohol, and marijuana use were 22.3%, 27.9%, and 2.3%, respectively. The prevalence of risky behaviors among Thai youth were found to be high, including behaviors that contribute to unintentional injuries and violence, unsafe sexual behaviors, and cigarette and alcohol consumption. © 2014 APJPH.
Ismayilova, Leyla; Hmoud, Olimat; Alkhasawneh, Esra; Shaw, Stacey; El-Bassel, Nabila
This study examines level of depression and factors associated with depression among female and male youth in Jordan. The study uses data from a cross-sectional survey conducted among a national sample of 14-25 year old youth attending educational institutions in Jordan (N = 8,129). On average, respondents reported frequently experiencing feelings of sadness (66 %), loss of joy (49 %) and loss of hope in living (43 %). Regression models demonstrated that higher levels of depressive symptoms were observed among females and among youth exposed to violence. Better parent-child relationships were associated with lower depression score. Among males depressive symptoms were associated with poor economic status, low assertiveness and a higher likelihood of alcohol use and smoking. There is a need for mental health prevention programs for youth in Jordan that enhance youth's social and emotional skills, strengthen parent-child relationships, and reduce violence in school, home and in the community.
U.S. Department of Health & Human Services — The National Database for Clinical Trials Related to Mental Illness (NDCT) is an extensible informatics platform for relevant data at all levels of biological and...
Maastrup, Ragnhild; Bojesen, Susanne Norby; Kronborg, Hanne; Hallström, Inger
The incidence of breastfeeding of preterm infants is affected by the support provided at the hospital and in the neonatal intensive care unit (NICU). However, policies and guidelines promoting breastfeeding vary both nationally and internationally. The aim of this survey was to describe breastfeeding support in Danish NICUs, where approximately 98% of mothers initiate lactation. A national survey of all 19 Danish NICUs was conducted in 2009. Four NICUs were at designated Baby-Friendly hospitals, and 5 had a lactation consultant. In all NICUs, it was possible for some parents to stay overnight; 2 units had short restrictions on parents' presence. Five NICUs had integrated postpartum care for mothers. Breastfeeding policies, written guidelines, and systematic breastfeeding training for the staff were common in most NICUs. Seventeen NICUs recommended starting breast milk expression within 6 hours after birth, and mothers were encouraged to double pump. Most NICUs aimed to initiate skin-to-skin contact the first time the parents were in the NICU, and daily skin-to-skin contact was estimated to last for 2-4 hours in 63% and 4-8 hours in 37% of the units. The use of bottle-feeding was restricted. The Danish NICUs described the support of breastfeeding as a high priority, which was reflected in the recommended policies for breast milk pumping, skin-to-skin contact, and the parents' presence in the NICU, as well as in the restricted use of bottle-feeding. However, support varied between units, and not all units supported optimal breastfeeding.
Russell, Evan; Hall, Andrew Koch; Hagel, Carly; Petrosoniak, Andrew; Dagnone, Jeffrey Damon; Howes, Daniel
Simulation-based education (SBE) is an important training strategy in emergency medicine (EM) postgraduate programs. This study sought to characterize the use of simulation in FRCPC-EM residency programs across Canada. A national survey was administered to residents and knowledgeable program representatives (PRs) at all Canadian FRCPC-EM programs. Survey question themes included simulation program characteristics, the frequency of resident participation, the location and administration of SBE, institutional barriers, interprofessional involvement, content, assessment strategies, and attitudes about SBE. Resident and PR response rates were 63% (203/321) and 100% (16/16), respectively. Residents reported a median of 20 (range 0-150) hours of annual simulation training, with 52% of residents indicating that the time dedicated to simulation training met their needs. PRs reported the frequency of SBE sessions ranging from weekly to every 6 months, with 15 (94%) programs having an established simulation curriculum. Two (13%) of the programs used simulation for resident assessment, although 15 (94%) of PRs indicated that they would be comfortable with simulation-based assessment. The most common PR-identified barriers to administering simulation were a lack of protected faculty time (75%) and a lack of faculty experience with simulation (56%). Interprofessional involvement in simulation was strongly valued by both residents and PRs. SBE is frequently used by Canadian FRCPC-EM residency programs. However, there exists considerable variability in the structure, frequency, and timing of simulation-based activities. As programs transition to competency-based medical education, national organizations and collaborations should consider the variability in how SBE is administered.
The results of analyses of the airborne gamma radiation and total magnetic field survey flown for the region identified as the Millett National Topographic Map NJ11-2 are presented. The airborne data gathered are reduced by ground computer facilities to yield profile plots of the basic uranium, thorium and potassium equivalent gamma radiation intensities, ratios of these intensities, aircraft altitude above the earth's surface, total gamma ray and earth's magnetic field intensity, correlated as a function of geologic units. The distribution of data within each geologic unit, for all surveyed map lines and tie lines, has been calculated and is included. Two sets profiled data for each line are included, with one set displaying the above-cited data. The second set includes only flight line magnetic field, temperature, pressure, altitude data plus magnetic field data as measured at a base station. A general description of the area, including descriptions of the various geologic units and the corresponding airborne data, is included.
Pidd, Ken; Roche, Ann M; Buisman-Pijlman, Femke
To identify prevalence of alcohol and drug use and intoxication at work. A total of 9,828 Australian workers ≥14 years old. Australia 2007. Work-place alcohol use and drug use, intoxication at work, industry and occupation of employment. Secondary analysis of a large nationally representative survey involving descriptive and weighted multivariate logistic regressions. Differential patterns were identified by drug type, worker characteristics and occupational setting, controlling for demographic variables. Nearly 9% of workers surveyed (8.7%) usually drank alcohol at work and 0.9% usually used drugs at work. Attending work under the influence of alcohol was more prevalent (5.6%) than attending work under the influence of drugs (2.0%), and significantly more likely among young, male, never married workers with no dependent children. Hospitality industry workers were 3.5 times more likely than other workers to drink alcohol and two to three times more likely to use drugs at work or attend work under the influence of alcohol or drugs. Other high-risk industries and occupations included construction, financial services, tradespersons and unskilled workers. More than one in 20 Australian workers admit to having worked under the influence of alcohol and almost one in 50 report attending work under the influence of psychoactive drugs. The rates are higher for some industries, such as the hospitality industry, than others. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
The results of analyses of the airborne gamma radiation and total magnetic field survey flown for the region identified as the Lander National Topographic Map NK12-6 are presented. The airborne data gathered are reduced by ground computer facilities to yield profile plots of the basic uranium, thorium and potassium equivalent gamma radiation intensities, ratios of these intensities, aircraft altitude above the earth's surface, total gamma ray and earth's magnetic field intensity, correlated as a function of geologic units. The distribution of data within each geologic unit, for all surveyed map lines and tie lines, has been calculated and is included. Two sets of profiled data for each line are included, with one set displaying the above-cited data. The second set includes only flight line magnetic field, temperature, pressure, altitude data plus magnetic field data as measured at a base station. A general description of the area, including descriptions of the various geologic units and the corresponding airborne data, is included also.
Heo, Jongho; Oh, Juhwan; Subramanian, S V; Kim, Yoon; Kawachi, Ichiro
A psychological disorder called 'Internet addiction' has newly emerged along with a dramatic increase of worldwide Internet use. However, few studies have used population-level samples nor taken into account contextual factors on Internet addiction. We identified 57,857 middle and high school students (13-18 year olds) from a Korean nationally representative survey, which was surveyed in 2009. To identify associated factors with addictive Internet use, two-level multilevel regression models were fitted with individual-level responses (1st level) nested within schools (2nd level) to estimate associations of individual and school characteristics simultaneously. Gender differences of addictive Internet use were estimated with the regression model stratified by gender. Significant associations were found between addictive Internet use and school grade, parental education, alcohol use, tobacco use, and substance use. Female students in girls' schools were more likely to use Internet addictively than those in coeducational schools. Our results also revealed significant gender differences of addictive Internet use in its associated individual- and school-level factors. Our results suggest that multilevel risk factors along with gender differences should be considered to protect adolescents from addictive Internet use.
Full Text Available BACKGROUND: A psychological disorder called 'Internet addiction' has newly emerged along with a dramatic increase of worldwide Internet use. However, few studies have used population-level samples nor taken into account contextual factors on Internet addiction. METHODS AND FINDINGS: We identified 57,857 middle and high school students (13-18 year olds from a Korean nationally representative survey, which was surveyed in 2009. To identify associated factors with addictive Internet use, two-level multilevel regression models were fitted with individual-level responses (1st level nested within schools (2nd level to estimate associations of individual and school characteristics simultaneously. Gender differences of addictive Internet use were estimated with the regression model stratified by gender. Significant associations were found between addictive Internet use and school grade, parental education, alcohol use, tobacco use, and substance use. Female students in girls' schools were more likely to use Internet addictively than those in coeducational schools. Our results also revealed significant gender differences of addictive Internet use in its associated individual- and school-level factors. CONCLUSIONS: Our results suggest that multilevel risk factors along with gender differences should be considered to protect adolescents from addictive Internet use.
Leão, Sylvia H de S; Oates, Jennifer M; Purdy, Suzanne C; Scott, David; Morton, Randall P
This study determined the prevalence and nature of voice problems in New Zealand (NZ) teachers using a national self-report questionnaire. Epidemiological cross-sectional survey. Participants were 1879 primary and secondary teachers (72.5% females). Three prevalence timeframes were estimated. Severity of voice problems, recovery time, days away from work, symptoms, health assistance, and voice education were also investigated. Prevalence of self-reported vocal problems was 33.2% during their teaching career, 24.7% over the teaching year, and 13.2% on the day of the survey. Primary teachers (Pteachers reporting voice problems during the year, 47% were moderate or severe; for 30%, voice recovery took more than 1 week. Approximately 28% stayed away from work 1-3 days owing to a vocal problem and 9% for more than 3 days. Women reported longer recovery times and more days away. Symptoms associated with voice problems (Pteachers reporting voice problems, only 22.5% consulted a health practitioner. Only 38% of the teachers with chronic voice problems visited an otolaryngologist. Higher hours of voice training/education were associated with fewer self-reported voice problems. Voice problems are of concern for NZ teachers, as has been reported for teachers in other countries. There is still limited awareness among teachers about vocal health, potential risks, and specialized health services for voice problems. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Curti, A.R.; Gatica, N.A.; Melis, H.J.
Full text: In 1997, the Nuclear Regulatory Authority of Argentina carried out a compilation of data on radiopharmaceuticals administered to patients in nuclear medicine procedures. Its aim was to get information on the radiopharmaceuticals that are used in different procedures and the activity administered to the patient, to assess the radiation exposure of the population and to contribute to a global survey of medical radiation usage and exposures conducted by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), by sending information of the country. The data compiled were analysed, and for the most frequent procedures, the mean activity administered, the standard deviation, the distribution of the number of procedures for different age groups, sex and radiopharmaceuticals were assessed. The radiation exposure for children and adults was estimated. For the main diagnostic examinations, the results of the survey were compared with specific values published in the Basic Safety Standards of the International Atomic Energy Agency (Safety Series No. 115, 1996). As a conclusion, it may be point out the importance of continuing with the compilation of this kind of information in order to identify emerging trends on the use of nuclear medicine procedures in Argentina and the activity of radiopharmaceuticals administered to the patients. (author) [es
Siburt, Hannah W; Holmes, Alice E
The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.
Roberts, Gwerfyl Wyn; Irvine, Fiona Elizabeth; Jones, Peter Reece; Spencer, Llinos Haf; Baker, Colin Ronald; Williams, Cen
The significance of effective interpersonal communication in healthcare is well established, as is the importance of overcoming language barriers. This has a particular bearing for minority language speakers, where denying language choice can compromise the quality of healthcare provision. Nevertheless, there is limited empirical research exploring language awareness in healthcare and the factors that influence language choice for minority language speakers. This paper reports on the nurses, midwives and health visitors (NMHV) data set of the first phase of a large-scale national study, commissioned by the Welsh Assembly Government, to examine the nature and extent of Welsh language awareness amongst healthcare professionals in Wales, UK. The study involved a questionnaire survey of healthcare professionals working in the public, private and voluntary sectors of healthcare. A stratified random sample of 3358 healthcare professionals was surveyed, of which 1842 (55%) were nurses, midwives and health visitors. The researcher-designed self-administered questionnaire was distributed by post to participants between July and September 2003. A total of 1042 (57%) NMHV returned their questionnaires for analysis. A strong positive correlation is identified between the NMHV use of the Welsh language in practice and their Welsh language proficiency (planguage attitudes (planguage region (planguage attitude scores are more positive than expected, particularly amongst those with limited Welsh language proficiency and those working in regions with the lowest proportions of Welsh speakers. In view of the universal drive for culturally and linguistically appropriate healthcare practice, the findings have important implications for bilingual and multilingual healthcare settings worldwide. The evidence emerging from this survey confirms that cross-cultural communication is enhanced by NMHV language attitudes as well as their proficiency levels. Language awareness training is
Full Text Available BACKGROUND: Previous surveys on the relationship between physicians and pharmaceutical representatives (PRs have been of limited quality. The purpose of our survey of practicing physicians in Japan was to assess the extent of their involvement in pharmaceutical promotional activities, physician characteristics that predict such involvement, attitudes toward relationships with PRs, correlations between the extent of involvement and attitudes, and differences in the extent of involvement according to self-reported prescribing behaviors. METHODS AND FINDINGS: From January to March 2008, we conducted a national survey of 2621 practicing physicians in seven specialties: internal medicine, general surgery, orthopedic surgery, pediatrics, obstetrics-gynecology, psychiatry, and ophthalmology. The response rate was 54%. Most physicians met with PRs (98%, received drug samples (85% and stationery (96%, and participated in industry-sponsored continuing medical education (CME events at the workplace (80% and outside the workplace (93%. Half accepted meals outside the workplace (49% and financial subsidies to attend CME events (49%. Rules at the workplace banning both meetings with PRs and gifts predicted less involvement of physicians in promotional activities. Physicians valued information from PRs. They believed that they were unlikely to be influenced by promotional activities, but that their colleagues were more susceptible to such influence than themselves. They were divided about the appropriateness of low-value gifts. The extent of physician involvement in promotional activities was positively correlated with the attitudes that PRs are a valuable source of information and that gifts are appropriate. The extent of such involvement was higher among physicians who prefer to ask PRs for information when a new medication becomes available, physicians who are not satisfied with patient encounters ending only with advice, and physicians who prefer to
Brian V Nahed
Full Text Available BACKGROUND: Concern over rising healthcare expenditures has led to increased scrutiny of medical practices. As medical liability and malpractice risk rise to crisis levels, the medical-legal environment has contributed to the practice of defensive medicine as practitioners attempt to mitigate liability risk. High-risk specialties, such as neurosurgery, are particularly affected and neurosurgeons have altered their practices to lessen medical-legal risk. We present the first national survey of American neurosurgeons' perceptions of malpractice liability and defensive medicine practices. METHODS: A validated, 51-question online-survey was sent to 3344 practicing U.S. neurosurgeon members of the American Association of Neurological Surgeons, which represents 76% of neurosurgeons in academic and private practices. RESULTS: A total of 1028 surveys were completed (31% response rate by neurosurgeons representing diverse sub-specialty practices. Respondents engaged in defensive medicine practices by ordering additional imaging studies (72%, laboratory tests (67%, referring patients to consultants (66%, or prescribing medications (40%. Malpractice premiums were considered a "major or extreme" burden by 64% of respondents which resulted in 45% of respondents eliminating high-risk procedures from their practice due to liability concerns. CONCLUSIONS: Concerns and perceptions about medical liability lead practitioners to practice defensive medicine. As a result, diagnostic testing, consultations and imaging studies are ordered to satisfy a perceived legal risk, resulting in higher healthcare expenditures. To minimize malpractice risk, some neurosurgeons have eliminated high-risk procedures. Left unchecked, concerns over medical liability will further defensive medicine practices, limit patient access to care, and increase the cost of healthcare delivery in the United States.
Full Text Available Introduction: The therapeutic benefits of yoga and meditation are well documented, yet little is known about the practice of yoga in Australia or elsewhere, whether as a physical activity, a form of therapy, a spiritual path or a lifestyle. Materials and Methods: To investigate the practice of yoga in Australia, a national survey of yoga practitioners was conducted utilizing a comprehensive web-based questionnaire. Respondents were self-selecting to participate. A total of 3,892 respondents completed the survey. Sixty overseas respondents and 1265 yoga teachers (to be reported separately were excluded, leaving 2,567 yoga practitioner respondents. Results: The typical yoga survey respondent was a 41-year-old, tertiary educated, employed, health-conscious female (85% women. Asana (postures and vinyasa (sequences of postures represented 61% of the time spent practicing, with the other 39% devoted to the gentler practices of relaxation, pranayama (breathing techniques, meditation and instruction. Respondents commonly started practicing yoga for health and fitness but often continued practicing for stress management. One in five respondents practiced yoga for a specific health or medical reason which was seen to be improved by yoga practice. Of these, more people used yoga for stress management and anxiety than back, neck or shoulder problems, suggesting that mental health may be the primary health-related motivation for practicing yoga. Healthy lifestyle choices were seen to be more prevalent in respondents with more years of practice. Yoga-related injuries occurring under supervision in the previous 12 months were low at 2.4% of respondents. Conclusions: Yoga practice was seen to assist in the management of specific health issues and medical conditions. Regular yoga practice may also exert a healthy lifestyle effect including vegetarianism, non-smoking, reduced alcohol consumption, increased exercise and reduced stress with resulting cost benefits
Giménez-Marín, Á; Rivas-Ruiz, F
To conduct a situational analysis of patient safety culture in public laboratories in the Spanish National Health System and to determine the clinical governance variables that most strongly influence patient safety. A descriptive cross-sectional study was carried out, in which a Survey of Patient Safety in Clinical Laboratories was addressed to workers in 26 participating laboratories. In this survey, which consisted of 45 items grouped into 6 areas, scores were assigned on a scale from 0 to 100 (where 0 is the lowest perception of patient safety). Laboratory managers were asked specific questions about quality management systems and technology. The mean scores for the 26 participating hospitals were evaluated, and the following results observed: in 4of the 6areas, the mean score was higher than 70 points. In the third area (equipment and resources) and the fourth area (working conditions), the scores were lower than 60 points. Every hospital had a digital medical record system. This 100% level of provision was followed by that of an electronic request management system, which was implemented in 82.6% of the hospitals. The results obtained show that the culture of security is homogeneous and of high quality in health service laboratories, probably due to the steady improvement observed. However, in terms of clinical governance, there is still some way to go, as shown by the presence of weaknesses in crucial dimensions of safety culture, together with variable levels of implementation of fail-safe technologies and quality management systems. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
Eva González-Haba Peña
Full Text Available Purpose: identify by means of a survey the off-label treatments more often used in the oncohaematology area, as well as to know the established procedures and criteria used to authorise those treatments. Methods: a four-section survey was designed: 1 demographic data and hospital activity, 2 Off-label treatments protocol, 3 Approval criteria and 4 Off-label oncology treatments conducted during the last year. Results: in 42.1% of the hospitals it’s needed an authorisation before dispensing in more tan 80% of the treatments. The most influential factor in the approval-dispensation system is the available evidence. The consent of the hospital management with previous Pharmacy department’s report was the most common authorisation procedure. 55.3% of the hospitals settled specific patient criteria to help the decision-making altogether with the available safety and efficacy data of the drug for the requested indication. In most centers a lower level of evidence is accepted if there are no therapeutic alternatives as well as in tumors of low prevalence. Most of the centers have not clearly established a criterion of effectiveness to consider a benefit as clinically relevant, nor the cost-effectiveness threshold for approving a FFT. Conclusions: there is a great variability in the off-label treatments use and also in the criteria used for its approval.
Full Text Available Abstract Background The National Health Service (NHS was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines. Methods Cascade approach to sampling, followed by telephone survey with senior member of the fall service. Characteristics of the service were assessed using an internationally agreed taxonomy. Reported service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE. Results We identified 303 clinics across the UK. 231 (76% were willing to participate. The majority of services were based in acute or community hospitals, with only a few in primary care or emergency departments. Access to services was, in the majority of cases, by health professional referral. Most services undertook a multi-factorial assessment. The content and quality of these assessments varied substantially. Services varied extensively in the way that interventions were delivered, and particular concern is raised about interventions for vision, home hazard modification, medication review and bone health. Conclusion The most common type of service provision was a multi-factorial assessment and intervention. There were a wide range of service models, but for a substantial number of services, delivery appears to fall below recommended NICE guidance.
