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Sample records for practice registry measurement

  1. Variation in performance measure criteria significantly affects cardiology practice rankings: Insights from the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry.

    Science.gov (United States)

    Eapen, Zubin J; Tang, Fengming; Jones, Phil G; Maddox, Thomas M; Oetgen, William J; Spertus, John A; Rumsfeld, John S; Heidenreich, Paul A; Peterson, Eric D; Drozda, Joseph P

    2015-06-01

    Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over 5 years by improving cardiovascular prevention. An important tool in the success of programs like Million Hearts is public ranking on the quality of practices, yet different measures may provide different rankings, so the true quality of practices is difficult to discern. We evaluated the quality of ambulatory cardiology care using performance measure metrics. We compared rankings of practices participating in the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence Registry using measures from (1) the physician quality reporting system and (2) the American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement. We compared achievement rates for measures between the 2 frameworks and determined correlations in rankings using Spearman correlation coefficients. From January 1, 2008 to December 31, 2012, there were 1,711,326 patients enrolled from 111 US practices. Among eligible patients, the physician quality reporting system and American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement measures were achieved in 76.1% versus 77.4% for antiplatelet prescription (P performance and failing to achieve public health goals. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Patient-reported outcome measures in arthroplasty registries

    DEFF Research Database (Denmark)

    Rolfson, Ola; Bohm, Eric; Franklin, Patricia

    2016-01-01

    The International Society of Arthroplasty Registries (ISAR) Patient-Reported Outcome Measures (PROMs) Working Group have evaluated and recommended best practices in the selection, administration, and interpretation of PROMs for hip and knee arthroplasty registries. The 2 generic PROMs in common use...... are the Short Form health surveys (SF-36 or SF-12) and EuroQol 5-dimension (EQ-5D). The Working Group recommends that registries should choose specific PROMs that have been appropriately developed with good measurement properties for arthroplasty patients. The Working Group recommend the use of a 1-item pain...... should consider the absolute level of pain, function, and general health status as well as improvement, missing data, approaches to analysis and case-mix adjustment, minimal clinically important difference, and minimal detectable change. The Working Group recommends data collection immediately before...

  3. Development and Evaluation of an Implementation Strategy for Collecting Data in a National Registry and the Use of Patient-Reported Outcome Measures in Physical Therapist Practices: Quality Improvement Study.

    Science.gov (United States)

    Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J

    2017-08-01

    In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017

  4. Registries Help Moms Measure Medication Risks

    Science.gov (United States)

    ... in the case of the North American Antiepileptic Drug Pregnancy Registry, which studies the effects of drugs for ... is taking. For example, the North American Antiepileptic Drug Pregnancy Registry website lists more than 30 medications being ...

  5. Cardiac performance measure compliance in outpatients: the American College of Cardiology and National Cardiovascular Data Registry's PINNACLE (Practice Innovation And Clinical Excellence) program.

    Science.gov (United States)

    Chan, Paul S; Oetgen, William J; Buchanan, Donna; Mitchell, Kristi; Fiocchi, Fran F; Tang, Fengming; Jones, Philip G; Breeding, Tracie; Thrutchley, Duane; Rumsfeld, John S; Spertus, John A

    2010-06-29

    We examined compliance with performance measures for 14,464 patients enrolled from July 2008 through June 2009 into the American College of Cardiology's PINNACLE (Practice Innovation And Clinical Excellence) program to provide initial insights into the quality of outpatient cardiac care. Little is known about the quality of care of outpatients with coronary artery disease (CAD), heart failure, and atrial fibrillation, and whether sex and racial disparities exist in the treatment of outpatients. The PINNACLE program is the first, national, prospective office-based quality improvement program of cardiac patients designed, in part, to capture, report, and improve outpatient performance measure compliance. We examined the proportion of patients whose care was compliant with established American College of Cardiology, American Heart Association, and American Medical Association-Physician Consortium for Performance Improvement (ACC/AHA/PCPI) performance measures for CAD, heart failure, and atrial fibrillation. There were 14,464 unique patients enrolled from 27 U.S. practices, accounting for 18,021 clinical visits. Of these, 8,132 (56.4%) had CAD, 5,012 (34.7%) had heart failure, and 2,786 (19.3%) had nonvalvular atrial fibrillation. Data from the PINNACLE program were feasibly collected for 24 of 25 ACC/AHA/PCPI performance measures. Compliance with performance measures ranged from being very low (e.g., 13.3% of CAD patients screened for diabetes mellitus) to very high (e.g., 96.7% of heart failure patients with blood pressure assessments), with moderate (70% to 90%) compliance observed for most performance measures. For 3 performance measures, there were small differences in compliance rates by race or sex. For more than 14,000 patients enrolled from 27 practices in the outpatient PINNACLE program, we found that compliance with performance measures was variable, even after accounting for exclusion criteria, suggesting an important opportunity to improve the quality of

  6. Patient-reported outcome measures in arthroplasty registries

    DEFF Research Database (Denmark)

    Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric

    2016-01-01

    survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario...... of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions...... all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health...

  7. The Research on Medical Education Outcomes (ROMEO) Registry: Addressing Ethical and Practical Challenges of Using "Bigger," Longitudinal Educational Data.

    Science.gov (United States)

    Gillespie, Colleen; Zabar, Sondra; Altshuler, Lisa; Fox, Jaclyn; Pusic, Martin; Xu, Junchuan; Kalet, Adina

    2016-05-01

    Efforts to evaluate and optimize the effectiveness of medical education have been limited by the difficulty of designing medical education research. Longitudinal, epidemiological views of educational outcomes can help overcome limitations, but these approaches require "bigger data"-more learners, sources, and time points. The rich data institutions collect on students and residents can be mined, however, ethical and practical barriers to using these data must first be overcome. In 2008, the authors established the Research on Medical Education Outcomes (ROMEO) Registry, an educational data registry modeled after patient registries. New York University School of Medicine students, residents, and fellows provide consent for routinely collected educational, performance, quality improvement, and clinical practice data to be compiled into a deidentified, longitudinal database. As of January 2015, this registry included 1,225 residents and fellows across 12 programs (71% consent rate) and 841 medical students (86% consent rate). Procedures ensuring voluntary informed consent are essential to ethical enrollment and data use. Substantial resources are required to provide access to and manage the data. The registry supports educational scholarship. Seventy-two studies using registry data have been presented or published. These focus on evaluating the curriculum, quality of care, and measurement quality and on assessing needs, competencies, skills development, transfer of skills to practice, remediation patterns, and links between education and patient outcomes. The authors are working to integrate assessment of relevant outcomes into the curriculum, maximize both the quantity and quality of the data, and expand the registry across institutions.

  8. Rapid Development of Specialty Population Registries and Quality Measures from Electronic Health Record Data.

    Science.gov (United States)

    Kannan, Vaishnavi; Fish, Jason S; Mutz, Jacqueline M; Carrington, Angela R; Lai, Ki; Davis, Lisa S; Youngblood, Josh E; Rauschuber, Mark R; Flores, Kathryn A; Sara, Evan J; Bhat, Deepa G; Willett, DuWayne L

    2017-01-01

    (a) real-time patient lists of registry patients and (b) EDW-gener-ated CQM data. Agile project management methods were employed, including co-development, lightweight requirements documentation with User Stories and acceptance criteria, and time-boxed iterative development of EHR features in 2-week "sprints" for rapid-cycle feedback and refinement. Using this approach, in calendar year 2015 we developed a total of 43 specialty chronic disease registries, with 111 new EHR data collection and clinical decision support tools, 163 new clinical quality measures, and 30 clinic-specific dashboards reporting on both real-time patient care gaps and summarized and vetted CQM measure performance trends. This study suggests concurrent design of EHR data collection tools and reporting can quickly yield useful EHR structured data for chronic disease registries, and bodes well for efforts to migrate away from manual abstraction. This work also supports the view that in new EHR-based registry development, as in new product development, adopting agile principles and practices can help deliver valued, high-quality features early and often. Schattauer GmbH.

  9. Evidence and practice in spine registries A systematic review, and recommendations for future design of registries

    NARCIS (Netherlands)

    van Hooff, M.L.; Jacobs, W.C.H.; Willems, P.C.; Wouters, M.W.J.M.; de Kleuver, M.; Peul, W.C.; Ostelo, R.W.J.G.; Fritzell, P.

    2015-01-01

    Background and purpose-We performed a systematic review and a survey in order to (1) evaluate the evidence for the impact of spine registries on the quality of spine care, and with that, on patient-related outcomes, and (2) evaluate the methodology used to organize, analyze, and report the "quality

  10. Ambulatory blood pressure monitoring in daily clinical practice - the Spanish ABPM Registry experience.

    Science.gov (United States)

    Gorostidi, Manuel; Banegas, José R; de la Sierra, Alejandro; Vinyoles, Ernest; Segura, Julián; Ruilope, Luis M

    2016-01-01

    Many patients are hypertensive at the medical settings but show normal blood pressure out of the doctor's office, and are classified as white-coat hypertensives. On the other hand, many patients with controlled hypertension at the clinic show ambulatory blood pressure levels above the thresholds considered for an adequate blood pressure control, known as having masked hypertension. Using data from the Spanish Ambulatory Blood Pressure Monitoring Registry (Spanish ABPM Registry), a national program developed to promote the use of the ambulatory technique for hypertension management in daily practice, we have reviewed the main strengths of this approach, that is the ability to detect discrepancies of blood pressure status with respect to office blood pressure measurement, and to better assess accurate rates of hypertension control. White-coat hypertension within patients with elevated office blood pressure, and masked hypertension within office-controlled patients affected one of three patients in each office status. On the other hand, rates of ambulatory blood pressure control (50%) doubled those of office blood pressure control (25%), still remaining half the patients uncontrolled. We think that a systematic use of ambulatory blood pressure monitoring, and strategies to improve blood pressure control constitute key priorities in hypertension management. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  11. Rapid Development of Specialty Population Registries and Quality Measures from Electronic Health Record Data*. An Agile Framework.

    Science.gov (United States)

    Kannan, Vaishnavi; Fish, Jason S; Mutz, Jacqueline M; Carrington, Angela R; Lai, Ki; Davis, Lisa S; Youngblood, Josh E; Rauschuber, Mark R; Flores, Kathryn A; Sara, Evan J; Bhat, Deepa G; Willett, DuWayne L

    2017-06-14

    both (a) real-time patient lists of registry patients and (b) EDW-generated CQM data. Agile project management methods were employed, including co-development, lightweight requirements documentation with User Stories and acceptance criteria, and time-boxed iterative development of EHR features in 2-week "sprints" for rapid-cycle feedback and refinement. Using this approach, in calendar year 2015 we developed a total of 43 specialty chronic disease registries, with 111 new EHR data collection and clinical decision support tools, 163 new clinical quality measures, and 30 clinic-specific dashboards reporting on both real-time patient care gaps and summarized and vetted CQM measure performance trends. This study suggests concurrent design of EHR data collection tools and reporting can quickly yield useful EHR structured data for chronic disease registries, and bodes well for efforts to migrate away from manual abstraction. This work also supports the view that in new EHR-based registry development, as in new product development, adopting agile principles and practices can help deliver valued, high-quality features early and often.

  12. Clinical trial registries: a practical guide for sponsors and researchers of medicinal products

    National Research Council Canada - National Science Library

    Foote, MaryAnn

    2006-01-01

    ... Industry perspective on public clinical trial registries and results databases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...

  13. Practitioner Gender and Quality of Care in Ambulatory Cardiology Practices: A Report From the National Cardiovascular Data Practice Innovation and Clinical Excellence (PINNACLE) Registry.

    Science.gov (United States)

    Gupta, Dipti; Tang, Fengming; Masoudi, Frederick A; Jones, Philip G; Chan, Paul S; Daugherty, Stacie L

    Some studies suggest that female practitioners are more likely to provide guideline-concordant care than male practitioners; however, little is known about the role of practitioner gender in cardiology. The aim of the study was to measure the association between practitioner gender and adherence to the cardiovascular performance measures in the American College of Cardiology's ambulatory Practice Innovation and Clinical Excellence Registry. Patients with at least 1 outpatient visit with a unique practitioner were included. Among eligible patients, adherence to 7 guideline-supported performance measures for coronary artery disease, heart failure, and atrial fibrillation over 12 months after registry entry was compared by practitioner gender using hierarchical models adjusting for practitioner type (physicians vs advance practice practitioners) and number of visits. The study cohort included 1493 individual practitioners who saw 769 139 patients; 80% of practitioners were men. Male practitioners were more often physicians compared with female practitioners (98.2% vs 43.7%, P < .01). Accounting for practitioner category and visit frequency, guideline adherence rates were similar by practitioner gender for all measures with the exception of marginally higher rates for coronary artery disease performance measures for male practitioners compared with female practitioners (antiplatelet: rate ratio [RR] = 1.06; 95% confidence interval [CI], 1.03-1.09; β-blockers: RR = 1.06; 95% CI, 1.01-1.10; and lipid-lowering drug: RR = 1.07; 95% CI, 1.04-1.10) and atrial fibrillation (oral anticoagulants: RR = 1.05; 95% CI, 1.01-1.09). Male practitioners marginally outperformed their female counterparts in ambulatory practices enrolled in a voluntary cardiovascular performance improvement registry program. Overall low adherence to some performance measures suggests room for improvement among all practitioners.

  14. Regorafenib in the Real-Life Clinical Practice: Data from the Czech Registry.

    Science.gov (United States)

    Kopeckova, Katerina; Buchler, Tomas; Bortlicek, Zbynek; Hejduk, Karel; Chloupkova, Renata; Melichar, Bohuslav; Pokorna, Petra; Tomasek, Jiri; Linke, Zdenek; Petruzelka, Lubos; Kiss, Igor; Prausova, Jana

    2017-02-01

    To describe the use of regorafenib for the treatment of metastatic colorectal cancer (mCRC) in clinical practice in the Czech Republic, and to describe the clinical outcomes of patients in terms of safety and survival. The data of patients treated with regorafenib were extracted from the national CORECT registry. The CORECT registry is a non-interventional post-marketing database, gathering information about patients with CRC and treated with targeted agents. Twenty oncology centres in the Czech Republic contributed to this registry. Collected data included patients' characteristics, disease history, cancer treatments, response to treatments and safety. A total of 148 patients treated with regorafenib in clinical practice were analysed. At regorafenib initiation, almost all patients were fully active or slightly restricted in physical activity. Regorafenib was not administered as first-line treatment in any patient. Median progression-free survival was 3.5 months and median overall survival was 9.3 months. One-year survival rate was 44.6 %. Four partial responses were observed and 51 stable diseases. Progression was observed in 66 patients (44.6 %). The main reported adverse events were skin toxicity (5.4 %) and fatigue (2.0 %). Regorafenib is a well-established treatment for pretreated patients with mCRC, however real-life data are scarce. Our results demonstrated slightly better efficacy of regorafenib and better safety profile in patients with mCRC compared to the randomised trials.

  15. Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry.

    Science.gov (United States)

    Navar, Ann Marie; Wang, Tracy Y; Li, Shuang; Robinson, Jennifer G; Goldberg, Anne C; Virani, Salim; Roger, Veronique L; Wilson, Peter W F; Elassal, Joseph; Lee, L Veronica; Peterson, Eric D

    2017-11-01

    The latest cholesterol guidelines have shifted focus from achieving low-density lipoprotein cholesterol (LDL-C) targets toward statin use and intensity guided by atherosclerotic cardiovascular disease (ASCVD) risk. Statin use and intensity were evaluated in 5,905 statin-eligible primary or secondary prevention patients from 138 PALM Registry practices. Overall, 74.7% of eligible adults were on statins; only 42.4% were on guideline-recommended intensity. Relative to primary prevention patients, ASCVD patients were more likely to be on a statin (83.6% vs 63.4%, Pcontemporary practice, 1 in 4 guideline-eligible patients was not on a statin; less than half were on the recommended statin intensity. Untreated and undertreated patients had significantly higher LDL-C levels than those receiving guideline-directed statin treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Lumbar spinal stenosis: comparison of surgical practice variation and clinical outcome in three national spine registries.

    Science.gov (United States)

    Lønne, Greger; Fritzell, Peter; Hägg, Olle; Nordvall, Dennis; Gerdhem, Paul; Lagerbäck, Tobias; Andersen, Mikkel; Eiskjaer, Søren; Gehrchen, Martin; Jacobs, Wilco; van Hooff, Miranda L; Solberg, Tore K

    2018-05-21

    Decompression surgery for lumbar spinal stenosis (LSS) is the most common spinal procedure in the elderly. To avoid persisting low back pain, adding arthrodesis has been recommended, especially if there is a coexisting degenerative spondylolisthesis. However, this strategy remains controversial, resulting in practice-based variation. The present study aimed to evaluate in a pragmatic study if surgical selection criteria and variation in use of arthrodesis in three Scandinavian countries can be linked to variation in treatment effectiveness. This is an observational study based on a combined cohort from the national spine registries of Norway, Sweden, and Denmark. Patients aged 50 and older operated during 2011-2013 for LSS were included. Patient-Reported Outcome Measures (PROMs): Oswestry Disability Index (ODI) (primary outcome), Numeric Rating Scale (NRS) for leg pain and back pain, and health-related quality of life (Euro-Qol-5D) were reported. Analysis included case-mix adjustment. In addition, we report differences in hospital stay. Analyses of baseline data were done by analysis of variance (ANOVA), chi-square, or logistic regression tests. The comparisons of the mean changes of PROMs at 1-year follow-up between the countries were done by ANOVA (crude) and analysis of covariance (case-mix adjustment). Out of 14,223 included patients, 10,890 (77%) responded at 1-year follow-up. Apart from fewer smokers in Sweden and higher comorbidity rate in Norway, baseline characteristics were similar. The rate of additional fusion surgery (patients without or with spondylolisthesis) was 11% (4%, 47%) in Norway, 21% (9%, 56%) in Sweden, and 28% (15%, 88%) in Denmark. At 1-year follow-up, the mean improvement for ODI (95% confidence interval) was 18 (17-18) in Norway, 17 (17-18) in Sweden, and 18 (17-19) in Denmark. Patients operated with arthrodesis had prolonged hospital stay. Real-life data from three national spine registers showed similar indications for decompression

  17. Practical precision measurement

    International Nuclear Information System (INIS)

    Kwak, Ho Chan; Lee, Hui Jun

    1999-01-01

    This book introduces basic knowledge of precision measurement, measurement of length, precision measurement of minor diameter, measurement of angles, measurement of surface roughness, three dimensional measurement, measurement of locations and shapes, measurement of screw, gear testing, cutting tools testing, rolling bearing testing, and measurement of digitalisation. It covers height gauge, how to test surface roughness, measurement of plan and straightness, external and internal thread testing, gear tooth measurement, milling cutter, tab, rotation precision measurement, and optical transducer.

  18. Clinical trial registries: a practical guide for sponsors and researchers of medicinal products

    National Research Council Canada - National Science Library

    Foote, MaryAnn

    2006-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix MaryAnn Foote Clinical trial registries and publication of results - a primer . . . . . . . . . . . . . . . . . . 1 Ana Marušić and Charlotte Haug The journal...

  19. Radiotherapy for bone metastases - Practice in Norway 1997 - 2007. A national registry-based study

    Energy Technology Data Exchange (ETDEWEB)

    Sande Laugsand, Tonje [European Palliative Care Research Centre (PRC), Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway)], e-mail: tonje.laugsand@ntnu.no; Kaasa, Stein; Lund, Jo-Aasmund [European Palliative Care Research Centre (PRC), Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway); Cancer Clinic, St. Olavs Hospital, Univ. Hospital of Trondheim, Trondheim (Norway); Romundstad, Paal [Dept. of Public Health, Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway); Johannesen, Tom Boerge [Cancer Registry of Norway, Oslo (Norway)

    2013-08-15

    Numerous randomised clinical trials have shown that the efficacy of single fraction radiotherapy for metastatic bone pain corresponds to that of multiple fractions of radiotherapy for the majority of patients. It is not clear to which extent single fraction radiotherapy has been implemented into clinical practice. Material and methods: A Norwegian national registry based study was conducted, including all radiotherapy schedules of 8 Gy x 1 and 3 Gy x 10 delivered to bone metastases in 1997 - 2007. Binomial regression analyses were used to study whether treatment centre, primary diagnosis, anatomical region irradiated, age, sex, and travel distance, were associated with the choice of fractionation. Results: A total of 14 380 radiotherapy episodes were identified. During the period 31% of the treatments were delivered as 8 Gy x 1. The proportion of single fraction treatments increased from 16% in 1997 to 41% in 2007. There were substantial differences in the proportion of single fraction treatments between the treatment centres (range 25 - 54%). These differences persisted after adjustment for sex, age, primary diagnosis, anatomical region, and travel distance. Conclusions: The study demonstrates an under utilisation of single fraction treatment for bone metastases in Norway during the study period.

  20. Type II diabetes and its therapy in clinical practice - results from the standardised non-interventional registry SIRTA.

    Science.gov (United States)

    Gallwitz, B; Kusterer, K; Hildemann, S; Fresenius, K

    2014-12-01

    Modern antidiabetic therapies should achieve low HbA1c values and avoid hypoglycaemic complications. The registry SIRTA included 1522 patients with type II diabetes mellitus (T2DM) from 306 German medical practices. Patients had an HbA1c > 6.5% under the maximum tolerated metformin dose. If required, they received combination therapy with other antidiabetics according to the guideline of the German Diabetes Society [Deutsche Diabetes Gesellschaft (DDG)] or usual medical practice. Patients were followed up for 6 months. The target criteria included the achievement of HbA1c target values and the emergence of severe hypoglycaemic episodes. Most patients (64.0%) were planned to achieve an HbA1c target < 6.5%, the standard target recommended by the 2009 DDG guideline valid throughout the registry. Primarily to reduce the individual risk for hypoglycaemia, 32.4% of patients had a less strict HbA1c-target of 6.5-7.0%. These targets were achieved by 31.3% and 44.3% of patients, respectively. Combination therapies increased from 45% to 56% over the 6 months registry. Four patients had severe hypoglycaemias (0.26%). The registry confirms results from other epidemiologic studies on the therapy of T2DM in everyday practice. The treatment strategies applied effectively reduced blood glucose and avoided severe hypoglycaemias. An early therapy of insufficiently controlled patients with T2DM is important, as lower baseline values facilitated achieving HbA1c targets. © 2014 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

  1. Implementation of a stroke registry is associated with an improvement in stroke performance measures in a tertiary hospital in Mexico.

    Science.gov (United States)

    Herrera, Ana Lucia; Góngora-Rivera, Fernando; Muruet, Walter; Villarreal, Héctor Jorge; Gutiérrez-Herrera, Mildred; Huerta, Lena; Carrasco, Diana; Soto-García, Anally; Espinosa-Ortega, Meztli

    2015-04-01

    Stroke registries provide a simple way for improving patient care, and its use has been associated with a better adherence to the published guidelines. Few Latin American countries had established stroke registries. Our study is the first in Mexico to report the effects of implementing a stroke registry. To determine if the implementation of a systematized registry is associated with an improved adherence to the performance measures. We compared prospective data (August 2008-November 2010) against historical controls (February 2005-July 2008). Our stroke registry (i-Registro Neurovascular) consists of a standardized clinical form that includes demographic and clinical variables (risk factors, medications, neuroimaging, etiology, acute and outpatient treatments, and neurologic scores [National Institutes of Health Stroke Scale and modified Rankin Scale]). We evaluated 9 performance measures suggested by the American Heart Association and the Joint Commission. We analyzed the data from 574 patients, 260 from the prospective phase and 314 from historical controls. No significant statistical differences in demographic characteristics or stroke risk factors were found. The implementation of the stroke registry was associated with a statistically significant (P cost and readily achievable and a viable option for encouraging an increased report of guidelines adherence of other hospitals in Latin America. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Imaginative Practices and Measure

    DEFF Research Database (Denmark)

    van Haeren, Kristen Danielle

    The Welfare State in Denmark, as established during a great surge of post-war technological developments, was firmly rooted in a time motivated by Modernist ideas of rationalization and regulation. The dreams and desires of establishing the Functionist City resulted in architectural and landscape...... projects being dictated by notions of objective truth. Motivated by the new industrial efficiency, social-housing projects became an experiment of standardization, fabricated from factual analysis and modern measure. It is the position of this paper that the notion of ‘the good life’ that the Modernist...

  3. Comparing the responsiveness of functional outcome assessment measures for trauma registries.

    Science.gov (United States)

    Williamson, Owen D; Gabbe, Belinda J; Sutherland, Ann M; Wolfe, Rory; Forbes, Andrew B; Cameron, Peter A

    2011-07-01

    Measuring long-term disability and functional outcomes after major trauma is not standardized across trauma registries. An ideal measure would be responsive to change but not have significant ceiling effects. The aim of this study was to compare the responsiveness of the Glasgow Outcome Scale (GOS), GOS-Extended (GOSE), Functional Independence Measure (FIM), and modified FIM in major trauma patients, with and without significant head injuries. Patients admitted to two adult Level I trauma centers in Victoria, Australia, who survived to discharge from hospital, were aged 15 years to 80 years with a blunt mechanism of injury, and had an estimated Injury Severity Score >15 on admission, were recruited for this prospective study. The instruments were administered at baseline (hospital discharge) and by telephone interview 6 months after injury. Measures of responsiveness, including effect sizes, were calculated. Bootstrapping techniques, and floor and ceiling effects, were used to compare the measures. Two hundred forty-three patients participated, of which 234 patients (96%) completed the study. The GOSE and GOS were the most responsive instruments in this major trauma population with effect sizes of 5.3 and 4.4, respectively. The GOSE had the lowest ceiling effect (17%). The GOSE was the instrument with greatest responsiveness and the lowest ceiling effect in a major trauma population with and without significant head injuries and is recommended for use by trauma registries for monitoring functional outcomes and benchmarking care. The results of this study do not support the use of the modified FIM for this purpose.

  4. Melanoma reporting to central cancer registries by US dermatologists: an analysis of the persistent knowledge and practice gap.

    Science.gov (United States)

    Cartee, Todd V; Kini, Seema P; Chen, Suephy C

    2011-11-01

    Every state requires diagnosing physicians to report new cases of melanoma to its central cancer registry. Previous regional studies and anecdotal experience suggest that few dermatologists are cognizant of this obligation. This oversight could result in a large number of unreported melanomas annually and, in turn, US melanoma statistics that markedly underestimate the true incidence of the disease. We sought to quantify the percentage of dermatologists who are unaware of melanoma reporting requirements (the knowledge gap) and who are not reporting melanoma diagnoses (the practice gap). We also sought to delineate factors predictive of reporting knowledge and behavior. A survey was administered to attendees of the Cutaneous Oncology Symposium at the 2010 American Academy of Dermatology annual meeting. In all, 104 of 419 eligible attendees completed surveys (response rate 26%). Fifty percent of respondents do not believe they are required to report melanomas and 56% do not actively report their diagnoses to a registry. Practice duration of less than 10 years was significantly associated with both a knowledge gap (P = .047) and practice gap (P = .056). Similarly, dermatologists who diagnosed fewer than 10 melanomas per year were more likely to possess a knowledge gap (P = .096) and a practice gap (P = .087) than those who diagnosed more than 10. Limitations include small sample size and low response rate. A majority of dermatologists are not reporting melanomas they diagnose to a cancer registry, and half of those surveyed were not aware that diagnosing physicians are required to report melanoma. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  5. COMBINED ANTIHYPERTENSIVE THERAPY IN REAL CLINICAL PRACTICE. FOCUS ON FIXED COMBINATIONS OF ANTIHYPERTENSIVE DRUGS (According to the Data of Outpatient Registries RECVASA and PROFILE

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2017-01-01

    prescribed original AHD; 75% of patients from RECVASA registry received generics. The most popular combinations in both registries were combinations of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers with thiazide/thiazide-like diuretics. The target level of BP was more often achieved in the patients of the PROFILE registry: 37.6% vs 26.1% in the RECVASA registry.Conclusion. The results of the analysis of the presented registries demonstrate the low frequency of prescribing fixed combinations in real clinical practice, the inertness of physicians in achieving the target BP levels and the low efficiency of antihypertensive therapy.

  6. Second generation registry framework.

    Science.gov (United States)

    Bellgard, Matthew I; Render, Lee; Radochonski, Maciej; Hunter, Adam

    2014-01-01

    Information management systems are essential to capture data be it for public health and human disease, sustainable agriculture, or plant and animal biosecurity. In public health, the term patient registry is often used to describe information management systems that are used to record and track phenotypic data of patients. Appropriate design, implementation and deployment of patient registries enables rapid decision making and ongoing data mining ultimately leading to improved patient outcomes. A major bottleneck encountered is the static nature of these registries. That is, software developers are required to work with stakeholders to determine requirements, design the system, implement the required data fields and functionality for each patient registry. Additionally, software developer time is required for ongoing maintenance and customisation. It is desirable to deploy a sophisticated registry framework that can allow scientists and registry curators possessing standard computing skills to dynamically construct a complete patient registry from scratch and customise it for their specific needs with little or no need to engage a software developer at any stage. This paper introduces our second generation open source registry framework which builds on our previous rare disease registry framework (RDRF). This second generation RDRF is a new approach as it empowers registry administrators to construct one or more patient registries without software developer effort. New data elements for a diverse range of phenotypic and genotypic measurements can be defined at any time. Defined data elements can then be utilised in any of the created registries. Fine grained, multi-level user and workgroup access can be applied to each data element to ensure appropriate access and data privacy. We introduce the concept of derived data elements to assist the data element standards communities on how they might be best categorised. We introduce the second generation RDRF that

  7. Pulmonary hypertension registry of Kerala, India (PRO-KERALA) - Clinical characteristics and practice patterns.

    Science.gov (United States)

    Harikrishnan, S; Sanjay, G; Ashishkumar, M; Menon, Jaideep; Rajesh, Gopalan Nair; Kumar, Raman Krishna; George Koshy, A; Attacheril, Thankachan V; George, Raju; Punnoose, Eapen; Ashraf, S M; Arun, S R; Cholakkal, Mohammed; Jeemon, Panniyammakal

    2018-08-15

    Epidemiological data on pulmonary hypertension (PH) are scarce from developing countries including India. We established a multi-center registry of PH, the PRO-KERALA registry, in Kerala, India. Fifty hospitals enrolled consecutive adult (>18 years) patients for one year. Echocardiographic criteria (right ventricular systolic pressure - RVSP > 50 mmHg) or invasively obtained mean pulmonary artery pressure > 25 mmHg was the criteria for entry. There were 2003 patients (52% Women, mean age 56 ± 16.1 years) enrolled. The mean RVSP was 68.2 (SD = 17.9) mmHg. Majority of the study participants (59%) belonged to group 2 of the WHO Nice Classification 2013 (PH secondary to left heart disease). One-fifth (21.2%) belonged to group 1, while 13.3%, 3.8% and 2.4% of the study population belonged to groups 3, 4 and 5 respectively. More than a quarter (27%) reported PH due to left heart disease with valvular disease etiology; while 20.7% had coronary artery disease. The other common etiological factors were chronic obstructive pulmonary disease (10.6%), congenital heart disease (14.6%), idiopathic pulmonary hypertension (5.8%), and chronic thromboembolic pulmonary hypertension (3.8%). Only one of two patients with pulmonary artery hypertension was receiving PH specific therapies. The use of combination therapy was negligible and PH-specific therapies were prescribed off-label to a small proportion of patients too. PRO-KERALA is the first PH registry from South Asia and the second largest globally. Left heart diseases attribute to three fifths of patients with PH. Utilization rates of PH specific drug therapies are remarkably lower than the Western population. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Radioactivity measurements principles and practice

    CERN Document Server

    Mann, W B; Spernol, A

    2012-01-01

    The authors have addressed the basic need for internationally consistent standards and methods demanded by the new and increasing use of radioactive materials, radiopharmaceuticals and labelled compounds. Particular emphasis is given to the basic and practical problems that may be encountered in measuring radioactivity. The text provides information and recommendations in the areas of radiation protection, focusing on quality control and the precautions necessary for the preparation and handling of radioactive substances. New information is also presented on the applications of both traditiona

  9. Data from the German Chest Pain Unit Registry: The well known gap between knowledge and practice.

    Science.gov (United States)

    Fernández-Bergés, Daniel

    2017-11-01

    In-hospital mortality of acute myocardial infarction with ST segment elevation remains high and is influenced by many factors, some of which are modifiable such as time to treatment initiation and modality of treatment. It is well established that reperfusion therapy is the gold-standard in the management of ST-elevation acute myocardial infarction. Despite recent developments and clear, comprehensible guidelines recommendations, it remains difficult to disseminate this knowledge to medical practitioners. The German Chest Pain Unit shows that the best door-to-balloon time is reached when patients contact the Emergency Medical Systems (EMS) directly, rather than when referred by the general practitioner (GP), or are transferred from another hospital, or present as a self-referral. In order to improve mortality in ST-elevation acute myocardial infarction, patients must be able to recognize symptoms and call the EMS as soon as possible, in addition to having an ECG within ten minutes and direct access to reperfusion therapy (PPCI preferred). The German Registry has highlighted the importance of training both patients and doctors. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Radiation practices and radiation measurements

    International Nuclear Information System (INIS)

    2008-03-01

    The guide presents the principal requirements on accuracy of radiation measurements and on the approval, calibration and operating condition inspections of radiation meters, together with requirements for dosimetric services measuring the individual radiation doses of workers engaged in radiation work (approved dosimetric services). The Guide also sets out the definitions of quantities and units used in radiation measurements. The radiation protection quantities used for assessing the harmful effects of radiation and for expressing the maximum values for radiation exposure (equivalent dose and effective dose) are set out in Guide ST 7.2. This Guide concerns measurements of ionizing radiation involved in radiation practices, the results of which are used for determining the radiation exposure of workers engaged in radiation work and members of the public, and of patients subject to the use of radiation in health services, or upon the basis of which compliance with safety requirements of appliances currently in use and of their premises of use or of the workplaces of workers is ensured. The Guide also concerns measurements of the radon concentration of inhaled air in both workplaces and dwellings. The Guide does not apply to determining the radiation exposure of aircrews, determination of exposure caused by internal radiation, or measurements made to protect the public in the event of, or in preparation for abnormal radiation conditions

  11. Comparison of carotid endarterectomy and stenting in real world practice using a regional quality improvement registry

    Science.gov (United States)

    Nolan, Brian W.; De Martino, Randall R.; Goodney, Philip P.; Schanzer, Andres; Stone, David H.; Butzel, David; Kwolek, Christopher J.; Cronenwett, Jack L.

    2013-01-01

    Objective Carotid artery stenting (CAS) vs endarterectomy (CEA) remains controversial and has been the topic of recent randomized controlled trials. The purpose of this study was to compare the practice and outcomes of CAS and CEA in a real world setting. Methods This is a retrospective analysis of 7649 CEA and 430 CAS performed at 17 centers from 2003 to 2010 within the Vascular Study Group of New England (VSGNE). The primary outcome measures were (1) any in-hospital stroke or death and (2) any stroke, death, or myocardial infarction (MI). Patients undergoing CEA in conjunction with cardiac surgery were excluded. Multivariate logistic regression was performed to identify predictors of stroke or death in patients undergoing CAS. Results CEA was performed in 17 centers by 111 surgeons, while CAS was performed in 6 centers by 30 surgeons and 8 interventionalists. Patient characteristics varied by procedure. Patients undergoing CAS had a higher prevalence of coronary artery disease, congestive heart failure, diabetes, and prior ipsilateral CEA. Embolic protection was used in 97% of CAS. Shunts were used in 48% and patches in 86% of CEA. The overall in-hospital stroke or death rate was higher among patients undergoing CAS (2.3% vs 1.1%; P = .03). Overall stroke, death, or MI (2.8% CAS vs 2.1% CEA; P = .32) were not different. Asymptomatic patients had similar rates of stroke or death (CAS 0.73% vs CEA 0.89%; P = .78) and stroke, death, or MI (CAS 1.1% vs CEA 1.8%; P = .40). Symptomatic patients undergoing CAS had higher rates of stroke or death (5.1% vs 1.6%; P = .001), and stroke, death, or MI (5.8% vs 2.7%; P = .02). By multivariate analysis, major stroke (odds ratio, 4.5; 95% confidence interval [CI], 1.9–10.8), minor stroke (2.7; CI, 1.5–4.8), prior ipsilateral CEA (3.2, CI, 1.7–6.1), age >80 (2.1; CI, 1.3–3.4), hypertension (2.6; CI, 1.0–6.3), and a history of chronic obstructive pulmonary disease (1.6; CI, 1.0–2.4) were predictors of stroke or death

  12. Usefulness of ambulatory blood pressure monitoring (ABPM) in daily clinical practice: Data from the Spanish ABPM registry.

    Science.gov (United States)

    Segura, Julian; Banegas, Jose R; Ruilope, Luis M

    2014-01-01

    1. Hypertension is one of the most important challenges for public health systems because of its high prevalence and its association with the risk of cardiovascular and renal diseases. 2. Adequate control of hypertension is low in population and medical settings, with physicians frequently misclassifying patients' blood pressure status based on readings taken in the clinic rather than ambulatory blood pressure measurements (ABPM). 3. Data from the Spanish Society of Hypertension ABPM registry support ABPM as a feasible option in the primary care setting, providing valuable information for the diagnosis and management of hypertension. By using ABPM rather than office BP monitoring, BP control can be doubled. This is an encouraging message to clinicians, although there is still a relatively large degree of undetected controlled and uncontrolled hypertension. 4. This short review describes the design, development and main results of the Spanish Society of Hypertension ABPM registry, a project based on a large-scale network of Spanish physicians trained in ABPM. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Verifying influenza and pneumococcal immunization status of children in 2009-2010 from primary care practice records and from the North Carolina Immunization Registry.

    Science.gov (United States)

    Poehling, Katherine A; Vannoy, Lauren; Peters, Timothy R

    2013-01-01

    The North Carolina Immunization Registry (NCIR) has been available since 2004. We sought to measure its utilization among practices that provide primary care for children who are enrolled in a prospective influenza surveillance study. This study included children aged 0.5-17 years who presented with fever or acute respiratory symptoms to an emergency department or inpatient setting in Winston-Salem, North Carolina, from September 1, 2009, through May 19, 2010. Study team members verified influenza and pneumococcal immunization status by requesting records from each child's primary care practice and by independently reviewing the NCIR. We assessed agreement of nonregistry immunization medical records with NCIR data using the kappa statistic. Fifty-six practices confirmed the immunization status of 292 study-enrolled children. For most children (238/292, 82%), practices verified the child's immunizations by providing a copy of the NCIR record. For 54 children whose practices verified their immunizations by providing practice records alone, agreement with the NCIR by the kappa statistic was 0.6-0.7 for seasonal and monovalent H1N1 influenza vaccines and 0.8-0.9 for pneumococcal conjugate and polysaccharide vaccines. A total of 221 (98%) of 226 enrolled children younger than 6 years of age had 2 or more immunizations documented in the NCIR. NCIR usage may vary in other regions of North Carolina. More than 95% of children younger than 6 years of age had 2 or more immunizations documented in the NCIR; thus, the Centers for Disease Control and Prevention 2010 goal for immunization information systems was met in this population. We found substantial agreement between practice records and the NCIR for influenza and pneumococcal immunizations in children.

  14. Feasibility of 4 patient-reported outcome measures in a registry setting

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma Becic; Overgaard, Søren

    2012-01-01

    Background and purpose Feasibility is an important parameter when choosing which patient-reported outcomes (PRO) to use in a study. We assessed the feasibility of PROs in a hip registry setting. Methods Primary total hip arthroplasty (THA) patients (n = 5,747) who had been operated on 1-2, 5.......1% to 46%, respectively. Missing items ranged from 1.2% to 3.4%, and 0.8-4.3% required manual validation (p analysis, depending on descriptive factor and choice of PRO. Interpretation All 4 PROs fulfilled...

  15. Practical quantitative measures of ALARA

    International Nuclear Information System (INIS)

    Kathren, R.L.; Larson, H.V.

    1982-06-01

    Twenty specific quantitative measures to assist in evaluating the effectiveness of as low as reasonably achievable (ALARA) programs are described along with their applicability, practicality, advantages, disadvantages, and potential for misinterpretation or dortion. Although no single index or combination of indices is suitable for all facilities, generally, these five: (1) mean individual dose equivalent (MIDE) to the total body from penetrating radiations; (2) statistical distribution of MIDE to the whole body from penetrating radiations; (3) cumulative penetrating whole body dose equivalent; (4) MIDE evaluated by job classification; and (5) MIDE evaluated by work location-apply to most programs. Evaluation of other programs may require other specific dose equivalent based indices, including extremity exposure data, cumulative dose equivalent to organs or to the general population, and nonpenetrating radiation dose equivalents. Certain nondose equivalent indices, such as the size of the radiation or contamination area, may also be used; an airborne activity index based on air concentration, room volume, and radiotoxicity is developed for application in some ALARA programs

  16. DIAGNOSIS AND TREATMENT OF PATIENTS WITH SEVERE HYPERCHOLESTEROLEMIA IN REAL OUTPATIENT PRACTICE (ACCORDING TO THE RECVASA REGISTRY

    Directory of Open Access Journals (Sweden)

    A. I. Ershova

    2014-01-01

    Full Text Available Hypercholesterolemia is a proven risk factor for atherosclerotic cardiovascular diseases and for their complications.Aim. To assess the quality of diagnosis and treatment of patients with severe hypercholesterolemia (total cholesterol >6.2 mmol/L in the real outpatient practice.Material and methods. All patients with a diagnosis of arterial hypertension, ischemic heart disease, chronic heart failure, atrial fibrillation applied to primary care physicians or cardiologists in one of the randomly selected out-patient clinic of Ryazan in March-May 2012 and included into the RECVASA registry were enrolled into the study group (n=1642.Results. The group of patients with severe hypercholesterolemia consisted of 561 (44% patients at the age of 67 (59-75 years [Me (25% -75%]. At that, diagnosis of hyperlipidemia was indicated only in 9% of outpatient cards. Data of one or more blood chemistries including low density cholesterol (LDC levels were presented only in 7% of outpatient cards. 83.7% of patients with severe hypercholesterolemia were classified as patients at high or very high cardiovascular risk, but statins were recommended only to 17.8% of them. Statins were mainly recommended in moderate doses; only one patient took atorvastatin 40 mg per day. Blood LDC levels were examined only in 5% of patients during statins therapy; nobody of them reached target LDC levels.Conclusion. The study data revealed the presence of a high prevalence of severe hypercholesterolemia in patients with cardiovascular diseases and poor quality of diagnosis and treatment in these patients in the real outpatient practice.

  17. Recent trends in Australian percutaneous coronary intervention practice: insights from the Melbourne Interventional Group registry.

    Science.gov (United States)

    Yan, Bryan P; Ajani, Andrew E; Clark, David J; Duffy, Stephen J; Andrianopoulos, Nick; Brennan, Angela L; Loane, Philippa; Reid, Christopher M

    2011-08-01

    To evaluate percutaneous coronary intervention (PCI) practice trends and 12-month outcomes in Australia in the era of drug-eluting stents (DES). Prospective study of consecutive patients undergoing 9204 PCIs between 1 April 2004 and 31 March 2008 at seven Victorian public hospitals. Temporal trends in baseline characteristics and in-hospital and 12-month clinical outcomes including death, myocardial infarction (MI), target vessel revascularisation (TVR) and composite major adverse cardiac events (MACE), from year to year. Between 2004-2005 and 2007-2008, the mean age of patients undergoing PCI was stable (65 ± 12 years), and comorbidities such as hypertension, hyperlipidaemia, peripheral arterial disease and stroke increased (P < 0.05). There were fewer elective and more urgent PCIs, especially for MI < 24 hours (17.6% in 2004-2005 to 27.2% in 2007-2008, P < 0.01). Overall stent use remained high (mean, 94.6%), but use of DES declined steadily (53.9% in 2004-2005 to 32.0% in 2007-2008, P < 0.01), despite increases in complex lesions. Planned clopidogrel therapy of ≥ 12 months after insertion of DES increased from 54.7% in 2004-2005 to 98.0% in 2007-2008 (P < 0.01). The overall procedural success rate was high (mean, 95.9%), and 12-month rates of mortality (3.8%), MI (4.8%), TVR (6.8%) and stent thrombosis (1.8%) remained low. Selective use of DES was an independent predictor of freedom from MACE at 12 months (odds ratio, 0.68; 95% CI, 0.56-0.81). Use of DES declined steadily from 2004-2005 to 2007-2008, despite increasing patient risk profile and lesion complexity. Procedural success remained high and 12-month adverse outcomes remained low, with increasing use of prolonged dual antiplatelet therapy.

  18. Measuring Practicing Clinicians’ Information Literacy

    Science.gov (United States)

    Barboza, Katherine; Jensen, Ashley E.; Bennett, Katelyn J.; Sherman, Scott E.; Schwartz, Mark D.

    2017-01-01

    Summary Background As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. Objectives This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans’ Affairs (VA) medical center. Methods Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention. Providers were asked about their use and comfort with two VA digital tools for panel management at baseline, 16 weeks, and post-intervention. An 8-item scale (range 0-40) was used to measure information literacy (Cronbach’s a=0.84). Scores between study arms and provider types were compared using paired t-tests and ANOVAs. Associations between self-reported digital tool use and information literacy were measured via Pearson’s correlations. Results Providers showed moderate levels of information literacy (M= 27.4, SD 6.5). There were no significant differences in mean information literacy between physicians (M=26.4, SD 6.7) and nurses (M=30.5, SD 5.2, p=0.57 for difference), or between intervention (M=28.4, SD 6.5) and control groups (M=25.1, SD 6.2, p=0.12 for difference). Information literacy was correlated with higher rates of self-reported information system usage (r=0.547, p=0.001). Clinicians identified data access, accuracy, and interpretability as potential information literacy barriers. Conclusions While exploratory in nature, cautioning generalizability, the study suggests that measuring and improving clinicians’ information literacy may play a significant role in the implementation and use of digital information tools, as these tools are rapidly being deployed to enhance communication among care teams, improve health care outcomes, and reduce overall costs. PMID:28197620

  19. Quality measures for nurse practitioner practice evaluation.

    Science.gov (United States)

    Kleinpell, Ruth; Kapu, April N

    2017-08-01

    Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

  20. Performance measurement in governmental agencies using BSC-AHP: A case study of Civil Registry Office in Tehran

    Directory of Open Access Journals (Sweden)

    Ahmad Valashjerdi Majd Abad Kohneh

    2013-04-01

    Full Text Available Measuring the performance of governmental organizations plays an important role on increasing public satisfaction in any society. One of the effective models for assessing the organizations performance is balance scorecard (BSC model, which investigates all aspects of organizations. In this paper, we use a hybrid of analytical hierarchy process along with BSC to measure the performance of five different civil registry offices in Tehran, Iran. We use fuzzy terms to handle uncertainty in input numbers and using some technique convert fuzzy numbers into crisp values. The results of our survey indicate that learning and development is number one priority with relative importance of 0.491, followed by customer with relative importance of 0.293, internal process with relative importance of 0.173 and financial affairs comes at last with relative weight of 0.043. The study uses organizational researchers, training, quality, customer satisfaction, performance measurement, expenses and annual budget as major components for analyzing five regions. We have also performed sensitivity analysis to see the effects of different changes on ranking.

  1. Design, implementation and practice of JBEI-ICE: an open source biological part registry platform and tools.

    Science.gov (United States)

    Ham, Timothy S; Dmytriv, Zinovii; Plahar, Hector; Chen, Joanna; Hillson, Nathan J; Keasling, Jay D

    2012-10-01

    The Joint BioEnergy Institute Inventory of Composable Elements (JBEI-ICEs) is an open source registry platform for managing information about biological parts. It is capable of recording information about 'legacy' parts, such as plasmids, microbial host strains and Arabidopsis seeds, as well as DNA parts in various assembly standards. ICE is built on the idea of a web of registries and thus provides strong support for distributed interconnected use. The information deposited in an ICE installation instance is accessible both via a web browser and through the web application programming interfaces, which allows automated access to parts via third-party programs. JBEI-ICE includes several useful web browser-based graphical applications for sequence annotation, manipulation and analysis that are also open source. As with open source software, users are encouraged to install, use and customize JBEI-ICE and its components for their particular purposes. As a web application programming interface, ICE provides well-developed parts storage functionality for other synthetic biology software projects. A public instance is available at public-registry.jbei.org, where users can try out features, upload parts or simply use it for their projects. The ICE software suite is available via Google Code, a hosting site for community-driven open source projects.

  2. Evaluating measurement accuracy a practical approach

    CERN Document Server

    Rabinovich, Semyon G

    2013-01-01

    The goal of Evaluating Measurement Accuracy: A Practical Approach is to present methods for estimating the accuracy of measurements performed in industry, trade, and scientific research. From developing the theory of indirect measurements to proposing new methods of reduction, transformation, and enumeration, this work encompasses the full range of measurement data processing. It includes many examples that illustrate the application of general theory to typical problems encountered in measurement practice. As a result, the book serves as an inclusive reference work for data processing of all types of measurements: single and multiple, combined and simultaneous, direct (both linear and nonlinear), and indirect (both dependent and independent). It is a working tool for experimental scientists and engineers of all disciplines who work with instrumentation. It is also a good resource for natural science and engineering students and for technicians performing measurements in industry. A key feature of the book is...

  3. Practical applications of the routine measuring program

    International Nuclear Information System (INIS)

    Busl, G.; Dehos, R.; Erl, S.; Kohl, R.; Pieper, H.; Winkovich, J.

    1989-01-01

    The colloquium participants were primarily concerned with discussing the tasks defined by Paragraph 3 of the Preventive Radiation Protection Act (StrVG). There are 23 papers in the proceedings focussing on the various tasks and their practical aspects, such as sampling, sample preparation, measurement and measuring techniques, data evaluation, and reporting and documentation. (HP) [de

  4. Heritability of ECG Biomarkers in the Netherlands Twin Registry Measured from Holter ECGs.

    Directory of Open Access Journals (Sweden)

    Emily C Hodkinson

    2016-04-01

    Full Text Available INTRODUCTIONThe resting ECG is the most commonly used tool to assess cardiac electrophysiology. Previous studies have estimated heritability of ECG parameters based on these snapshots of the cardiac electrical activity. In this study we set out to determine whether analysis of heart rate specific data from Holter ECGs allows more complete assessment of the heritability of ECG parameters.METHODS and RESULTSHolter ECGs were recorded from 221 twin pairs and analyzed using a multi-parameter beat binning approach. Heart rate dependent estimates of heritability for QRS duration, QT interval, Tpeak–Tend and Theight were calculated using structural equation modelling. QRS duration is largely determined by environmental factors whereas repolarization is primarily genetically determined. Heritability estimates of both QT interval and Theight were significantly higher when measured from Holter compared to resting ECGs and the heritability estimate of each was heart rate dependent. Analysis of the genetic contribution to correlation between repolarization parameters demonstrated that covariance of individual ECG parameters at different heart rates overlap but at each specific heart rate there was relatively little overlap in the genetic determinants of the different repolarization parameters.CONCLUSIONSHere we present the first study of heritability of repolarization parameters measured from Holter ECGs. Our data demonstrate that higher heritability can be estimated from the Holter than the resting ECG and reveals rate dependence in the genetic – environmental determinants of the ECG that has not previously been tractable. Future applications include deeper dissection of the ECG of participants with inherited cardiac electrical disease.

  5. Measurement Errors and Uncertainties Theory and Practice

    CERN Document Server

    Rabinovich, Semyon G

    2006-01-01

    Measurement Errors and Uncertainties addresses the most important problems that physicists and engineers encounter when estimating errors and uncertainty. Building from the fundamentals of measurement theory, the author develops the theory of accuracy of measurements and offers a wealth of practical recommendations and examples of applications. This new edition covers a wide range of subjects, including: - Basic concepts of metrology - Measuring instruments characterization, standardization and calibration -Estimation of errors and uncertainty of single and multiple measurements - Modern probability-based methods of estimating measurement uncertainty With this new edition, the author completes the development of the new theory of indirect measurements. This theory provides more accurate and efficient methods for processing indirect measurement data. It eliminates the need to calculate the correlation coefficient - a stumbling block in measurement data processing - and offers for the first time a way to obtain...

  6. Rationale and design of the worldwide prospective multicenter registry on radiation dose estimates of cardiac CT angiography in daily practice in 2017 (PROTECTION VI)

    DEFF Research Database (Denmark)

    Stocker, Thomas J; Deseive, Simon; Chen, Marcus

    2018-01-01

    -randomized and randomized studies have been performed to reduce the associated radiation exposure. Currently, it is unclear if the advances in technology and knowledge about radiation reduction translated into reduced levels of cardiac CTA radiation dose in daily clinical practice as well as a wide utilization of dose......-saving strategies. METHODS: The PROTECTION VI study is a multicenter, prospective, worldwide registry designed to evaluate radiation dose exposure, utilization of dose-saving strategies and diagnostic image quality during cardiac CTA in current daily practice. Assessment of image quality will be addressed...... median radiation dose levels, image quality, frequency of use and efficacy of algorithms for dose reduction, and patient and study-related predictors associated with radiation dose. CONCLUSIONS: The PROTECTION VI study is designed to provide a reliable estimate of current radiation dose for cardiac CTA...

  7. The Practice Pattern of Percutaneous Coronary Intervention in Korea: Based on Year 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry.

    Science.gov (United States)

    Gwon, Hyeon-Cheol; Jeon, Dong Woon; Kang, Hyun-Jae; Jang, Jae-Sik; Park, Duk-Woo; Shin, Dong-Ho; Moon, Keon-Woong; Kim, Jung-Sun; Kim, Juhan; Bae, Jang-Whan; Hur, Seung-Ho; Kim, Byung Ok; Choi, Donghoon; Han, Kyoo-Rok; Kim, Hyo-Soo

    2017-05-01

    Appropriate use criteria (AUC) was developed to improve the quality of percutaneous coronary intervention (PCI). However, these criteria should consider the current practice pattern in the country where they are being applied. The algorithm for the Korean PCI practice pattern (KP3) was developed by modifying the United States-derived AUC in expert consensus meetings. KP3 class A was defined as any strategy with evidence from randomized trials that was more conservative for PCI than medical therapy or coronary artery bypass graft (CABG). Class C was defined as any strategy with less evidence from randomized trials and more aggressive for PCI than medical therapy or CABG. Class B was defined as a strategy that was partly class A and partly class C. We applied the KP3 classification system to the Korean PCI registry. The KP3 class A was noted in 67.7% of patients, class B in 28.8%, and class C in 3.5%. The median proportion of class C cases per center was 2.0%. The distribution of KP3 classes varied significantly depending on clinical and angiographic characteristics. The proportion of KP3 class C cases per center was not significantly dependent on PCI volume, but rather on the percentage of ACS cases in each center. We report the current PCI practice pattern by applying the new KP3 classification in a nationwide PCI registry. The results should be interpreted carefully with due regard for the complex relationships between the determining variables and the healthcare system in Korea.

  8. eRegistries: Electronic registries for maternal and child health.

    Science.gov (United States)

    Frøen, J Frederik; Myhre, Sonja L; Frost, Michael J; Chou, Doris; Mehl, Garrett; Say, Lale; Cheng, Socheat; Fjeldheim, Ingvild; Friberg, Ingrid K; French, Steve; Jani, Jagrati V; Kaye, Jane; Lewis, John; Lunde, Ane; Mørkrid, Kjersti; Nankabirwa, Victoria; Nyanchoka, Linda; Stone, Hollie; Venkateswaran, Mahima; Wojcieszek, Aleena M; Temmerman, Marleen; Flenady, Vicki J

    2016-01-19

    The Global Roadmap for Health Measurement and Accountability sees integrated systems for health information as key to obtaining seamless, sustainable, and secure information exchanges at all levels of health systems. The Global Strategy for Women's, Children's and Adolescent's Health aims to achieve a continuum of quality of care with effective coverage of interventions. The WHO and World Bank recommend that countries focus on intervention coverage to monitor programs and progress for universal health coverage. Electronic health registries - eRegistries - represent integrated systems that secure a triple return on investments: First, effective single data collection for health workers to seamlessly follow individuals along the continuum of care and across disconnected cadres of care providers. Second, real-time public health surveillance and monitoring of intervention coverage, and third, feedback of information to individuals, care providers and the public for transparent accountability. This series on eRegistries presents frameworks and tools to facilitate the development and secure operation of eRegistries for maternal and child health. In this first paper of the eRegistries Series we have used WHO frameworks and taxonomy to map how eRegistries can support commonly used electronic and mobile applications to alleviate health systems constraints in maternal and child health. A web-based survey of public health officials in 64 low- and middle-income countries, and a systematic search of literature from 2005-2015, aimed to assess country capacities by the current status, quality and use of data in reproductive health registries. eRegistries can offer support for the 12 most commonly used electronic and mobile applications for health. Countries are implementing health registries in various forms, the majority in transition from paper-based data collection to electronic systems, but very few have eRegistries that can act as an integrating backbone for health

  9. Implementation of recommended measures in patients with stable coronary artery disease: the data from 2014 Russian registry

    Directory of Open Access Journals (Sweden)

    Korotin A.S.

    2015-03-01

    Full Text Available A report presents the data on assessment of recommended treatment implementation in patients with stable coronary artery disease (CAD. The source of the data of the year 2014 was multicenter Russian registry of hypertension, CAD and chronic heart failure.

  10. Interest of a simple on-line screening registry for measuring ICU burden related to an influenza pandemic.

    Science.gov (United States)

    Richard, Jean-Christophe Marie; Pham, Tài; Brun-Buisson, Christian; Reignier, Jean; Mercat, Alain; Beduneau, Gaëtan; Régnier, Bernard; Mourvillier, Bruno; Guitton, Christophe; Castanier, Matthias; Combes, Alain; Le Tulzo, Yves; Brochard, Laurent

    2012-07-09

    The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs. We conducted a prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden. Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated in a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. Three hundred ninety-one critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non-University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas. The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non-University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs.

  11. Clinical Case Registries (CCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Clinical Case Registries (CCR) replaced the former Immunology Case Registry and the Hepatitis C Case Registry with local and national databases. The CCR:HIV and...

  12. [The QuIK-Registry of the German Society of Cardiologists in private practice: countrywide and benchmarking quality assurance in invasive cardiology].

    Science.gov (United States)

    Albrecht, A; Levenson, B; Göhring, S; Haerer, W; Reifart, N; Ringwald, G; Troger, B

    2009-10-01

    QuIK is the German acronym for QUality Assurance in Invasive Cardiology. It describes the continuous project of an electronic data collection in Cardiac catheterization laboratories all over Germany. Mainly members of the German Society of Cardiologists in Private Practice (BNK) participate in this computer based project. Since 1996 data of diagnostic and interventional procedures are collected and send to a registry-center where a regular benchmarking analysis of the results is performed. Part of the project is a yearly auditing process including an on-site visit to the cath lab to guarantee for the reliability of information collected. Since 1996 about one million procedures have been documented. Georg Thieme Verlag KG Stuttgart , New York.

  13. Canadian Registry of ICD Implant Testing procedures (CREDIT): current practice, risks, and costs of intraoperative defibrillation testing.

    Science.gov (United States)

    Healey, Jeff S; Dorian, Paul; Mitchell, L Brent; Talajic, Mario; Philippon, Francois; Simpson, Chris; Yee, Raymond; Morillo, Carlos A; Lamy, Andre; Basta, Magdy; Birnie, David H; Wang, Xiaoyin; Nair, Girish M; Crystal, Eugene; Kerr, Charles R; Connolly, Stuart J

    2010-02-01

    There is uncertainty about the proper role of defibrillation testing (DT) at the time of implantable cardioverter defibrillator (ICD) insertion. A prospective registry was conducted at 13 sites in Canada between January 2006 and October 2007. To document the details of DT, the reasons for not conducting DT, and the costs and complications associated with DT. DT was conducted at implantation in 230 of 361 patients (64%). DT was more likely to be conducted for new implants compared with impulse generator replacements (71% vs 32%, P = 0.0001), but was similar for primary and secondary prevention indications (64% vs 63%, P = NS). Among patients not having DT, the reason(s) given were: considered unnecessary (44%); considered unsafe, mainly due to persistent atrial fibrillation (37%); lack of an anesthetist (20%); and, patient or physician preference (6%). When performed, DT consisted of a single successful shock > or = 10J below maximum device output in 65% of cases. A 10J safety-margin was met by 97% of patients, requiring system modification in 2.3%. Major perioperative complications occurred in 4.4% of patients having DT versus 6.6% of patients not having DT (P = NS). ICD insertion was $844 more expensive for patients having DT (P = 0.16), largely due to increased costs ($28,017 vs $24,545) among patients having impulse generator replacement (P = 0.02). DT was not performed in a third of ICD implants, usually due to a perceived lack of need or relative contraindication.

  14. Converged Registries Solution (CRS)

    Data.gov (United States)

    Department of Veterans Affairs — The Converged Registries platform is a hardware and software architecture designed to host individual patient registries and eliminate duplicative development effort...

  15. EsPRit: ethics committee proposals for Long Term Medical Data Registries in rapidly evolving research fields - a future-proof best practice approach.

