WorldWideScience

Sample records for retrospective chart audit

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

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    Leonard K. Katalambula

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  3. Colorectal cancer screening in patients with spinal cord injury yields similar results to the general population with an effective bowel preparation: a retrospective chart audit.

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    Teng, Brandon J; Song, Shawn H; Svircev, Jelena N; Dominitz, Jason A; Burns, Stephen P

    2018-03-01

    Retrospective chart audit. To compare adequacy of colonoscopy bowel preparation and diagnostic findings between persons with SCI receiving an extended inpatient bowel preparation and the general population. Veterans Affairs Puget Sound Healthcare System, Seattle, WA, USA. We reviewed an electronic database of all colonoscopies performed at a tertiary Veterans Affairs medical center between 7/12/13 and 15/10/15. Patients with SCI received a multi-day bowel preparation with magnesium citrate, and 8-10 liters of polyethylene glycol-3350 and electrolyte colonic lavage solution (PEG-ELS) over two and one half days. The control population received a standard bowel preparation consisting of magnesium citrate and 4 liters of PEG-ELS over 1 day. Two hundred and fifty-five patients were included in the study, including 85 patients with SCI. Average risk screening was a more common colonoscopy indication in patients with SCI vs. the control population (24 vs. 13% p = 0.03). There was no difference in adequacy of bowel preparation (87 vs. 85%, p = 0.73) or adenoma detection rate (55 vs. 51%, p = 0.59) when comparing patients with SCI with the control population. No difference in polyp histopathology was detected (p = 0.748). Our study demonstrated that an extended bowel preparation for patients with SCI produces similar bowel preparation results and diagnostic yield when compared to patients without SCI undergoing colonoscopy.

  4. CHARTE D'AUDIT INTERNE

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

    sblanchard

    30 mars 2015 ... Au CRDI, la fonction d'audit interne a pour objet de fournir des ... méthodes de gestion, de manière à fournir l'assurance raisonnable que ... explications des employés du Centre et des entrepreneurs dont il retient les services.

  5. Assessing achievement in nephrology training: using clinic chart audits to quantitatively screen competency.

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    Yuan, Christina M; Prince, Lisa K; Zwettler, Amy J; Nee, Robert; Oliver, James D; Abbott, Kevin C

    2014-11-01

    Entrustable professional activities (EPAs) are complex tasks representing vital physician functions in multiple competencies, used to demonstrate trainee development along milestones. Managing a nephrology outpatient clinic has been proposed as an EPA for nephrology fellowship training. Retrospective cohort study of nephrology fellow outpatient clinic performance using a previously validated chart audit tool. Outpatient encounter chart audits for training years 2008-2009 through 2012-2013, corresponding to participation in the Nephrology In-Training Examination (ITE). A median of 7 auditors (attending nephrologists) audited a mean of 1,686±408 (SD) charts per year. 18 fellows were audited; 12, in both of their training years. Proportion of chart audit and quality indicator deficiencies. Longitudinal deficiency and ITE performance. Among fellows audited in both their training years, chart audit deficiencies were fewer in the second versus the first year (5.4%±2.0% vs 17.3%±7.0%; PITE score less than the 25th percentile for second-year fellows (P=0.03), with no significant association for first-year fellows. Auditor-reported deficiencies declined between the first and second halves of the year (17.0% vs 11.1%; PITE and the nephrology subspecialty board examination. Published by Elsevier Inc.

  6. Chart Audit and Chart Stimulated Recall as Methods of Needs Assessment in Continuing Professional Health Education.

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    Affleck, Louise; Jennett, Penny

    1998-01-01

    Chart audit (assessment of patient medical records) is a cost-effective continuing-education needs-assessment method. Chart stimulated recall, in which physicians' memory of particular cases is stimulated by records, potentially increases content validity and exploration of clinical reasoning as well as the context of clinical decisions. (SK)

  7. Assessment of dizziness among older patients at a family practice clinic: a chart audit study

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    Pimlott Nicholas JG

    2005-01-01

    Full Text Available Abstract Background Dizziness is a common complaint among the elderly with a prevalence of over 30% in people over the age of 65. Although it is a common problem the assessment and management of dizziness in the elderly is challenging for family physicians. There is little published research which assesses the quality of dizziness assessment and management by family physicians. Methods We conducted a retrospective, chart audit study of patients with dizziness attending the Sunnybrook Family Practice Center of Sunnybrook and Women's College Health Sciences Center (SWCHSC in Toronto. We audited a random sample of 50 charts of patients from 310 eligible charts. Quality indicators across all dizziness subtypes were assessed. These quality indicators included: onset and course of symptoms; symptoms in patients' own words; number of medications used; postural blood pressure changes; symptoms of depression or anxiety; falls; syncope; diagnosis; outcome; specialty referrals. Quality indicators specific to each dizziness subtype were also audited. Results 310 charts satisfied inclusion criteria with 20 charts excluded and 50 charts were randomly generated. Documentation of key quality indicators in the management of dizziness was sub-optimal. Charts documenting patients' dizziness symptoms in their own words were more likely to have a clinical diagnosis compared to charts without (P = 0.002. Conclusions Documentation of selected key quality indicators could be improved, especially that of patients' symptoms in their own words.