Lamb, B W; Sevdalis, N; Taylor, C; Vincent, C; Green, J S A
Using data from a national survey, this study aimed to address whether the current model for multidisciplinary team (MDT) working is appropriate for all tumour types. Responses to the 2009 National Cancer Action Team national survey were analysed by tumour type. Differences indicate lack of consensus between MDT members in different tumour types. One thousand one hundred and forty-one respondents from breast, gynaecological, colorectal, upper gastrointestinal, urological, head and neck, haematological and lung MDTs were included. One hundred and sixteen of 136 statements demonstrated consensus between respondents in different tumour types. There were no differences regarding the infrastructure for meetings and team governance. Significant consensus was seen for team characteristics, and respondents disagreed regarding certain aspects of meeting organisations and logistics, and patient-centred decision making. Haematology MDT members were outliers in relation to the clinical decision-making process, and lung MDT members disagreed with other tumour types regarding treating patients with advanced disease. This analysis reveals strong consensus between MDT members from different tumour types, while also identifying areas that require a more tailored approach, such as the clinical decision-making process, and preparation for and the organisation of MDT meetings. Policymakers should remain sensitive to the needs of health care teams working in individual tumour types.
Eno, L M; Spigelman, A D
A postal survey was undertaken to determine the extent of surgical audit in Australian public hospitals in the context of clinical governance. Participants were 88 surgical units from 74 Australian public hospitals in 1998 with more than 70 beds. The main outcome measures were performance of audit, methods used, frequency, documentation and perceived adequacy of resources and comparison of performance with Royal Australasian College of Surgeons requirements for re-certification. The main findings were that most units performed audit, but over two-thirds declared that they had insufficient resources to conduct audit according to College requirements, while a substantial proportion did not comply with other published guidelines for the conduct of audit meetings. The conclusion from this survey is that surgical audit will be unable to play its part in quality initiatives inherent in the clinical governance concept unless appropriately resourced.
Chiu, Helen H L; Tangri, Navdeep; Djurdjev, Ognjenka; Barrett, Brendan J; Hemmelgarn, Brenda R; Madore, François; Rigatto, Claudio; Muirhead, Norman; Sood, Manish M; Clase, Catherine M; Levin, Adeera
Predicting the clinical trajectories of chronic kidney disease (CKD) to discern personalized care remains a complex challenge in nephrology. Understanding the appropriate risk thresholds and time frame associated with predicting risks of key outcomes (kidney failure, cardiovascular (CV) events, and death) is critical in facilitating decision-making. As part of an exploratory research and practice support needs assessment, we aimed to determine the importance of the time frames for predicting key outcomes, and to assess the perceived demand for risk prediction tools among Canadian nephrologists. A web-based survey was developed by a pan-Canadian expert panel of practitioners. Upon pre-test for clarity and ease of completion, the final survey was nationally deployed to Canadian nephrologists. Anonymous responses were gathered over a 4-month period. The results were analyzed using descriptive statistics. One hundred eleven nephrologists responded to our survey. The majority of the respondents described prediction of events over time frames of 1-5 years as being "extremely important" or "very important" to decision-making on a 5-point Likert scale. To plan for arteriovenous fistula referral, the respondents deemed thresholds which would predict probability of kidney failure between >30 and >50 % at 1 year, as useful, while many commented that the rate of progression should be included for decision-making. Over 80 % of the respondents were not satisfied with their current ability to predict the progression to kidney failure, CV events, and death. Most of them indicated that they would value and use validated risk scores for decision-making. Our national survey of nephrologists shows that the risk prediction for major adverse clinical outcomes is valuable in CKD at multiple time frames and risk thresholds. Further research is required in developing relevant and meaningful risk prediction models for clinical decision-making in patient-centered CKD care.
In this study the question asked is: what clinical nursing skills are predominantly used in intellectual disability nursing? A survey of the nursing needs of people with moderate to severe intellectual disability in both residential and community units was undertaken with a questionnaire.The measure was a Likert design scale ranging across: skills used more than once a day, skills used daily, skills used weekly, skills used monthly, skills very rarely used, and skills never used.The results o...
Yusoff, Fadhli; Saari, Riyanti; Naidu, Balkish M; Ahmad, Noor Ani; Omar, Azahadi; Aris, Tahir
The National School-Based Health Survey 2012 was a nationwide school health survey of students in Standard 4 to Form 5 (10-17 years of age), who were schooling in government schools in Malaysia during the period of data collection. The survey comprised 3 subsurveys: the Global School Health Survey (GSHS), the Mental Health Survey, and the National School-Based Nutrition Survey. The aim of the survey was to provide data on the health status of adolescents in Malaysia toward strengthening the adolescent health program in the country. The design of the survey was created to fulfill the requirements of the 3 subsurveys. A 2-stage stratified sampling method was adopted in the sampling. The methods for data collection were via questionnaire and physical examination. The National School-Based Health Survey 2012 adopted an appropriate methodology for a school-based survey to ensure valid and reliable findings. © 2014 APJPH.
Egley, Arlen, Jr.; Ritz, Christina E.
Annually since 1995, the National Youth Gang Center (NYGC) has conducted the National Youth Gang Survey (NYGS) of law enforcement agencies across the United States regarding the presences and characteristics of local gang problems. This Fact Sheet summarizes NYGS findings from the 2004 survey. The nationally representative sample included the…
... use of other forms of information technology. Titles: VA National Veterans Sports Programs and Special... National Veterans Sports Programs and Special Event Surveys Data Collection) Activity: Comment Request... needed to evaluate the National Veterans Sports Programs and Special Event Surveys Data Collection is...
Garcia, Edna; Fisher, Patrick B
To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois. Electronic survey invitations were sent to individuals who are currently practicing in the field. Data reveal increased salaries since 2013 for all staff-level laboratory professionals surveyed except phlebotomists and pathologists' assistants. Laboratory assistants and phlebotomists, regardless of level, continue to have lower salaries while pathologists' assistants and administration personnel have higher salaries than the rest of the laboratory professions surveyed. Survey results put emphasis on strategic recruitment and retention by laboratory training programs and institutions that hire laboratory professionals. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Lu, Ying; Zhao, Shoujun; Chu, Philip W; Arenson, Ronald L
The total number of procedures and their relative value units (RVUs) were used to measure the productivity of radiologists. Besides variations in productivity due to differences in the percentage of clinical effort, baseline productivity also varies among clinical subspecialty sections. The authors' previous research used the full-time equivalent (FTE) as the unit to adjust for differences in the percentage of clinical effort and a set of adjustment factors (or calibration constants) to modify the default work RVUs according to types of procedures. These adjustments led to comparable average productivity measurements across subspecialty sections. Since 2003, radiology practice has continued to change, including the introduction of positron emission tomography/computed tomography into clinical practice, suggesting a need to update the understanding of clinical productivity and refine the authors' adjustment procedure. In this study, the authors analyzed the most recent survey of academic departments and derived updated adjustment factors for differences in workload among subspecialty sections. The results can be used to determine faculty staffing requirements and evaluate radiologists' performance. A survey performed by the Society of Chairmen of Academic Radiology Departments collected data in 2006 for 1,134 radiologists in 24 departments, including 10 departments that also reported productivity in an earlier 2003 survey. These data included the numbers of procedures (represented by Current Procedural Terminology [CPT] codes) performed by radiologists, percentage clinical effort, subspecialty sections, and the number of clinical days. The numbers of CPT codes were converted into total work RVUs per FTE faculty member. By grouping the CPT codes into 6 prespecified examination categories, adjustment factors were created to adjust the RVUs for CPT categories to ensure that the median total adjusted work RVUs from different subspecialty sections were comparable
Moore, Amber; Canaway, Rachel; O'Brien, Kylie A
Little is known about how prepared Chinese medicine (CM) students perceive themselves to enter the workforce. The objective of this study was to investigate perceptions of preparedness for clinical practice of final-year CM students in Australia. The study design consisted of a written survey focusing on eight dimensions relating to practice: Interpersonal Skills, Confidence/Coping Skills, Professional Networks, Professional Practice Management, Professional Patient Management, Prevention, Holistic Care, and Self-Directed Learning. Part 1 of the survey required participants to choose from six possible responses on how well they believe their CM course has prepared them in relation to 41 statements about aspects of practice (1 = very inadequately through to 6 = very adequately). Part 2 consisted of nine open-ended questions. The study participants were final-year Bachelor degree CM and acupuncture students from Australian universities and privately operated educational institutions. ANALYSIS AND MAIN OUTCOME MEASURES: Part 1 of survey: mean scores on the eight dimensions of practice. Part 2 of survey: transcribed responses were imported into NVivo8. Each part of the questions was analyzed and grouped into broad themes. Seventy-one (71) of one hundred and seven (71/107) invited students (average age 29.4 years +/- 7.4 years) participated in the survey conducted in 2008. Mean scores on eight dimensions of clinical practice were as follows: Interpersonal Skills 3.9 (+/-1.1), Confidence/Coping Skills 4.0 (+/-0.8), Professional Networks 4.2 (+/-0.8), Professional Practice Management 4.2 (+/-0.8), Professional Patient Management 4.7 (+/-0.7), Prevention 4.6 (+/-0.7), Holistic Care 4.4 (+/-0.7), and Self-Directed Learning 4.6 (+/-0.6). There was no significant difference in mean scores across gender. Responses to Part 2 indicated a range of suggestions on the strengths of educational courses and how transition to clinical practice could be facilitated. In general, CM
Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Afshin, Ashkan; Daoud, Farah; AlMazroa, Mohammad A; Al Saeedi, Mohammad; Basulaiman, Mohammed; Memish, Ziad A; Al Rabeeah, Abdullah A; Mokdad, Ali H
No recent original studies on the pattern of diet are available for Saudi Arabia at the national level. The present study was performed to describe the consumption of foods and beverages by Saudi adults. The Saudi Health Interview Survey (SHIS) was conducted in 2013. Data were collected through interviews and anthropometric measurements were done. A diet history questionnaire was used to determine the amount of consumption for eighteen food or beverage items in a typical week. The study was a household survey in all thirteen administrative regions of Saudi Arabia. Participants were 10 735 individuals aged 15 years or older. Mean daily consumption was 70·9 (se 1·3) g for fruits, 111·1 (se 2·0) g for vegetables, 11·6 (se 0·3) g for dark fish, 13·8 (se 0·3) g for other fish, 44·2 (se 0·7) g for red meat, 4·8 (se 0·2) g for processed meat, 10·9 (se 0·3) g for nuts, 219·4 (se 5·1) ml for milk and 115·5 (se 2·6) ml for sugar-sweetened beverages. Dietary guideline recommendations were met by only 5·2 % of individuals for fruits, 7·5 % for vegetables, 31·4 % for nuts and 44·7 % for fish. The consumption of processed foods and sugar-sweetened beverages was high in young adults. Only a small percentage of the Saudi population met the dietary recommendations. Programmes to improve dietary behaviours are urgently needed to reduce the current and future burden of disease. The promotion of healthy diets should target both the general population and specific high-risk groups. Regular assessments of dietary status are needed to monitor trends and inform interventions.
Stachelek, Joseph; Ford, Chanse; Kincaid, Dustin; King, Katelyn; Miller, Heather; Nagelkirk, Ryan
Historical ecological surveys serve as a baseline and provide context for contemporary research, yet many of these records are not preserved in a way that ensures their long-term usability. The National Eutrophication Survey (NES) database is currently only available as scans of the original reports (PDF files) with no embedded character information. This limits its searchability, machine readability, and the ability of current and future scientists to systematically evaluate its contents. The NES data were collected by the US Environmental Protection Agency between 1972 and 1975 as part of an effort to investigate eutrophication in freshwater lakes and reservoirs. Although several studies have manually transcribed small portions of the database in support of specific studies, there have been no systematic attempts to transcribe and preserve the database in its entirety. Here we use a combination of automated optical character recognition and manual quality assurance procedures to make these data available for analysis. The performance of the optical character recognition protocol was found to be linked to variation in the quality (clarity) of the original documents. For each of the four archival scanned reports, our quality assurance protocol found an error rate between 5.9 and 17 %. The goal of our approach was to strike a balance between efficiency and data quality by combining entry of data by hand with digital transcription technologies. The finished database contains information on the physical characteristics, hydrology, and water quality of about 800 lakes in the contiguous US (Stachelek et al.(2017), https://doi.org/10.5063/F1639MVD). Ultimately, this database could be combined with more recent studies to generate meta-analyses of water quality trends and spatial variation across the continental US.
Earth Data Analysis Center, University of New Mexico — This data set is a digital soil survey and generally is the most detailed level of soil geographic data developed by the National Cooperative Soil Survey. The...
U.S. Department of Health & Human Services — This file includes data from the 2002 through 2013 National Survey on Drug Use and Health (NSDUH) survey. The only variables included in the data file are ones that...
U.S. Department of Health & Human Services — This file includes data from the 2002 through 2011 National Survey on Drug Use and Health (NSDUH) survey. The only variables included in the data file are ones that...
U.S. Department of Health & Human Services — This file includes data from the 2002 through 2009 National Survey on Drug Use and Health (NSDUH) survey. The only variables included in the 8-year 2002-2009 data...
Department of Transportation — The National Motor Vehicle Crash Causation Survey (NMVVCS) was a nationwide survey of crashes involving light passenger vehicles, with a focus on the factors related...
Earth Data Analysis Center, University of New Mexico — This data set is a digital soil survey and generally is the most detailed level of soil geographic data developed by the National Cooperative Soil Survey. The...
Full Text Available Abstract Background Many smokers believe that "light" cigarettes are less harmful than regular cigarettes, which is at variance with the scientific evidence. The Framework Convention on Tobacco Control (FCTC aims to address this problem in Article 11 which deals with misleading labelling of tobacco products. In this study we aimed to determine smokers' use and beliefs concerning "light" and "mild" cigarettes ("lights", including in relation to ethnicity, deprivation and other socio-demographic characteristics. Methods The New Zealand (NZ arm of the International Tobacco Control Policy Evaluation Survey (ITC Project uses as its sampling frame the NZ Health Survey. This is a national sample with boosted sampling of Maori, Pacific peoples and Asians. From this sample we surveyed adult smokers (n = 1376 about use and beliefs relating to "light" cigarettes. We assessed the associations with smoking "lights" after adjusting for socio-demographic variables, and smoking-related behaviours and beliefs. Results Many smokers of "lights" believed that smoking "lights" made it easier to quit smoking (25%, that "lights" are less harmful (42%, and that smokers of "lights" take in less tar (43%. Overall most "lights" smokers (60% had at least one of these three beliefs, a proportion significantly higher than for smokers of "regular" cigarettes at 45% (adjusted odds ratio (aOR = 1.96, 95% CI = 1.29 – 2.96. While "lights" smokers had significantly lower tobacco consumption and were more aware of smoking harms, they were no more likely to be intending to quit or have made a previous quit attempt. By ethnicity, both Maori and Pacific people were less likely to smoke "lights" than Europeans (aOR = 0.53, 95% CI = 0.35 – 0.80 and aOR = 0.14, 95% CI = 0.05 – 0.40 respectively. In contrast there was no significant difference by level of deprivation. Roll-your-own (RYO tobacco smokers were less likely to smoke "light" forms of RYO tobacco while both older and women
Danguilan, R A; De Belen-Uriarte, R; Jorge, S L; Lesaca, R J; Amarillo, M L L; Ampil, R S; Ona, E T
The increasing number of patients requiring transplantation has brought about a shortage of donor kidneys. Incentives can potentially improve organ donation. There is a need to know if the public can accept incentivized organ donation. To evaluate knowledge and opinions on organ donation and compensating the donor/donor family and to determine factors affecting consent. The third survey in 2009 covered 15 regions, 29 provinces, and 14 cities in the National Capital Region. There were 1500 respondents interviewed using a structured questionnaire. Analysis used Statistical Package for Social Science and chi-square. Of the respondents, 63% were females and 74% were married. Nearly half were between 26 and 45 years old. Fewer than 5% were unschooled. Monthly household income was less than USD $222.00 in 70% of respondents. A majority knew about donation from 2001 to 2009. Fewer than 20% knew about deceased donors. Those who wanted to become donors decreased. Sixty-five percent were willing to donate a brain-dead relative's organs. Respondents felt that kidney donors deserve a token of gratitude. Options included livelihood (32%), cash (31%), and educational assistance (26%). Sixty percent wanted the donor assistance termed a "token of gratitude." Consent for donation was positively correlated (P organ transplantation and donation increased. Factors that promote organ donation are higher education and monthly income. A majority of Filipinos felt that the donor deserves a token of gratitude. Public acceptance of incentivized organ donation may be pursued. Strategies to improve the national advocacy campaign for deceased donation are needed. Copyright © 2012 Elsevier Inc. All rights reserved.
Sha, Ji-Chao; Zhu, Dong-Dong; Dong, Zhen; Jiang, Xiao-Dan; Li, Lin; Zhu, Xue-Wei; Cui, Na; Wang, Qian
To investigate the clinical symptom, precipitating factor, associated symptom, family history and life quality of pediatric patients with allergic rhinitis, and to analyze the characteristic of clinical symptoms. A questionnaire survey on pediatric AR patients since June 2008 to June 2010, one hundred and forty-eight pediatric AR patients were divided into 2 groups, group A (n = 43) included children aged from 3.2 to 6.0, group B (n = 105) included children aged from 6.1 to 14.8. The severity degree of clinical symptom was assessed by visual analogue scale. Preschool age children had more severe rhinocleisis, more severe cough and less rhinorrhea than school age children (χ(2) value were 29.194, 12.277 and 16.904, respectively, P allergic disease history was 11.5% (17/148). Quality of sleep that 66.2% (98/148) were upset and 62.2% (92/148) had no cathexis. The preschool children have different clinical symptom characteristic from the school age children, and we got some clinical data of pediatric AR patients, those were beneficial to the diagnose and therapy of pediatric AR. The clinical data obtained in this study from pediatric AR patients are beneficial to the diagnosis and therapy of pediatric AR.
Full Text Available Background Acute Fatty Liver of Pregnancy (AFLP is one of the serious complications of the pregnancy period. Surveying the laboratory and clinical signs is effective in timely prognosis and fast treatment of this illness. Objectives The current study aimed to evaluate AFLP among the hospitalized subjects. Patients and Methods This retrospective study was conducted on clinical and preclinical records of 25 females with AFLP for maternal and perinatal prognosis from 2000 to 2009. The data was analyzed using SPSS ver. 19. Results The patients aged 16 - 45 years old with one to four pregnancies (pregnancy; they were 24 to 39 weeks pregnant with the mean of 33.56 weeks, and 56% were multifarious. The most prevalent clinical symptoms were nausea, vomiting, abdominal pain, headache, pruritus, and icterus. The laboratory signs included disorders of liver, coagulation, kidney, and hypoglycemia. Nausea and vomiting in the first and second age groups (Group 1, patients were 35 years. were the most prevalent symptoms. No patient had fever, ascites, and polydipsia. There was one case of mother and fetal death. Conclusions In the current study, the clinical and paraclinical signs of AFLP were mostly - liver, coagulation, kidney, and hypoglycemia disorders. Considering that patients mostly refer in three phases of clinical, laboratory, and complications, it is essential to evaluate the suspected ones who present clinical symptoms especially nausea, vomiting and abdominal pain.
Cushing, C.E.; Mueller, R.P.
Biologists from Pacific Northwest National Laboratory (PNNL) were requested by personnel from Fort Irwin to conduct a biological reconnaissance of the Avawatz Mountains northeast of Fort Irwin, an area for proposed expansion of the Fort. Surveys of vegetation, small mammals, birds, reptiles, amphibians, and aquatic resources were conducted during 1995 to characterize the populations and habitats present with emphasis on determining the presence of any species of special concern. This report presents a description of the sites sampled, a list of the organisms found and identified, and a discussion of relative abundance. Taxonomic identifications were done to the lowest level possible commensurate with determining the status of the taxa relative to its possible listing as a threatened, endangered, or candidate species. Consultation with taxonomic experts was undertaken for the Coleoptera ahd Hemiptera. In addition to listing the macroinvertebrates found, the authors also present a discussion related to the possible presence of any threatened or endangered species or species of concern found in Sheep Creek Springs, Tin Cabin Springs, and the Amargosa River.