    Science.gov (United States)

    Oberbichler, S; Hackl, W O; Hörbst, A

    2017-10-18

    Long-term data collection is a challenging task in the domain of medical research. Many effects in medicine require long periods of time to become traceable e.g. the development of secondary malignancies based on a given radiotherapeutic treatment of the primary disease. Nevertheless, long-term studies often suffer from an initial lack of available information, thus disallowing a standardized approach for their approval by the ethics committee. This is due to several factors, such as the lack of existing case report forms or an explorative research approach in which data elements may change over time. In connection with current medical research and the ongoing digitalization in medicine, Long Term Medical Data Registries (MDR-LT) have become an important means of collecting and analyzing study data. As with any clinical study, ethical aspects must be taken into account when setting up such registries. This work addresses the problem of creating a valid, high-quality ethics committee proposal for medical registries by suggesting groups of tasks (building blocks), information sources and appropriate methods for collecting and analyzing the information, as well as a process model to compile an ethics committee proposal (EsPRit). To derive the building blocks and associated methods software and requirements engineering approaches were utilized. Furthermore, a process-oriented approach was chosen, as information required in the creating process of ethics committee proposals remain unknown in the beginning of planning an MDR-LT. Here, we derived the needed steps from medical product certification. This was done as the medical product certification itself also communicates a process-oriented approach rather than merely focusing on content. A proposal was created for validation and inspection of applicability by using the proposed building blocks. The proposed best practice was tested and refined within SEMPER (Secondary Malignoma - Prospective Evaluation of the

  16. Measuring Cutaneous Lesions: Trends in Clinical Practice.

    Science.gov (United States)

    Zhang, Shali; Blalock, Travis W

    2018-03-01

    Knowing the size of a cutaneous lesion can be important for tracking its progression over time, selecting the proper treatment modality, surgical planning, determining prognosis, and accurate billing. However, providers vary in their consistency, accuracy, and methods of measuring cutaneous lesions. To investigate the clinical practices of US dermatologists and dermatologic surgeons regarding how they determine the size of cutaneous lesions. A survey was electronically distributed to members of the American Society for Dermatologic Surgery. Four hundred twenty-six dermatologists completed the online survey. When a lesion is suspected to be malignant, 85% of respondents obtained exact measurements most, if not all, of the time; however, only 8% did for benign lesions. Most providers determined lesion sizes themselves rather than delegating to staff. When performing visual estimation, approximately three-quarters believed that they were accurate to within 1 to 2 mm. The top reasons for obtaining exact measurements were for tracking atypical pigmented lesions, determining treatment pathways, and accurate billing. The majority of respondents believed that lesion size affected management decisions; however, the need for exact measurement remains controversial, particularly for benign lesions. Future studies may investigate whether taking exact versus estimated measurements has an effect on outcomes.

  17. Measurement of the Inter-Rater Reliability Rate Is Mandatory for Improving the Quality of a Medical Database: Experience with the Paulista Lung Cancer Registry.

    Science.gov (United States)

    Lauricella, Leticia L; Costa, Priscila B; Salati, Michele; Pego-Fernandes, Paulo M; Terra, Ricardo M

    2018-06-01

    Database quality measurement should be considered a mandatory step to ensure an adequate level of confidence in data used for research and quality improvement. Several metrics have been described in the literature, but no standardized approach has been established. We aimed to describe a methodological approach applied to measure the quality and inter-rater reliability of a regional multicentric thoracic surgical database (Paulista Lung Cancer Registry). Data from the first 3 years of the Paulista Lung Cancer Registry underwent an audit process with 3 metrics: completeness, consistency, and inter-rater reliability. The first 2 methods were applied to the whole data set, and the last method was calculated using 100 cases randomized for direct auditing. Inter-rater reliability was evaluated using percentage of agreement between the data collector and auditor and through calculation of Cohen's κ and intraclass correlation. The overall completeness per section ranged from 0.88 to 1.00, and the overall consistency was 0.96. Inter-rater reliability showed many variables with high disagreement (>10%). For numerical variables, intraclass correlation was a better metric than inter-rater reliability. Cohen's κ showed that most variables had moderate to substantial agreement. The methodological approach applied to the Paulista Lung Cancer Registry showed that completeness and consistency metrics did not sufficiently reflect the real quality status of a database. The inter-rater reliability associated with κ and intraclass correlation was a better quality metric than completeness and consistency metrics because it could determine the reliability of specific variables used in research or benchmark reports. This report can be a paradigm for future studies of data quality measurement. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Characterisation of antibiotic prescriptions for acute respiratory tract infections in Danish general practice: a retrospective registry based cohort study.

    Science.gov (United States)

    Aabenhus, Rune; Hansen, Malene Plejdrup; Saust, Laura Trolle; Bjerrum, Lars

    2017-05-19

    Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice. Acute respiratory tract infections accounted for 456,532 antibiotic prescriptions issued between July 2012 and June 2013. Pneumonia was the most common indication with 178,354 prescriptions (39%), followed by acute tonsillitis (21%) and acute otitis media (19%). In total, penicillin V accounted for 58% of all prescriptions, followed by macrolides (18%) and amoxicillin (15%). The use of second-line agents increased with age for all indications, and comprised more than 40% of the prescriptions in patients aged >75 years. Women were more often prescribed antibiotics regardless of clinical indication. This is the first Danish study to characterise antibiotic prescription patterns for acute respiratory tract infections by data linkage of clinical indications. The findings confirm that penicillin V is the most commonly prescribed antibiotic agent for treatment of patients with an acute respiratory tract infection in Danish general practice. However, second-line agents like macrolides and amoxicillin with or without clavulanic acid are overused. Strategies to improve the quality of antibiotic prescribing especially for pneumonia, acute otitis media and acute rhinosinusitis are warranted. TRACKING THE OVERUSE OF ANTIBIOTICS: Better adherence to guidelines for prescribing antibiotics for different respiratory tract infections are warranted in Danish general practice. The over-use of antibiotics, particularly so

  19. Variation in practice patterns in device closure of atrial septal defects and patent ductus arteriosus: An analysis of data from the IMproving Pediatric and Adult Congenital Treatment (IMPACT) registry.

    Science.gov (United States)

    O'Byrne, Michael L; Kennedy, Kevin F; Rome, Jonathan J; Glatz, Andrew C

    2018-02-01

    Practice variation is a potentially important measure of healthcare quality. The IMPACT registry provides a representative national sample with which to study practice variation in trans-catheter interventions for congenital heart disease. We studied cases for closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) in IMPACT between January 1, 2011, and September 30, 2015, using hierarchical multivariate models studying (1) the distribution of indications for closure and (2) in patients whose indication for closure was left (LVVO) or right ventricular volume overload (RVVO), the factors influencing probability of closure of a small defect (either in size or in terms of the magnitude of shunt). Over the study period, 5233 PDA and 4459 ASD cases were performed at 77 hospitals. The indications for ASD closure were RVVO in 84% and stroke prevention in 13%. Indications for PDA closure were LVVO in 57%, endocarditis prevention in 36%, and pulmonary hypertension in 7%. There was statistically significant variability in indications between hospitals for PDA and ASD procedures (median rate ratio (MRR): 1.3 and 1.1; both Pclosure of PDA and ASD. Further research is necessary to study whether this affects outcomes or resource utilization. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Efficacy of the Essential Amino Acids and Keto-Analogues on the CKD progression rate in real practice in Russia - city nephrology registry data for outpatient clinic.

    Science.gov (United States)

    Zemchenkov, Alexander; Konakova, Irina N

    2016-07-07

    Renal replacement therapy (RRT) is growing by 10 % per year in Russia, but pre-dialysis care which can retard CKD progression and delay the start of RRT remains limited. We evaluate the effect of Essential Amino Acids and Keto-analogues (EAA/KA) on CKD progression. The effect of low protein diet (LPD), supplemented by EAA/KA, on GFR slope changes between first and second treatment period (five sequential visits per period) in 96 patients withs CKD Stage 3B-5 was compared to GFR slope changes in the control group of 96 patients, randomly selected from matched (by gender, age, diagnosis and CKD Stage) cohort of 320 patients from the city Registry. The mean baseline eGFR was 23 ± 9 ml/min/1.73 m2; 29 % had CKD3B, 45 % - CKD4, 26 % - CKD5. The rate of eGFR decline changed from -2.71 ± 2.38 to -2.01 ± 2.26 ml/min/1.73 m2 per year in the treatment group and from -2.18 ± 2.01 to -2.04 ± 2.18 ml/min/1.73 m2 per year in the control group. Only in the treatment group the difference was significant (p = 0.04 and p = 0.6). Standardized effect size for intervention was significant in treatment group: -0.3 (of pooled SD), 95 % CI -0.58 ÷  -0.02 and non-significant in control group: -0.07 (-0.35 ÷ +0.22). The univariate and multivariate analysis of EAA/KA therapy effect demonstrated that it was probably more effective in patients of older age, with higher time-averaged proteinuria (PU), lower phosphate level, in patients with glomerular v. interstitial diseases, and in females. Only the latter factor was significant at pre-specified level (<0.05). LPD combined with EAA/KA supplementation lead to the decrease of the CKD progression both in well-designed clinical study and in real nephrology practice in wide variety diseases and settings. Registry data can be helpful to reveal patients with optimal chances for beneficial effect of LPD supplemented by EAA/KA. ISRCTN28190556 06/05/2016.

  1. Danish Hip Arthroscopy Registry (DHAR)

    DEFF Research Database (Denmark)

    Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

    2017-01-01

    The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM). Peri-operative data and Patient Reported Outcome Measures (PROM......-5 D demonstrated improvement after 1 and 2 years from 0.66 pre-op to 0.78 at 2 years. HSAS improved significantly from 2.5 to 3.3. Pain score data demonstrated improvement in NRS-rest 39 to 17 and NRS Walk 49 to 22 at follow-up. We conclude that patients with FAI undergoing hip arthroscopy...

  2. Oxaliplatin/5-fluorouracil-based adjuvant chemotherapy as a standard of care for colon cancer in clinical practice: Outcomes of the ACCElox registry.

    Science.gov (United States)

    Park, Young Suk; Ji, Jiafu; Zalcberg, John Raymond; El-Serafi, Mostafa; Buzaid, Antonio; Ghosn, Marwan

    2015-12-01

    The ACCElox registry was set up to assess therapeutic management of early-stage colon cancer with oxaliplatin/5-fluorouracil (5-FU)-based regimen and the duration of adjuvant chemotherapy in current clinical practice. This prospective observational study was conducted between 2006 and 2008 in 19 countries on 1548 newly diagnosed patients with stage II/III colon cancer, who had complete resection of the primary tumor and treated with at least one dose of oxaliplatin. The patient/disease characteristics, dose intensity, toxicity management, treatment delay and duration of disease-free survival (DFS)/relapse were assessed. About 73 and 27% of the patients were diagnosed with stage III (Dukes C) and stage II (Dukes B2) colon cancer, respectively. Overall, 74.4% patients completed the prescribed chemotherapy (FOLFOX 88%) and 97.6% patients received at least two cycles of oxaliplatin chemotherapy. The median actual dose intensity of oxaliplatin per cycle was 85 mg/m(2) . Relapse within 3 years occurred in 18.4% of patients with similar rate in all three groups (FOLFOX - 18.1%, FLOX - 19%, XELOX - 18.6%). At 3 years follow-up only 72 deaths were reported. The most common adverse events (AEs) at any cycle were neutropenia (63.9%), thrombocytopenia (23.3%), diarrhea (9.7%), sensory neuropathy (4.5%) and infection (2.6%). Disorders of central and peripheral nervous systems were frequently reported AEs at 6 months (54.3%, grade ≥1) and 12 months (36.4%, grade ≥1) of follow-up. Majority of the patients completed the prescribed oxaliplatin/5-FU regimen. There was no significant difference in the DFS among these regimens. Our results confirm the favorable benefit/risk profile of oxaliplatin/5-FU-based regimens in this setting in clinical practice. © 2015 Wiley Publishing Asia Pty Ltd.

  3. EMI Registry Design

    CERN Document Server

    Memon, S

    2011-01-01

    Grid services are the fundamental building blocks of today's Distributed Computing Infrastructures (DCI). The discovery of services in the DCI is a primary function that is a precursor to other tasks such as workload and data management. In this context, a service registry can be used to fulfil such a requirement. Existing service registries, such as the ARC Information Index or UNICORE Registry, are examples that have proven themselves in production environments. Such implementations provide a centralized service registry, however, todays DCIs, such as EGI, are based on a federation model. It is therefore necessary for the service registry to mirror such a model in order for it to seamlessly fit into the operational and management requirements - a DCI built using federated approach. This document presents an architecture for a federated service registry and a prototype based on this architecture, the EMI Registry. Special attention is given to how the federated service registry is robust to environment failu...

  4. Measuring racial microaggression in medical practice.

    Science.gov (United States)

    Almond, Amanda Lee

    2017-08-01

    The purpose of this study was to validate the already existing Racial Microaggression in Counseling Scale (RMCS) when the term 'therapist' was replaced with 'physician', thus constituting the modification as the Racial Microaggression in Medical Practice Scale (RMMPS). Racial microaggressions work at reinforcing inferior social status on a cognitive level. Unlike overt racism, messages behind microaggression are subtler and more every day. A lack of acceptance, respect, and regard emerges from interactions in medical contexts as there are layers of in-group and out-group statuses at play (e.g. physician-patient, Black-White, expert-lay, and Westernized-alternative). The layer focused on in this study was that of race or skin color. A sample of racial minorities in the Northeast (n = 91) was investigated both quantitatively and qualitatively to validate the modification and future use of a RMMPS. The scale was related to the racial incongruence between patient and provider. Qualitative findings support the original concepts and themes used when developing the 10-item measure in a counseling setting. Psychometric findings for the scale also supported its factorial structure using generalizability theory estimates. Future implications of this research relate to health behavior, trustworthiness, and health outcomes of minority patients. Its potential for use among various practitioners, educators, and researchers is also discussed.

  5. [Assessing the economic impact of cancer in Chile: a direct and indirect cost measurement based on 2009 registries].

    Science.gov (United States)

    Cid, Camilo; Herrera, Cristian; Rodríguez, Rodrigo; Bastías, Gabriel; Jiménez, Jorge

    2016-08-02

    This paper aims to determine the economic impact that cancer represents to Chile, exploring the share of costs for the most important cancers and the differences between the public and private sector. We used the cost of illness methodology, through the assessment of the direct and indirect costs associated with cancer treatment. Data was obtained from 2009 registries of the Chilean Ministry of Health and the Superintendence of Health. Indirect costs were calculated by days of job absenteeism and potential years of life lost. Over US$ 2.1 billion were spent on cancer in 2009, which represents almost 1% of Chile’s Gross Domestic Product. The direct per capita cost was US$ 47. Indirect costs were 1.92 times more than direct costs. The three types of cancer that embody the highest share of costs were gastric cancer (17.6%), breast cancer (7%) and prostate cancer (4.2%) in the public sector, and breast cancer (14%), lung cancer (7.5%) and prostate cancer (4.1%) in the private sector. On average men spent 30.33% more than women. There are few studies of this kind in Chile and the region. The country can be classified as having a cancer economic impact below the average of those in European Union countries. We expect that this information can be used to develop access policies and resource allocation decision making, and as a first step into further cancer-costing studies in Chile and the Latin American and Caribbean region.

  6. Impact of Global Economic Disparities on Practices and Outcomes of Chronic Peritoneal Dialysis in Children: Insights from the International Pediatric Peritoneal Dialysis Network Registry

    Science.gov (United States)

    Schaefer, Franz; Borzych-Duzalka, Dagmara; Azocar, Marta; Munarriz, Reyner Loza; Sever, Lale; Aksu, Nejat; Barbosa, Lorena Sànchez; Galan, Yajaira Silva; Xu, Hong; Coccia, Paula A.; Szabo, Attila; Wong, William; Salim, Rosana; Vidal, Enrico; Pottoore, Stephen; Warady, Bradley A.

    2012-01-01

    ♦ Background, Objectives, and Methods: The number of patients on chronic peritoneal dialysis (CPD) is increasing rapidly on a global scale. We analyzed the International Pediatric Peritoneal Dialysis Network (IPPN) registry, a global database active in 33 countries spanning a wide range in gross national income (GNI), to identify the impact of economic conditions on CPD practices and outcomes in children and adolescents. ♦ Results: We observed close associations of GNI with the fraction of very young patients on dialysis, the presence and number of comorbidities, the prevalence of patients with unexplained causes of end-stage kidney disease, and the rate of culture-negative peritonitis. The prevalence of automated PD increased with GNI, but was 46% even in the lowest GNI stratum. The GNI stratum also affected the use of biocompatible peritoneal dialysis fluids, enteral tube feeding, calcium-free phosphate binders, active vitamin D analogs, and erythropoiesis-stimulating agents (ESAs). Patient mortality was strongly affected by GNI (hazard ratio per $10 000: 3.3; 95% confidence interval: 2.0 to 5.5) independently of young patient age and the number of comorbidities present. Patients from low-income countries tended to die more often from infections unrelated to CPD (5 of 9 vs 15 of 61, p = 0.1). The GNI was also a strong independent predictor of standardized height (p < 0.0001), adding to the impact of congenital renal disease, anuria, age at PD start, and dialysis vintage. Patients from the lower economic strata (GNI < $18 000) had higher serum parathyroid hormone (PTH) and lower serum calcium, and achieved lower hemoglobin concentrations. No impact of GNI was observed with regard to CPD technique survival or peritonitis incidence. ♦ Conclusions: We conclude that CPD is practiced successfully, albeit with major regional variation related to economic differences, in children around the globe. The variations encompass the acceptance of very young patients and

  7. Evaluating measurement accuracy a practical approach

    CERN Document Server

    Rabinovich, Semyon G

    2017-01-01

    This book presents a systematic and comprehensive exposition of the theory of measurement accuracy and provides solutions that fill significant and long-standing gaps in the classical theory. It eliminates the shortcomings of the classical theory by including methods for estimating accuracy of single measurements, the most common type of measurement. The book also develops methods of reduction and enumeration for indirect measurements, which do not require Taylor series and produce a precise solution to this problem. It produces grounded methods and recommendations for summation of errors. The monograph also analyzes and critiques two foundation metrological documents, the International Vocabulary of Metrology (VIM) and the Guide to the Expression of Uncertainty in Measurement (GUM), and discusses directions for their revision. This new edition adds a step-by-step guide on how to evaluate measurement accuracy and recommendations on how to calculate systematic error of multiple measurements. There is also an e...

  8. Facility Registry Service (FRS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Facility Registry Service (FRS) provides an integrated source of comprehensive (air, water, and waste) environmental information about facilities across EPA,...

  9. Epidemiology and Management of Patients With Acute Coronary Syndromes in Contemporary Real-World Practice: Evolving Trends From the EYESHOT Study to the START-ANTIPLATELET Registry.

    Science.gov (United States)

    Calabrò, Paolo; Gragnano, Felice; di Maio, Marco; Patti, Giuseppe; Antonucci, Emilia; Cirillo, Plinio; Gresele, Paolo; Palareti, Gualtiero; Pengo, Vittorio; Pignatelli, Pasquale; Pennacchi, Mauro; Granatelli, Antonino; De Servi, Stefano; De Luca, Leonardo; Marcucci, Rossella

    2018-01-01

    The epidemiology and management of patients with acute coronary syndromes (ACSs) have evolved. We aimed to describe recent demographics and therapeutic changes in the Italian ACS population. We analyzed data from 2 multicenter consecutive Italian registries (the EYESHOT [EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalised in iTalian cardiac care units] and START-ANTIPLATELET registries) enrolling patients with ACS between December 2013 and June 2016. An overall population of 3756 patients with ACS was enrolled: 2585 in the EYESHOT and 1171 in the START-ANTIPLATELET. Compared with the EYESHOT, patients in the START-ANTIPLATELET registry presented more frequently with ST-segment elevation myocardial infarction and were more often smokers and dyslipidemic (all P START-ANTIPLATELET (all P START-ANTIPLATELET compared with the EYESHOT. The START-ANTIPLATELET and EYESHOT registries provide consecutive snapshots in the contemporary management of patients with ACS in Italy, showing important changes in both demographic characteristics and treatment strategies.

  10. Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension : Insights from the Global TOPP Registry (tracking outcomes and practice in paediatric pulmonary hypertension)

    NARCIS (Netherlands)

    Beghetti, M.; Schulze-Neick, I.; Berger, R. M. F.; Ivy, D. D.; Bonnet, D.; Weintraub, R. G.; Saji, T.; Yung, D.; Mallory, G. B.; Geiger, R.; Berger, J. T.; Barst, R. J.; Humpl, T.; Mattos, S.; Jing, Z. C.; Han, Z. Y.; Sondergaard, L.; Jensen, T.; Levy, M.; Mebus, S.; Apitz, Ch.; Szatmari, A.; Ablonczy, L.; Milanesi, O.; Favero, V.; Pulido, T.; De La Garza, P.; Douwes, J. M.; Brun, H.; Moll, L.; Michalak, K.; Kawalec, W.; Zuk, M.; Boillat, M. Fasnacht; Olgunturk, R.; Kula, S. Serdar; Alehan, D.; Day, R. W.; Austin, E.; Moore, D. J.; Atz, A. M.; Feinstein, J. A.

    2016-01-01

    Background: The TOPP Registry has been designed to provide epidemiologic, diagnostic, clinical, and outcome data on children with pulmonary hypertension (PH) confirmed by heart catheterisation (HC). This study aims to identify important characteristics of the haemodynamic profile at diagnosis and HC

  11. Impact of global economic disparities on practices and outcomes of chronic peritoneal dialysis in children: insights from the International Pediatric Peritoneal Dialysis Network Registry

    NARCIS (Netherlands)

    Schaefer, Franz; Borzych-Duzalka, Dagmara; Azocar, Marta; Munarriz, Reyner Loza; Sever, Lale; Aksu, Nejat; Barbosa, Lorena Sànchez; Galan, Yajaira Silva; Xu, Hong; Coccia, Paula A.; Szabo, Attila; Wong, William; Salim, Rosana; Vidal, Enrico; Pottoore, Stephen; Warady, Bradley A.; Alconcher, L.; Sojo, E.; Coccia, P. A.; Suarez, A.; Valles, P. G.; Salim, R.; Salta, S. A.; van Hoeck, K.; Koch, V.; Feber, J.; Geary, D. A.; White, C.; Valenzuela, M.; Villagra, J.; Cano, F.; Contreras, M. A.; Vogel, A.; Zambrano, P.; Berrocal, P.; Tse, K. C.; Xu, H.; Vondrak, K.; Rönnholm, K.; Harambat, J.; Ranchin, B.; Roussey, G.; Ulinski, T.; Fischbach, M.; Büscher, R.; Kemper, M.; Pape, L.; Schaefer, F.; Borzych, D.; Groothoff, J. W.

    2012-01-01

    BACKGROUND, OBJECTIVES, AND METHODS: The number of patients on chronic peritoneal dialysis (CPD) is increasing rapidly on a global scale. We analyzed the International Pediatric Peritoneal Dialysis Network (IPPN) registry, a global database active in 33 countries spanning a wide range in gross

  12. Practical use of natriuretic peptide measurement

    DEFF Research Database (Denmark)

    Husby, Simon; Lind, Bent; Goetze, Jens P

    2012-01-01

    To elucidate the knowledge regarding B-type natriuretic peptide (BNP)/N-terminal proBNP (NT-proBNP) measurement among doctors using this biomarker.......To elucidate the knowledge regarding B-type natriuretic peptide (BNP)/N-terminal proBNP (NT-proBNP) measurement among doctors using this biomarker....

  13. Electrical measurements in the laboratory practice

    CERN Document Server

    Bartiromo, Rosario

    2016-01-01

    This book covers the basic theory of electrical circuits, describes analog and digital instrumentation, and applies modern methods to evaluate uncertainties in electrical measurements. It is comprehensive in scope and is designed specifically to meet the needs of students in physics and electrical engineering who are attending laboratory classes in electrical measurements. The topics addressed in individual chapters include the analysis of continuous current circuits; sources of measurement uncertainty and their combined effect; direct current measurements; analysis of alternating current circuits; special circuits including resonant circuits, frequency filters and impedance matching networks; alternating current measurements; analog and digital oscilloscopes; non-sinusoidal waveforms and circuit excitation by pulses; distributed parameter components and transmission lines. Each chapter is equipped with a number of problems. A special appendix describes a series of nine experiments, in each case providing a p...

  14. A review of national shoulder and elbow joint replacement registries

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe V; Olsen, Bo S; Fevang, Bjørg-Tilde S

    2012-01-01

    The aim was to review the funding, organization, data handling, outcome measurements, and findings from existing national shoulder and elbow joint replacement registries; to consider the possibility of pooling data between registries; and to consider wether a pan european registry might be feasible....

  15. Loeb measures in practice recent advances

    CERN Document Server

    Cutland, Nigel J

    2000-01-01

    This expanded version of the 1997 European Mathematical Society Lectures given by the author in Helsinki, begins with a self-contained introduction to nonstandard analysis (NSA) and the construction of Loeb Measures, which are rich measures discovered in 1975 by Peter Loeb, using techniques from NSA. Subsequent chapters sketch a range of recent applications of Loeb measures due to the author and his collaborators, in such diverse fields as (stochastic) fluid mechanics, stochastic calculus of variations ("Malliavin" calculus) and the mathematical finance theory. The exposition is designed for a general audience, and no previous knowledge of either NSA or the various fields of applications is assumed.

  16. Neutron energy measurement for practical applications

    Indian Academy of Sciences (India)

    M V Roshan

    2018-02-07

    . Elastic scattering of monoenergetic α-particles from neutron collision enables neutron energy measurement by calculating the amount of deviation from the position where collision takes place. The neutron numbers with ...

  17. Some practical aspects of peak kilovoltage measurements

    International Nuclear Information System (INIS)

    Irfan, A.Y.; Pugh, V.I.; Jeffery, C.D.

    1985-01-01

    The peak kilovoltage (kVsub(p)) across the X-ray tube electrodes in diagnostic X-ray machines is a most important parameter, affecting both radiation output and beam quality. Four commercially available non-invasive devices used for kVsub(p) measurement were tested using a selection of generator waveforms. The majority of the devices provided satisfactory measurements of the kVsub(p) to within approximately +- kV provided certain operating conditions are observed. (U.K.)

  18. Neutron energy measurement for practical applications

    Science.gov (United States)

    Roshan, M. V.; Sadeghi, H.; Ghasabian, M.; Mazandarani, A.

    2018-03-01

    Industrial demand for neutrons constrains careful energy measurements. Elastic scattering of monoenergetic α -particles from neutron collision enables neutron energy measurement by calculating the amount of deviation from the position where collision takes place. The neutron numbers with specific energy is obtained by counting the number of α -particles in the corresponding location on the charged particle detector. Monte Carlo simulation and COMSOL Multiphysics5.2 are used to account for one-to-one collision of neutrons with α -particles.

  19. Measuring Changes in the Economics of Medical Practice.

    Science.gov (United States)

    Fleming, Christopher; Rich, Eugene; DesRoches, Catherine; Reschovsky, James; Kogan, Rachel

    2015-08-01

    For the latter third of the twentieth century, researchers have estimated production and cost functions for physician practices. Today, those attempting to measure the inputs and outputs of physician practice must account for many recent changes in models of care delivery. In this paper, we review practice inputs and outputs as typically described in research on the economics of medical practice, and consider the implications of the changing organization of medical practice and nature of physician work. This evolving environment has created conceptual challenges in what are the appropriate measures of output from physician work, as well as what inputs should be measured. Likewise, the increasing complexity of physician practice organizations has introduced challenges to finding the appropriate data sources for measuring these constructs. Both these conceptual and data challenges pose measurement issues that must be overcome to study the economics of modern medical practice. Despite these challenges, there are several promising initiatives involving data sharing at the organizational level that could provide a starting point for developing the needed new data sources and metrics for physician inputs and outputs. However, additional efforts will be required to establish data collection approaches and measurements applicable to smaller and single specialty practices. Overcoming these measurement and data challenges will be key to supporting policy-relevant research on the changing economics of medical practice.

  20. EMI Registry Development Plan

    CERN Document Server

    Memon, S.; Szigeti, G.; Field, L.

    2012-01-01

    This documents describes the overall development plan of the EMI Registry product, the plan focuses on the realisation of the EMI Registry specification as defined in the document. It is understood that during the course of the development phase the specification will likely evolve and the changes will be fed into the specification document.

  1. The Qingdao Twin Registry

    DEFF Research Database (Denmark)

    Duan, Haiping; Ning, Feng; Zhang, Dongfeng

    2013-01-01

    In 1998, the Qingdao Twin Registry was initiated as the main part of the Chinese National Twin Registry. By 2005, a total of 10,655 twin pairs had been recruited. Since then new twin cohorts have been sampled, with one longitudinal cohort of adolescent twins selected to explore determinants of me...

  2. Dementia registries around the globe and their applications: A systematic review.

    Science.gov (United States)

    Krysinska, Karolina; Sachdev, Perminder S; Breitner, John; Kivipelto, Miia; Kukull, Walter; Brodaty, Henry

    2017-09-01

    Patient registries are valuable tools helping to address significant challenges in research, care, and policy. Registries, well embedded in many fields of medicine and public health, are relatively new in dementia. This systematic review presents the current situation in regards to dementia registries worldwide. We identified 31 dementia registries operating on an international, national, or local level between 1986 and 2016. More than half of the registries aimed to conduct or facilitate research, including preclinical research registries and registries recruiting research volunteers. Other dementia registries collected epidemiological or quality of care data. We present evidence of practical and economic outcomes of registries for research, clinical practice and policy, and recommendations for future development. Global harmonization of recruitment methods and minimum data would facilitate international comparisons. Registries provide a positive return on investment; their establishment and maintenance require ongoing support by government, policy makers, research funding bodies, clinicians, and individuals with dementia and their caregivers. Copyright © 2017 the Alzheimer's Association. All rights reserved.

  3. Blood lipid measurements. Variations and practical utility.

    Science.gov (United States)

    Cooper, G R; Myers, G L; Smith, S J; Schlant, R C

    1992-03-25

    To describe the magnitude and impact of the major biological and analytical sources of variation in serum lipid and lipoprotein levels on risk of coronary heart disease; to present a way to qualitatively estimate the total intraindividual variation; and to demonstrate how to determine the number of specimens required to estimate, with 95% confidence, the "true" underlying total cholesterol value in the serum of a patient. Representative references on each source of variation were selected from more than 300 reviewed publications, most published within the past 5 years, to document current findings and concepts. Most articles reviewed were in English. Studies on biological sources of variation were selected using the following criteria: representative of published findings, clear statement of either significant or insignificant results, and acquisition of clinical and laboratory data under standardized conditions. Representative results for special populations such as women and children are reported when results differ from those of adult men. References were selected based on acceptable experimental design and use of standardized laboratory lipid measurements. The lipid levels considered representative for a selected source of variation arose from quantitative measurements by a suitably standardized laboratory. Statistical analysis of data was examined to assure reliability. The proposed method of estimating the biological coefficient of variation must be considered to give qualitative results, because only two or three serial specimens are collected in most cases for the estimation. Concern has arisen about the magnitude, impact, and interpretation of preanalytical as well as analytical sources of variation on reported results of lipid measurements of an individual. Preanalytical sources of variation from behavioral, clinical, and sampling sources constitute about 60% of the total variation in a reported lipid measurement of an individual. A technique is presented

  4. Statewide Quality Improvement Initiative to Reduce Early Elective Deliveries and Improve Birth Registry Accuracy.

    Science.gov (United States)

    Kaplan, Heather C; King, Eileen; White, Beth E; Ford, Susan E; Fuller, Sandra; Krew, Michael A; Marcotte, Michael P; Iams, Jay D; Bailit, Jennifer L; Bouchard, Jo M; Friar, Kelly; Lannon, Carole M

    2018-04-01

    To evaluate the success of a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data accuracy rapidly and at scale in Ohio. Between February 2013 and March 2014, participating hospitals were involved in a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data. This initiative was designed as a learning collaborative model (group webinars and a single face-to-face meeting) and included individual quality improvement coaching. It was implemented using a stepped wedge design with hospitals divided into three balanced groups (waves) participating in the initiative sequentially. Birth registry data were used to assess hospital rates of nonmedically indicated inductions at less than 39 weeks of gestation. Comparisons were made between groups participating and those not participating in the initiative at two time points. To measure birth registry accuracy, hospitals conducted monthly audits comparing birth registry data with the medical record. Associations were assessed using generalized linear repeated measures models accounting for time effects. Seventy of 72 (97%) eligible hospitals participated. Based on birth registry data, nonmedically indicated inductions at less than 39 weeks of gestation declined in all groups with implementation (wave 1: 6.2-3.2%, Pinitiative, they saw significant decreases in rates of early elective deliveries as compared with wave 3 (control; P=.018). All waves had significant improvement in birth registry accuracy (wave 1: 80-90%, P=.017; wave 2: 80-100%, P=.002; wave 3: 75-100%, Pinitiative enabled statewide spread of change strategies to decrease early elective deliveries and improve birth registry accuracy over 14 months and could be used for rapid dissemination of other evidence-based obstetric care practices across states or hospital systems.

  5. Measures for assessing practice change in medical practitioners.

    Science.gov (United States)

    Hakkennes, Sharon; Green, Sally

    2006-12-06

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

  6. Patient Satisfaction Measurement in Occupational and Environmental Medicine Practice.

    Science.gov (United States)

    Drury, David L; Adamo, Philip; Cloeren, Marianne; Hegmann, Kurt T; Martin, Douglas W; Levine, Michael J; Olson, Shawn M; Pransky, Glenn S; Tacci, James A; Thiese, Matthew

    2018-05-01

    : High patient satisfaction is a desirable goal in medical care. Patient satisfaction measures are increasingly used to evaluate and improve quality in all types of medical practices. However, the unique aspects of occupational and environmental medicine (OEM) practice require development of OEM-specific measures and thoughtful interpretation of results. The American College of Occupational and Environmental Medicine has developed and recommends a set of specific questions to measure patient satisfaction in OEM, designed to meet anticipated regulatory requirements, facilitate quality improvement of participating OEM practices, facilitate case-management review, and offer fair and accurate assessment of OEM physicians.

  7. [Trauma registry and injury].

    Science.gov (United States)

    Shapira, S C

    2001-10-01

    The trauma registry network constitutes an essential database in every injury prevention system. In order to rationally estimate the extent of injury in general, and injuries from traffic accidents in particular, the trauma registry systems should contain the most comprehensive and broad database possible, in line with the operational definitions. Ideally, the base of the injury pyramid should also include mild injuries and even "near-misses". The Israeli National Trauma Registry has come a long way in the last few years. The eventual inclusion of all trauma centers in Israel will enable the establishment of a firm base for the allocation of resources by decision-makers.

  8. Danish Registry of Childhood and Adolescent Diabetes

    DEFF Research Database (Denmark)

    Svensson, Jannet; Cerqueira, Charlotte; Kjærsgaard, Per

    2016-01-01

    children diagnosed with diabetes before the age of 15 years since 1996. Since 2015, every child followed up at a pediatric center (years of age) will be included. MAIN VARIABLES: The variables in the registry are the quality indicators, demographic variables, associated conditions, diabetes......, neuropathy, number of severe hypoglycemic events, and hospitalization with ketoacidosis. DESCRIPTIVE DATA: The number of children diagnosed with diabetes is increasing with ∼3% per year mainly for type 1 diabetes (ie, 296 new patients years of age were diagnosed in 2014). The disease management has...... classification, family history of diabetes, growth parameters, self-care, and treatment variables. The quality indicators are selected based on international consensus of measures of good clinical practice. The indicators are metabolic control as assessed by HbA1c, blood pressure, albuminuria, retinopathy...

  9. Practical measurement of affordability: An application to medicines

    NARCIS (Netherlands)

    L.M. Niëns (Laurens); E. Van de Poel (Ellen); A. Cameron (ALexandra); M. Ewen (Margaret); R. Laing (Richard); W.B.F. Brouwer (Werner)

    2012-01-01

    markdownabstract__Objective:__ To develop two practical methods for measuring the affordability of medicines in developing countries. __Methods:__ The proposed methods - catastrophic and impoverishment methods - rely on easily accessible aggregated expenditure data and take into account a

  10. Errors in practical measurement in surveying, engineering, and technology

    International Nuclear Information System (INIS)

    Barry, B.A.; Morris, M.D.

    1991-01-01

    This book discusses statistical measurement, error theory, and statistical error analysis. The topics of the book include an introduction to measurement, measurement errors, the reliability of measurements, probability theory of errors, measures of reliability, reliability of repeated measurements, propagation of errors in computing, errors and weights, practical application of the theory of errors in measurement, two-dimensional errors and includes a bibliography. Appendices are included which address significant figures in measurement, basic concepts of probability and the normal probability curve, writing a sample specification for a procedure, classification, standards of accuracy, and general specifications of geodetic control surveys, the geoid, the frequency distribution curve and the computer and calculator solution of problems

  11. Data Element Registry Services

    Data.gov (United States)

    U.S. Environmental Protection Agency — Data Element Registry Services (DERS) is a resource for information about value lists (aka code sets / pick lists), data dictionaries, data elements, and EPA data...

  12. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten; Maagaard, Niels

    2016-01-01

    Danish Hip Arthroscopy Registry (DHAR) was initiated in 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the epidemiologic and perioperative data of the first 2000 procedures in a Danish hip arthroscopy population and to describe the development of DHAR...... was 0.65 and HAGOS sub-scores were 51 (pain), 49 (symptoms), 53 (ADL), 35 (sport), 20 (physical activity) and 29, respectively. We conclude that patients undergoing hip arthroscopy report considerable pain, loss of function, reduced level of activity and reduced quality-of-life prior to surgery....... The problems with development and maintaining a large clinical registry are described and further studies are needed to validate data completeness. We consider the development of a national clinical registry for hip arthroscopy as a successful way of developing and maintaining a valuable clinical...

  13. 911 Master PSAP Registry

    Data.gov (United States)

    Federal Communications Commission — Updated as of 5Oct2017. The Registry lists PSAPs by an FCC assigned identification number, PSAP Name, State, County, City, and provides information on any type of...

  14. Danish Registry of Childhood and Adolescent Diabetes

    Directory of Open Access Journals (Sweden)

    Svensson J

    2016-10-01

    Full Text Available Jannet Svensson,1 Charlotte Cerqueira,2 Per Kjærsgaard,3 Lene Lyngsøe,4 Niels Thomas Hertel,5 Mette Madsen,6 Henrik B Mortensen,1 Jesper Johannesen1 1Pediatric and Adolescent Department, Copenhagen University Hospital, Herlev and Gentofte, Herlev, 2Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, 3Pediatric Department, County Hospital Herning, Herning, 4Pediatric and Adolescent Department, Nordsjællands Hospital, Hillerød, 5HC Andersen Childrens Hospital, Odense University Hospital, Odense, 6Pediatric Department, Aalborg University Hospital, Aalborg, Denmark Aim: The aims of the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids are to monitor and improve the quality of care for children and adolescents with diabetes in Denmark and to follow the incidence and prevalence of diabetes. Study population: The study population consists of all children diagnosed with diabetes before the age of 15 years since 1996. Since 2015, every child followed up at a pediatric center (<18 years of age will be included. Main variables: The variables in the registry are the quality indicators, demographic variables, associated conditions, diabetes classification, family history of diabetes, growth parameters, self-care, and treatment variables. The quality indicators are selected based on international consensus of measures of good clinical practice. The indicators are metabolic control as assessed by HbA1c, blood pressure, albuminuria, retinopathy, neuropathy, number of severe hypoglycemic events, and hospitalization with ketoacidosis. Descriptive data: The number of children diagnosed with diabetes is increasing with ~3% per year mainly for type 1 diabetes (ie, 296 new patients <15 years of age were diagnosed in 2014. The disease management has changed dramatically with more children treated intensively with multiple daily injections, insulin pumps

  15. On the Current Measurement Practices in Agile Software Development

    OpenAIRE

    Javdani, Taghi; Zulzalil, Hazura; Ghani, Abdul Azim Abd; Sultan, Abu Bakar Md; Parizi, Reza Meimandi

    2013-01-01

    Agile software development (ASD) methods were introduced as a reaction to traditional software development methods. Principles of these methods are different from traditional methods and so there are some different processes and activities in agile methods comparing to traditional methods. Thus ASD methods require different measurement practices comparing to traditional methods. Agile teams often do their projects in the simplest and most effective way so, measurement practices in agile metho...

  16. SveDem, the Swedish Dementia Registry - a tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice.

    Directory of Open Access Journals (Sweden)

    Dorota Religa

    Full Text Available The Swedish Dementia Registry (SveDem was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden.SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se. The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes.The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007-2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden.SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses.

  17. Practical application of the theory of errors in measurement

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    This chapter addresses the practical application of the theory of errors in measurement. The topics of the chapter include fixing on a maximum desired error, selecting a maximum error, the procedure for limiting the error, utilizing a standard procedure, setting specifications for a standard procedure, and selecting the number of measurements to be made

  18. Measures for assessing practice change in medical practitioners

    Directory of Open Access Journals (Sweden)

    Green Sally

    2006-12-01

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

  19. Practical aspects of tritium measurement in ground and surface waters

    Energy Technology Data Exchange (ETDEWEB)

    Nitzsche, O [Technische Univ. Bergakademie Freiberg (Germany). Inst. fuer Angewandte Physik; Hebert, D [Technische Univ. Bergakademie Freiberg (Germany). Inst. fuer Angewandte Physik

    1997-03-01

    Tritium measurements are a powerful tool in hydrological and hydrogeological investigations for detecting mean residence times of several water reservoirs. Due to the low tritium activities in precipitation, ground and surface waters a low level measurement is necessary. Therefore often the liquid scintillation counting after an electrolytic enrichment of water is used. In this paper some practical aspects and problems of measurement are discussed and the problem of contamination in low level laboratories is shown. (orig.)

  20. Measures of Rheumatoid Arthritis Disease Activity in Australian Clinical Practice

    OpenAIRE

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological...

  1. Thrombosis of second-generation drug-eluting stents in real practice results from the multicenter Spanish registry ESTROFA-2 (Estudio Español Sobre Trombosis de Stents Farmacoactivos de Segunda Generacion-2).

    Science.gov (United States)

    de la Torre Hernández, José M; Alfonso, Fernando; Gimeno, Federico; Diarte, Jose A; Lopez-Palop, Ramón; Pérez de Prado, Armando; Rivero, Fernando; Sanchis, Juan; Larman, Mariano; Diaz, Jose F; Elizaga, Jaime; Moreiras, Javier Martín; Gomez Jaume, Alfredo; Hernández, José M; Mauri, Josepa; Recalde, Angel Sánchez; Bullones, Juan A; Rumoroso, Jose R; Del Blanco, Bruno García; Baz, Jose A; Bosa, Francisco; Botas, Javier; Hernández, Felipe

    2010-09-01

    This study sought to evaluate second-generation drug-eluting stent (DES) thrombosis in clinical practice. First-generation DES are associated with a significant incidence of late thrombosis. There is paucity of data regarding real practice late thrombosis incidence and predictors with second-generation DES, zotarolimus-eluting stent (ZES), and everolimus-eluting stents (EES). A prospective, large-scale, non-industry-linked multicenter registry was designed. Complete clinical-procedural data and systematic follow-up of all patients treated with these stents was reported in a dedicated registry supported by the Spanish Working Group on Interventional Cardiology. From 2005 to 2008, 4,768 patients were included in 34 centers: 2,549 treated with ZES, and 2,219 with EES. The cumulative incidence of definite/probable thrombosis for ZES was 1.3% at 1 year and 1.7% at 2 years and for EES 1.4% at 1 year and 1.7% at 2 years (p = 0.8). The increment of definite thrombosis between the first and second year was 0.2% and 0.25%, respectively. In a propensity score analysis, the incidence remained very similar. Ejection fraction (adjusted hazard ratio [HR]: 0.97; 95% confidence interval [CI]: 0.95 to -0.99; p = 0.008), stent diameter (adjusted HR: 0.37; 95% CI: 0.17to 0.81; p = 0.01) and bifurcations (adjusted HR: 2.1; 95% CI: 1.14 to 3.7; p = 0.02) emerged as independent predictors of thrombosis. In the subgroup of patients with bifurcations, the use of ZES was independently associated with a higher thrombosis rate (adjusted HR: 4; 95% CI: 1.1 to 13; p = 0.03). In a real practice setting, the incidence of thrombosis at 2 years with ZES and EES was low and quite similar. The incidence of very late thrombosis resulted lower than was reported in registries of first-generation DES. In the subset of bifurcations, the use of ZES significantly increased the risk of thrombosis. Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. The Danish Heart Registry

    DEFF Research Database (Denmark)

    Özcan, Cengiz; Juel, Knud; Lassen, Jens Flensted

    2016-01-01

    AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...... undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. MAIN VARIABLES: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR...

  3. The Western Denmark Heart Registry

    DEFF Research Database (Denmark)

    Schmidt, Morten; Maeng, Michael; Madsen, Morten

    2018-01-01

    The WDHR (Western Denmark Heart Registry) is a seminational, multicenter-based registry with longitudinal registration of detailed patient and procedure data since 1999. The registry includes as of January 1, 2017 approximately 240,000 coronary angiographies, 90,000 percutaneous coronary interven......The WDHR (Western Denmark Heart Registry) is a seminational, multicenter-based registry with longitudinal registration of detailed patient and procedure data since 1999. The registry includes as of January 1, 2017 approximately 240,000 coronary angiographies, 90,000 percutaneous coronary...

  4. ISHKS joint registry: A preliminary report.

    Science.gov (United States)

    Pachore, Jawahir A; Vaidya, Shrinand V; Thakkar, Chandrasekhar J; Bhalodia, Haresh Kumar P; Wakankar, Hemant M

    2013-09-01

    Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are the most widely practiced surgical options for arthritis all over the world and its application is rising in India. Indian Society of Hip and Knee Surgeons (ISHKS) has established a joints registry and has been collecting data for last 6 years. All members of ISHKS are encouraged to actively participate in the registry. A simple two page knee and hip form can be downloaded from the website www.ishks.com. The information collected includes patient demographics, indication for surgery, implant details and in case of revision arthroplasty: the details of implants removed and the cause of failure of primary arthroplasty. These forms are mailed to the central registry office and the data is fed in computerized registry. Data collection started in October 2006. Joint registry is a very important initiative of ISHKS and till date, have data of 34,478 TKAs and 3604 THAs, contributed by 42 surgeons across India. Some important observations have emerged. Data of 34,478 TKAs was assessed: These included 8612 males (25%) and 25,866 females (75%). Average age was 64.4 years (Osteoarthritis range: 45 to 88 years; Rheumatoid arthritis range: 22 to 74 years). Average body mass index was 29.1 (Range: 18.1 to 42.9). The indication for TKA was osteoarthritis in 33,444 (97%) and rheumatoid arthritis in 759 (2.2%). Total of 3604 THA procedures were recorded. These included 2162 (60%) male patients and 1442 (40%) female patients. Average age was 52 years (Range 17 to 85 years) and average BMI was 25.8 (Range: 17.3 to 38.5). The indications for THA was AVN in 49%. The registry will become more meaningful in years to come. Active participation of all arthroplasty surgeons across India is vital for the success of the joints registry.

  5. Accounting in Agriculture: Measurement practices of listed firms

    OpenAIRE

    Rute Gonçalves; Patrícia Lopes

    2015-01-01

    Based on the International Accounting Standard (IAS) 41 – Agriculture, this paper examines measurement practices of biological assets and their drivers, under accounting choice theory, given data from 2012. Taking into consideration 324 listed firms worldwide that have adopted International Financial Reporting Standards (IFRS) until 2011, the empirical evidence supports that while a large number of firms measures biological assets at fair value, there are others that refute the presumption of...

  6. Cancer Registry Data

    Centers for Disease Control (CDC) Podcasts

    2017-05-24

    Dr. Loria Pollack, a Senior Medical Epidemiologist, talks about the importance of cancer registry data to understanding how cancer affects the United States–now and in the future.  Created: 5/24/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/24/2017.

  7. Danish Hip Arthroscopy Registry

    DEFF Research Database (Denmark)

    Mygind-Klavsen, Bjarne; Lund, Bent; Nielsen, Torsten Grønbech

    2018-01-01

    PURPOSE: Predictors of outcome after femoroacetabular impingement (FAI) surgery are not well-documented. This study presents data from the Danish Hip Arthroscopy Registry (DHAR) for such analyses. The purpose of this study was to identify predictors of poor outcome after FAI surgery in a Danish FAI...

  8. The Danish Twin Registry

    DEFF Research Database (Denmark)

    Skytthe, Axel; Ohm Kyvik, Kirsten; Vilstrup Holm, Niels

    2011-01-01

    Introduction: The Danish Twin Registry is a unique source for studies of genetic, familial and environmental factors on life events, health conditions and diseases. Content: More than 85,000 twin pairs born 1870-2008 in Denmark. Validity and coverage: Four main ascertainment methods have been emp...

  9. Measuring the Impact of Communities of Practice: A Conceptual model

    NARCIS (Netherlands)

    dr. Donald Ropes

    2011-01-01

    Communities of practice (CoPs) impact different actors in different ways. Because using a singular approach would not do justice to the complexity that surrounds CoPs, a multi-disciplinary and pluralistic approach is used here to develop a model for measuring the impact CoPs may have on individuals,

  10. Measures of rheumatoid arthritis disease activity in Australian clinical practice.

    Science.gov (United States)

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological agent for rheumatoid arthritis. Disease activity measures and radiographic assessments were collected from each patient's last consultation. For biologic patients, disease activity measures were also collected from when the patient was first initiated on the biological agent. Results. At last consultation, the disease measures that were recorded most often were ESR (89.2%), haemoglobin (87.5%), and CRP (84.2%). DAS28 was infrequently recorded (16.3%). The rate of recording disease activity measures for patients receiving biologic DMARDs decreased over time (mean 27 months). Conclusion. This review has shown inconsistency of RA activity measures being recorded in Australian rheumatology clinical practice. An accurate assessment of the disease process is necessary to effectively target rheumatoid arthritis patients to treat in order to achieve optimal outcomes.

  11. Artificial Nutritional Support Registries: systematic review.

    Science.gov (United States)

    Castelló-Botía, I; Wanden-Berghe, C; Sanz-Valero, J

    2009-01-01

    The nutritional registries are data bases through which we obtain the information to understand the nutrition of populations. Several main nutrition societies of the world have these types of registries, outstanding the NADYA (Home artificial and Ambulatory nutrition) group in Spain. The object of this study is to determine by means of a systematic review, the existent scientific production in the international data bases referred to nutritional support registries. Descriptive transversal study of the results of a critical bibliographic research done in the bioscience data bases: MEDLINE, EMBASE, The Cochrane Library, ISI (Web of Sciences), LILACS, CINHAL. A total of 20 original articles related to nutritional registries were found and recovered. Eleven registries of eight countries were identified: Australia, Germany, Italy, Japan, Spain, Sweden, United Status and United Kingdom. The Price Index was of 65% and all the articles were published in the last 20 years. The Price Index highlights the innovativeness of this practice. The articles related to nutritional support are heterogeneous with respect to data and population, which exposes this as a limitation for a combined analysis.

  12. The EuroMyositis registry

    DEFF Research Database (Denmark)

    Lilleker, James B; Vencovsky, Jiri; Wang, Guochun

    2018-01-01

    AIMS: The EuroMyositis Registry facilitates collaboration across the idiopathic inflammatory myopathy (IIM) research community. This inaugural report examines pooled Registry data. METHODS: Cross-sectional analysis of IIM cases from 11 countries was performed. Associations between clinical subtyp...

  13. Improving Diabetes Outcomes Using a Web-Based Registry and Interactive Education: A Multisite Collaborative Approach

    Science.gov (United States)

    Morrow, Robert W.; Fletcher, Jason; Kelly, Kim F.; Shea, Laura A.; Spence, Maureen M.; Sullivan, Janet N.; Cerniglia, Joan R.; Yang, YoonJung

    2013-01-01

    Introduction: To support the adoption of guideline concordant care by primary care practices, the New York Diabetes Coalition (NYDC) promoted use of an electronic diabetes registry and developed an interactive educational module on using the registry and improving patient communication. The NYDC hypothesized that use of a registry with immediate…

  14. Clinical features of paediatric pulmonary hypertension : a registry study

    NARCIS (Netherlands)

    Berger, Rolf M. F.; Beghetti, Maurice; Humpl, Tilman; Raskob, Gary E.; Ivy, D. Dunbar; Jing, Zhi-Cheng; Bonnet, Damien; Schulze-Neick, Ingram; Barst, Robyn J.

    2012-01-01

    Background Paediatric pulmonary hypertension, is an important cause of morbidity and mortality, and is insufficiently characterised in children. The Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension (TOPP) registry is a global, prospective study designed to provide information about

  15. Practical Use of the Braking Attributes Measurements Results

    Directory of Open Access Journals (Sweden)

    Ondruš Ján

    2017-01-01

    Full Text Available This contribution deals with issues of braking the passenger car. The measurement of braking deceleration of the vehicle Kia Cee´d 1,6 16 V was carried out by an optical device Correvit system. The measurement was carried out on the airport of the village of Rosina located close to Zilina. 10 drivers of different age, praxis, and kilometers driven participated in the measurement. The measured process was the vehicle full braking with the service brake of the initial speed of approximately 50 km.h-1. Each of the drivers had 10 attempts. In the closure of this contribution the results of the performed measurements, their evaluation and comparison are presented. Practical result from the contribution is mainly the measurement set of braking deceleration of the respective vehicle during intensive braking.

  16. Best practices for measuring students' attitudes toward learning science.

    Science.gov (United States)

    Lovelace, Matthew; Brickman, Peggy

    2013-01-01

    Science educators often characterize the degree to which tests measure different facets of college students' learning, such as knowing, applying, and problem solving. A casual survey of scholarship of teaching and learning research studies reveals that many educators also measure how students' attitudes influence their learning. Students' science attitudes refer to their positive or negative feelings and predispositions to learn science. Science educators use attitude measures, in conjunction with learning measures, to inform the conclusions they draw about the efficacy of their instructional interventions. The measurement of students' attitudes poses similar but distinct challenges as compared with measurement of learning, such as determining validity and reliability of instruments and selecting appropriate methods for conducting statistical analyses. In this review, we will describe techniques commonly used to quantify students' attitudes toward science. We will also discuss best practices for the analysis and interpretation of attitude data.

  17. Process-oriented performance indicators for measuring ecodesign management practices

    DEFF Research Database (Denmark)

    Rodrigues, Vinicius Picanco; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

    2016-01-01

    In order to support ecodesign performance measurement from a business perspective, this paper performs an exploration of available process-oriented indicators to be applied to ecodesign management practices. With the Ecodesign Maturity Model as a background framework, a systematic literature review...... coupled with a cross-content analysis was carried out to assign proper indicators to the practices. Results show that the currently available indicators do not fully reflect the characteristics of ecodesign and there is significant room for improving the development of tailor-made indicators....

  18. Assessment and Reporting of Driving Fitness in Patients with Dementia in Clinical Practice: Data from SveDem, the Swedish Dementia Registry.

    Science.gov (United States)

    Lovas, Joel; Fereshtehnejad, Seyed-Mohammad; Cermakova, Pavla; Lundberg, Catarina; Johansson, Björn; Johansson, Kurt; Winblad, Bengt; Eriksdotter, Maria; Religa, Dorota

    2016-05-05

    Driving constitutes a very important aspect of daily life and is dependent on cognitive functions such as attention, visuo-spatial skills and memory, which are often compromised in dementia. Therefore, the driving fitness of patients with dementia needs to be addressed by physicians and those that are deemed unfit should not be allowed to continue driving. We aimed at investigating to what extent physicians assess driving fitness in dementia patients and determinant factors for revoking of their licenses. This study includes 15113 patients with newly diagnosed dementia and driver's license registered in the Swedish Dementia Registry (SveDem). The main outcomes were reporting to the licensing authority and making an agreement about driving eligibility with the patients. Physicians had not taken any action in 16% of dementia patients, whereas 9% were reported to the authority to have their licenses revoked. Males (OR = 3.04), those with an MMSE score between 20-24 (OR = 1.35) and 10-19 (OR = 1.50), patients with frontotemporal (OR = 3.09) and vascular dementia (OR = 1.26) were more likely to be reported to the authority. For the majority of patients with dementia, driving fitness was assessed. Nevertheless, physicians did not address the issue in a sizeable proportion of dementia patients. Type of dementia, cognitive status, age, sex and burden of comorbidities are independent factors associated with the assessment of driving fitness in patients with dementia. Increased knowledge on how these factors relate to road safety may pave the way for more specific guidelines addressing the issue of driving in patients with dementia.

  19. Nordic registry-based cohort studies: Possibilities and pitfalls when combining Nordic registry data.

    Science.gov (United States)

    Maret-Ouda, John; Tao, Wenjing; Wahlin, Karl; Lagergren, Jesper

    2017-07-01

    All five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have nationwide registries with similar data structure and validity, as well as personal identity numbers enabling linkage between registries. These resources provide opportunities for medical research that is based on large registry-based cohort studies with long and complete follow-up. This review describes practical aspects, opportunities and challenges encountered when setting up all-Nordic registry-based cohort studies. Relevant articles describing registries often used for medical research in the Nordic countries were retrieved. Further, our experiences of conducting this type of study, including planning, acquiring permissions, data retrieval and data cleaning and handling, and the possibilities and challenges we have encountered are described. Combining data from the Nordic countries makes it possible to create large and powerful cohorts. The main challenges include obtaining all permissions within each country, usually in the local language, and retrieving the data. These challenges emphasise the importance of having experienced collaborators within each country. Following the acquisition of data, data management requires the understanding of the differences between the variables to be used in the various countries. A concern is the long time required between initiation and completion. Nationwide Nordic registries can be combined into cohorts with high validity and statistical power, but the considerable expertise, workload and time required to complete such cohorts should not be underestimated.

  20. Semi-spontaneous oral text production: measurements in clinical practice.

    Science.gov (United States)

    Lind, Marianne; Kristoffersen, Kristian Emil; Moen, Inger; Simonsen, Hanne Gram

    2009-12-01

    Functionally relevant assessment of the language production of speakers with aphasia should include assessment of connected speech production. Despite the ecological validity of everyday conversations, more controlled and monological types of texts may be easier to obtain and analyse in clinical practice. This article discusses some simple measurements for the analysis of semi-spontaneous oral text production by speakers with aphasia. Specifically, the measurements are related to the production of verbs and nouns, and the realization of different sentence types. The proposed measurements should be clinically relevant, easily applicable, and linguistically meaningful. The measurements have been applied to oral descriptions of the 'Cookie Theft' picture by eight monolingual Norwegian speakers, four with an anomic type of aphasia and four without any type of language impairment. Despite individual differences in both the clinical and the non-clinical group, most of the measurements seem to distinguish between speakers with and without aphasia.

  1. A Practical Device for Measuring the Luminance Distribution

    Directory of Open Access Journals (Sweden)

    Thijs Kruisselbrink

    2017-06-01

    Full Text Available Various applications in building lighting such as automated daylight systems, dynamic lighting control systems, lighting simulations, and glare analyzes can be optimized using information on the actual luminance distributions of the surroundings. Currently, commercially available luminance distribution measurement devices are often not suitable for these kind of applications or simply too expensive for broad application. This paper describes the development of a practical and autonomous luminance distribution measurement device based on a credit card-sized single-board computer and a camera system. The luminance distribution was determined by capturing High Dynamic Range images and translating the RGB information to the CIE XYZ color space. The High Dynamic Range technology was essential to accurately capture the data needed to calculate the luminance distribution because it allows to capture luminance ranges occurring in real scenarios. The measurement results were represented in accordance with established methods in the field of daylighting. Measurements showed that the accuracy of the luminance distribution measurement device ranged from 5% to 20% (worst case which was deemed acceptable for practical measurements and broad applications in the building realm.

  2. The Danish adult diabetes registry

    DEFF Research Database (Denmark)

    Jørgensen, Marit Eika; Kristensen, Jette K.; Husted, Gitte Reventlov

    2016-01-01

    Aim of the database: The aim of the Danish Adult Diabetes Registry (DADR) is to provide data from both the primary health care sector (general practice [GP]) and the secondary sector (specialized outpatient clinics) to assess the quality of treatment given to patients with diabetes. The indicators...... represent process and outcome indicators selected from the literature. Study population: The total diabetes population in Denmark is estimated to be ∼300,000 adult diabetes patients. Approximately 10% have type 1 diabetes, which is managed mainly in the secondary sector, and 90% have type 2 diabetes......, glucose-, blood pressure-, and lipid-lowering treatment (yes/no), insulin pump treatment (yes/ no), and date of last eye and foot examination. Descriptive data: In 2014, the annual report included data regarding over 38,000 patients from outpatient clinics, which is assumed to have included almost all...

  3. A description and comparison of selected forest carbon registries: a guide for States considering the development of a forest carbon registry

    Science.gov (United States)

    Jessica Call; Jennifer Hayes

    2007-01-01

    There is increasing interest in tools for measuring and reducing emissions of carbon dioxide, a major greenhouse gas. Two tools that have been receiving a lot of attention include carbon markets and carbon registries. Carbon registries are established to record and track net carbon emission levels over time. These registries provide quantifiable and verifiable carbon...