  8. User compliance with documenting on a track and trigger-based observation and response chart: a two-phase multi-site audit study.

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    Elliott, Doug; Allen, Emily; McKinley, Sharon; Perry, Lin; Duffield, Christine; Fry, Margaret; Gallagher, Robyn; Iedema, Rick; Roche, Michael

    2017-12-01

    To examine user compliance and completeness of documentation with a newly designed observation and response chart and whether a rapid response system call was triggered when clinically indicated. Timely recognition and responses to patient deterioration in hospital general wards remain a challenge for healthcare systems globally. Evaluating practice initiatives to improve recognition and response are required. Two-phase audit. Following introduction of the charts in ten health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1; 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2; 2012). Overall, 818 and 1,058 charts were audited during the two phases respectively. Compliance was mixed but improved with the new chart (4%-14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart. User compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  9. Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME competency in practice-based learning and improvement

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    Patel Sangnya

    2007-07-01

    Full Text Available Abstract Background The Accreditation Council on Graduate Medical Education (ACGME supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. Methods A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin from the charts of patients followed by their physician peers. No formal feedback or education was provided. Results Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33% (p = 0.001, 26% (from 45% to 71% (p Conclusion Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.

  10. Separation from supported employment: a retrospective chart review study.

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    West, Michael; Targett, Pamela; Wehman, Paul; Cifu, Gabriella; Davis, Jacob

    2015-01-01

    The objective of this study was to examine job separations from supported employment (SE). The aim was to identify the types and nature of separations and precipitating events leading to the separation. A retrospective chart review methodology was utilized. The study was conducted in a metropolitan area in the Southeast United States by a university-based SE program. Participants were 47 SE clients who had been placed into and separated from 67 jobs. Using a coding form, information regarding the type of separation and issues that preceded the separation were recorded. Data were aggregated using descriptive statistics. The largest number of separations was due to termination, followed by resignation and mutual consent of the employer and employee. The mean number of issues leading to the separation was 2.2, ranging from one to five. Only eight positive issues were found (compared to 116 negative and 20 neutral), the most prevalent being entry into an educational or training program. Common negative issues included poor work performance, attendance and punctuality problems, conflicts with the supervisor, and social and behavioral issues. The findings of this study illustrate the need to address job retention issues during the job development process, finding the most appropriate person-job fit and workplace culture for each client. The findings also support the need for vigilant and regular communication between the SE program and employers to intervene quickly when problems arise. Separation from Supported Employment (SE) SE is an evidence-based employment practice that has been shown effective across multiple disability groups. Studying job separations can provide valuable information for improving service. Locating the best person-job fit, as well as frequent contract with employers, can help prevent unnecessary job loss.

  11. CREATING AND AUDITING A NEW ELECTRONIC CONTINUOUS INFUSION PRESCRIPTION CHART FOR A PAEDIATRIC CRITICAL CARE UNIT.

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    Siu, Emily; Sadasivam, Kalaimaran; Christiansen, Nanna

    2016-09-01

    Prescription errors, including continuous infusion prescriptions are one major source of concern in the paediatric population. Evidence suggests that use of an electronic or web-based calculator could minimise these errors. In our paediatric critical care unit (PCCU) we have created an electronic continuous infusion prescription chart to target errors in this area and conducted an audit to assess its effect on error reduction. To create an electronic continuous infusion prescription chart and audit its effect on prescription errors. Similar electronic continuous infusion prescription charts were evaluated. A Choice of electronic formats were considered and excel was chosen for its simplicity and flexibility. The choice of medications to be included, dilution method, and dosage range was agreed between PCCU consultant, pharmacy and nursing staff. Formulas for calculating each medication infusion was created and validated for different age and weight ranges by at least 2 PCCU trained pharmacists, accounting for capping at certain age and weight bands as appropriate for the medication. These were programmed into the spreadsheet for automatic calculation using inputted age and weight for the selected medications. Continuous infusion prescriptions were audited 6 months before and after implementation in April 2015 of this electronic chart. Parameters audited include medication dose, infusion rate, concentration, route, legibility, and missing or incorrect patient details. A trial period of 4 weeks preceded implementation. The electronic continuous infusion prescription form was created and used on PCCU. Hand written prescriptions had higher error rate (30.7%) as compared to electronic charts (0.7%) with a p-value <0.002. No errors were found in electronic prescriptions in regards to dose, volume and rate calculation. The use of an electronic continuous infusion prescription chart has been successfully set up and used on PCCU. Its use has significantly reduced continuous