Ricci, Zaccaria; Benelli, Sonia; Barbarigo, Fabio; Cocozza, Giulia; Pettinelli, Noemi; Di Luca, Emanuela; Mettifogo, Mariangela; Toniolo, Andrea; Ronco, Claudio
The current role of nurses in the management of critically ill patients needing continuous renal replacement therapies is clearly fundamental. The care of these complex patients is typically shared by critical care and dialysis nurses: their precise duties may vary from country to country. To clarify this issue we conducted a national-level survey at a recent Italian course on nursing practices during continuous renal replacement therapies. A total of 119 questionnaires were analysed. The participants, who were equally divided between critical care and dialysis nurses, came from 44 different hospitals and 35 Italian cities. Overall, 23% of participants answered that "the dialysis staff" were responsible for continuous renal replacement therapies in the Intensive Care Unit, while 39% answered "the critical care nurse", and 38% "a shared organization". Interestingly, less than the half of participants claimed specific continuous renal replacement therapies training was provided to employees before handling an acute dialysis machine. Finally, about 60% of participants had experience of extra-corporeal membrane oxygenation machines used in conjunction with continuous renal replacement therapies. Workload coordination and management of critically ill patients undergoing continuous renal replacement therapies in Italy is not standardized. At present, the duties of critical care and dialysis nurses vary significantly across the country. They frequently overlap or leave gaps in the assistance received by patients. The role of nurses involved in the care of continuous renal replacement therapies patients in Italy currently requires better organization, possibly starting with intensive standardized training and educational programs.
Saunier, C; Raimond, E; Dupont, A; Pelissier, A; Bonneau, S; Gabriel, R; Graesslin, O
To evaluate French residents in Obstetrics and Gynaecology's training in instrumental deliveries in 2015. We conducted a national descriptive survey among 758 residents between December 2014 and January 2015. Respondents were invited by email to specify their University Hospital, their current university term, the number of instrumental deliveries performed by vacuum extractor, forceps or spatulas, and whether they made systematic ultrasound exams before performing the extraction. Response rate was 34.7 % (n=263). There were important differences between regions in terms of type of instruments used. Vacuum extractor was the most commonly used instrument for instrumental deliveries by French residents (56.9 %), more than forceps (25.2 %) and spatulas (17.9 %). At the end of the residency, all the residents had been trained in instrumental deliveries with at least two instruments. The training of difficult techniques as well as their perfect control is required for instrumental deliveries. Yet, we are forced to note that there are substantial differences in the French residents' training in instrumental deliveries depending on their region. So, teaching at least two techniques seems essential as well as improving the training capacities and standardizing practices. A greater systematization of the teaching of the mechanics and obstetric techniques might be a solution to be considered too. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Armstrong Laboratory Occupational and Environmental Health Directorate (AL/OEBW), Brooks Air Force Base, Texas conducted a wastewater characterization survey at Atlantic City Air National Guard Base (ACANGB...
Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Daoud, Farah; Tuffaha, Marwa; Kravitz, Hannah; Al Saeedi, Mohammad; Basulaiman, Mohammed; Memish, Ziad A; AlMazroa, Mohammad A; Al Rabeeah, Abdullah A; Mokdad, Ali H
There are not enough data on the epidemiology of asthma in the Kingdom of Saudi Arabia (KSA). We analyzed data from a national household survey conducted in KSA in 2013 to estimate prevalence, associated risk factors and control measurements of asthma. The Saudi Health Interview Survey was a cross-sectional national multistage survey of 10,735 individuals aged 15 years or older. The survey included a detailed household questionnaire and a physical exam. We used self-reported clinical diagnosis of asthma to assess prevalence of asthma. The prevalence of asthma in KSA was 4.05 % (95 % confidence interval [CI]: 3.54-4.62 %). Asthma was less frequent in individuals with higher education but higher in former smokers and obese individuals. Around 76.7 % of asthma patients (95 % CI: 70.6-82.0 %) experienced an asthmatic attack, and 61.6 % (95 % CI: 54.4-68.4 %) visited a hospital/emergency room because of asthma during the past year. Asthma attack was less frequent in older patients (odds ratio [OR] = 0.78, 95 %CI: 0.59-0.96 for each decade of life). Current use of medication for asthma was highly associated with asthma attacks (OR = 9.14, 95 % CI: 3.29-25.38). Asthma attack was also more frequent in individuals who were exposed to secondhand smoking (OR = 2.17, 95 %CI: 1.05-4.45) and those who were obese (OR = 3.01, 95 %CI: 1.34-6.78). Saudi Arabia has a relatively low prevalence of diagnosed asthma; however, many of the patients with known asthma do not have it under good control. Our study calls for programs to inform patients about the importance and proper means of controlling their condition. Implementing and monitoring of clinical guidelines can also help to improve asthma control among patients as well as identify undiagnosed cases.
This report presents results from the eighth in a series of national telephone surveys conducted for the National Highway Traffic Safety Administration : (NHTSA) to assess current status and trends regarding the publics attitudes, knowledge, and s...
This report presents results from the eighth in a series of national telephone surveys conducted for the National Highway Traffic Safety : Administration (NHTSA) to assess current status and trends regarding the publics attitudes, knowledge, and s...
The National Highway Traffic Safety Administration : conducts the National Survey of Drinking and Driving : Attitudes and Behaviors on a periodic basis to monitor the : publics attitudes, knowledge, and self-reported behavior : regarding drinking ...
U.S. Department of Health & Human Services — The primary objective of the National Pregnancy and Health Survey (NPHS) was to produce national annual estimates of the percentages and numbers of mothers of live...
Kozak, Lola J; Owings, Maria F; Hall, Margaret J
This report presents 2002 national estimates and selected trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2002, data were collected for approximately 327,000 discharges. Of the 474 eligible non-Federal short-stay hospitals in the sample, 445 (94 percent) responded to the survey. An estimated 33.7 million inpatients were discharged from non-Federal short-stay hospitals in 2002. They used 164.2 million days of care and had an average length of stay of 4.9 days. Common first-listed discharge diagnoses included delivery, ischemic heart disease, psychoses, pneumonia, and malignant neoplasms. Inpatients had 6.8 million cardiovascular procedures and 6.6 million obstetric procedures. Males had higher rates for cardiac procedures such as cardiac catheterization and coronary artery bypass graft, but males and females had similar rates of pacemaker procedures. The number and rate of all cesarean deliveries, primary and repeat, rose from 1995 to 2002; the rate of vaginal birth after cesarean delivery dropped from 35.5 in 1995 to 15.8 in 2002.
Morris, N S; Possidente, C J; Muskus, C
Model Pharmacology and Pharmacotherapeutics Curriculum Guidelines were developed by the National Council of State Boards of Nursing and the National Organization of Nurse Practitioner Faculties and published in 1998. To date, no publication of evaluation of adoption or adherence to these guidelines is available. The purpose of this survey was to determine how family nurse practitioner programs incorporate the guidelines into their curriculum. A mailed self-report questionnaire to 193 schools yielded a 41% response rate. Eighty-five percent (n = 68) of the programs have not yet fully integrated the guidelines into their curriculum. Difficulties addressing the extensive content within a 3-credit course and the challenges of teaching students with varied clinical backgrounds and knowledge levels were frequently cited. Although further study of achievement of the guidelines is necessary, an increase in credit allocation, consideration of a conceptual approach to the topic, and use of varied teaching strategies may make achievement of the guidelines more realistic.
Sznajder-Murray, Brittany; Jang, Joy Bohyun; Slesnick, Natasha; Snyder, Anastasia
Homeless youth represent a vulnerable and understudied population. Little research has prospectively identified factors that may place youth at risk for experiencing homelessness. The current study utilizes data from the National Longitudinal Survey of Youth-97 (NLSY-97) to examine predictors of experiencing homelessness as a young adult (before age 25). The NLSY-97 includes a nationally representative sample of 8,984 youth. Data were first collected from these youth when they were between the ages of 12 to 18 years. The current study examined whether individual and family risk factors reported during adolescence predict homelessness by the age of 25. The findings showed that multiple runaway episodes, non-traditional family structure, lower educational attainment, and parental work limitations due to health increased the risk of homelessness. A permissive parenting style and being Hispanic protected against homelessness. This study offers unique insight into risk and protective factors for youth homelessness, and has important clinical implications.
Waghorn, Geoffrey; Saha, Sukanta; Harvey, Carol; Morgan, Vera A; Waterreus, Anna; Bush, Robert; Castle, David; Galletly, Cherrie; Stain, Helen J; Neil, Amanda L; McGorry, Patrick; McGrath, John J
Participation in mainstream education and employment facilitates both the recovery and the social inclusion of people with psychotic disorders. As part of the second Australian survey of psychosis, we assessed labour force activity and participation in formal education among working age adults with psychotic disorders. Data were drawn from a large national community prevalence survey of adults with psychotic disorders. Known as the Survey of High Impact Psychosis (SHIP), it was conducted in seven Australian catchment areas during March to December 2010. Current and past year labour force activity, current employment, past year participation in formal education and vocational training, and key clinical and demographic characteristics were examined in a sample of 1825 participants. Only 22.4% of people with psychotic disorders were found to be employed (either full-time or part-time) in the month prior to the survey. In the previous 12 months, 32.7% were employed at some time. Of those in competitive employment, the majority worked part-time (63.9%), while a quarter worked 38 or more hours per week (23.4%). In terms of educational attainment, 18.4% reported difficulties with reading or writing, while 31.9% completed high school, which represents 12 years of formal education. The proportion currently employed has remained stable at 22% since the last national survey in 1997. Policy makers and service providers could do more to ensure people with psychotic disorders obtain access to more effective forms of assistance with respect to both their continuing education and employment. More effective vocational and educational interventions for people with psychotic disorders appear to be urgently needed.
Londero, Stefano Christian; Mathiesen, Jes Sloth; Krogdahl, Annelise
BACKGROUND: Although a prospective national clinical thyroid cancer database (DATHYRCA) has been active in Denmark since January 1, 1996, no assessment of data quality has been performed. The purpose of the study was to evaluate completeness and data validity in the Danish national clinical thyroid...... was around or above 90% in most instances. Perfect agreement on the diagnosis of thyroid carcinoma was found, both inter- and intra-observer, and κ values of selected variables showed overall good to excellent agreement. CONCLUSION: In a setup with public health insurance, personal identity numbers...
Garcia, Edna; Ali, Asma M; Soles, Ryan M; Lewis, D Grace
To determine the extent and distribution of workforce shortages within the nation's medical laboratories. Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2014 Vacancy Survey was conducted through collaboration between American Society for Clinical Pathology's Institute of Science, Technology, and Policy in Washington, DC, and the Evaluation, Measurement, and Assessment Department and Board of Certification in Chicago, Illinois. Data were collected via an Internet survey that was distributed to individuals who were able to report on staffing and certifications for their laboratories. Data reveal increased overall vacancy rates since 2012 for all departments surveyed except cytology and cytogenetics. Also, results show higher anticipated retirement rates for both staff and supervisors. Overall certification rates are highest among laboratory personnel in cytogenetics, hematology/coagulation, and flow cytometry departments and lowest among phlebotomy, specimen processing, and anatomic pathology. Factors such as retirement and the improving economy are driving the need for more laboratory professionals. Recruitment of qualified laboratory professionals in the workforce and students in laboratory programs will be the key in fulfilling the higher vacancies revealed from the survey results in 2014. Copyright© by the American Society for Clinical Pathology.
Shah, Hitesh H; Monga, Divya; Caperna, April; Jhaveri, Kenar D
Palliative care (PC) training and experience of United States (US) adult nephrology fellows was not known. It was also not clear whether nephrology fellows in the US undergo formal training in PC medicine during fellowship. To gain a better understanding of the clinical training and experience of US adult nephrology fellows in PC medicine, we conducted a national survey in March 2012. An anonymous on-line survey was sent to US adult nephrology fellows via nephrology fellowship training program directors. Fellows were asked several PC medicine experience and training questions. A total of 105 US adult nephrology fellows responded to our survey (11% response rate). Majority of the respondents (94%) were from university-based fellowship programs. Over two-thirds (72%) of the fellows had no formal PC medicine rotation during their medical school. Half (53%) of the respondents had no formal PC elective experience during residency. Although nearly 90% of the fellows had a division or department of PC medicine at their institution, only 46.9% had formal didactic PC medicine experience. Over 80% of the respondent's program did not offer formal clinical training or rotation in PC medicine during fellowship. While 90% of the responding fellows felt most comfortable with either writing dialysis orders in the chronic outpatient unit, seeing an ICU consult or writing continuous dialysis orders in the ICU, only 35% of them felt most comfortable "not offering" dialysis to a patient in the ICU with multi-organ failure. Nearly one out of five fellows surveyed felt obligated to offer dialysis to every patient regardless of benefit. Over two-thirds (67%) of the respondents thought that a formal rotation in PC medicine during fellowship would be helpful to them. To enhance clinical competency and confidence in PC medicine, a formal PC rotation during fellowship should be highly considered by nephrology training community.
Sissung, Tristan M; McKeeby, Jon W; Patel, Jharana; Lertora, Juan J; Kumar, Parag; Flegel, Willy A; Adams, Sharon D; Eckes, Ellen J; Mickey, Frank; Plona, Teri M; Mellot, Stephanie D; Baugher, Ryan N; Wu, Xiaolin; Soppet, Daniel R; Barcus, Mary E; Datta, Vivekananda; Pike, Kristen M; DiPatrizio, Gary; Figg, William D; Goldspiel, Barry R
The National Institutes of Health Clinical Center (NIH CC) is the largest hospital in the United States devoted entirely to clinical research, with a highly diverse spectrum of patients. Patient safety and clinical quality are major goals of the hospital, and therapy is often complicated by multiple cotherapies and comorbidities. To this end, we implemented a pharmacogenomics program in 2 phases. In the first phase, we implemented genotyping for HLA-A and HLA-B gene variations with clinical decision support (CDS) for abacavir, carbamazepine, and allopurinol. In the second phase, we implemented genotyping for drug-metabolizing enzymes and transporters: SLCO1B1 for CDS of simvastatin and TPMT for CDS of mercaptopurine, azathioprine, and thioguanine. The purpose of this review is to describe the implementation process, which involves clinical, laboratory, informatics, and policy decisions pertinent to the NIH CC. © 2017, The American College of Clinical Pharmacology.
Orringer, Carl E; Robinson, Jennifer G; La Forge, Ralph; Seymour, Christopher R
In 2010 a survey of the National Lipid Association (NLA) membership was developed and launched with the objective of exploring the demographics, practice patterns, and educational needs of the health professionals in our organization involved in the practice of clinical lipidology. To report the results of this survey and use this information to enable the organization to better serve the needs of our membership. A 30-question survey was administered to the NLA membership before and shortly after the Annual Scientific Sessions in May, 2010. Demographic information, test ordering patterns, educational needs and resources, and technology awareness of 640 valid respondents was assessed. The respondents represent a balanced mix of practitioners in rural and metropolitan population centers throughout the United States. Physicians represent 67%, nurse practitioners and physician assistants 16%, and pharmacists 8% of the respondents. Among physicians, 50% are internal medicine or family medicine specialists, 32% cardiologists, and 11% endocrinologists. Most working in lipid clinics reported that their clinic was financially solvent. The respondents believed that adjunctive lipoprotein testing was clinically useful in risk prediction. The greatest educational needs included statin intolerance; strategies for improving compliance; metabolic syndrome; and lipoprotein particle and apolipoprotein B concentration. The most important sources of lipid information were the Journal of Clinical Lipidology and the NLA Annual Scientific Sessions. The survey provided valuable information that may be used to better serve the practice and educational needs of the membership of the NLA. Copyright Â© 2011 National Lipid Association. Published by Elsevier Inc. All rights reserved.
Pelz, R; Schmidt-Faber, B; Heseker, H
In nutritional epidemiological studies high consumption of fruits and vegetables was shown to be an important preventive measure to reduce the risk of cancer, coronary heart disease, and cataracts. These effects cannot be explained completely and in a sufficient way by the intake of beta-carotene and vitamin C. Other carotenoids differing in their antioxidative and biological properties are also provided with fruits and vegetables in significant amounts. Because data for other carotenoids than beta-carotene are not considered in computerized German food database and food composition tables, representative carotenoid intake calculations for the German population are missing. Therefore a carotenoid database, containing alpha- and beta-carotene, lycopene, lutein/zeaxanthin, and cryptoxanthin values for different fruits, vegetables, and other carotenoid-containing foods, was developed. With this database the carotenoid intake of the German population--stratified by sex and age--was evaluated on the basis of the German National Food Consumption Survey (NVS). The mean total carotenoid intake amounts to 5.33 mg/day. The average intake lutein was 1.91 mg/day, beta-carotene intake amounts to 1.81 mg/day, lycopene intake was 1.28 mg/day, alpha-carotene intake was 0.29 mg/day, and cryptoxanthin intake was 0.05 mg/day. Tomatoes and tomato products provide most of the lycopene. Green salads and vegetables are the most important contributors of lutein in Germany. Zeaxanthin is mainly consumed with maize but also with spinach and other vegetables like cabbage; alpha- and beta-carotene are mainly consumed with carrots. Peppers, oranges, and orange-juice are the most important cryptoxanthin sources.
Best, Matthew J; Buller, Leonard T; Miranda, Alejandro
Foot and ankle arthrodesis reliably reduces pain and functional disability among patients with arthritis and deformity. Since its introduction in 1953, improvements in surgical technique have enhanced the outcomes and reduced complications. However, little is known regarding US national trends of foot and ankle arthrodesis. The present study sought to use the most recently available Centers for Disease Control and Prevention data to investigate changes in the usage of inpatient and ambulatory foot and ankle arthrodesis. Cases of foot and ankle arthrodesis were identified using the National Hospital Discharge Survey and National Survey of Ambulatory Surgery, and the data were analyzed for trends in demographics, treatment, and usage. From 1994 to 2006, the population-adjusted rates of foot and ankle arthrodeses increased by 146% (8.2/100,000 capita to 20.2/100,000 capita). The number of outpatient arthrodeses performed with arthroscopic assistance increased by 858%. The population-adjusted rate of outpatient and inpatient procedures increased by 415% and 17%, respectively. The gender-adjusted rates increased by 59% for males and 209% for females. The age-adjusted rates increased among patients >35 years old in both settings. The use of peripheral nerve blocks during ambulatory procedures increased from 3.3% to 10.1%. Private insurance was the largest compensator. In conclusion, the rate of foot and ankle arthrodesis increased dramatically from 1990 to 2007 using the most up-to-date publicly available data. Knowledge of these national practice patterns could aid policy-makers and surgeons in appropriately allocating healthcare resources to ensure quality patient care. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Kosciw, Joseph G.; Greytak, Emily A.; Giga, Noreen M.; Villenas, Christian; Danischewski, David J.
The Gay, Lesbian and Straight Education Network (GLSEN) "National School Climate Survey" is our flagship report on the school experiences of LGBTQ youth in schools, including the extent of the challenges that they face at school and the school-based resources that support LGBTQ students' well-being. The survey has consistently indicated…
Kosciw, Joseph G.
The experiences of lesbian, gay, bisexual and transgender (LGBT) students in schools have been under-documented. For this reason, a third national survey was conducted by the Gay, Lesbian and Straight Education Network (GLSEN). As in previous surveys, LGBT youth were asked about biased language in their schools, feelings of comfort and safety in…
Utzon, Jan; Petri, A.L.; Christophersen, S.
There is little agreement on the philosophy of measuring clinical quality in health care. How data should be analyzed and transformed to healthcare information is an ongoing discussion. To accept a difference in quality between health departments as a real difference, one should consider to which...... extent the selection of patients, random variation, confounding and inconsistency may have influenced results. The aim of this article is to summarize aspects of clinical healthcare data analyses provided from the national clinical quality databases and to show how data may be presented in a way which...
ORIGINAL ARTICLES. 521. 522. August 2010, Vol. 100, No. 8 SAMJ. Does South Africa need a national clinical trials support unit? N Siegfried, J Volmink, A Dhansay. The randomised controlled trial (RCT) is the gold standard for evaluating the effects of health care interventions.1 Therefore,. South African health policy and ...
The EPA Radiation Advisory Committee found that the document presented a valid approach to designing a national radon survey. In addition, the Committee felt that the study is important from a national health point of view and that all efforts must be made to insure that a survey of high quality is conducted. Major conclusions and recommendations are summarized in the report
Olfson, Mark; He, Jian-ping; Merikangas, Kathleen Ries
Objective: To examine the 12-month prevalence of psychotropic medication use among adolescents, and the match between mental disorder diagnoses and past-year antidepressant and stimulant use. Method: Data are from the National Comorbidity Survey--Adolescent Supplement (2002-2004), a nationally representative survey of 10,123 adolescents aged 13 to…
The National Lakes Assessment (NLA) surveyed over 1200 U.S. lakes in the summer of 2007, evaluating lake quality based on water quality, physical habitat, and indicators of biological and recreational condition. An upcoming national report will summarize survey results primarily ...
... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... use of other forms of information technology. Title: Nation-wide Customer Satisfaction Surveys, VA...