  4. The Brazilian Twin Registry.

    Science.gov (United States)

    Ferreira, Paulo H; Oliveira, Vinicius C; Junqueira, Daniela R; Cisneros, Lígia C; Ferreira, Lucas C; Murphy, Kate; Ordoñana, Juan R; Hopper, John L; Teixeira-Salmela, Luci F

    2016-12-01

    The Brazilian Twin Registry (BTR) was established in 2013 and has impelled twin research in South America. The main aim of the initiative was to create a resource that would be accessible to the Brazilian scientific community as well as international researchers interested in the investigation of the contribution of genetic and environmental factors in the development of common diseases, phenotypes, and human behavior traits. The BTR is a joint effort between academic and governmental institutions from Brazil and Australia. The collaboration includes the Federal University of Minas Gerais (UFMG) in Brazil, the University of Sydney and University of Melbourne in Australia, the Australian Twin Registry, as well as the research foundations CNPq and CAPES in Brazil. The BTR is a member of the International Network of Twin Registries. Recruitment strategies used to register twins have been through participation in a longitudinal study investigating genetic and environmental factors for low back pain occurrence, and from a variety of sources including media campaigns and social networking. Currently, 291 twins are registered in the BTR, with data on demographics, zygosity, anthropometrics, and health history having been collected from 151 twins using a standardized self-reported questionnaire. Future BTR plans include the registration of thousands of Brazilian twins identified from different sources and collaborate nationally and internationally with other research groups interested on twin studies.

  5. Characteristics of dosemeter types for skin dose measurements in practice

    International Nuclear Information System (INIS)

    Van, D. J.; Bosmans, H.; Marchal, G.; Wambersie, A.

    2005-01-01

    A growing number of papers report deterministic effects in the skin of patients who have undergone interventional radiological procedures. Dose measurements, and especially skin dose measurements, are therefore increasingly important. Methods and acceptable dosemeters are, however, not clearly defined. This paper is the result of a literature overview with regard to assessing the entrance skin dose during radiological examinations by putting a dosemeter on the patient's skin. The relevant intrinsic characteristics, as well as some examples of clinical use of the different detector types, are presented. In this respect, thermoluminescence, scintillation, semiconductor and film dosemeters are discussed and compared with respect to their practical use. (authors)

  6. Measuring Effects on the Clinical Practice from a Configured EHR

    DEFF Research Database (Denmark)

    Møller-Jensen, John; Simonsen, Jesper; K. Iversen, Rikke

    2006-01-01

    during a series of workshops with the clinicians after which the XML configuration files were written and deployed. In parallel with this, the participants from the University specified a number of effects related to the clinical practice to be measured. Measurements were focused on the requested effects......The objective of the project was to measure the clinical usability of an EHR configured by use of participatory design with clinicians from a neurological stroke unit in order to get input to the County’s future strategy for incremental implementation of EHR. The content of the EHR was defined...... and acquired using various techniques including questionnaires, interviews, observations, and Task Load Index (TLX) ratings. In total, 15 nursing handovers, 8 ward rounds, and 11 patient conferences involving a total of 35 patients and more than 20 clinicians were included in the measurements. Data from...

  7. Agile Model Driven Development of Electronic Health Record-Based Specialty Population Registries

    Science.gov (United States)

    Kannan, Vaishnavi; Fish, Jason C.; Willett, DuWayne L.

    2018-01-01

    The transformation of the American healthcare payment system from fee-for-service to value-based care increasingly makes it valuable to develop patient registries for specialized populations, to better assess healthcare quality and costs. Recent widespread adoption of Electronic Health Records (EHRs) in the U.S. now makes possible construction of EHR-based specialty registry data collection tools and reports, previously unfeasible using manual chart abstraction. But the complexities of specialty registry EHR tools and measures, along with the variety of stakeholders involved, can result in misunderstood requirements and frequent product change requests, as users first experience the tools in their actual clinical workflows. Such requirements churn could easily stall progress in specialty registry rollout. Modeling a system’s requirements and solution design can be a powerful way to remove ambiguities, facilitate shared understanding, and help evolve a design to meet newly-discovered needs. “Agile Modeling” retains these values while avoiding excessive unused up-front modeling in favor of iterative incremental modeling. Using Agile Modeling principles and practices, in calendar year 2015 one institution developed 58 EHR-based specialty registries, with 111 new data collection tools, supporting 134 clinical process and outcome measures, and enrolling over 16,000 patients. The subset of UML and non-UML models found most consistently useful in designing, building, and iteratively evolving EHR-based specialty registries included User Stories, Domain Models, Use Case Diagrams, Decision Trees, Graphical User Interface Storyboards, Use Case text descriptions, and Solution Class Diagrams. PMID:29750222

  8. Insightful practice: a reliable measure for medical revalidation

    Science.gov (United States)

    Guthrie, Bruce; Sullivan, Frank M; Mercer, Stewart W; Russell, Andrew; Bruce, David A

    2012-01-01

    Background Medical revalidation decisions need to be reliable if they are to reassure on the quality and safety of professional practice. This study tested an innovative method in which general practitioners (GPs) were assessed on their reflection and response to a set of externally specified feedback. Setting and participants 60 GPs and 12 GP appraisers in the Tayside region of Scotland, UK. Methods A feedback dataset was specified as (1) GP-specific data collected by GPs themselves (patient and colleague opinion; open book self-evaluated knowledge test; complaints) and (2) Externally collected practice-level data provided to GPs (clinical quality and prescribing safety). GPs' perceptions of whether the feedback covered UK General Medical Council specified attributes of a ‘good doctor’ were examined using a mapping exercise. GPs' professionalism was examined in terms of appraiser assessment of GPs' level of insightful practice, defined as: engagement with, insight into and appropriate action on feedback data. The reliability of assessment of insightful practice and subsequent recommendations on GPs' revalidation by face-to-face and anonymous assessors were investigated using Generalisability G-theory. Main outcome measures Coverage of General Medical Council attributes by specified feedback and reliability of assessor recommendations on doctors' suitability for revalidation. Results Face-to-face assessment proved unreliable. Anonymous global assessment by three appraisers of insightful practice was highly reliable (G=0.85), as were revalidation decisions using four anonymous assessors (G=0.83). Conclusions Unlike face-to-face appraisal, anonymous assessment of insightful practice offers a valid and reliable method to decide GP revalidation. Further validity studies are needed. PMID:22653078

  9. Cost of Operating Central Cancer Registries and Factors That Affect Cost: Findings From an Economic Evaluation of Centers for Disease Control and Prevention National Program of Cancer Registries.

    Science.gov (United States)

    Tangka, Florence K L; Subramanian, Sujha; Beebe, Maggie Cole; Weir, Hannah K; Trebino, Diana; Babcock, Frances; Ewing, Jean

    2016-01-01

    The Centers for Disease Control and Prevention (CDC) evaluated the economics of the National Program of Cancer Registries to provide the CDC, the registries, and policy makers with the economics evidence-base to make optimal decisions about resource allocation. Cancer registry budgets are under increasing threat, and, therefore, systematic assessment of the cost will identify approaches to improve the efficiencies of this vital data collection operation and also justify the funding required to sustain registry operations. To estimate the cost of cancer registry operations and to assess the factors affecting the cost per case reported by National Program of Cancer Registries-funded central cancer registries. We developed a Web-based cost assessment tool to collect 3 years of data (2009-2011) from each National Program of Cancer Registries-funded registry for all actual expenditures for registry activities (including those funded by other sources) and factors affecting registry operations. We used a random-effects regression model to estimate the impact of various factors on cost per cancer case reported. The cost of reporting a cancer case varied across the registries. Central cancer registries that receive high-quality data from reporting sources (as measured by the percentage of records passing automatic edits) and electronic data submissions, and those that collect and report on a large volume of cases had significantly lower cost per case. The volume of cases reported had a large effect, with low-volume registries experiencing much higher cost per case than medium- or high-volume registries. Our results suggest that registries operate with substantial fixed or semivariable costs. Therefore, sharing fixed costs among low-volume contiguous state registries, whenever possible, and centralization of certain processes can result in economies of scale. Approaches to improve quality of data submitted and increasing electronic reporting can also reduce cost.

  10. A measure to evaluate classroom teaching practices in nursing.

    Science.gov (United States)

    Herinckx, Heidi; Munkvold, Julia Paschall; Winter, Elisabeth; Tanner, Christine A

    2014-01-01

    The Oregon Consortium for Nursing Education (OCNE) Classroom Teaching Fidelity Scale was created to measure the implementation of the OCNE curriculum and its related pedagogy. OCNE is a partnership of eight community colleges and the five-campus state-supported university. OCNE developed a shared competency-based curriculum and pedagogical practices. An essential part of the OCNE evaluation was to measure the extent the curriculum and pedagogical model were implemented on each partner campus. The scale was developed using a multistep methodology, including review of the literature and OCNE guidelines and materials, frequent consultation with local and national advisory boards, and multiple observations of OCNE classrooms over a two-year period. Fidelity scores are reported for 10 OCNE colleges observed in 2009. CONCLUSlON: The creation and use of this fidelity scale and similar measures may contribute to the emerging science of nursing education by more clearly documenting educational reform efforts..

  11. The Danish Schizophrenia Registry

    DEFF Research Database (Denmark)

    Baandrup, Lone; Cerqueira, Charlotte; Haller, Lea

    2016-01-01

    Aim of database: To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. Study population: Patients diagnosed with schizophrenia and receiving mental health care...... to the data for use in specific research projects by applying to the steering committee. Conclusion: The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time...

  12. The comprehensive care project: measuring physician performance in ambulatory practice.

    Science.gov (United States)

    Holmboe, Eric S; Weng, Weifeng; Arnold, Gerald K; Kaplan, Sherrie H; Normand, Sharon-Lise; Greenfield, Sheldon; Hood, Sarah; Lipner, Rebecca S

    2010-12-01

    To investigate the feasibility, reliability, and validity of comprehensively assessing physician-level performance in ambulatory practice. Ambulatory-based general internists in 13 states participated in the assessment. We assessed physician-level performance, adjusted for patient factors, on 46 individual measures, an overall composite measure, and composite measures for chronic, acute, and preventive care. Between- versus within-physician variation was quantified by intraclass correlation coefficients (ICC). External validity was assessed by correlating performance on a certification exam. Medical records for 236 physicians were audited for seven chronic and four acute care conditions, and six age- and gender-appropriate preventive services. Performance on the individual and composite measures varied substantially within (range 5-86 percent compliance on 46 measures) and between physicians (ICC range 0.12-0.88). Reliabilities for the composite measures were robust: 0.88 for chronic care and 0.87 for preventive services. Higher certification exam scores were associated with better performance on the overall (r = 0.19; pmeasures and by sampling feasible numbers of patients for each condition. © Health Research and Educational Trust.

  13. Mexican registry of pulmonary hypertension: REMEHIP.

    Science.gov (United States)

    Sandoval Zarate, Julio; Jerjes-Sanchez, Carlos; Ramirez-Rivera, Alicia; Zamudio, Tomas Pulido; Gutierrez-Fajardo, Pedro; Elizalde Gonzalez, Jose; Leon, Mario Seoane Garcia De; Gamez, Miguel Beltran; Abril, Francisco Moreno Hoyos; Michel, Rodolfo Parra; Aguilar, Humberto Garcia

    REMEHIP is a prospective, multicentre registry on pulmonary hypertension. The main objective will be to identify the clinical profile, medical care, therapeutic trends and outcomes in adult and pediatric Mexican patients with well-characterized pulmonary hypertension. REMEHIP a multicenter registry began in 2015 with a planned recruitment time of 12 months and a 4-year follow-up. The study population will comprise a longitudinal cohort study, collecting data on patients with prevalent and incident pulmonary hypertension. Will be included patients of age >2 years and diagnosis of pulmonary hypertension by right heart catheterization within Group 1 and Group 4 of the World Health Organization classification. The structure, data collection and data analysis will be based on quality current recommendations for registries. The protocol has been approved by institutional ethics committees in all participant centers. All patients will sign an informed consent form. Currently in Mexico, there is a need of observational registries that include patients with treatment in the everyday clinical practice so the data could be validated and additional information could be obtained versus the one from the clinical trials. In this way, REMEHIP emerges as a link among randomized clinical trials developed by experts and previous Mexican experience. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  14. Association between gender, process of care measures, and outcomes in ACS in India: results from the detection and management of coronary heart disease (DEMAT registry.

    Directory of Open Access Journals (Sweden)

    Neha J Pagidipati

    Full Text Available Studies from high-income countries have shown that women receive less aggressive diagnostics and treatment than men in acute coronary syndromes (ACS, though their short-term mortality does not appear to differ from men. Data on gender differences in ACS presentation, management, and outcomes are sparse in India.The Detection and Management of Coronary Heart Disease (DEMAT Registry collected data from 1,565 suspected ACS patients (334 women; 1,231 men from ten tertiary care centers throughout India between 2007-2008. We evaluated gender differences in presentation, in-hospital and discharge management, and 30-day death and major adverse cardiovascular event (MACE; death, re-hospitalization, and cardiac arrest rates. Women were less likely to present with STEMI than men (38% vs. 55%, p<0.001. Overall inpatient diagnostics and treatment patterns were similar between men and women after adjustment for potential confounders. Optimal discharge management with aspirin, clopidogrel, beta-blockers, and statin therapy was lower for women than men, (58% vs. 65%, p = 0.03, but these differences were attenuated after adjustment (OR = 0.86 (0.62, 1.19. Neither the outcome of 30-day mortality (OR = 1.40 (0.62, 3.16 nor MACE (OR = 1.00 (0.67, 1.48 differed significantly between men and women after adjustment.ACS in-hospital management, discharge management, and 30-day outcomes did not significantly differ between genders in the DEMAT registry, though consistently higher treatment rates and lower event rates in men compared to women were seen. These findings underscore the importance of further investigation of gender differences in cardiovascular care in India.

  15. Contextualized B2B Registries

    OpenAIRE

    Radetzki, U; Boniface, M.J.; Surridge, M.

    2007-01-01

    Abstract. Service discovery is a fundamental concept underpinning the move towards dynamic service-oriented business partnerships. The business process for integrating service discovery and underlying registry technologies into busi-ness relationships, procurement and project management functions has not been examined and hence existing Web Service registries lack capabilities required by business today. In this paper we present a novel contextualized B2B registry that supports dynamic regist...

  16. Measuring Infant and Young Child Complementary Feeding Practices: Indicators, Current Practice, and Research Gaps.

    Science.gov (United States)

    Ruel, Marie T

    2017-01-01

    The publication of the WHO Infant and Young Child Feeding (IYCF) indicators in 2008 equipped the nutrition and broader development community with an invaluable tool for measuring, documenting, and advocating for faster progress in improving these practices in low- and middle-income countries (LMICs). The indicators, with 5 of them focusing on complementary feeding (CF) practices, were originally designed for population level assessment, targeting, monitoring, and evaluation. This chapter takes stock of where we are with the existing CF indicators: it reviews how the indicators have been used, what we have learned, and what their strengths and limitations are, and it suggests a way forward. We find that the indicators have been used extensively for population level assessments and country comparisons, and to track progress. They have also been adopted by researchers in program impact evaluations and in research seeking to understand the determinants and consequences of poor CF practices for child growth and development outcomes. In addition to generating a wealth of knowledge and unveiling the severity of the global problem of poor CF practices in LMICs, the indicators have been an invaluable tool to raise awareness and call for urgent action on improving CF practices at scale. The indicators have strengths and limitations, which are summarized in this chapter. Although enormous progress has been achieved since the indicators were released in 2008, we feel it is time to reflect and revisit the CF indicators, improve them, develop new ones, and promote their appropriate use. Better indicators are critically important to stimulate action and investments in improving CF practices at scale. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.

  17. A PRACTICAL APPROACH TO THE GROUND OSCILLATION VELOCITY MEASUREMENT METHOD

    Directory of Open Access Journals (Sweden)

    Siniša Stanković

    2017-01-01

    Full Text Available The use of an explosive’s energy during blasting includes undesired effects on the environment. The seismic influence of a blast, as a major undesired effect, is determined by many national standards, recommendations and calculations where the main parameter is ground oscillation velocity at the field measurement location. There are a few approaches and methods for calculation of expected ground oscillation velocities according to charge weight per delay and the distance from the blast to the point of interest. Utilizations of these methods and formulas do not provide satisfactory results, thus the measured values on diverse distance from the blast field more or less differ from values given by previous calculations. Since blasting works are executed in diverse geological conditions, the aim of this research is the development of a practical and reliable approach which will give a different model for each construction site where blasting works have been or will be executed. The approach is based on a greater number of measuring points in line from the blast field at predetermined distances. This new approach has been compared with other generally used methods and formulas through the use of measurements taken during research along with measurements from several previously executed projects. The results confirmed that the suggested model gives more accurate values.

  18. Codifference as a practical tool to measure interdependence

    Science.gov (United States)

    Wyłomańska, Agnieszka; Chechkin, Aleksei; Gajda, Janusz; Sokolov, Igor M.

    2015-03-01

    Correlation and spectral analysis represent the standard tools to study interdependence in statistical data. However, for the stochastic processes with heavy-tailed distributions such that the variance diverges, these tools are inadequate. The heavy-tailed processes are ubiquitous in nature and finance. We here discuss codifference as a convenient measure to study statistical interdependence, and we aim to give a short introductory review of its properties. By taking different known stochastic processes as generic examples, we present explicit formulas for their codifferences. We show that for the Gaussian processes codifference is equivalent to covariance. For processes with finite variance these two measures behave similarly with time. For the processes with infinite variance the covariance does not exist, however, the codifference is relevant. We demonstrate the practical importance of the codifference by extracting this function from simulated as well as real data taken from turbulent plasma of fusion device and financial market. We conclude that the codifference serves as a convenient practical tool to study interdependence for stochastic processes with both infinite and finite variances as well.

  19. Measures to Improve Diagnostic Safety in Clinical Practice.

    Science.gov (United States)

    Singh, Hardeep; Graber, Mark L; Hofer, Timothy P

    2016-10-20

    Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient. Thus, it poses special challenges for measurement. In this paper, we discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. We highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, we propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined. This would enable safe diagnosis to become an organizational priority and facilitate quality improvement. Health-care systems should consider measurement and evaluation of diagnostic performance as essential to timely and accurate diagnosis and to the reduction of preventable diagnostic harm.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  20. Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective.

    Science.gov (United States)

    Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn

    2017-06-01

    The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.

  1. Gonorrhoea and Syphilis Epidemiology in Flemish General Practice 2009–2013: Results from a Registry-based Retrospective Cohort Study Compared with Mandatory Notification

    Directory of Open Access Journals (Sweden)

    Christoph Schweikardt

    2016-09-01

    Full Text Available Background: The number of newly diagnosed gonorrhoea and syphilis cases has increased in Flanders in recent years. Our aim was to investigate, to which extent these diagnoses were registered by general practitioners (GPs, and to examine opportunities and limits of the Intego database in this regard. Methods: Data from a retrospective cohort study based on the Flemish Intego general practice database was analyzed for the years 2009–2013. Case definitions were applied. Due to small case numbers obtained, cases were pooled and averaged over the observation period. Frequencies were compared with those calculated from figures of mandatory notification. Results: A total of 91 gonorrhoea and 23 syphilis cases were registered. The average Intego annual frequency of gonorrhoea cases obtained was 11.9 (95% Poisson confidence interval (CI 9.6; 14.7 per 100,000 population, and for syphilis 3.0 (CI 1.9; 4.5, respectively, while mandatory notification was calculated at 14.0 (CI: 13.6, 14.4 and 7.0 (CI: 6.7, 7.3, respectively. Conclusion: In spite of limitations such as small numbers and different case definitions, comparison with mandatory notification suggests that the GP was involved in the large majority of gonorrhoea cases, while the majority of new syphilis cases did not come to the knowledge of the GP.

  2. [Multicenter international registry to evaluate the clinical practice delivered to patients with type 2 diabetes mellitus: a sub-analysis of the experience in Mexico].

    Science.gov (United States)

    Fanghänel Salmón, Guillermo; Sánchez-Reyes, Leticia; Chiquete Anaya, Erwin; de la Luz Castro, Julieta; Escalante Herrera, Antonio

    2011-01-01

    There is a lack of information on the characteristics of the medical attention delivered to Mexican patients with type 2 diabetes (T2D). Our aim was to describe the current state on the medical management of T2D in Mexico. Among 17,232 patients included in the International Diabetes Management Practices Study (IDMPS), 2,620 (15%) corresponded to Mexico. Information regarding clinical, demographics and management characteristics, as well as the impact of T2D in the patient is clinical and social condition was registered. The metabolic control and achievement of therapeutic goals were also analyzed. Diagnosis of T2D was performed by the general practitioner in 76% of cases. Only about a quarter of the cohort had a blood pressure goal of diabetes. The managing physician is personal impression about the quality of the metabolic control was not in accordance with HbA1c. Eight percent of patients had work absences in the last 3 months due to complications of T2D (mean of 15 days lost). In Mexico, quality of metabolic control of T2D patients could have important deficiencies. The personal impression of the physician on the patient is metabolic control is not consistent with objective data.

  3. Measurement uncertainty. A practical guide for Secondary Standards Dosimetry Laboratories

    International Nuclear Information System (INIS)

    2008-05-01

    necessary that they conform to given safety and performance criteria. The demonstration of the competence of calibration laboratories is achieved through comparisons and the establishment of a quality system following the International Organization for Standardization (ISO) Guide 17025. One of the requirements of the quality system of a calibration laboratory is the assessment of the measurement uncertainty for all its calibration services. General guidance on the estimation of measurement uncertainty was published by ISO in 1995. However, that document addresses all calibration and testing laboratories and not specifically dosimetry calibration laboratories. To provide SSDLs of the IAEA/WHO Network with a practical guide on the assessment of the measurement uncertainty, two consultants meetings were held at IAEA Headquarters on 26-30 April, 2004 and 19-23 September 2005. The present publication was prepared during these meetings. It is addressed to scientists working in calibration laboratories and to physicists involved in radiation dosimetry measurement

  4. Danish National Lymphoma Registry

    DEFF Research Database (Denmark)

    Arboe, Bente; Josefsson, Pär; Jørgensen, Judit

    2016-01-01

    AIM OF DATABASE: The Danish National Lymphoma Registry (LYFO) was established in order to monitor and improve the diagnostic evaluation and the quality of treatment of all lymphoma patients in Denmark. STUDY POPULATION: The LYFO database was established in 1982 as a seminational database including...... all lymphoma patients referred to the departments of hematology. The database became nationwide on January 1, 2000. MAIN VARIABLES: The main variables include both clinical and paraclinical variables as well as details of treatment and treatment evaluation. Up to four forms are completed for each......-100 years) and a male/female ratio of 1.23:1. Patients can be registered with any of 42 different subtypes according to the World Health Organization classifications. CONCLUSION: LYFO is a nationwide database for all lymphoma patients in Denmark and includes detailed information. This information is used...

  5. Danish Prostate Cancer Registry

    DEFF Research Database (Denmark)

    Helgstrand, J Thomas; Klemann, Nina; Røder, Martin Andreas

    2016-01-01

    of SNOMED codes were identified. A computer algorithm was developed to transcode SNOMED codes into an analyzable format including procedure (eg, biopsy, transurethral resection, etc), diagnosis, and date of diagnosis. For validation, ~55,000 pathological reports were manually reviewed. Prostate-specific...... antigen, vital status, causes of death, and tumor-node-metastasis classification were integrated from national registries. RESULTS: Of the 161,525 specimens from 113,801 males identified, 83,379 (51.6%) were sets of prostate biopsies, 56,118 (34.7%) were transurethral/transvesical resections......BACKGROUND: Systematized Nomenclature of Medicine (SNOMED) codes are computer-processable medical terms used to describe histopathological evaluations. SNOMED codes are not readily usable for analysis. We invented an algorithm that converts prostate SNOMED codes into an analyzable format. We...

  6. Elaboration of reduced versions of Measurement tools: A practical Perspective

    Directory of Open Access Journals (Sweden)

    Nekane Balluerka

    2012-01-01

    Full Text Available The aim of the present study is to show, from a practical perspective, the guidelines that may be followed to create a reduced version of a measurement tool. Therefore, it describes in detail the process of creating the reduced Basque version of the CDS scale (Children's Depression Scale; Lang and Tisher, 1978, which measures depression in children and adolescents. In a first study, the items that make up the reduced version of the CDS (CDS-R are selected from a set of analysis conducted on a sample of 886 children and adolescents who were administered the extensive version of the CDS adapted to the Basque language (Balluerka, Gorostiaga, and Haranburu, 2012. Subsequently, the CDS-R is validated on a sample of 2,165 participants. This second study examines the factorial structure, the internal consistency and the temporal stability of the instrument, as well as the relationship between its dimensions and gender, academic performance, emotional intelligence and attachment. Thus, evidence is obtained on the reliability and validity of the reduced version of the instrument, which guarantees suitable evaluation of the construct the instrument is intended to measure.

  7. Innovative measures to combat rare diseases in China: The national rare diseases registry system, larger-scale clinical cohort studies, and studies in combination with precision medicine research.

    Science.gov (United States)

    Song, Peipei; He, Jiangjiang; Li, Fen; Jin, Chunlin

    2017-02-01

    China is facing the great challenge of treating the world's largest rare disease population, an estimated 16 million patients with rare diseases. One effort offering promise has been a pilot national project that was launched in 2013 and that focused on 20 representative rare diseases. Another government-supported special research program on rare diseases - the "Rare Diseases Clinical Cohort Study" - was launched in December 2016. According to the plan for this research project, the unified National Rare Diseases Registry System of China will be established as of 2020, and a large-scale cohort study will be conducted from 2016 to 2020. The project plans to develop 109 technical standards, to establish and improve 2 national databases of rare diseases - a multi-center clinical database and a biological sample library, and to conduct studies on more than 50,000 registered cases of 50 different rare diseases. More importantly, this study will be combined with the concept of precision medicine. Chinese population-specific basic information on rare diseases, clinical information, and genomic information will be integrated to create a comprehensive predictive model with a follow-up database system and a model to evaluate prognosis. This will provide the evidence for accurate classification, diagnosis, treatment, and estimation of prognosis for rare diseases in China. Numerous challenges including data standardization, protecting patient privacy, big data processing, and interpretation of genetic information still need to be overcome, but research prospects offer great promise.

  8. Optical measurements for scientists and engineers a practical guide

    CERN Document Server

    McClelland, Arthur

    2018-01-01

    With this accessible, introductory guide, you will quickly learn how to use and apply optical spectroscopy and optical microscopy techniques. Focusing on day-to-day implementation and offering practical lab tips throughout, it provides step-by-step instructions on how to select the best technique for a particular application, how to set up and customize new optical systems, and how to analyze optical data. You will gain an intuitive understanding of the full range of standard optical techniques, from fluorescence and Raman spectroscopy to super resolution microscopy. Understand how to navigate around an optics lab with clear descriptions of the most common optical components and tools. Including explanations of basic optics and photonics, and easy-to-understand mathematics, this is an invaluable resource for graduate students, instructors, researchers and professionals who use or teach optical measurements in laboratories.

  9. Caries preventive measures in orthodontic practice: the development of a clinical practice guideline.

    Science.gov (United States)

    Oosterkamp, B C M; van der Sanden, W J M; Frencken, J E F M; Kuijpers-Jagtman, A M

    2016-02-01

    White spot lesions (WSLs) are a side effect of orthodontic treatment, causing esthetic problems and a risk of deeper enamel and dentine lesions. Many strategies have been developed for preventing WSLs, but great variability exists in preventive measures between orthodontists. This study developed statements on which a clinical practice guideline (CPG) can be developed in order to help orthodontists select preventive measures based on the best available evidence. A nominal group technique (RAND-e modified Delphi procedure) was used. A multidisciplinary expert panel rated 264 practice- and evidence-based statements related to the management of WSLs. To provide panel members with the same knowledge, a total of six articles obtained from a systematic review of the literature were read by the panel in preparation of three consensus rounds. According to the technique, a threshold of 75% of all ratings within any 3-point section of the 9-point scale regarding a specific statement was accepted as consensus. After the first and second consensus rounds, consensus was reached on 37.5 and 31.1% of statements, respectively. For the remaining 31.4% of statements, consensus was reached during a 4-h consensus meeting. Statements on the management of WSLs derived from a systematic literature review combined with expert opinion were formally integrated toward consensus through a nominal group technique. These statements formed the basis for developing a CPG on the management of WSLs before and during orthodontic treatment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. [Real-life efficacy and tolerability of methocarbamol in patients suffering from refractory muscle-related low/back pain - Results of a health care research project based on data from the German pain practice registry].

    Science.gov (United States)

    Überall, Michael A; Emrich, Oliver M D; Müller-Schwefe, Gerhard H H

    2017-12-01

    Subacute, muscle-related low/back pain (L/BP) is known to be difficult to treat and frequently requires more specific causal-oriented treatments with agents improving the increased muscle tone. Currently, only methocarbamol is approved and available for the 1st-line treatment of patients with muscle-related L/BP in Germany - however, without sufficient data on longer lasting effects (> 1 week) in elsewhere refractory patients. Noninterventional cohort study, based on anonymized routine data of the German pain practice registry; retrospective evaluation of patients with refractory L/BP, who first time received a treatment with methocarbamol between October 1st until December 31st, 2015, and who documented their response to treatment with the standardized and validated instruments of the German pain questionnaire over at least 4 weeks (n = 251 patients). During the 4-week evaluation period, patients reported a highly significant and clinically relevant improvement of pain intensity (from 53.0 ± 10.5 to 19.0 ± 10.0 mm VAS), pain-related disability in daily life (mPDI: from 42.1 ± 12.5 to 15.5 ± 10.8) and quality of life (QLIP: from 18.6 ± 6.3 to 34.0 ± 5.5; all changes p life, patients with elsewhere refractory L/BP reported a significant and clinically relevant improvement of pain intensity, pain-related disability and quality of life in response to a 4-week treatment with methocarbamol.

  11. Danish Hip Arthroscopy Registry (DHAR)

    DEFF Research Database (Denmark)

    Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

    2017-01-01

    The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) data from DHAR between January 2012 and November 2015 were extracted. Radiological pincer-type FAI was defined as LCE > 35° and cam FAI as alpha-angle > 55°. These data were combined with FAI surgical data such as osteochondroplasty and labral repair or resection. PROMs consisting of HAGOS, EQ-5 D...

  12. Feasibility of establishing an Australian ACL registry: a pilot study by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).

    Science.gov (United States)

    Lekkas, Christina; Clarnette, Richard; Graves, Stephen E; Rainbird, Sophia; Parker, David; Lorimer, Michelle; Paterson, Roger; Roe, Justin; Morris, Hayden; Feller, Julian A; Annear, Peter; Forster, Ben; Hayes, David

    2017-05-01

    Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible. Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data. A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study. It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent

  13. Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: The electronic Patient-reported Outcomes from Cancer Survivors (ePOCS system

    Directory of Open Access Journals (Sweden)

    Velikova Galina

    2011-10-01

    Full Text Available Abstract Background Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service. Methods/Design Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups, within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore

  14. Establishment and use of national registries for actinide elements in humans

    International Nuclear Information System (INIS)

    1996-05-01

    This TECDOC covers all aspects of the establishment and use of registries for actinide elements in Member States. These aspects include assessing the need for such registries; defining scope of the work and developing objectives; administration; organization and staffing; policies; practices; procedures; protocols; registration and enrollment; data collection and evaluation; establishing and analytical laboratory; publication of results and application of findings. Not all aspects will be relevant to all Member States establishing such registries. 1 tab

  15. Establishment and use of national registries for actinide elements in humans

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    This TECDOC covers all aspects of the establishment and use of registries for actinide elements in Member States. These aspects include assessing the need for such registries; defining scope of the work and developing objectives; administration; organization and staffing; policies; practices; procedures; protocols; registration and enrollment; data collection and evaluation; establishing and analytical laboratory; publication of results and application of findings. Not all aspects will be relevant to all Member States establishing such registries. 1 tab.

  16. Review of patient registries in dermatology.

    Science.gov (United States)

    DiMarco, Gabriella; Hill, Dane; Feldman, Steven R

    2016-10-01

    Patient registries are datasets containing information on patients with a particular disease or patients who are undergoing a specific treatment. Our objective was to search for and catalog the types of registries being used in dermatology and investigate their characteristics and uses. We searched Google, the Registry of Patient Registries, Orphanet, and ClinicalTrials.gov to compile a list of dermatology disease registries. We also conducted a literature review on the uses of dermatology registries using PubMed. We identified 48 dermatology patient registries, with 23 distinct diseases represented. We also identified 11 registries used for postmarketing surveillance of skin disease. Our search was limited to registries in English. Registries are commonly used for the study of rare dermatologic diseases and for postsurveillance monitoring of systemic therapies in more common dermatologic diseases, such as psoriasis. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Measuring Student Teachers' Practices and Beliefs about Teaching Mathematics Using the Rasch Model

    Science.gov (United States)

    Kaspersen, Eivind; Pepin, Birgit; Sikko, Svein Arne

    2017-01-01

    Several attempts have been made to measure and categorize beliefs and practices of mathematics teachers [Swan, M. 2006. "Designing and Using Research Instruments to Describe the Beliefs and Practices of Mathematics Teachers." "Research in Education" 75 (1): 58-70]. One of the reasons for measuring both beliefs and practices is…

  18. A Proposed Conceptual Model to Measure Unwarranted Practice Variation

    National Research Council Canada - National Science Library

    Barr, Andrew M

    2007-01-01

    .... Employing a unit of analysis of the U.S. Army healthcare system and utilizing research by Wennberg and the Institute of Medicine, a model describing healthcare quality in terms of unwarranted practice variation and healthcare outcomes...

  19. The evolution and development of an instrument to measure essential professional nursing practices.

    Science.gov (United States)

    Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia

    2014-11-01

    Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.

  20. Spot-checks to measure general hygiene practice.

    Science.gov (United States)

    Sonego, Ina L; Mosler, Hans-Joachim

    2016-01-01

    A variety of hygiene behaviors are fundamental to the prevention of diarrhea. We used spot-checks in a survey of 761 households in Burundi to examine whether something we could call general hygiene practice is responsible for more specific hygiene behaviors, ranging from handwashing to sweeping the floor. Using structural equation modeling, we showed that clusters of hygiene behavior, such as primary caregivers' cleanliness and household cleanliness, explained the spot-check findings well. Within our model, general hygiene practice as overall concept explained the more specific clusters of hygiene behavior well. Furthermore, the higher general hygiene practice, the more likely children were to be categorized healthy (r = 0.46). General hygiene practice was correlated with commitment to hygiene (r = 0.52), indicating a strong association to psychosocial determinants. The results show that different hygiene behaviors co-occur regularly. Using spot-checks, the general hygiene practice of a household can be rated quickly and easily.

  1. The value of trauma registries.

    Science.gov (United States)

    Moore, Lynne; Clark, David E

    2008-06-01

    Trauma registries are databases that document acute care delivered to patients hospitalised with injuries. They are designed to provide information that can be used to improve the efficiency and quality of trauma care. Indeed, the combination of trauma registry data at regional or national levels can produce very large databases that allow unprecedented opportunities for the evaluation of patient outcomes and inter-hospital comparisons. However, the creation and upkeep of trauma registries requires a substantial investment of money, time and effort, data quality is an important challenge and aggregated trauma data sets rarely represent a population-based sample of trauma. In addition, trauma hospitalisations are already routinely documented in administrative hospital discharge databases. The present review aims to provide evidence that trauma registry data can be used to improve the care dispensed to victims of injury in ways that could not be achieved with information from administrative databases alone. In addition, we will define the structure and purpose of contemporary trauma registries, acknowledge their limitations, and discuss possible ways to make them more useful.

  2. Outcome Measures in Myasthenia Gravis: Incorporation Into Clinical Practice.

    Science.gov (United States)

    Muppidi, Srikanth

    2017-03-01

    The development of validated assessment tools for evaluating disease status and response to interventions in patients with myasthenia gravis (MG) has been driven by clinical studies of emerging MG therapies. However, only a small proportion of MG-focused neurology practices have adopted these assessment tools for routine clinical use. This article reviews the suitability of 5 assessment instruments for incorporation into clinical practice, which should be driven by their ability to contribute to improved patient outcomes, and to be implemented within practice personnel and resource constraints. It is recommended that assessments based on both physician-evaluated and patient-reported outcomes be selected, to adequately evaluate both point-in-time symptom load and functional impact of MG symptoms over time. Provider resource allocation and reimbursement issues may be the most significant roadblocks to successful ongoing use of these tools; to that end, the addition of regular assessments to MG standards of care is recommended.

  3. Quality of Care for Lung Cancer in Taiwan: A Pattern of Care Based on Core Measures in the Taiwan Cancer Database Registry

    Directory of Open Access Journals (Sweden)

    Chun-Ru Chien

    2008-08-01

    Conclusion: It is very likely that significant variation in QOC for lung cancer in Taiwan exists among different types but not locations of hospitals, at least in the diagnostic domain. The introduction of internal benchmarking (TCDB and core measures was associated with some changes, at least in some diagnostic domains, which may lead to improvement in QOC for lung cancer in Taiwan.

  4. Thyroid Cancer and Tumor Collaborative Registry (TCCR).

    Science.gov (United States)

    Shats, Oleg; Goldner, Whitney; Feng, Jianmin; Sherman, Alexander; Smith, Russell B; Sherman, Simon

    2016-01-01

    A multicenter, web-based Thyroid Cancer and Tumor Collaborative Registry (TCCR, http://tccr.unmc.edu) allows for the collection and management of various data on thyroid cancer (TC) and thyroid nodule (TN) patients. The TCCR is coupled with OpenSpecimen, an open-source biobank management system, to annotate biospecimens obtained from the TCCR subjects. The demographic, lifestyle, physical activity, dietary habits, family history, medical history, and quality of life data are provided and may be entered into the registry by subjects. Information on diagnosis, treatment, and outcome is entered by the clinical personnel. The TCCR uses advanced technical and organizational practices, such as (i) metadata-driven software architecture (design); (ii) modern standards and best practices for data sharing and interoperability (standardization); (iii) Agile methodology (project management); (iv) Software as a Service (SaaS) as a software distribution model (operation); and (v) the confederation principle as a business model (governance). This allowed us to create a secure, reliable, user-friendly, and self-sustainable system for TC and TN data collection and management that is compatible with various end-user devices and easily adaptable to a rapidly changing environment. Currently, the TCCR contains data on 2,261 subjects and data on more than 28,000 biospecimens. Data and biological samples collected by the TCCR are used in developing diagnostic, prevention, treatment, and survivorship strategies against TC.

  5. Characterizing Teaching in Introductory Geology Courses: Measuring Classroom Practices

    Science.gov (United States)

    Budd, D. A.; van der Hoeven Kraft, K. J.; McConnell, D. A.; Vislova, T.

    2013-01-01

    Most research about reformed teaching practices in the college science classroom is based on instructor self-report. This research describes what is happening in some introductory geology courses at multiple institutions across the country using external observers. These observations are quantified using the Reformed Teaching Observation Protocol…

  6. Semi-Spontaneous Oral Text Production: Measurements in Clinical Practice

    Science.gov (United States)

    Lind, Marianne; Kristoffersen, Kristian Emil; Moen, Inger; Simonsen, Hanne Gram

    2009-01-01

    Functionally relevant assessment of the language production of speakers with aphasia should include assessment of connected speech production. Despite the ecological validity of everyday conversations, more controlled and monological types of texts may be easier to obtain and analyse in clinical practice. This article discusses some simple…

  7. Development of an International Prostate Cancer Outcomes Registry.

    Science.gov (United States)

    Evans, Sue M; Nag, Nupur; Roder, David; Brooks, Andrew; Millar, Jeremy L; Moretti, Kim L; Pryor, David; Skala, Marketa; McNeil, John J

    2016-04-01

    To establish a Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ) for monitoring outcomes of prostate cancer treatment and care, in a cost-effective manner. Stakeholders were recruited based on their interest, importance in achieving the monitoring and reporting of clinical practice and patient outcomes, and in amalgamation of existing registries. Each participating jurisdiction is responsible for local governance, site recruitment, data collection, and data transfer into the PCOR-ANZ. To establish each local registry, hospitals and clinicians within a jurisdiction were approached to voluntarily contribute to the registry following relevant ethical approval. Patient contact occurs following notification of prostate cancer through a hospital or pathology report, or from a cancer registry. Patient registration is based on an opt-out model. The PCOR-ANZ is a secure web-based registry adhering to ISO 27001 standards. Based on a standardised minimum data set, information on demographics, diagnosis, treatment, outcomes, and patient reported quality of life, are collected. Eight of nine jurisdictions have agreed to contribute to the PCOR-ANZ. Each jurisdiction has commenced implementation of necessary infrastructure to support rapid rollout. PCOR-ANZ has defined a minimum data set for collection, to enable analysis of key quality indicators that will aid in assessing clinical practice and patient focused outcomes. PCOR-ANZ will provide a useful resource of risk-adjusted evidence-based data to clinicians, hospitals, and decision makers on prostate cancer clinical practice. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  8. Conceptual and measurement issues in early parenting practices research: an epidemiologic perspective.

    Science.gov (United States)

    Walker, Lorraine O; Kirby, Russell S

    2010-11-01

    Early parenting practices are significant to public health because of their linkages to child health outcomes. This paper focuses on the current state of the science regarding conceptual frameworks that incorporate early parenting practices in epidemiologic research and evidence supporting reliability and validity of self-report measures of such practices. Guided by a provisional definition of early parenting practices, literature searches were conducted using PubMed and Sociological Abstracts. Twenty-five published studies that included parent-report measures of early parenting practices met inclusion criteria. Findings on conceptual frameworks were analyzed qualitatively, whereas evidence of reliability and validity were organized into four domains (safety, feeding and oral health, development promotion, and discipline) and summarized in tabular form. Quantitative estimates of measures of reliability and validity were extracted, where available. We found two frameworks incorporating early parenting: one a program theory and the other a predictive model. We found no reported evidence of the reliability or validity of parent-report measures of safety or feeding and oral health practices. Evidence for reliability and validity were reported with greater frequency for development promotion and discipline practices, but report of the most pertinent type of reliability estimation, test-retest reliability, was rare. Failure to examine associations of early parenting practices with any child outcomes within most studies resulted in missed opportunities to indirectly estimate validity of parenting practice measures. Stronger evidence concerning specific measurement properties of early parenting practices is important to advancing maternal-child research, surveillance, and practice.

  9. The theory, practice, and measurement of Music Therapy

    DEFF Research Database (Denmark)

    Moore, Kimberly Sena; Hanson-Abromeit, Deanna; Magee, Wendy L.

    2013-01-01

    from an understanding of music perception and cognition. Given the diversity of practice, there are several key challenges for the discipline. One is developing a theory-based clinical and research approach. This supports a deeper understanding of the complex music stimulus and therapeutic interactions......Music therapy is a clinical healthcare discipline that draws its evidence base from music neuroscience and psychology to improve the health and well-being in individuals from varied clinical populations. Working with individuals across the lifespan, evidence-based therapeutic methods are developed...... of interest. This symposium will bring together some of the latest research from the discipline of music therapy relating to the clinical needs of complex neurological and psychiatric populations. The papers offer diverse perspectives reflecting interdisciplinary influences on the theory and practice of music...

  10. The Medical Birth Registry of Norway – An international perspective

    Directory of Open Access Journals (Sweden)

    Allen J. Wilcox

    2007-01-01

    Full Text Available Some of the most practical questions of perinatal medicine are regarding couples who have had pregnancy problems in the past, and their risk of having such problems in future pregnancies. For example, if a couple has a child with a birth defect, what are their chances that their next child will have a defect? The key to answering such questions is the availability of linked data such as those provided by the Medical Birth Registry of Norway. Such linked data provide a unique resource for addressing a broad range of questions in perinatal epidemiology. The Medical Birth Registry of Norway has been a pioneer in answering such questions.

  11. The Medical Birth Registry of Norway – An international perspective

    Directory of Open Access Journals (Sweden)

    Allen J. Wilcox

    2009-10-01

    Full Text Available Some of the most practical questions of perinatal medicine are regarding couples who have had pregnancy problems in the past, and their risk of having such problems in future pregnancies. For example, if a couple has a child with a birth defect, what are their chances that their next child will have a defect? The key to answering such questions is the availability of linked data such as those provided by the Medical Birth Registry of Norway. Such linked data provide a unique resource for addressing a broad range of questions in perinatal epidemiology. The Medical Birth Registry of Norway has been a pioneer in answering such questions

  12. Real-world heart failure management in 10,910 patients with chronic heart failure in the Netherlands : Design and rationale of the Chronic Heart failure ESC guideline-based Cardiology practice Quality project (CHECK-HF) registry.

    Science.gov (United States)

    Brugts, J J; Linssen, G C M; Hoes, A W; Brunner-La Rocca, H P

    2018-05-01

    Data from patient registries give insight into the management of patients with heart failure (HF), but actual data from unselected real-world HF patients are scarce. Therefore, we performed a cross sectional study of current HF care in the period 2013-2016 among more than 10,000 unselected HF patients at HF outpatient clinics in the Netherlands. In 34 participating centres, all 10,910 patients with chronic HF treated at cardiology centres were included in the CHECK-HF registry. Of these, most (96%) were managed at a specific HF outpatient clinic. Heart failure was typically diagnosed according to the ESC guidelines 2012, based on signs, symptoms and structural and/or functional cardiac abnormalities. Information on diagnostics, treatment and co-morbidities were recorded, with specific focus on drug therapy and devices. In our cohort, the mean age was 73 years (SD 12) and 60% were male. Frequent co-morbidities reported in the patient records were diabetes mellitus 30%, hypertension 43%, COPD 19%, and renal insufficiency 58%. In 47% of the patients, ischaemia was the origin of HF. In our registry, the prevalence of HF with preserved ejection fraction was 21%. The CHECK-HF registry will provide insight into the current, real world management of patient with chronic HF, including HF with reduced ejection fraction, preserved ejection fraction and mid-range ejection fraction, that will help define ways to improve quality of care. Drug and device therapy and guideline adherence as well as interactions with age, gender and co-morbidities will receive specific attention.

  13. Perceptions of the role of general practice and practical support measures for carers of stroke survivors: a qualitative study

    Directory of Open Access Journals (Sweden)

    Harris Ruth

    2011-06-01

    Full Text Available Abstract Background Informal carers frequently suffer adverse consequences from caring. General practice teams are well positioned to support them. However, what carers of stroke survivors want and expect from general practice, and the practical support measures they might like, remain largely unexplored. The aims of this study are twofold. Firstly it explores both the support stroke carers would like from general practice and their reactions to the community based support proposed in the New Deal. Secondly, perceptions of a general practice team are investigated covering similar topics to carer interviews but from their perspective. Methods Semi-structured interviews were conducted with 13 stroke carers and 10 members of a general practice team. Carers' experiences and expectations of general practice and opinions of support measures from recent government policy were explored. General practice professionals were asked about their perceived role and their perceptions of carers' support needs. Interviews were content analysed. Results Carers' expectations of support from general practice were low and they neither received nor expected much support for themselves. General practice was seen as reactive primarily because of time constraints. Some carers would appreciate emotional support but others did not want additional services. Responses to recent policy initiatives were mixed with carers saying these might benefit other carers but not themselves. General practice professionals' opinions were broadly similar. They recognise carers' support needs but see their role as reactive, focussed on stroke survivors, rather than carers. Caring was recognised as challenging. Providing emotional support and referral were seen as important but identification of carers was considered difficult. Time constraints limit their support. Responses to recent policy initiatives were positive. Conclusions Carers' expectations of support from general practice for

  14. Practical estimation of the uncertainty of analytical measurement standards

    NARCIS (Netherlands)

    Peters, R.J.B.; Elbers, I.J.W.; Klijnstra, M.D.; Stolker, A.A.M.

    2011-01-01

    Nowadays, a lot of time and resources are used to determine the quality of goods and services. As a consequence, the quality of measurements themselves, e.g., the metrological traceability of the measured quantity values is essential to allow a proper evaluation of the results with regard to

  15. Automating Performance Measures and Clinical Practice Guidelines: Differences and Complementarities.

    Science.gov (United States)

    Tu, Samson W; Martins, Susana; Oshiro, Connie; Yuen, Kaeli; Wang, Dan; Robinson, Amy; Ashcraft, Michael; Heidenreich, Paul A; Goldstein, Mary K

    2016-01-01

    Through close analysis of two pairs of systems that implement the automated evaluation of performance measures (PMs) and guideline-based clinical decision support (CDS), we contrast differences in their knowledge encoding and necessary changes to a CDS system that provides management recommendations for patients failing performance measures. We trace the sources of differences to the implementation environments and goals of PMs and CDS.

  16. Environmental Agents Service (EAS) Registry System of Records

    Data.gov (United States)

    Department of Veterans Affairs — The Environmental Agent Service (EAS) Registries is the information system encompassing the Ionizing Radiation Registry (IRR), the Agent Orange Registry (AOR), and...

  17. CIRSE Vascular Closure Device Registry

    NARCIS (Netherlands)

    Reekers, Jim A.; Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

    2011-01-01

    Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. The CIRSE registry of closure devices

  18. The danish multiple sclerosis registry

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Koch-Henriksen, Nils; Stenager, Egon

    2011-01-01

    Introduction: The Danish Multiple Sclerosis (MS) Registry was established in 1956. Content: The register comprises data on all Danes who had MS in 1949 or who have been diagnosed since. Data on new cases and updated information on persons with an MS diagnosis already notified are continuously...

  19. The European Cystic Fibrosis Society Patient Registry: valuable lessons learned on how to sustain a disease registry.

    Science.gov (United States)

    Viviani, Laura; Zolin, Anna; Mehta, Anil; Olesen, Hanne Vebert

    2014-06-07

    collection that automatically computes derived variables, and automatically performs basic data quality controls is a good data management practice, that also helps in reducing missing data. We found crucial for success the collaboration with existing national and international registries, cystic fibrosis organisations and patients' associations.

  20. Measuring radioactive half-lives via statistical sampling in practice

    Science.gov (United States)

    Lorusso, G.; Collins, S. M.; Jagan, K.; Hitt, G. W.; Sadek, A. M.; Aitken-Smith, P. M.; Bridi, D.; Keightley, J. D.

    2017-10-01

    The statistical sampling method for the measurement of radioactive decay half-lives exhibits intriguing features such as that the half-life is approximately the median of a distribution closely resembling a Cauchy distribution. Whilst initial theoretical considerations suggested that in certain cases the method could have significant advantages, accurate measurements by statistical sampling have proven difficult, for they require an exercise in non-standard statistical analysis. As a consequence, no half-life measurement using this method has yet been reported and no comparison with traditional methods has ever been made. We used a Monte Carlo approach to address these analysis difficulties, and present the first experimental measurement of a radioisotope half-life (211Pb) by statistical sampling in good agreement with the literature recommended value. Our work also focused on the comparison between statistical sampling and exponential regression analysis, and concluded that exponential regression achieves generally the highest accuracy.

  1. Alternative validation practice of an automated faulting measurement method.

    Science.gov (United States)

    2010-03-08

    A number of states have adopted profiler based systems to automatically measure faulting, : in jointed concrete pavements. However, little published work exists which documents the : validation process used for such automated faulting systems. This p...

  2. The CRAC cohort model: A computerized low cost registry of interventional cardiology with daily update and long-term follow-up.

    Science.gov (United States)

    Rangé, G; Chassaing, S; Marcollet, P; Saint-Étienne, C; Dequenne, P; Goralski, M; Bardiére, P; Beverilli, F; Godillon, L; Sabine, B; Laure, C; Gautier, S; Hakim, R; Albert, F; Angoulvant, D; Grammatico-Guillon, L

    2018-05-01

    To assess the reliability and low cost of a computerized interventional cardiology (IC) registry to prospectively and systematically collect high-quality data for all consecutive coronary patients referred for coronary angiogram or/and coronary angioplasty. Rigorous clinical practice assessment is a key factor to improve prognosis in IC. A prospective and permanent registry could achieve this goal but, presumably, at high cost and low level of data quality. One multicentric IC registry (CRAC registry), fully integrated to usual coronary activity report software, started in the centre Val-de-Loire (CVL) French region in 2014. Quality assessment of CRAC registry was conducted on five IC CathLab of the CVL region, from January 1st to December 31st 2014. Quality of collected data was evaluated by measuring procedure exhaustivity (comparing with data from hospital information system), data completeness (quality controls) and data consistency (by checking complete medical charts as gold standard). Cost per procedure (global registry operating cost/number of collected procedures) was also estimated. CRAC model provided a high-quality level with 98.2% procedure completeness, 99.6% data completeness and 89% data consistency. The operating cost per procedure was €14.70 ($16.51) for data collection and quality control, including ST-segment elevation myocardial infarction (STEMI) preadmission information and one-year follow-up after angioplasty. This integrated computerized IC registry led to the construction of an exhaustive, reliable and costless database, including all coronary patients entering in participating IC centers in the CVL region. This solution will be developed in other French regions, setting up a national IC database for coronary patients in 2020: France PCI. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  3. Demographics of US pediatric contact dermatitis registry providers.

    Science.gov (United States)

    Goldenberg, Alina; Jacob, Sharon E

    2015-01-01

    Children are as likely as adults to be sensitized and reactive to contact allergens. However, the prevailing data on pediatric allergic contact dermatitis are quantitatively and qualitatively limited because of a narrow geographic localization of data-reporting providers. The aim of the study was to present the first quarter results from the Loma Linda Pediatric Contact Dermatitis Registry focused on registered providers who self-identified as providing care for pediatric allergic contact dermatitis (ACD) within the United States. The US providers were invited to join the registry via completion of an online, secure, 11-question registration survey addressing demographics and clinical practice essentials. The presented results reflect data gathered within the first quarter of registry recruitment; registration is ongoing. Of 169 responders from 48 states, the majority of providers were female (60.4%), academic (55.6%), and dermatologists (76.3%). Based on individual provider averages, the minimum cumulative number of pediatric patch-test evaluations performed each year ranged between 1372 and 3468 children. The Pediatric Contact Dermatitis Registry provides a description of the current leaders in the realm of pediatric ACD and gaps, which are in need of attention. The registry allows for a collaborative effort to exchange information, educate providers, and foster investigative research with the hope of legislation that can reduce the disease burden of ACD in US children.

  4. Agency for Toxic Substances and Disease Registry

    Science.gov (United States)

    ... Z # Search Form Controls Search The CDC submit Agency for Toxic Substances and Disease Registry Note: Javascript ... gov . Recommend on Facebook Tweet Share Compartir The Agency for Toxic Substances and Disease Registry (ATSDR) , based ...

  5. Educational measurement for applied researchers theory into practice

    CERN Document Server

    Wu, Margaret; Jen, Tsung-Hau

    2016-01-01

    This book is a valuable read for a diverse group of researchers and practitioners who analyze assessment data and construct test instruments. It focuses on the use of classical test theory (CTT) and item response theory (IRT), which are often required in the fields of psychology (e.g. for measuring psychological traits), health (e.g. for measuring the severity of disorders), and education (e.g. for measuring student performance), and makes these analytical tools accessible to a broader audience. Having taught assessment subjects to students from diverse backgrounds for a number of years, the three authors have a wealth of experience in presenting educational measurement topics, in-depth concepts and applications in an accessible format. As such, the book addresses the needs of readers who use CTT and IRT in their work but do not necessarily have an extensive mathematical background. The book also sheds light on common misconceptions in applying measurement models, and presents an integrated approach to differ...

  6. Theoretical and practical aspects of measuring market potential

    Directory of Open Access Journals (Sweden)

    Bešlagić Mirza

    2016-01-01

    Full Text Available The area of research in this paper refers to the theoretical, practical and methodological aspects of the assessment of market potential. It presents the main factors relevant to assessing market potential. The process of evaluating the market potential is important, first of all, for optimal adoption of future strategic decisions in business. Planning of business processes is one of the main reasons for the assessment of the market potential and managers often face, when planning, the environmental factors that can not be influenced. Realistic and quality assessment of market potential and sales forecasting in companies becomes not only a means of gaining competitive advantage, but also a necessary condition for long-term development and survival in the market. Knowledge of the potential market increases the efficiency of business operations. To this end, the theoretical, methodological and practical problems of assessment of market potential were analyzed. The need for this is all the more pronounced because of objective, reliable and valid assessment of the market potential is a prerequisite of business improvement and long-term development of enterprises. The aim was to explain the characteristics of the market potential as one of the primary market sizes in order to carry out its assessment. In this context, it was necessary to identify the main factors influencing the assessment of market potential. Results of the study showed that factors of macro and micro environment of the company, competition and purchasing power determine the market potential of edible oil in Bosnia and Herzegovina. In the empirical part of the paper are applied most common methods of assessment of market potential.

  7. Practical Measurement and Productive Persistence: Strategies for Using Digital Learning System Data to Drive Improvement

    Science.gov (United States)

    Krumm, Andrew E.; Beattie, Rachel; Takahashi, Sola; D'Angelo, Cynthia; Feng, Mingyu; Cheng, Britte

    2016-01-01

    This paper outlines the development of practical measures of productive persistence using digital learning system data. Practical measurement refers to data collection and analysis approaches originating from improvement science; productive persistence refers to the combination of academic and social mindsets as well as learning behaviours that…

  8. Registries in European post-marketing surveillance

    DEFF Research Database (Denmark)

    Bouvy, Jacoline C; Blake, Kevin; Slattery, Jim

    2017-01-01

    at gaining further insight into the European Medicines Agency's (EMA) requests for new registries and registry studies using existing registries and to review the experience gained in their conduct. METHODS: European Public Assessment Reports were consulted to identify products for which a request...

  9. Measuring farmer conservation behaviors: Challenges and best practices

    Science.gov (United States)

    Kristin Floress; Adam Reimer; Aaron Thompson; Mark Burbach; Cody Knutson; Linda Prokopy; Marc Ribaudo; Jessica. Ulrich-Schad

    2018-01-01

    This article presents a guide for understanding the purposes and appropriate uses of different measures of conservation behavior. While applicable across natural resource management contexts, we primarily draw upon agricultural conservation research to illustrate our points. Farmers are often of interest to researchers, program managers, extension professionals, and...

  10. Putting Measurement First: Understanding "Grit" in Educational Policy and Practice

    Science.gov (United States)

    Peterson, Daniel

    2015-01-01

    Non-cognitive dispositions have recently become psychological constructs of interest in the education, economics, philosophy, sociology, and psychology literature. In this article, I draw the distinction between property-first and measurement-first approaches to understanding the meaning of a particular non-cognitive disposition theoretical term,…

  11. BOOK REVIEW: Evaluating the Measurement Uncertainty: Fundamentals and practical guidance

    Science.gov (United States)

    Lira, Ignacio

    2003-08-01

    Evaluating the Measurement Uncertainty is a book written for anyone who makes and reports measurements. It attempts to fill the gaps in the ISO Guide to the Expression of Uncertainty in Measurement, or the GUM, and does a pretty thorough job. The GUM was written with the intent of being applicable by all metrologists, from the shop floor to the National Metrology Institute laboratory; however, the GUM has often been criticized for its lack of user-friendliness because it is primarily filled with statements, but with little explanation. Evaluating the Measurement Uncertainty gives lots of explanations. It is well written and makes use of many good figures and numerical examples. Also important, this book is written by a metrologist from a National Metrology Institute, and therefore up-to-date ISO rules, style conventions and definitions are correctly used and supported throughout. The author sticks very closely to the GUM in topical theme and with frequent reference, so readers who have not read GUM cover-to-cover may feel as if they are missing something. The first chapter consists of a reprinted lecture by T J Quinn, Director of the Bureau International des Poids et Mesures (BIPM), on the role of metrology in today's world. It is an interesting and informative essay that clearly outlines the importance of metrology in our modern society, and why accurate measurement capability, and by definition uncertainty evaluation, should be so important. Particularly interesting is the section on the need for accuracy rather than simply reproducibility. Evaluating the Measurement Uncertainty then begins at the beginning, with basic concepts and definitions. The third chapter carefully introduces the concept of standard uncertainty and includes many derivations and discussion of probability density functions. The author also touches on Monte Carlo methods, calibration correction quantities, acceptance intervals or guardbanding, and many other interesting cases. The book goes

  12. Measuring solar reflectance - Part II: Review of practical methods

    Energy Technology Data Exchange (ETDEWEB)

    Levinson, Ronnen; Akbari, Hashem; Berdahl, Paul [Heat Island Group, Environmental Energy Technologies Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States)

    2010-09-15

    A companion article explored how solar reflectance varies with surface orientation and solar position, and found that clear sky air mass 1 global horizontal (AM1GH) solar reflectance is a preferred quantity for estimating solar heat gain. In this study we show that AM1GH solar reflectance R{sub g,0} can be accurately measured with a pyranometer, a solar spectrophotometer, or an updated edition of the Solar Spectrum Reflectometer (version 6). Of primary concern are errors that result from variations in the spectral and angular distributions of incident sunlight. Neglecting shadow, background and instrument errors, the conventional pyranometer technique can measure R{sub g,0} to within 0.01 for surface slopes up to 5:12 [23 ], and to within 0.02 for surface slopes up to 12:12 [45 ]. An alternative pyranometer method minimizes shadow errors and can be used to measure R{sub g,0} of a surface as small as 1 m in diameter. The accuracy with which it can measure R{sub g,0} is otherwise comparable to that of the conventional pyranometer technique. A solar spectrophotometer can be used to determine R{sub g,0}{sup *}, a solar reflectance computed by averaging solar spectral reflectance weighted with AM1GH solar spectral irradiance. Neglecting instrument errors, R{sub g,0}{sup *} matches R{sub g,0} to within 0.006. The air mass 1.5 solar reflectance measured with version 5 of the Solar Spectrum Reflectometer can differ from R{sub g,0}{sup *} by as much as 0.08, but the AM1GH output of version 6 of this instrument matches R{sub g,0}{sup *} to within about 0.01. (author)

  13. Presenting an evaluation model of the trauma registry software.

    Science.gov (United States)

    Asadi, Farkhondeh; Paydar, Somayeh

    2018-04-01

    and sub criteria related to each main criteria separately. This model was validated by experts in this field. Therefore, this model can be used as a comprehensive model and a standard evaluation tool for measuring efficiency and effectiveness and performance improvement of trauma registry software. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. The Prostate Cancer Registry: monitoring patterns and quality of care for men diagnosed with prostate cancer.