Pamela J. Edwards; Gordon W. Stuart
The National Association of State Foresters conducts surveys of silviculture nonpoint source (NPS) pollution control programs to measure progress and identify needs. The 2000 survey results are summarized here for the nation and for the 20-state northeastern region. Current emphasis of NPS pollution programs is on education, training, and monitoring. Educational...
Zarra, T; Lambrianidis, T
To investigate amongst Greek endodontists, the incidence of ocular accidents during practice, the circumstances associated with them, the therapeutic measures taken after the accidents, their compliance with the use of eye protection and their eye care behaviour. One hundred and forty-seven endodontists met the inclusion criteria and were invited to participate in the survey. Data were gathered through interviews based on a questionnaire. Participants were asked for personal/professional data, information on ocular accidents in the past 5 years, post-accident actions and the type of eye protection used. Their eyesight status and frequency of ocular examination were also recorded. Data were analysed using chi-square test, independent samples t-test and logistic regression. The level of significance was set at P = 0.05. The response rate was 84%. Ocular accidents were reported by 73% of the participants. Amalgam and NaOCl were the foreign bodies most frequently associated with ocular accidents. Medical assistance was sought in 16% of the most recent accidents. No permanent eye damage was reported. Regular use of magnification (OR:0.305, 95%CI:0.123-0.754) and years of clinical experience (OR:0.191, 95%CI:0.066-0.551) were significant predictors for the incidence of ocular accidents. Adequate eye protection was utilized by 82% of endodontists. Endodontists with eyesight deficiencies attended more frequently for ocular examination (P = 0.018). A high percentage of endodontists experienced ocular accidents. Regular use of magnification and increasing years in practice were associated with a reduced risk of ocular accidents. The majority of endodontists reported using adequate eye protection. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.
Gander, Philippa H; Marshall, Nathaniel S; Harris, Ricci B; Reid, Papaarangi
To assess the role of sleep-related factors, ethnicity and socioeconomic deprivation in self-reported motor vehicle accidents while driving, after controlling for gender, age and driving exposure. Mail survey to a random electoral roll sample of 10,000 people aged 30-60 years, stratified by age decades and ethnicity (71% response rate). The analytical sample included 5,534 current drivers (21.6% Maori men, 21.2% Maori women, 30% non-Maori men, 27.2% non-Maori women). Multiple logistic regression analyses revealed the following independent risk factors for accident involvement while driving (last three years): being younger; higher average weekly driving hours; never/rarely getting enough sleep (OR=1.26, 95% CI 1.06-1.49); reporting any chance of dozing in a car while stopped in traffic (Epworth Sleepiness Scale question 8, OR=1.52, 95% CI 1.15-2.02); and among women, being non-Maori. Total Epworth score was not significantly related to reported accident involvement. Chronic sleep restriction, and any likelihood of dozing off at the wheel of a motor vehicle, were significant independent predictors of self-reported involvement in all types of motor vehicle accidents, not only those identified as fatigue-related. The Epworth Sleepiness Scale alone is not a reliable clinical tool for identifying individuals at higher risk of crashes. Factors relating to chronic sleepiness were as important as established demographic risk factors for self-reported motor vehicle accident involvement among 30-60 year-old drivers. The findings reinforce the need for multi-faceted campaigns to reduce sleepy driving.
Helweg-Larsen, Karin; Larsen, Helmer Bøving
Cross National Comparisons: Youth Population Surveys About Child Maltreatment In this multi-session track, researchers will present the results concerning the epidemiology of child maltreatment from over one dozen general population surveys of youth, covering four continents and portions of the w...... comparison and the advantages and disadvantages of various sampling designs, modes of survey administration, question formats and human subject protection procedures.......Cross National Comparisons: Youth Population Surveys About Child Maltreatment In this multi-session track, researchers will present the results concerning the epidemiology of child maltreatment from over one dozen general population surveys of youth, covering four continents and portions...... of the world where epidemiologic data has not been previously available. Organizers will request in advance that the presenters include some data in formats that can be compared across studies. In a final session, the organizers will lead a discussion about the challenges of national surveys and cross national...
Regina M. Rochefort; Darin D. Swinney
Three survey methods were utilized to describe human impacts in one wilderness management zone of Mount Rainier National Park: wilderness impact cards, social trail and campsite surveys, and condition class surveys. Results were compared with respect to assessment of wilderness condition and ecological integrity. Qualitative wilderness impact cards provided location of...
Meara, M O; Morrissey, Y; Corcoran, B
In 2008 the Health Service Executive (HSE) carried out a survey to assess general practitioners (GPs) satisfaction with the National Vaccine Cold Chain Service. This survey found high levels of satisfaction (> 90%) with the service. Over half of those surveyed had used the vaccine returns service with the majority (89.2%) finding it good or very good.
Sweet, Jerry J; Lee, Catherine; Guidotti Breting, Leslie M; Benson, Laura M
This paper describes gender-related trends within clinical neuropsychology, based primarily on recurrent practice surveys within the specialty and, to a lesser extent, job-related information from medical specialties and the general U.S. labor market. Chronological and cross-sectional analyses of professional practice survey data from 2005, 2010, and 2015 relevant to gender. As is common with survey data, descriptive analysis and independent samples t-tests were conducted. Longitudinal data allowed for examination of gender trends, as well as observations of change and stability of factors associated with gender, over time. Women have become dominant in number in clinical neuropsychology, and also comprise a vast majority of practitioners entering the specialty. Gender differences are noted in professional identity, work status, work settings, types of career satisfaction, and retirement expectations. Women are more likely to identify work environment and personal/family obstacles to aspects of career satisfaction. A gender pay gap was found at all time points and is not narrowing. As is true nationally, multiple factors appear related to the gender pay gap in clinical neuropsychology. Women in neuropsychology are now dominant in number, and their presence is strongly associated with specific practice patterns, such as greater institutional employment, less involvement in forensic practice, and strong involvement in pediatric practice, which may be maintaining the sizeable gender pay gap in neuropsychology. As the proportion of women neuropsychologists continues to increase, flexible work hours, and alternative means of remuneration may be needed to offset current disproportionate family-related responsibilities.
Mainz, Jan; Hansen, Anne-Marie; Palshof, Torben
This article describes the Danish National Indicator Project that aims to document and improve the quality of care at national level. Specific clinical indicators, standards, and prognostic factors have been developed for eight diseases (e.g. lung cancer). It has been implemented in all clinical...... departments in Denmark. Participation is mandatory. Results related to lung cancer are presented and discussed. The experiences from 2000 to 2008 indicate that the quality of care related to the eight diseases improve over time and that that performance and outcome measurement will get paid in terms...... of quality improvement....
Sameer A Dhayat
Full Text Available Pancreatic ductal adenocarcinoma (PDAC remains one of the most deadly cancers in Europe and the USA. There is consensus that radical tumor surgery is the only viable option for any long-term survival in patients with PDAC. So far, limited data are available regarding the routine surgical management of patients with advanced PDAC in the light of surgical guidelines.A national survey on perioperative management of patients with PDAC and currently applied criteria on their tumor resectability in German university and community hospitals was carried out.With a response rate of 81.6% (231/283 a total of 95 (41.1% participating departments practicing pancreatic surgery in Germany are certified as competence and reference centers for surgical diseases of the pancreas in 2016. More than 95% of them indicate to carry out structured and interdisciplinary therapies along with an interdisciplinary pre- and postoperative tumor board. The majority of survey respondents prefer the pylorus-preserving partial pancreatoduodenectomy (93.1% with standard lymphadenectomy for cancer of the pancreatic head. Intraoperative histological evaluation of the resection margins is used regularly by 99% of the survey respondents. 98.7% of survey respondents carry out partial or complete vein resection, 126 respondents (54.5% would resect tumor adjacent arteries, and 102 respondents (44.2% would perform metastasectomy if complete PDAC resection (R0 is possible.Evidence-based and standardized pancreatic surgery is practiced by a large number of hospitals in Germany. However, a significant number of survey respondents support an extended radical tumor resection in patients with advanced PDAC even when not indicated by current clinical guidelines.
Election Assistance Commission — This dataset contains voter registration data for the 2010 election cycle. The dataset and corresponding report address the impact of the National Voter Registration...
U.S. Department of Health & Human Services — This series measures the prevalence and correlates of drug use in the United States. The surveys are designed to provide quarterly, as well as annual, estimates....
U.S. Department of Health & Human Services — This series measures the prevalence and correlates of drug use in the United States. The surveys are designed to provide quarterly, as well as annual, estimates....
U.S. Department of Health & Human Services — This series measures the prevalence and correlates of drug use in the United States. The surveys are designed to provide quarterly, as well as annual, estimates....
Ali, Joseph; Califf, Robert; Sugarman, Jeremy
PCORnet, the National Patient-Centered Clinical Research Network, seeks to establish a robust national health data network for patient-centered comparative effectiveness research. This article reports the results of a PCORnet survey designed to identify the ethics and regulatory challenges anticipated in network implementation. A 12-item online survey was developed by leadership of the PCORnet Ethics and Regulatory Task Force; responses were collected from the 29 PCORnet networks. The most pressing ethics issues identified related to informed consent, patient engagement, privacy and confidentiality, and data sharing. High priority regulatory issues included IRB coordination, privacy and confidentiality, informed consent, and data sharing. Over 150 IRBs and five different approaches to managing multisite IRB review were identified within PCORnet. Further empirical and scholarly work, as well as practical and policy guidance, is essential if important initiatives that rely on comparative effectiveness research are to move forward.
Schlabach, Martin; Steinnes, Eiliv; Uggerud, Hilde Thelle
For the second Norwegian Moss survey on organic contaminants 20 samples were collected on the Norwegian mainland in rural areas presumably little affected by local point sources of pollutants. PeCB, HCB, PCB, HCH, DDT, PBDE, DBDPE, HBCD, PFAS, and PAH were determined. There is a general trend of decreasing contamination from 2010 to 2015 for the POPs included in the survey. A trend of decreasing contamination with increasing latitude shown in the 2010 moss data is confirmed in the results fro...
Harland, Nicholas; Blacklidge, Brian
Physiotherapy phone based, "Physio Direct" (PD) musculoskeletal triage and treat services are a relatively new phenomena. This study explored Physiotherapist and GP attitudes towards PD services. Online national survey via cascade e-mail initiated by study leads. 488 Physiotherapists and 68 GPs completed the survey. The survey asked three negatively worded and three positively worded Likert scale questions regarding PD services. It also collected demographic data and more global attitudes including a version of the friends and family test. Overall both Physiotherapists and GP's have positive attitudes towards PD services. There was global agreement that PD triage was a good idea but in both groups the majority of respondents who expressed a definite opinion thought that patients would still eventually need to be seen face to face. The vast majority of all respondents also thought patients should be given a choice about first accessing PD services. Physiotherapists with experience of PD services had more positive and less negative attitudes than those without experience. More detailed results are discussed. Relevant clinical stakeholders have generally positive attitudes towards PD services, but more so when they have experience of them. Counter to research findings significant proportions of respondents believe patients accessing PD services will still need to be seen face to face. The significant majority of respondents believe patients should be given a choice whether they access PD services in the first instance or not. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Holliday, Emma B.; Thomas, Charles R.; Kusano, Aaron S.
Purpose: The aim of this study was to examine the experiences of radiation oncology applicants and to evaluate the prevalence of behaviors that may be in conflict with established ethical standards. Methods and Materials: An anonymous survey was sent to all 2013 applicants to a single domestic radiation oncology residency program through the National Resident Matching Program (NRMP). Questions included demographics, survey of observed behaviors, and opinions regarding the interview and matching process. Descriptive statistics were presented. Characteristics and experiences of respondents who matched were compared with those who did not match. Results: Questionnaires were returned by 87 of 171 applicants for a 51% response rate. Eighty-two questionnaires were complete and included for analysis. Seventy-eight respondents (95.1%) reported being asked at least 1 question in conflict with the NRMP code of conduct. When asked where else they were interviewing, 64% stated that this query made them uncomfortable. Forty-five respondents (54.9%) reported unsolicited post-interview contact by programs, and 31 (37.8%) felt pressured to give assurances. Fifteen respondents (18.3%) reported being told their rank position or that they were “ranked to match” prior to Match day, with 27% of those individuals indicating this information influenced how they ranked programs. Half of respondents felt applicants often made dishonest or misleading assurances, one-third reported that they believed their desired match outcome could be improved by deliberately misleading programs, and more than two-thirds felt their rank position could be improved by having faculty from their home institutions directly contact programs on their behalf. Conclusions: Radiation oncology applicants report a high prevalence of behaviors in conflict with written NRMP policies. Post-interview communication should be discouraged in order to enhance fairness and support the professional development of future
Sufrin, Carolyn B; Creinin, Mitchell D; Chang, Judy C
Incarcerated women have had limited access to health care prior to their arrest. Although their incarceration presents an opportunity to provide them with health care, their reproductive health needs have been overlooked. We performed a cross-sectional study of a nationally representative sample of 950 correctional health providers who are members of the Academy of Correctional Health Providers. A total of 405 surveys (43%) were returned, and 286 (30%) were eligible for analysis. Most ineligible surveys were from clinicians at male-only facilities. Of eligible respondents, 70% reported some degree of contraception counseling for women at their facilities. Only 11% provided routine counseling prior to release. Seventy percent said that their institution had no formal policy on contraception. Thirty-eight percent of clinicians provided birth control methods at their facilities. Although the most frequently counseled and prescribed method was oral contraceptive pills, only 50% of providers rated their oral contraceptive counseling ability as good or very good. Contraception counseling was associated with working at a juvenile facility, and with screening for sexually transmitted infections. Contraception does not appear to be integrated into the routine delivery of clinical services to incarcerated women. Because the correctional health care system can provide important clinical and public health interventions to traditionally marginalized populations, services for incarcerated women should include access to contraception.
Buchholz, Susan Weber; Bloch, Joan Rosen; Westrin, David; Fogg, Louis
To better understand the research capacity and productivity of nurse practitioner (NP) faculty, a study was conducted to describe the types of research that have been and are being completed by National Organization of Nurse Practitioner Faculties (NONPF) members. A web-based survey was developed with input from members of the NONPF Research Special Interest Group and the NONPF Board. This 23-question survey included demographic, academic degree, NP population focus, and research-related questions. Three e-mails were sent to NONPF members over a 10-week period of time (late December 2012 to early February 2013). Respondents (N = 344) in the sample were Advanced Practice Registered Nurses with either a Masters, Doctor of Nursing Practice, DNS or PhD as their highest academic degree. Study results demonstrated that current NP faculty research includes a wide breadth of clinical areas studied, types of methodologies used, variety of funding mechanisms, and successful publication records. Because NP faculty conduct a wide array of research on clinically relevant topics, and demonstrate successful funding and publication track records, they are poised to continue to be leaders in healthcare research. ©2015 American Association of Nurse Practitioners.
An aerial radiological survey was conducted over the facilities of the Argonne National Laboratory in Argonne, Illinois, on 2 to 13 May 1977. The survey was flown at an altitude of 46 m by a helicopter containing 20 sodium iodide detectors. The line spacing was also 46 m. Enhanced gamma exposure rate levels, which could be attributed to Argonne operations, were observed at many locations
Watson, Meg; Benard, Vicki; King, Jessica; Crawford, Anatasha; Saraiya, Mona
Major organizations recommend cytology screening (Pap test) every 3years for women aged 21-65; women aged 30 to 65 have the option of adding the HPV test (co-test) every 5years. We examined national percentages of cervical cancer screening, and we examined use of co-testing as an option for screening. We used 2015 U.S. National Health Interview Survey (NHIS) data to examine recent cervical cancer screening (Pap test within 3years among women aged 21-65 without a hysterectomy; N=10,596) and co-testing (N=9,125). We also conducted a multivariable analysis to determine odds of having had a Pap test or co-test by demographic variables. To evaluate changes in screening over time, we examined Pap testing during the years 2000, 2005, 2008, 2010, 2013 and 2015. Analysis completed in Atlanta, GA during 2016. Overall, 81.1% of eligible women reported having a Pap test within 3years; percentages declined over time among all age groups. An estimated 14 million women aged 21-65 had not been screened within the past 3years. Recent immigrants to the United States, women without insurance, and women without a usual source of healthcare had lower odds of being up to date with screening. About 1/3 of women up to date on Pap testing reported having a co-test with their most recent Pap test. Declines in screening among women aged 21-65 are cause for concern. More research is needed on co-testing practices. Provider and patient education efforts may be needed to clarify recommended use of HPV tests. Published by Elsevier Inc.
Reis, Steven E; Berglund, Lars; Bernard, Gordon R; Califf, Robert M; Fitzgerald, Garret A; Johnson, Peter C
Advances in human health require the efficient and rapid translation of scientific discoveries into effective clinical treatments; this process, in turn, depends on observational data gathered from patients, communities, and public health research that can be used to guide basic scientific investigation. Such bidirectional translational science, however, faces unprecedented challenges due to the rapid pace of scientific and technological development, as well as the difficulties of negotiating increasingly complex regulatory and commercial environments that overlap the research domain. Further, numerous barriers to translational science have emerged among the nation's academic research centers, including basic structural and cultural impediments to innovation and collaboration, shortages of trained investigators, and inadequate funding.To address these serious and systemic problems, in 2006 the National Institutes of Health created the Clinical and Translational Science Awards (CTSA) program, which aims to catalyze the transformation of biomedical research at a national level, speeding the discovery and development of therapies, fostering collaboration, engaging communities, and training succeeding generations of clinical and translational researchers. The authors report in detail on the planning process, begun in 2008, that was used to engage stakeholders and to identify, refine, and ultimately implement the CTSA program's overarching strategic goals. They also discuss the implications and likely impact of this strategic planning process as it is applied among the nation's academic health centers.
Stevens, Andrew; Doyle, Nick; Littlejohns, Peter; Docherty, Mary
The requirements of the UK Equality Act 2010 and some high profile criticism for using a potentially ageist methodology have prompted the National Institute for Health and Clinical Excellence (NICE) to assess the processes and methodology it uses to make appraisal decisions. This paper argues that NICE has established rigorous systems to protect against ageist decisions, has no track record of ageism and is well placed to meet the requirements of new UK equality legislation.
Májovský, Martin; Netuka, David; Beneš, Vladimír
A pineal cyst is a benign affection of a pineal gland on the borderline between a pathological lesion and a variant of normality. Clinical management of patients with a pineal cyst remains controversial, especially when patients present with non-specific symptoms. An online questionnaire consisting of 13 questions was completed by 110 neurosurgeons worldwide. Responses were entered into a database and subsequently analysed. Based on data from the questionnaire, the main indication criteria for pineal cyst resection are hydrocephalus (90 % of the respondents), Parinaud's syndrome (80 %) and growth of the cyst (68 %). Only 15 % of the respondents occasionally operate on patients with non-specific symptoms. If surgery is indicated, improvement is expected in 88 % of the patients. The vast majority of the respondents favour a supracerebellar infratentorial approach to the pineal region. Most (78 %) of the respondents regarded the patient registry as a potentially useful instrument. This survey sheds light on the current practice of pineal cyst management across the world. Most of the respondents perform surgery on pineal cysts only if patients are presenting with symptoms attributable to a mass effect. Surgery for patients with non-specific complaints (headache, vertigo) is not widely accepted, although it may prove effective. A prospective patient registry might be useful in the decision-making process in the clinical management of pineal cysts.
Durand, Yvonnick; Jacquin, Philippe
growth in the so called 'eligible' products on the market. The availability of an increasing number of technical solutions on the market enables builders, architects and promoters to offer their clients new options for incorporating photovoltaics into their structures. The development of the market has attracted new stakeholders at all stages of the photovoltaic supply line, and many companies have been created to study, engineer, install, provide and operate such systems. Investors are taking part in large-scale projects, such as the construction of major multi-megawatt ground power plants. New activities and actors are appearing, such as in the field of funding specifically for photovoltaic projects, leasing rooftops for installing systems and surveying ground for building power plants on. The industrial sector has been strengthened with the ambition to be able to vertically integrate the photovoltaic supply chain, from the production of silicon to the operation of electrical power production systems. This development creates jobs. According to the SER's member companies (which represent 80% of the market), photovoltaic activity has generated about 1,500 direct jobs in 2008, and the total estimated jobs for supply chain is about 4,000, or three times what it was in 2004, representing 70% growth over 2007. A new consortium that has brought together private companies and public bodies, known as the 'PV Alliance Lab Fab' was established, and a major R and D project known as 'Solar Nano Crystal' began in late 2008. Research programs concentrate efforts to improve the conversion efficiency of cells and modules, as well as their life span. A major effort has been undertaken to reduce production costs, engineer new photovoltaic materials, prevent environmental impacts, and manage systems. ADEME (the French Environment and Energy Management Agency) as well as ANR (the National Research Agency www.agence-nationale-recherche.fr), OSEO
ZHU, Hui-hui; ZHOU, Chang-hai; CHEN, Ying-dan; ZANG, Wei; XIAO, Ning; ZHOU, Xiao-nong
The National Survey on Current Status of Major Human Parasitic Diseases in China has been carried out since 2014 under the organization of the National Health and Family Planning Commission of the People's Republic of China. The National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (NIPD, China CDC) provided technical support and was responsible for quality control in this survey. This study used SWOT method to analyze the strengths, weaknesses, opportunities and threats that were encountered by he NIPD, China CDC during the completion of the survey. Accordingly, working strategies were proposed to facilitate the future field work.
Bodkin, James L.; Kloecker, Kimberly A.; Coletti, Heather A.; Esslinger, George G.; Monson, Daniel H.; Ballachey, Brenda E.
Since 1999, vessel based surveys to estimate species composition, distribution and relative abundance of marine birds and mammals have been conducted along coastal and pelagic (offshore) transects in Glacier Bay, Alaska. Surveys have been conducted during winter (November-March) and summer (June). This annual report presents the results of those surveys conducted in March and June of 2001. Following completion of surveys in 2002 we will provide a final report of the results of all surveys conducted between 1999 and 2002. Glacier Bay supports diverse and abundant assemblages of marine birds and mammals. In 2001 we identified 58 species of bird, 7 species of marine mammal, and 6 species of terrestrial mammal on transects sampled during winter and summer. Of course all species are not equally abundant. Among all taxa, in both seasons, sea ducks were the numerically dominant group. In their roles as consumers and because of their generally large size, marine mammals are also likely important in the consumption of energy produced in the Glacier Bay ecosystem. Most common and abundant marine birds and mammals can be placed in either a fish based (e.g. alcids and pinnipeds), or a benthic invertebrate (e.g. sea ducks and sea otters) based food web. Distinct differences in the species composition and abundance of marine birds were observed between winter and summer surveys. Winter marine bird assemblages were dominated numerically (> 11,000; 65% of all birds) by a relatively few species of sea ducks (scoters, goldeneye, Bufflehead, Harlequin and Long-tailed ducks). The sea ducks were distributed almost exclusively along near shore habitats. The prevalence of sea ducks during the March surveys indicates the importance of Glacier Bay as a wintering area for this poorly understood group of animals that occupy a high trophic position in a principally benthic invertebrate (mussel and clam) food web. Marine mammal assemblages were generally consistent between seasons, although
Kozak, Lola Jean; DeFrances, Carol Jean; Hall, Margaret Jean
This report presents 2004 national estimates and selected trend data on the use of nonfederal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2004, data were collected for approximately 371,000 discharges. Of the 476 eligible nonfederal short-stay hospitals in the sample, 439 (92 percent) responded to the survey. An estimated 34.9 million inpatients were discharged from nonfederal short-stay hospitals in 2004. They used 167.9 million days of care and had an average length of stay of 4.8 days. Hospital use by age ranged from 4.3 million days of care for patients 5-14 years of age to 31.8 million days of care for 75-84 year olds. Almost a third of patients 85 years and over were discharged from hospitals to long-term care institutions. Diseases of the circulatory system was the leading diagnostic category for males. Childbirth was the leading category for females, followed by circulatory diseases. The proportion of HIV discharges who were 40 years of age and over increased from 40 percent in 1995 to 67 percent in 2004. The rate of cardiac catheterizations was higher for males than for females and higher for patients 65-74 and 75-84 years of age than for older or younger groups. The average length of stay for both vaginal and cesarean deliveries decreased from 1980 through 1995 but stays for vaginal deliveries increased 24 percent during the period from 1995 to 2004.
DeFrances, Carol J; Cullen, Karen A; Kozak, Lola Jean
This report presents 2005 national estimates and selected trend data on the use of nonfederal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, Ninth Revision, Clinical Modification codes. The estimates are based on data collected through the National Hospital Discharge Survey. The survey has been conducted annually since 1965. In 2005, data were collected for approximately 375,000 discharges. Of the 473 eligible nonfederal short-stay hospitals in the sample, 444 (94 percent) responded to the survey. An estimated 34.7 million discharges from nonfederal short-stay hospitals occurred in 2005. Discharges used 165.9 million days of care and had an average length of stay of 4.8 days. Persons 65 years and over accounted for 38 percent of the hospital discharges and 44 percent of the days of care. The proportion of discharges whose status was described as routine discharge or discharged to the patient's home declined with age, from 91 percent for inpatients under 45 years of age to 41 percent for those 85 years and over. Hospitalization for malignant neoplasms decreased from 1990-2005. The hospitalization rate for asthma was the highest for children under 15 years of age and those 65 years of age and over. The rate was lowest for those 15-44 years of age. Thirty-eight percent of hospital discharges had no procedures performed, whereas 12 percent had four or more procedures performed. An episiotomy was performed during a majority of vaginal deliveries in 1980 (64 percent), but by 2005, it was performed during less than one of every five vaginal deliveries (19 percent).
Kozak, Lola Jean; Lees, Karen A; DeFrances, Carol J
This report presents 2003 national estimates and trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2003, data were collected for approximately 320,000 discharges. Of the 479 eligible non-Federal short-stay hospitals in the sample, 426 (89 percent) responded to the survey. An estimated 34.7 million inpatients were discharged from non-Federal short-stay hospitals in 2003. They used 167.3 million days of care and had an average length of stay of 4.8 days. Females used almost one-third more days of hospital care than males. Patients with five or more diagnoses rose from 29 percent of discharges in 1990 to 57 percent in 2003. The leading diagnostic category was respiratory diseases for children under 15 years, childbirth for 15-44 year olds, and circulatory diseases for patients 45 years of age and over. Only surgical procedures were performed for 27 percent of discharges, 18 percent had surgical and nonsurgical procedures, and 16 percent had only nonsurgical procedures. A total of 664,000 coronary angioplasties were performed, and stents were inserted during 86 percent of these procedures with drug-eluting stents used in 28 percent. The number and rate of total and primary cesarean deliveries rose from 1995 to 2003. The rate of vaginal birth after cesarean delivery dropped 58 percent, from 35.5 in 1995 to 14.8 in 2003.
Kritsaneepaiboon, Supika; Trinavarat, Panruethai; Visrutaratna, Pannee
Increasing pediatric CT usage worldwide needs the optimization of CT protocol examination. Although there are previous published dose reference level (DRL) values, the local DRLs should be established to guide for clinical practice and monitor the CT radiation. To determine the multidetector CT (MDCT) radiation dose in children in three university hospitals in Thailand in four age groups using the CT dose index (CTDI) and dose length product (DLP). A retrospective review of CT dosimetry in pediatric patients (CT in pediatric patients from the UK and Switzerland according to International Commission on Radiological Protection (ICRP) recommendation. Results Per age group, the third quartile values for brain, chest, and abdominal CTs were, respectively, in terms of CTDI(vol): 25, 30, 40, and 45 mGy; 4.5, 5.7, 10, and 15.6 mGy; 8.5, 9, 14, and 17 mGy; and in terms of DLP: 400, 570, 610, and 800 mGy cm; 80, 140, 305, and 470 mGy cm; and 190, 275, 560,765 mGy cm. This preliminary national dose survey for pediatric CT in Thailand found that the majority of CTDI(vol) and DLP values in brain, chest, and abdominal CTs were still below the diagnostic reference levels (DRLs) from the UK and Switzerland regarding to ICRP recommendation.
... Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking. Points of view or opinions expressed in this document are those ...
Kritsaneepaiboon, Supika [Dept. of Radiology, Faculty of Medicine, Prince of Songkla Univ., Hat Yai (Thailand)], e-mail: email@example.com; Trinavarat, Panruethai [Dept. of Radiology, Faculty of Medicine, Chulalongkorn Univ., Bangkok (Thailand); Visrutaratna, Pannee [Dept. of Radiology, Faculty of Medicine, Chiang Mai Univ., Chiang Mai (Thailand)
Background: Increasing pediatric CT usage worldwide needs the optimization of CT protocol examination. Although there are previous published dose reference level (DRL) values, the local DRLs should be established to guide for clinical practice and monitor the CT radiation. Purpose: To determine the multidetector CT (MDCT) radiation dose in children in three university hospitals in Thailand in four age groups using the CT dose index (CTDI) and dose length product (DLP). Material and Methods: A retrospective review of CT dosimetry in pediatric patients (<15 years of age) who had undergone head, chest, and abdominal MDCT in three major university hospitals in Thailand was performed. Volume CTDI (CTDIvol) and DLP were recorded, categorized into four age groups: <1 year, 1- < 5 years, 5- <10 years, and 10- <15 years in each scanner. Range, mean, and third quartile values were compared with the national reference dose levels for CT in pediatric patients from the UK and Switzerland according to International Commission on Radiological Protection (ICRP) recommendation. Results: Per age group, the third quartile values for brain, chest, and abdominal CTs were, respectively, in terms of CTDIvol: 25, 30, 40, and 45 mGy; 4.5, 5.7, 10, and 15.6 mGy; 8.5, 9, 14, and 17 mGy; and in terms of DLP: 400, 570, 610, and 800 mGy cm; 80, 140, 305, and 470 mGy cm; and 190, 275, 560,765 mGy cm. Conclusion: This preliminary national dose survey for pediatric CT in Thailand found that the majority of CTDIvol and DLP values in brain, chest, and abdominal CTs were still below the diagnostic reference levels (DRLs) from the UK and Switzerland regarding to ICRP recommendation.
Silva, John M., III
Sport psychology has made significant advances in organization and research technology while creating an instrumental and influential subdiscipline of physical education. A survey of high school and college coaches was performed to discover specific areas of sport psychology found to be important and how coaches would like to integrate sport…
Jensen, Helene Nordahl; Krølner, Rikke; Páll, Gabrilla
Indicators such as country of birth and language spoken at home have been used as proxy measures for ethnic background, but the validity of these indicators in surveys among school children remains unclear. This study aimed at comparing item response and student-parent agreement on four questions...... about country of birth and language spoken at home in three European countries....
McCullough, C. Sue; And Others
Computer technology can assist school psychologists in assessment, data management, and consultation, but there is little centralized information available about the most appropriate ways to use the computer. There is even debate about the amount of interest school psychologists have in acquiring computer skills. A nationwide survey of school…
Greyson, Devon; Vezina, Kumiko; Morrison, Heather; Taylor, Donald; Black, Charlyn
The advent of policies at research-funding organizations requiring grantees to make their funded research openly accessible alters the life cycle of scholarly research. This survey-based study explores the approaches that libraries and research administration offices at the major Canadian universities are employing to support the…
Objective: A survey was performed to identify factors for professional career satisfaction and for dissatisfaction. Methods: During General Assembly of CSPS, attendees answered the 37-question form grouped into the following categories: demographic, professional activity and organizational issues, type of service, ...
Ahmed S Bahammam
Conclusion: The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA.
Mar 3, 1994 ... Whitfield (l989c) worked in the surf zone and Beckley. (\\ 986) sampled the nearshore region immediately behind the breaker line and has also conducted an extensive ichthyo- plankton survey on the east coast both on and beyond the continenllli shelf (Beckley & van Ballegooyen 1992; Beck- ley 1993).
Graham, Steve; Capizzi, Andrea; Harris, Karen R.; Hebert, Michael; Morphy, Paul
A random sample of language arts, social studies, and science middle school teachers from the United States were surveyed about their preparation to teach writing, beliefs about responsibilities for teaching writing, use of evidence-based writing practices, assessment of writing, use of technology, and adaptations for struggling writers. The…
... on sexual violence, stalking, and intimate partner violence victimization of adult women and men in the United States. The survey ... of this violence, the im- mediate impacts of victimization, and the lifelong health ... are disproportionally affected by sexual violence, intimate partner ...
Full Text Available Many prescribed treatments for children have not been adequately tested in children, sometimes resulting in harmful treatments being given and beneficial treatments being withheld. In the absence of specific trial-based data in children, results of studies in adults are extrapolated, which is often inappropriate because children have different range of diseases and metabolize medications differently. Trials in children are more challenging than those in adults and the pool of eligible children entering trials is often small. Children must have at last the same rights as adults in relation to receiving treatment with medicinal products that have been fully tested. The need for more studies to obtain paediatric information for medicines used in children is now a matter of consensus on a global basis and is considered a public health priority. Therfore a survey was performed in university hospitals in Germany targeting the current and future situation of children in clinical trials. The questionnaire of this survey was sent to 68 paediatric departments in 31 university clinics in Germany with a respond rate of 27% with respect to 18 returned questionnaires. With regard to new laws, guidelines and strong governmental support and funding an increasing number of clinical trials is expected. Surprisingly, the number of trials in the paediatric population remains unchanged within a period of 4 years (2005-2008. Added to the surveys performed within the pharmaceutical industry from Heinrich and Hark the number of trials in children remains unchanged even within a period of 9 years (2000-2008. The efforts undertaken by the government regarding funding and supporting KKS (Coordinating Centers for Clinical Trials and affiliated PAED-Net (Pediatric Network on Medication Development and Testing in Children and Adolescents at KKS appear to be insufficient. Beginning of this year the legal framework with the urgent expected “Paediatric Regulation” was
Ross, Joseph S; Blount, Katrina L; Ritchie, Jessica D; Hodshon, Beth; Krumholz, Harlan M
In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA) to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA's pre-market approval (PMA) pathway. We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%), nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives.
Ross, Joseph S; Blount, Katrina L; Ritchie, Jessica D; Hodshon, Beth; Krumholz, Harlan M
Background In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA) to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA’s pre-market approval (PMA) pathway. Methods and results We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%), nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Conclusion Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives. PMID:26060416
Roydhouse, Jessica K; Gutman, Roee; Keating, Nancy L; Mor, Vincent; Wilson, Ira B
Proxy respondents are frequently used in surveys, including those assessing health-related quality of life (HRQOL). In cancer, most research involving proxies has been undertaken with paired proxy-patient populations, where proxy responses are compared to patient responses for the same individual. In these populations, proxy-patient differences are small and suggest proxy underestimation of patient HRQOL. In practice, however, proxy responses will only be used when patient responses are not available. The difference between proxy and patient reports of patient HRQOL where patients are not able to report for themselves in cancer is not known. The objective of this study was to evaluate the difference between patient and proxy reports of patient HRQOL in a large national cancer survey, and determine if this difference could be mitigated by adjusting for clinical and sociodemographic information about patients. Data were from the Cancer Care Outcomes Research and Surveillance (CanCORS) study. Patients or their proxies were recruited within 3-6 months of diagnosis with lung or colorectal cancer. HRQOL was measured using the SF-12 mental and physical composite scales. Differences of ½ SD (=5 points) were considered clinically significant. The primary independent variable was proxy status. Linear regression models were used to adjust for patient sociodemographic and clinical covariates, including cancer stage, patient age and education, and patient co-morbidities. Of 6471 respondents, 1011 (16%) were proxies. Before adjustment, average proxy-reported scores were lower for both physical (-6.7 points, 95% CI -7.4 to -5.9) and mental (-6 points, 95% CI -6.7 to -5.2) health. Proxy-reported scores remained lower after adjustment (physical: -5.8 points, -6.6 to -5; mental: -5.8 points, -6.6 to 5). Proxy-patient score differences remained clinically and statistically significant, even after adjustment for sociodemographic and clinical variables. Proxy-reported outcome scores
Jarmie, N.; Rogers, F.J. [Mycology Associates, Los Alamos, NM (United States)
The authors have completed a 5-year survey (1991--1995) of macromycetes found in Los Alamos County, Los Alamos National Laboratory, and Bandelier National Monument. The authors have compiled a database of 1,048 collections, their characteristics, and identifications. The database represents 123 (98%) genera and 175 (73%) species reliably identified. Issues of habitat loss, species extinction, and ecological relationships are addressed, and comparisons with other surveys are made. With this baseline information and modeling of this baseline data, one can begin to understand more about the fungal flora of the area.
Schapkaitz, Elise; Mafika, Zipho
Critical value policies are used by clinical laboratories to decide when to notify caregivers of life-threatening results. Despite their widespread use, critical value policies have not been published locally. A survey was designed to determine critical value policies for haematology tests in South Africa. A survey was carried out on 136 identified laboratories across South Africa in January 2013. Of these, 36 responded. Data collected included critical value policies, critical values for haematology parameters, and critical value reporting. Of the 36 laboratories surveyed, 11.1% (n=4) were private, 33.3% (n=12) were affiliated to academic institutions and 55.6% (n=20) were peripheral or regional National Health Laboratory Service laboratories. All the laboratories confirmed that they had a critical value policy, and 83.3% of such policies were derived from local clinical opinion. Mean low and high critical limits for the most frequently listed tests were as follows: haemoglobin 20 g/dl, platelet count 1 000 ×10(9)/l, white cell count 46 ×10(9)/l, activated partial thromboplastin time >101 seconds, and international normalised ratio >6. In almost all cases critical value reporting was performed by the technologist on duty (97.2%). The majority of laboratories required that the person notified of the critical value be the doctor who ordered the test or the caregiver directly involved in the patient's care (83.3%); 73.3% of laboratories indicated that they followed an algorithm if the doctor/caregiver could not be reached. Each laboratory is responsible for establishing clinically relevant critical limits. Clinicians should be involved in developing the laboratory's critical value policy. The findings of this survey may be of value to local laboratories that are in the process of establishing or reviewing critical value policies.
Bullis, Michael; Otos, Maurine
A national survey of state coordinators of specialized service programs for children with deaf-blindness examined program characteristics including administrative structure, teacher certification requirements, technical assistance, eligibility determination, educational placement, curricula/instructional settings, transition, and unmet educational…
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
This report presents the Survey, Interviews, and Workshops Test Plan for the national evaluation of the : Seattle/Lake Washington Corridor (LWC) Urban Partnership Agreement (UPA) under the United States : Department of Transportation (U.S. DOT) UPA P...
Earth Data Analysis Center, University of New Mexico — This data contains a set of geodetic control stations maintained by the National Geodetic Survey. Each geodetic control station in this dataset has either a precise...
... SECURITY National Protection and Programs Directorate; Infrastructure Protection Data Call Survey... (NPPD), Office of Infrastructure Protection (IP), Infrastructure Information Collection Division (IICD... Homeland Security. BILLING CODE 9110-9P-P ...
Department of the Interior — A large-scale lake study on Interior Alaska National Wildlife Refuges (NWR) was undertaken from 1984–1986. Six NWRs were surveyed (Innoko, Kanuti, Koyukuk, Nowitna,...
National Aeronautics and Space Administration — ABSTRACT: This data set contains the results of a biometric tree survey of a 19.25 ha area adjacent to the eddy flux tower at the km 83 logged forest tower site in...
National Aeronautics and Space Administration — This data set contains the results of a biometric tree survey of a 19.25 ha area adjacent to the eddy flux tower at the km 83 logged forest tower site in Tapajos...
... An Overview of 2010 Findings on Victimization by Sexual Orientation About NISVS NISVS is an ongoing, nationally representative ... Violence Survey (NISVS): 2010 Findings on Victimization by Sexual Orientation is the first of its kind to present ...
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
Department of Agriculture — This layer represents the National Cooperative Soil Survey laboratory data of soil properties for soil samples taken at sites or points on the Earth’s globe – mainly...
This report presents the prevalence estimates for alcohol-involved driving derived from the recently completed U.S. : national field survey of alcohol- and drug-involved driving (primarily of nighttime weekend drivers, but also daytime : Friday drive...
This report proposes an assessment of the impact of the national radiotherapy measures present in the road map (November 2007 - March 2009) and describes the creation of a national support unit to manage the operating difficulties of 27 radiotherapy centres. It comments how a transition period between 2009 and 2011 must accompany radiotherapy before the implementation of opposable agreement criteria in 2011, notably through an improvement of recruitment, a support to cooperation between radiotherapy centres, the implementation of a radio-vigilance unit. Finally, it briefly discusses how to prepare the 2011-2013 period
Wittenberg-Lyles, Elaine; Schneider, Greg; Oliver, Debra Parker
Although the role of volunteers is at the heart of hospice care, little is known about hospice volunteer training and volunteer activity. A survey was used to assess current training programs for hospice volunteers. Hospices were invited to participate in the study from a link on the website for the Hospice Volunteer Association and Hospice Educators Affirming Life Project. Survey results revealed that the majority of volunteer work is in patient care, with most hospice agencies requiring a minimum 12-month volunteer commitment and an average 4-hour volunteer shift per week. Volunteer training is separate from staff training, is provided by paid agency staff, and costs approximately $14,303 per year. Communication and family support are considered important curriculum topics. Revisions to current volunteer training curriculum and format are suggested.