    Science.gov (United States)

    Evans, Sue M; Millar, Jeremy L; Wood, Julie M; Davis, Ian D; Bolton, Damien; Giles, Graham G; Frydenberg, Mark; Frauman, Albert; Costello, Antony; McNeil, John J

    2013-04-01

    To establish a pilot population-based clinical registry with the aim of monitoring the quality of care provided to men diagnosed with prostate cancer. All men aged >18 years from the contributing hospitals in Victoria, Australia, who have a diagnosis of prostate cancer confirmed by histopathology report notified to the Victorian Cancer Registry are eligible for inclusion in the Prostate Cancer Registry (PCR). A literature review was undertaken aiming to identify existing quality indicators and source evidence-based guidelines from both Australia and internationally. A Steering Committee was established to determine the minimum dataset, select quality indicators to be reported back to clinicians, identify the most effective recruitment strategy, and provide a governance structure for data requests; collection, analysis and reporting of data; and managing outliers. A minimum dataset comprising 72 data items is collected by the PCR, enabling ten quality indicators to be collected and reported. Outcome measures are risk adjusted according to the established National Comprehensive Cancer Network and Cancer of the Prostate Risk Assessment Score (surgery only) risk stratification model. Recruitment to the PCR occurs concurrently with mandatory notification to the state-based Cancer Registry. The PCR adopts an opt-out consent process to maximize recruitment. The data collection approach is standardized, using a hybrid of data linkage and manual collection, and data collection forms are electronically scanned into the PCR. A data access policy and escalation policy for mortality outliers has been developed. The PCR provides potential for high-quality population-based data to be collected and managed within a clinician-led governance framework. This approach satisfies the requirement for health services to establish quality assessment, at the same time as providing clinically credible data to clinicians to drive practice improvement. © 2012 THE AUTHORS. BJU INTERNATIONAL

  15. Measuring health: a practical challenge with a philosophical solution?

    Science.gov (United States)

    Shroufi, Amir; Chowdhury, Rajiv; Aston, Louise M; Pashayan, Nora; Franco, Oscar H

    2011-03-01

    With the current demographic shift being experienced by populations globally, almost linear increases in life expectancy have been seen and can be expected. However, increases in healthy life expectancy may not keep pace. Among older populations the proportion of time spent in less than full health tends to increase. As a result, the accurate valuation of life spent in states less than full health will become increasingly important. Different techniques and approaches have been used to measure health in populations. The use of summary measures of population health such as DALYs (Disability Adjusted Life Years) has become common, and is widely used to compare health between populations and to evaluate the potential impact of interventions in economic analyses. Most of the commonly used summary measures of health express some measure of life lived in full health and life lived with disability or in a state of sub-optimal health. Critical to the construction of summary health measures are values assigned to health states. Current tools used in determining these values include the standard gamble, time trade off, person trade off, and the visual analogue scale. However, these techniques all have the disadvantage of incorporating individual biases (derived from particular characteristics specific to individuals or populations) into the process through which health state valuations are derived. As a consequence health states are often not directly comparable between populations, since characteristics such as nationality and ethnicity can influence how health states are valued. Furthermore, health can be judged differently by those of different ages, with the young often assigning a lower value to life lived at less than full health compared to older people. The challenge of obtaining opinions which are not influenced by an individual's own circumstances is not new. This issue was encountered and described by the American philosopher John Rawls in 'A Theory of Justice

  16. Quality measurement affecting surgical practice: Utility versus utopia.

    Science.gov (United States)

    Henry, Leonard R; von Holzen, Urs W; Minarich, Michael J; Hardy, Ashley N; Beachy, Wilbur A; Franger, M Susan; Schwarz, Roderich E

    2018-03-01

    The Triple Aim: improving healthcare quality, cost and patient experience has resulted in massive healthcare "quality" measurement. For many surgeons the origins, intent and strengths of this measurement barrage seems nebulous-though their shortcomings are noticeable. This article reviews the major organizations and programs (namely the Centers for Medicare and Medicaid Services) driving the somewhat burdensome healthcare quality climate. The success of this top-down approach is mixed, and far from convincing. We contend that the current programs disproportionately reflect the definitions of quality from (and the interests of) the national payer perspective; rather than a more balanced representation of all stakeholders interests-most importantly, patients' beneficence. The result is an environment more like performance management than one of valid quality assessment. Suggestions for a more meaningful construction of surgical quality measurement are offered, as well as a strategy to describe surgical quality from all of the stakeholders' perspectives. Our hope is to entice surgeons to engage in institution level quality improvement initiatives that promise utility and are less utopian than what is currently present. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Associations between structural capabilities of primary care practices and performance on selected quality measures.

    Science.gov (United States)

    Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Zaslavsky, Alan M; Schneider, Eric C

    2009-10-06

    Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown. To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures. Cross-sectional analysis. Massachusetts. 412 primary care practices. During 2007, 1 physician from each participating primary care practice (median size, 4 physicians) was surveyed about structural capabilities of the practice (responses representing 308 practices were obtained). Data on practice structural capabilities were linked to multipayer performance data on 13 Healthcare Effectiveness Data and Information Set (HEDIS) process measures in 4 clinical areas: screening, diabetes, depression, and overuse. Frequently used multifunctional electronic health records were associated with higher performance on 5 HEDIS measures (3 in screening and 2 in diabetes), with statistically significant differences in performance ranging from 3.1 to 7.6 percentage points. Frequent meetings to discuss quality were associated with higher performance on 3 measures of diabetes care (differences ranging from 2.3 to 3.1 percentage points). Physician awareness of patient experience ratings was associated with higher performance on screening for breast cancer and cervical cancer (1.9 and 2.2 percentage points, respectively). No other structural capabilities were associated with performance on more than 1 measure. No capabilities were associated with performance on depression care or overuse. Structural capabilities of primary care practices were assessed by physician survey. Among the investigated structural capabilities of primary care practices, electronic health records were associated with higher performance across multiple HEDIS measures. Overall, the modest magnitude and

  18. Specificity of Geotechnical Measurements and Practice of Polish Offshore Operations

    Directory of Open Access Journals (Sweden)

    Bogumil Laczynski

    2015-12-01

    Full Text Available As offshore market in Europe grows faster and faster, new sea areas are being managed and new ideas on how to use the sea potential are being developed. In North Sea, where offshore industry conducts intensive expansion since late 1960s, numerous wind farms, oil and gas platforms and pipelines have been put into operation following extensive research, including geotechnical measurement. Recently, a great number of similar projects is under development in Baltic Sea, inter alia in Polish EEZ, natural conditions of which vary from the North Sea significantly. In this paper, those differences are described together with some solutions to problems thereby arising.

  19. How to measure soundscapes. A theoretical and practical approach

    Science.gov (United States)

    Schulte-Fortkamp, Brigitte

    2002-11-01

    Noise sources interact with the specific acoustic and environmental makeup, topography, meteorology, land use pattern, and lifestyle. The evaluation of soundscapes needs subject-related methodological procedures. With such suitable measurements a way has to be found that allows us to rely on different dimensions on reaction to noise. Improving the soundscape of an urban environment imposes to account for the qualitative appreciation as a cognitive judgment given by listeners and, particularly, for the interaction between acoustic dimensions and other sensory modalities in qualitative judgments of an urban environment (Maffiolo). The structure of the residential area that is, the combination of noise sources are important for the judgment of a soundscope and are also important as subjective parameters which are relevant in people's point of view. Moreover, the relationship of both define the background for assessments. Studies are needed on the subject and its capability in perception and interpretation; studies on the subject inside the society, studies on the social and cultural context, and field studies including physical measurements. Soundscapes may be defined in its effects on man and vice versa and probably acoustical ecology will serve to understand the function of soundscapes.

  20. Practical Weak-lensing Shear Measurement with Metacalibration

    Energy Technology Data Exchange (ETDEWEB)

    Sheldon, Erin S. [Brookhaven National Laboratory, Bldg. 510, Upton, NY 11973 (United States); Huff, Eric M. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, CA 91109 (United States)

    2017-05-20

    Metacalibration is a recently introduced method to accurately measure weak gravitational lensing shear using only the available imaging data, without need for prior information about galaxy properties or calibration from simulations. The method involves distorting the image with a small known shear, and calculating the response of a shear estimator to that applied shear. The method was shown to be accurate in moderate-sized simulations with galaxy images that had relatively high signal-to-noise ratios, and without significant selection effects. In this work we introduce a formalism to correct for both shear response and selection biases. We also observe that for images with relatively low signal-to-noise ratios, the correlated noise that arises during the metacalibration process results in significant bias, for which we develop a simple empirical correction. To test this formalism, we created large image simulations based on both parametric models and real galaxy images, including tests with realistic point-spread functions. We varied the point-spread function ellipticity at the five-percent level. In each simulation we applied a small few-percent shear to the galaxy images. We introduced additional challenges that arise in real data, such as detection thresholds, stellar contamination, and missing data. We applied cuts on the measured galaxy properties to induce significant selection effects. Using our formalism, we recovered the input shear with an accuracy better than a part in a thousand in all cases.

  1. The Danish Lung Cancer Registry

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Rasmussen, Torben Riis

    2016-01-01

    AIM OF DATABASE: The Danish Lung Cancer Registry (DLCR) was established by the Danish Lung Cancer Group. The primary and first goal of the DLCR was to improve survival and the overall clinical management of Danish lung cancer patients. STUDY POPULATION: All Danish primary lung cancer patients since...... 2000 are included into the registry and the database today contains information on more than 50,000 cases of lung cancer. MAIN VARIABLES: The database contains information on patient characteristics such as age, sex, diagnostic procedures, histology, tumor stage, lung function, performance...... the results are commented for local, regional, and national audits. Indicator results are supported by descriptive reports with details on diagnostics and treatment. CONCLUSION: DLCR has since its creation been used to improve the quality of treatment of lung cancer in Denmark and it is increasingly used...

  2. Hospital process orientation from an operations management perspective: development of a measurement tool and practical testing in three ophthalmic practices.

    Science.gov (United States)

    Gonçalves, Pedro D; Hagenbeek, Marie Louise; Vissers, Jan M H

    2013-11-13

    Although research interest in hospital process orientation (HPO) is growing, the development of a measurement tool to assess process orientation (PO) has not been very successful yet. To view a hospital as a series of processes organized around patients with a similar demand seems to be an attractive proposition, but it is hard to operationalize this idea in a measurement tool that can actually measure the level of PO. This research contributes to HPO from an operations management (OM) perspective by addressing the alignment, integration and coordination of activities within patient care processes. The objective of this study was to develop and practically test a new measurement tool for assessing the degree of PO within hospitals using existing tools. Through a literature search we identified a number of constructs to measure PO in hospital settings. These constructs were further operationalized, using an OM perspective. Based on five dimensions of an existing questionnaire a new HPO-measurement tool was developed to measure the degree of PO within hospitals on the basis of respondents' perception. The HPO-measurement tool was pre-tested in a non-participating hospital and discussed with experts in a focus group. The multicentre exploratory case study was conducted in the ophthalmic practices of three different types of Dutch hospitals. In total 26 employees from three disciplines participated. After filling in the questionnaire an interview was held with each participant to check the validity and the reliability of the measurement tool. The application of the HPO-measurement tool, analysis of the scores and interviews with the participants resulted in the possibility to identify differences of PO performance and the areas of improvement--from a PO point of view--within each hospital. The result of refinement of the items of the measurement tool after practical testing is a set of 41 items to assess the degree of PO from an OM perspective within hospitals. The

  3. The Danish Registry of Diabetic Retinopathy

    DEFF Research Database (Denmark)

    Andersen, Nis; Hjortdal, Jesper Østergaard; Schielke, Katja Christina

    2016-01-01

    . Denmark (5.5 million inhabitants) has ~320,000 diabetes patients with an annual increase of 27,000 newly diagnosed patients. The Danish Registry of Diabetic Retinopathy (DiaBase) collects data on all diabetes patients aged ≥18 years who attend screening for diabetic eye disease in hospital eye departments...... and in private ophthalmological practice. In 2014-2015, DiaBase included data collected from 77,968 diabetes patients. Main variables: The main variables provide data for calculation of performance indicators to monitor the quality of diabetic eye screening and development of diabetic retinopathy. Data...... with respect to age, sex, best corrected visual acuity, screening frequency, grading of diabetic retinopathy and maculopathy at each visit, progression/regression of diabetic eye disease, and prevalence of blindness were obtained. Data analysis from DiaBase’s latest annual report (2014-2015) indicates...

  4. The Danish Registry of Diabetic Retinopathy

    DEFF Research Database (Denmark)

    Andersen, Nis; Hjortdal, Jesper Østergaard; Schielke, Katja Christina

    2016-01-01

    . Denmark (5.5 million inhabitants) has ~320,000 diabetes patients with an annual increase of 27,000 newly diagnosed patients. The Danish Registry of Diabetic Retinopathy (DiaBase) collects data on all diabetes patients aged ≥18 years who attend screening for diabetic eye disease in hospital eye departments...... and in private ophthalmological practice. In 2014-2015, DiaBase included data collected from 77,968 diabetes patients. MAIN VARIABLES: The main variables provide data for calculation of performance indicators to monitor the quality of diabetic eye screening and development of diabetic retinopathy. Data...... with respect to age, sex, best corrected visual acuity, screening frequency, grading of diabetic retinopathy and maculopathy at each visit, progression/regression of diabetic eye disease, and prevalence of blindness were obtained. Data analysis from DiaBase's latest annual report (2014-2015) indicates...

  5. Practical application of COD measurement in welded assemblies

    International Nuclear Information System (INIS)

    Beghe, S.

    1975-01-01

    Measurement of the COD makes it possible to evaluate sensitivity to brittle fracture initiation. This technique is ideal for welded structures, owing to the types of defect likely to affect them, and the magnitude of the residual stresses introduced. Moreover, the COD concept, based on thickness and temperature experiments on materials, enables evaluation of the critical defect size in these structures. However, its application to welded joints encounters certain problems. The presence of fatigue cracks in the molten zone of a welded joint is frequently disturbed by the residual stresses caused by welding. An additional difficulty is created by the problem of stable growth of the crack during the bending test. This discussion covers all these matters and suggests some solutions [fr

  6. CIRSE Vascular Closure Device Registry

    International Nuclear Information System (INIS)

    Reekers, Jim A.; Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

    2011-01-01

    Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only 5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.

  7. CIRSE Vascular Closure Device Registry

    Science.gov (United States)

    Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

    2010-01-01

    Purpose Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only 5.9 cm, and two vessel occlusions. Conclusion The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters. PMID:20981425

  8. I RBH - First Brazilian Hypertension Registry.

    Science.gov (United States)

    Jardim, Paulo César Brandão Veiga; Souza, Weimar Kunz Sebba Barroso de; Lopes, Renato Delascio; Brandão, Andréa Araújo; Malachias, Marcus V Bolívar; Gomes, Marco Mota; Moreno Júnior, Heitor; Barbosa, Eduardo Costa Duarte; Póvoa, Rui Manoel Dos Santos

    2016-08-01

    A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP) control, and adherence to treatment. National, observational, prospective, and multicenter study that will include patients older than 18 years with hypertension for at least 4 weeks, following up in public and private centers and after signing a consent form. The study will exclude patients undergoing dialysis, hospitalized in the previous 30 days, with class III or IV heart failure, pregnant or nursing, with severe liver disease, stroke or acute myocardial infarction in the past 30 days, or with diseases with a survival prognosis crisis, cardiocirculatory events, and cardiovascular death, while secondary outcomes will be hospitalization for heart failure and requirement of dialysis. A subgroup analysis of 15% of the sample will include noninvasive central pressure evaluation at baseline and study end. The estimated sample size is 3,000 individuals for a prevalence of 5%, sample error of 2%, and 95% confidence interval. The results will be presented after the final evaluation, which will occur at the end of a 1-year follow-up. The analysis of this registry will improve the knowledge and optimize the treatment of hypertension in Brazil, as a way of modifying the prognosis of cardiovascular disease in the country.

  9. Factors influencing the use of outcome measures in physical therapy practice.

    Science.gov (United States)

    Wedge, Frances M; Braswell-Christy, Jennifer; Brown, Cynthia J; Foley, Kathleen T; Graham, Cecilia; Shaw, Sharon

    2012-02-01

    Use of outcome measures in physical therapy practice is central to evaluating the effectiveness of treatment interventions, providing accountability and addressing quality of physical therapy programs. There is limited discussion on barriers and facilitators to using outcome measures in physical therapy practice. The purpose of this study was to identify factors that influence a physical therapist when deciding to use outcome measures in clinical practice. Participants were 21 physical therapists, seven each from skilled nursing facilities, outpatient clinics, and inpatient rehabilitation facilities. A grounded theory approach was used for interview and data collection. Common themes were determined from the data and a theory developed to explain the rationale behind physical therapists' decisions to use or not use outcome measures in clinical practice. Three overlapping themes related to (1) concepts of time, (2) knowledge, and (3) facility culture were indentified as factors influencing the use of outcome measures. A fourth encompassing theme, professionalism, identified the value placed on the use of outcome measures in practice. Data revealed that therapists require more information on the outcome measures available, and this information needs to be easily accessible within the workplace. Therapists value information generated by using outcome measures in the clinical setting, but need information on what measures are available and psychometric properties. Information must be easily accessible and measures easy to use. Newer graduates and recent learners have a foundation in the use of outcome measures, but more needs to be done in the clinic and through continuing education to promote increased use and understanding.

  10. Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

    Science.gov (United States)

    Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J

    2015-12-01

    Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

  11. Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice.

    Science.gov (United States)

    Feuerstein, Joseph D; Castillo, Natalia E; Siddique, Sana S; Lewandowski, Jeffrey J; Geissler, Kathy; Martinez-Vazquez, Manuel; Thukral, Chandrashekhar; Leffler, Daniel A; Cheifetz, Adam S

    2016-03-01

    Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P measures. We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures. Copyright © 2016 AGA Institute. Published by Elsevier Inc

  12. How Suitable Are Registry Data for Recurrence Risk Calculations?

    DEFF Research Database (Denmark)

    Ellesøe, Sabrina Gade; Jensen, Anders Boeck; Ängquist, Lars Henrik

    2016-01-01

    if registry data are used indiscriminately. Here, we investigated the consequences of misclassifications for the RRR using validated diagnoses on Danish patients with familial CHD. METHODS: Danish citizens are assigned a civil registration number (CPR number) at birth or immigration, which acts as a unique...... of the PPVs of diagnoses in the Danish registries, and from this, we deduced the false discovery rate (FDR). To measure the consequences on the RRR, the FDR was applied to a simulated data set with true RRR values of 2 and 10. RESULTS: We validated diagnoses of 2,442 patients from 1,593 families. Of these...

  13. The Lombardia Stroke Unit Registry: a year experience

    Directory of Open Access Journals (Sweden)

    Giuseppe Micieli

    2010-12-01

    Full Text Available Stroke is the third cause of death and the first long-term disability cause in industrialised countries. It is therefore an important problem, not only from a clinical point of view, but also because of the high costs involved in its management. The results of clinical trials, reviews and meta-analysis highlight the importance of the Stroke Unit in the correct and adequate management of the patient with stroke. This article describes the Lombardia Stroke Unit and the related Stroke Registry. In 2010 this Registry includes 27 Centres and recruits patients with acute stroke or transient ischaemic attacks (TIAs. The Registry aims at measuring performance parameters, identifying guidelines, non-compliance causes, and analysing care processes.

  14. Developing risk management dashboards using risk and quality measures: A visual best practices approach.

    Science.gov (United States)

    Bunting, Robert F; Siegal, Dana

    2017-10-01

    Because quality measures are ubiquitous, health care risk management leaders often use them as a proxy for risk management measures. While certain quality measures adequately reflect some aspects of risk management, they are neither a perfect nor complete substitute for well-developed and comprehensive risk management measures. Using a comprehensive approach consisting of quality measures, risk measures, and measures that are less amenable to classification would be the best approach. Identifying the most powerful and informative measures, designing the most appropriate dashboards, and incorporating visual best practices are crucial steps required for evaluating the effectiveness and value of an enterprise risk management program. The authors explain the terms and concepts, review the measures available in the literature, propose new measures, discuss visual best practices, and provide sample dashboard components. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  15. Has the frequency of bleeding changed over time for patients presenting with an acute coronary syndrome? The global registry of acute coronary events.

    OpenAIRE

    Fox, KA; Carruthers, K; Steg, PG; Avezum, A; Granger, CB; Montalescot, G; Goodman, SG; Gore, JM; Quill, AL; Eagle, KA; GRACE Investigators,

    2010-01-01

    08.09.14 KB. Ok to add published version to spiral, OA paper AIMS: To determine whether changes in practice, over time, are associated with altered rates of major bleeding in acute coronary syndromes (ACS). METHODS AND RESULTS: Patients from the Global Registry of Acute Coronary Events were enrolled between 2000 and 2007. The main outcome measures were frequency of major bleeding, including haemorrhagic stroke, over time, after adjustment for patient characteristics, and impact of major b...

  16. The Three Mile Island Population Registry.

    Science.gov (United States)

    Goldhaber, M K; Tokuhata, G K; Digon, E; Caldwell, G G; Stein, G F; Lutz, G; Gur, D

    1983-01-01

    Shortly after the March 28, 1979, accident at the Three Mile Island (TMI) nuclear plant outside Harrisburg, Pa., the Pennsylvania Department of Health, in conjunction with the Centers for Disease Control and the U.S. Bureau of the Census, conducted a census of the 35,930 persons residing within 5 miles of the plant. With the help of 150 enumerators, demographic and health-related information was collected on each person to provide baseline data for future short- and long-term epidemiologic studies of the effects of the accident. Individual radiation doses were estimated on the basis of residential location and the amount of time each person spent in the 5-mile area during the 10 days after the accident. Health and behavioral resurveys of the population will be conducted approximately every 5 years. Population-mobility, morbidity, and mortality will be studied yearly by matching the TMI Population Registry with postal records, cancer registry records, and death certificate data. Because the radiation dose from TMI was extremely small, any increase in morbidity or mortality attributable to the accident would be so small as not to be measurable by present methods; however, adverse health effects as a result of psychological stress may occur. Also, a temporary increase in reporting of disease could occur because of increased surveillance and attention to health.

  17. Measuring Collaboration and Communication to Increase Implementation of Evidence-Based Practices: The Cultural Exchange Inventory

    Science.gov (United States)

    Palinkas, Lawrence A.; Garcia, Antonio; Aarons, Gregory; Finno-Velasquez, Megan; Fuentes, Dahlia; Holloway, Ian; Chamberlain, Patricia

    2018-01-01

    The Cultural Exchange Inventory (CEI) is a 15-item instrument designed to measure the process (7 items) and outcomes (8 items) of exchanges of knowledge, attitudes and practices between members of different organisations collaborating in implementing evidence-based practice. We conducted principal axis factor analyses and parallel analyses of data…

  18. Use of general practice, diagnostic investigations and hospital services before and after cancer diagnosis - a population-based nationwide registry study of 127,000 incident adult cancer patients

    Directory of Open Access Journals (Sweden)

    Christensen Karina

    2012-07-01

    Full Text Available Abstract Background Knowledge of patterns in cancer patients’ health care utilisation around the time of diagnosis may guide health care resource allocation and provide important insights into this groups’ demand for health care services. The health care need of patients with comorbid conditions far exceeds the oncology capacity and it is therefore important to elucidate the role of both primary and secondary care. The aim of this paper is to describe the use of health care services amongst incident cancer patients in Denmark one year before and one year after cancer diagnosis. Methods The present study is a national population-based case–control (1:10 registry study. All incident cancer patients (n = 127,210 diagnosed between 2001 and 2006 aged 40 years or older were identified in the Danish Cancer Registry. Data from national health registries were provided for all cancer patients and for 1,272,100 controls. Monthly consultation frequencies, monthly proportions of persons receiving health services and three-month incidence rate ratios for one year before and one year after the cancer diagnosis were calculated. Data were analysed separately for women and men. Results Three months before their diagnosis, cancer patients had twice as many general practitioner (GP consultations, ten to eleven times more diagnostic investigations and five times more hospital contacts than the reference population. The demand for GP services peaked one month before diagnosis, the demand for diagnostic investigations one month after diagnosis and the number of hospital contacts three months after diagnosis. The proportion of cancer patients receiving each of these three types of health services remained more than 10% above that of the reference population from two months before diagnosis until the end of the study period. Conclusions Cancer patients’ health service utilisation rose dramatically three months before their diagnosis. This increase applied to

  19. Best practices in selecting performance measures and standards for effective asset management.

    Science.gov (United States)

    2011-06-01

    "This report assesses and provides guidance on best practices in performance measurement, management and standards : setting for effective Transportation Asset Management (TAM). The study is conducted through a literature review, a : survey of the 50...

  20. The Danish Heart Failure Registry

    DEFF Research Database (Denmark)

    Schjødt, Inge; Nakano, Anne; Egstrup, Kenneth

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Heart Failure Registry (DHFR) is to monitor and improve the care of patients with incident heart failure (HF) in Denmark. STUDY POPULATION: The DHFR includes inpatients and outpatients (≥18 years) with incident HF. Reporting to the DHFR is mandatory......: The main variables recorded in the DHFR are related to the indicators for quality of care in patients with incident HF: performance of echocardiography, functional capacity (New York Heart Association functional classification), pharmacological therapy (angiotensin converting enzyme/angiotensin II...

  1. The Danish National Prescription Registry

    DEFF Research Database (Denmark)

    Kildemoes, Helle Wallach; Toft Sørensen, Henrik; Hallas, Jesper

    2011-01-01

    Introduction: Individual-level data on all prescription drugs sold in Danish community pharmacies has since 1994 been recorded in the Register of Medicinal Products Statistics of the Danish Medicines Agency. Content: The register subset, termed the Danish National Prescription Registry (DNPR......), contains information on dispensed prescriptions, including variables at the level of the drug user, the prescriber, and the pharmacy. Validity and coverage: Reimbursement-driven record keeping, with automated bar-code-based data entry provides data of high quality, including detailed information...

  2. Uses and limitations of registry and academic databases.

    Science.gov (United States)

    Williams, William G

    2010-01-01

    A database is simply a structured collection of information. A clinical database may be a Registry (a limited amount of data for every patient undergoing heart surgery) or Academic (an organized and extensive dataset of an inception cohort of carefully selected subset of patients). A registry and an academic database have different purposes and cost. The data to be collected for a database is defined by its purpose and the output reports required for achieving that purpose. A Registry's purpose is to ensure quality care, an Academic Database, to discover new knowledge through research. A database is only as good as the data it contains. Database personnel must be exceptionally committed and supported by clinical faculty. A system to routinely validate and verify data integrity is essential to ensure database utility. Frequent use of the database improves its accuracy. For congenital heart surgeons, routine use of a Registry Database is an essential component of clinical practice. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  3. Using data to improve medical practice by measuring processes and outcomes of care.

    Science.gov (United States)

    Nelson, E C; Splaine, M E; Godfrey, M M; Kahn, V; Hess, A; Batalden, P; Plume, S K

    2000-12-01

    The purpose of this article is to help clinicians expand their use of data to improve medical practice performance and to do improvement research. Clinical practices can be viewed as small, complex organizations (microsystems) that produce services for specific patient populations. These services can be greatly improved by embedding measurement into the flow of daily work in the practice. WHY DO IT?: Four good reasons to build measures into daily medical practice are to (1) diagnose strengths and weaknesses in practice performance; (2) improve and innovate in providing care and services using improvement research; (3) manage patients and the practice; and (4) evaluate changes in results over time. It is helpful to have a "physiological" model of a medical practice to analyze the practice, to manage it, and to improve it. One model views clinical practices as microsystems that are designed to generate desired health outcomes for specific subsets of patients and to use resources efficiently. This article provides case study examples to show what an office-based practice might look like if it were using front-line measurement to improve care and services most of the time and to conduct clinical improvement research some of the time. WHAT ARE THE PRINCIPLES FOR USING DATA TO IMPROVE PROCESSES AND OUTCOMES OF CARE?: Principles reflected in the case study examples--such as "Keep Measurement Simple. Think Big and Start Small" and "More Data Is Not Necessarily Better Data. Seek Usefulness, Not Perfection, in Your Measures"--may help guide the development of data to study and improve practice. HOW CAN A PRACTICE START TO USE DATA TO IMPROVE CARE AND CONDUCT IMPROVEMENT RESEARCH?: Practical challenges are involved in starting to use data for enhancing care and improvement research. To increase the odds for success, it would be wise to use a change management strategy to launch the startup plan. Other recommendations include "Establish a Sense of Urgency. (Survival Is Not

  4. High Mortality without ESCAPE: The Registry of Heart Failure Patients Receiving Pulmonary Artery Catheters without Randomization

    Science.gov (United States)

    Allen, Larry A.; Rogers, Joseph G.; Warnica, J. Wayne; DiSalvo, Thomas G.; Tasissa, Gudaye; Binanay, Cynthia; O’Connor, Christopher M.; Califf, Robert M.; Leier, Carl V.; Shah, Monica R.; Stevenson, Lynne W.

    2008-01-01

    Background In ESCAPE, there was no difference in days alive and out of the hospital for patients with decompensated heart failure (HF) randomly assigned to therapy guided by pulmonary artery catheter (PAC) plus clinical assessment versus clinical assessment alone. The external validity of these findings is debated. Methods and Results ESCAPE sites enrolled 439 patients receiving PAC without randomization in a prospective registry. Baseline characteristics, pertinent trial exclusion criteria, reasons for PAC use, hemodynamics, and complications were collected. Survival was determined from the National Death Index and the Alberta Registry. On average, registry patients had lower blood pressure, worse renal function, less neurohormonal antagonist therapy, and higher use of intravenous inotropes as compared with trial patients. Although clinical assessment anticipated less volume overload and greater hypoperfusion among the registry population, measured filling pressures were similarly elevated in the registry and trial, while measured perfusion was slightly higher among registry patients. Registry patients had longer hospitalization (13 vs. 6 days, p <0.001) and higher 6-month mortality (34% vs. 20%, p < 0.001) than trial patients. Conclusions The decision to use PAC without randomization identified a population with higher disease severity and risk of mortality. This prospective registry highlights the complex context of patient selection for randomized trials. PMID:18926438

  5. A Review of Psychometric Assessment and Reporting Practices: An Examination of Measurement-Oriented versus Non-Measurement-Oriented Domains

    Science.gov (United States)

    Slaney, Kathleen L.; Tkatchouk, Masha; Gabriel, Stephanie M.; Ferguson, Leona P.; Knudsen, Jared R. S.; Legere, Julien C.

    2010-01-01

    The primary aim of the present study is to determine whether the psychometric evaluation practices and test-analytic rationales of researchers publishing in journals with a measurement focus differ from those of researchers publishing in journals with varying substantive research foci. Several components of two different samples of articles were…

  6. Do pre-diagnosis primary care consultation patterns explain deprivation-specific differences in net survival among women with breast cancer? An examination of individually-linked data from the UK West Midlands cancer registry, national screening programme and Clinical Practice Research Datalink.

    Science.gov (United States)

    Morris, M; Woods, L M; Bhaskaran, K; Rachet, B

    2017-02-23

    In England and Wales breast cancer survival is higher among more affluent women. Our aim was to investigate the potential of pre-diagnostic factors for explaining deprivation-related differences in survival. Individually-linked data from women aged 50-70 in the West Midlands region of England, diagnosed with breast cancer 1989-2006 and continuously eligible for screening, was retrieved from the cancer registry, screening service and Clinical Practice Research Datalink. Follow-up was to the end of July 2012. Deprivation was measured at small area level, based on the quintiles of the income domain of the English indices of deprivation. Consultation rates per woman per week, time from last breast-related GP consultation to diagnosis, and from diagnosis to first surgery were calculated. We estimated net survival using the non-parametric Pohar-Perme estimator. The rate of primary care consultations was similar during the 18 months prior to diagnosis in each deprivation group for breast and non-breast symptoms. Survival was lower for more deprived women from 4 years after diagnosis. Lower net survival was associated with more advanced extent of disease and being non-screen-detected. There was a persistent trend of lower net survival for more deprived women, irrespective of the woman's obesity, alcohol, smoking or comorbidity status. There was no significant variation in time from last breast symptom to diagnosis by deprivation. However, women in more deprived categories experienced significantly longer periods between cancer diagnosis and first surgery (mean = 21.5 vs. 28.4 days, p = 0.03). Those whose surgery occurred more than 12 weeks following their cancer diagnosis had substantially lower net survival. Our data suggest that although more deprived women with breast cancer display lifestyle factors associated with poorer outcomes, their consultation frequency, comorbidities and the breast cancer symptoms they present with are similar. We found weak

  7. Immunization registries in the EMR Era

    Science.gov (United States)

    Stevens, Lindsay A.; Palma, Jonathan P.; Pandher, Kiran K.; Longhurst, Christopher A.

    2013-01-01

    Background: The CDC established a national objective to create population-based tracking of immunizations through regional and statewide registries nearly 2 decades ago, and these registries have increased coverage rates and reduced duplicate immunizations. With increased adoption of commercial electronic medical records (EMR), some institutions have used unidirectional links to send immunization data to designated registries. However, access to these registries within a vendor EMR has not been previously reported. Purpose: To develop a visually integrated interface between an EMR and a statewide immunization registry at a previously non-reporting hospital, and to assess subsequent changes in provider use and satisfaction. Methods: A group of healthcare providers were surveyed before and after implementation of the new interface. The surveys addressed access of the California Immunization Registry (CAIR), and satisfaction with the availability of immunization information. Information Technology (IT) teams developed a “smart-link” within the electronic patient chart that provides a single-click interface for visual integration of data within the CAIR database. Results: Use of the tool has increased in the months since its initiation, and over 20,000 new immunizations have been exported successfully to CAIR since the hospital began sharing data with the registry. Survey data suggest that providers find this tool improves workflow and overall satisfaction with availability of immunization data. (p=0.009). Conclusions: Visual integration of external registries into a vendor EMR system is feasible and improves provider satisfaction and registry reporting. PMID:23923096

  8. On Domain Registries and Website Content

    DEFF Research Database (Denmark)

    Schwemer, Sebastian Felix

    2018-01-01

    such as Internet access service providers, hosting platforms, and websites that link to content. This article shows that in recent years, however, that the (secondary) liability of domain registries and registrars, and more specifically country code top-level domain registries (ccTLDs) for website content, has...... been tested in several EU Member States. The article investigates tendencies in the national lower-court jurisprudence and explores to what extent the liability exemption regime of the E-Commerce Directive applies to domain registries. The analysis concludes that whereas domain registries fall under...

  9. Knowledge, attitude and practices about hepatitis B and Infection Control Measures among dental students in Patiala

    Directory of Open Access Journals (Sweden)

    Vishal Malhotra

    2017-01-01

    Full Text Available Background: Hepatitis B is highly infectious, but preventable diseases and dentists are at increased risk of exposure to saliva and blood of patients during their clinical practice, and so it is of utmost importance that they follow standard guidelines for infection control. Aims: To assess knowledge, attitude, and practices regarding infection control measures among dental students of Government Dental College in Punjab. Materials and Methods: A cross-sectional survey using a self-administered pretested questionnaire to dental students and responses were statistically analyzed. The analysis of variance was used to compare means of knowledge, attitude, and practice scores between four groups of study subjects and P < 0.05 is considered statistically significant. Results: Although the students have sufficient knowledge regarding hepatitis B, still there are gaps in putting their knowledge into practice. Third and final year students have significantly less mean knowledge and practice scores compared to interns and postgraduate students. The majority of students have a positive attitude and were willing to perform any procedure on hepatitis B-infected patients. Conclusions: Dental students have adequate knowledge and good attitude but still there are some misconceptions. There is poor implementation of standard infection control measures in their practice. Rigorous training programs on preventive practices and regular workshops must be organized on an annual basis in dental colleges. Moreover, hepatitis B vaccination must be made mandatory for students before they start their clinical practice.

  10. Caries preventive measures used in orthodontic practices: an evidence-based decision?

    NARCIS (Netherlands)

    Derks, A.; Kuijpers-Jagtman, A.M.; Frencken, J.E.F.M.; Hof, M.A. van 't; Katsaros, C.

    2007-01-01

    INTRODUCTION: Although it is well known that treatment with fixed appliances increases the risk of enamel demineralization, little information is available about preventive measures that orthodontists actually use. This study was executed to survey measures used in orthodontic practices to prevent

  11. A new method of measuring the adoption of soil conservation practices : theory and applications

    NARCIS (Netherlands)

    Castaño, J.; Meulenberg, M.T.G.; Tilburg, van A.

    2002-01-01

    This paper presents a new methodology for measuring the adoption of sustainable agricultural practices that attempts to integrate positive features of earlier approaches. It measures the degree of sustainability observed by the farmer and, at the same time, is straightforward and efficient in

  12. National nephrectomy registries: Reviewing the need for population-based data.

    Science.gov (United States)

    Pearson, John; Williamson, Timothy; Ischia, Joseph; Bolton, Damien M; Frydenberg, Mark; Lawrentschuk, Nathan

    2015-09-01

    Nephrectomy is the cornerstone therapy for renal cell carcinoma (RCC) and continued refinement of the procedure through research may enhance patient outcomes. A national nephrectomy registry may provide the key information needed to assess the procedure at a national level. The aim of this study was to review nephrectomy data available at a population-based level in Australia and to benchmark these data against data from the rest of the world as an examination of the national nephrectomy registry model. A PubMed search identified records pertaining to RCC nephrectomy in Australia. A similar search identified records relating to established nephrectomy registries internationally and other surgical registries of clinical importance. These records were reviewed to address the stated aims of this article. Population-based data within Australia for nephrectomy were lacking. Key issues identified were the difficulty in benchmarking outcomes and no ongoing monitoring of trends. The care centralization debate, which questions whether small-volume centers provide comparable outcomes to high-volume centers, is ongoing. Patterns of adherence and the effectiveness of existing protocols are uncertain. A review of established international registries demonstrated that the registry model can effectively address issues comparable to those identified in the Australian literature. A national nephrectomy registry could address deficiencies identified in a given nation's nephrectomy field. The model is supported by evidence from international examples and will provide the population-based data needed for studies. Scope exists for possible integration with other registries to develop a more encompassing urological or surgical registry. Need remains for further exploration of the feasibility and practicalities of initiating such a registry including a minimum data set, outcome indicators, and auditing of data.

  13. Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice.

    Science.gov (United States)

    Hummel, Riët; Bruers, Josef; van der Galiën, Onno; van der Sanden, Wil; van der Heijden, Geert

    2017-10-05

    It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices. A literature search identified previously described outcome measures for oral healthcare. Using a structured approach, identified measures were (i) prioritized, adjusted and added to after discussion and then (ii) tested for feasibility of data collection, their face validity and discriminative validity. Data sources were claims records from Achmea, clinical records from dental practices, and prospective, pre-determined clinical assessment data obtained during routine consultations. In total eight measures (four on dental caries, one on tooth wear, two on periodontal health, one on retreatment) were identified, prioritized and tested. The retreatment measure and three measures for dental caries were found promising as data collection was feasible, they had face validity and discriminative validity. Deployment of these measures demonstrated variation in clinical practices of GDPs. Feedback of this data to GDPs led to vivid discussions on best practices and quality of care. The measure 'tooth wear' was not considered sufficiently responsive; 'changes in periodontal health score' was considered a controversial measure. The available data for the measures 'percentage of 18-year-olds with no tooth decay' and 'improvement in gingival bleeding index at reassessment' was too limited to provide accurate estimates per dental practice. The evaluated measures 'time to first

  14. Parametric model measurement: reframing traditional measurement ideas in neuropsychological practice and research.

    Science.gov (United States)

    Brown, Gregory G; Thomas, Michael L; Patt, Virginie

    Neuropsychology is an applied measurement field with its psychometric work primarily built upon classical test theory (CTT). We describe a series of psychometric models to supplement the use of CTT in neuropsychological research and test development. We introduce increasingly complex psychometric models as measurement algebras, which include model parameters that represent abilities and item properties. Within this framework of parametric model measurement (PMM), neuropsychological assessment involves the estimation of model parameters with ability parameter values assuming the role of test 'scores'. Moreover, the traditional notion of measurement error is replaced by the notion of parameter estimation error, and the definition of reliability becomes linked to notions of item and test information. The more complex PMM approaches incorporate into the assessment of neuropsychological performance formal parametric models of behavior validated in the experimental psychology literature, along with item parameters. These PMM approaches endorse the use of experimental manipulations of model parameters to assess a test's construct representation. Strengths and weaknesses of these models are evaluated by their implications for measurement error conditional upon ability level, sensitivity to sample characteristics, computational challenges to parameter estimation, and construct validity. A family of parametric psychometric models can be used to assess latent processes of interest to neuropsychologists. By modeling latent abilities at the item level, psychometric studies in neuropsychology can investigate construct validity and measurement precision within a single framework and contribute to a unification of statistical methods within the framework of generalized latent variable modeling.

  15. Practical and theoretical basis for performing redox-measurements in compacted bentonite. A literature survey

    International Nuclear Information System (INIS)

    Carlsson, T.; Muurinen, A.

    2008-12-01

    This report reviews the state-of-the-art with regard to redox measurements, especially in compacted water saturated bentonite, but also in natural systems like sediments and ground waters. Both theoretical and practical aspects of redox measurements are discussed, as well as some basic concepts like terminal electron-accepting processes (TEAPs) and oxidative capacity (OXC). The problems associated with the interpretation of measured electrode potentials are treated. Despite many practical and theoretical difficulties, redox measurements continue to be carried out by researchers all over the world. The over-all conclusion from the literature survey is that fruitful redox-measurements can be performed in compacted bentonite. Irrespective of whether the measured redox potentials are absolute or not, the use of electrodes provide a valuable tool for studying, e.g., long-term changes in the pore water of compacted bentonite and/or the diffusion of oxygen into a bentonite. (orig.)

  16. Validation of an instrument to measure inter-organisational linkages in general practice.

    Science.gov (United States)

    Amoroso, Cheryl; Proudfoot, Judith; Bubner, Tanya; Jayasinghe, Upali W; Holton, Christine; Winstanley, Julie; Beilby, Justin; Harris, Mark F

    2007-12-03

    Linkages between general medical practices and external services are important for high quality chronic disease care. The purpose of this research is to describe the development, evaluation and use of a brief tool that measures the comprehensiveness and quality of a general practice's linkages with external providers for the management of patients with chronic disease. In this study, clinical linkages are defined as the communication, support, and referral arrangements between services for the care and assistance of patients with chronic disease. An interview to measure surgery-level (rather than individual clinician-level) clinical linkages was developed, piloted, reviewed, and evaluated with 97 Australian general practices. Two validated survey instruments were posted to patients, and a survey of locally available services was developed and posted to participating Divisions of General Practice (support organisations). Hypotheses regarding internal validity, association with local services, and patient satisfaction were tested using factor analysis, logistic regression and multilevel regression models. The resulting General Practice Clinical Linkages Interview (GP-CLI) is a nine-item tool with three underlying factors: referral and advice linkages, shared care and care planning linkages, and community access and awareness linkages. Local availability of chronic disease services has no affect on the comprehensiveness of services with which practices link, however, comprehensiveness of clinical linkages has an association with patient assessment of access, receptionist services, and of continuity of care in their general practice. The GP-CLI may be useful to researchers examining comparable health care systems for measuring the comprehensiveness and quality of linkages at a general practice-level with related services, possessing both internal and external validity. The tool can be used with large samples exploring the impact, outcomes, and facilitators of high

  17. Parental feeding practices in Mexican American families: initial test of an expanded measure

    Science.gov (United States)

    2013-01-01

    Background Although obesity rates are high among Latino children, relatively few studies of parental feeding practices have examined Latino families as a separate group. Culturally-based approaches to measurement development can begin to identify parental feeding practices in specific cultural groups. This study used qualitative and quantitative methods to develop and test the Parental Feeding Practices (PFP) Questionnaire for use with Mexican American parents. Items reflected both parent’s use of control over child eating and child-centered feeding practices. Methods In the qualitative phase of the research, 35 Latino parents participated in focus groups. Items for the PFP were developed from focus group discussions, as well as adapted from existing parent feeding practice measures. Cognitive interviews were conducted with 37 adults to evaluate items. In the quantitative phase, mothers and fathers of 174 Mexican American children ages 8–10 completed the PFP and provided demographic information. Anthropometric measures were obtained on family members. Results Confirmatory factor analyses identified four parental feeding practice dimensions: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. Factorial invariance modeling suggested equivalent factor meaning and item response scaling across mothers and fathers. Mothers and fathers differed somewhat in their use of feeding practices. All four feeding practices were related to child body mass index (BMI) percentiles, for one or both parents. Mothers reporting more positive involvement had children with lower BMI percentiles. Parents using more pressure to eat had children with lower BMI percentiles, while parents using more restriction had children with higher BMI percentiles. Fathers using food to control behavior had children with lower BMI percentiles. Conclusions Results indicate good initial validity and reliability for the PFP. It can be

  18. Parental feeding practices in Mexican American families: initial test of an expanded measure

    Directory of Open Access Journals (Sweden)

    Tschann Jeanne M

    2013-01-01

    Full Text Available Abstract Background Although obesity rates are high among Latino children, relatively few studies of parental feeding practices have examined Latino families as a separate group. Culturally-based approaches to measurement development can begin to identify parental feeding practices in specific cultural groups. This study used qualitative and quantitative methods to develop and test the Parental Feeding Practices (PFP Questionnaire for use with Mexican American parents. Items reflected both parent’s use of control over child eating and child-centered feeding practices. Methods In the qualitative phase of the research, 35 Latino parents participated in focus groups. Items for the PFP were developed from focus group discussions, as well as adapted from existing parent feeding practice measures. Cognitive interviews were conducted with 37 adults to evaluate items. In the quantitative phase, mothers and fathers of 174 Mexican American children ages 8–10 completed the PFP and provided demographic information. Anthropometric measures were obtained on family members. Results Confirmatory factor analyses identified four parental feeding practice dimensions: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. Factorial invariance modeling suggested equivalent factor meaning and item response scaling across mothers and fathers. Mothers and fathers differed somewhat in their use of feeding practices. All four feeding practices were related to child body mass index (BMI percentiles, for one or both parents. Mothers reporting more positive involvement had children with lower BMI percentiles. Parents using more pressure to eat had children with lower BMI percentiles, while parents using more restriction had children with higher BMI percentiles. Fathers using food to control behavior had children with lower BMI percentiles. Conclusions Results indicate good initial validity and

  19. Practice and experience in traceability of radioactivity measurements of environmental samples

    International Nuclear Information System (INIS)

    Huang Zhijian

    1990-01-01

    This paper discusses some aspects on radioactivity measurement traceability and summarizes the work on quality assurance of radioactivity measurements of environmental samples in the laboratory, including transfer of standards, preparation of reference materials, and calibration of efficiency for volumse surces with Ge(Li) spectrometer. Some practical activitis regarding intercomparison of radioactivity measurements and other traceabillity-related activities are also described. Some sugestions relating to performing quality assurance are made

  20. Measuring the Physical Activity Practices Used by Parents of Preschool Children

    OpenAIRE

    Vaughn, Amber; Hales, Derek; Ward, Dianne S.

    2013-01-01

    Parents play a critical role in shaping children’s attitudes, beliefs and behaviors, including those around physical activity and inactivity. Our ability to identify which practices effectively promote children’s physical activity and limit inactivity is limited by existing measurement instruments. This project will present a newly developed physical activity parenting practices survey, the psychometric properties of this survey’s scales, and their association with child physical activity and...

  1. The Danish National Chronic Lymphocytic Leukemia Registry

    DEFF Research Database (Denmark)

    da Cunha-Bang, Caspar; Geisler, Christian Hartmann; Enggaard, Lisbeth

    2016-01-01

    AIM: In 2008, the Danish National Chronic Lymphocytic Leukemia Registry was founded within the Danish National Hematology Database. The primary aim of the registry is to assure quality of diagnosis and care of patients with chronic lymphocytic leukemia (CLL) in Denmark. Secondarily, to evaluate...

  2. Service registry design: an information service approach

    NARCIS (Netherlands)

    Ferreira Pires, Luis; Wang, J.; van Oostrum, Arjen; Wijnhoven, Alphonsus B.J.M.

    2010-01-01

    A service registry is a Service-Oriented Architecture (SOA) component that keeps a ‘catalogue’ of available services. It stores service specifications so that these specifications can be found by potential users. Discussions on the design of service registries currently focus on technical issues,

  3. The Canadian Registry for Pulmonary Fibrosis: Design and Rationale of a National Pulmonary Fibrosis Registry

    Directory of Open Access Journals (Sweden)

    Christopher J. Ryerson

    2016-01-01

    Full Text Available Background. The relative rarity and diversity of fibrotic interstitial lung disease (ILD have made it challenging to study these diseases in single-centre cohorts. Here we describe formation of a multicentre Canadian registry that is needed to describe the outcomes of fibrotic ILD and to enable detailed healthcare utilization analyses that will be the cornerstone for future healthcare planning. Methods. The Canadian Registry for Pulmonary Fibrosis (CARE-PF is a prospective cohort anticipated to consist of at least 2,800 patients with fibrotic ILD. CARE-PF will be used to (1 describe the natural history of fibrotic ILD, specifically determining the incidence and outcomes of acute exacerbations of ILD subtypes and (2 determine the impact of ILD and acute exacerbations of ILD on health services use and healthcare costs in the Canadian population. Consecutive patients with fibrotic ILD will be recruited from five Canadian ILD centres over a period of five years. Patients will be followed up as clinically indicated and will complete standardized questionnaires at each clinic visit. Prespecified outcomes and health services use will be measured based on self-report and linkage to provincial health administrative databases. Conclusion. CARE-PF will be among the largest prospective multicentre ILD registries in the world, providing detailed data on the natural history of fibrotic ILD and the healthcare resources used by these patients. As the largest and most comprehensive cohort of Canadian ILD patients, CARE-PF establishes a network for future clinical research and early phase clinical trials and provides a platform for translational and basic science research.

  4. Windows registry forensics advanced digital forensic analysis of the Windows registry

    CERN Document Server

    Carvey, Harlan

    2011-01-01

    Harlan Carvey brings readers an advanced book on Windows Registry - the most difficult part of Windows to analyze in forensics! Windows Registry Forensics provides the background of the Registry to help develop an understanding of the binary structure of Registry hive files. Approaches to live response and analysis are included, and tools and techniques for postmortem analysis are discussed at length. Tools and techniques will be presented that take the analyst beyond the current use of viewers and into real analysis of data contained in the Registry. This book also has a DVD containing tools, instructions and videos.

  5. Clinical disease registries in acute myocardial infarction.

    Science.gov (United States)

    Ashrafi, Reza; Hussain, Hussain; Brisk, Robert; Boardman, Leanne; Weston, Clive

    2014-06-26

    Disease registries, containing systematic records of cases, have for nearly 100 years been valuable in exploring and understanding various aspects of cardiology. This is particularly true for myocardial infarction, where such registries have provided both epidemiological and clinical information that was not readily available from randomised controlled trials in highly-selected populations. Registries, whether mandated or voluntary, prospective or retrospective in their analysis, have at their core a common study population and common data definitions. In this review we highlight how registries have diversified to offer information on epidemiology, risk modelling, quality assurance/improvement and original research-through data mining, transnational comparisons and the facilitation of enrolment in, and follow-up during registry-based randomised clinical trials.

  6. RHEUMATOID ARTHRITIS IN THE RUSSIAN FEDERATION ACCORDING TO RUSSIAN ARTHRITIS REGISTRY DATA (COMMUNICATION I

    Directory of Open Access Journals (Sweden)

    E. L. Nasonov

    2016-01-01

    Full Text Available The paper presents the materials of the Russian Arthritis Registry (OREL that includes 3276 patients from 11 Russian Federation's largest research-and-practical centers situated in Moscow, Saint Petersburg, Novosibirsk, Kazan, Tula, Yaroslavl, Tyumen. It discusses the main goals of setting up registries, compares the results of an analysis of the data available in the Russian Registry OREL and registries of European countries and the USA. The findings suggest that there is non-uniform information on clinical, laboratory, and instrumental parameters in the national registers of a number of European countries and the USA. According to its basic characteristics, the Russian Registry OREL compares favorably with a number of other registries in the completeness of data collection, which allows a general idea of rheumatoidarthritis (RA patients in Russia. For further development of the OREL Registry, it is necessary to concentrate our attention on the following main areas: to improve the quality of filling out documents; to follow-up patients receiving different RA therapy regimens according to the guidelines of the Association of Rheumatologists of Russia for the treatment of RA; to conduct in-depth studies of comorbidity, primarily depressive disorders; to analyze adverse reactions that make RA therapy difficult; to actively use modules for patients' self-rating of their condition; to develop nursing care, etc.

  7. Validation of an instrument to measure inter-organisational linkages in general practice

    Directory of Open Access Journals (Sweden)

    Cheryl Amoroso

    2007-11-01

    Full Text Available Purpose: Linkages between general medical practices and external services are important for high quality chronic disease care. The purpose of this research is to describe the development, evaluation and use of a brief tool that measures the comprehensiveness and quality of a general practice’s linkages with external providers for the management of patients with chronic disease. In this study, clinical linkages are defined as the communication, support, and referral arrangements between services for the care and assistance of patients with chronic disease. Methods: An interview to measure surgery-level (rather than individual clinician-level clinical linkages was developed, piloted, reviewed, and evaluated with 97 Australian general practices. Two validated survey instruments were posted to patients, and a survey of locally available services was developed and posted to participating Divisions of General Practice (support organisations. Hypotheses regarding internal validity, association with local services, and patient satisfaction were tested using factor analysis, logistic regression and multilevel regression models. Results: The resulting General Practice Clinical Linkages Interview (GP-CLI is a nine-item tool with three underlying factors: referral and advice linkages, shared care and care planning linkages, and community access and awareness linkages. Local availability of chronic disease services has no affect on the comprehensiveness of services with which practices link, however comprehensiveness of clinical linkages has an association with patient assessment of access, receptionist services, and of continuity of care in their general practice. Conclusions: The GP-CLI may be useful to researchers examining comparable health care systems for measuring the comprehensiveness and quality of linkages at a general practice-level with related services, possessing both internal and external validity. The tool can be used with large samples

  8. Ideas on a practical method to make more uniform the measure and the account of doses

    International Nuclear Information System (INIS)

    Boussard, P.; Dollo, R.; De Kerviller, M.; Penneroux, M.

    1992-01-01

    The ICRP 60 publication and its consequences on the revision of CEC regulations and basic norms, discussions on dosimetry of outside workers and more generally on the development of exchanges of information between users have led EDF to question its practices for measuring counting doses. Faced with this wide range of french practices and in a desire for harmonisation, an EDF and CEA work team has established a summary of present methods, an evaluation of the consequences of these different strategies and have then suggested a harmonisation of dosimetric measures based on systematic methodology. (author)

  9. Do Activity Level Outcome Measures Commonly Used in Neurological Practice Assess Upper-Limb Movement Quality?

    Science.gov (United States)

    Demers, Marika; Levin, Mindy F

    2017-07-01

    Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.

  10. Fasa Registry on Acute Myocardial Infarction (FaRMI: Feasibility Study and Pilot Phase Results.

    Directory of Open Access Journals (Sweden)

    Ehsan Bahramali

    Full Text Available Myocardial infarction (MI is the leading cause of death in Iran. Every attempt to improve treatment patterns and patient outcomes needs a surveillance system to both consider the efficacy and safety measures. Fasa Registry on Myocardial Infarction (FaRMI is the first population-based registry for acute MI in Iran targeted to provide meticulous description of patients' characteristics, to explore the management patterns of these patients, to discover the degree of adherence to the practice guidelines, and to investigate the determinants of poor in-hospital and later outcomes.A diagnosis of acute MI (type I, II and III was made upon the accepted criteria by the attending cardiologists and types IV and V MI were excluded. Two registrar nurses gathered data on demographics, place of residence and ethnicity, past medical history, risk factors, and the clinical course. Management patterns in the pre-hospital setting, during the hospital stay and at the discharge time were recorded. Routine laboratory results and cardiac biomarkers on three consecutive days were registered.pilot phase included the first 95 patients, 63.5% of whom were men and 31.5% were women. With a mean age of 62.89±13.75 years among participants, the rate of premature MI was 31.8%. ST segment elevation MI accounted for 68.2% cases and inferior wall was the most prevalent region involved followed by anterior and posterior walls.Obtained data on the characteristics of patients suffering an MI event revealed the major determinants of delay in initiation of therapies and contributors of poor outcome. Completeness of data was guaranteed upon involvement of multiple checkpoints and data quality was secured by means of automatic validation processes in addition to weekly physicians' roundups.Execution of FaRMI in the form presented is feasible and it will build up a comprehensive population-based registry for MI in the region.

  11. Measure for measure. Outcome assessment of arthritis treatment in clinical practice

    OpenAIRE

    Gülfe, Anders

    2009-01-01

    Objective: To investigate (i) the performance and agreement between various activity indices and response criteria in TNF-blockade of RA; (ii) the predictive ability of different response criteria and disease activity states regarding continuation of anti-TNF treatment of RA; (iii) Euro-QoL-5-dimensions utility development during TNF blockade of RA, PsA and SpA. Also, (iv) to develop a simple, utility-based outcome measure, the number needed to treat per quality adjusted life year gained (NN...

  12. Practical disarmament measures to consolidate peace in post-conflict environments

    International Nuclear Information System (INIS)

    Mason, M.

    1998-01-01

    At the 51st Session of the United Nations General Assembly, one of the many resolutions passed was entitled 'Consolidation of peace through practical disarmament measures'. The resolution stresses the relevance of certain practical disarmament measures - such as the control of small arms and light weapons, confidence building measures and the demobilization and reintegration of former combatants - for the consolidation of peace in areas that have suffered conflict. With the intention of building on this promising beginning, the United Nations Disarmament Commission (UNDC), at its 1997 session, began the first of a three-year effort to formulate guidelines for a comprehensive approach to the development and implementation of such practical measures. As a co-sponsor of the General Assembly resolution and a strong supporter of the UNDC follow up activity, Canada made available a Background Paperi on the design and implementation of an effective disarmament, demobilization and reintegration programme in post-conflict environments, in an effort to facilitate discussions in the Disarmament Commission. Once completed and circulated, it led to the tabling of a formal Canadian Working Paper, containing the principle findings and recommendations from the Background Paper. It is the purpose of this paper to discuss the subject of practical disarmament, demobilization, and reintegration measures to consolidate peace in post-conflict environments by (1) drawing from the Background Paper and updating where necessary; (2) reviewing other recent developments in the subject area and (3) identifying future policy action, especially relevant research needs. (author)

  13. From Practice to Evidence in Child Welfare: Model Specification and Fidelity Measurement of Team Decisionmaking.

    Science.gov (United States)

    Bearman, Sarah Kate; Garland, Ann F; Schoenwald, Sonja K

    2014-04-01

    Fidelity measurement methods have traditionally been used to develop and evaluate the effects of psychosocial treatments and, more recently, their implementation in practice. The fidelity measurement process can also be used to operationally define and specify components of emerging but untested practices outside the realm of conventional treatment. Achieving optimal fidelity measurement effectiveness (scientific validity and reliability) and efficiency (feasibility and relevance in routine care contexts) is challenging. The purpose of this paper is to identify strategies to address these challenges in child welfare system practices. To illustrate the challenges, and operational steps to address them, we present a case example using the "Team Decisionmaking" (TDM; Annie E. Casey Foundation) intervention. This intervention has potential utility for decreasing initial entry into and time spent in foster care and increasing rates of reunification and relative care. While promising, the model requires rigorous research to refine knowledge regarding the relationship between intervention components and outcomes-research that requires fidelity measurement. The intent of this paper is to illustrate how potentially generalizable steps for developing effective and efficient fidelity measurement methods can be used to more clearly define and test the effects of child welfare system practices.

  14. A REVIEW ON LEGAL TRACEABILITY OF GNSS MEASUREMENTS IN THE MALAYSIAN CADASTRAL PRACTICE

    Directory of Open Access Journals (Sweden)

    J. Gill

    2016-09-01

    Full Text Available As the dependency on Global Navigation Satellite System (GNSS in surveying has been growing over the years, the need for legal traceability of GNSS measurements has become a significant matter. In Malaysia, with the advent of the Malaysia Real-time Kinematic Network (MyRTKnet, GNSS surveying has revolutionised land survey and mapping. Correspondingly, the Department of Survey and Mapping Malaysia (DSMM amended and published standard regulations and guidelines concerning cadastral survey, i.e., Cadastral Survey Regulations 2009, to include GNSS measurements. However, these regulations and guidelines has not comprehensively incorporated legal traceability of GNSS measurements; which is a prerequisite for cadastral surveys as it requires reliable and conclusive evidence for issues such as boundary disputes. The first objective of this paper is to review and discuss the legal traceability of GNSS measurements. Secondly, it will highlight the current practice and issues, i.e., with regard to legal traceability, within the present Malaysian cadastral regulation and guidelines, in relation to the prevalently adopted Network RTK (N-RTK technique, GNSS instrument calibrations, and reference stations’ accuracy. Lastly, a rudimentary best practice guideline for GNSS surveying in cadastral survey for Malaysia is proposed. It is expected that this paper will contribute to the implementation of a best practice guideline, which is inclusive of legal traceability of GNSS measurements, for the Malaysian cadastral practice.

  15. Quick, simple measures of family relationships for use in clinical practice and research. A systematic review.

    Science.gov (United States)

    Pritchett, Rachel; Kemp, Jeremy; Wilson, Philip; Minnis, Helen; Bryce, Graham; Gillberg, Christopher

    2011-04-01

    Family functioning has been implicated in the onset of child and adult psychopathology. Various measures exist for assessing constructs in the areas of parent-child relationships, parental practices and discipline, parental beliefs, marital quality, global family functioning and situation-specific measures. To identify systematically all questionnaire measures of family functioning appropriate for use in primary care and research. A systematic literature review was conducted, following PRISMA guidelines and searching 14 bibliographic databases using pre-determined filters, to identify family functioning measures suitable for use in families with children from 0 to 3 years old. One hundred and seven measures of family functioning were reported and tabulated and the most commonly used measures were identified. There are numerous measures available demonstrating characteristics, which make them suitable for continued use. Future research is needed to examine the more holistic measurement of family functioning using integration of multi-informant data.

  16. Comparison of Colonoscopy Quality Measures Across Various Practice Settings and the Impact of Performance Scorecards.

    Science.gov (United States)

    Inra, Jennifer A; Nayor, Jennifer; Rosenblatt, Margery; Mutinga, Muthoka; Reddy, Sarathchandra I; Syngal, Sapna; Kastrinos, Fay

    2017-04-01

    Quality performance measures for screening colonoscopy vary among endoscopists. The impact of practice setting is unknown. We aimed to (1) compare screening colonoscopy performance measures among three different US practice settings; (2) evaluate factors associated with adenoma detection; and (3) assess a scorecard intervention on performance metrics. This multi-center prospective study compared patient, endoscopist, and colonoscopy characteristics performed at a tertiary care hospital (TCH), community-based hospital (CBH), and private practice group (PPG). Withdrawal times (WT), cecal intubation, and adenoma detection rates (ADR) were compared by site at baseline and 12 weeks following scorecard distribution. Generalized linear mixed models identified factors associated with adenoma detection. Twenty-eight endoscopists performed colonoscopies on 1987 asymptomatic, average-risk individuals ≥50 years. Endoscopist and patient characteristics were similar across sites. The PPG screened more men (TCH: 42.8%, CBH: 45.0%, PPG: 54.2%; p scorecard distribution. Adenoma detection was associated with increasing patient age, male gender, WT, adequate preparation, but not practice setting. Each practice performed high-quality screening colonoscopy. Scorecards did not improve performance metrics. Preparation quality varies among practice settings and can be modified to improve adenoma detection.

  17. Use of standardized outcome measures in physical therapist practice: perceptions and applications.

    Science.gov (United States)

    Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak

    2009-02-01

    Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

  18. Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice.

    Science.gov (United States)

    Anderson, Jaclyn; Caplan, Liron; Yazdany, Jinoos; Robbins, Mark L; Neogi, Tuhina; Michaud, Kaleb; Saag, Kenneth G; O'Dell, James R; Kazi, Salahuddin

    2012-05-01

    Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures. We recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. Copyright © 2012 by the American College of Rheumatology.

  19. Promoting Organ Donor Registries Through Public Education: What Is the Cost of Securing Organ Donors?

    Science.gov (United States)

    Razdan, Manik; Smith, Kenneth J; Bryce, Cindy L; Degenholtz, Howard B

    2016-06-01

    Transplant medicine's impact on America's public health is seriously limited by acute shortage of transplantable organs. Consequently, the United Sates has witnessed considerable investment in the promotion of organ donor registries. Although there is no evidence to support that donor registry promotion alleviates organ shortage, this belief continues to drive investments into registry promotion. In this study, return on investment in donor registry promotion was examined using cost-outcomes analysis. Cost of promoting the donor registry was estimated in US dollars whereas the outcome was measured as the number of individuals who join the registry (registrants) and their value in terms of organ donors. The study was conducted from the perspective of a regional Organ Procurement Organization (OPO). Costs were directly obtained from the OPO. The number of new registrants was obtained from the OPO and the departments of motor vehicles that maintain the donor registry. The value of registrants in terms of organ donors was computed based on a registrant's age-dependent risk of dying and age-dependent probability of becoming an organ donor. Six thousand seven hundred eight individuals joined the organ donor registry (95% confidence interval [95% CI], 5429-7956) at a cost of $455 per registrant (95% CI, US $383-US $562). These individuals result in 4.2 present-day donors (95% CI, 2.5-6.6) at a cost of US $726 000 (95% CI, US $462000-US $1.2 million). Because the cost per registrant and cost per donor is less than society's willingness to pay, donor registry promotion offers positive return on investment. Investment in registry promotion should at the minimum be maintained at current levels.

  20. Quality Nutrition Care: Measuring Hospital Staff’s Knowledge, Attitudes, and Practices

    Directory of Open Access Journals (Sweden)

    Celia Laur

    2016-10-01

    Full Text Available Understanding the knowledge, attitudes, and practices (KAP of hospital staff is needed to improve care activities that support the detection/prevention/treatment of malnutrition, yet quality measures are lacking. The purpose was to develop (study 1 and assess the administration and discriminative potential (study 2 of using such a KAP measure in acute care. In study 1, a 27-question KAP questionnaire was developed, face validated (n = 5, and tested for reliability (n = 35. Kappa and Intraclass Correlation (ICC were determined. In study 2, the questionnaire was sent to staff at five diverse hospitals (n = 189. Administration challenges were noted and analyses completed to determine differences across sites, professions, and years of practice. Study 1 results demonstrate that the knowledge/attitude (KA and the practice (P subscales are reliable (KA: ICC = 0.69 95% CI 0.45–0.84, F = 5.54, p < 0.0001; P: ICC = 0.84 95% CI 0.68−0.92, F = 11.12, p < 0.0001. Completion rate of individual questions in study 2 was high and suggestions to improve administration were identified. The KAP mean score was 93.6/128 (range 51–124 with higher scores indicating more knowledge, better attitudes and positive practices. Profession and years of practice were associated with KAP scores. The KAP questionnaire is a valid and reliable measure that can be used in needs assessments to inform improvements to nutrition care in hospital.

  1. How Is Science Being Taught? Measuring Evidence-Based Teaching Practices across Undergraduate Science Departments

    Science.gov (United States)

    Drinkwater, Michael J.; Matthews, Kelly E.; Seiler, Jacob

    2017-01-01

    While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy. PMID:28232589

  2. Standard practice for examination of welds using the alternating current field measurement technique

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This practice describes procedures to be followed during alternating current field measurement examination of welds for baseline and service-induced surface breaking discontinuities. 1.2 This practice is intended for use on welds in any metallic material. 1.3 This practice does not establish weld acceptance criteria. 1.4 The values stated in either inch-pound units or SI units are to be regarded separately as standard. The values stated in each system might not be exact equivalents; therefore, each system shall be used independently of the other. 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  3. Measuring Costs to Community-Based Agencies for Implementation of an Evidence-Based Practice.

    Science.gov (United States)

    Lang, Jason M; Connell, Christian M

    2017-01-01

    Healthcare reform has led to an increase in dissemination of evidence-based practices. Cost is frequently cited as a significant yet rarely studied barrier to dissemination of evidence-based practices and the associated improvements in quality of care. This study describes an approach to measuring the incremental, unreimbursed costs in staff time and direct costs to community-based clinics implementing an evidence-based practice through participating in a learning collaborative. Initial implementation costs exceeding those for providing "treatment as usual" were collected for ten clinics implementing trauma-focused cognitive behavioral therapy through participation in 10-month learning collaboratives. Incremental implementation costs of these ten community-based clinic teams averaged the equivalent of US$89,575 (US$ 2012). The most costly activities were training, supervision, preparation time, and implementation team meetings. Recommendations are made for further research on implementation costs, dissemination of evidence-based practices, and implications for researchers and policy makers.

  4. Current variables, definitions and endpoints of the European Cardiovascular Magnetic Resonance Registry

    Directory of Open Access Journals (Sweden)

    Schwitter Juerg

    2009-11-01

    Full Text Available Abstract Background Cardiovascular Magnetic Resonance (CMR is increasingly used in daily clinical practice. However, little is known about its clinical utility such as image quality, safety and impact on patient management. In addition, there is limited information about the potential of CMR to acquire prognostic information. Methods The European Cardiovascular Magnetic Resonance Registry (EuroCMR Registry will consist of two parts: 1 Multicenter registry with consecutive enrolment of patients scanned in all participating European CMR centres using web based online case record forms. 2 Prospective clinical follow up of patients with suspected coronary artery disease (CAD and hypertrophic cardiomyopathy (HCM every 12 months after enrolment to assess prognostic data. Conclusion The EuroCMR Registry offers an opportunity to provide information about the clinical utility of routine CMR in a large number of cases and a diverse population. Furthermore it has the potential to gather information about the prognostic value of CMR in specific patient populations.

  5. Analysis of Existing Guidelines for the Systematic Planning Process of Clinical Registries.

    Science.gov (United States)

    Löpprich, Martin; Knaup, Petra

    2016-01-01

    Clinical registries are a powerful method to observe the clinical practice and natural disease history. In contrast to clinical trials, where guidelines and standardized methods exist and are mandatory, only a few initiatives have published methodological guidelines for clinical registries. The objective of this paper was to review these guidelines and systematically assess their completeness, usability and feasibility according to a SWOT analysis. The results show that each guideline has its own strengths and weaknesses. While one supports the systematic planning process, the other discusses clinical registries in great detail. However, the feasibility was mostly limited and the special requirements of clinical registries, their flexible, expandable and adaptable technological structure was not addressed consistently.

  6. CSR’s Measuring Corporate Social Responsibility Practice in Islamic Banking: A Review

    OpenAIRE

    Alamer, Abdullah Rajeh Ali; Salamon, Hussin Bin; Qureshi, Muhammad Imran; Rasli, Amran Md.

    2015-01-01

    Academic efforts have started for around one decade to measure corporate social responsibility (CSR) in Islamic Banks (IBs) practices. The authors, in this field, have written based on two thoughts wide and narrow of the CSR in Islamic banking but there still are important gaps that need to fill. The first authors were dependent who established variety indexes and the second group was independent writers who followed benchmark index to measure of CSR in Islamic banking. This work tried to com...

  7. Fear of birth in clinical practice: A structured review of current measurement tools.

    Science.gov (United States)

    Richens, Yana; Smith, Debbie M; Lavender, Dame Tina

    2018-06-01

    To identify measurement tools which screen for the presence of fear of birth (FOB) and to determine the most effective tool/s for use in clinical practice. Fear or birth (FOB) is internationally recognised as a cause for increasing concern, despite a lack of consensus on a definition or optimal measure of assessment. There is a wide array of FOB measurement tools, however little clarity on which tool should be used to screen for FOB in clinical practice. This review explores the use of tools that are used to screen for FOB and discusses the perceived effectiveness of such tools. A structured literature review was undertaken. Electronic databases were searched in July 2017 and manuscripts reviewed for quality. The review included 46 papers. The majority of studies were undertaken in Scandinavia (n = 29) and a range of tools were used to measure FOB. The most widely used tool was the Wijma Delivery Expectancy Experience Questionnaire' (W-DEQ). Inconsistencies were found in the way this tool was used, including variations in assessment cut-off points, implementation and use across a range of cultural settings and women of varying gestations. Moreover, the tool may be too lengthy to use in clinical practice. The Fear of Birth Scale (FOBS) has been shown to be as effective as W-DEQ but has the advantage of being short and easy to administer. The inconsistencies in tools reflect the difficulties in defining FOB. A clear consensus definition of FOB would aid comparisons across practice and research. The W-DEQ is not used in clinical practice; this may be due to its length and complexity. The FOBS is likely to be a more versatile tool that can be used in clinical practice. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Why quality of life measurement is important in dermatology clinical practice

    DEFF Research Database (Denmark)

    Finlay, A Y; Salek, M S; Abeni, D

    2017-01-01

    The aim of this study was to describe the many ways in which quality of life (QoL) measurement may potentially be advantageous in routine clinical dermatology practice. Thirteen members of the EADV Task Force on Quality of Life, eight dermatologists, three health psychologists, one epidemiologist...

  9. A Dataset for Education-Related Majors' Performance Measures with Pre/Post-Video Game Practice

    Science.gov (United States)

    Novak, Elena; Tassell, Janet Lynne

    2015-01-01

    This dataset includes a series of 30 education-related majors' performance measures before and after they completed a 10-hour video game practice in a computer lab. The goal of the experimental study was to examine the effects of action video gaming on students' mathematics performance and mathematics anxiety as mediated by the effect of attention…

  10. Designing Chemistry Practice Exams for Enhanced Benefits: An Instrument for Comparing Performance and Mental Effort Measures

    Science.gov (United States)

    Knaus, Karen J.; Murphy, Kristen L.; Holme, Thomas A.

    2009-01-01

    The design and use of a chemistry practice exam instrument that includes a measure for student mental effort is described in this paper. Use of such an instrument can beneficial to chemistry students and chemistry educators as well as chemical education researchers from both a content and cognitive science perspective. The method for calculating…

  11. Teacher Competency in Classroom Testing, Measurement Preparation, and Classroom Testing Practices.

    Science.gov (United States)

    Newman, Dorothy C.; Stallings, William M.

    An assessment instrument and a questionnaire (Appendices A and B) were developed to determine how well teachers understand classroom testing principles and to gain information on the measurement preparation and classroom practices of teachers. Two hundred ninety-four inservice teachers, grades 1 through 12, from three urban school systems in…

  12. Measuring Job Content: Skills, Technology, and Management Practices. Discussion Paper No. 1357-08

    Science.gov (United States)

    Handel, Michael J.

    2008-01-01

    The conceptualization and measurement of key job characteristics has not changed greatly for most social scientists since the Dictionary of Occupational Titles and Quality of Employment surveys were created, despite their recognized limitations. However, debates over the roles of job skill requirements, technology, and new management practices in…

  13. Performance measures for improving the prevention of venous thromboembolism: achievement in clinical practice.

    Science.gov (United States)

    Wilson, Kenneth C; Merli, Geno J

    2011-10-01

    Venous thromboembolism (VTE) is a common complication during and after hospitalization for acute medical illness or surgery. Despite the existence of evidence-based guidelines for VTE prevention, real-world prescribing practices are frequently suboptimal. Specific performance measures relating to VTE prevention and treatment have been developed by US health care organizations to increase adherence with best-practice recommendations and ultimately reduce the number of preventable VTE events. Two measures developed by the Surgical Care Improvement Project have been endorsed by the National Quality Forum (NQF) and focus on VTE prevention. In addition, six measures have been developed recently by The Joint Commission in collaboration with the NQF; three measures relate to VTE prevention and three focus on treatment. To attain widespread achievement of these performance goals, it is essential to raise awareness of their existence and specifications. It is also imperative that hospitals develop and implement effective VTE protocols. The use of multiple, active strategies, such as computer decision support systems with regular audit and feedback, may be particularly valuable approaches to improve current practices within an integrated quality improvement program. During practical implementation of VTE protocols at Norton Healthcare (Kentucky's largest healthcare system), strong leadership, physician engagement, and caregiver accountability were identified as key factors influencing the process. As such, more hospitals may be able to increase adherence with guidelines, improve achievement of quality goals, and help to reduce the substantial burden associated with avoidable VTE.

  14. Goal Attainment Scaling in paediatric rehabilitation practice : a useful outcome measure

    NARCIS (Netherlands)

    Steenbeek, D.

    2010-01-01

    The main aim of this thesis was to investigate the use of a 6-point Goal Attainment Scaling (GAS) system to measure change over time in interdisciplinary rehabilitation practice for children with Cerebral Palsy (CP). GAS is a generic individualized evaluative criterion-referenced instrument. It can

  15. Measuring Parenting Practices among Parents of Elementary School-Age Youth

    Science.gov (United States)

    Randolph, Karen A.; Radey, Melissa

    2011-01-01

    Objectives: The objective of this study is to establish the factor structure of the Alabama Parenting Questionnaire (APQ), an instrument designed to measure parenting practices among parents of elementary school children. Methods: Exploratory (EFA) and confirmatory factor analytic (CFA) procedures are used to validate the APQ with 790 parents of…

  16. The Western Denmark Cardiac Computed Tomography Registry

    DEFF Research Database (Denmark)

    Nielsen, Lene Hüche; Nørgaard, Bjarne Linde; Tilsted, Hans-Henrik

    2014-01-01

    BACKGROUND: As a subregistry to the Western Denmark Heart Registry (WDHR), the Western Denmark Cardiac Computed Tomography Registry (WDHR-CCTR) is a clinical database established in 2008 to monitor and improve the quality of cardiac computed tomography (CT) in Western Denmark. OBJECTIVE: We...... examined the content, data quality, and research potential of the WDHR-CCTR. METHODS: We retrieved 2008-2012 data to examine the 1) content; 2) completeness of procedure registration using the Danish National Patient Registry as reference; 3) completeness of variable registration comparing observed vs...

  17. The German Aortic Valve Registry (GARY): a nationwide registry for patients undergoing invasive therapy for severe aortic valve stenosis.

    Science.gov (United States)

    Beckmann, A; Hamm, C; Figulla, H R; Cremer, J; Kuck, K H; Lange, R; Zahn, R; Sack, S; Schuler, G C; Walther, T; Beyersdorf, F; Böhm, M; Heusch, G; Funkat, A K; Meinertz, T; Neumann, T; Papoutsis, K; Schneider, S; Welz, A; Mohr, F W

    2012-07-01

    Background The increasing prevalence of severe aortic valve defects correlates with the increase of life expectancy. For decades, surgical aortic valve replacement (AVR), under the use of extracorporeal circulation, has been the gold standard for treatment of severe aortic valve diseases. In Germany ~12,000 patients receive isolated aortic valve surgery per year. For some time, percutaneous balloon valvuloplasty has been used as a palliative therapeutic option for very few patients. Currently, alternatives for the established surgical procedures such as transcatheter aortic valve implantation (TAVI) have become available, but there are only limited data from randomized studies or low-volume registries concerning long-time outcome. In Germany, the implementation of this new technology into hospital care increased rapidly in the past few years. Therefore, the German Aortic Valve Registry (GARY) was founded in July 2010 including all available therapeutic options and providing data from a large quantity of patients.Methods The GARY is assembled as a complete survey for all invasive therapies in patients with relevant aortic valve diseases. It evaluates the new therapeutic options and compares them to surgical AVR. The model for data acquisition is based on three data sources: source I, the mandatory German database for external performance measurement; source II, a specific registry dataset; and source III, a follow-up data sheet (generated by phone interview). Various procedures will be compared concerning observed complications, mortality, and quality of life up to 5 years after the initial procedure. Furthermore, the registry will enable a compilation of evidence-based indication criteria and, in addition, also a comparison of all approved operative procedures, such as Ross or David procedures, and the use of different mechanical or biological aortic valve prostheses.Results Since the launch of data acquisition in July 2010, almost all institutions performing

  18. AAN Epilepsy Quality Measures in clinical practice: a survey of neurologists.

    Science.gov (United States)

    Wasade, Vibhangini S; Spanaki, Marianna; Iyengar, Revathi; Barkley, Gregory L; Schultz, Lonni

    2012-08-01

    Epilepsy Quality Measures (EQM) were developed by the American Academy of Neurology (AAN) to convey standardization and eliminate gaps and variations in the delivery of epilepsy care (Fountain et al., 2011 [1]). The aim of this study was to identify adherence to these measures and other emerging practice standards in epilepsy care. A 15-item survey was mailed to neurologists in Michigan, USA, inquiring about their practice patterns in relation to EQM. One hundred thirteen of the 792 surveyed Michigan Neurologists responded (14%). The majority (83% to 94%) addressed seizure type and frequency, reviewed EEG and MRI, and provided pregnancy counseling to women of childbearing potential. Our survey identified gaps in practice patterns such as counseling about antiepileptic drug (AED) side effects and knowledge about referral for surgical therapy of intractable epilepsy. Statistical significance in the responses on the AAN EQM was noted in relation to number of years in practice, number of epilepsy patients seen, and additional fellowship training in epilepsy. Practice patterns assessment in relation to other comorbidities revealed that although bone health and sudden unexplained death in epilepsy are addressed mainly in patients at risk, depression is infrequently discussed. The findings in this study indicate that additional educational efforts are needed to increase awareness and to improve quality of epilepsy care at various points of health care delivery. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. An official American thoracic society workshop report: developing performance measures from clinical practice guidelines.

    Science.gov (United States)

    Kahn, Jeremy M; Gould, Michael K; Krishnan, Jerry A; Wilson, Kevin C; Au, David H; Cooke, Colin R; Douglas, Ivor S; Feemster, Laura C; Mularski, Richard A; Slatore, Christopher G; Wiener, Renda Soylemez

    2014-05-01

    Many health care performance measures are either not based on high-quality clinical evidence or not tightly linked to patient-centered outcomes, limiting their usefulness in quality improvement. In this report we summarize the proceedings of an American Thoracic Society workshop convened to address this problem by reviewing current approaches to performance measure development and creating a framework for developing high-quality performance measures by basing them directly on recommendations from well-constructed clinical practice guidelines. Workshop participants concluded that ideally performance measures addressing care processes should be linked to clinical practice guidelines that explicitly rate the quality of evidence and the strength of recommendations, such as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. Under this framework, process-based performance measures would only be developed from strong recommendations based on high- or moderate-quality evidence. This approach would help ensure that clinical processes specified in performance measures are both of clear benefit to patients and supported by strong evidence. Although this approach may result in fewer performance measures, it would substantially increase the likelihood that quality-improvement programs based on these measures actually improve patient care.

  20. Image, measure, figure: a critical discourse analysis of nursing practices that develop children.

    Science.gov (United States)

    Einboden, Rochelle; Rudge, Trudy; Varcoe, Colleen

    2013-07-01

    Motivated by discourses that link early child development and health, nurses engage in seemingly benign surveillance of children. These practices are based on knowledge claims and technologies of developmental science, which remain anchored in assumptions of the child body as an incomplete form with a universal developmental trajectory and inherent potentiality. This paper engages in a critical discursive analysis, drawing on Donna Haraway's conceptualizations of technoscience and figuration. Using a contemporary developmental screening tool from nursing practice, this analysis traces the effects of this tool through production, transformation, distribution, and consumption. It reveals how the techniques of imaging, abstraction, and measurement collide to fix the open, transformative child body in a figuration of the developing child. This analysis also demonstrates how technobiopower infuses nurses' understandings of children and structures developmentally appropriate expectations for children, parents, and nurses. Furthermore, it describes how practices that claim to facilitate healthy child development may inversely deprive children of agency and foster the production of normal or ideal children. An alternative ontological perspective is offered as a challenge to the individualism of developmental models and other dominant ideologies of development, as well as practices associated with these ideologies. In summary, this analysis argues that nurses must pay closer attention to how technobiopower infuses practices that monitor and promote child development. Fostering a critical understanding of the harmful implications of these practices is warranted and offers the space to conceive of human development in alternate and exciting ways. © 2013 John Wiley & Sons Ltd.

  1. Probabilistic measure of factors contributing to social media practices among Facebook users

    Directory of Open Access Journals (Sweden)

    Jandryle U. Trondillo

    2016-01-01

    Full Text Available Social media is the most popular tool to communicate and interact with people nowadays and offers easy access to connect with people anywhere in the globe. This study was conducted to develop a construct about social media practice and explore the probabilistic measure of the factors contributing to social media practices among selected Facebook users. Data was gathered utilizing a structured online survey form from selected 162 online Facebook users who consented to participate in this study. Most of the respondents are male, from 21 to 30 age group, employed and with average social media use of 1 to 4 hours in a day. Out of 30 items in the structured questionnaire, 19 items where retained with eight new factors that served as construct for social media practice (KMO= Bartlett's test of Sphericity= 2109.530, p=0.000,<0.01. Proposed model was significant 99% (p=0.002,<0.01, chi-square of 19.25 which can explain 6.4% to 13.3% of the variation in social media practice. Eight new components were found to simulate respondent’s social media practices. Social media practice varies between males and females while characteristics of age, occupational status and average number of hours spent in social media in a day have no variation.

  2. Standard practices for verification of displacement measuring systems and devices used in material testing machines

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2005-01-01

    1.1 These practices cover procedures and requirements for the calibration and verification of displacement measuring systems by means of standard calibration devices for static and quasi-static testing machines. This practice is not intended to be complete purchase specifications for testing machines or displacement measuring systems. Displacement measuring systems are not intended to be used for the determination of strain. See Practice E83. 1.2 These procedures apply to the verification of the displacement measuring systems associated with the testing machine, such as a scale, dial, marked or unmarked recorder chart, digital display, etc. In all cases the buyer/owner/user must designate the displacement-measuring system(s) to be verified. 1.3 The values stated in either SI units or inch-pound units are to be regarded separately as standard. The values stated in each system may not be exact equivalents; therefore, each system shall be used independently of the other. Combining values from the two systems m...

  3. Practical experience with measurement of diesel engine smoke pursuant to ECE-R 24

    Energy Technology Data Exchange (ETDEWEB)

    Dittrich, W

    1975-01-01

    Since the ECE regulation 24 demands that diesel smoke of automobiles be measured with opacimeters or units yielding equivalent results, the smoke density of diesel engines was measured with opacimeters and filter units for comparison. Conversion tables, comparative curves, and calculations are provided permitting the conversion of grey tones into opacity units with an accuracy sufficient for practical use. The correlation of measurements obtained with the filters and opacimeters was studied during operation at constant full load and at free acceleration. A relationship could be found in most cases; however, it provided no basis for setting up correlations. Finally, smoke characteristics of induction diesel engines were compared with supercharged engines at different geographical altitudes, based upon practical road tests in the Grossglockner mountains. A linear smoke increase with increasing altitude or decreasing air density was observed.

  4. Application of data mining techniques and data analysis methods to measure cancer morbidity and mortality data in a regional cancer registry: The case of the island of Crete, Greece.

    Science.gov (United States)

    Varlamis, Iraklis; Apostolakis, Ioannis; Sifaki-Pistolla, Dimitra; Dey, Nilanjan; Georgoulias, Vassilios; Lionis, Christos

    2017-07-01

    Micro or macro-level mapping of cancer statistics is a challenging task that requires long-term planning, prospective studies and continuous monitoring of all cancer cases. The objective of the current study is to present how cancer registry data could be processed using data mining techniques in order to improve the statistical analysis outcomes. Data were collected from the Cancer Registry of Crete in Greece (counties of Rethymno and Lasithi) for the period 1998-2004. Data collection was performed on paper forms and manually transcribed to a single data file, thus introducing errors and noise (e.g. missing and erroneous values, duplicate entries etc.). Data were pre-processed and prepared for analysis using data mining tools and algorithms. Feature selection was applied to evaluate the contribution of each collected feature in predicting patients' survival. Several classifiers were trained and evaluated for their ability to predict survival of patients. Finally, statistical analysis of cancer morbidity and mortality rates in the two regions was performed in order to validate the initial findings. Several critical points in the process of data collection, preprocessing and analysis of cancer data were derived from the results, while a road-map for future population data studies was developed. In addition, increased morbidity rates were observed in the counties of Crete (Age Standardized Morbidity/Incidence Rates ASIR= 396.45 ± 2.89 and 274.77 ±2.48 for men and women, respectively) compared to European and world averages (ASIR= 281.6 and 207.3 for men and women in Europe and 203.8 and 165.1 in world level). Significant variation in cancer types between sexes and age groups (the ratio between deaths and reported cases for young patients, less than 34 years old, is at 0.055 when the respective ratio for patients over 75 years old is 0.366) was also observed. This study introduced a methodology for preprocessing and analyzing cancer data, using a

  5. The development of practice manual for LSC based on job analysis in radiation measurement and analysis

    International Nuclear Information System (INIS)

    Shin, W H; Park, T J

    2017-01-01

    Radiation technology is closely related to the industrial growth and the creation of employment in Korea. The techniques as radiation or/and radioactivity measurement, and the practical skills achieving a higher level analysis are required. In this study, practice manual for liquid scintillation counter were developed by job analysis. Raw data applied in job analysis are collected by on/off line survey by 420 workers employed in KOREA. Importance-priority analysis was performed to make duties and competency unit that consists of knowledge, skills as each task. Refined data was reviewed by expert who experienced actual duties on site. Classification was conducted by focus group interview to deduct duties and competency unit. From the radiation devices in measurement and analysis, liquid scintillation counter was preferentially selected because of the high demands for training. Investigation of build-up status to liquid scintillation counter in KOREA was conducted. Then technical specification and operating procedure of 2 main devices were analyzed and integrated by practice manual. Duties and competency unit were applied to integrated materials respectively. To validate effectiveness, test curriculum was designed by the advanced course to workers who engaged in radiation measurement and analysis. The developed manual is structured to take advantage of test training. This manual will be a practical handbook that can improve the knowledge, skills of radiation workers in Korea. (paper)

  6. Indicators of club management practices and biological measurements of patrons' drug and alcohol use.

    Science.gov (United States)

    Byrnes, Hilary F; Miller, Brenda A; Johnson, Mark B; Voas, Robert B

    2014-12-01

    Electronic music and dance events in nightclubs attract patrons with heavy alcohol/drug use. Public health concerns are raised from risks related to these behaviors. Practices associated with increased risk in these club settings need to be identified. The relationship between club management practices and biological measures of patrons' alcohol/drug use is examined. Observational data from 25 events across six urban clubs were integrated with survey data (N = 738 patrons, 42.8% female) from patrons exiting these events, 2010-2012. Five indicators of club management practices were examined using mixed model regressions: club security, bar crowding, safety signs, serving intoxicated patrons, and isolation. Analyses revealed that serving intoxicated patrons and safety signs were related to substance use. Specifically, serving intoxicated patrons was related to heavy alcohol and drug use at exit, while safety signs were marginally related to less exit drug use. CONCLUSIONS/IMPORTANCE: Findings indicate observable measures in nightclubs provide important indicators for alcohol/drug use, suggesting practices to target. Study strengths include the use of biological measures of substance use on a relatively large scale. Limitations and future directions are discussed.

  7. The development of practice manual for LSC based on job analysis in radiation measurement and analysis

    Science.gov (United States)

    Shin, W. H.; Park, T. J.

    2017-06-01

    Radiation technology is closely related to the industrial growth and the creation of employment in Korea. The techniques as radiation or/and radioactivity measurement, and the practical skills achieving a higher level analysis are required. In this study, practice manual for liquid scintillation counter were developed by job analysis. Raw data applied in job analysis are collected by on/off line survey by 420 workers employed in KOREA. Importance-priority analysis was performed to make duties and competency unit that consists of knowledge, skills as each task. Refined data was reviewed by expert who experienced actual duties on site. Classification was conducted by focus group interview to deduct duties and competency unit. From the radiation devices in measurement and analysis, liquid scintillation counter was preferentially selected because of the high demands for training. Investigation of build-up status to liquid scintillation counter in KOREA was conducted. Then technical specification and operating procedure of 2 main devices were analyzed and integrated by practice manual. Duties and competency unit were applied to integrated materials respectively. To validate effectiveness, test curriculum was designed by the advanced course to workers who engaged in radiation measurement and analysis. The developed manual is structured to take advantage of test training. This manual will be a practical handbook that can improve the knowledge, skills of radiation workers in Korea.

  8. Balance Assessment Practices and Use of Standardized Balance Measures Among Ontario Physical Therapists

    Science.gov (United States)

    Sibley, Kathryn M.; Straus, Sharon E.; Inness, Elizabeth L.; Salbach, Nancy M.

    2011-01-01

    Background Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design This was a cross-sectional study. Methods A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed “Up & Go” Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall. PMID:21868613

  9. EPA Facility Registry Service (FRS): RADINFO

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  10. EPA Facility Registry Service (FRS): NEI

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  11. EPA Facility Registry Service (FRS): BIA

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  12. EPA Facility Registry Service (FRS): BRAC

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  13. EPA Facility Registry Service (FRS): NCDB

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  14. Substance Identification Information from EPA's Substance Registry

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Substance Registry Services (SRS) is the authoritative resource for basic information about substances of interest to the U.S. EPA and its state and tribal...

  15. Assessing Ontario's Personal Support Worker Registry

    Directory of Open Access Journals (Sweden)

    Audrey Laporte

    2013-08-01

    Full Text Available In response to the growing role of personal support workers (PSWs in the delivery of health care services to Ontarians, the Ontario government has moved forward with the creation of a PSW registry. This registry will be mandatory for all PSWs employed by publicly funded health care employers, and has the stated objectives of better highlighting the work that PSWs do in Ontario, providing a platform for PSWs and employers to more easily access the labour market, and to provide government with information for human resources planning. In this paper we consider the factors that brought the creation of a PSW registry onto the Ontario government’s policy agenda, discuss how the registry is being implemented, and provide an analysis of the strengths and weaknesses of this policy change.

  16. Veterans Affairs Central Cancer Registry (VACCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Affairs Central Cancer Registry (VACCR) receives and stores information on cancer diagnosis and treatment constraints compiled and sent in by the local...

  17. EPA Linked Open Data: Facility Registry Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Facility Registry Service (FRS) identifies facilities, sites, or places subject to environmental regulation or of environmental interest to EPA programs or...

  18. Linking Medicare, Medicaid, and Cancer Registry Data...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Linking Medicare, Medicaid, and Cancer Registry Data to Study the Burden of Cancers in West Virginia In the United States, the elderly carry an unequal burden of...

  19. EPA Facility Registry Service (FRS): TRI

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  20. EPA Facility Registry Service (FRS): ICIS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  1. EPA Facility Registry Service (FRS): OIL

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Oil...

  2. EPA Facility Registry Service (FRS): RBLC

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  3. EPA Facility Registry Service (FRS): ACRES

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service consists of location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of sites that link to...

  4. EPA Facility Registry System (FRS): NCES

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  5. EPA Facility Registry Service (FRS): LANDFILL

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of non-hazardous waste...

  6. EPA Linked Open Data: Substance Registry Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — Substance Registry Services (SRS) is the Environmental Protection Agency's (EPA) central system for information about substances that are tracked or regulated by EPA...

  7. EPA Facility Registry Service (FRS): CAMDBS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  8. EPA Facility Registry System (FRS): NEPT

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry System (FRS) for the subset of facilities that link...

  9. EPA Facility Registry Service (FRS): SDWIS

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  10. EPA Facility Registry Service (FRS): RCRA

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of hazardous waste...

  11. EPA Facility Registry Service (FRS): RMP

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link...

  12. Defining incidental perineural invasion: the need for a national registry.

    Science.gov (United States)

    Buchanan, Lauren; De'Ambrosis, Brian; DeAmbrosis, Kathryn; Warren, Timothy; Huilgol, Shyamala; Soyer, H Peter; Panizza, Benedict

    2014-05-01

    This article by the Perineural Invasion (PNI) Registry Group aims to clarify clinical and histopathological ambiguities surrounding PNI in non-melanoma skin cancer (NMSC). PNI is reportedly present in approximately 2-6% of cases of NMSC and is associated with greater rates of morbidity and mortality. The distinction between clinical PNI and incidental PNI is somewhat unclear, especially in regard to management and prognosis. One important objective of the PNI Registry is to develop a standardised method of classifying perineural invasion. Hence, in this article we propose a definition for PNI and for its sub-classification. This article also provides a critical analysis of the current literature on the treatment of incidental PNI by evaluating the key cohort studies that have investigated the use of surgery or radiotherapy in the management of incidental PNI. At present, there are no universal clinical guidelines that specify the acceptable treatment of NMSC exhibiting incidental PNI. Consequently, patients often receive surgery with varying wider margins, or radiotherapy despite the limited evidence substantiating such management options. It is evident from the existing literature that current opinion is divided over the benefit of adjuvant radiotherapy. Certain prognostic factors have been proposed, such as the size and depth of tumour invasion, nerve diameter, the presence of multifocal PNI and the type of tumour. The PNI Registry is a web-based registry that has been developed to assist in attaining further data pertaining to incidental PNI in NMSC. It is envisaged that this information will provide the foundation for identifying and defining best practice in managing incidental PNI. © 2013 The Australasian College of Dermatologists.

  13. Definition, epidemiology and registries of pulmonary hypertension.

    Science.gov (United States)

    Awdish, R; Cajigas, H

    2016-05-01

    Pulmonary arterial hypertension (PAH) is a subcategory of pulmonary hypertension (PH) that comprises a group of disorders with similar pulmonary vascular pathology. Though PH is common, the estimated incidence of IPAH is 1-3 cases per million, making it a rare disease. The hemodynamic definition of PAH is a mean pulmonary artery pressure at rest >OR = 25 mm Hg in the presence of a pulmonary capillary wedge pressure registries. These registries have been indispensable in the characterization and mapping of the natural history of the disease. Equations and risk calculators derived from registries have given clinicians a basis for risk stratification and prognostication. The sequential accumulation of data since the registries began in the 1980s allows for comparisons to be made. Patients who are differentiated by treatment eras and environments can be contrasted. Variability among inclusion criteria similarly allows for comparisons of these subpopulations. This article provides an overview of available registries, highlights insights provided by each and discusses key issues around the interpretation and extrapolation of data from PAH registries. Registries have allowed us to appreciate the improvement in survival afforded by modern therapy and enhanced detection of this disease. Moving forward, a more global approach to registries is needed, as is enhanced collaboration and centralization.

  14. Occupational Disease Registries-Characteristics and Experiences.

    Science.gov (United States)

    Davoodi, Somayeh; Haghighi, Khosro Sadeghniat; Kalhori, Sharareh Rostam Niakan; Hosseini, Narges Shams; Mohammadzadeh, Zeinab; Safdari, Reza

    2017-06-01

    Due to growth of occupational diseases and also increase of public awareness about their consequences, attention to various aspects of diseases and improve occupational health and safety has found great importance. Therefore, there is the need for appropriate information management tools such as registries in order to recognitions of diseases patterns and then making decision about prevention, early detection and treatment of them. These registries have different characteristics in various countries according to their occupational health priorities. Aim of this study is evaluate dimensions of occupational diseases registries including objectives, data sources, responsible institutions, minimum data set, classification systems and process of registration in different countries. In this study, the papers were searched using the MEDLINE (PubMed) Google scholar, Scopus, ProQuest and Google. The search was done based on keyword in English for all motor engines including "occupational disease", "work related disease", "surveillance", "reporting", "registration system" and "registry" combined with name of the countries including all subheadings. After categorizing search findings in tables, results were compared with each other. Important aspects of the registries studied in ten countries including Finland, France, United Kingdom, Australia, Czech Republic, Malaysia, United States, Singapore, Russia and Turkey. The results show that surveyed countries have statistical, treatment and prevention objectives. Data sources in almost the rest of registries were physicians and employers. The minimum data sets in most of them consist of information about patient, disease, occupation and employer. Some of countries have special occupational related classification systems for themselves and some of them apply international classification systems such as ICD-10. Finally, the process of registration system was different in countries. Because occupational diseases are often

  15. Emerging good practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) measures.

    Science.gov (United States)

    Acquadro, Catherine; Patrick, Donald L; Eremenco, Sonya; Martin, Mona L; Kuliś, Dagmara; Correia, Helena; Conway, Katrin

    2017-01-01

    This paper presents emerging Good Practices for Translatability Assessment (TA) of Patient-Reported Outcome (PRO) Measures. The ISOQOL Translation and Cultural Adaptation Special Interest Group (TCA-SIG) undertook the review of several TA approaches, with the collaboration of organizations who are involved in conducting TA, and members of the TCA-SIG. The effort led to agreement by the writing group on Good Practices for 1) the terminology to be used in referring to translatability process, 2) the best definition of TA, 3) the methodology that is recommended at each step of the process, 4) the persons involved in TA, 5) the timing of assessment, 6) the review criteria for TA, and 7) the recommendations to be made at the end of the TA process. With input from the TCA-SIG membership and in consultation with experts in the field, these emerging good practices can guide the future use of TA in the development of PROs.

  16. COMMUNITY PRACTICE, THE MILLENNIUM DEVELOPMENT GOALS AND CIVIL SOCIETY MEASURES IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Caru Bowns

    2011-07-01

    Most of the MDGs literature focuses on the first six Goals. Comparatively little research considers the interface between MDG7 Targets and community practice, i.e. those organizational and participatory measures integral to most civil society efforts to implement MDGs objectives. This study provides a discussion of the MDGs from an environmental design perspective pertaining to substandard urban environments and the importance of community practices to facilitate participation in decisions for sustainable development. A Brazil case study serves to exemplify urban poverty in one developing country and the civil society institutions that foster “grassroots” participation in Brazil. The conclusion addresses the potential of environmental design’s community practices to expand civic participation in implementing the MDGs.

  17. [Do you measure gait speed in your daily clinical practice? A review].

    Science.gov (United States)

    Inzitari, Marco; Calle, Alicia; Esteve, Anna; Casas, Álvaro; Torrents, Núria; Martínez, Nicolás

    Gait speed (GS), measured at usual pace, is an easy, quick, reliable, non-expensive and informative measurement. With a standard chronometer, like those that currently found in mobile phones, and with two marks on the floor, trained health professionals obtain a more objective and quick measurement compared with many geriatric scales used in daily practice. GS is one of the pillars of the frailty phenotype, and is closely related to sarcopenia. It is a powerful marker of falls incidence, disability and death, mostly useful in the screening of older adults that live in the community. In recent years, the evidence is reinforcing the usefulness of GS in acute care and post-surgical patients. Its use in patients with cognitive impairment is suggested, due to the strong link between cognitive and physical function. Although GS meets the criteria for a good geriatric screening tool, it is not much used in clinical practice. Why? This review has different aims: (i)disentangling the relationship between GS and frailty; (ii)reviewing the protocols to measure GS and the reference values; (iii)reviewing the evidence in different clinical groups (older adults with frailty, with cognitive impairment, with cancer or other pathologies), and in different settings (community, acute care, rehabilitation), and (iv)speculating about the reasons for its poor use in clinical practice and about the gaps to be filled. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Workload and time management in central cancer registries: baseline data and implication for registry staffing.

    Science.gov (United States)

    Chapman, Susan A; Mulvihill, Linda; Herrera, Carolina

    2012-01-01

    The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions,together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey.Results indicate that registries faced reductions in budgeted staffing from 2008-2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing,case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however,estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines.

  19. Comparing contemporary revision burden among hip and knee joint replacement registries

    Directory of Open Access Journals (Sweden)

    Brian J. McGrory, MD, MS

    2016-06-01

    Conclusions: Revision burden has gradually decreased for hip replacements and has remained relatively constant for knee replacements both for the last 4 years and compared to historic controls. Knee revision burden was lower than hip revision burden for each period examined. Revision burden is one measure that may be helpful in following the effect of changes in surgical technique and implant design over time in registry populations and may be a helpful way to compare overall results between registries.

  20. The design, construction and implementation of a computerised trauma registry in a developing South African metropolitan trauma service.

    Science.gov (United States)

    Laing, G L; Bruce, J L; Aldous, C; Clarke, D L

    2014-01-01

    The Pietermaritzburg Metropolitan Trauma Service formerly lacked a robust computerised trauma registry. This made surgical audit difficult for the purpose of quality of care improvement and development. We aimed to design, construct and implement a computerised trauma registry within our service. Twelve months following its implementation, we sought to examine and report on the quality of the registry. Formal ethical approval to maintain a computerised trauma registry was obtained prior to undertaking any design and development. Appropriate commercial software was sourced to develop this project. The registry was designed as a flat file. A flat file is a plain text or mixed text and binary file which usually contains one record per line or physical record. Thereafter the registry file was launched onto a secure server. This provided the benefits of access security and automated backups. Registry training was provided to clients by the developer. The exercise of data capture was then integrated into the process of service delivery, taking place at the endpoint of patient care (discharge, transfer or death). Twelve months following its implementation, the compliance rates of data entry were measured. The developer of this project managed to design, construct and implement an electronic trauma registry into the service. Twelve months following its implementation the data were extracted and audited to assess the quality. A total of 2640 patient entries were captured onto the registry. Compliance rates were in the order of eighty percent and client satisfaction rates were high. A number of deficits were identified. These included the omission of weekend discharges and underreporting of deaths. The construction and implementation of the computerised trauma registry was the beginning of an endeavour to continue improvements in the quality of care within our service. The registry provided a reliable audit at twelve months post implementation. Deficits and limitations were

  1. The use of databases and registries to enhance colonoscopy quality.

    Science.gov (United States)

    Logan, Judith R; Lieberman, David A

    2010-10-01

    Administrative databases, registries, and clinical databases are designed for different purposes and therefore have different advantages and disadvantages in providing data for enhancing quality. Administrative databases provide the advantages of size, availability, and generalizability, but are subject to constraints inherent in the coding systems used and from data collection methods optimized for billing. Registries are designed for research and quality reporting but require significant investment from participants for secondary data collection and quality control. Electronic health records contain all of the data needed for quality research and measurement, but that data is too often locked in narrative text and unavailable for analysis. National mandates for electronic health record implementation and functionality will likely change this landscape in the near future. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. How Is Science Being Taught? Measuring Evidence-Based Teaching Practices across Undergraduate Science Departments.

    Science.gov (United States)

    Drinkwater, Michael J; Matthews, Kelly E; Seiler, Jacob

    2017-01-01

    While there is a wealth of research evidencing the benefits of active-learning approaches, the extent to which these teaching practices are adopted in the sciences is not well known. The aim of this study is to establish an evidential baseline of teaching practices across a bachelor of science degree program at a large research-intensive Australian university. Our purpose is to contribute to knowledge on the adoption levels of evidence-based teaching practices by faculty within a science degree program and inform our science curriculum review in practical terms. We used the Teaching Practices Inventory (TPI) to measure the use of evidence-based teaching approaches in 129 courses (units of study) across 13 departments. We compared the results with those from a Canadian institution to identify areas in need of improvement at our institution. We applied a regression analysis to the data and found that the adoption of evidence-based teaching practices differs by discipline and is higher in first-year classes at our institution. The study demonstrates that the TPI can be used in different institutional contexts and provides data that can inform practice and policy. © 2017 M. J. Drinkwater et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  3. Practice Innovation for Care Integration, Opioid Management, and Quality Measurement in Family Medicine.

    Science.gov (United States)

    Neale, Anne Victoria; Bowman, Marjorie A; Seehusen, Dean A

    Ringing in the new year 2017! This may finally be the year of real practice improvement after many false starts. Research into practice transformation has informed both local work and national policy. Human factors and payment structures are key. And payment structures depend on how quality is measured. Large gaps between practicing physician recommendations for the most important quality measures and those currently imposed externally are exposed in this issue. Also see information on in-practice social work consultations and their outcomes and recommendations from innovators in integrated care, and for chronic opioid therapy management based on visits to many family medicine offices. Visit entropy is negative for hospital readmissions. Another article reaffirms the importance of family physicians in rural obstetrics, including Cesarean deliveries. Two articles address changing Latino health care access. New Mexico's innovative health extension agent implementation now includes research in ways that benefit all. And a glass half-full: the growth in the diversity of family medicine faculty is above average, but is not occurring as quickly as in the general population. © Copyright 2017 by the American Board of Family Medicine.

  4. Pragmatic characteristics of patient-reported outcome measures are important for use in clinical practice.

    Science.gov (United States)

    Kroenke, Kurt; Monahan, Patrick O; Kean, Jacob

    2015-09-01

    Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. Although psychometric rigor is essential, this article focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice. Three sources were drawn on in identifying pragmatic criteria for PROs: (1) selected literature review including recommendations by other expert groups; (2) key features of several model public domain PROs; and (3) the authors' experience in developing practical PROs. Eight characteristics of a practical PRO include: (1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision making); (2) appropriateness for the relevant clinical setting; (3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); (4) self-administration; (5) item features (number of items and bundling issues); (6) response options (option number and dimensions, uniform vs. varying options, time frame, intervals between options); (7) scoring (simplicity and interpretability); and (8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, and incorporated into electronic health records). Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice. Published by Elsevier Inc.

  5. A practical system for the measurement of flows in a nuclear reactor

    International Nuclear Information System (INIS)

    Carrion V, F.J.

    1980-01-01

    With the purpose of making practical the neutron flux map in a nuclear reactor, the traditional foils are replaced by calibrated wires, and the activity rates through the wire are maked with a directional detector coupled to a collimator and to a servomechanism that moves the wire, to make the measurements through it. The servomechanism can be automatically controlled, and the information can be stored in a multichannel or directly pass to a plotter according to the continued or step by step measurements through the wire. For the system design it was necessary to fix the collimator dimensions according to the detector and the wire characteristics. In conclusion, this method is practical and exact, and their automation allows time economy. (author)

  6. Measuring public health practice and outcomes in chronic disease: a call for coordination.

    Science.gov (United States)

    Porterfield, Deborah S; Rogers, Todd; Glasgow, LaShawn M; Beitsch, Leslie M

    2015-04-01

    A strategic opportunity exists to coordinate public health systems and services researchers' efforts to develop local health department service delivery measures and the efforts of divisions within the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) to establish outcome indicators for public health practice in chronic disease. Several sets of outcome indicators developed by divisions within NCCDPHP and intended for use by state programs can be tailored to assess outcomes of interventions within smaller geographic areas or intervention settings. Coordination of measurement efforts could potentially allow information to flow from the local to the state to the federal level, enhancing program planning, accountability, and even subsequent funding for public health practice.

  7. Practical aspects of spherical near-field antenna measurements using a high-order probe

    DEFF Research Database (Denmark)

    Laitinen, Tommi; Pivnenko, Sergey; Nielsen, Jeppe Majlund

    2006-01-01

    Two practical aspects related to accurate antenna pattern characterization by probe-corrected spherical near-field antenna measurements with a high-order probe are examined. First, the requirements set by an arbitrary high-order probe on the scanning technique are pointed out. Secondly, a channel...... balance calibration procedure for a high-order dual-port probe with non-identical ports is presented, and the requirements set by this procedure for the probe are discussed....

  8. Establishing best practices for the validation of atmospheric composition measurements from satellites

    Science.gov (United States)

    Lambert, Jean-Christopher

    As a contribution to the implementation of the Global Earth Observation System of Systems (GEOSS), the Committee on Earth Observation Satellites (CEOS) is developing a data quality strategy for satellite measurements. To achieve GEOSS requirements of consistency and interoperability (e.g. for comparison and for integrated interpretation) of the measurements and their derived data products, proper uncertainty assessment is essential and needs to be continuously monitored and traceable to standards. Therefore, CEOS has undertaken the task to establish a set of best practices and guidelines for satellite validation, starting with current practices that could be improved with time. Best practices are not intended to be imposed as firm requirements, but rather to be suggested as a baseline for comparing against, which could be used by the widest community and provide guidance to newcomers. The present paper reviews the current development of best practices and guidelines for the validation of atmospheric composition satellites. Terminologies and general principles of validation are reminded. Going beyond elementary definitions of validation like the assessment of uncertainties, the specific GEOSS context calls also for validation of individual service components and against user requirements. This paper insists on two important aspects. First one, the question of the "collocation". Validation generally involves comparisons with "reference" measurements of the same quantities, and the question of what constitutes a valid comparison is not the least of the challenges faced. We present a tentative scheme for defining the validity of a comparison and of the necessary "collocation" criteria. Second focus of this paper: the information content of the data product. Validation against user requirements, or the verification of the "fitness for purpose" of both the data products and their validation, needs to identify what information, in the final product, is contributed really

  9. Measuring Provider Attitudes Toward Evidence-Based Practice: Consideration of Organizational Context and Individual Differences

    OpenAIRE

    Aarons, Gregory A.

    2005-01-01

    Mental health provider attitudes toward adoption of innovation in general, and toward evidence-based practice (EBP) in particular, are important in considering how best to disseminate and implement EBPs. This article first explores the role of attitudes in acceptance of innovation and proposes a model of organizational and individual factors that may affect or be affected by attitudes toward adoption of EBP. Next, a recently developed measure of mental health provider attitudes toward adoptio...

  10. The use of EORTC measures in daily clinical practice: A synopsis of a newly developed manual.

    OpenAIRE

    Wintner, L.M.; Sztankay, M.; Aaronson, N.; Bottomley, A.; Giesinger, J.M.; Groenvold, M.; Petersen, M.A.; van de Poll-Franse, L.; Velikova, G.; Verdonck-de Leeuw, I.; Holzner, B.

    2016-01-01

    Cancer has increasingly become a chronic condition and the routine collection of patient-reported outcomes (PROs) like quality of life is widely recommended for clinical practice. Nonetheless, the successful implementation of PROs is still a major challenge, although common barriers to and facilitators of their beneficial use are well known. To support health care professionals and other stakeholders in the implementation of the EORTC PRO measures, the EORTC Quality of Life Group provides gui...

  11. Using Project Performance to Measure Effectiveness of Quality Management System Maintenance and Practices in Construction Industry

    OpenAIRE

    Tiong Kung Leong; Norhayati Zakuan; Muhamad Zameri Mat Saman; Mohd. Shoki Md. Ariff; Choy Soon Tan

    2014-01-01

    This paper proposed seven existing and new performance indicators to measure the effectiveness of quality management system (QMS) maintenance and practices in construction industry. This research is carried out with a questionnaire based on QMS variables which are extracted from literature review and project performance indicators which are established from project management's theory. Data collected was analyzed using correlation and regression analysis. The findings indicate that client sat...

  12. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice.

    Science.gov (United States)

    Coughlin, Mary; Gibbins, Sharyn; Hoath, Steven

    2009-10-01

    This paper is a discussion of evidence-based core measures for developmental care in neonatal intensive care units. Inconsistent definition, application and evaluation of developmental care have resulted in criticism of its scientific merit. The key concept guiding data organization in this paper is the United States of America's Joint Commission's concept of 'core measures' for evaluating and accrediting healthcare organizations. This concept is applied to five disease- and procedure-independent measures based on the Universe of Developmental Care model. Electronically accessible, peer reviewed studies on developmental care published in English were culled for data supporting the selected objective core measures between 1978 and 2008. The quality of evidence was based on a structured predetermined format that included three independent reviewers. Systematic reviews and randomized control trials were considered the strongest level of evidence. When unavailable, cohort, case control, consensus statements and qualitative methods were considered the strongest level of evidence for a particular clinical issue. Five core measure sets for evidence-based developmental care were evaluated: (1) protected sleep, (2) pain and stress assessment and management, (3) developmental activities of daily living, (4) family-centred care, and (5) the healing environment. These five categories reflect recurring themes that emerged from the literature review regarding developmentally supportive care and quality caring practices in neonatal populations. This practice model provides clear metrics for nursing actions having an impact on the hospital experience of infant-family dyads. Standardized disease-independent core measures for developmental care establish minimum evidence-based practice expectations and offer an objective basis for cross-institutional comparison of developmental care programmes.

  13. Review of U.S. registries for psoriasis.

    Science.gov (United States)

    Amin, Mina; No, Daniel J; Wu, Jashin J

    2017-12-01

    Patient registries are databases comprised of standardized clinical data for a specific population of patients with a particular disease or medical condition. Information from patient registries allows clinicians to assess long-lasting outcomes in patients with a specific disease, such as psoriasis. Our primary objective was to identify available psoriasis registries in the United States (U.S.) and evaluate the application of patient registries compared to clinical trials. We searched Google, the Registry of Patient Registries, Orphanet and ClinicalTrials.gov to create a list of U.S. psoriasis registries. We also performed a literature review on the application of psoriasis registries using PubMed. We identified 6 psoriasis patient registries in the United States. Patient registries are frequently used for psoriasis in the U.S. and provide important information about the safety, efficacy and long-term effects of systemic therapies.

  14. Towards a best practice of modeling unit of measure and related statistical metadata

    CERN Document Server

    Grossmann, Wilfried

    2011-01-01

    Data and metadata exchange between organizations requires a common language for describing structure and content of statistical data and metadata. The SDMX consortium develops content oriented guidelines (COG) recommending harmonized cross-domain concepts and terminology to increase the efficiency of (meta-) data exchange. A recent challenge is a recommended code list for the unit of measure. Based on examples from SDMX sponsor organizations this paper analyses the diversity of ""unit of measure"" as used in practice, including potential breakdowns and interdependencies of the respective meta-

  15. Achieving efficiency in Africa: What are the priorities, the best practices and the policy measures?

    Energy Technology Data Exchange (ETDEWEB)

    Fall, Latsoucabe

    2010-09-15

    Energy Efficiency (EE) improvements offer huge opportunities for Africa to meet growing energy needs, secure a more sustainable energy supply and demand, improve business productivity, preserve local environment and mitigate GHG emissions. The paper focuses on the ways and means to overcome the related challenges in order to reap the benefits of such improvements. It also identifies the priorities for Africa and provides responses on how to establish and implement effective policy-measures to enhance EE in African countries. Subsequently, it delivers key recommendations to help improve EE policies and practices and to implement national and regional measures of EE improvements.

  16. SMART literature review report on existing practice in measuring success factors in second chance education

    DEFF Research Database (Denmark)

    Jensen, Ulla Højmark

    2015-01-01

    criteria, indicators and benchmarks that measures developments of learners, impacts of informal and non-formal learning methods and evidences success factors of second chance education. The aim of the project is to build an evidence base of outcomes and impacts of second chance education and to enhance......, and the Commission cannot be held responsible for any use which may be made of the information contained therein. This literature review aims at developing an insight of the existing practice of measuring and evidencing success factors in second chance education. In the following, we will highlight examples of good...

  17. Best practice guide for radioactivity measurement laboratories in a post-accident situation

    International Nuclear Information System (INIS)

    2011-01-01

    Published for laboratories likely to be asked to perform radioactivity measurements at the time of or after a radiological or nuclear accident in France or abroad, this guide aims at defining the best practices in terms of laboratory organisation (sample flow management, personnel radioprotection, sample identification and recording, sample cross-contamination risks, result transmission, archiving of data, results and samples, waste dismissal), and in terms of metrology (adaptation to needs in terms of detection limit and measurement uncertainty, preferred use of gamma spectrometry, analysis strategies)

  18. Standard practice for calculation of corrosion rates and related information from electrochemical measurements

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    1989-01-01

    1.1 This practice covers the providing of guidance in converting the results of electrochemical measurements to rates of uniform corrosion. Calculation methods for converting corrosion current density values to either mass loss rates or average penetration rates are given for most engineering alloys. In addition, some guidelines for converting polarization resistance values to corrosion rates are provided. 1.2 The values stated in SI units are to be regarded as standard. No other units of measurement are included in this standard.

  19. How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations.

    Science.gov (United States)

    Jelsma, Judith G M; Mertens, Vera-Christina; Forsberg, Lisa; Forsberg, Lars

    2015-07-01

    Many randomized controlled trials in which motivational interviewing (MI) is a key intervention make no provision for the assessment of treatment fidelity. This methodological shortcoming makes it impossible to distinguish between high- and low-quality MI interventions, and, consequently, to know whether MI provision has contributed to any intervention effects. This article makes some practical recommendations for the collection, selection, coding and reporting of MI fidelity data, as measured using the Motivational Interviewing Treatment Integrity Code. We hope that researchers will consider these recommendations and include MI fidelity measures in future studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Measurement invariance of an instrument assessing sustainability of school-based universal behavior practices.

    Science.gov (United States)

    Mercer, Sterett H; McIntosh, Kent; Strickland-Cohen, M Kathleen; Horner, Robert H

    2014-06-01

    The purpose of the study was to examine the extent to which the School-Wide Universal Behavior Sustainability Index: School Teams (SUBSIST; McIntosh, Doolittle, Vincent, Horner, & Ervin, 2009), a measure of school and district contextual factors that promote the sustainability of school practices, demonstrated measurement invariance across groups of schools that differed in length of time implementing school-wide Positive Behavioral Interventions and Supports (PBIS; Sugai & Horner, 2009), student ethnic composition, and student socioeconomic status (SES). School PBIS team members and district coaches representing 860 schools in 14 U.S. states completed the SUBSIST. Findings supported strong measurement invariance, for all items except 1, of a model with two school-level factors (School Priority and Team Use of Data) and 2 district-level factors (District Priority and Capacity Building) across groups of schools at initial implementation, institutionalization, and sustainability phases of PBIS implementation. Schools in the sustainability phase were rated significantly higher on School Priority and Team Use of Data than schools in initial implementation. Strong measurement invariance held across groups of schools that differed in student ethnicity and SES. The findings regarding measurement invariance are important for future longitudinal investigations of factors that may promote the sustained implementation of school practices. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  1. Exploring nurses' perceptions of collecting and using HOBIC measures to guide clinical practice and improve care.