Ruppert, Leslie F.; Kirschbaum, Mark A.; Warwick, Peter D.; Flores, Romeo M.; Affolter, Ronald H.; Hatch, Joseph R.
The US Geological Survey and the State geological surveys of many coal-bearing States recently completed a new assessment of the top producing coal beds and coal zones in five major producing coal regions—the Appalachian Basin, Gulf Coast, Illinois Basin, Colorado Plateau, and Northern Rocky Mountains and Great Plains. The assessments, which focused on both coal quality and quantity, utilized geographic information system technology and large databases. Over 1,600,000 million short tons of coal remain in over 60 coal beds and coal zones that were assessed. Given current economic, environmental, and technological restrictions, the majority of US coal production will occur in that portion of the assessed coal resource that is lowest in sulfur content. These resources are concentrated in parts of the central Appalachian Basin, Colorado Plateau, and the Northern Rocky Mountains.
Synnott, H; Hanley, O; Fenton, D; Colgan, P A
This paper presents the results of a survey of radon concentrations in Irish primary and post-primary schools. The objective of this survey was to assess the distribution of radon in Irish schools and to identify those requiring remedial work to reduce radon exposure to children and staff. All primary and post-primary schools were invited to participate in the survey. Indoor radon concentrations were measured during the academic year using integrating passive alpha track-etch detectors with a measurement period from three to nine months. The survey was carried out on a phased basis from 1998 to 2004 and is one of the most comprehensive of its kind undertaken in Europe. Measurements were completed in 38 531 ground floor classrooms and offices in 3826 schools, representing over 95% of the approximate 4000 primary and post-primary schools in Ireland. Of these, 984 schools had radon concentrations greater than 200 Bq m -3 in 3028 rooms and 329 schools had radon concentrations in excess of 400 Bq m -3 in 800 rooms. The average radon concentration in schools was 93 Bq m -3 . This results in an annual average effective dose to an Irish child from exposure to radon of 0.3 mSv per year, assuming that the long-term radon concentration is equal to the radon concentration present during the working hours and that the annual average occupancy is 1000 h per year. A programme of remediation of schools with radon concentrations above 200 Bq m -3 has been put in place
system for vertebrate recruitment and DNA diversity. The lakes are independent as well, but could well be polluted by inappropriate application of...individual was not observed. Scat can sometimes be used as adequate sign, but without DNA test (which was not performed in this survey) errors are pos... Grasshopper Sparrow X US Ammodramus henslowii Henslow’s Sparrow* RS Ammospiza leconteii LeConte’s Sparrow RT Melospiza lincolnii Lincoln’s
Snowdon, David A; Millard, Geraldine; Taylor, Nicholas F
Limited literature exists on the practice of clinical supervision (CS) of professional physiotherapists despite current Australian safety and quality health standards stating that CS is to be provided to all physiotherapists. The aim of the present study was to evaluate the effectiveness of CS of physiotherapists working in an Australian public health service. CS was measured using the allied health-specific 26-item modified Manchester Clinical Supervision Scale (MCSS-26). Subscales of the MCSS-26 were summed for three domain scores (normative, restorative and formative) and a total score was calculated, which was compared with the reported threshold score of 73 for effective supervision. Sixty registered physiotherapists (response rate 92%), working for a large metropolitan public health service, with six different site locations, completed the survey. The mean (± s.d.) total MCSS-26 score was 71.0 ± 14.3 (95% confidence interval (CI) 67.4-74.6). Hospital site was the only variable that had a significant effect on total MCSS-26 score (P=0.005); there was no effect for supervisor or supervisee experience, or hospital setting (acute vs subacute). Physiotherapists scored a significantly lower mean percentage MCSS-26 score on the normative domain compared with the restorative domain (mean difference 7.8%; 95% CI 2.9-12.7; P=0.002) and the formative domain (mean difference 9.6%; 95% CI 6.3-13.0; Ppercentage MCSS-26 score than 'importance/value of CS' (mean difference 35.4%; 95% CI 31.3-39.4; P<0.001). Within this publicly funded physiotherapy department there was uncertainty about the effectiveness of CS, with more than half the physiotherapists rating their supervision as less than effective, suggesting there is opportunity for improvement in the practice of physiotherapy CS. Physiotherapists scored lowest in the normative domain, indicating that they found it difficult to find time for CS.
Small mammals were sampled in Tarangire National Park between 1994 and 1996. Twenty-six species of small mammals, including four species of Soricomorpha, seven species of Chiroptera and 15 species of Rodentia were documented, with some records being the first for the park. Identifications and natural history data ...
National archival institutions have a legal obligation to provide access to their collections. By so doing, archivists should adhere to a code of ethics and archival standards in the design and delivery of suitable and sustainable archival access programmes. The significance of an archival establishment is best measured by ...
Robertson, Charles M; Klingensmith, Mary E; Coopersmith, Craig M
To quantify the prevalence, outcomes, and cost of surgical resident research. General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1 to 3 years performing full-time research. No comprehensive data exists on the scope of this practice. Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Response rate was 200 of 239 (84%). A total of 381 of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and postresidency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (P < 0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of Accreditation Council for Graduate Medical Education work hour regulations for clinical residents, whereas a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. Although performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after postgraduate training.
Simon D Makombe
Full Text Available BACKGROUND: HIV/AIDS is having a devastating effect on the education sector in sub-Saharan Africa. A national survey was conducted in all public sector and private sector facilities in Malawi providing antiretroviral therapy (ART to determine the uptake of ART by teachers and their outcomes while on treatment. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective cohort study was carried out based on patient follow-up records from ART Registers and treatment master cards in all 138 ART clinics in Malawi; observations were censored on September 30(th 2006. By this date, Malawi's 102 public sector and 36 private sector ART clinics had registered a total of 72,328 patients for treatment. Of these, 2,643 (3.7% were teachers. Adjusting for double-registration caused by clinic transfers, it is estimated that 2,380 individual teachers had ever accessed ART. There were 15% of teachers starting ART in WHO clinical stage 1 or 2 with a CD4-lymphocyte count of
Yoon, John D; Hunt, Natalie B; Ravella, Krishna C; Jun, Christine S; Curlin, Farr A
Physician burnout raises concerns over what sustains physicians' career motivations. We assess whether physicians in end-of-life specialties had higher rates of burnout and/or calling to care for the dying. We also examined whether the patient centeredness of the clinical environment was associated with burnout. In 2010 to 2011, we conducted a national survey of US physicians from multiple specialties. Primary outcomes were a validated single-item measure of burnout or sense of calling to end-of-life care. Primary predictors of burnout (or calling) included clinical specialty, frequency of encounters with dying patients, and patient centeredness of the clinical environments ("My clinical environment prioritizes the need of the patient over maximizing revenue"). Adjusted response rate among eligible respondents was 62% (1156 of 1878). Nearly a quarter of physicians (23%) experienced burnout, and rates were similar across all specialties. Half of the responding physicians (52%) agreed that they felt called to take care of patients who are dying. Burned-out physicians were more likely to report working in profit-centered clinical environments (multivariate odds ratio [OR] of 1.9; confidence interval [CI]: 1.3-2.8) or experiencing emotional exhaustion when caring for the dying (multivariate OR of 2.1; CI: 1.4-3.0). Physicians who identified their work as a calling were more likely to work in end-of-life specialties, to feel emotionally energized when caring for the dying, and to be religious. Physicians from end-of-life specialties not only did not have increased rates of burnout but they were also more likely to report a sense of calling in caring for the dying.
Educational Communications, Inc., Lake Forest, IL.
This document contains factsheets and news releases which cite findings from a national survey of 1,985 high achieving high school students. Factsheets describe the Who's Who Among American High School Students recognition and service program for high school students and explain the Who's Who survey. A summary report of this eighteenth annual…
... the Environment (NSRE) AGENCY: Forest Service, USDA. ACTION: Notice; request for comments. SUMMARY: In..., National Survey on Recreation and the Environment. DATES: Comments must be received in writing on or before... Survey on Recreation and the Environment. OMB Number: 0596-0127. Expiration Date of Approval: 1/31/11...
Ammendrup, Astrid Cecilie; Jørgensen, Anette; Sander, Pia
OBJECTIVE: To perform a national survey on self-reported cure, satisfaction and complications four years after mid-urethral sling (MUS) for urinary stress incontinence in Danish women operated in 2001. DESIGN: A postal questionnaire survey. POPULATION: All Danish women who received an MUS operation...
... Request; Health Information National Trends Survey 4 (HINTS 4) (NCI) SUMMARY: In compliance with the... Trends Survey 4 (HINTS 4) (OMB 0925-0538, Exp 11/30/2008). Type of Information Collection Request... and/or suggestions from the public and affected agencies are invited on one or more of the following...
Takeuchi, Lori M.; Vaala, Sarah
Digital games have the potential to transform K-12 education as we know it. But what has been the real experience among teachers who use games in the classroom? In 2013, the Games and Learning Publishing Council conducted a national survey among nearly 700 K-8 teachers. The report reveals key findings from the survey, and looks at how often and…
Stanley J. Zarnoch; H. Ken Cordell; Carter J. Betz; John C. Bergstrom
Multiple imputation is used to create values for missing family income data in the National Survey on Recreation and the Environment. We present an overview of the survey and a description of the missingness pattern for family income and other key variables. We create a logistic model for the multiple imputation process and to impute data sets for family income. We...
Fratanduono, M. L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)
Garcia and Associates (GANDA) was contracted by the Lawrence Livermore National Laboratory (LLNL) to conduct surveys for bald eagles (Haliaeetus leucocephalus) and golden eagles (Aquila chrysaetos) at Site 300 and in the surrounding area out to 10-miles. The survey effort was intended to document the boundaries of eagle territories by careful observation of eagle behavior from selected viewing locations throughout the study area.
Byung-kyu Lee; Wilbur F. LaPage
A three-wave Delphi survey of a panel of 40 key experts very knowledgeable of Korean national parks was conducted between February 2001 and March in 2002. In Wave 1, park professionals, environmental Nongovernmental Organizations (NGOs) managers, and a retiree identified the issues the Korean park system is facing. Findings from Wave 1 of the survey were analyzed and...
Office of National Drug Control Policy, 2010
The National Survey on Drug Use and Health (NSDUH) is the primary source of information on the prevalence, patterns, and consequences of substance abuse among people age 12 and older. The survey is conducted every year by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2009 NSDUH, released September 16, 2010, shows…
Aroua, A.; Valley, J.F.; Vader, J.-P.; Burnand, B.
A nation-wide survey on radiation doses in diagnostic radiology was conducted in Switzerland in 1998-1999. More than 250 types of examinations were considered, covering conventional and interventional radiology, angiography, CT, mammography, osteodensitometry, conventional tomography and dental radiology. This survey aimed at establishing the collective radiological impact of radiodiagnostics on the Swiss population. The methodology of the survey is described. The examination frequencies and integral dosimetric results associated with diagnostic radiology in Switzerland are presented. (author)
Egley, Arlen, Jr.; Howell, James C.; Harris, Meena
This fact sheet provides an overview of the nation's gang problem and summarizes findings from the 2012 survey. Of the 2,538 survey recipients, 2,199 (87 percent) responded to the survey. In 2012, there were an estimated 30,700 gangs (an increase from 29,900 in 2011) and 850,000 gang members (an increase from 782,500 in 2011) throughout 3,100…
An aerial radiological survey of the Idaho National Engineering Laboratory (INEL) was conducted during June 1982 by EG and G Energy Measurements, Inc. for the United States Department of Energy (DOE). The survey consisted of airborne measurements of both natural and man-made gamma radiation from the terrain surface in and around the INEL site. These measurements allowed an estimate of the distribution of isotopic concentrations in the survey area. Results are reported as isopleths superimposed on maps and photographs of the area. Gamma ray energy spectra are also presented for the net man-made radionuclides. The survey was designed to cover all of the area within a 2 mile radius of any facility at the INEL. Several areas of man-made activity were detected. These areas are all known working or storage areas which are associated with normal operations at the INEL. 3 references, 48 figures, 5 tables
Egro, Francesco M; Blecher, Nathaniel A; Losee, Joseph E; Nguyen, Vu T; Goldstein, Jesse
Candidate characteristics for craniofacial fellowship training still remain unknown, as no data are available in the literature. This study aims to provide information on the criteria that are used to select and rank applicants for the craniofacial surgery fellowship match. A 38-question survey was sent in April 2015 to all craniofacial surgery fellowship program directors (n = 29) involved in the US match using QuestionPro Survey Software. The survey investigated factors used for selection of applicants, including medical school, residency training, research experience, fellowship interview, and candidate characteristics. A 5-point Likert scale was used to grade 33 factors from "not at all important" (1) to "essential in making my decision" (5); or for 5 controversial factors from "very negative impact" (1) to "very positive impact in making my decision" (5). A total of 62% (18 out of 29) of responses were received from craniofacial surgery program directors. The most important factors were professionalism and ethics (4.7 ± 0.5), perceived commitment to craniofacial surgery (4.6 ± 0.8), interactions with faculty and staff (4.5 ± 0.5), interpersonal skills (4.5 ± 0.5), and overall interview performance (4.4 ± 0.6). Factors that have a negative impact on the selection process include graduation from a nonplastic surgery residency program (1.9 ± 0.7) or a non-US plastic surgery residency program (2.2 ± 0.6), and visa requirement (2.2 ± 0.5). This study provides data on craniofacial surgery program directors' perception on the criteria important for fellowship applicant selection. It is our hope that program directors, residency programs, and applicants find this data useful as they prepare for the craniofacial fellowship match.
Spinks, Jean; Hollingsworth, Bruce
The objective of this study was to investigate the drivers of complementary and alternative medicine (CAM) use in the general population in Australia and to identify key policy implications. The National Health Survey 2007/2008, a representative survey of the Australian population, provides information on CAM use (practitioners and products) in the last 12 months. All adult respondents (N=15,779) aged 18 years or older are included in this study. Logistic regression is employed to determine the effect of socio-economic, condition-specific, health behavior variables, and private health insurance status on CAM use. In addition to socio-economic variables known to affect CAM use, individuals who have a chronic condition, particularly a mental health condition, are more likely to use CAM. There does not appear to be a correlation between CAM use and more frequent General Practitioner use; however, ancillary private health insurance is correlated with a greater likelihood of CAM use, as expected. The Australian government does not currently intervene in the CAM market in a systematic way. CAM is clearly considered to be a legitimate and important component of health care for many Australians, despite the limited availability of clinical evidence for its efficacy and safety. Policy interventions may include the regulation of CAM products, practitioners, and information as well as providing subsidies for cost-effective modalities.
Benn, A M L; Broadbent, J M; Thomson, W M
We investigated the prevalence, associations and impact of xerostomia in a nationally representative sample of dentate adult community-dwelling New Zealanders aged 18 years and over. The data were collected from a representative sample of 2209 adults, as part of the 2009 New Zealand Oral Health Survey (NZOHS). Data were collected using face-to-face interviews, dental examinations and the short-form Oral Health Impact Profile (OHIP-14). Data analysis used appropriate weighting for all procedures to account for the complex survey design. The overall prevalence estimate for xerostomia was 13.1% (95% CI 11.7, 14.7), and it was more common among females. Those in the 75+ and 25-34 age groups were more likely (odds ratios of 6.5 and 4.0, respectively) to have xerostomia. After controlling for sociodemographic characteristics and clinical oral disease, the mean OHIP-14 score among xerostomics was 50% higher than among those who did not have the condition. These data indicate that xerostomia is a common condition which can affect quality of life among people of all ages. © 2015 Australian Dental Association.
de la Espriella Guerrero, Ricardo Andrés; Rodriguez, Viviana; Rincón, Carlos J; Morales, Diana Cabrera; Rodríguez, Sandy Johanna Pérez; Gómez-Restrepo, Carlos
National Survey of Mental Health (ENSM) in 2015 in Colombia asks, among other conditions, about alcohol consumption in people 12-17 years old, and 18 and older. Data were presented by age and region, with no cross-references to other categories of mental health problems, disorders, access to services, and health status. To assess alcohol consumption in Colombia, taking into account sociodemographic and clinical screening categories included. Secondary database analysis, sample size: 15,231 people from 13,200 households of five regions (Atlantic, Bogotá, Central, Eastern, and Pacific), with an age range from 12 to 96 years. AUDIT and AUDIT-C were used and stratified according to score and other variables included in the survey analysis. The high-risk drinking category was observed in 2.7% of children studied, with the highest percentage of drinking risk lying in the range of 18 to 44 years, with a clear majority of men. The study finds that a positive AUDIT-C in adults is associated with a higher percentage of non-anxiety, less anxiety problems, and traumatic events and traumatic events related to armed conflict. This requires further studies. Adults with positive AUDIT-C have a greater perception of well-being, but also a higher percentage of households in poverty. The study of individual, social, family and environmental factors in specific populations should be developed in order to make more appropriate interventions. Copyright © 2016. Publicado por Elsevier España.
Sciocchetti, G.; Scacco, F.
In this paper data are reported on the natural radiation environments in Italian mines and spas. The survey and relevant internal exposure assessment indicated that large groups of persons are chronically exposed to nonnegligible levels of radon and daughter products, which are always present in variable concentrations. Since the radiological environment of the spa is similar to that of mine one, there is the possibility of comparing two population groups living in different conditions, but similarly exposed, to evaluate the synergistic factors, if any
Full Text Available Tarutao National Park is the first national marine park of Thailand. It consists of 51 islands. Though flora and fauna are very rich, there is no record of ant fauna. Thus, this study is a pioneer ant report on this marine park. Six sites were randomly chosen in the largest island of the archipelago, namely Tarutao. Two sampling methods, hand collecting and litter sifting, were applied to ant collecting within a time limit of 30 minutes for each method. There were 3 replications of each sampling method in each study site. This study was conducted during 10-17 March 2001. Five subfamilies of ants, comprising 61 species were found. The results also showed that sites had no effect on species number of ants but sampling methods differed significantly in species number of the subfamily Formicinae (P<0.05.
Brown, James; Ryan, Christopher; Harris, Anthony
Background Doctors are uncertain of their ethical and legal obligations when communicating with patients online. Professional guidelines for patient-doctor interaction online have been written with limited quantitative data about doctors’ current usage and attitudes toward the medium. Further research into these trends will help to inform more focused policy and guidelines for doctors communicating with patients online. Objective The intent of the study was to provide the first national profi...
Meyerson, Joseph M; Coffey, Rebecca; Jones, Larry M; Miller, Sidney F
Infection control is a critical component of post-burn care with prevention of infection serving as a major cause of decreasing morbidity and mortality. One potential deterrent for infection is barrier protection during dressing changes; however, no evidence-based standard has been established among burn centers. The purpose of this study is to describe the current barrier techniques of American burn centers. A 24-question survey was sent to 121 burn center nurse managers within the United States. The survey was comprised of yes or no questions with comment sections available for further detail. Questions were constructed to gain insight into the variation and commonality that may exist between burn center barrier protocols. Forty-one out of 121 centers (34%) responded. Centers reported the use of head covers, masks, gowns, and gloves during admission of a new burn (71%, 82%, 95%, and 100% respectively); daily dressing changes (64%, 80%, 97%, and 100% respectively); postoperative dressing changes (64%, masks 80%, 97%, and 100% respectively); and dressing changes of a nonburn (66%, 82%, 97%, and 100% respectively). Burn centers reported their use of sterile gloves and gowns during typical burn dressing changes as occurring 20% and 10% of the time, respectively. Estimates for costs of these garments annually ranged from $0 to $250,000. A calculation performed for this study demonstrated that barrier garments used for dressing changes nationwide is approximately $2.43 million. We demonstrated the immense cost, to an institution and nationwide, of barrier garments used solely for dressing changes.
Alexandra Monteiro Guerra, Liliana; Façanha da Cruz Fresco, Paula
The primary purpose of this paper is to collect reliable information to characterize the pharmacy services in Portuguese prisons. The secondary purpose is to develop a set of suggestions for improving these services and, therefore, improve the health services provided to the inmate population. A three pages survey was developed that included questions covering the characterization of prison health teams, pharmacy services and pharmacy activities. This survey was sent to all Portuguese prisons, with capacity higher than 50 prisoners. The response rate was of 87.5 per cent. It was found that only 6.1 per cent of prisons had pharmacists and that in 63 per cent the guards still participated in pharmacy activities. There were not Pharmacy and Therapeutics Committees in 94 per cent of prisons and 94.4 per cent did not present adequate storage conditions for drugs. Only 51.7 per cent of prisons had computers in the pharmacy and only 3.4 per cent had access to the internet. This study found that there is a gap between public and prison pharmacy services, since most prison pharmacies in Portugal are solely locals of storage and distribution of drugs, with no effective management nor promotion of drug rational use. This paper is the first study about pharmacy services in Portuguese prisons. The information collected could be very useful to improve the Portuguese prison pharmacy services provided to prisoners.
Bhatti, Nasir I; Ahmed, Aadil; Choi, Sukgi S
Evidence shows a positive association between quality of surgical training received and patient outcomes. Traditionally, improved patient outcomes are linked with increased operative volume. However, generalizing this finding to surgeons in training is unclear. In addition, reduced exposure due to work-hour restrictions calls for alternative methods to determine the quality of training. The purpose of this study was to identify the indicators of high-quality training by surveying the trainees and trainers. A questionnaire was developed based on input from faculty and previous studies. The survey was divided into three sections asking about the indicators of quality training, methods to measure them, and interventions for improvement. The questionnaire was administered to program directors (PDs) and senior residents of otolaryngology training programs nationwide. The strongest indicators of quality training that were agreed upon by both residents and PDs were having faculty development as an ideal trainer while having a balanced level of supervision and independence, logbooks for exposure to volume and variety of pathology, continuous evaluation and provision of feedback. However, structured teaching, simulation-based training, and trainee exam scores failed to reach an agreement as a metric of high-quality surgical training. Measuring quality of a residency training program is imperative to produce competent surgeons and ensuring patient safety. The results of this study will help the residency programs to better train their residents and improve the quality of their teaching. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.
Linetzky, Bruno; Morello, Paola; Virgolini, Mario; Ferrante, Daniel
The Global School Health Survey (EMSE, in Spanish) has been implemented globally since 2003 to estimate the prevalence of mayor risk behaviours and protective factors among teenagers aged 13 to 15 year old. In 2007, the first EMSE was implemented in Argentina. To describe the prevalence of certain risk factors among youth attending high school in Argentina. A low stage probabilistic sampling was used to select 50 schools nationwide. All students in randomly selected classes were invited to fill the self-administered questionnaire including 75 questions on demographics, alcohol, tobacco and other drugs use, eating habits, hygiene, violence, mental health, physical activity, sexual activity and protective factors. Overall, the survey was answered by 1980 students from 47 schools. We include in this report data related to alcohol, tobacco and other drugs, weight, physical and sexual activity. In the last 30 days, 56,8% had consumed alcohol and 25,5% cigarettes. Overall, 11,7% had tried an illegal drug in their lifetime. Nineteen percent is overweight and less than 81% has completed the minimum required exercise for their age. Also, 33,6% had already had sex; 10,4% before age 13 and less than half of them always use a contraceptive method. A high prevalence of sedentarism, overweight and substances use, like alcohol, tobacco and illegal drugs, was shown. The rate of condom use was low.
Díaz-Soler, Beatriz María; López-Alonso, Mónica; Martínez-Aires, María Dolores
The exposure to engineered nanomaterials (ENMs) is a new emerging risk at work due to an increase in the number of workers potentially exposed to them and the current lack of data on their health and safety risks. This paper reports the findings of a survey designed to study the safety practices employed by workers in Spanish research facilities performing tasks involving the use of ENMs at research level. A questionnaire pretested and validated by an expert panel was sent by e-mail to the target audience. The 425 surveys completed show that most of the respondents handled up to 5 different ENMs, in suspension, in small amounts during short periods of exposure. The implementation of common hygienic practices, such as the use of protection for hands and the implementation of fume hoods, is widely indicated. The selection of the preventive and protective measures does not depend on the characteristics of ENMs handled. Also, the risks posed by ENMs are widely ignored. Besides the performance of risk assessment, hygienic monitoring and the conducting of a specific health surveillance are practically non-existent although some accidents relating to ENMs were identified. In conclusion, workers' exposure to ENMs seems to be low. Even though the best practices and preventive and protective measures reported were employed, most of the respondents could not be correctly protected. Moreover, workers do not associate the measures implemented with the nanorisks. Finally, there is a lack of proactive action underway to protect the workers, and concerns about safety are weakly evidenced.
Christensen, Anne Illemann; Ekholm, Ola; Glümer, Charlotte
In 2010 the five Danish regions and the National Institute of Public Health at the University of Southern Denmark conducted a national representative health survey among the adult population in Denmark. This paper describes the study design and the sample and study population as well as the content...
Ferrer, Rebecca A.; Bergman, Hannah E.; Klein, William M. P.
Worry has been shown to predict a variety of health behaviors, such as cancer screening, yet there are few studies linking worry and nutrition. This study used nationally representative data from National Cancer Institute's Food Attitudes and Behavior Survey ("n" = 3,397) to examine the association between health-related worry and a variety of…
... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...
... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0712.'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction...
... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... techniques or the use of other forms of information technology. Title: Nation-wide Customer Satisfaction...
van der Veer, Sabine N.; Ravani, Pietro; Coentrão, Luis; Fluck, Richard; Kleophas, Werner; Labriola, Laura; Hoischen, Susanne H.; Noordzij, Marlies; Jager, Kitty J.; van Biesen, Wim
The purpose of this study is to explore how vascular access care was reimbursed, promoted, and organised at the national level in European and neighbouring countries. An electronic survey among national experts to collect country-level data. Forty-seven experts (response rate, 76%) from 37 countries
Toots, Anu; Laanpere, Mart
Estonia has not participated in international studies of ICT in education, nor have there been any similar studies at the national level up until the year 2000. The first survey of ICT in Estonian schools was conducted after completion of the national school computerization programme called Tiger Leap. This paper focuses on the targeted responses…
Ekholm, Ola; Hesse, Ulrik; Davidsen, Michael
AIMS: The Danish National Institute of Public Health, University of Southern Denmark has carried out national representative health interview surveys among adult Danes in 1987, 1994, 2000 and 2005. The aim of this study is to describe the characteristics of the design, including the response rates.......1% in 1994 to 51.5% in 2005. The decrease is particularly marked among the young. The mean interview length has increased from 33.3 minutes in 1987 to 50.2 minutes in 2005. CONCLUSIONS: The declining response rate in the surveys is a major concern and can pose problems in generalizing data from the surveys...
Josephson, Colin B; Patten, Scott B; Bulloch, Andrew; Williams, Jeanne V A; Lavorato, Dina; Fiest, Kirsten M; Secco, Mary; Jette, Nathalie
The aim of this study was to examine the impact of seizures on persons living with epilepsy in a national, community-based setting. The data source was the Survey of Living with Neurological Conditions in Canada (SLNCC), a cohort derived from a national population-based survey of noninstitutionalized persons aged 15 or more years. Participants had to be on a seizure drug or to have had a seizure in the past 5 years to meet the definition of active epilepsy. The respondents were further stratified by seizure status: the seizure group experienced ≥1 seizure in the past 5 years versus the no seizure group who were seizure-free in the past ≥5 years regardless of medication status. Weighted overall and stratified prevalence estimates and odds ratios were used to estimate associations. The SLNCC included 713 persons with epilepsy with a mean age of 45.4 (standard deviation 18.0) years. Fewer people in the seizure group (42.7%) reported being much better than a year ago versus those in the no seizure group (70.1%). Of those with seizures, 32.1% (95% confidence interval [95% CI] 18.8-45.3) had symptoms suggestive of major depression (as per the Patient Health Questionnaire-9) compared to 7.7% (95% CI 3.4-11.9) of those without seizures. Driving, educational, and work opportunities were also significantly limited, whereas stigma was significantly greater in those with seizures. This community-based study emphasizes the need for seizure freedom to improve clinical and psychosocial outcomes in persons with epilepsy. Seizure freedom has an important influence on overall health, as those with at least one seizure over the prior 5 years had an increased risk of mood disorders, worse quality of life, and faced significantly more stigma. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.
In order to understand the current status and trends of the important parasitic diseases in human population, to evaluate the effect of control activities in the past decade and provide scientific base for further developing control strategies, a national survey was carried out in the country (Taiwan, Hongkong and Macau not included) from June, 2001 to 2004 under the sponsorship of the Ministry of Health. The sample sizes of the nationwide survey and of the survey in each province (autonomous region and municipality, P/A/M) were determined following a calculating formula based on an estimation of the sample size of random sampling to the rate of population. A procedure of stratified cluster random sampling was conducted in each province based on geographical location and economical condition with three strata: county/city, township/town, and spot, each spot covered a sample of 500 people. Parasitological examinations were conducted for the infections of soil-transmitted nematodes, Taenia spp, and Clonorchis sinensis, including Kato-Katz thick smear method, scotch cellulose adhesive tape technique and test tube-filter paper culture (for larvae). At the same time, another sampled investigation for Clonorchis sinensis infection was carried out in the known endemic areas in 27 provinces. Serological tests combined with questionnaire and/or clinical diagnosis were applied for hydatid disease, cysticercosis, paragonimiasis, trichinosis, and toxoplasmosis. A total sampled population of 356 629 from the 31 P/A/M was examined by parasitological methods and 26 species of helminth were recorded. Among these helminth, human infections of Metorchis orientalis and Echinostoma aegypti were detected in Fujian Province which seemed to be the first report in the world, and Haplorchis taichui infection in Guangxi Region was the first human infection record in the country. The overall prevalence of helminth infections was 21.74%. The prevalence of soil-transmitted nematodes was 19
Egro, Francesco M; Vangala, Sai K; Nguyen, Vu T; Spiess, Alexander M
Candidate characteristics for hand surgery fellowship training remains unknown, as very little data is available in the literature. This study aims to provide information on the criteria that are employed to select candidates for the hand surgery fellowship match. A 38-question survey was sent in April 2015 to all Accreditation Council for Graduate Medical Education recognized hand surgery fellowship program directors (n=81) involved in the U.S. match. The survey investigated factors used for the selection of applicants, including medical school, residency training, research experience, fellowship interview, and candidate characteristics. A 5-point Likert scale was used to grade 33 factors from "not at all important" (1) to "essential in making my decision" (5); or for five controversial factors from "very negative impact" (1) to "very positive impact in making my decision" (5). A total of 52% (42 out of 81) of responses were received from hand surgery fellowship program directors. The most important influential factors were interactions with faculty during interview and visit (4.6±0.6), interpersonal skills (4.6±0.5), overall interview performance in the selection process (4.6±0.6), professionalism and ethics (4.6±0.7), and letters of recommendation from hand surgeons (4.5±0.7). Factors that have a negative impact on the selection process include visa requirement (2.1±1.2), graduate of non-plastic surgery residency program (2.4±1.3), and graduate of a foreign medical school (2.4±1.1). This study provides data on hand surgery fellowship directors' perception on the criteria important for fellowship applicant selection, and showed that interview-related criteria and letters of recommendation are the important factors.
Francesco M. Egro
Full Text Available Background Candidate characteristics for hand surgery fellowship training remains unknown, as very little data is available in the literature. This study aims to provide information on the criteria that are employed to select candidates for the hand surgery fellowship match. Methods A 38-question survey was sent in April 2015 to all Accreditation Council for Graduate Medical Education recognized hand surgery fellowship program directors (n=81 involved in the U.S. match. The survey investigated factors used for the selection of applicants, including medical school, residency training, research experience, fellowship interview, and candidate characteristics. A 5-point Likert scale was used to grade 33 factors from “not at all important” (1 to “essential in making my decision” (5; or for five controversial factors from “very negative impact” (1 to “very positive impact in making my decision” (5. Results A total of 52% (42 out of 81 of responses were received from hand surgery fellowship program directors. The most important influential factors were interactions with faculty during interview and visit (4.6±0.6, interpersonal skills (4.6±0.5, overall interview performance in the selection process (4.6±0.6, professionalism and ethics (4.6±0.7, and letters of recommendation from hand surgeons (4.5±0.7. Factors that have a negative impact on the selection process include visa requirement (2.1±1.2, graduate of non-plastic surgery residency program (2.4±1.3, and graduate of a foreign medical school (2.4±1.1. Conclusions This study provides data on hand surgery fellowship directors’ perception on the criteria important for fellowship applicant selection, and showed that interview-related criteria and letters of recommendation are the important factors.
Moynihan, Ray; Nickel, Brooke; Hersch, Jolyn; Beller, Elaine; Doust, Jenny; Compton, Shane; Barratt, Alexandra; Bero, Lisa; McCaffery, Kirsten
Despite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions. We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions. Our sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13%) of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28%) of men who reported having prostate cancer screening, and 10% (95% CI 6%-15%) of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95%) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82%) felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100%) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity. A small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies
Full Text Available Despite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions.We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20, then with participants recruited by a research company (n=20. Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions.Our sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13% of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28% of men who reported having prostate cancer screening, and 10% (95% CI 6%-15% of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95% agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82% felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100% believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity.A small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest
Barr, Susan I
Although double-blind studies show that lactose-intolerant individuals can consume moderate quantities of milk products without perceptible symptoms, many who perceive that they are lactose intolerant limit or avoid milk products, potentially compromising calcium and vitamin D intakes. Adult Canadians are at risk of inadequate intakes of these nutrients, but no data exist on the prevalence, correlates, and potential impact of perceived lactose intolerance among Canadians. To address this, a Web-based survey of a population-representative sample of 2251 Canadians aged ≥19 years was conducted. Overall, 16% self-reported lactose intolerance. This was more common in women (odds ratio (OR), 1.84; 95% CI, 1.46-2.33) and in nonwhites (OR, 1.79; 95% CI, 1.24-2.58) and less common in those >50 years of age (OR, 0.71; 95% CI, 0.56-0.90) and in those completing the survey in French (OR, 0.74; 95% CI, 0.56-0.99). Those with self-reported lactose intolerance had lower covariate-adjusted milk product and alternative intakes (mean ± SE; 1.40 ± 0.08 servings·day(-1) vs. 2.33 ± 0.03 servings·day(-1), p lactose intolerance by sex, age, and language preference was unexpected and suggests that some groups may be more vulnerable to the perception that they are lactose intolerant. Regardless of whether lactose intolerance is physiologically based or perceptual, education is required to ensure that calcium intakes are not compromised.
Lambert, R Frederick; Wong, Chloe A; Woodmansey, Karl F; Rowland, Brianna; Horne, Steven O; Seymour, Brittany
Globalization, along with the increasing prevalence of non-communicable diseases, their risk factors, and poor oral health, demands global approaches to oral health care. Trained health care workers' providing volunteer services abroad is one model used for improving access to dental services for some communities. Currently, little is known about U.S. dental student involvement in international clinical service volunteerism. The aim of this exploratory study was to capture national survey data from predoctoral dental students about their interest in and experience with global health service trips. The survey sought to assess students' past experiences and current and future interest in programs providing dental and/or medical services in order to lay the foundation for further research. A 12-question web-based survey was distributed in May 2017 to 22,930 students enrolled in U.S. dental schools. A total of 1,555 students responded, for a response rate of 7%. Respondents were evenly distributed across the four academic years. Approximately 22% (n=342) of the respondents had already participated in a service trip experience, 83% reported interest in a service trip while in school, and 92% were interested after graduation. Reported motivations for international trips included the desire to care for the underserved and to obtain a more global view of health and disease. Concerns were expressed regarding costs and time constraints. This study provided preliminary, exploratory data on dental student engagement with international service trips. Both interest and participation in international service trips among responding students were high, reflecting current trends in both dentistry and medicine. Dental education may have an opportunity to guide student engagement in more sustainable and ethical volunteering in the U.S. and abroad.
Ashack, Kurt A; Burton, Kyle A; Johnson, Teresa R; Currie, Dustin W; Comstock, R Dawn; Dellavalle, Robert P
Skin infections have long been a reported problem among high school athletes, particularly wrestlers. There has yet to be a national study describing the epidemiology of skin infections across multiple high school sports. We sought to report the epidemiology of skin infections among US high school athletes. High school sports-related skin infections resulting in time loss were reported by a convenience sample of US high schools from 2009/2010 through 2013/2014 via High School Reporting Information Online. During the study, 474 skin infections were reported among 20,858,781 athlete exposures, a rate of 2.27 per 100,000 athlete exposures. The largest number of skin infections occurred in wrestling (73.6%) followed by football (17.9%). The most common infections were bacterial (60.6%) and tinea (28.4%) infections. Body parts most often affected were the head/face (25.3%) followed by the forearm (12.7%). The study included only high schools with National Athletic Trainers' Association-affiliated athletic trainers, which may limit generalizability. However, using athletic trainers as data reporters improved data quality. Skin infections are an important subset of high school sports-related adverse events. An understanding of the epidemiology of sports-related skin infections should promote awareness and drive evidence-based prevention efforts. Published by Elsevier Inc.
National Oceanic and Atmospheric Administration, Department of Commerce — These data were collected by the National Oceanic Atmospheric Administration National Geodetic Survey Remote Sensing Division using a Riegl Q680i-D system. The data...
Kushalnagar, Poorna; Harris, Raychelle; Paludneviciene, Raylene; Hoglind, TraciAnn
The Health Information National Trends Survey (HINTS) collects nationally representative data about the American's public use of health-related information. This survey is available in English and Spanish, but not in American Sign Language (ASL). Thus, the exclusion of ASL users from these national health information survey studies has led to a significant gap in knowledge of Internet usage for health information access in this underserved and understudied population. The objectives of this study are (1) to culturally adapt and linguistically translate the HINTS items to ASL (HINTS-ASL); and (2) to gather information about deaf people's health information seeking behaviors across technology-mediated platforms. We modified the standard procedures developed at the US National Center for Health Statistics Cognitive Survey Laboratory to culturally adapt and translate HINTS items to ASL. Cognitive interviews were conducted to assess clarity and delivery of these HINTS-ASL items. Final ASL video items were uploaded to a protected online survey website. The HINTS-ASL online survey has been administered to over 1350 deaf adults (ages 18 to 90 and up) who use ASL. Data collection is ongoing and includes deaf adult signers across the United States. Some items from HINTS item bank required cultural adaptation for use with deaf people who use accessible services or technology. A separate item bank for deaf-related experiences was created, reflecting deaf-specific technology such as sharing health-related ASL videos through social network sites and using video remote interpreting services in health settings. After data collection is complete, we will conduct a series of analyses on deaf people's health information seeking behaviors across technology-mediated platforms. HINTS-ASL is an accessible health information national trends survey, which includes a culturally appropriate set of items that are relevant to the experiences of deaf people who use ASL. The final HINTS
Harris, Raychelle; Paludneviciene, Raylene; Hoglind, TraciAnn
Background The Health Information National Trends Survey (HINTS) collects nationally representative data about the American’s public use of health-related information. This survey is available in English and Spanish, but not in American Sign Language (ASL). Thus, the exclusion of ASL users from these national health information survey studies has led to a significant gap in knowledge of Internet usage for health information access in this underserved and understudied population. Objective The objectives of this study are (1) to culturally adapt and linguistically translate the HINTS items to ASL (HINTS-ASL); and (2) to gather information about deaf people’s health information seeking behaviors across technology-mediated platforms. Methods We modified the standard procedures developed at the US National Center for Health Statistics Cognitive Survey Laboratory to culturally adapt and translate HINTS items to ASL. Cognitive interviews were conducted to assess clarity and delivery of these HINTS-ASL items. Final ASL video items were uploaded to a protected online survey website. The HINTS-ASL online survey has been administered to over 1350 deaf adults (ages 18 to 90 and up) who use ASL. Data collection is ongoing and includes deaf adult signers across the United States. Results Some items from HINTS item bank required cultural adaptation for use with deaf people who use accessible services or technology. A separate item bank for deaf-related experiences was created, reflecting deaf-specific technology such as sharing health-related ASL videos through social network sites and using video remote interpreting services in health settings. After data collection is complete, we will conduct a series of analyses on deaf people’s health information seeking behaviors across technology-mediated platforms. Conclusions HINTS-ASL is an accessible health information national trends survey, which includes a culturally appropriate set of items that are relevant to the
Robert S. Green
Full Text Available Introduction: Respiratory failure is a common problem in emergency medicine (EM and critical care medicine (CCM. However, little is known about the resuscitation of critically ill patients prior to emergency endotracheal intubation (EETI. Our aim was to describe the resuscitation practices of EM and CCM physicians prior to EETI. Methods: A cross-sectional survey was developed and tested for content validity and retest reliability by members of the Canadian Critical Care Trials Group. The questionnaire was distributed to all EM and CCM physician members of three national organizations. Using three clinical scenarios (trauma, pneumonia, congestive heart failure, we assessed physician preferences for use and types of fluid and vasopressor medication in pre-EETI resuscitation of critically ill patients. Results: In total, 1,758 physicians were surveyed (response rate 50.2%, 882/1,758. Overall, physicians would perform pre-EETI resuscitation using either fluids or vasopressors in 54% (1,193/2,203 of cases. Most physicians would “always/often” administer intravenous fluid pre-EETI in the three clinical scenarios (81%, 1,484/1,830. Crystalloids were the most common fluid physicians would “always/often” administer in congestive heart failure (EM 43%; CCM 44%, pneumonia (EM 97%; CCM 95% and trauma (EM 96%; CCM 96%. Pre-EETI resuscitation using vasopressors was uncommon (4.9%. Training in CCM was associated with performing pre-EETI resuscitation (odds ratio, 2.20; 95% CI, [1.44-3.36], p<0.001. Conclusion: Pre-EETI resuscitation is common among Canadian EM and CCM physicians. Most physicians use crystalloids pre-EETI as a resuscitation fluid, while few would give vasopressors. Physicians with CCM training were more likely to perform pre-EETI resuscitation.