    Science.gov (United States)

    Jeffs, Lianne; Wilson, Gail; Ferris, Ella; Cardiff, Brenda; Ng, San; Lanceta, Mary; White, Peggy; Pringle, Dorothy

    2012-03-01

    Ontario's Health Outcomes for Better Information and Care (HOBIC) is designed to help organizations and nurses plan and evaluate care by comparing patient outcomes with historical data on similar cases. Yet, fewer than 15% of patients in a 2010 study were found to have complete admission and discharge data sets. This low utilization rate of HOBIC measures prompted the current qualitative study, in which nurses from three clinical settings in an academic teaching hospital were interviewed to gain their perceptions related to collecting and using HOBIC measures in practice. The objective was to identify factors that promote or impede the collection and use of HOBIC data in clinical practice to improve patient care and outcomes. Analysis of interview results produced four key themes related to (a) use of HOBIC measures to inform patient care, (b) collecting and documenting HOBIC measures, (c) HOBIC as an afterthought and "black hole" and (d) impediments to assessing and documenting HOBIC measures because of language barriers, patients' cognitive status and lack of time. Recommendations to improve uptake include developing, implementing and evaluating a communication and learning plan that promotes HOBIC's values and benefits, and determining how managers and administrators perceive utilization of HOBIC at the clinical unit and organizational levels.

  2. Practical aspects of the uncertainty and traceability of spectrochemical measurement results by electrothermal atomic absorption spectrometry

    International Nuclear Information System (INIS)

    Duta, S.; Robouch, P.; Barbu, L.; Taylor, P.

    2007-01-01

    The determination of trace elements concentration in water by electrothermal atomic absorption spectrometry (ETAAS) is a common and well established technique in many chemical testing laboratories. However, the evaluation of measurement uncertainty results is not systematically implemented. The paper presents an easy step-by-step example leading to the evaluation of the combined standard uncertainty of copper determination in water using ETAAS. The major contributors to the overall measurement uncertainty are identified due to amount of copper in water sample that mainly depends on the absorbance measurements, due to certified reference material and due to auto-sampler volume measurements. The practical aspects how the traceability of copper concentration in water can be established and demonstrated are also pointed out

  3. Practical aspects of the uncertainty and traceability of spectrochemical measurement results by electrothermal atomic absorption spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Duta, S. [Institute for Reference Materials and Measurements, Joint Research Centre, European Commission, Retieseweg 111, B-2440 Geel (Belgium); National Institute of Metrology, 042122 Vitan Barzesti 11, sector 4 Bucharest (Romania)], E-mail: steluta.duta@inm.ro; Robouch, P. [Institute for Reference Materials and Measurements, Joint Research Centre, European Commission, Retieseweg 111, B-2440 Geel (Belgium)], E-mail: Piotr.Robouch@ec.europa.eu; Barbu, L. [Coca-Cola Entreprise, Analytical Department, Bucharest (Romania); Taylor, P. [Institute for Reference Materials and Measurements, Joint Research Centre, European Commission, Retieseweg 111, B-2440 Geel (Belgium)], E-mail: Philip.Taylor@ec.europa.eu

    2007-04-15

    The determination of trace elements concentration in water by electrothermal atomic absorption spectrometry (ETAAS) is a common and well established technique in many chemical testing laboratories. However, the evaluation of measurement uncertainty results is not systematically implemented. The paper presents an easy step-by-step example leading to the evaluation of the combined standard uncertainty of copper determination in water using ETAAS. The major contributors to the overall measurement uncertainty are identified due to amount of copper in water sample that mainly depends on the absorbance measurements, due to certified reference material and due to auto-sampler volume measurements. The practical aspects how the traceability of copper concentration in water can be established and demonstrated are also pointed out.

  4. Calibration of kV measurers with the practical peak voltage (IEC 1676)

    International Nuclear Information System (INIS)

    Becker, Paulo H.B.; Peres, Marcos A.L.; Ludwig, Jaime L.; Chernicharo, Carlos C.

    2002-01-01

    The IEC 1676 standard introduces a new quantity for the measurements of the high voltages applied to the X ray tubes used for diagnosis, the 'Practical Peak Voltage' (PPV). In order to start the introduction of this new quantity in Brazil the National Laboratory for Metrology of Ionizing Radiation has developed a procedure for calibrating measuring instruments in this quantity. This procedure is based in the same set up used for the calibration of the conventional kVp, which consists in a high voltage divider (Dynalyser III from Radcal Corporation), a fast analogue to digital conversion board and a data acquisition software. In order to evaluate this procedure a commercial kVp measure instrument that is able to measure PPV (Universal Diavolt from PTW) was calibrated and the results compared. This work presents a summary of the procedure developed and the results obtained with the comparison. (author)

  5. Pharmacy Service Orientation: a measure of organizational culture in pharmacy practice sites.

    Science.gov (United States)

    Clark, Bartholomew E; Mount, Jeanine K

    2006-03-01

    The importance of organizational culture in shaping everyday organizational life is well accepted, but little work has focused on organizational culture in pharmacy. Examining new pharmacists' experiences at various practice sites may help us to understand how these shape their professional ethos and practice habits. (1) Present development and assessment of the Pharmacy Service Orientation (PSO) measure, a tool for assessing pharmacists' impressions of pharmacy practice sites. (2) Use data gathered from a sample of new pharmacists to explore potential predictors of PSO, including type of practice site, type of pharmacy work experience, and type of pharmacy degree. Mail survey of randomly selected class of 1999 pharmacy graduates within 3 months of graduation (response rate: 259 of 1,850; 14%), each of whom reported on up to 6 different pharmacy practice sites for a total of 1,192 pharmacy observations. Pharmacy Service Orientation is scored on a 1-10 semantic differential scale and reliability was assessed using Cronbach's alpha. Predictors of PSO were explored using t test and ordinary least squares regression procedures. Reliability of the PSO across all observations was 0.86. When divided according to recency of experience and type of experience, reliabilities ranged from 0.78 to 0.87. Analysis of potential predictors of PSO showed that non-corporate-community sites had significantly greater pharmaceutical care-oriented cultures (mean PSOs of 7.42 and 5.13, respectively; PService Orientation is a reliable measure. Statistically significant differences in PSO comparisons by degree and by experience type are explained by significant differences between the PSOs of corporate-community and non-corporate-community sites.

  6. Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

    Directory of Open Access Journals (Sweden)

    Green Michael E

    2012-07-01

    Full Text Available Abstract Purpose To evaluate the appropriateness of potential data sources for the population of performance indicators for primary care (PC practices. Methods This project was a cross sectional study of 7 multidisciplinary primary care teams in Ontario, Canada. Practices were recruited and 5-7 physicians per practice agreed to participate in the study. Patients of participating physicians (20-30 were recruited sequentially as they presented to attend a visit. Data collection included patient, provider and practice surveys, chart abstraction and linkage to administrative data sets. Matched pairs analysis was used to examine the differences in the observed results for each indicator obtained using multiple data sources. Results Seven teams, 41 physicians, 94 associated staff and 998 patients were recruited. The survey response rate was 81% for patients, 93% for physicians and 83% for associated staff. Chart audits were successfully completed on all but 1 patient and linkage to administrative data was successful for all subjects. There were significant differences noted between the data collection methods for many measures. No single method of data collection was best for all outcomes. For most measures of technical quality of care chart audit was the most accurate method of data collection. Patient surveys were more accurate for immunizations, chronic disease advice/information dispensed, some general health promotion items and possibly for medication use. Administrative data appears useful for indicators including chronic disease diagnosis and osteoporosis/ breast screening. Conclusions Multiple data collection methods are required for a comprehensive assessment of performance in primary care practices. The choice of which methods are best for any one particular study or quality improvement initiative requires careful consideration of the biases that each method might introduce into the results. In this study, both patients and providers were

  7. Inclusion of Functional Status Measures in the Risk Adjustment of 30-Day Mortality After Transcatheter Aortic Valve Replacement: A Report From the Society of Thoracic Surgeons/American College of Cardiology TVT Registry.

    Science.gov (United States)

    Arnold, Suzanne V; O'Brien, Sean M; Vemulapalli, Sreekanth; Cohen, David J; Stebbins, Amanda; Brennan, J Matthew; Shahian, David M; Grover, Fred L; Holmes, David R; Thourani, Vinod H; Peterson, Eric D; Edwards, Fred H

    2018-03-26

    The aim of this study was to develop and validate a risk adjustment model for 30-day mortality after transcatheter aortic valve replacement (TAVR) that accounted for both standard clinical factors and pre-procedural health status and frailty. Assessment of risk for TAVR is important both for patient selection and provider comparisons. Prior efforts for risk adjustment have focused on in-hospital mortality, which is easily obtainable but can be biased because of early discharge of ill patients. Using data from patients who underwent TAVR as part of the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry (June 2013 to May 2016), a hierarchical logistic regression model to estimate risk for 30-day mortality after TAVR based only on pre-procedural factors and access site was developed and internally validated. The model included factors from the original TVT Registry in-hospital mortality model but added the Kansas City Cardiomyopathy Questionnaire (health status) and gait speed (5-m walk test). Among 21,661 TAVR patients at 188 sites, 1,025 (4.7%) died within 30 days. Independent predictors of 30-day death included older age, low body weight, worse renal function, peripheral artery disease, home oxygen, prior myocardial infarction, left main coronary artery disease, tricuspid regurgitation, nonfemoral access, worse baseline health status, and inability to walk. The predicted 30-day mortality risk ranged from 1.1% (lowest decile of risk) to 13.8% (highest decile of risk). The model was able to stratify risk on the basis of patient factors with good discrimination (C = 0.71 [derivation], C = 0.70 [split-sample validation]) and excellent calibration, both overall and in key patient subgroups. A clinical risk model was developed for 30-day death after TAVR that included clinical data as well as health status and frailty. This model will facilitate tracking outcomes over time as TAVR expands to lower risk patients and

  8. Cohort profile: the TrueNTH Global Registry - an international registry to monitor and improve localised prostate cancer health outcomes.

    Science.gov (United States)

    Evans, Sue M; Millar, Jeremy L; Moore, Caroline M; Lewis, John D; Huland, Hartwig; Sampurno, Fanny; Connor, Sarah E; Villanti, Paul; Litwin, Mark S

    2017-11-28

    Globally, prostate cancer treatment and outcomes for men vary according to where they live, their race and the care they receive. The TrueNTH Global Registry project was established as an international registry monitoring care provided to men with localised prostate cancer (CaP). Sites with existing CaP databases in Movember fundraising countries were invited to participate in the international registry. In total, 25 Local Data Centres (LDCs) representing 113 participating sites across 13 countries have nominated to contribute to the project. It will collect a dataset based on the International Consortium for Health Outcome Measures (ICHOM) standardised dataset for localised CaP. A governance strategy has been developed to oversee registry operation, including transmission of reversibly anonymised data. LDCs are represented on the Project Steering Committee, reporting to an Executive Committee. A Project Coordination Centre and Data Coordination Centre (DCC) have been established. A project was undertaken to compare existing datasets, understand capacity at project commencement (baseline) to collect the ICHOM dataset and assist in determining the final data dictionary. 21/25 LDCs provided data dictionaries for review. Some ICHOM data fields were well collected (diagnosis, treatment start dates) and others poorly collected (complications, comorbidities). 17/94 (18%) ICHOM data fields were relegated to non-mandatory fields due to poor capture by most existing registries. Participating sites will transmit data through a web interface biannually to the DCC. Recruitment to the TrueNTH Global Registry-PCOR project will commence in late 2017 with sites progressively contributing reversibly anonymised data following ethical review in local regions. Researchers will have capacity to source deidentified data after the establishment phase. Quality indicators are to be established through a modified Delphi approach in later 2017, and it is anticipated that reports on

  9. A practical strategy for the accurate measurement of residual dipolar couplings in strongly aligned small molecules

    Science.gov (United States)

    Liu, Yizhou; Cohen, Ryan D.; Martin, Gary E.; Williamson, R. Thomas

    2018-06-01

    Accurate measurement of residual dipolar couplings (RDCs) requires an appropriate degree of alignment in order to optimize data quality. An overly weak alignment yields very small anisotropic data that are susceptible to measurement errors, whereas an overly strong alignment introduces extensive anisotropic effects that severely degrade spectral quality. The ideal alignment amplitude also depends on the specific pulse sequence used for the coupling measurement. In this work, we introduce a practical strategy for the accurate measurement of one-bond 13C-1H RDCs up to a range of ca. -300 to +300 Hz, corresponding to an alignment that is an order of magnitude stronger than typically employed for small molecule structural elucidation. This strong alignment was generated in the mesophase of the commercially available poly-γ-(benzyl-L-glutamate) polymer. The total coupling was measured by the simple and well-studied heteronuclear two-dimensional J-resolved experiment, which performs well in the presence of strong anisotropic effects. In order to unequivocally determine the sign of the total coupling and resolve ambiguities in assigning total couplings in the CH2 group, coupling measurements were conducted at an isotropic condition plus two anisotropic conditions of different alignment amplitudes. Most RDCs could be readily extracted from these measurements whereas more complicated spectral effects resulting from strong homonuclear coupling could be interpreted either theoretically or by simulation. Importantly, measurement of these very large RDCs actually offers significantly improved data quality and utility for the structure determination of small organic molecules.

  10. Towards a practical Johnson noise thermometer for long-term measurements in harsh environments

    Energy Technology Data Exchange (ETDEWEB)

    Greenen, Adam; Pearce, Jonathan [National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, (United Kingdom); Cruickshank, David; Bramley, Paul [Metrosol Limited, Plum Park Estate, Watling Street, Paulerspury, Northamptonshire, NN12 6LQ, (United Kingdom)

    2015-07-01

    The impact of mechanical and chemical changes in conventional sensors such as thermocouples and resistance thermometers can be avoided by instead using temperature sensors based on fundamental thermometry. A prime example of this is Johnson noise thermometry, which is based on measurement of the fluctuations in the voltage of a resistor arising from thermal motion of charge carriers - i.e. the 'Johnson noise'. A Johnson noise thermometer never needs calibration and is insensitive to the condition of the sensor material. It is therefore ideally suited to long-term temperature measurements in harsh environments, such as nuclear reactor coolant circuits, in-pile measurements, nuclear waste management and storage, and severe accident monitoring. There have been a number of previous attempts to develop a Johnson noise thermometer for the nuclear industry, but none have reached commercial exploitation because of technical problems in practical implementation. The main challenge is to extract the tiny Johnson noise signal from ambient electrical noise influences, both from the internal amplification electronics, and from external electrical noise sources. Recent advances in electronics technology and digital signal processing techniques have opened up new possibilities for developing a viable, practical Johnson noise thermometer. We describe a project funded by the UK Technology Strategy Board (now Innovate UK) 'Developing the nuclear supply chain' call, currently underway, to develop a practical Johnson noise thermometer that makes use of innovative electronics for ultralow noise amplification and signal processing. The new electronics technology has the potential to help overcome the problems encountered with previous attempts at constructing a practical Johnson noise thermometer. An outline of the new developments is presented, together with an overview of the current status of the project. (authors)

  11. Towards a practical Johnson noise thermometer for long-term measurements in harsh environments

    International Nuclear Information System (INIS)

    Greenen, Adam; Pearce, Jonathan; Cruickshank, David; Bramley, Paul

    2015-01-01

    The impact of mechanical and chemical changes in conventional sensors such as thermocouples and resistance thermometers can be avoided by instead using temperature sensors based on fundamental thermometry. A prime example of this is Johnson noise thermometry, which is based on measurement of the fluctuations in the voltage of a resistor arising from thermal motion of charge carriers - i.e. the 'Johnson noise'. A Johnson noise thermometer never needs calibration and is insensitive to the condition of the sensor material. It is therefore ideally suited to long-term temperature measurements in harsh environments, such as nuclear reactor coolant circuits, in-pile measurements, nuclear waste management and storage, and severe accident monitoring. There have been a number of previous attempts to develop a Johnson noise thermometer for the nuclear industry, but none have reached commercial exploitation because of technical problems in practical implementation. The main challenge is to extract the tiny Johnson noise signal from ambient electrical noise influences, both from the internal amplification electronics, and from external electrical noise sources. Recent advances in electronics technology and digital signal processing techniques have opened up new possibilities for developing a viable, practical Johnson noise thermometer. We describe a project funded by the UK Technology Strategy Board (now Innovate UK) 'Developing the nuclear supply chain' call, currently underway, to develop a practical Johnson noise thermometer that makes use of innovative electronics for ultralow noise amplification and signal processing. The new electronics technology has the potential to help overcome the problems encountered with previous attempts at constructing a practical Johnson noise thermometer. An outline of the new developments is presented, together with an overview of the current status of the project. (authors)

  12. Awareness and practice of road safety measures among undergraduate medical students in a South Indian state.

    Science.gov (United States)

    Kulkarni, Vaman; Kanchan, Tanuj; Palanivel, C; Papanna, M K; Kumar, Nithin; Unnikrishnan, B

    2013-05-01

    The UN general assembly has declared 2011-2020 as the "Decade of Action for Road Safety". The declaration holds significance because road traffic accidents (RTAs) have become a major cause of morbidity and mortality, especially among the adults and middle aged individuals who constitute economically most productive age groups of society. The importance of knowledge and practice of road safety measures needs to be emphasized in the prevention of RTAs. The present study is aimed to assess the knowledge and practice of road safety measures among the students of a medical college in coastal, South India. A total of 260 medical students were included in this cross-sectional study. A semi-structured questionnaire was used to collect the relevant information from the participants. The data collected was analyzed using SPSS version 11.5. Out of the 260 participants, 149 (57.3%) were females and 111 (42.7%) were males. The overall awareness on road safety measures was slightly higher among females (20.6%) than males (19.9%). The participants had significantly low awareness with regard to alcohol and driving (4.2%), use of seat belts (20%) and use of mobile phones without hands free device (6.1%). The participants had a better knowledge about traffic signs and more than half of them identified all the signs correctly. With regard to the road safety practices, 25% were involved in drunken driving in the past one year. The practice of using mobile phones with hands free devices while driving was admitted by 20% of them. Nearly two-third participants (68%) admitted to have crossed speed limits on multiple occasions. Observations of the study emphasize on the need to generate awareness among medical students through training and IEC activities to curb the epidemic of RTAs. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  13. Linked Registries: Connecting Rare Diseases Patient Registries through a Semantic Web Layer.

    Science.gov (United States)

    Sernadela, Pedro; González-Castro, Lorena; Carta, Claudio; van der Horst, Eelke; Lopes, Pedro; Kaliyaperumal, Rajaram; Thompson, Mark; Thompson, Rachel; Queralt-Rosinach, Núria; Lopez, Estrella; Wood, Libby; Robertson, Agata; Lamanna, Claudia; Gilling, Mette; Orth, Michael; Merino-Martinez, Roxana; Posada, Manuel; Taruscio, Domenica; Lochmüller, Hanns; Robinson, Peter; Roos, Marco; Oliveira, José Luís

    2017-01-01

    Patient registries are an essential tool to increase current knowledge regarding rare diseases. Understanding these data is a vital step to improve patient treatments and to create the most adequate tools for personalized medicine. However, the growing number of disease-specific patient registries brings also new technical challenges. Usually, these systems are developed as closed data silos, with independent formats and models, lacking comprehensive mechanisms to enable data sharing. To tackle these challenges, we developed a Semantic Web based solution that allows connecting distributed and heterogeneous registries, enabling the federation of knowledge between multiple independent environments. This semantic layer creates a holistic view over a set of anonymised registries, supporting semantic data representation, integrated access, and querying. The implemented system gave us the opportunity to answer challenging questions across disperse rare disease patient registries. The interconnection between those registries using Semantic Web technologies benefits our final solution in a way that we can query single or multiple instances according to our needs. The outcome is a unique semantic layer, connecting miscellaneous registries and delivering a lightweight holistic perspective over the wealth of knowledge stemming from linked rare disease patient registries.

  14. Toward criteria for pragmatic measurement in implementation research and practice: a stakeholder-driven approach using concept mapping

    NARCIS (Netherlands)

    Powell, B.J.; Stanick, C.F.; Halko, H.M.; Dorsey, C.N.; Weiner, B.J.; Barwick, M.A.; Damschroder, L.J.; Wensing, M.; Wolfenden, L.; Lewis, C.C.

    2017-01-01

    BACKGROUND: Advancing implementation research and practice requires valid and reliable measures of implementation determinants, mechanisms, processes, strategies, and outcomes. However, researchers and implementation stakeholders are unlikely to use measures if they are not also pragmatic. The

  15. [Types of medical registries - definitions, methodological aspects and quality of the scientific work with registries].

    Science.gov (United States)

    Mathis-Edenhofer, Stefan; Piso, Brigitte

    2011-12-01

    This work presents a comprehensive list of registry definitions including broader and narrower definitions. Compared to each other different methodological issues can be identified. Some of these issues are common for all registry types; some can be assigned more easily to a specific registry type. Instruments for evaluating the quality of registers reflect many of the mentioned aspects. Generally, and especially at registers with a descriptive or exploratory research dimension it is important to consider their intended purpose and in about it was achieved. This includes, for instance, whether the purpose and the methodology are coordinated. From the start of registration an initiator should be - based on the purpose - aware of the methodological dimension of the registry. This helps to apply the correct type of the registry, the appropriate guidance and, ultimately, the arguments for the effort (cost-benefit ratio).

  16. A statistical examination of the practical problems of measurement in accountancy tanks

    International Nuclear Information System (INIS)

    Davies, W.; Good, P.T.; Hamlin, A.G.

    1979-01-01

    In the first part of the paper the general problems of measurement in large accountancy tanks are considered. The generalized tank is assumed to have an extended geometry for the avoidance of criticality, to be fitted with pneumatic level indicating devices and with temperature sensors, and to contain liquid to be accounted, such as that derived from irradiated fuel elements, which is sufficiently active to generate appreciable heat and also radiolytic gases. Possible uncertainties contributed to the final measurement of fissile material contained in or discharged from the tank by the effects of hydrostatic heads, temperature, radiolysis, surface tension, and drainage are considered in detail. The magnitude of these is established from practical data and the errors combined in order to estimate the best possible performance, which, under the specified conditions, appears to be about +-0.3% (1 sigma). The implications for the design of large accountancy tanks are considered, with particular reference to the design of accountancy tanks for future plants where the above precision may not be adequate. The second part of the paper considers practical approaches to the problem of ensuring that actual performance of the measuring system approaches the best possible as closely as possible. In particular, a system of operation in which the accountancy tank is utilized essentially as a fixed volume, with the measuring systems restricted to determining small variations from this nominal volume, offers considerable promise

  17. Measurable benefits on brain activity from the practice of educational leisure.

    Science.gov (United States)

    Requena, Carmen; López, Verónica

    2014-01-01

    Even if behavioral studies relate leisure practices to the preservation of memory in old persons, there is unsubstantial evidence of the import of leisure on brain activity. This study was to compare the brain activity of elderly retired people who engage in different types of leisure activities. Quasi-experimental study over a sample of 60 elderly, retired subjects distributed into three groups according to the leisure activities they practised: educational leisure (G1), memory games (G2), and card games (G3). Applied measures include the conceptual distinction between free time and leisure, the test of the organization of free time measuring 24 clock divisions, and EEG register during 12 word list memorizing. The results show that the type of leisure activity is associated with significant quantitative differences regarding the use of free time. G1 devotes more time to leisure activities than G2 (p = 0.007) and G3 (p = 0.034). G1 rests more actively than the other two groups (p = 0.001). The electrical localization of brain activity indicated a reverse tendency of activation according to the bands and groups. Engaging in educational leisure activities is a useful practice to protect healthy brain compensation strategies. Future longitudinal research may verify the causal relation between practicing educational leisure activities and functional brain aging.

  18. Measurable benefits on brain activity from the practice of educational leisure

    Directory of Open Access Journals (Sweden)

    Carmen eRequena

    2014-03-01

    Full Text Available Even if behavioural studies relate leisure practices to the preservation of memory in old persons, there is unsubstantial evidence of the import of leisure on brain activity. Aim of this study was to compare the brain activity of elderly retired people who engage in different types of leisure activities. Methods: quasi-experimental study over a sample of 60 elderly, retired subjects distributed into three groups according to the leisure activities they practised: educational leisure (G1, memory games (G2 and card games (G3. Applied measures include the conceptual distinction between free time and leisure, the Test of Organization of Free Time (TOFT measuring 24 clock divisions, and EEG register during 12 word list memorizing. The results show that the type of leisure activity is associated with significant quantitative differences regarding the use of free time. G1 devotes more time to leisure activities than G2 (p = 0.007 and G3 (p = 0.034. G1 rests more actively than the other two groups (p=0.001. The electrical localization of brain activity indicated a reverse tendency of activation according to the bands and groups. Discussion. Engaging in educational leisure activities is a useful practice to protect healthy brain compensation strategies. Future longitudinal research may verify the causal relation between practicing educational leisure activities and functional brain aging.

  19. The National Mental Health Registry (NMHR).

    Science.gov (United States)

    Aziz, A A; Salina, A A; Abdul Kadir, A B; Badiah, Y; Cheah, Y C; Nor Hayati, A; Ruzanna, Z Z; Sharifah Suziah, S M; Chee, K Y

    2008-09-01

    The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.

  20. ISHKS joint registry: A preliminary report

    Directory of Open Access Journals (Sweden)

    Jawahir A Pachore

    2013-01-01

    form can be downloaded from the website www.ishks.com. The information collected includes patient demographics, indication for surgery, implant details and in case of revision arthroplasty: the details of implants removed and the cause of failure of primary arthroplasty. These forms are mailed to the central registry office and the data is fed in computerized registry. Data collection started in October 2006. Results: Joint registry is a very important initiative of ISHKS and till date, have data of 34,478 TKAs and 3604 THAs, contributed by 42 surgeons across India. Some important observations have emerged. Data of 34,478 TKAs was assessed: These included 8612 males (25% and 25,866 females (75%. Average age was 64.4 years (Osteoarthritis range: 45 to 88 years; Rheumatoid arthritis range: 22 to 74 years. Average body mass index was 29.1 (Range: 18.1 to 42.9. The indication for TKA was osteoarthritis in 33,444 (97% and rheumatoid arthritis in 759 (2.2%. Total of 3604 THA procedures were recorded. These included 2162 (60% male patients and 1442 (40% female patients. Average age was 52 years (Range 17 to 85 years and average BMI was 25.8 (Range: 17.3 to 38.5. The indications for THA was AVN in 49%. Conclusion: The registry will become more meaningful in years to come. Active participation of all arthroplasty surgeons across India is vital for the success of the joints registry.

  1. Management of Major Bleeding in Patients With Atrial Fibrillation Treated With Non-Vitamin K Antagonist Oral Anticoagulants Compared With Warfarin in Clinical Practice (from Phase II of the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation [ORBIT-AF II]).

    Science.gov (United States)

    Steinberg, Benjamin A; Simon, DaJuanicia N; Thomas, Laine; Ansell, Jack; Fonarow, Gregg C; Gersh, Bernard J; Kowey, Peter R; Mahaffey, Kenneth W; Peterson, Eric D; Piccini, Jonathan P

    2017-05-15

    Non-vitamin K antagonist oral anticoagulants (NOACs) are effective at preventing stroke in patients with atrial fibrillation (AF). However, little is known about the management of bleeding in contemporary, clinical use of NOACs. We aimed to assess the frequency, management, and outcomes of major bleeding in the setting of community use of NOACs. Using the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II registry, we analyzed rates of International Society on Thrombosis and Haemostasis major bleeding and subsequent outcomes in patients treated with NOACs versus warfarin. Outcomes of interest included acute and chronic bleeding management, recurrent bleeding, thromboembolic events, and death. In total, 344 patients with atrial fibrillation experienced major bleeding events over a median follow-up of 360 days follow-up: n = 273 on NOAC (3.3 per 100 patient-years) and n = 71 on warfarin (3.5 per 100 patient-years). Intracranial bleeding was uncommon but similar (0.34 per 100 patient-years for NOAC vs 0.44 for warfarin, p = 0.5), as was gastrointestinal bleeding (1.8 for NOAC vs 1.3 for warfarin, p = 0.1). Blood products and correction agents were less commonly used in NOAC patients with major bleeds compared with warfarin-treated patients (53% vs 76%, p = 0.0004 for blood products; 0% vs 1.5% for recombinant factor; p = 0.0499); no patients received pharmacologic hemostatic agents (aminocaproic acid, tranexamic acid, desmopressin, aprotinin). Within 30 days, 23 NOAC-treated patients (8.4%) died versus 5 (7.0%) on warfarin (p = 0.7). At follow-up, 126 NOAC-treated (46%) and 29 warfarin-treated patients (41%) were not receiving any anticoagulation. In conclusion, rates of major bleeding are similar in warfarin and NOAC-treated patients in clinical practice. However, NOAC-related bleeds require less blood product administration and rarely require factor replacement. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights

  2. Occupational dose assessment and national dose registry system in Iran

    International Nuclear Information System (INIS)

    Jafari-Zadeh, M.; Nazeri, F.; Hosseini-Pooya, S. M.; Taheri, M.; Gheshlaghi, F.; Kardan, M. R.; Babakhani, A.; Rastkhah, N.; Yousefi-Nejad, F.; Darabi, M.; Oruji, T.; Gholamali-Zadeh, Z.; Karimi-Diba, J.; Kazemi-Movahed, A. A.; Dashti-Pour, M. R.; Enferadi, A.; Jahanbakhshian, M. H.; Sadegh-Khani, M. R.

    2011-01-01

    This report presents status of external and internal dose assessment of workers and introducing the structure of National Dose Registry System of Iran (NDRSI). As well as types of individual dosemeters in use, techniques for internal dose assessment are presented. Results obtained from the International Atomic Energy Agency intercomparison programme on measurement of personal dose equivalent H p (10) and consistency of the measured doses with the delivered doses are shown. Also, implementation of dosimetry standards, establishment of quality management system, authorisation and approval procedure of dosimetry service providers are discussed. (authors)

  3. Response Burden in Official Business Surveys: Measurement and Reduction Practices of National Statistical Institutes

    Directory of Open Access Journals (Sweden)

    Bavdaž Mojca

    2015-12-01

    Full Text Available Response burden in business surveys has long been a concern for National Statistical Institutes (NSIs for three types of reasons: political reasons, because response burden is part of the total administrative burden governments impose on businesses; methodological reasons, because an excessive response burden may reduce data quality and increase data-collection costs; and strategic reasons, because it affects relations between the NSIs and the business community. This article investigates NSI practices concerning business response burden measurement and reduction actions based on a survey of 41 NSIs from 39 countries. Most NSIs monitor at least some burden aspects and have implemented some actions to reduce burden, but large differences exist between NSIs’ methodologies for burden measurement and actions taken to reduce burden. Future research should find ways to deal with methodological differences in burden conceptualization, operationalization, and measurement, and provide insights into the effectiveness and efficiency of burden-reduction actions.

  4. Specification of safety requirements for waste packages with respect to practicable quality control measures

    International Nuclear Information System (INIS)

    Gruendler, D.; Wurtinger, W.

    1987-01-01

    Waste packages for disposal in a repository in the Federal Republic of Germany have to meet safety requirements derived from site specific safety analyses. The examination of the waste packages with regard to compliance with these requirements is the main objective of quality control measures. With respect to quality control the requirements have to be specified in a way that practicable control measures can be applied. This is dealt with for the quality control of the activity inventory and the quality control of the waste form. The paper discusses the determination of the activity of hard-to-measure radionuclides and the specification of safety related requirements for the waste form and the packaging using typical examples

  5. A Practitioner's Instrument for Measuring Secondary Mathematics Teachers' Beliefs Surrounding Learner-Centered Classroom Practice.

    Science.gov (United States)

    Lischka, Alyson E; Garner, Mary

    In this paper we present the development and validation of a Mathematics Teaching Pedagogical and Discourse Beliefs Instrument (MTPDBI), a 20 item partial-credit survey designed and analyzed using Rasch measurement theory. Items on the MTPDBI address beliefs about the nature of mathematics, teaching and learning mathematics, and classroom discourse practices. A Rasch partial credit model (Masters, 1982) was estimated from the pilot study data. Results show that item separation reliability is .96 and person separation reliability is .71. Other analyses indicate the instrument is a viable measure of secondary teachers' beliefs about reform-oriented mathematics teaching and learning. This instrument is proposed as a useful measure of teacher beliefs for those working with pre-service and in-service teacher development.

  6. Practical approach to a procedure for judging the results of analytical verification measurements

    International Nuclear Information System (INIS)

    Beyrich, W.; Spannagel, G.

    1979-01-01

    For practical safeguards a particularly transparent procedure is described to judge analytical differences between declared and verified values based on experimental data relevant to the actual status of the measurement technique concerned. Essentially it consists of two parts: Derivation of distribution curves for the occurrence of interlaboratory differences from the results of analytical intercomparison programmes; and judging of observed differences using criteria established on the basis of these probability curves. By courtesy of the Euratom Safeguards Directorate, Luxembourg, the applicability of this judging procedure has been checked in practical data verification for safeguarding; the experience gained was encouraging and implementation of the method is intended. Its reliability might be improved further by evaluation of additional experimental data. (author)

  7. Measuring sports injuries on the pitch: a guide to use in practice.

    Science.gov (United States)

    Hespanhol Junior, Luiz C; Barboza, Saulo D; van Mechelen, Willem; Verhagen, Evert

    2015-01-01

    Sports participation is a major ally for the promotion of physical activity. However, sports injuries are important adverse effects of sports participation and should be monitored in sports populations. The purpose of this paper is to review the basic concepts of injury monitoring and discuss the implementation of these concepts in practice. The aspects discussed are: (1) sports injury definition; (2) classification of sports injuries; (3) population at risk, prevalence, and incidence; (4) severity measures; (5) economic costs; (6) systems developed to monitor sports injuries; and (7) online technology. Only with reliable monitoring systems applied in a continuous and long-term manner will it be possible to identify the burden of injuries, to identify the possible cases at an early stage, to implement early interventions, and to generate data for sports injury prevention. The implementation of sports injuries monitoring systems in practice is strongly recommended.

  8. Practicable methods for histological section thickness measurement in quantitative stereological analyses.

    Science.gov (United States)

    Matenaers, Cyrill; Popper, Bastian; Rieger, Alexandra; Wanke, Rüdiger; Blutke, Andreas

    2018-01-01

    The accuracy of quantitative stereological analysis tools such as the (physical) disector method substantially depends on the precise determination of the thickness of the analyzed histological sections. One conventional method for measurement of histological section thickness is to re-embed the section of interest vertically to its original section plane. The section thickness is then measured in a subsequently prepared histological section of this orthogonally re-embedded sample. However, the orthogonal re-embedding (ORE) technique is quite work- and time-intensive and may produce inaccurate section thickness measurement values due to unintentional slightly oblique (non-orthogonal) positioning of the re-embedded sample-section. Here, an improved ORE method is presented, allowing for determination of the factual section plane angle of the re-embedded section, and correction of measured section thickness values for oblique (non-orthogonal) sectioning. For this, the analyzed section is mounted flat on a foil of known thickness (calibration foil) and both the section and the calibration foil are then vertically (re-)embedded. The section angle of the re-embedded section is then calculated from the deviation of the measured section thickness of the calibration foil and its factual thickness, using basic geometry. To find a practicable, fast, and accurate alternative to ORE, the suitability of spectral reflectance (SR) measurement for determination of plastic section thicknesses was evaluated. Using a commercially available optical reflectometer (F20, Filmetrics®, USA), the thicknesses of 0.5 μm thick semi-thin Epon (glycid ether)-sections and of 1-3 μm thick plastic sections (glycolmethacrylate/ methylmethacrylate, GMA/MMA), as regularly used in physical disector analyses, could precisely be measured within few seconds. Compared to the measured section thicknesses determined by ORE, SR measures displayed less than 1% deviation. Our results prove the applicability

  9. Head impact exposure measured in a single youth football team during practice drills.

    Science.gov (United States)

    Kelley, Mireille E; Kane, Joeline M; Espeland, Mark A; Miller, Logan E; Powers, Alexander K; Stitzel, Joel D; Urban, Jillian E

    2017-11-01

    OBJECTIVE This study evaluated the frequency, magnitude, and location of head impacts in practice drills within a youth football team to determine how head impact exposure varies among different types of drills. METHODS On-field head impact data were collected from athletes participating in a youth football team for a single season. Each athlete wore a helmet instrumented with a Head Impact Telemetry (HIT) System head acceleration measurement device during all preseason, regular season, and playoff practices. Video was recorded for all practices, and video analysis was performed to verify head impacts and assign each head impact to a specific drill. Eleven drills were identified: dummy/sled tackling, install, special teams, Oklahoma, one-on-one, open-field tackling, passing, position skill work, multiplayer tackle, scrimmage, and tackling drill stations. Generalized linear models were fitted to log-transformed data, and Wald tests were used to assess differences in head accelerations and impact rates. RESULTS A total of 2125 impacts were measured during 30 contact practices in 9 athletes (mean age 11.1 ± 0.6 years, mean mass 44.9 ± 4.1 kg). Open-field tackling had the highest median and 95th percentile linear accelerations (24.7 g and 97.8 g, respectively) and resulted in significantly higher mean head accelerations than several other drills. The multiplayer tackle drill resulted in the highest head impact frequency, with an average of 0.59 impacts per minute per athlete, but the lowest 95th percentile linear accelerations of all drills. The front of the head was the most common impact location for all drills except dummy/sled tackling. CONCLUSIONS Head impact exposure varies significantly in youth football practice drills, with several drills exposing athletes to high-magnitude and/or high-frequency head impacts. These data suggest that further study of practice drills is an important step in developing evidence-based recommendations for modifying or eliminating

  10. Training clinicians in how to use patient-reported outcome measures in routine clinical practice.

    Science.gov (United States)

    Santana, Maria J; Haverman, Lotte; Absolom, Kate; Takeuchi, Elena; Feeny, David; Grootenhuis, Martha; Velikova, Galina

    2015-07-01

    Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs data. However, as the experience in using those measures increased, it became obvious the clinical value in using individual patient PROs profiles in daily practice to identify/monitor symptoms, evaluate treatment outcomes and support shared decision-making. A key issue limiting successful implementation is clinicians' lack of knowledge on how to effectively utilize PROs data in their clinical encounters. Using a change management theoretical framework, this paper describes the development and implementation of three programs for training clinicians to effectively use PRO data in routine practice. The training programs are in three diverse clinical areas (adult oncology, lung transplant and paediatrics), in three countries with different healthcare systems, thus providing a rare opportunity to pull out common approaches whilst recognizing specific settings. For each program, we describe the clinical and organizational setting, the program planning and development, the content of the training session with supporting material, subsequent monitoring of PROs use and evidence of adoption. The common successful components and practical steps are identified, leading to discussion and future recommendations. The results of the three training programs are described as the implementation. In the oncology program, PRO data have been developed and are currently evaluated; in the lung transplant program, PRO data are used in daily practice and the integration with electronic patient records is under development; and in the paediatric program, PRO data are fully implemented with around 7,600 consultations since the start of the implementation. Adult learning programs teaching clinicians

  11. The Danish National Acute Leukemia Registry

    DEFF Research Database (Denmark)

    Østgård, Lene Sofie Granfeldt; Nørgaard, Jan Maxwell; Raaschou-Jensen, Klas Kræsten

    2016-01-01

    AIM OF DATABASE: The main aim of the Danish National Acute Leukemia Registry (DNLR) was to obtain information about the epidemiology of the hematologic cancers acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome (MDS). STUDY POPULATION: The registry...... was established in January 2000 by the Danish Acute Leukemia Group and has been expanded over the years. It includes adult AML patients diagnosed in Denmark since 2000, ALL patients diagnosed since 2005, and MDS patients diagnosed since 2010. The coverage of leukemia patients exceeds 99%, and the coverage of MDS...... years. To ensure this high coverage, completeness, and quality of data, linkage to the Danish Civil Registration System and the Danish National Registry of Patients, and several programmed data entry checks are used. CONCLUSION: The completeness and positive predictive values of the leukemia data have...

  12. United States Transuranium and Uranium Registries

    International Nuclear Information System (INIS)

    Kathren, R.L.; Filipy, R.E.; Dietert, S.E.

    1991-06-01

    This report summarizes the primary scientific activities of the United States Transuranium and Uranium Registries for the period October 1, 1989 through September 30, 1990. The Registries are parallel human tissue research programs devoted to the study of the actinide elements in humans. To date there have been 261 autopsy or surgical specimen donations, which include 11 whole bodies. The emphasis of the Registry was directed towards quality improvement and the development of a fully computerized data base that would incorporate not only the results of postmortem radiochemical analysis, but also medical and monitoring information obtained during life. Human subjects reviews were also completed. A three compartment biokinetic model for plutonium distribution is proposed. 2 tabs

  13. An international registry for primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Werner, Claudius; Lablans, Martin; Ataian, Maximilian

    2016-01-01

    Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disorder leading to chronic upper and lower airway disease. Fundamental data on epidemiology, clinical presentation, course and treatment strategies are lacking in PCD. We have established an international PCD registry to realise...... an unmet need for an international platform to systematically collect data on incidence, clinical presentation, treatment and disease course.The registry was launched in January 2014. We used internet technology to ensure easy online access using a web browser under www.pcdregistry.eu. Data from 201...... methods in addition to classical clinical symptoms. Preliminary analysis of lung function data demonstrated a mean annual decline of percentage predicted forced expiratory volume in 1 s of 0.59% (95% CI 0.98-0.22).Here, we present the development of an international PCD registry as a new promising tool...

  14. Technology transfer from biomedical research to clinical practice: measuring innovation performance.

    Science.gov (United States)

    Balas, E Andrew; Elkin, Peter L

    2013-12-01

    Studies documented 17 years of transfer time from clinical trials to practice of care. Launched in 2002, the National Institutes of Health (NIH) translational research initiative needs to develop metrics for impact assessment. A recent White House report highlighted that research and development productivity is declining as a result of increased research spending while the new drugs output is flat. The goal of this study was to develop an expanded model of research-based innovation and performance thresholds of transfer from research to practice. Models for transfer of research to practice have been collected and reviewed. Subsequently, innovation pathways have been specified based on common characteristics. An integrated, intellectual property transfer model is described. The central but often disregarded role of research innovation disclosure is highlighted. Measures of research transfer and milestones of progress have been identified based on the Association of University Technology Managers 2012 performance reports. Numeric milestones of technology transfer are recommended at threshold (top 50%), target (top 25%), and stretch goal (top 10%) performance levels. Transfer measures and corresponding target levels include research spending to disclosure (0.81), patents to start-up (>0.1), patents to licenses (>2.25), and average per license income (>$48,000). Several limitations of measurement are described. Academic institutions should take strategic steps to bring innovation to the center of scholarly discussions. Research on research, particularly on pathways to disclosures, is needed to improve R&D productivity. Researchers should be informed about the technology transfer performance of their institution and regulations should better support innovators.

  15. Common variables in European pancreatic cancer registries

    DEFF Research Database (Denmark)

    De Leede, E. M.; Sibinga Mulder, B. G.; Bastiaannet, E.

    2016-01-01

    Background Quality assurance of cancer care is of utmost importance to detect and avoid under and over treatment. Most cancer data are collected by different procedures in different countries, and are poorly comparable at an international level. EURECCA, acronym for European Registration of Cancer...... registries, as well as specific pancreatic cancer audits/registries, were invited to participate in EURECCA Pancreas. Participating countries were requested to share an overview of their collected data items. Of the received datasets, a shared items list was made which creates insight in similarities between...

  16. The Danish Neuro-Oncology Registry

    DEFF Research Database (Denmark)

    Hansen, Steinbjørn; Nielsen, Jan; Laursen, René J

    2016-01-01

    BACKGROUND: The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe the establishment of the DNOR and further to evaluate the database completen......BACKGROUND: The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe the establishment of the DNOR and further to evaluate the database...

  17. Calculation of uncertainties associated to environmental radioactivity measurements and their functions. Practical Procedure

    International Nuclear Information System (INIS)

    Gasco Leonarte, C; Anton Mateos, M. P.

    1995-01-01

    This report summarizes the procedure used to calculate the uncertainties associated to environmental radioactivity measurements, focusing on those obtained by radiochemical separation in which tracers have been added. Uncertainties linked to activity concentration calculations, isotopic rat iso, inventories, sequential leaching data, chronology dating by using C.R.S. model and duplicate analysis are described in detail. The objective of this article is to serve as a guide to people not familiarized with this kind of calculations, showing clear practical examples. The input of the formulas and all the data needed to achieve these calculations into the Lotus 1, 2, 3 WTN is outlined as well. (Author) 13 refs

  18. Calculation of uncertainties associated to environmental radioactivity measurements and their functions. Practical Procedure

    International Nuclear Information System (INIS)

    Gasco Leonarte, C.; Anton Mateos, M.P.

    1995-12-01

    This report summarizes the procedure used to calculate the uncertainties associated to environmental radioactivity measurements. focusing on those obtained by radiochemical separation in which tracers have been added. Uncertainties linked to activity concentration calculations, isotopic ratio, inventories, sequential leaching data, chronology dating by using C.R.S model and duplicate analysis are described in detail. The objective of this article is to serve as a guide to people not familiarized with this kind of calculations, showing clear practical examples. The input of the formulas and all the data needed to achieve these calculations into the Lotus 1,2,3, WIN is outlined as well. (Author)

  19. Practical colorimeter for direct measurement of microplates in enzyme immunoassay systems.

    Science.gov (United States)

    Clem, T R; Yolken, R H

    1978-01-01

    A colorimeter capable of measuring results of enzyme-linked immunosorbent assay (ELISA) reactions directly in the wells of a microtiter plate is described. This colorimeter proved to be as accurate as a conventional spectrophotometer in assessing ELISA reactions, but had the advantage of not requiring transfer of the specimen to a separate chamber. With this colorimeter, 96 specimens can be read in approximately 5 min. A practical colorimeter such as this can make the use of ELISA tests more feasible for many laboratories.

  20. Phase shift errors in the theory and practice of surface intensity measurements

    Science.gov (United States)

    Mcgary, M. C.; Crocker, M. J.

    1982-01-01

    The surface acoustical intensity method (sometimes known as the microphone-accelerometer cross-spectral method) is a relatively new noise source/path identification tool. Several researchers have had difficulties implementing this method because of instrumentation phase mis-match. A simple technique for measuring and correcting instrumentation phase mis-match has been developed. This new technique has been tested recently on a noise source identification problem of practical interest. The results of the experiments indicate that the surface acoustic intensity method produces reliable data and can be applied to a variety of noise source/path problems.

  1. Human figure drawings as a measure of children's emotional status: critical review for practice.

    Science.gov (United States)

    Skybo, Theresa; Ryan-Wenger, Nancy; Su, Ying-Hwa

    2007-02-01

    Human figure drawing is a common measurement that is used in practice and research. Drawing is a fun, inexpensive, and easy-to-administer method used to provide school-age children a projective means of expressing attitudes and emotions. As cognition matures, the content of drawing develops. The inclusion of emotional indicators in drawing signifies possible emotional problems. Recently, drawing has been used in countries and cultures other than the United States. Drawing can be implemented in any setting by all health care professionals.

  2. Theory of the Allen method and its practical bearing on pipe discharge measurement

    International Nuclear Information System (INIS)

    Guizerix, J.; Margrita, R.

    1976-01-01

    The Allen method for measurement of pipe discharge is based on a general relationship between discharge, instrument section volume and the first moment of the residence time distribution. An original demonstration of this standard chemical engineering relationship is given. The Allen method thus offers a very wide practical application scope. Requirements are limited to knowing the volume of the instrument section and the residence time distribution; the shape of the instrument section is immaterial. The information can be obtained for example by means of a system correlating the instrument section input and output signals [fr

  3. Quality Registries in Sweden, Healthcare Improvements and Elderly Persons with Cognitive Impairments.

    Science.gov (United States)

    Mattsson, Titti

    2016-12-01

    Policy-makers, the medical industry and researchers are demonstrating a keen interest in the potential of large registries of patient data, both nationally and internationally. The registries offer promising ways to measure and develop operational quality within health and medical care services. As a result of certain favourable patient data regulations and government funding, the development of quality registries is advanced in Sweden. The combination of increasing demand for more cost-efficient healthcare that can accommodate the demographic development of a rapidly ageing population, and the emergence of eHealth with an increasing digitalisation of patient data, calls attention to quality registries as a possible way for healthcare improvements. However, even if the use of registries has many advantages, there are some drawbacks from a patient privacy point of view. This article aims to analyse this growing interdependence of quality registries for the healthcare sector. It discusses some lessons from the Swedish case, with particular focus on the collection of data from elderly persons with cognitive impairments.

  4. Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

    Science.gov (United States)

    Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

    2017-10-27

    Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

  5. A web-based, patient driven registry for Angelman syndrome: the global Angelman syndrome registry.

    Science.gov (United States)

    Napier, Kathryn R; Tones, Megan; Simons, Chloe; Heussler, Helen; Hunter, Adam A; Cross, Meagan; Bellgard, Matthew I

    2017-08-01

    Angelman syndrome (AS) is a rare neurodevelopmental disorder that is characterised by severe global developmental delays, ataxia, loss of speech, epilepsy, sleep disorders, and a happy disposition. There is currently no cure for AS, though several pharmaceutical companies are anticipating drug trials for new therapies to treat AS. The Foundation for Angelman Therapeutics (FAST) Australia therefore identified a need for a global AS patient registry to identify patients for recruitment for clinical trials.The Global AS Registry was deployed in September 2016 utilising the Rare Disease Registry Framework, an open-source tool that enables the efficient creation and management of patient registries. The Global AS Registry is web-based and allows parents and guardians worldwide to register, provide informed consent, and enter data on individuals with AS. 286 patients have registered in the first 8 months since deployment.We demonstrate the successful deployment of the first patient-driven global registry for AS. The data generated from the Global AS Registry will be crucial in identifying patients suitable for clinical trials and in informing research that will identify treatments for AS, and ultimately improve the lives of individuals and their families living with AS.

  6. Field Measurements at River and Tidal Current Sites for Hydrokinetic Energy Development: Best Practices Manual

    Energy Technology Data Exchange (ETDEWEB)

    Neary, Vincent S [ORNL; Gunawan, Budi [Oak Ridge National Laboratory (ORNL)

    2011-09-01

    In this report, existing data collection techniques and protocols for characterizing open channel flows are reviewed and refined to further address the needs of the MHK industry. The report provides an overview of the hydrodynamics of river and tidal channels, and the working principles of modern acoustic instrumentation, including best practices in remote sensing methods that can be applied to hydrokinetic energy site characterization. Emphasis is placed upon acoustic Doppler velocimeter (ADV) and acoustic-Doppler current profiler (ADCP) instruments, as these represent the most practical and economical tools for use in the MHK industry. Incorporating the best practices as found in the literature, including the parameters to be measured, the instruments to be deployed, the instrument deployment strategy, and data post-processing techniques. The data collected from this procedure aims to inform the hydro-mechanical design of MHK systems with respect to energy generation and structural loading, as well as provide reference hydrodynamics for environmental impact studies. The standard metrics and protocols defined herein can be utilized to guide field experiments with MHK systems.

  7. A new practice environment measure based on the reality and experiences of nurses working lives.

    Science.gov (United States)

    Webster, Joan; Flint, Anndrea; Courtney, Mary

    2009-01-01

    To explore the underlying organizational issues affecting a nurses' decision to leave and to develop a contemporary practice environment measure based on the experiences of nurses working lives. Turnover had reached an unacceptable level in our organization but underlying reasons for leaving were unknown. In-depth interviews were conducted with 13 nurses who had resigned. Transcripts were analysed using the constant comparative method. Information from the interviews informed the development a new practice environment tool, which has undergone initial testing using the Content Validity Index and Chronbach's alpha. Two domains ('work life' and 'personal life/professional development') and five themes ('feeling safe', 'feeling valued', 'getting things done', 'professional development' and 'being flexible') emerged from the interviews. A content validity score for the new instrument was 0.79 and Chronbach's alpha 0.93. The new practice environment tool has shown useful initial reliability and validity but requires wider testing in other settings. The reality and experiences of nurses working lives can be identified through exit interviews conducted by an independent person. Information from such interviews is useful in identifying an organization's strength and weaknesses and to develop initiatives to support retention.

  8. Measuring HINARI use in Nigeria through a citation analysis of Nigerian Journal of Clinical Practice.

    Science.gov (United States)

    Anyaoku, Ebele N; Anunobi, Chinwe V

    2014-06-01

    HINARI is one of the four programmes of Research4Life managed by the World Health Organization in partnership with Yale University Library. HINARI provides online access to the world's health-related scientific literature free or at very low cost to researchers in developing countries. The research examined the use of HINARI through a 5-year (2007-2011) citation analysis of Nigerian Journal of Clinical Practice. The study was a citation analysis of 5 years of published volumes of Nigerian Journal of Clinical Practice. The analysis was carried out using issues ranging from volume 10 (2007) to 14 (2011). The use of HINARI was determined by comparing the total journal titles and articles cited from HINARI with non-HINARI journals in the five volumes of Nigerian Journal of Clinical Practice (NJCP). Results show that only 42.8% of the journal titles cited are available in HINARI. On the contrary, in terms of total articles cited from the journals, HINARI had a higher citation of 56.1% with a greater citation frequency of individual titles. The higher article citations and repeated use of individual titles available in HINARI suggest that health researchers in Nigeria are using the HINARI resource to a measurable extent. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

  9. Calculation of uncertainties associated to environmental radioactivity measurements and their functions. Practical Procedure II

    International Nuclear Information System (INIS)

    Gascon, C.; Anton, M.P.

    1997-01-01

    Environmental radioactivity measurements are mainly affected by counting uncertainties. In this report the uncertainties associated to certain functions related to activity concentration calculations are determined. Some practical exercise are presented to calculate the uncertainties associated to: a) Chemical recovery of a radiochemical separation when employing tracers (i.e. Pu and Am purification from a sediment sample). b) Indirect determination of a mother radionuclide through one of its daughters (i. e. ''210 Pb quantification following its daughter ''210 Po building-up activity). c) Time span from last separation date of one of the components of a disintegration chain (i.e. Am last purification date from a nuclear weapons following ''241 Am and ''241 Pu measurements). Calculations concerning example b) and c) are based on Baterman equations, regulating radioactive equilibria. Although the exercises here presented are performed with certain radionuclides, they could be applied as generic procedures for other alpha-emitting radioelements

  10. REAC/TS radiation accident registry. Update of accidents in the United States

    International Nuclear Information System (INIS)

    Ricks, R.C.; Berger, M.E.; Holloway, E.C.; Goans, R.E.

    2000-01-01

    Serious injury due to ionizing radiation is a rare occurrence. From 1944 to the present, 243 US accidents meeting dose criteria for classification as serious are documented in the REAC/TS Registry. Thirty individuals have lost their lives in radiation accidents in the United States. The Registry is part of the overall REAC/TS program providing 24-hour direct or consultative assistance regarding medical and heath physics problems associated with radiation accidents in local, national, and international incidents. The REAC/TS Registry serves as a repository of medically important information documenting the consequences of these accidents. Registry data are gathered from various sources. These include reports from the World Heath Organization (WHO), International Atomic Energy Agency (IAEA), US Nuclear Regulatory Commission (US NRC), state radiological health departments, medical/health physics literature, personal communication, the Internet, and most frequently, from calls for medical assistance to REAC/TS, as part of our 24-hour medical assistance program. The REAC/TS Registry for documentation of radiation accidents serves several useful purposes: 1) weaknesses in design, safety practices, training or control can be identified, and trends noted; 2) information regarding the medical consequences of injuries and the efficacy of treatment protocols is available to the treating physician; and 3) Registry case studies serve as valuable teaching tools. This presentation will review and summarize data on the US radiation accidents including their classification by device, accident circumstances, and frequency by respective states. Data regarding accidents with fatal outcomes will be reviewed. The inclusion of Registry data in the IAEA's International Reporting System of Radiation Events (RADEV) will also be discussed. (author)

  11. The Parental Bonding Instrument: A psychometric measure to assess parenting practices in the homes in Bangladesh.

    Science.gov (United States)

    Karim, A K M Rezaul; Begum, Taslima

    2017-02-01

    There is growing importance of the Parental Bonding Instrument (PBI) in clinical practice and research on parenting and parental bonding. Since the development of this diagnostic tool (Parker et al., Brit. J. Med. Psycho.1979; 52:1-10), a number of validation studies have been done in various cultures. The aim of the present study was to translate the measure into Bangla and validate in Bangladeshi culture. A total of 200 adolescents participated in the study. Exploratory factor analysis (EFA) of the data from 191 participants (who provided complete responses) identified a two-factor (Care and Overprotection) structure of the PBI with 17 items. The two factors together explained 44.18% of the total variance. The factors showed moderate to very high internal consistency (Cronbach's α=0.863 for Care; 0.622 for Overprotection), and very strong convergent and discriminant validity as evident by their correlations with the measures of cognitive distortions and antisocial behaviors. In line with the original tool we defined four types of parenting style, such as Affectionate constraint, Affectionless control, Optimal parenting, and Neglectful parenting. This study opens the door of future research on parenting practices and parent-child relationships in Bangladesh. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. The Danish National Acute Leukemia Registry

    DEFF Research Database (Denmark)

    Østgård, Lene Sofie Granfeldt; Nørgaard, Jan Maxwell; Raaschou-Jensen, Klas Kræsten

    2016-01-01

    years. To ensure this high coverage, completeness, and quality of data, linkage to the Danish Civil Registration System and the Danish National Registry of Patients, and several programmed data entry checks are used. CONCLUSION: The completeness and positive predictive values of the leukemia data have...

  13. Validation of the Netherlands pacemaker patient registry

    NARCIS (Netherlands)

    Dijk, WA; Kingma, T; Hooijschuur, CAM; Dassen, WRM; Hoorntje, JCA; van Gelder, LM

    1997-01-01

    This paper deals with the validation of the information stored in the Netherlands central pacemaker patient database. At this moment the registry database contains information on more than 70500 patients, 85000 pacemakers and 90000 leads. The validation procedures consisted of an internal

  14. Costing Tool for International Cancer Registries

    Centers for Disease Control (CDC) Podcasts

    2016-11-21

    A health economist at CDC talks about a new tool for estimating how much it costs to run cancer registries in developing countries.  Created: 11/21/2016 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/21/2016.

  15. Airborne Hazards and Open Burn Pit Registry

    Science.gov (United States)

    ... this problem if you are in a high security environment where this is disabled by a network policy. The Registry will work in JavaScript-enabled browsers such as: Google Chrome 17+ Mozilla Firefox 12+ Internet Explorer 10+ Safari 5+ Safari iOS 5+ Android 2.3+ If you are using a compatible ...

  16. [History of the cancer registry in Mexico].

    Science.gov (United States)

    Allende-López, Aldo; Fajardo-Gutiérrez, Arturo

    2011-01-01

    A cancer registry is to record the data which let us to know the epidemiology of neoplasm, but led us take a decision in medical policy about this health problem that benefit patients. In this paper we did a brief historical review about models and attempts for having a cancer registry in Mexico. However, since 1940 "the fight against cancer" was declared, we have not had a confident cancer registry today validated and built with data from whole the country. In 1982, the Registro Nacional del Cancer was created. The design and validation of a registration card in four hospitals were the main results. In 1988, the Registro Nacional del Cancer was reinforced with a computerized system for facilitation the data capture. In 1994, it was signed the first interinstitutional agreement that led to Registro Histopatol6gico de Neoplasias Malignas. In 1996, the Instituto Mexicano del Seguro Social established a cancer registry in children in Mexico with the intention to have data from this population.

  17. An active registry for bioinformatics web services.

    NARCIS (Netherlands)

    Pettifer, S.; Thorne, D.; McDermott, P.; Attwood, T.; Baran, J.; Bryne, J.C.; Hupponen, T.; Mowbray, D.; Vriend, G.

    2009-01-01

    SUMMARY: The EMBRACE Registry is a web portal that collects and monitors web services according to test scripts provided by the their administrators. Users are able to search for, rank and annotate services, enabling them to select the most appropriate working service for inclusion in their

  18. 50 CFR 600.1410 - Registry process.

    Science.gov (United States)

    2010-10-01

    ... United States § 600.1410 Registry process. (a) A person may register through the NMFS web site at www... state registration or U.S. Coast Guard documentation number; home port or principal area of operation... website. (b) Individuals must submit their name; address; telephone number; date of birth; region(s) of...

  19. Correlating Orphaned Windows Registry Data Structures

    Directory of Open Access Journals (Sweden)

    Damir Kahved

    2009-06-01

    Full Text Available Recently, it has been shown that deleted entries of the Microsoft Windows registry (keys may still reside in the system files once the entries have been deleted from the active database. Investigating the complete keys in context may be extremely important from both a Forensic Investigation point of view and a legal point of view where a lack of context can bring doubt to an argument. In this paper we formalise the registry behaviour and show how a retrieved value may not maintain a relation to the part of the registry it belonged to and hence lose that context. We define registry orphans and elaborate on how they can be created inadvertently during software uninstallation and other system processes. We analyse the orphans and attempt to reconstruct them automatically. We adopt a data mining approach and introduce a set of attributes that can be applied by the forensic investigator to match values to their parents. The heuristics are encoded in a Decision Tree that can discriminate between keys and select those which most likely owned a particular orphan value.

  20. The Savant Syndrome Registry: A Preliminary Report.

    Science.gov (United States)

    Treffert, Darold A; Rebedew, David L

    2015-08-01

    A registry has been established to document certain characteristics on a sizeable worldwide sample of individuals with savant syndrome, a rare but remarkable condition in which persons with developmental disabilities, brain injury, or brain disease have some spectacular "islands" of skill or ability that stand in jarring, marked contrast to overall handicap. Of the 319 savants included in the registry, 90% are congenital savants, while 10% are acquired savants. The registry includes individuals from 33 countries, with 70% from the United States or Canada. Sex distribution was 79% male vs. 21% female (4:1). This report summarizes the findings in the congenital savant syndrome category of the registry. Among the individuals with congenital savant syndrome, the most common underlying disability was Autistic Spectrum Disorder (75%); various other central nervous system (CNS) disorders were present in the other 25%. Fifty-five percent possessed a single special skill, while 45% had multiple skills. Music was the most frequent principal skill followed by art, memory, mathematics, calendar calculating, language, visual-spatial/mechanical, athletic, computer, extrasensory perception, and other skills.

  1. The Value and Relevance of the T Cell Lymphoma Registries and International Collaborations: the Case of COMPLETE and the T-Cell Project.

    Science.gov (United States)

    Bellei, Monica; Nabhan, Chadi; Pesce, Emanuela Anna; Conte, Luana; Vose, Julie M; Foss, Francine; Federico, Massimo

    2015-12-01

    Peripheral T cell lymphomas (PTCLs) are a heterogeneous group of lymphoid malignancies that portend a poor prognosis and have an undefined optimal therapeutic strategy. Data on best practices stem from prior studies that have generally included B cell lymphomas. However, the enhanced ability to diagnose PTCLs, the development of newer agents specific for PTCLs, and its increased incidence have called the scientific community to develop better strategies to combat these neoplasms. To that end, T cell lymphoma registries were developed in an attempt to answer relevant questions on the prognosis and management of PTCLs. The largest registries currently enrolling patients are the Comprehesive Oncology Measures for PeripheraL T-cEll Lymphoma TrEatment (COMPLETE) and the T-Cell Project. Despite the inherent limitations of these studies, valuable information are being collected to refine our management approaches and to aid in designing future clinical trials. This review illustrates the value of these registries and describes the critical questions that need to be answered.

  2. Development of clinical process measures for pediatric burn care: Understanding variation in practice patterns.

    Science.gov (United States)

    Kazis, Lewis E; Sheridan, Robert L; Shapiro, Gabriel D; Lee, Austin F; Liang, Matthew H; Ryan, Colleen M; Schneider, Jeffrey C; Lydon, Martha; Soley-Bori, Marina; Sonis, Lily A; Dore, Emily C; Palmieri, Tina; Herndon, David; Meyer, Walter; Warner, Petra; Kagan, Richard; Stoddard, Frederick J; Murphy, Michael; Tompkins, Ronald G

    2018-04-01

    There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients. We conducted a systematic literature review to compile a set of process-based indicators. These measures were refined by an expert panel of burn care providers, yielding 36 process-based indicators in four clinical areas: initial evaluation and resuscitation, acute excisional surgery and critical care, psychosocial and pain control, and reconstruction and aftercare. We assessed variability in adherence to the indicators in a cohort of 1,076 children with burns at four regional pediatric burn programs in the Shriners Hospital system. The percentages of the cohort at each of the four sites were as follows: Boston, 20.8%; Cincinnati, 21.1%; Galveston, 36.0%; and Sacramento, 22.1%. The cohort included children who received care between 2006 and 2010. Adherence to the process indicators varied both across sites and by clinical area. Adherence was lowest for the clinical areas of acute excisional surgery and critical care, with a range of 35% to 48% across sites, followed by initial evaluation and resuscitation (range, 34%-60%). In contrast, the clinical areas of psychosocial and pain control and reconstruction and aftercare had relatively high adherence across sites, with ranges of 62% to 93% and 71% to 87%, respectively. Of the 36 process indicators, 89% differed significantly in adherence between clinical sites (p measures represents an important step in the assessment of clinical practice in pediatric burn care. Substantial variation was observed

  3. Electronic warehouse receipts registry as a step from paper to electronic warehouse receipts

    Directory of Open Access Journals (Sweden)

    Kovačević Vlado

    2016-01-01

    Full Text Available The aim of this paper is to determine the economic viability of the electronic warehouse receipt registry introduction, as a step toward electronic warehouse receipts. Both forms of warehouse receipt paper and electronic exist in practice, but paper warehouse receipts are more widespread. In this paper, the dematerialization process is analyzed in two steps. The first step is the dematerialization of warehouse receipt registry, with warehouse receipts still in paper form. The second step is the introduction of electronic warehouse receipts themselves. Dematerialization of warehouse receipts is more complex than that for financial securities, because of the individual characteristics of each warehouse receipt. As a consequence, electronic warehouse receipts are in place for only to a handful of commodities, namely cotton and a few grains. Nevertheless, the movement towards the electronic warehouse receipt, which began several decades ago with financial securities, is now taking hold in the agricultural sector. In this paper is analyzed Serbian electronic registry, since the Serbia is first country in EU with electronic warehouse receipts registry donated by FAO. Performed analysis shows the considerable impact of electronic warehouse receipts registry establishment on enhancing the security of the system of public warehouses, and on advancing the trade with warehouse receipt.

  4. Clinical Case Registries: Simultaneous Local and National Disease Registries for Population Quality Management

    Science.gov (United States)

    Backus, Lisa I.; Gavrilov, Sergey; Loomis, Timothy P.; Halloran, James P.; Phillips, Barbara R.; Belperio, Pamela S.; Mole, Larry A.

    2009-01-01

    The Department of Veterans Affairs (VA) has a system-wide, patient-centric electronic medical record system (EMR) within which the authors developed the Clinical Case Registries (CCR) to support population-centric delivery and evaluation of VA medical care. To date, the authors have applied the CCR to populations with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Local components use diagnosis codes and laboratory test results to identify patients who may have HIV or HCV and support queries on local care delivery with customizable reports. For each patient in a local registry, key EMR data are transferred via HL7 messaging to a single national registry. From 128 local registry systems, over 60,000 and 320,000 veterans in VA care have been identified as having HIV and HCV, respectively, and entered in the national database. Local and national reports covering demographics, resource usage, quality of care metrics and medication safety issues have been generated. PMID:19717794

  5. The Italian Registry of Antiphospholipid Antibodies.

    Science.gov (United States)

    Finazzi, G

    1997-01-01

    The clinical importance of antiphospholipid antibodies (APA) derives from their association with a syndrome of venous and arterial thrombosis, recurrent fetal loss and thrombocytopenia known as the antiphospholipid syndrome (APS). The Italian Registry of Antiphospholipid Antibodies was set up in 1989 for the purpose of collecting a large number of patients with lupus anticoagulant (LA) or anticardiolipin antibodies (ACA) for clinical studies in order to obtain more information on the clinical features of APS. The Italian Registry has completed two clinical studies and proposed an international trial on the treatment of APS patients. These activities of the Registry are reviewed herein. Additional information has been obtained from pertinent articles and abstracts published in journals covered by the Science Citation Index and Medline. The first study of the Registry was a retrospective analysis of enrolled patients which showed that: a) the prevalence of thrombosis and thrombocytopenia was similar in cases with idiopathic APA or APA secondary to systemic lupus erythematosus, and b) the rate of thrombosis was significantly reduced in patients with severe thrombocytopenia but not in those with only a mild reduction of the platelet count. The second study was a prospective survey of the natural history of the disease, showing that a) previous thrombosis and ACA titer > 40 units were independent predictors of subsequent vascular complications; b) a history of miscarriage or thrombosis is significantly associated with adverse pregnancy outcome; c) hematological malignancies can develop during follow-up and patients with APA should be considered at increased risk of developing NHL. Thus the possibility of a hematologic neoplastic disease should be borne in mind in the initial evaluation and during the follow-up of these patients. The latest initiative of the Registry was the proposal of an international, randomized clinical trial (WAPS study) aimed at assessing the

  6. Imbalance: Objective measures versus subjective self-report in clinical practice.

    Science.gov (United States)

    Chiarovano, Elodie; Wang, Wei; Reynolds, Pam; MacDougall, Hamish G

    2018-01-01

    Dizziness and imbalance are very common complaints in clinical practice. One of the challenges is to evaluate the 'real' risk of falls. Two tools are available: the patient's self-report and the measure of the patient's balance. We evaluated the relationship between these methods using the Dizziness Handicap Inventory (DHI) and measures of balance while visual inputs are perturbed with Virtual Reality (VR). 90 consecutive patients underwent the DHI questionnaire and the balance test. The DHI questionnaire was used to measure the subject's perception of handicap associated with dizziness. The balance test measured the postural sway in several visual conditions: eyes open, eyes closed, and with an unpredictable visual perturbation using VR at several amplitudes of movement. No correlation was found between the DHI score and the balance measurement. The visual perturbations allow us to characterize patients into three groups: one group with a high DHI score who did not fall on the balance test (5.5%), one group with a low DHI score who failed eyes closed on a compliant surface (9.0%), and one group of the remaining patients (85.5%). The correlation between the DHI score and the balance performance became significant on the remaining group of patients. Both subjective self-report and objective measure are important to characterize a patient. The use of VR visual perturbations allowed us to define three important groups of patients. VR visual perturbations provided additional information that helps explain the lack of correlation between DHI and objective test results. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Measuring energy metabolism in the mouse – theoretical, practical and analytical considerations

    Directory of Open Access Journals (Sweden)

    John Roger Speakman

    2013-03-01

    Full Text Available The mouse is one of the most important model organisms for understanding human genetic function and disease. This includes characterisation of the factors that influence energy expenditure and dysregulation of energy balance leading to obesity and its sequalae. Measuring energy metabolism in the mouse presents a challenge because the animals are small, and in this respect it presents similar challenges to measuring energy demands in many other species of small mammal. This paper considers some theoretical, practical and analytical considerations to be considered when measuring energy expenditure in mice. Theoretically total daily energy expenditure is comprised of several different components: basal or resting expenditure, physical activity, thermoregulation and the thermic effect of food. Energy expenditure in mice is normally measured using open flow indirect calorimetry apparatus. Two types of system are available – one of which involves a single small Spartan chamber linked to a single analyser, which is ideal for measuring the individual components of energy demand. The other type of system involves a large chamber which mimics the home cage environment and is generally configured with several chambers per analyser. These latter systems are ideal for measuring total daily energy expenditure but at present do not allow accurate decomposition of the total expenditure into its components. The greatest analytical challenge for mouse expenditure data is how to account for body size differences between individuals. This has been a matter of some discussion for at least 120 years. The statistically most appropriate approach is to use ANCOVA with individual aspects of body composition as independent predictors.

  8. Implementing and using quality measures for children's health care: perspectives on the state of the practice.

    Science.gov (United States)

    Shaller, Dale

    2004-01-01

    care quality measurement and improvement based on rigorous cost-bigorous cost-benefit analysis and documentation of quantifiable successes; 2) develop new measures to fill the gaps in critical areas (including adolescent health care, behavioral health, and chronic conditions) that can be applied at the hospital and ambulatory care provider levels; 3) invest in building needed research capacity, a trained pool of users of quality measures, and the capacity among providers to understand and use quality-improvement methods and tools; 4) invest in developing an information infrastructure that will support the efficient collection and use of measures for multiple purposes, including clinical practice, quality measurement, and quality improvement; and 5) develop increased public awareness and support for quality measurement based on improved strategies for communicating with consumers, purchasers, providers, and policy makers. Several implications are suggested by these perspectives for the future direction of quality measurement in children's health care. First, to meet the funding needs identified, many funders must improve coordination to reduce the noise and fragmentation generated by numerous competing or redundant activities. Improved coordination among funders will help assure maximum impact and the efficient use of scarce resources. Second, the importance attached to standardization of measures by both users and developers may conflict at times with the need for innovation and flexibility. Child health quality leaders will need to manage this tension between standardization and innovation to maintain an appropriate balance between the benefits of both. Finally, many of the obstacles identified are not unique to children's health care. Child health quality leaders will need to determine to what extent their efforts to overcome these obstacles can be successfully undertaken independently as opposed to in concert with groups concerned about other populations and sectors

  9. Iranian Joint Registry(Iranian National Hip and Knee Arthroplasty Registry

    Directory of Open Access Journals (Sweden)

    Hamidreza Aslani

    2016-04-01

    Full Text Available Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR with a joint collaboration of the Social Security Organization (SSO and academic research departments considering the requirements of the Iran’s Ministry of Health and Education.

  10. Health-related quality of life measurement in pediatric clinical practice: An appraisal and precept for future research and application

    Directory of Open Access Journals (Sweden)

    Lane Mariella M

    2005-05-01

    Full Text Available Abstract Health-related quality of life (HRQOL measurement has emerged as an important health outcome in clinical trials, clinical practice improvement strategies, and healthcare services research and evaluation. HRQOL measures are also increasingly proposed for use in clinical practice settings to inform treatment decisions. In settings where HRQOL measures have been utilized with adults, physicians report such measures as useful, some physicians alter their treatment based on patient reports on such instruments, and patients themselves generally feel the instruments to be helpful. However, there is a dearth of studies evaluating the clinical utility of HRQOL measurement in pediatric clinical practice. This paper provides an updated review of the literature and proposes a precept governing the application of pediatric HRQOL measurement in pediatric clinical practice. Utilizing HRQOL measurement in pediatric healthcare settings can facilitate patient-physician communication, improve patient/parent satisfaction, identify hidden morbidities, and assist in clinical decision-making. Demonstrating the utility of pediatric HRQOL measurement in identifying children with the greatest needs, while simultaneously demonstrating the cost advantages of providing timely, targeted interventions to address those needs, may ultimately provide the driving force for incorporating HRQOL measurement in pediatric clinical practice.

  11. Prosthetists' perceptions and use of outcome measures in clinical practice: Long-term effects of focused continuing education.

    Science.gov (United States)

    Hafner, Brian J; Spaulding, Susan E; Salem, Rana; Morgan, Sara J; Gaunaurd, Ignacio; Gailey, Robert

    2017-06-01

    Continuing education is intended to facilitate clinicians' skills and knowledge in areas of practice, such as administration and interpretation of outcome measures. To evaluate the long-term effect of continuing education on prosthetists' confidence in administering outcome measures and their perceptions of outcomes measurement in clinical practice. Pretest-posttest survey methods. A total of 66 prosthetists were surveyed before, immediately after, and 2 years after outcomes measurement education and training. Prosthetists were grouped as routine or non-routine outcome measures users, based on experience reported prior to training. On average, prosthetists were just as confident administering measures 1-2 years after continuing education as they were immediately after continuing education. In all, 20% of prosthetists, initially classified as non-routine users, were subsequently classified as routine users at follow-up. Routine and non-routine users' opinions differed on whether outcome measures contributed to efficient patient evaluations (79.3% and 32.4%, respectively). Both routine and non-routine users reported challenges integrating outcome measures into normal clinical routines (20.7% and 45.9%, respectively). Continuing education had a long-term impact on prosthetists' confidence in administering outcome measures and may influence their clinical practices. However, remaining barriers to using standardized measures need to be addressed to keep practitioners current with evolving practice expectations. Clinical relevance Continuing education (CE) had a significant long-term impact on prosthetists' confidence in administering outcome measures and influenced their clinical practices. In all, approximately 20% of prosthetists, who previously were non-routine outcome measure users, became routine users after CE. There remains a need to develop strategies to integrate outcome measurement into routine clinical practice.

  12. Towards data integration automation for the French rare disease registry.

    Science.gov (United States)

    Maaroufi, Meriem; Choquet, Rémy; Landais, Paul; Jaulent, Marie-Christine

    2015-01-01

    Building a medical registry upon an existing infrastructure and rooted practices is not an easy task. It is the case for the BNDMR project, the French rare disease registry, that aims to collect administrative and medical data of rare disease patients seen in different hospitals. To avoid duplicating data entry for health professionals, the project plans to deploy connectors with the existing systems to automatically retrieve data. Given the data heterogeneity and the large number of source systems, the automation of connectors creation is required. In this context, we propose a methodology that optimizes the use of existing alignment approaches in the data integration processes. The generated mappings are formalized in exploitable mapping expressions. Following this methodology, a process has been experimented on specific data types of a source system: Boolean and predefined lists. As a result, effectiveness of the used alignment approach has been enhanced and more good mappings have been detected. Nonetheless, further improvements could be done to deal with the semantic issue and process other data types.

  13. A practical and theoretical definition of very small field size for radiotherapy output factor measurements.

    Science.gov (United States)

    Charles, P H; Cranmer-Sargison, G; Thwaites, D I; Crowe, S B; Kairn, T; Knight, R T; Kenny, J; Langton, C M; Trapp, J V

    2014-04-01

    This work introduces the concept of very small field size. Output factor (OPF) measurements at these field sizes require extremely careful experimental methodology including the measurement of dosimetric field size at the same time as each OPF measurement. Two quantifiable scientific definitions of the threshold of very small field size are presented. A practical definition was established by quantifying the effect that a 1 mm error in field size or detector position had on OPFs and setting acceptable uncertainties on OPF at 1%. Alternatively, for a theoretical definition of very small field size, the OPFs were separated into additional factors to investigate the specific effects of lateral electronic disequilibrium, photon scatter in the phantom, and source occlusion. The dominant effect was established and formed the basis of a theoretical definition of very small fields. Each factor was obtained using Monte Carlo simulations of a Varian iX linear accelerator for various square field sizes of side length from 4 to 100 mm, using a nominal photon energy of 6 MV. According to the practical definition established in this project, field sizes ≤ 15 mm were considered to be very small for 6 MV beams for maximal field size uncertainties of 1 mm. If the acceptable uncertainty in the OPF was increased from 1.0% to 2.0%, or field size uncertainties are 0.5 mm, field sizes ≤ 12 mm were considered to be very small. Lateral electronic disequilibrium in the phantom was the dominant cause of change in OPF at very small field sizes. Thus the theoretical definition of very small field size coincided to the field size at which lateral electronic disequilibrium clearly caused a greater change in OPF than any other effects. This was found to occur at field sizes ≤ 12 mm. Source occlusion also caused a large change in OPF for field sizes ≤ 8 mm. Based on the results of this study, field sizes ≤ 12 mm were considered to be theoretically very small for 6 MV beams. Extremely

  14. The measurement of the effect on citation inequality of differences in citation practices across scientific fields.

    Science.gov (United States)

    Crespo, Juan A; Li, Yunrong; Li, Yungrong; Ruiz-Castillo, Javier

    2013-01-01

    This paper has two aims: (i) to introduce a novel method for measuring which part of overall citation inequality can be attributed to differences in citation practices across scientific fields, and (ii) to implement an empirical strategy for making meaningful comparisons between the number of citations received by articles in 22 broad fields. The number of citations received by any article is seen as a function of the article's scientific influence, and the field to which it belongs. A key assumption is that articles in the same quantile of any field citation distribution have the same degree of citation impact in their respective field. Using a dataset of 4.4 million articles published in 1998-2003 with a five-year citation window, we estimate that differences in citation practices between the 22 fields account for 14% of overall citation inequality. Our empirical strategy is based on the strong similarities found in the behavior of citation distributions. We obtain three main results. Firstly, we estimate a set of average-based indicators, called exchange rates, to express the citations received by any article in a large interval in terms of the citations received in a reference situation. Secondly, using our exchange rates as normalization factors of the raw citation data reduces the effect of differences in citation practices to, approximately, 2% of overall citation inequality in the normalized citation distributions. Thirdly, we provide an empirical explanation of why the usual normalization procedure based on the fields' mean citation rates is found to be equally successful.

  15. A framework and a measurement instrument for sustainability of work practices in long-term care

    Directory of Open Access Journals (Sweden)

    Slaghuis Sarah S

    2011-11-01

    Full Text Available Abstract Background In health care, many organizations are working on quality improvement and/or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices after implementation. The objective of this study is to develop a theoretical framework and measurement instrument for sustainability. To this end sustainability is conceptualized with two dimensions: routinization and institutionalization. Methods The exploratory methodological design consisted of three phases: a framework development; b instrument development; and c field testing in former improvement teams in a quality improvement program for health care (N teams = 63, N individual = 112. Data were collected not until at least one year had passed after implementation. Underlying constructs and their interrelations were explored using Structural Equation Modeling and Principal Component Analyses. Internal consistency was computed with Cronbach's alpha coefficient. A long and a short version of the instrument are proposed. Results The χ2- difference test of the -2 Log Likelihood estimates demonstrated that the hierarchical two factor model with routinization and institutionalization as separate constructs showed a better fit than the one factor model (p Conclusions The theoretical framework offers a valuable starting point for the analysis of sustainability on the level of actual changed work practices. Even though the two dimensions routinization and institutionalization are related, they are clearly distinguishable and each has distinct value in the discussion of sustainability. Finally, the subscales conformed to psychometric properties defined in literature. The instrument can be used in the evaluation of improvement projects.

  16. Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice.

    Science.gov (United States)

    Cortez, Susan; Dietrich, Mary S; Wells, Nancy

    2016-07-01

    To measure the effect of clinical decision support (CDS) on oncology nurse evidence-based practice (EBP).
. Longitudinal cluster-randomized design.
. Four distinctly separate oncology clinics associated with an academic medical center.
. The study sample was comprised of randomly selected data elements from the nursing documentation software. The data elements were patient-reported symptoms and the associated nurse interventions. The total sample observations were 600, derived from a baseline, posteducation, and postintervention sample of 200 each (100 in the intervention group and 100 in the control group for each sample).
. The cluster design was used to support randomization of the study intervention at the clinic level rather than the individual participant level to reduce possible diffusion of the study intervention. An elongated data collection cycle (11 weeks) controlled for temporary increases in nurse EBP related to the education or CDS intervention.
. The dependent variable was the nurse evidence-based documentation rate, calculated from the nurse-documented interventions. The independent variable was the CDS added to the nursing documentation software.
. The average EBP rate at baseline for the control and intervention groups was 27%. After education, the average EBP rate increased to 37%, and then decreased to 26% in the postintervention sample. Mixed-model linear statistical analysis revealed no significant interaction of group by sample. The CDS intervention did not result in an increase in nurse EBP.
. EBP education increased nurse EBP documentation rates significantly but only temporarily. Nurses may have used evidence in practice but may not have documented their interventions.
. More research is needed to understand the complex relationship between CDS, nursing practice, and nursing EBP intervention documentation. CDS may have a different effect on nurse EBP, physician EBP, and other medical professional EBP.

  17. 14 CFR 47.19 - FAA Aircraft Registry.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false FAA Aircraft Registry. 47.19 Section 47.19... REGISTRATION General § 47.19 FAA Aircraft Registry. Each application, request, notification, or other communication sent to the FAA under this Part must be mailed to the FAA Aircraft Registry, Department of...

  18. 14 CFR 49.11 - FAA Aircraft Registry.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false FAA Aircraft Registry. 49.11 Section 49.11... AIRCRAFT TITLES AND SECURITY DOCUMENTS General § 49.11 FAA Aircraft Registry. To be eligible for recording, a conveyance must be mailed to the FAA Aircraft Registry, Department of Transportation, Post Office...

  19. Added Value of Patient-Reported Outcome Measures in Stroke Clinical Practice.

    Science.gov (United States)

    Katzan, Irene L; Thompson, Nicolas R; Lapin, Brittany; Uchino, Ken

    2017-07-21

    There is uncertainty regarding the clinical utility of the data obtained from patient-reported outcome measures (PROMs) for patient care. We evaluated the incremental information obtained by PROMs compared to the clinician-reported modified Rankin Scale (mRS). This was an observational study of 3283 ischemic stroke patients seen in a cerebrovascular clinic from September 14, 2012 to June 16, 2015 who completed the routinely collected PROMs: Stroke Impact Scale-16 (SIS-16), EQ-5D, Patient Health Questionnaire-9, PROMIS Physical Function, and PROMIS fatigue. The amount of variation in the PROMs explained by mRS was determined using r 2 after adjustment for age and level of stroke impairment. The proportion with meaningful change was calculated for patients with ≥2 visits. Concordance with change in the other scales and the ability to discriminate changes in health state as measured by c-statistic was evaluated for mRS versus SIS-16. Correlation between PROMs and mRS was highest for SIS-16 ( r =-0.64, P measures. PROMs provide additional valuable information compared to the mRS alone in stroke patients seen in the ambulatory setting. SIS-16 may have a better ability to identify change than mRS in health status of relevance to the patient. PROMs may be a useful addition to mRS in the assessment of health status in clinical practice. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  20. Measurement of anatomy contouring in EPI review: a practical method for use in radiation therapy departments

    International Nuclear Information System (INIS)

    Halkett, Georgia; Williams, Marie

    2004-01-01

    Radiation therapy treatment verification can be performed using hard copy portal films or digital Electronic Portal Images (EPI) of the treatment field, acquired at the time of treatment. This paper describes a practical method of assessing the accuracy of reference anatomy outlining, for treatment sites involving the pelvis, breast and lumbar spine. Seven original bone anatomy outlines contoured onto verification images of five patients, were printed on transparency sheets and reference points were marked at equal distances along the anatomy curves. Two sample anatomy contour sets were created by two independent radiation therapists who outlined visible bone anatomy on the same seven digitally reconstructed radiographs (DRR) and hard copy outlines were obtained. Three independent observers with differing levels of experience, assessed the discrepancies between the original anatomy contours and the sample sets on two occasions one week apart, by measuring the distances between the original and sample set contours (absolute values in mm). The degree of agreement between the same assessor on two occasions (intra-rater reliability) and between assessors (inter-rater reliability) was analysed using parametric analysis for levels of relationship and significant differences. This simple method of reference anatomy outline measurement was shown to be highly reliable within assessors and between assessors (r > 0.87 and rz > 0.75 for both intra- and inter-rater comparisons). This measurement process may be a suitable method, for undertaking quality assurance activities in image verification within radiation therapy departments. Copyright (2004) Australian Institute of Radiography

  1. Developing the Safety of Atrial Fibrillation Ablation Registry Initiative (SAFARI) as a collaborative pan-stakeholder critical path registry model: a Cardiac Safety Research Consortium "Incubator" Think Tank.

    Science.gov (United States)

    Al-Khatib, Sana M; Calkins, Hugh; Eloff, Benjamin C; Kowey, Peter; Hammill, Stephen C; Ellenbogen, Kenneth A; Marinac-Dabic, Danica; Waldo, Albert L; Brindis, Ralph G; Wilbur, David J; Jackman, Warren M; Yaross, Marcia S; Russo, Andrea M; Prystowsky, Eric; Varosy, Paul D; Gross, Thomas; Pinnow, Ellen; Turakhia, Mintu P; Krucoff, Mitchell W

    2010-10-01

    Although several randomized clinical trials have demonstrated the safety and efficacy of catheter ablation of atrial fibrillation (AF) in experienced centers, the outcomes of this procedure in routine clinical practice and in patients with persistent and long-standing persistent AF remain uncertain. Brisk adoption of this therapy by physicians with diverse training and experience highlights potential concerns regarding the safety and effectiveness of this procedure. Some of these concerns could be addressed by a national registry of AF ablation procedures such as the Safety of Atrial Fibrillation Ablation Registry Initiative that was initially proposed at a Cardiac Safety Research Consortium Think Tank meeting in April 2009. In January 2010, the Cardiac Safety Research Consortium, in collaboration with the Duke Clinical Research Institute, the US Food and Drug Administration, the American College of Cardiology, and the Heart Rhythm Society, held a follow-up meeting of experts in the field to review the construct and progress to date. Other participants included the National Heart, Lung, and Blood Institute; the Centers for Medicare and Medicaid Services; the Agency for Healthcare Research and Quality; the AdvaMed AF working group; and additional industry representatives. This article summarizes the discussions that occurred at the meeting of the state of the Safety of Atrial Fibrillation Ablation Registry Initiative, the identification of a clear pathway for its implementation, and the exploration of solutions to potential issues in the execution of this registry. Copyright © 2010 Mosby, Inc. All rights reserved.

  2. Standard practice for measuring the ultrasonic velocity in polyethylene tank walls using lateral longitudinal (LCR) waves

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2011-01-01

    1.1 This practice covers a procedure for measuring the ultrasonic velocities in the outer wall of polyethylene storage tanks. An angle beam lateral longitudinal (LCR) wave is excited with wedges along a circumferential chord of the tank wall. A digital ultrasonic flaw detector is used with sending-receiving search units in through transmission mode. The observed velocity is temperature corrected and compared to the expected velocity for a new, unexposed sample of material which is the same as the material being evaluated. The difference between the observed and temperature corrected velocities determines the degree of UV exposure of the tank. 1.2 The practice is intended for application to the outer surfaces of the wall of polyethylene tanks. Degradation typically occurs in an outer layer approximately 3.2-mm (0.125-in.) thick. Since the technique does not interrogate the inside wall of the tank, wall thickness is not a consideration other than to be aware of possible guided (Lamb) wave effects or reflection...

  3. Measuring practical knowledge about balanced meals: development and validation of the brief PKB-7 scale.

    Science.gov (United States)

    Mötteli, S; Barbey, J; Keller, C; Bucher, T; Siegrist, M

    2016-04-01

    As a high-quality diet is associated with a lower risk for several diseases and all-cause mortality, current nutrition education tools provide people with information regarding how to build a healthy and a balanced meal. To assess this basic nutrition knowledge, the research aim was to develop and validate a brief scale to measure the Practical Knowledge about Balanced meals (PKB-7). A pool of 25 items was pretested with experts and laypeople before being tested on a random sample in Switzerland (n=517). For item selection, a Rasch model analysis was applied. The validity and reliability of the new scale were assessed by three additional studies including laypeople (n=597; n=145) and nutrition experts (n=59). The final scale consists of seven multiple-choice items, which met the assumptions of the Rasch model. The validity of the new scale was shown by several aspects: the Rasch model was replicated in a second study, and nutrition experts achieved significantly higher scores than laypeople (t(148)=20.27, Pbalanced meals based on current dietary guidelines. This brief and easy-to-use scale is intended for application in both research and practice.

  4. A Unified Framework for Measuring Stewardship Practices Applied to Digital Environmental Datasets

    Directory of Open Access Journals (Sweden)

    Ge Peng

    2015-01-01

    Full Text Available This paper presents a stewardship maturity assessment model in the form of a matrix for digital environmental datasets. Nine key components are identified based on requirements imposed on digital environmental data and information that are cared for and disseminated by U.S. Federal agencies by U.S. law, i.e., Information Quality Act of 2001, agencies’ guidance, expert bodies’ recommendations, and users. These components include: preservability, accessibility, usability, production sustainability, data quality assurance, data quality control/monitoring, data quality assessment, transparency/traceability, and data integrity. A five-level progressive maturity scale is then defined for each component associated with measurable practices applied to individual datasets, representing Ad Hoc, Minimal, Intermediate, Advanced, and Optimal stages. The rationale for each key component and its maturity levels is described. This maturity model, leveraging community best practices and standards, provides a unified framework for assessing scientific data stewardship. It can be used to create a stewardship maturity scoreboard of dataset(s and a roadmap for scientific data stewardship improvement or to provide data quality and usability information to users, stakeholders, and decision makers.

  5. When the business of nursing was the nursing business: the private duty registry system, 1900-1940.

    Science.gov (United States)

    Whelan, Jean C

    2012-05-31

    In the initial decades of the 20th century, most nurses worked in the private sector as private duty nurses dependent on their own resources for securing and obtaining employment with individual patients. To organize and systematize the ways in which nurses sought jobs, a structure of private duty registries, agencies which connected nurses with patients, was established via professional nurse associations. This article describes the origins of the private duty nurse labor market as the main employment field for early nurses and ways in which the private duty registry system connected nurses and patients. The impact of professional nurses associations and two registries, (New York and Chicago) illustrates how the business of nursing was carried out, including registry formation, operation, and administration. Private duty nurses are compelling examples of a previous generation of nurse entrepreneurs. The discussion identifies problems and challenges of private nursing practice via registries, including the decline and legacy of this innovative nurse role. The story of early 20th century nurse owned and operated registries provides an early and critical historical illustration of the realization of nurse power, entrepreneurship, and control over professional practice that we still learn from today.

  6. Using Project Performance to Measure Effectiveness of Quality Management System Maintenance and Practices in Construction Industry

    Science.gov (United States)

    Leong, Tiong Kung; Ariff, Mohd. Shoki Md.

    2014-01-01

    This paper proposed seven existing and new performance indicators to measure the effectiveness of quality management system (QMS) maintenance and practices in construction industry. This research is carried out with a questionnaire based on QMS variables which are extracted from literature review and project performance indicators which are established from project management's theory. Data collected was analyzed using correlation and regression analysis. The findings indicate that client satisfaction and time variance have positive and significant relationship with QMS while other project performance indicators do not show significant results. Further studies can use the same project performance indicators to study the effectiveness of QMS in different sampling area to improve the generalizability of the findings. PMID:24701182

  7. Using Project Performance to Measure Effectiveness of Quality Management System Maintenance and Practices in Construction Industry

    Directory of Open Access Journals (Sweden)

    Tiong Kung Leong

    2014-01-01

    Full Text Available This paper proposed seven existing and new performance indicators to measure the effectiveness of quality management system (QMS maintenance and practices in construction industry. This research is carried out with a questionnaire based on QMS variables which are extracted from literature review and project performance indicators which are established from project management's theory. Data collected was analyzed using correlation and regression analysis. The findings indicate that client satisfaction and time variance have positive and significant relationship with QMS while other project performance indicators do not show significant results. Further studies can use the same project performance indicators to study the effectiveness of QMS in different sampling area to improve the generalizability of the findings.

  8. Using project performance to measure effectiveness of quality management system maintenance and practices in construction industry.

    Science.gov (United States)

    Leong, Tiong Kung; Zakuan, Norhayati; Mat Saman, Muhamad Zameri; Ariff, Mohd Shoki Md; Tan, Choy Soon

    2014-01-01

    This paper proposed seven existing and new performance indicators to measure the effectiveness of quality management system (QMS) maintenance and practices in construction industry. This research is carried out with a questionnaire based on QMS variables which are extracted from literature review and project performance indicators which are established from project management's theory. Data collected was analyzed using correlation and regression analysis. The findings indicate that client satisfaction and time variance have positive and significant relationship with QMS while other project performance indicators do not show significant results. Further studies can use the same project performance indicators to study the effectiveness of QMS in different sampling area to improve the generalizability of the findings.

  9. Registro Absorb Italiano (BVS-RAI): an investigators-owned and -directed, open, prospective registry of consecutive patients treated with the Absorb™ BVS: study design

    Energy Technology Data Exchange (ETDEWEB)

    Cortese, Bernardo, E-mail: bcortese@gmail.com [Azienda Ospedaliera Fatebenefratelli e Oftalmico, Milano (Italy); Ielasi, Alfonso [Azienda Ospedaliera Bolognini, Seriate (Italy); Varricchio, Attilio [Ospedale Monaldi, Napoli (Italy); Tarantini, Giuseppe [Azienda Ospedaliera Universitaria, Padova (Italy); LaVecchia, Luigi [Azienda Ospedaliera San Bortolo, Vicenza (Italy); Pisano, Francesco [Ospedale Regionale, Aosta (Italy); Facchin, Michela [Ospedale di Este (Italy); Gistri, Roberto [Ospedale S. Andrea, La Spezia (Italy); D’Urbano, Maurizio [Ospedale di Magenta (Italy); Lucci, Valerio [Ospedale di Avezzano (Italy); Loi, Bruno [Azienda Ospedaliera Brotzu, Cagliari (Italy); Tumminello, Gabriele [Ospedale Cardinal Massaia, Asti (Italy); Colombo, Alessandro [Ospedale Sacco, Milano (Italy); Limbruno, Ugo [Ospedale della Misericordia, Grosseto (Italy); Nicolino, Annamaria [Ospedale Santa Corona, Pietra Ligure (Italy); Calzolari, Diego [Azienda Ospedaliera Ca Foncello, Treviso (Italy); Tognoni, Gianni [Centro di Ricerche Farmacologiche e Biomediche ' Mario Negri' , Milano (Italy); Defilippi, Gianfranco [Ospedale Cardinal Massaia, Asti (Italy); Buccheri, Dario [Azienda Ospedaliera Fatebenefratelli e Oftalmico, Milano (Italy); Tespili, Maurizio [Azienda Ospedaliera Bolognini, Seriate (Italy); and others

    2015-09-15

    Background: The Absorb™ BVS is a bioresorbable, everolimus-eluting scaffold approved and marketed for coronary use. Published data on long-term results after treatment are limited to a small number of patients, most of them with elective PCI of simple lesions. The importance of scaffold resorption is variably appreciated among cardiologists, and indications for use from health technology assessment bodies or guidelines are missing. Instruments are needed to collect, share and assess the experience being accumulated with this new device in several centres. Methods/Design: The BVS-RAI Registry is a spontaneous initiative of a group of Italian interventional cardiologists in cooperation with Centro di Ricerche Farmacologiche e Biomediche 'Mario Negri' Institute, and is not recipient of funding or benefits originating from the BVS manufacturer. It is a prospective registry with 5-year follow-up of all consecutive patients who have undergone successful implantation of 1 or more coronary BVS following the indications, techniques and protocols used in each of the participating institutions. Outcome measures are BVS target lesion failure within one year and device-oriented major adverse cardiac events within 5 years. The registry started in October 2012 and will extend enrolment throughout 2015, with the aim to include about 1000 patients. ClinicalTrials.gov identifier is CT02298413. Conclusions: The BVS-RAI Registry will contribute observational knowledge on the long-term safety and efficacy of the Absorb™ BVS as used in a number of Italian interventional centres in a broad spectrum of settings. Unrewarded and undirected consecutive patient enrolments are key-features of this observation, which is therefore likely to reflect common clinical practice in those centres. - Highlights: • prospective data collection of successful Absorb implantation; • expert Italian centers; • no restrictions for enrollment/no exclusion criteria; • clinical follow up;

  10. Rasch Validation of a Measure of Reform-Oriented Science Teaching Practices

    Science.gov (United States)

    You, Hye Sun

    2016-06-01

    Growing evidence from recent curriculum documents and previous research suggests that reform-oriented science teaching practices promote students' conceptual understanding, levels of achievement, and motivation to learn, especially when students are actively engaged in constructing their ideas through scientific inquiries. However, it is difficult to identify to what extent science teachers engage students in reform-oriented teaching practices (RTPs) in their science classrooms. In order to exactly diagnose the current status of science teachers' implementation of the RTPs, a valid and reliable instrument tool is needed. The principles of validity and reliability are fundamental cornerstones in developing a robust measurement tool. As such, this study was motivated by the desire to point out the limitations of the existing statistical and psychometric analyses and to further examine the validation of the RTP survey instrument. This paper thus aims at calibrating the items of the RTPs for science teachers using the Rasch model. The survey instrument scale was adapted from the 2012 National Survey of Science and Mathematics Education (NSSME) data. A total of 3701 science teachers from 1403 schools from across the USA participated in the NSSME survey. After calibrating the RTP items and persons on the same scale, the RTP instrument well represented the population of US science teachers. Model-data fit determined by Infit and Outfit statistics was within an appropriate range (0.5-1.5), supporting the unidimensional structure of the RTPs. The ordered category thresholds and the probability of the thresholds showed that the five-point rating scale functioned well. The results of this study support the use of the RTP measure from the 2012 NSSME in assessing usage of RTPs.

  11. An Approach for Measuring Reductions in Operations, Maintenance, and Energy Costs: Baseline Measures of Construction Industry Practices for the National Construction Goals.

    Science.gov (United States)

    Chapman, Robert E.; Rennison, Roderick

    The Construction and Building Subcommittee of the National Science and Technology Council (NSTC) has established seven National Construction Goals for the construction industry and is developing baseline measures for current practices and progress with respect to each goal. This document provides a detailed set of baseline measures for the NSTC…

  12. Towards a national trauma registry for the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Barka Ezedin

    2010-07-01

    Full Text Available Abstract Background Trauma is a major health problem in the United Arab Emirates (UAE as well as worldwide. Trauma registries provide large longitudinal databases for analysis and policy improvement. We aim in this paper to report on the development and evolution of a national trauma registry using a staged approach by developing a single-center registry, a two-center registry, and then a multi-center registry. The three registries were established by developing suitable data collection forms, databases, and interfaces to these databases. The first two registries collected data for a finite period of time and the third is underway. The steps taken to establish these registries depend on whether the registry is intended as a single-center or multi-center registry. Findings Several issues arose and were resolved during the development of these registries such as the relational design of the database, whether to use a standalone database management system or a web-based system, and the usability and security of the system. The inclusion of preventive medicine data elements is important in a trauma registry and the focus on road traffic collision data elements is essential in a country such as the UAE. The first two registries provided valuable data which has been analyzed and published. Conclusions The main factors leading to the successful establishment of a multi-center trauma registry are the development of a concise data entry form, development of a user-friendly secure web-based database system, the availability of a computer and Internet connection in each data collection center, funded data entry personnel well trained in extracting medical data from the medical record and entering it into the computer, and experienced personnel in trauma injuries and data analysis to continuously maintain and analyze the registry.

  13. Validation of jump squats as a practical measure of post-activation potentiation.

    Science.gov (United States)

    Nibali, Maria L; Chapman, Dale W; Robergs, Robert A; Drinkwater, Eric J

    2013-03-01

    To determine if post-activation potentiation (PAP) can augment sports performance, it is pertinent that researchers be confident that any enhancement in performance is attributable to the PAP phenomenon. However, obtaining mechanistic measures of PAP in the daily training environment of highly trained athletes is impractical. We sought to validate jump squats as a practical measure with ecological validity to sports performance against a mechanistic measure of PAP. We assessed the evoked muscle twitch properties of the knee extensors and jump squat kinetics of 8 physically trained males in response to a 5-repetition-maximum back squat conditioning stimulus (CS). Evoked muscle twitch, followed by 3 jump squats, was assessed before and at 4, 8, and 12 min post CS. Time intervals were assessed on separate occasions using a Latin square design. Linear regression was used to determine the relationship between post-pre changes in kinetic variables and muscle twitch peak force (Ft) and twitch rate of force development (RFDt). Large correlations were observed for both concentric relative and absolute mean power and Ft (r = 0.50 ± 0.30) and RFDt (r = 0.56 ± 0.27 and r = 0.58 ± 0.26). Concentric rate of force development (RFD) showed moderate correlations with Ft (r = 0.45 ± 0.33) and RFDt (r = 0.49 ± 0.32). Small-to-moderate correlations were observed for a number of kinetic variables (r = -0.42-0.43 ± 0.32-0.38). Jump squat concentric mean power and RFD are valid ecological measures of muscle potentiation, capable of detecting changes in athletic performance in response to the PAP phenomenon.

  14. Cohort Profile : The National Academy of Sciences-National Research Council Twin Registry (NAS-NRC Twin Registry)

    NARCIS (Netherlands)

    Gatz, Margaret; Harris, Jennifer R.; Kaprio, Jaakko; McGue, Matt; Smith, Nicholas L.; Snieder, Harold; Spiro, Avron; Butler, David A.

    The National Academy of Sciences-National Research Council Twin Registry (NAS-NRC Twin Registry) is a comprehensive registry of White male twin pairs born in the USA between 1917 and 1927, both of the twins having served in the military. The purpose was medical research and ultimately improved

  15. Chronic Care Team Profile: a brief tool to measure the structure and function of chronic care teams in general practice.

    Science.gov (United States)

    Proudfoot, Judith G; Bubner, Tanya; Amoroso, Cheryl; Swan, Edward; Holton, Christine; Winstanley, Julie; Beilby, Justin; Harris, Mark F

    2009-08-01

    At a time when workforce shortages in general practices are leading to greater role substitution and skill-mix diversification, and the demand on general practices for chronic disease care is increasing, the structure and function of the general practice team is taking on heightened importance. To assist general practices and the organizations supporting them to assess the effectiveness of their chronic care teamworking, we developed an interview tool, the Chronic Care Team Profile (CCTP), to measure the structure and function of teams in general practice. This paper describes its properties and potential use. An initial pool of items was derived from guidelines of best-practice for chronic disease care and performance standards for general practices. The items covered staffing, skill-mix, job descriptions and roles, training, protocols and procedures within the practice. The 41-item pool was factor analysed, retained items were measured for internal consistency and the reduced instrument's face, content and construct validity were evaluated. A three-factor solution corresponding to non-general practitioner staff roles in chronic care, administrative functions and management structures provided the best fit to the data and explained 45% of the variance in the CCTP. Further analyses suggested that the CCTP is reliable, valid and has some utility. The CCTP measures aspects of the structure and function of general practices which are independent of team processes. It is associated with the job satisfaction of general practice staff and the quality of care provided to patients with chronic illnesses. As such, the CCTP offers a simple and useful tool for general practices to assess their teamworking in chronic disease care.

  16. The national dose registry of Canada

    International Nuclear Information System (INIS)

    1982-04-01

    In 1951, when the National Dosimetry Service was established by the Department of National Health and Welfare, a system of centralized records was created as an integral part of the new service. Over the last few years the dose record system has expanded in size and content, and improvements have been made in the physical methods of record storage. In addition to the 250 000 individual dose records from the National Dosimetry Service, the National Dose Registry now includes internal tritium and external doses from nuclear generating stations, and radon daughter exposures submitted by uranium mining companies. With the increase in the use of radiation in the medical, industrial and research fields, it is becoming more important to have a comprehensive and readily accessible centralized record system. The Canadian National Dose Registry is particularly suited for continuing health risk studies of radiation workers and provides a base for future epidemiological studies

  17. Practical quantum private query with better performance in resisting joint-measurement attack

    Science.gov (United States)

    Wei, Chun-Yan; Wang, Tian-Yin; Gao, Fei

    2016-04-01

    As a kind of practical protocol, quantum-key-distribution (QKD)-based quantum private queries (QPQs) have drawn lots of attention. However, joint-measurement (JM) attack poses a noticeable threat to the database security in such protocols. That is, by JM attack a malicious user can illegally elicit many more items from the database than the average amount an honest one can obtain. Taking Jacobi et al.'s protocol as an example, by JM attack a malicious user can obtain as many as 500 bits, instead of the expected 2.44 bits, from a 104-bit database in one query. It is a noticeable security flaw in theory, and would also arise in application with the development of quantum memories. To solve this problem, we propose a QPQ protocol based on a two-way QKD scheme, which behaves much better in resisting JM attack. Concretely, the user Alice cannot get more database items by conducting JM attack on the qubits because she has to send them back to Bob (the database holder) before knowing which of them should be jointly measured. Furthermore, JM attack by both Alice and Bob would be detected with certain probability, which is quite different from previous protocols. Moreover, our protocol retains the good characters of QKD-based QPQs, e.g., it is loss tolerant and robust against quantum memory attack.

  18. Measuring impact of JAMA Dermatology Practice Gaps section on training in US dermatology residency programs.

    Science.gov (United States)

    Britton, Kristina M; Stratman, Erik J

    2013-07-01

    JAMA Dermatology Practice Gaps commentaries are intended to aid in the interpretation of the literature to make it more practical and applicable to daily patient care. Practice Gaps commentaries have had an impact on physician clinical practice and dermatology residency curricula. To assess the impact of JAMA Dermatology Practice Gaps commentaries on dermatology residency training programs in the United States, including journal club discussions and local quality improvement activities. A web-based questionnaire of 17 questions was sent via e-mail to US dermatology residency program directors (PDs) in February 2012. Program director report of incorporating Practice Gaps themes and discussions into resident journal club activities, clinical practice, quality improvement activities, or research projects in the residency programs, as a result of a Practice Gaps commentary. Of the 114 surveys distributed to US dermatology residency PDs, 48 were completed (42% response rate). Sixty percent of PDs reported familiarity with the Practice Gaps section of JAMA Dermatology, and 56% discuss these commentaries during resident journal club activities. Quality improvement and research projects have been initiated as a result of Practice Gaps commentaries. Practice Gaps commentaries are discussed during most dermatology residency journal club activities. Practice Gaps have had an impact on physician practice and dermatology residency curricula and can serve as a tool for enhanced continuing medical education and quality improvement initiatives.

  19. Vision for a Global Registry of Anticipated Public Health Studies

    Science.gov (United States)

    Choi, Bernard C.K.; Frank, John; Mindell, Jennifer S.; Orlova, Anna; Lin, Vivian; Vaillancourt, Alain D.M.G.; Puska, Pekka; Pang, Tikki; Skinner, Harvey A.; Marsh, Marsha; Mokdad, Ali H.; Yu, Shun-Zhang; Lindner, M. Cristina; Sherman, Gregory; Barreto, Sandhi M.; Green, Lawrence W.; Svenson, Lawrence W.; Sainsbury, Peter; Yan, Yongping; Zhang, Zuo-Feng; Zevallos, Juan C.; Ho, Suzanne C.; de Salazar, Ligia M.

    2007-01-01

    In public health, the generation, management, and transfer of knowledge all need major improvement. Problems in generating knowledge include an imbalance in research funding, publication bias, unnecessary studies, adherence to fashion, and undue interest in novel and immediate issues. Impaired generation of knowledge, combined with a dated and inadequate process for managing knowledge and an inefficient system for transferring knowledge, mean a distorted body of evidence available for decisionmaking in public health. This article hopes to stimulate discussion by proposing a Global Registry of Anticipated Public Health Studies. This prospective, comprehensive system for tracking research in public health could help enhance collaboration and improve efficiency. Practical problems must be discussed before such a vision can be further developed. PMID:17413073

  20. Registry of Mineral and Petroleum Titles

    Energy Technology Data Exchange (ETDEWEB)

    Maclellan, I. M.; Kaizer, J. L.; McCulloch, P. D.; Ratcliffe, R.; Wenning, A. S. [Nova Scotia Dept. of Natural Resources, Halifax, NS (Canada)

    2000-07-01

    Activities of the Nova Scotia Registry of Mineral and Petroleum Titles are described, including statistical information about staking and mining activity in the province during 1999. In terms of activities, the Registry receives applications and issues licenses and leases for mineral and petroleum rights, receives statements of exploration expenditures and assessment reports that pertain to renewal of licenses and leases, maintains maps showing the disposition of lands under license or lease, and maintains a system of prospector registration. In addition, the Registry processes applications for underground gas storage rights and treasure trove rights and maintains a database of information concerning production and employment in Nova Scotia mines and quarries. At the end 1999 there were 230,660 hectares under exploration licence. Exploration expenditures, including engineering, economic and feasibility studies during 1999 totalled $4.2 million, mostly by junior mining companies searching for industrial mineral commodities. Mining activity during 1999 generated revenues of $340 million. Coal production dropped by 25 per cent, due mainly to the closure of the Phalen Mine. Gypsum production was up to 7.9 million tonnes; shipments of cement, barite and clay products also increased during 1999; salt production remained unchanged from 1998 with 842,000 tonnes. Production of construction aggregates totalled 10.6 million tonnes, down slightly from the year before. Mineral industry employment was roughly 2,500 persons, down by 24 per cent from 1998 levels, due primarily to the closure of the Phalen Mine.

  1. Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures.

    Science.gov (United States)

    Deighton, Jessica; Croudace, Tim; Fonagy, Peter; Brown, Jeb; Patalay, Praveetha; Wolpert, Miranda

    2014-01-01

    There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures' psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against

  2. Prediction of work metabolism from heart rate measurements in forest work: some practical methodological issues.

    Science.gov (United States)

    Dubé, Philippe-Antoine; Imbeau, Daniel; Dubeau, Denise; Auger, Isabelle; Leone, Mario

    2015-01-01

    Individual heart rate (HR) to workload relationships were determined using 93 submaximal step-tests administered to 26 healthy participants attending physical activities in a university training centre (laboratory study) and 41 experienced forest workers (field study). Predicted maximum aerobic capacity (MAC) was compared to measured MAC from a maximal treadmill test (laboratory study) to test the effect of two age-predicted maximum HR Equations (220-age and 207-0.7 × age) and two clothing insulation levels (0.4 and 0.91 clo) during the step-test. Work metabolism (WM) estimated from forest work HR was compared against concurrent work V̇O2 measurements while taking into account the HR thermal component. Results show that MAC and WM can be accurately predicted from work HR measurements and simple regression models developed in this study (1% group mean prediction bias and up to 25% expected prediction bias for a single individual). Clothing insulation had no impact on predicted MAC nor age-predicted maximum HR equations. Practitioner summary: This study sheds light on four practical methodological issues faced by practitioners regarding the use of HR methodology to assess WM in actual work environments. More specifically, the effect of wearing work clothes and the use of two different maximum HR prediction equations on the ability of a submaximal step-test to assess MAC are examined, as well as the accuracy of using an individual's step-test HR to workload relationship to predict WM from HR data collected during actual work in the presence of thermal stress.

  3. The impact of patient-reported outcome measures in clinical practice for pain: a systematic review.

    Science.gov (United States)

    Holmes, Michelle M; Lewith, George; Newell, David; Field, Jonathan; Bishop, Felicity L

    2017-02-01

    Patient-reported outcome measures (PROMs) have increasingly been incorporated into clinical practice. Research suggests that PROMs could be viewed as active components of complex interventions and may affect the process and outcome of care. This systematic review examines PROMs in the context of treatment for non-malignant pain. An electronic search on: MEDLINE, EMBASE, PsycINFO, PsycARTICLES, Cochrane Library and Web of Science identified relevant papers (February 2015). The inclusion criteria were: focused on implementing PROMs into clinical practice, adults, and primary data studies. Critical interpretive synthesis was used to synthesise qualitative and quantitative findings into a theoretical argument. Thirteen eligible studies were identified. Synthesis suggested that PROMs may be included in the initial consultation to assess patients and for shared decision-making regarding patient care. During the course of treatment, PROMs can be used to track progress, evaluate treatment, and change the course of care; using PROMs may also influence the therapeutic relationship. Post-treatment, using PROMs might directly influence other outcomes such as pain and patient satisfaction. However, although studies have investigated these areas, evidence is weak and inconclusive. Due to the poor quality, lack of generalisability and heterogeneity of these studies, it is not possible to provide a comprehensive understanding of how PROMs may impact clinical treatment of non-malignant pain. The literature suggests that PROMs enable pain assessment, decision-making, the therapeutic relationship, evaluation of treatment and may influence outcomes. Further research is needed to provide better evidence as to whether PROMs do indeed have any effects on these domains.

  4. Registry Assessment of Peripheral Interventional Devices (RAPID): Registry assessment of peripheral interventional devices core data elements.

    Science.gov (United States)

    Jones, W Schuyler; Krucoff, Mitchell W; Morales, Pablo; Wilgus, Rebecca W; Heath, Anne H; Williams, Mary F; Tcheng, James E; Marinac-Dabic, J Danica; Malone, Misti L; Reed, Terrie L; Fukaya, Rie; Lookstein, Robert A; Handa, Nobuhiro; Aronow, Herbert D; Bertges, Daniel J; Jaff, Michael R; Tsai, Thomas T; Smale, Joshua A; Zaugg, Margo J; Thatcher, Robert J; Cronenwett, Jack L

    2018-02-01

    The current state of evaluating patients with peripheral artery disease and more specifically of evaluating medical devices used for peripheral vascular intervention (PVI) remains challenging because of the heterogeneity of the disease process, the multiple physician specialties that perform PVI, the multitude of devices available to treat peripheral artery disease, and the lack of consensus about the best treatment approaches. Because PVI core data elements are not standardized across clinical care, clinical trials, and registries, aggregation of data across different data sources and physician specialties is currently not feasible. Under the auspices of the U.S. Food and Drug Administration's Medical Device Epidemiology Network initiative-and its PASSION (Predictable and Sustainable Implementation of the National Registries) program, in conjunction with other efforts to align clinical data standards-the Registry Assessment of Peripheral Interventional Devices (RAPID) workgroup was convened. RAPID is a collaborative, multidisciplinary effort to develop a consensus lexicon and to promote interoperability across clinical care, clinical trials, and national and international registries of PVI. The current manuscript presents the initial work from RAPID to standardize clinical data elements and definitions, to establish a framework within electronic health records and health information technology procedural reporting systems, and to implement an informatics-based approach to promote the conduct of pragmatic clinical trials and registry efforts in PVI. Ultimately, we hope this work will facilitate and improve device evaluation and surveillance for patients, clinicians, health outcomes researchers, industry, policymakers, and regulators. Copyright © 2017 Society for Vascular Surgery. All rights reserved.

  5. Quality of record linkage in a highly automated cancer registry that relies on encrypted identity data

    Directory of Open Access Journals (Sweden)

    Schmidtmann, Irene

    2016-06-01

    Full Text Available Objectives: In the absence of unique ID numbers, cancer and other registries in Germany and elsewhere rely on identity data to link records pertaining to the same patient. These data are often encrypted to ensure privacy. Some record linkage errors unavoidably occur. These errors were quantified for the cancer registry of North Rhine Westphalia which uses encrypted identity data. Methods: A sample of records was drawn from the registry, record linkage information was included. In parallel, plain text data for these records were retrieved to generate a gold standard. Record linkage error frequencies in the cancer registry were determined by comparison of the results of the routine linkage with the gold standard. Error rates were projected to larger registries.Results: In the sample studied, the homonym error rate was 0.015%; the synonym error rate was 0.2%. The F-measure was 0.9921. Projection to larger databases indicated that for a realistic development the homonym error rate will be around 1%, the synonym error rate around 2%.Conclusion: Observed error rates are low. This shows that effective methods to standardize and improve the quality of the input data have been implemented. This is crucial to keep error rates low when the registry’s database grows. The planned inclusion of unique health insurance numbers is likely to further improve record linkage quality. Cancer registration entirely based on electronic notification of records can process large amounts of data with high quality of record linkage.

  6. Statistical Process Control: A Quality Tool for a Venous Thromboembolic Disease Registry.

    Science.gov (United States)

    Posadas-Martinez, Maria Lourdes; Rojas, Liliana Paloma; Vazquez, Fernando Javier; De Quiros, Fernan Bernaldo; Waisman, Gabriel Dario; Giunta, Diego Hernan

    2016-01-01

    We aim to describe Statistical Control Process as a quality tool for the Institutional Registry of Venous Thromboembolic Disease (IRTD), a registry developed in a community-care tertiary hospital in Buenos Aires, Argentina. The IRTD is a prospective cohort. The process of data acquisition began with the creation of a computerized alert generated whenever physicians requested imaging or laboratory study to diagnose venous thromboembolism, which defined eligible patients. The process then followed a structured methodology for patient's inclusion, evaluation, and posterior data entry. To control this process, process performance indicators were designed to be measured monthly. These included the number of eligible patients, the number of included patients, median time to patient's evaluation, and percentage of patients lost to evaluation. Control charts were graphed for each indicator. The registry was evaluated in 93 months, where 25,757 patients were reported and 6,798 patients met inclusion criteria. The median time to evaluation was 20 hours (SD, 12) and 7.7% of the total was lost to evaluation. Each indicator presented trends over time, caused by structural changes and improvement cycles, and therefore the central limit suffered inflexions. Statistical process control through process performance indicators allowed us to control the performance of the registry over time to detect systematic problems. We postulate that this approach could be reproduced for other clinical registries.