Walitt, Brian; Nahin, Richard L.; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick
Background Most knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail. Methods We developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults. Results Fibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician’s diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale. Conclusions Persons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia. PMID:26379048
Walitt, Brian; Nahin, Richard L; Katz, Robert S; Bergman, Martin J; Wolfe, Frederick
Most knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail. We developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults. Fibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician's diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale. Persons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia.
Hannoun-Levi, J.M.; Hennequin, C.; Pommier, P.; Izar, F.; Thomas, L.; Le Scodan, R.; Lesaunier, F.; Nguyen, T.; Heymann, S.; Truc, G.; Peiffert, D.
Purpose To present the national survey patterns in France for breast cancer brachytherapy in 2009. Material and method A written questionnaire was sent to the academic and general hospitals and the anticancer centres. The different items were type of institution; breast cancer clinical trial participation; number of breast brachytherapy per year; its indications; material and dose rate used. Results Among the 76 sent questionnaires, 35 (46 %) answers were available: 9 % of academic hospitals and 50 % of cancer centres performed breast brachytherapy. The number of breast brachytherapy per year ranged between 300 and 350. The indications were boost (100 %), partial breast irradiation (20 %) and second conservative treatment for local recurrence (53 %). The implanted material consisted in needles (27 %) and plastic tubes (73 %). The dose rate was low (50 %), pulsed (25 %) and high (25 %). Conclusion Breast brachytherapy appears as a validated technique in case of boost but remains under investigation for partial breast irradiation and second conservative treatments. Good clinical practice rules as well as technical and dosimetric guidelines are needed. A cost-effective analysis of breast brachytherapy is warranted. (authors)
Nishigori, Hiroshi; Takahashi, Osamu; Sugimoto, Naomi; Kitamura, Kiyoshi; McMahon, Graham T
International electives can provide experiences for medical students to learn about health systems and foster critical self-reflection. So far, little is known about the status of Japanese students' engagement in international electives. We sought to provide information about the internationalization of Japanese medical education by clarifying the current situations of international electives. We undertook a cross-sectional national 17-item questionnaire survey of program officers in all medical schools in Japan in February 2010. Sixty-five (81.3%) of 80 Japanese medical schools responded to the questionnaire. 462 Japanese medical students (3% of all students in their clinical years) travelled to North America (45.5%), Asia (25.0%), or Western Europe (24.4%) to study abroad. The number of students who participated in international electives was significantly increased when academic credit was available (median 6 vs. 1, p < 0.001) and institutional affiliations were present (median 7 vs. 2 students, p < 0.001). Most students were evaluated by means of written assignment on return. About 3% of Japanese medical students participate in international clinical exchanges. Academic credit and institutional affiliations appear to promote greater utilization of international exchange opportunities.
Hughes, Christine M; Kramer, Erich; Colamonico, Jennifer; Duszak, Richard
To understand perceptions of primary care physicians (PCPs) about the value of advanced medical imaging. A national quantitative survey of 500 PCPs was conducted using an online self-administered questionnaire. Questions focused on advanced medical imaging (CT, MRI, and PET) and its perceived impact on the delivery of patient care. Responses were stratified by physician demographics. Large majorities of the PCPs indicated that advanced imaging increases their diagnostic confidence (441; 88%); provides data not otherwise available (451; 90%); permits better clinical decision making (440; 88%); increases confidence in treatment choices (438; 88%), and shortens time to definitive diagnosis (430; 86%]). Most (424; 85%) believe that patient care would be negatively affected without access to advanced imaging. PCPs whose clinical careers predated the proliferation of advanced imaging modalities (>20 years of practice) assigned higher value to advanced imaging on several dimensions compared with younger physicians whose training overlapped widespread technology availability. By a variety of metrics, large majorities of PCPs believe that advanced medical imaging provides considerable value to patient care. Those whose careers predated the widespread availability of advanced imaging tended to associate it with even higher value. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E; Rogers, Ann E
To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through "on the job" training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap.
Claverie, Andre; Equer, Bernard
The activity in France during the year 2006 is summarized according to five items: installed PV power, costs and prices, PV production, budgets and energy policy. The overall power of the systems installed in France in 2006, was estimated at 10,9 MW of which 9,4 MW are connected to the grid. A 55 % increase compared to the previous year (7,0 MW total and 5,9 MW grid-connected). Operational photovoltaic capacity at the end of 2006 is 43,9 MW. This accounts for the annual production of around 44 GWh in electrical energy. System prices continue to decrease with an 8,12 EUR/W for roof added-on PV. Some grid-connected systems with power larger than 10 kW were proposed at the turnkey price of 5 EUR/W. Prices of equipment followed trends of European market. PV modules prices (imported) increased by 20 % due to a demand greater than the offer and increase in feedstock silicon price. Concerning manufacturers of materials, cells and modules, direct production costs decreased due to the increase in volume production and introduction of innovations in the manufacturing processes thanks to R and D results transferred to production. Production of photovoltaic cells and modules by Photowatt International Company was of 33 MW in 2006 and has almost reached full production capacity. The Emix production of multi-crystalline silicon ingots using the cold crucible continuous electromagnetic casting process has reached 35 tons (3 MW equivalent) with one furnace (10 MW equivalent capacity). Tenesol is operating a 15 MW capacity PV modules manufacturing line in its subsidiary Tenesol Technologies. Another subsidiary, located in South Africa can produce up to 35 MW modules. Both factories rely upon crystalline silicon technology. Thin film hydrogenated amorphous silicon PV modules on glass substrate, are produced by Free Energy at a nearly constant 0,5 MW per year. The French national R and D budget on PV, as estimated by the Ministry of Research, amounts to 24,2 MEUR including the ADEME
Dewitte, Vincent; De Pauw, Robby; De Meulemeester, Kayleigh; Peersman, Wim; Danneels, Lieven; Bouche, Katie; Roets, Arne; Cagnie, Barbara
Nonspecific low back pain (NSLBP) is a common problem. Attempts have been made to classify NSLBP patients into homogenous subgroups. Classification systems based on identifying the underlying mechanism(s) driving the disorder are clinically useful to guide specific interventions. To establish consensus among experts regarding clinical criteria suggestive of a dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns (DPs) in NSLBP patients. A 2-phase sequential design of a focus group and Delphi-study. A focus group with 10 academic experts was organized to elaborate on the different DPs discernible in LBP patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 DPs resulting from the focus group. Fifteen musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating LBP patients completed the Delphi-survey. Respectively, 34 (response rate, 100.0%), 20 (58.8%) and 15 (44.12%) respondents replied to rounds 1, 2 and 3. Twenty-two 'articular', 20 'myofascial', 21 'neural', 18 'central' and 11 'sensorimotor control' criteria reached a predefined ≥80% consensus level. For example, after round 2, 85.0% of the Delphi-experts agreed to identify 'referred pain below the knee' as a subjective examination criterion suggestive for a predominant 'neural DP'. These indicators suggestive of a clinical dominance of the proposed DPs could help clinicians to assess and diagnose NSLBP patients. Future reliability and validity testing is needed to determine how these criteria may help to improve physical therapy outcome for NSLBP patients. Copyright © 2018 Elsevier Ltd. All rights reserved.
Mathieu, Roynard; Peter, Silverans; Yvan, Casteels; Philippe, Lesire
In September 2011 the Belgian Road Safety Institute (BRSI) conducted its first roadside survey of child restraint system (CRS) use and misuse. The aim of this study was to obtain population-bases estimates of the prevalence of use and misuse of CRS and to identify predictors of misuse on the basis of observations in real traffic conditions. The survey was conducted on randomly selected sites across the country, stratified across various types of journeys. The principal parameters analysed were: the characteristics of the children and the car drivers, type of journey, types of CRS and types of misuse. The sample consisted of 1461 children (under 135cm) for whom the conditions of restraint were observed in detail and the driver was interviewed. At least 50% of the children were not correctly restrained and 10% were not restrained at all. The most significant factors associated with CRS use were the use of a seatbelt by the driver (31% of unrestrained children for unbelted drivers, compared to 7% for belted drivers - only 32% of correctly restrained children for unbelted drivers compared to 54% for belted drivers), whether the CRS was bought in a specialized shop (only 27% of misuse compared to 45% of misuse for CRS both in supermarkets) and the age of the children. The proportion of correctly restrained children (appropriate without misuse, the bottom category in the figure) has a roughly curvilinear relation with age; decreasing from 75% at age 0 to 24% at age 8 and going back up to 63% at age 10. Although the sample of ISOFIX users was small (n=76), it appears that the ISOFIX system reduced misuse significantly. Most of the drivers were ignorant of their own errors concerning the inappropriateness and/or misuse of the CRS or they were remiss and underestimated the risk. The three main reasons given by the drivers to explain or justify the misuse noticed were: low attention level to safety (inattention, time pressure, and short distance), the child's resistance to
Dowdall, A; Murphy, P; Pollard, D; Fenton, D
In 2002, a National Radon Survey (NRS) in Ireland established that the geographically weighted national average indoor radon concentration was 89 Bq m -3 . Since then a number of developments have taken place which are likely to have impacted on the national average radon level. Key among these was the introduction of amending Building Regulations in 1998 requiring radon preventive measures in new buildings in High Radon Areas (HRAs). In 2014, the Irish Government adopted the National Radon Control Strategy (NRCS) for Ireland. A knowledge gap identified in the NRCS was to update the national average for Ireland given the developments since 2002. The updated national average would also be used as a baseline metric to assess the effectiveness of the NRCS over time. A new national survey protocol was required that would measure radon in a sample of homes representative of radon risk and geographical location. The design of the survey protocol took into account that it is not feasible to repeat the 11,319 measurements carried out for the 2002 NRS due to time and resource constraints. However, the existence of that comprehensive survey allowed for a new protocol to be developed, involving measurements carried out in unbiased randomly selected volunteer homes. This paper sets out the development and application of that survey protocol. The results of the 2015 survey showed that the current national average indoor radon concentration for homes in Ireland is 77 Bq m -3 , a decrease from the 89 Bq m -3 reported in the 2002 NRS. Analysis of the results by build date demonstrate that the introduction of the amending Building Regulations in 1998 have led to a reduction in the average indoor radon level in Ireland. Copyright © 2016 Elsevier Ltd. All rights reserved.
Callaghan, Brian C; Kerber, Kevin; Smith, Andrea L; Fendrick, A Mark; Feldman, Eva L
To define current clinical practice for evaluating distal symmetric polyneuropathy. Using a modified Dillman method, we sent surveys to 600 internists, 600 neurologists, and 45 neuromuscular specialists selected from the American Medical Association Physician Masterfile. Survey questions pertained to which tests providers would order in the following 3 scenarios: (1) the initial evaluation of distal symmetric polyneuropathy, (2) the use of additional tests if the initial evaluation was unrevealing, and (3) patients with diabetes. The t test was used to compare the number of tests ordered by physician type, and the χ(2) test was used to compare proportions of tests ordered. National survey of physicians. Internists, neurologists, and neuromuscular specialists. The response rate was 35%. Overall, many tests were ordered for the full evaluation of distal symmetric polyneuropathy (mean [SD], 16.5 [7.2] tests), and there was substantial variation within and between provider types. Internists ordered fewer tests (mean [SD], 14.5 [6.1] tests) than did neurologists (mean [SD], 17.5 [7.9] tests) (P current practice intent on evaluating distal symmetric polyneuropathy is highly variable and differs widely. For this disorder of the peripheral nerves, a high-yield test such as the glucose tolerance test is rarely used, whereas magnetic resonance imaging is likely overused. Research that defines the optimal evaluation of distal symmetric polyneuropathy has the potential to result in more efficient care.
Oliffe, John L; Hannan-Leith, Madeline N; Ogrodniczuk, John S; Black, Nick; Mackenzie, Corey S; Lohan, Maria; Creighton, Genevieve
Male suicide prevention strategies include diagnosis and effective management of men's depression. Fundamental to suicide prevention efforts is public awareness, which in turn, is influenced by literacy levels about men's depression and suicide. The aim of this study is to examine sex differences in mental health literacy with respect to men's depression and suicide among a cohort of Canadian respondents. About 901 English-speaking Canadian men and women completed online survey questionnaires to evaluate mental health literacy levels using 10-item D-Lit and 8-item LOSS questionnaires, which assess factual knowledge concerning men's depression and suicide. Statistical tests (Chi-square, z-test) were used to identify significant differences between sex sub-groups at 95% confidence. Overall, respondents correctly identified 67% of questions measuring literacy levels about male depression. Respondents' male suicide literacy was significantly poorer at 53.7%. Misperceptions were especially evident in terms of differentiating men's depressive symptoms from other mental illnesses, estimating prevalence and identifying factors linked to male suicide. Significant sex differences highlighted that females had higher literacy levels than men in regard to male depression. Implementing gender sensitive and specific programs to target and advance literacy levels about men's depression may be key to ultimately reducing depression and suicide among men in Canada.
Muscarella, L F
In June 1998, a questionnaire was mailed to approximately 2,900 healthcare professionals to assess current instrument reprocessing and infection control practices and determine whether they have changed during the past decade. Surveys were returned from 146 respondents whose facilities performed gastrointestinal endoscopy. Most respondents were registered nurses and almost all worked in healthcare facilities located in the United States. More than 75% of the respondents reported that infection control practices in endoscopy have improved during the past 10 years. Most respondents used glutaraldehyde to reprocess flexible endoscopes. Immersing endoscopes for 20 minutes at room temperature was commonly practiced. Almost 75% of respondents used an automated device to reprocess flexible endoscopes. Most respondents terminally rinsed the endoscope's channels with 70% alcohol followed by forced-air drying. Few respondents outsourced instruments to a commercial reprocessing company and almost 50% reused disposable items. While some practices in endoscope reprocessing have changed during the past several years, others have not. In general, infection controls appear to have improved during the past decade, with the possible exception of a trend to reuse single-use items.
Alvarado, Doris; Rivera, Belinda; Lagos, Luis; Ochoa, Mayra; Starkman, Ivette; Castillo, Mariela; Flores, Eduardo; Lansingh, Van C; Limburg, Hans; Silva, Juan Carlos
To determine the prevalence of blindness and visual impairment in Honduras, its causes and the response by the health services to growing demand. A cross-sectional population study was conducted between June and December 2013 using the standard methodology of the Rapid Assessment of Avoidable Blindness. A random sample survey was done in 63 clusters of 50 individuals aged ≥ 50, representative of the country as a whole. Visual acuity (VA) was assessed using a Snellen eye chart, and the condition of the lens and posterior pole was examined by direct ophthalmoscopy. Cataract surgical coverage was calculated and an assessment made of its quality, the causes of VA glaucoma (21.1%). Uncorrected refraction error was the main cause of severe (19.7%) and moderate (58.6%) visual impairment. Cataract surgical coverage was 75.2%. 62.5% of the eyes operated for cataracts achieved a VA > 20/60 with available correction. The main barriers against cataract surgery were cost (27.7%) and the lack of availability or difficulty of geographical access to the treatment (24.6%). The prevalence of blindness and visual impairment in Honduras is similar to that of other Latin American countries. 67% of cases of blindness could be resolved by improving the response capacity of the ophthalmological services, especially of cataract surgery, improving optician services and incorporating eye care in primary health care.
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Los Alamos National Laboratory (LANL), conducted March 29, 1987 through April 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the LANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the LANL, and interviews with site personnel. The Survey team developed Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by the Idaho National Engineering Laboratory. When completed, the results will be incorporated into the LANL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Survey for the LANL. 65 refs., 68 figs., 73 tabs
This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy's (DOE) Los Alamos National Laboratory (LANL), conducted March 29, 1987 through April 17, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team components are outside experts being supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with the LANL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at the LANL, and interviews with site personnel. The Survey team developed Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by the Idaho National Engineering Laboratory. When completed, the results will be incorporated into the LANL Environmental Survey Interim Report. The Interim Report will reflect the final determinations of the Survey for the LANL. 65 refs., 68 figs., 73 tabs.
This report presents the preliminary findings from the first phase of the Environmental Survey of the US Department of Energy (DOE) Oak Ridge National Laboratory (ORNL), X-10 site, conducted August 17 through September 4, 1987. The Survey is being conducted by an interdisciplinary team of environmental specialists, led and managed by the Office of Environment, Safety and Health's Office of Environmental Audit. Individual team specialists are outside experts supplied by a private contractor. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with ORNL. The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. The on-site phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at ORNL, and interviews with site personnel. The Survey team developed a Sampling and Analysis Plan to assist in further assessing certain of the environmental problems identified during its on-site activities. The Sampling and Analysis Plan will be executed by a DOE National Laboratory or a support contractor. When completed, the results will be incorporated into the Environmental Survey Interim Report for ORNL. The Interim Report will reflect the final determinations of the ORNL Survey. 120 refs., 68 figs., 71 tabs.
Black, Nick; Barker, Marian; Payne, Mary
Objectives To describe the multicentre clinical databases that exist in the United Kingdom, to report on their quality, to explore which organisational and managerial features are associated with high quality, and to make recommendations for improvements. Design Cross sectional survey, with interviews with database custodians and search of electronic bibliographic database (PubMed). Studies reviewed 105 clinical databases across the United Kingdom. Results Clinical databases existed in all areas of health care, but their distribution was uneven—cancer and surgery were better covered than mental health and obstetrics. They varied greatly in age, size, growth rate, and geographical areas covered. Their scope (and thus their potential uses) and the quality of the data collected also varied. The latter was not associated with any organisational characteristics. Despite impressive achievements, many faced substantial financial uncertainty. Considerable scope existed for improvements: greater use of nationally approved codes; more support from relevant professional organisations; greater involvement by nurses, allied health professionals, managers, and laypeople in database management teams; and more attention to data security and ensuring patient confidentiality. With some notable exceptions, the audit and research potential of most databases had not been realised: half the databases had each produced only four or fewer peer reviewed research articles. Conclusions At least one clinical database support unit is needed in the United Kingdom to provide assistance in organisation and management, information technology, epidemiology, and statistics. Without such an initiative, the variable picture of databases reported here is likely to persist and their potential not be realised. PMID:15205292
Sellers, Katie; Leider, Jonathon P; Harper, Elizabeth; Castrucci, Brian C; Bharthapudi, Kiran; Liss-Levinson, Rivka; Jarris, Paul E; Hunter, Edward L
Public health practitioners, policy makers, and researchers alike have called for more data on individual worker's perceptions about workplace environment, job satisfaction, and training needs for a quarter of a century. The Public Health Workforce Interests and Needs Survey (PH WINS) was created to answer that call. Characterize key components of the public health workforce, including demographics, workplace environment, perceptions about national trends, and perceived training needs. A nationally representative survey of central office employees at state health agencies (SHAs) was conducted in 2014. Approximately 25,000 e-mail invitations to a Web-based survey were sent out to public health staff in 37 states, based on a stratified sampling approach. Balanced repeated replication weights were used to account for the complex sampling design. A total of 10,246 permanently employed SHA central office employees participated in PH WINS (46% response rate). Perceptions about training needs; workplace environment and job satisfaction; national initiatives and trends; and demographics. Although the majority of staff said they were somewhat or very satisfied with their job (79%; 95% confidence interval [CI], 78-80), as well as their organization (65%; 95% CI, 64-66), more than 42% (95% CI, 41-43) were considering leaving their organization in the next year or retiring before 2020; 4% of those were considering leaving for another job elsewhere in governmental public health. The majority of public health staff at SHA central offices are female (72%; 95% CI, 71-73), non-Hispanic white (70%; 95% CI, 69-71), and older than 40 years (73%; 95% CI, 72-74). The greatest training needs include influencing policy development, preparing a budget, and training related to the social determinants of health. PH WINS represents the first nationally representative survey of SHA employees. It holds significant potential to help answer previously unaddressed questions in public health