  7. The preschool child in Suka Village, North Sumatera. I. Feeding practices and measured food intake.

    Science.gov (United States)

    Kusin, J A; Parlindungan Sinaga, H S; Purba, K; Rengvist, U; Houtkooper, J M

    1981-01-01

    The primary objective of a prospective study conducted over the July 1976-August 1977 period, as part of the joint project of the University of North Sumatra, Medan and the University of Amsterdam, was to determine the duration of prevention against hypovitaminosis A by 1 oral dose of 300,000 IU vitamin A. At 3-month intervals children were examined critically, fresh stool specimens were analyzed on the presence of parasite ova and protozoa, blood specimens were collected for analysis of protein and vitamin A status. Anthropometric measurements were scheduled at monthly (weight, height) and 6 monthly intervals (upper arm circumference and skinfolds). A dietary history was taken at the start of the study. Food consumption was measured separately. In this discussion only the dietary aspects of the study were reported. Families with children age 0-5 years in Suka Vilage, North Sumatra, were included in the prospective study. Childfeeding practices were recorded by interview (dietary history and 24 hour recall method for types of food eaten) and by observation during home visits. For the 1st period 59 children, age 1-4 years, were chosen at random from the total number of children in the respective age group. In the 2nd period in 39 of the same children and in 13 of their older siblings food weighing was repeated. As in most rural areas in Indonesia infants were put to the breast after birth and breastfeeding was continued for about 2 years. After the 1st year the percentage of chidlren breastfed dropped gradually. Exclusive breastfeeding was practiced by most mothers during the 1st 5 months. Few mothers supplemented her own milk with fresh cow's milk or milk formula. The 1st supplementary food given to the infant was almost exclusively rice in different consistencies. After 1 year of age fish was introduced. At age 2 children were given part of the family diet composed of rice, fish, and some vegetables mainly of the nonleafy type. In 2 seasons food consumption of the

  8. Can an Arthroplasty Registry Help Decrease Transfusions in Primary Total Joint Replacement? A Quality Initiative.

    Science.gov (United States)

    Markel, David C; Allen, Mark W; Zappa, Nicole M

    2016-01-01

    Standardized care plans are effective at controlling cost and quality. Registries provide insights into quality and outcomes for use of implants, but most registries do not combine implant and care quality data. In 2012, several Michigan area hospitals and a major insurance provider formed a voluntary statewide total joint database/registry, the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI), to collect procedural, hospital, discharge, and readmission data. Noting substantial variation in transfusion practices after total joint arthroplasty (TJA) in our institutions, we used these prospectively collected data to examine whether awareness and education of the American Association of Blood Banks' (AABB) transfusion guidelines would result in decreased transfusions. (1) Can an established arthroplasty registry help implement a quality initiative (QI) designed to decrease the proportion of transfused postoperative patients undergoing TJA? (2) Do data-driven transfusion protocols decrease length of stay without increasing ischemic complications (myocardial infarctions and cerebrovascular accidents)? (3) Are decreased transfusion proportions associated with decreased readmissions, nonischemic morbidity (including deep vein thrombosis and deep prosthetic infection), and mortality in postoperative patients who had undergone TJA? After reviewing data from the recently established MARCQI registry, the orthopaedic department noticed many discrepancies and practice variances regarding blood transfusions among their providers. In October 2013, a QI was implemented to raise awareness of the discrepancies and education about the AABB guidelines was presented at the monthly orthopaedic service line meeting. A total of 1872 TJA cases were reviewed; 50 were excluded for incomplete data and two for intraoperative transfusions for the period before education (May 2012 to June 2013, n = 1240) and after education (November 2013 to April 2014, n = 580). Data

  9. Developing a research and practice tool to measure walkability: a demonstration project.

    Science.gov (United States)

    Giles-Corti, Billie; Macaulay, Gus; Middleton, Nick; Boruff, Bryan; Bull, Fiona; Butterworth, Iain; Badland, Hannah; Mavoa, Suzanne; Roberts, Rebecca; Christian, Hayley

    2014-12-01

    Growing evidence shows that higher-density, mixed-use, pedestrian-friendly neighbourhoods encourage active transport, including transport-related walking. Despite widespread recognition of the benefits of creating more walkable neighbourhoods, there remains a gap between the rhetoric of the need for walkability and the creation of walkable neighbourhoods. Moreover, there is little objective data to benchmark the walkability of neighbourhoods within and between Australian cities in order to monitor planning and design intervention progress and to assess built environment and urban policy interventions required to achieve increased walkability. This paper describes a demonstration project that aimed to develop, trial and validate a 'Walkability Index Tool' that could be used by policy makers and practitioners to assess the walkability of local areas; or by researchers to access geospatial data assessing walkability. The overall aim of the project was to develop an automated geospatial tool capable of creating walkability indices for neighbourhoods at user-specified scales. The tool is based on open-source software architecture, within the Australian Urban Research Infrastructure Network (AURIN) framework, and incorporates key sub-component spatial measures of walkability (street connectivity, density and land use mix). Using state-based data, we demonstrated it was possible to create an automated walkability index. However, due to the lack of availability of consistent of national data measuring land use mix, at this stage it has not been possible to create a national walkability measure. The next stage of the project is to increase useability of the tool within the AURIN portal and to explore options for alternative spatial data sources that will enable the development of a valid national walkability index. AURIN's open-source Walkability Index Tool is a first step in demonstrating the potential benefit of a tool that could measure walkability across Australia. It

  10. Semi-automatic handling of meteorological ground measurements using WeatherProg: prospects and practical implications

    Science.gov (United States)

    Langella, Giuliano; Basile, Angelo; Bonfante, Antonello; De Mascellis, Roberto; Manna, Piero; Terribile, Fabio

    2016-04-01

    WeatherProg is a computer program for the semi-automatic handling of data measured at ground stations within a climatic network. The program performs a set of tasks ranging from gathering raw point-based sensors measurements to the production of digital climatic maps. Originally the program was developed as the baseline asynchronous engine for the weather records management within the SOILCONSWEB Project (LIFE08 ENV/IT/000408), in which daily and hourly data where used to run water balance in the soil-plant-atmosphere continuum or pest simulation models. WeatherProg can be configured to automatically perform the following main operations: 1) data retrieval; 2) data decoding and ingestion into a database (e.g. SQL based); 3) data checking to recognize missing and anomalous values (using a set of differently combined checks including logical, climatological, spatial, temporal and persistence checks); 4) infilling of data flagged as missing or anomalous (deterministic or statistical methods); 5) spatial interpolation based on alternative/comparative methods such as inverse distance weighting, iterative regression kriging, and a weighted least squares regression (based on physiography), using an approach similar to PRISM. 6) data ingestion into a geodatabase (e.g. PostgreSQL+PostGIS or rasdaman). There is an increasing demand for digital climatic maps both for research and development (there is a gap between the major of scientific modelling approaches that requires digital climate maps and the gauged measurements) and for practical applications (e.g. the need to improve the management of weather records which in turn raises the support provided to farmers). The demand is particularly burdensome considering the requirement to handle climatic data at the daily (e.g. in the soil hydrological modelling) or even at the hourly time step (e.g. risk modelling in phytopathology). The key advantage of WeatherProg is the ability to perform all the required operations and

  11. International Consortium of Vascular Registries Consensus Recommendations for Peripheral Revascularisation Registry Data Collection

    DEFF Research Database (Denmark)

    Behrendt, Christian-Alexander; Bertges, Daniel; Eldrup, Nikolaj

    2018-01-01

    intervention; (ix) complications; and (x) follow up. CONCLUSION: A modified Delphi study allowed 25 international vascular registry experts to achieve a consensus recommendation for a minimum core data set and an optimum data set for peripheral arterial revascularisation registries. Continued global...... via internet exchange and face to face discussions. In total, 187 different items from the various registry data forms were identified for potential inclusion in the recommended data set. Ultimately, 79 items were recommended for inclusion in minimum core data sets, including 65 items in the level 1...... data set, and an additional 14 items in the more specific level 2 and 3 recommended data sets. Data elements were broadly divided into (i) patient characteristics; (ii) comorbidities; (iii) current medications; (iv) lesion treated; (v) procedure; (vi) bypass; (vii) endarterectomy (viii) catheter based...

  12. [Knowledge and adherence to bio-safety measures and biological accidents by nursing students during their clinical practice].

    Science.gov (United States)

    Merino-de la Hoz, Felicitas; Durá-Ros, María Jesús; Rodríguez-Martín, Elías; González-Gómez, Silvia; Mariano López-López, Luis; Abajas-Bustillo, Rebeca; de la Horra-Gutiérrez, Inmaculada

    2010-01-01

    To identify the degree of knowledge and performance of bio-safety measures by nursing students and knowing the type of biological accidents suffered during their clinical practice. A cross-sectional study was conducted on the students of three Nursing courses held in May of 2008. Data was collected by an anonymous self-administered questionnaire, with a return of 54%. A total of 97% of students seemed to know the standard biosafety measures, and all of them (100%) stated that those measures must be applied to every patient. However, the reality of clinical practice shows that biosafety measures are only partially applied. An average of 60.2% implement the personal hygiene measures, 66.1% use physical barriers, and 44% use sharp materials safely. Around 32.25% of the students have suffered some biological accident, with a greater incidence in the second year: administering injections (24%), drawing blood samples with Venojet needles (18%) and recapping used needles (17%). The high level of knowledge shown by the students on standard precautions is not always shown in clinical practice. There are significant deficiencies in student safety practices: recapping of used needles continues to be one of the most common risk practices carried out. Copyright (c) 2009 Elsevier España, S.L. All rights reserved.

  13. Practical performance of real-time shot-noise measurement in continuous-variable quantum key distribution

    Science.gov (United States)

    Wang, Tao; Huang, Peng; Zhou, Yingming; Liu, Weiqi; Zeng, Guihua

    2018-01-01

    In a practical continuous-variable quantum key distribution (CVQKD) system, real-time shot-noise measurement (RTSNM) is an essential procedure for preventing the eavesdropper exploiting the practical security loopholes. However, the performance of this procedure itself is not analyzed under the real-world condition. Therefore, we indicate the RTSNM practical performance and investigate its effects on the CVQKD system. In particular, due to the finite-size effect, the shot-noise measurement at the receiver's side may decrease the precision of parameter estimation and consequently result in a tight security bound. To mitigate that, we optimize the block size for RTSNM under the ensemble size limitation to maximize the secure key rate. Moreover, the effect of finite dynamics of amplitude modulator in this scheme is studied and its mitigation method is also proposed. Our work indicates the practical performance of RTSNM and provides the real secret key rate under it.

  14. Racionalidade e métodos: registro da prática clínica em pacientes de alto risco cardiovascular Racionalidad y métodos: registro de la práctica clínica en pacientes de alto riesgo cardiovascular Rationality and methods: registry of clinical practice in high-risk cardiovascular patients

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Piva e Mattos

    2011-07-01

    ón a la atención de pacientes de alto riesgo cardiovascular en una representativa y amplia muestra de centros investigadores, incluyendo hospitales públicos y privados en un ámbito nacional. Siendo así, este estudio permitirá identificar los vacíos existentes en la incorporación de intervenciones con el beneficio comprobado en nuestro medio. OBJETIVO: Elaborar un registro que evalúe la práctica clínica brasileña en lo que se refiere a la atención del paciente cardiovascular clasificado como de alto riesgo. MÉTODOS: Estudio observacional del tipo registro, prospectivo, con el objetivo de documentar la práctica clínica actual aplicada a un nivel ambulatorial para pacientes de alto riesgo cardiovascular, clasificados cuando se les diagnostica una de estas variables: evidencia de enfermedad arterial coronaria, enfermedad cerebrovascular, vascular periférica, en diabéticos o no diabéticos; o en presencia de por lo menos tres de los siguientes factores de riesgo cardiovascular: hipertensión arterial sistémica, tabaquismo activo, dislipidemia, edad superior a los 70 años, nefropatía crónica, historia familiar de enfermedad arterial coronaria y/o enfermedad carotídea asintomática. Los pacientes serán seleccionados en 43 centros de todas las regiones brasileñas, incluyendo hospitales públicos y privados, como también en unidades básicas de atención a la salud y seguidos clínicamente hasta un año después de su inclusión en el estudio. RESULTADOS: Los resultados se presentarán un año después del inicio de la selección (setiembre de 2011 y consolidados, después de la reunión de la población y de los objetivos deseados a posteriori. CONCLUSIÓN: El análisis de este registro multicéntrico permitirá proyectar una perspectiva horizontal del tratamiento de los pacientes afectados con la enfermedad cardiovascular en Brasil.BACKGROUND: To date, no Brazilian registry has been designed to document the clinical practice regarding assistance to

  15. Incorporating PROMIS Symptom Measures into Primary Care Practice-a Randomized Clinical Trial.

    Science.gov (United States)

    Kroenke, Kurt; Talib, Tasneem L; Stump, Timothy E; Kean, Jacob; Haggstrom, David A; DeChant, Paige; Lake, Kittie R; Stout, Madison; Monahan, Patrick O

    2018-04-05

    Symptoms account for more than 400 million clinic visits annually in the USA. The SPADE symptoms (sleep, pain, anxiety, depression, and low energy/fatigue) are particularly prevalent and undertreated. To assess the effectiveness of providing PROMIS (Patient-Reported Outcome Measure Information System) symptom scores to clinicians on symptom outcomes. Randomized clinical trial conducted from March 2015 through May 2016 in general internal medicine and family practice clinics in an academic healthcare system. Primary care patients who screened positive for at least one SPADE symptom. After completing the PROMIS symptom measures electronically immediately prior to their visit, the 300 study participants were randomized to a feedback group in which their clinician received a visual display of symptom scores or a control group in which scores were not provided to clinicians. The primary outcome was the 3-month change in composite SPADE score. Secondary outcomes were individual symptom scores, symptom documentation in the clinic note, symptom-specific clinician actions, and patient satisfaction. Most patients (84%) had multiple clinically significant (T-score ≥ 55) SPADE symptoms. Both groups demonstrated moderate symptom improvement with a non-significant trend favoring the feedback compared to control group (between-group difference in composite T-score improvement, 1.1; P = 0.17). Symptoms present at baseline resolved at 3-month follow-up only one third of the time, and patients frequently still desired treatment. Except for pain, clinically significant symptoms were documented less than half the time. Neither symptom documentation, symptom-specific clinician actions, nor patient satisfaction differed between treatment arms. Predictors of greater symptom improvement included female sex, black race, fewer medical conditions, and receiving care in a family medicine clinic. Simple feedback of symptom scores to primary care clinicians in the absence of

  16. Measurement and monitoring of safety: impact and challenges of putting a conceptual framework into practice.

    Science.gov (United States)

    Chatburn, Eleanor; Macrae, Carl; Carthey, Jane; Vincent, Charles

    2018-03-06

    The Measurement and Monitoring of Safety Framework provides a conceptual model to guide organisations in assessing safety. The Health Foundation funded a large-scale programme to assess the value and impact of applying the Framework in regional and frontline care settings. We explored the experiences and reflections of key participants in the programme. The study was conducted in the nine healthcare organisations in England and Scotland testing the Framework (three regional improvement bodies, six frontline settings). Post hoc interviews with clinical and managerial staff were analysed using template analysis. Participants reported that the Framework promoted a substantial shift in their thinking about how safety is actively managed in their environment. It provided a common language, facilitated a more inquisitive approach and encouraged a more holistic view of the components of safety. These changes in conceptual understanding, however, did not always translate into broader changes in practice, with many sites only addressing some aspects of the Framework. One of the three regions did embrace the Framework in its entirety and achieved wider impact with a range of interventions. This region had committed leaders who took time to fully understand the concepts, who maintained a flexible approach to exploring the utility of the Framework and who worked with frontline staff to translate the concepts for local settings. The Measuring and Monitoring of Safety Framework has the potential to support a broader and richer approach to organisational safety. Such a conceptually based initiative requires both committed leaders who themselves understand the concepts and more time to establish understanding and aims than might be needed in a standard improvement programme. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Measuring treatment effects on dual-task performance: a framework for research and clinical practice

    Directory of Open Access Journals (Sweden)

    Prudence ePlummer

    2015-04-01

    Full Text Available The relevance of dual-task walking to everyday ambulation is widely acknowledged, and numerous studies have demonstrated that dual-task interference can significantly impact recovery of functional walking in people with neurological disorders. The magnitude and direction of dual-task interference is influenced by the interaction between the two tasks, including how individuals spontaneously prioritize their attention. Therefore, to accurately interpret and characterize dual-task interference and identify changes over time, it is imperative to evaluate single and dual-task performance in both tasks, as well as the tasks relative to each other. Yet, reciprocal dual-task effects are frequently ignored. The purpose of this perspective paper is to present a framework for measuring treatment effects on dual-task interference, specifically taking into account the interactions between the two tasks and how this can provide information on whether overall dual-task capacity has improved or a different attentional strategy has been adopted. In discussing the clinical implications of using this framework, we provide specific examples of using this method and provide some explicit recommendations for research and clinical practice.

  18. Effects of air pollution on human health and practical measures for prevention in Iran.

    Science.gov (United States)

    Ghorani-Azam, Adel; Riahi-Zanjani, Bamdad; Balali-Mood, Mahdi

    2016-01-01

    Air pollution is a major concern of new civilized world, which has a serious toxicological impact on human health and the environment. It has a number of different emission sources, but motor vehicles and industrial processes contribute the major part of air pollution. According to the World Health Organization, six major air pollutants include particle pollution, ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. Long and short term exposure to air suspended toxicants has a different toxicological impact on human including respiratory and cardiovascular diseases, neuropsychiatric complications, the eyes irritation, skin diseases, and long-term chronic diseases such as cancer. Several reports have revealed the direct association between exposure to the poor air quality and increasing rate of morbidity and mortality mostly due to cardiovascular and respiratory diseases. Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer, ventricular hypertrophy, Alzheimer's and Parkinson's diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight. In this review article, we aimed to discuss toxicology of major air pollutants, sources of emission, and their impact on human health. We have also proposed practical measures to reduce air pollution in Iran.

  19. Effects of air pollution on human health and practical measures for prevention in Iran

    Science.gov (United States)

    Ghorani-Azam, Adel; Riahi-Zanjani, Bamdad; Balali-Mood, Mahdi

    2016-01-01

    Air pollution is a major concern of new civilized world, which has a serious toxicological impact on human health and the environment. It has a number of different emission sources, but motor vehicles and industrial processes contribute the major part of air pollution. According to the World Health Organization, six major air pollutants include particle pollution, ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. Long and short term exposure to air suspended toxicants has a different toxicological impact on human including respiratory and cardiovascular diseases, neuropsychiatric complications, the eyes irritation, skin diseases, and long-term chronic diseases such as cancer. Several reports have revealed the direct association between exposure to the poor air quality and increasing rate of morbidity and mortality mostly due to cardiovascular and respiratory diseases. Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer, ventricular hypertrophy, Alzheimer's and Parkinson's diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight. In this review article, we aimed to discuss toxicology of major air pollutants, sources of emission, and their impact on human health. We have also proposed practical measures to reduce air pollution in Iran. PMID:27904610

  20. Effects of air pollution on human health and practical measures for prevention in Iran

    Directory of Open Access Journals (Sweden)

    Adel Ghorani-Azam

    2016-01-01

    Full Text Available Air pollution is a major concern of new civilized world, which has a serious toxicological impact on human health and the environment. It has a number of different emission sources, but motor vehicles and industrial processes contribute the major part of air pollution. According to the World Health Organization, six major air pollutants include particle pollution, ground-level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. Long and short term exposure to air suspended toxicants has a different toxicological impact on human including respiratory and cardiovascular diseases, neuropsychiatric complications, the eyes irritation, skin diseases, and long-term chronic diseases such as cancer. Several reports have revealed the direct association between exposure to the poor air quality and increasing rate of morbidity and mortality mostly due to cardiovascular and respiratory diseases. Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer, ventricular hypertrophy, Alzheimer′s and Parkinson′s diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight. In this review article, we aimed to discuss toxicology of major air pollutants, sources of emission, and their impact on human health. We have also proposed practical measures to reduce air pollution in Iran.

  1. Fair value or cost-based measurement for PPE and IP: evidence from accounting practice under IFRS

    OpenAIRE

    Fonseca, Maria

    2007-01-01

    Some standards permit a choice between different measurement bases. IAS 16 and IAS 40 allow entities to choose between fair value and cost-based measurement for property, plant and equipment (PPE) and investment property (IP), respectively. This study analyzes the accounting practice concerning measurement of PPE and IP after recognition, under IFRS. The sample was extracted from stock exchange listed European companies included in the S&P Europe 350 Index. Data was hand collec...

  2. Meta-analysis of individual registry results enhances international registry collaboration.

    Science.gov (United States)

    Paxton, Elizabeth W; Mohaddes, Maziar; Laaksonen, Inari; Lorimer, Michelle; Graves, Stephen E; Malchau, Henrik; Namba, Robert S; Kärrholm, John; Rolfson, Ola; Cafri, Guy

    2018-03-28

    Background and purpose - Although common in medical research, meta-analysis has not been widely adopted in registry collaborations. A meta-analytic approach in which each registry conducts a standardized analysis on its own data followed by a meta-analysis to calculate a weighted average of the estimates allows collaboration without sharing patient-level data. The value of meta-analysis as an alternative to individual patient data analysis is illustrated in this study by comparing the risk of revision of porous tantalum cups versus other uncemented cups in primary total hip arthroplasties from Sweden, Australia, and a US registry (2003-2015). Patients and methods - For both individual patient data analysis and meta-analysis approaches a Cox proportional hazard model was fit for time to revision, comparing porous tantalum (n = 23,201) with other uncemented cups (n = 128,321). Covariates included age, sex, diagnosis, head size, and stem fixation. In the meta-analysis approach, treatment effect size (i.e., Cox model hazard ratio) was calculated within each registry and a weighted average for the individual registries' estimates was calculated. Results - Patient-level data analysis and meta-analytic approaches yielded the same results with the porous tantalum cups having a higher risk of revision than other uncemented cups (HR (95% CI) 1.6 (1.4-1.7) and HR (95% CI) 1.5 (1.4-1.7), respectively). Adding the US cohort to the meta-analysis led to greater generalizability, increased precision of the treatment effect, and similar findings (HR (95% CI) 1.6 (1.4-1.7)) with increased risk of porous tantalum cups. Interpretation - The meta-analytic technique is a viable option to address privacy, security, and data ownership concerns allowing more expansive registry collaboration, greater generalizability, and increased precision of treatment effects.

  3. Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students

    OpenAIRE

    Katowa-Mukwato, Patricia; Banda, Sekelani

    2016-01-01

    Objectives To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. Methods The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objec...

  4. A Dialogue with Social Media Experts: Measurement and Challenges of Social Media Use in Chinese Public Relations Practice

    OpenAIRE

    Yi Luo; Hua Jiang

    2012-01-01

    With the advent and increasing popularity of new communication technologies, social media tools have been widely used in corporate organization-public communication. The extant literature on social media use in public relations practice has largely centered on the ways social media tools have transformed the practice of public relations in the United States. Limited studies have examined the role of social media in China. The present study represents one of the first to investigate the measur...

  5. A Registry Framework Enabling Patient-Centred Care.

    Science.gov (United States)

    Bellgard, Matthew I; Napier, Kathryn; Render, Lee; Radochonski, Maciej; Lamont, Leanne; Graham, Caroline; Wilton, Steve D; Fletcher, Sue; Goldblatt, Jack; Hunter, Adam A; Weeramanthri, Tarun

    2015-01-01

    Clinical decisions rely on expert knowledge that draws on quality patient phenotypic and physiological data. In this regard, systems that can support patient-centric care are essential. Patient registries are a key component of patient-centre care and can come in many forms such as disease-specific, recruitment, clinical, contact, post market and surveillance. There are, however, a number of significant challenges to overcome in order to maximise the utility of these information management systems to facilitate improved patient-centred care. Registries need to be harmonised regionally, nationally and internationally. However, the majority are implemented as standalone systems without consideration for data standards or system interoperability. Hence the task of harmonisation can become daunting. Fortunately, there are strategies to address this. In this paper, a disease registry framework is outlined that enables efficient deployment of national and international registries that can be modified dynamically as registry requirements evolve. This framework provides a basis for the development and implementation of data standards and enables patients to seamlessly belong to multiple registries. Other significant advances include the ability for registry curators to create and manage registries themselves without the need to contract software developers, and the concept of a registry description language for ease of registry template sharing.

  6. Current situation and challenge of registry in China.

    Science.gov (United States)

    Zhang, Yang; Feng, Yuji; Qu, Zhi; Qi, Yali; Zhan, Siyan

    2014-09-01

    Increasing emphasis has been placed on registries for an organized system used in developing clinical research to improve health care. China has sufficient data that can be applied broadly, but the heterogeneity and irregularity of registries limit their applicability. This article aims to describe the status of registries in China and the related challenges. Patient registries for observational studies were retrieved from the International Clinical Trials Registry to quantitatively evaluate the number of comparatively high-quality registries in China. A literature search was also performed to provide support and updates. A total of 64 patient registries were retrieved from ClinicalTrials.gov using disease, product, and health service as criteria. The sample sizes ranged from 15 to 30,400, with only 12 registries marked as completed. This article describes and compares the detailed information in many aspects. The efficient use of registries has already made considerable progress in China; however, registries still require standardization, high-quality transition, and coordinated development.

  7. Eye Care Professionals' Perspectives on Eye Donation and an Eye Donation Registry for Research: A Single-Institution, Cross-Sectional Study.

    Science.gov (United States)

    Williams, Andrew M; Allingham, R Rand; Stamer, W Daniel; Muir, Kelly W

    2016-06-01

    A centralized eye donation registry for research could help to bridge the gap between patients interested in donating their eyes to science and scientists who conduct research on human eye tissue. Previous research has demonstrated patient and family support for such a registry. In this study, we assessed the views that eye care professionals have toward an eye donation registry for research. Surveys were distributed to all 46 clinical faculty members of the Duke University Eye Center. In addition to collecting demographic information, the surveys assessed clinicians' experience with discussing eye donation with patients, described the proposed eye donation registry for research and asked how the registry would affect the clinicians' practice. A total of 21 eye care professionals returned the survey. Thirty-three percent reported discussing eye donation with patients, and 43% reported that a patient has asked about donating their eyes for research on their disease. Eighty-six percent of eye care professionals reported that a centralized registry would improve the way they work with patients who express a desire to donate their eyes for research. The majority of eye care professionals at our academic institution indicated that an eye donation registry for research would improve how they work with patients who are interested in donating their eyes for research on their disease. Future research should examine how best to communicate this registry to ophthalmic patients.

  8. Multiprofessional evaluation in clinical practice: establishing a core set of outcome measures for children with cerebral palsy.

    Science.gov (United States)

    Mäenpää, Helena; Autti-Rämö, Ilona; Varho, Tarja; Forsten, Wivi; Haataja, Leena

    2017-03-01

    To develop a national consensus on outcome measures that define functional ability in children with cerebral palsy (CP) according to the International Classification of Functioning, Disability and Health (ICF) framework. The project started in 2008 in neuropaediatric units of two university hospitals and one outpatient clinic. Each professional group selected representatives to be knowledge brokers for their own specialty. Based on the evidence, expert opinion, and the ICF framework, multiprofessional teams selected the most valid measures used in clinical practice (2009-2010). Data from 269 children with CP were analysed, classified by the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System, and evaluated. The process aimed at improving and unifying clinical practice in Finland through a national consensus on the core set of measures. The selected measures were presented by professional groups, and consensus was reached on the recommended core set of measures to be used in all hospitals treating children with CP in Finland. A national consensus on relevant and feasible measures is essential for identifying differences in the effectiveness of local practices, and for conducting multisite intervention studies. This project showed that multiprofessional rehabilitation practices can be improved through respect for and inclusion of everyone involved. © 2016 Mac Keith Press.

  9. Measures of upper limb function for people with neck pain. A systematic review of measurement and practical properties.

    Science.gov (United States)

    Alreni, Ahmad Salah Eldin; Harrop, Deborah; Lowe, Anna; Tanzila Potia; Kilner, Karen; McLean, Sionnadh Mairi

    2017-06-01

    There is a strong relationship between neck pain (NP) and upper limb disability (ULD). Optimal management of NP should incorporate upper limb rehabilitation and therefore include the use of an ULD measure in the assessment and management process. Clear guidance regarding the suitability of available measures does not exist. The aim of this study was to identify all available measures of ULD for populations with NP, critically evaluate their measurement properties and finally recommend a list of suitable measures. This two-phase systematic review is reported in accordance with the PRISMA statement. Phase one identified clearly reproducible measures of ULD for patients with NP. Phase two identified evidence of their measurement properties. In total, 11 papers evaluating the measurement properties of five instruments were included in this review. The instruments identified were the DASH questionnaire, the QuickDASH questionnaire, the NULI questionnaire, the SFA and the SAMP test. There was limited positive evidence of validity of the DASH, QuickDASH, NULI, SFA and SAMP. There was limited positive evidence of reliability of the NULI, SFA and SAMP. There was unknown evidence of responsiveness of the DASH and QuickDASH. Although all measures are supported by a limited amount of low quality evidence, the DASH, QuickDASH, NULI questionnaires, and the SAMP test are promising measures, but they require further robust evaluation. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  10. Final report of the project. Emission of nitrogen oxides by the soils. Measures, modelization, land registry and inventory. Impact on the air quality, the climatic change and the evaluation of possibilities of these emissions reduction

    International Nuclear Information System (INIS)

    Serca, D.; Cortinovis, J.; Laville, P.; Gabrielle, B.; Beekmann, M.; Ravetta, F.; Henault, C.

    2007-01-01

    This project deals with NOx biosphere-atmosphere exchanges, NOx being considered as an indirect greenhouse gases (tropospheric O 3 precursor). It relies on four laboratory specialized both on the soil-plant-atmosphere interface, and on the atmospheric chemistry. Methodology used bear on a set of in situ and laboratory measurements aiming at improving existing emission parameterization, or building new ones for the agro-ecosystems encountered in France or Europe. In situ measurements allowed to study the emission phenology in relation with relevant environmental parameters (meteorological, soil characteristics, and agricultural). Laboratory measurements allowed to establish an emission algorithm related to the three main parameters, that is, soil temperature, water and ammonia content. This algorithm has been adapted and simplified to spatialize the emissions at the France level. This spatialization was performed using environmental parameters accessible through data base (ECMWF) or agricultural statistics (such as nitrogen inputs, land use, crops). Spatial and temporal extrapolation allowed reaching the main objective, that is, to build a national inventory for a reference year (2002). This inventory allowed determining the contribution of NOx emitted by soil as compared to total emitted NOx, and the proportion of NOx emitted by soil due to fertilizer use. Our study, based on 57% of the French used agricultural area, and extrapolated to the whole arable surface, shows that soils would be responsible of about 5% of the total NOx emissions. On these 5%, 20%, which finally is a rather low percentage, would be linked to fertilizer use. The impact of these emissions on the atmospheric chemistry has been evaluated using the CHIMERE chemistry-transport model. We found that NOx emissions from soil would be of minor importance when compared to the industrial emissions, being a factor of ten lower in France. As a matter of consequence, the impact of the emissions on the

  11. Patient-reported outcomes (PROs): the significance of using humanistic measures in clinical trial and clinical practice.

    Science.gov (United States)

    Refolo, P; Minacori, R; Mele, V; Sacchini, D; Spagnolo, A G

    2012-10-01

    Patient-reported outcome (PRO) is an "umbrella term" that covers a whole range of potential types of measurement but it is used specifically to refer to all measures quantifying the state of health through the evaluation of outcomes reported by the patient himself/herself. PROs are increasingly seen as complementary to biomedical measures and they are being incorporated more frequently into clinical trials and clinical practice. After considering the cultural background of PROs - that is the well known patient-centered model of medicine -, their historical profile (since 1914, the year of the first outcome measure) and typologies, the paper aims at debating their methodological complexity and implementation into practice. Some clinical trials and therapeutic managements utilizing patient-centered measures will be also analyzed.

  12. A Dutch Nationwide Bariatric Quality Registry: DATO.

    Science.gov (United States)

    Poelemeijer, Youri Q M; Liem, Ronald S L; Nienhuijs, Simon W

    2017-12-22

    In the Netherlands, the number of bariatric procedures increased exponentially in the 90s. To ensure and improve the quality of bariatric surgery, the nationwide Dutch Audit for Treatment of Obesity (DATO) was established in 2014. The audit was coordinated by the Dutch Institute for Clinical Auditing (DICA). This article provides a review of the aforementioned process in establishing a nationwide registry in the Netherlands. In collaboration with the DATO's scientific committee and other stakeholders, an annual list of several external quality indicators was formulated. This list consists of volume, process, and outcome indicators. In addition to the annual external indicators, the database permits individual hospitals to analyze their own data. The dashboard provides several standardized reports and detailed quality indicators, which are updated on a weekly base. Since the start, all 18 Dutch bariatric centers participated in the nationwide audit. A total of 21,941 cases were registered between 2015 and 2016. By 2016, the required variables were registered in 94.3% of all cases. A severe complicated course was seen in 2.87%, and mortality in 0.05% in 2016. The first-year follow-up shows a > 20% TWL in 86.1% of the registered cases. The DATO has become rapidly a mature registry. The well-organized structure of the national audit institution DICA and governmental funding were essential. However, most important were the bariatric teams themselves. The authors believe reporting the results from the registry has already contributed to more knowledge and acceptance by other health care providers.

  13. National registry of hemoglobinopathies in Spain (REPHem).

    Science.gov (United States)

    Cela, Elena; Bellón, José M; de la Cruz, María; Beléndez, Cristina; Berrueco, Rubén; Ruiz, Anna; Elorza, Izaskun; Díaz de Heredia, Cristina; Cervera, Aurea; Vallés, Griselda; Salinas, J Antonio; Coll, M Teresa; Bermúdez, Mar; Prudencio, Marta; Argilés, Bienvenida; Vecilla, Cruz

    2017-07-01

    Although highly prevalent throughout the world, the accurate prevalence of hemoglobinopathies in Spain is unknown. This study presents data on the national registry of hemoglobinopathies of patients with thalassemia major (TM), thalassemia intermedia (TI), and sickle cell disease (SCD) in Spain created in 2014. Fifty centers reported cases retrospectively. Data were registered from neonatal screening or from the first contact at diagnosis until last follow-up or death. Data of the 715 eligible patients were collected: 615 SCD (497 SS, 64 SC, 54 SBeta phenotypes), 73 thalassemia, 9 CC phenotype, and 18 other variants. Most of the SCD patients were born in Spain (65%), and 51% of these were diagnosed at newborn screening. Median age at the first diagnosis was 0.4 years for thalassemia and 1.0 years for SCD. The estimated incidence was 0.002 thalassemia cases and 0.03 SCD cases/1,000 live births. Median age was 8.9 years (0.2-33.7) for thalassemia and 8.1 years (0.2-32.8) for SCD patients. Stroke was registered in 16 SCD cases. Transplantation was performed in 43 TM and 23 SCD patients at a median age of 5.2 and 7.8 years, respectively. Twenty-one patients died (3 TM, 17 SCD, 1 CC) and 200 were lost to follow-up. Causes of death were related to transplantation in three patients with TM and three patients with SCD. Death did not seem to be associated with SCD in six patients, but nine patients died secondary to disease complications. Overall survival was 95% at 15 years of age. The registry provides data about the prevalence of hemoglobinopathies in Spain and will permit future cohort studies and the possibility of comparison with other registries. © 2016 Wiley Periodicals, Inc.

  14. The Danish Neuro-Oncology Registry

    DEFF Research Database (Denmark)

    Hansen, Steinbjørn

    2016-01-01

    AIM OF DATABASE: The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. STUDY POPULATION: DNOR has...... advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. CONCLUSION: The establishment of DNOR has optimized the quality...

  15. A framework and a measurement instrument for sustainability of work practices in long-term care

    NARCIS (Netherlands)

    S.S. Slaghuis (Sarah); M.M.H. Strating (Mathilde); R.A. Bal (Roland); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground: In health care, many organizations are working on quality improvement and/or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices

  16. Measuring actual scope of nursing practice: a new tool for nurse leaders.

    Science.gov (United States)

    D'Amour, Danielle; Dubois, Carl-Ardy; Déry, Johanne; Clarke, Sean; Tchouaket, Eric; Blais, Régis; Rivard, Michèle

    2012-05-01

    : This project describes the development and testing of the actual scope of nursing practice questionnaire. : Underutilization of the skill sets of registered nurses (RNs) is a widespread concern. Cost-effective, safe, and efficient care requires support by management to facilitate the implementation of nursing practice at the full scope. : Literature review, expert consultation, and face validity testing were used in item development. The instrument was tested with 285 nurses in 22 medical units in 11 hospitals in Canada. : The 26-item, 6-dimension questionnaire demonstrated validity and reliability. The responses suggest that nurses practice at less than their optimal scope, with key dimensions of professional practice being implemented infrequently. : This instrument can help nurse leaders increase the effective use of RN time in carrying out the full scope of their professional practice.

  17. Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada.

    Science.gov (United States)

    Sibley, Kathryn M; Straus, Sharon E; Inness, Elizabeth L; Salbach, Nancy M; Jaglal, Susan B

    2013-03-20

    Balance impairment is common in multiple clinical populations, and comprehensive assessment is important for identifying impairments, planning individualized treatment programs, and evaluating change over time. However, little information is available regarding whether clinicians who treat balance are satisfied with existing assessment tools. In 2010 we conducted a cross-sectional survey of balance assessment practices among physiotherapists in Ontario, Canada, and reported on the use of standardized balance measures (Sibley et al. 2011 Physical Therapy; 91: 1583-91). The purpose of this study was to analyse additional survey data and i) evaluate satisfaction with current balance assessment practices and standardized measures among physiotherapists who treat adult or geriatric populations with balance impairment, and ii) identify factors associated with satisfaction. The questionnaire was distributed to 1000 practicing physiotherapists. This analysis focuses on questions in which respondents were asked to rate their general perceptions about balance assessment, the perceived utility of individual standardized balance measures, whether they wanted to improve balance assessment practices, and why. Data were summarized with descriptive statistics and utility of individual measures was compared across clinical practice areas (orthopaedic, neurological, geriatric or general rehabilitation). The questionnaire was completed by 369 respondents, of which 43.4% of respondents agreed that existing standardized measures of balance meet their needs. In ratings of individual measures, the Single Leg Stance test and Berg Balance Scale were perceived as useful for clinical decision-making and evaluating change over time by over 70% of respondents, and the Timed Up-and-Go test was perceived as useful for decision-making by 56.9% of respondents and useful for evaluating change over time by 62.9% of respondents, but there were significant differences across practice groups. Seventy

  18. Development of recommended practices and guidance documents for upstream oil and gas flow measurement

    Energy Technology Data Exchange (ETDEWEB)

    Dahl, Eivind; Scheers, Lex; Ting, Frank; Letton, Chip

    2005-07-01

    As first stated in the Introduction, improvements in multiphase flow meters during the last 15 years have resulted in their increased usage in upstream oil and gas applications, especially in difficult offshore locations both topside and deep subsea. To address user needs for information and standardization in the area, documentation has recently been created under the auspices of the NFOGM, API, and ISO. Our intent here was to familiarize potential users with the three new documents, which should be helpful in a number of respects, e.g., (a) distribution of best knowledge and operational practices on the subject, (b) provision of a common language for discussing multiphase flow, and (c) accounting for the requirements of governing regulatory authorities. At this stage of completion of NFOGM, API, and ISO reports, a natural question arises as to what the future holds for another round of flow measurement documentation. Candidate areas include: 1) In Situ Verification of Multiphase Flow Meters. 2) Wet Gas Flow Measurement. 3) Flare Gas Meters. 4) Virtual Metering. 5) Composition and Phase Behavior Issues In Measurement. 6) Flow Measurement Uncertainty. Addressing certain of these is already being proposed in several possible venues, among which are (1) the DeepStar Consortium, (2) a JIP for investigating total system (meter + flowline + separator) uncertainty organized by a group at Tulsa University, and (3) a program for development of drilling and production capabilities in ultradeep water to be sponsored by the US Department of Energy. The creation of the three documents discussed in this paper demonstrates the benefits that strong international cooperation can achieve in producing standardization documents, ensuring their true global input and acceptance. On the other hand, it should also be questioned why two or more documents are required, which are the result of much duplication of effort. For example, although there are differences between API RP86 and the

  19. Impact of Advanced Practice Registered Nurses on Quality Measures: The Missouri Quality Initiative Experience.

    Science.gov (United States)

    Rantz, Marilyn J; Popejoy, Lori; Vogelsmeier, Amy; Galambos, Colleen; Alexander, Greg; Flesner, Marcia; Murray, Cathy; Crecelius, Charles; Ge, Bin; Petroski, Gregory

    2018-06-01

    The purpose of this article is to review the impact of advanced practice registered nurses (APRNs) on the quality measure (QM) scores of the 16 participating nursing homes of the Missouri Quality Initiative (MOQI) intervention. The MOQI was one of 7 program sites in the US, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services Innovations Center. While the goals of the MOQI for long-stay nursing home residents did not specifically include improvement of the QM scores, it was anticipated that improvement most likely would occur. Primary goals of the MOQI were to reduce the frequency of avoidable hospital admissions and readmissions; improve resident health outcomes; improve the process of transitioning between inpatient hospitals and nursing facilities; and reduce overall healthcare spending without restricting access to care or choice of providers. A 2-group comparison analysis was conducted using statewide QMs; a matched comparison group was selected from facilities in the same counties as the intervention homes, similar baseline QM scores, similar size and ownership. MOQI nursing homes each had an APRN embedded full-time to improve care and help the facility achieve MOQI goals. Part of their clinical work with residents and staff was to focus on quality improvement strategies with potential to influence healthcare outcomes. Trajectories of QM scores for the MOQI intervention nursing homes and matched comparison group homes were tested with nonparametric tests to examine for change in the desired direction between the 2 groups from baseline to 36 months. A composite QM score for each facility was constructed, and baseline to 36-month average change scores were examined using nonparametric tests. Then, adjusting for baseline, a repeated measures analysis using analysis of covariance as conducted. Composite QM scores of the APRN intervention group were significantly better (P = .025) than the comparison group

  20. The Danish Multiple Sclerosis Registry. History, data collection and validity

    DEFF Research Database (Denmark)

    Koch-Henriksen, N; Rasmussen, S; Stenager, E

    2001-01-01

    The Danish Multiple Sclerosis Registry was formally established in 1956 but started operating in 1949 with a nationwide prevalence survey. Since then, the Registry has continued collecting data on new and old cases of multiple sclerosis (MS) or suspected MS from multiple sources. The Registry...... instrument for monitoring incidence and prevalence, analysing survival, performing genetic analysis, providing unselected patient samples for clinical analyses, performing case-control studies and prospective studies and estimating the need for treatment and care....

  1. The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Duncan Edward AS

    2012-05-01

    Full Text Available Abstract Background Allied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice. Methods A systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings. Results 960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals’ use of routine outcome measurement include: professionals’ level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice. Conclusions Whilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians’ ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome

  2. Analyzing quality of colorectal cancer care through registry statistics: a small community hospital example.

    Science.gov (United States)

    Hopewood, Ian

    2011-01-01

    As the quantity of elderly Americans requiring oncologic care grows, and as cancer treatment and medicine become more advanced, assessing quality of cancer care becomes a necessary and advantageous practice for any facility.' Such analysis is especially practical in small community hospitals, which may not have the resources of their larger academic counterparts to ensure that the care being provided is current and competitive in terms of both technique and outcome. This study is a comparison of the colorectal cancer care at one such center, Falmouth Community Hospital (FCH)--located in Falmouth, Massachusetts, about an hour and a half away from the nearest metropolitan center--to the care provided at a major nearby Boston Tertiary Center (BTC) and at teaching and research facilities across New England and the United States. The metrics used to measure performance encompass both outcome (survival rate data) as well as technique, including quality of surgery (number of lymph nodes removed) and the administration of adjuvant treatments, chemotherapy, and radiation therapy, as per national guidelines. All data for comparison between FCH and BTC were culled from those hospitals' tumor registries. Data for the comparison between FCH and national tertiary/referral centers were taken from the American College of Surgeons' Commission on Cancer, namely National Cancer Data Base (NCDB) statistics, Hospital Benchmark Reports and Practice Profile Reports. The results showed that, while patients at FCH were diagnosed at both a higher age and at a more advanced stage of colorectal cancer than their BTC counterparts, FCH stands up favorably to BTC and other large centers in terms of the metrics referenced above. Quality assessment such as the analysis conducted here can be used at other community facilities to spotlight, and ultimately eliminate, deficiencies in cancer programs.

  3. Toward criteria for pragmatic measurement in implementation research and practice: a stakeholder-driven approach using concept mapping.

    Science.gov (United States)

    Powell, Byron J; Stanick, Cameo F; Halko, Heather M; Dorsey, Caitlin N; Weiner, Bryan J; Barwick, Melanie A; Damschroder, Laura J; Wensing, Michel; Wolfenden, Luke; Lewis, Cara C

    2017-10-03

    Advancing implementation research and practice requires valid and reliable measures of implementation determinants, mechanisms, processes, strategies, and outcomes. However, researchers and implementation stakeholders are unlikely to use measures if they are not also pragmatic. The purpose of this study was to establish a stakeholder-driven conceptualization of the domains that comprise the pragmatic measure construct. It built upon a systematic review of the literature and semi-structured stakeholder interviews that generated 47 criteria for pragmatic measures, and aimed to further refine that set of criteria by identifying conceptually distinct categories of the pragmatic measure construct and providing quantitative ratings of the criteria's clarity and importance. Twenty-four stakeholders with expertise in implementation practice completed a concept mapping activity wherein they organized the initial list of 47 criteria into conceptually distinct categories and rated their clarity and importance. Multidimensional scaling, hierarchical cluster analysis, and descriptive statistics were used to analyze the data. The 47 criteria were meaningfully grouped into four distinct categories: (1) acceptable, (2) compatible, (3) easy, and (4) useful. Average ratings of clarity and importance at the category and individual criteria level will be presented. This study advances the field of implementation science and practice by providing clear and conceptually distinct domains of the pragmatic measure construct. Next steps will include a Delphi process to develop consensus on the most important criteria and the development of quantifiable pragmatic rating criteria that can be used to assess measures.

  4. The use of EORTC measures in daily clinical practice-A synopsis of a newly developed manual.

    Science.gov (United States)

    Wintner, Lisa M; Sztankay, Monika; Aaronson, Neil; Bottomley, Andrew; Giesinger, Johannes M; Groenvold, Mogens; Petersen, Morten Aa; van de Poll-Franse, Lonneke; Velikova, Galina; Verdonck-de Leeuw, Irma; Holzner, Bernhard

    2016-11-01

    Cancer has increasingly become a chronic condition and the routine collection of patient-reported outcomes (PROs) like quality of life is widely recommended for clinical practice. Nonetheless, the successful implementation of PROs is still a major challenge, although common barriers to and facilitators of their beneficial use are well known. To support health care professionals and other stakeholders in the implementation of the EORTC PRO measures, the EORTC Quality of Life Group provides guidance on issues considered important for their use in daily clinical practice. Herein, we present an outline of the newly developed "'Manual for the use of EORTC measures in daily clinical practice", covering the following issues: * a rationale for using EORTC measures in routine care *selection of EORTC measures, timing of assessments, scoring and presentation of results * aspects of a strategic implementation * electronic data assessment and telemonitoring, and * further use of EORTC measures and ethical considerations. Next to an extensive overview of currently available literature, the manual specifically focuses on knowledge about EORTC measures to give evidence-based recommendations whenever possible and to encourage readers and end-users of EORTC measures to contribute to further needed high-quality research. The manual will be accessible on the EORTC Quality of Life Group website's homepage and will be periodically updated to take into account any new knowledge due to medical, technical, regulatory and scientific advances. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Evaluating the completeness of the national ALS registry, United States.

    Science.gov (United States)

    Kaye, Wendy E; Wagner, Laurie; Wu, Ruoming; Mehta, Paul

    2018-02-01

    Our objective was to evaluate the completeness of the United States National ALS Registry (Registry). We compared persons with ALS who were passively identified by the Registry with those actively identified in the State and Metropolitan Area ALS Surveillance project. Cases in the two projects were matched using a combination of identifiers, including, partial social security number, name, date of birth, and sex. The distributions of cases from the two projects that matched/did not match were compared and Chi-square tests conducted to determine statistical significance. There were 5883 ALS cases identified by the surveillance project. Of these, 1116 died before the Registry started, leaving 4767 cases. We matched 2720 cases from the surveillance project to those in the Registry. The cases identified by the surveillance project that did not match cases in the Registry were more likely to be non-white, Hispanic, less than 65 years of age, and from western states. The methods used by the Registry to identify ALS cases, i.e. national administrative data and self-registration, worked well but missed cases. These findings suggest that developing strategies to identify and promote the Registry to those who were more likely to be missing, e.g. non-white and Hispanic, could be beneficial to improving the completeness of the Registry.

  6. Pediatric Contact Dermatitis Registry Inaugural Case Data.

    Science.gov (United States)

    Goldenberg, Alina; Mousdicas, Nico; Silverberg, Nanette; Powell, Douglas; Pelletier, Janice L; Silverberg, Jonathan I; Zippin, Jonathan; Fonacier, Luz; Tosti, Antonella; Lawley, Leslie; Wu Chang, Mary; Scheman, Andrew; Kleiner, Gary; Williams, Judith; Watsky, Kalman; Dunnick, Cory A; Frederickson, Rachel; Matiz, Catalina; Chaney, Keri; Estes, Tracy S; Botto, Nina; Draper, Michelle; Kircik, Leon; Lugo-Somolinos, Aida; Machler, Brian; Jacob, Sharon E

    2016-01-01

    Little is known about the epidemiology of allergic contact dermatitis (ACD) in US children. More widespread diagnostic confirmation through epicutaneous patch testing is needed. The aim was to quantify patch test results from providers evaluating US children. The study is a retrospective analysis of deidentified patch test results of children aged 18 years or younger, entered by participating providers in the Pediatric Contact Dermatitis Registry, during the first year of data collection (2015-2016). One thousand one hundred forty-two cases from 34 US states, entered by 84 providers, were analyzed. Sixty-five percent of cases had one or more positive patch test (PPT), with 48% of cases having 1 or more relevant positive patch test (RPPT). The most common PPT allergens were nickel (22%), fragrance mix I (11%), cobalt (9.1%), balsam of Peru (8.4%), neomycin (7.2%), propylene glycol (6.8%), cocamidopropyl betaine (6.4%), bacitracin (6.2%), formaldehyde (5.7%), and gold (5.7%). This US database provides multidisciplinary information on pediatric ACD, rates of PPT, and relevant RPPT reactions, validating the high rates of pediatric ACD previously reported in the literature. The registry database is the largest comprehensive collection of US-only pediatric patch test cases on which future research can be built. Continued collaboration between patients, health care providers, manufacturers, and policy makers is needed to decrease the most common allergens in pediatric consumer products.

  7. The Mid-Atlantic Twin Registry, revisited.

    Science.gov (United States)

    Lilley, Emily C H; Silberg, Judy L

    2013-02-01

    The Mid-Atlantic Twin Registry (MATR) is a population-based registry of more than 56,000 twins primarily born or living in Virginia, North Carolina, and South Carolina. The MATR employs several methods of ascertaining twins, and devotes considerable resources to tracking and maintaining communication with MATR participants. Researchers may utilize the MATR for administration of research services including study recruitment, collection of DNA, archival data set creation, as well as data collection through mailed, phone, or online surveys. In addition, the MATR houses the MATR Repository, with over 1,200 blood samples available for researchers interested in DNA genotyping. For over 35 years MATR twins have participated in research studies with investigators from diverse scientific disciplines and various institutions. These studies, which have resulted in numerous publications, have covered a range of topics, including the human microbiome, developmental psychopathology, depression, anxiety, substance use, epigenetics of aging, children of twins, pre-term birth, social attitudes, seizures, eating disorders, as well as sleep homeostasis. Researchers interested in utilizing twins are encouraged to contact the MATR to discuss potential research opportunities.

  8. The national registry for radiation workers

    International Nuclear Information System (INIS)

    Kendall, G.M.; Dennis, J.A.

    1985-01-01

    The National Registry for Radiation Workers (NRRW) was set up by the National Radiological Protection Board in 1976. The analysis of registry data has four aims: a) To determine whether there is any evidence of differences in the causes of and ages at death of workers exposed to different levels of radiation and, if any differences are found, whether it seems likely that they can be attributed to radiation. b) To estimate the magnitude of the risk, if any differences are found, that seem likely to be attributable to radiation. c) To estimate bounds to the possible risk for particular types of malignancy, such as leukemia. d) To compare the mortality experience of radiation workers with national mortality data and also with that of other industrial groups for whom data exist. If current estimates of the risks of ionizing radiation are correct, very few deaths will be induced in the study population and it will be impossible to detect them statistically. The NRRW currently includes records for over 60,000 individuals. 6 refs

  9. Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment.

    Science.gov (United States)

    Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R

    2018-05-01

    To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

  10. Evaluation of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee: a systematic review.

    Science.gov (United States)

    Howe, Tracey E; Dawson, Lesley J; Syme, Grant; Duncan, Louise; Reid, Judith

    2012-04-01

    This systematic review reported on the clinimetric properties of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee. A systematic search was performed in Medline, EMBASE, Cinahl and AMED to identify studies examining the clinimetric properties of outcome measures for adults undergoing conservative treatment of ligament injuries, meniscal lesions, patellofemoral pain and osteoarthritis of the knee. Outcomes measures taking less than 20 min to administer and requiring minimal equipment and space were included. Pairs of authors used a checklist to record the characteristics of the outcome measures, their reported clinimetric properties and the demographics of the study populations. The OMERACT filters of 'truth' and 'discrimination' were applied to the data for each outcome measure by an expert panel. Forty-seven studies were included evaluating 37 outcome measures. Ten outcome measures had adequate supporting evidence for 'truth' and 'discrimination': AAOS, AKPS, goniometer measurement, IKDC, KOOS, LEFS, Lysholm, Tegner, WOMAC and WOMET. However none of the outcome measures had been comprehensively tested across all clinimetric properties. Despite the widespread use of some outcome measures in clinical practice and primary research, data on the clinimetric properties were available for only 37 and of these only 10 had adequate supporting evidence for use in this population. However, before a core set of outcome measures can be recommended use in clinical practice, for adults with musculoskeletal conditions of the knee, consensus should be obtained on 'feasibility' in terms of burden on the clinician and the participant. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Patient reported outcomes in hip arthroplasty registries.

    Science.gov (United States)

    Paulsen, Aksel

    2014-05-01

    PROs are used increasingly in orthopedics and in joint registries, but still many aspects of use in this area have not been examined in depth. To be able to introduce PROs in the DHR in a scientific fashion, my studies were warranted; the feasibility of four often used PROs (OHS, HOOS, EQ-5D and SF-12) was examined in a registry context. Having the PROs in the target language is an absolute necessity, so I translated, cross-culturally adapted and validated a Danish language version of an often used PRO (OHS), since this PRO had no properly developed Danish language version. To minimize data loss and to maximize the data quality I validated our data capture procedure, an up to date AFP system, by comparing scannable, paper-based PROs, with manual single-key- and double-key entered data. To help further registry-PRO studies, I calculated the number of patients needed to discriminate between subgroups of age, sex, diagnosis, and prosthesis type for each of four often used PROs (OHS, HOOS, EQ-5D and SF-12), and to simplify the clinical interpretation of PRO scores and PRO change scores in PRO studies, I estimated MCII and PASS for two often used PROs (EQ-5D and HOOS). The feasibility study included 5,747 THA patients registered in the DHR, and I found only minor differences between the disease-specific and the generic PROs regarding ceiling and floor effects as well as discarded items. The HOOS, the OHS, the SF-12, and the EQ-5D are all appropriate PROs for administration in a hip registry. I found that group sizes from 51 to 1,566 were needed for subgroup analysis, depending on descriptive factors and choice of PRO. The AFP study included 200 THA patients (398 PROs, 4,875 items and 21,887 data fields), and gave excellent results provided use of highly structured questionnaires. OMR performed equally as well as manual double-key entering, and better than single-key entering. The PRO translation and validation study included 2,278 patients (and 212 patients for the test

  12. Uncertainty in measurements in practice ionization chamber; Incerteza nas medidas realizadas pela pratica da camara de ionizacao

    Energy Technology Data Exchange (ETDEWEB)

    Sales, Emer; Pinto, Fernando Sandi; Sousa Junior, Samuel Facanha; Freitas, Dayslon Luiz Gaudaret; Andrade, Lucio das Chagas de, E-mail: fernandopintofis@gmail.com [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil)

    2016-07-01

    The calculation of uncertainty is a mathematical tool widely used in the analysis of experimental data, ensuring that the values obtained by measuring equipment are the most accurate and close to the possible real. This paper presents a theoretical review of uncertainty, and with application of objective determination of uncertainty for repeatability and reproducibility of processes measuring for determining dose of a radioactive source, in practice ionization chamber, held at the Professional Master of Medical Physics State University of Rio de Janeiro. (author)

  13. An Evaluation and Implementation Guide for Current Groundwater Mass Flux Measurement Practices

    National Research Council Canada - National Science Library

    Wheeldon, III, Jack G

    2008-01-01

    ... capabilities, limitations, and costs. This study provides such information on each of the methods by reviewing implementation practices and comparing the costs of applying the methods at 16 standardized "template" sites...

  14. Translation, cross-cultural adaption and measurement properties of the evidence-based practice profile

    OpenAIRE

    Titlestad, Kristine Berg; Snibsoer, Anne Kristin; Stromme, Hilde; Nortvedt, Monica Wammen; Graverholt, Birgitte; Espehaug, Birgitte

    2017-01-01

    Background The evidence-based practice profile (EBP2) questionnaire assesses students? self-reported knowledge, behaviour and attitudes related to evidence-based practice. The aim of this study was to translate and cross-culturally adapt EBP2 into Norwegian and to evaluate the reliability, validity and responsiveness of the Norwegian version. Methods EBP2 was translated and cross-culturally adapted using recommended methodology. Face validity and feasibility were evaluated in a pilot on bache...

  15. Measuring Ultraviolet Radiation Underwater: A Practical Application of the Beer-Lambert-Bouguer Law for High School Physics

    Science.gov (United States)

    Schouten, Peter; Parisi, Alfio; Downs, Nathan

    2009-01-01

    The measurement of solar UV under water is not a simple process. In the underwater environment the difficulty of obtaining useable data is greatly amplified due to the optically complicated and at times unpredictable nature of water itself. The following practical exercise designed for use in the Year 11 and Year 12 Physics classroom aims to…

  16. Reliability and Validity of a Questionnaire to Measure Consumer Knowledge regarding Safe Practices to Prevent Microbiological Contamination in Restaurants

    Science.gov (United States)

    Uggioni, Paula Lazzarin; Salay, Elisabette

    2013-01-01

    Objective: The objective of this study was to develop a validated and reliable questionnaire to measure consumer knowledge regarding safe practices to prevent microbiological contamination in restaurants and commercial kitchens. Methods: Non-probabilistic samples of individuals were interviewed in the city of Campinas, Brazil. Questionnaire items…

  17. [Design, use and introduction of the practice of measureable complexes for psychophysiological studies].

    Science.gov (United States)

    Bokser, O Ia; Gurtovoĭ, E S

    1997-01-01

    The paper outlines a background of chronoreaction measurement, an important trend of psychophysiological studies. It mainly deals with the chronoreaction measuring methods and tools introduced into production.

  18. Should we all go to the PROM? The first two years of the British Spine Registry.

    Science.gov (United States)

    Breakwell, L M; Cole, A A; Birch, N; Heywood, C

    2015-07-01

    The effective capture of outcome measures in the healthcare setting can be traced back to Florence Nightingale's investigation of the in-patient mortality of soldiers wounded in the Crimean war in the 1850s. Only relatively recently has the formalised collection of outcomes data into Registries been recognised as valuable in itself. With the advent of surgeon league tables and a move towards value based health care, individuals are being driven to collect, store and interpret data. Following the success of the National Joint Registry, the British Association of Spine Surgeons instituted the British Spine Registry. Since its launch in 2012, over 650 users representing the whole surgical team have registered and during this time, more than 27 000 patients have been entered onto the database. There has been significant publicity regarding the collection of outcome measures after surgery, including patient-reported scores. Over 12 000 forms have been directly entered by patients themselves, with many more entered by the surgical teams. Questions abound: who should have access to the data produced by the Registry and how should they use it? How should the results be reported and in what forum? ©2015 The British Editorial Society of Bone & Joint Surgery.

  19. Annual Outcomes With Transcatheter Valve Therapy: From the STS/ACC TVT Registry.

    Science.gov (United States)

    Holmes, David R; Nishimura, Rick A; Grover, Frederick L; Brindis, Ralph G; Carroll, John D; Edwards, Fred H; Peterson, Eric D; Rumsfeld, John S; Shahian, David M; Thourani, Vinod H; Tuzcu, E Murat; Vemulapalli, Sreekanth; Hewitt, Kathleen; Michaels, Joan; Fitzgerald, Susan; Mack, Michael J

    2016-02-01

    The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry has been a joint initiative of the STS and the ACC in concert with multiple stakeholders. The TVT Registry has important information regarding patient selection, delivery of care, science, education, and research in the field of structural valvular heart disease. This report provides an overview on current U.S. TVT practice and trends. The emphasis is on demographics, in-hospital procedural characteristics, and outcomes of patients having transcatheter aortic valve replacement (TAVR) performed at 348 U.S. centers. The TVT Registry captured 26,414 TAVR procedures as of December 31, 2014. Temporal trends between 2012 and 2013 versus 2014 were compared. Comparison of the 2 time periods reveals that TAVR patients remain elderly (mean age 82 years), with multiple comorbidities, reflected by a high mean STS predicted risk of mortality (STS PROM) for surgical valve replacement (8.34%), were highly symptomatic (New York Heart Association functional class III/IV in 82.5%), frail (slow 5-m walk test in 81.6%), and have poor self-reported health status (median baseline Kansas City Cardiomyopathy Questionnaire score of 39.1). Procedure performance is changing, with an increased use of moderate sedation (from 1.6% to 5.1%) and increase in femoral access using percutaneous techniques (66.8% in 2014). Vascular complication rates are decreasing (from 5.6% to 4.2%), whereas site-reported stroke rates remain stable at 2.2%. The TVT Registry provides important information on characteristics and outcomes of TAVR in contemporary U.S. clinical practice. It can be used to identify trends in practice and opportunities for quality improvement.

  20. The GEOSS Component and Service Registry

    Science.gov (United States)

    Di, L.; Bai, Y.; Shen, D.; Shao, Y.; Shrestha, R.; Wang, H.; Nebert, D. D.

    2011-12-01

    Petabytes of Earth science data have been accumulated through space- and air-borne Earth observation programs during the last several decades. The data are valuable both scientifically and socioeconomically. The value of these data could be further increased significantly if the data from these programs can be easily discovered, accessed, integrated, and analyzed. The Global Earth Observation System of Systems (GEOSS) is addressing this need. Coordinated by the Group on Earth Observations (or GEO), a voluntary partnership of 86 governments, the European Commission, and 61 intergovernmental, international, and regional organizations has been working on implementing GEOSS for a number of years. After four years of international collaboration, the GEOSS Common Infrastructure (GCI) has been established. GCI consists of the Standards and Interoperability Registry (SIR), the Component and Service Registry (CSR), the GEO clearinghouse, and the GEO Portal. The SIR maintains the list of the public standards recognized by the GEO. CSR provides a centralized registry for available Earth Observation resources. The GEO clearinghouse works as a single search facility for GEOSS-wide resources and the GEO Portal provides an integrated Web-based interfaces for users. Since January 2007, researchers at CSISS, GMU have collaborated with officials from the Federal Geographic Data Committee (FGDC) on designing, implementing, maintaining, and upgrading CSR. Currently CSR provides the following capabilities for data providers: user registration, resource registration, and service interface registration. The CSR clients can discover the resources registered in CSR through OGC Catalog for Web (CSW), UUDI, and other standard interfaces. During the resource registration process, providers may define detailed descriptive information for their resources, in particular, the targeted societal benefit area and sub-areas of focus, and the targeted critical Earth Observations. The service