  12. Are primary care practitioners in Barbados following hypertension guidelines? - a chart audit

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    Carter Anne O

    2010-11-01

    Full Text Available Abstract Background About 55% of the population 40 to 80 years of age in Barbados is hypertensive. The quality of hypertension primary care compared to available practice guidelines is uncertain. Findings Charts of hypertensive and diabetic patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all hypertensive patients ≥ 40 years of age were then selected and processes of care and blood pressure (BP maintenance 343 charts of hypertensive patients (170 public, and 173 private were audited. Patients had the following characteristics: mean age 64 years, female gender 63%, mean duration of diagnosis 9.1 years, and diabetes diagnosed 58%. Patients had an average of 4.7 clinic visits per year, 70% were prescribed a thiazide diuretic, 42% a calcium channel blocker, 40% an angiotensin receptor blocker, and 19% a beta blocker. Public patients compared to private patients were more likely to be female (73% vs. 52%, p Conclusions Improvements are needed in following guidelines for basic interventions such as body mass assessment, accurate BP measurement, use of thiazide diuretics and lifestyle advice. BP control is inadequate.

  13. Tuberculosis in Far North Queensland, Australia: a retrospective clinical audit.

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    Wilson, Malcolm; Weston, Jana; Mullen, Annette; Knight, Trevor; Simpson, Graham

    2018-06-05

    Compared with global numbers, Australia has enjoyed relatively good tuberculosis control over the last thirty years with an annual incidence of 5.7 per 100,000 population. 1 Thanks to its unique geography and proximity to high-burden countries, such as Papua New Guinea (PNG), Far North Queensland (FNQ) has previously been shown to have higher rates of tuberculosis compared with both the state and national average. 2,3 AIMS: Document tuberculosis epidemiology in FNQ with comparison to two previous audits of the region. Retrospective clinical audit of all cases of tuberculosis notified to the Cairns Tuberculosis Control Unit between 2006 and 2016. 453 cases were identified, 374 with microbiological/histological confirmation. There were 312 cases of pulmonary tuberculosis; 155 extra-pulmonary; and 21 disseminated. Three-quarters (327/453) were identified in the overseas-born population. Of the remaining 126 cases, 40 were Torres Strait Islander and 19 Aboriginal Australians. Where drug susceptibility was known, two-thirds (247/368) were fully sensitive; 42 mono-resistant; 78 multidrug-resistant; and one extensively drug resistant. Rates of HIV co-infection were less than three percent (10/362). Tuberculosis remains a significant problem in FNQ. Case numbers have increased three-fold since the 1990s. Much of the increase comes from the overseas-born population. Although PNG accounts for the majority, the number of positive notifications amongst those born elsewhere abroad has increased five-fold since 2010. Tuberculosis amongst Aboriginal Australians has decreased following policy changes in response previous audits. Tuberculosis in Torres Strait residents, however, has increased from 12 cases (1993-2002) to 40 (2006-2016). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Monitoring Compliance to Promote Quality Assurance: Development of a Mental Health Clinical Chart Audit Tool in Belize, 2013.

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    Winer, Rachel A; Bennett, Eleanor; Murillo, Illouise; Schuetz-Mueller, Jan; Katz, Craig L

    2015-09-01

    Belize trained psychiatric nurse practitioners (PNPs) in the early 1990s to provide mental health services throughout the country. Despite overwhelming success, the program is limited by lack of monitoring, evaluation, and surveillance. To promote quality assurance, we developed a chart audit tool to monitor mental healthcare delivery compliance for initial psychiatric assessment notes completed by PNPs. After reviewing the Belize Health Information System electronic medical record system, we developed a clinical audit tool to capture 20 essential components for initial assessment clinical notes. The audit tool was then piloted for initial assessment notes completed during July through September of 2013. One hundred and thirty-four initial psychiatric interviews were audited. The average chart score among all PNPs was 9.57, ranging from 3 to 15. Twenty-three charts-or 17.2%-had a score of 14 or higher and met a 70% compliance benchmark goal. Among indicators most frequently omitted included labs ordered and named (15.7%) and psychiatric diagnosis (21.6%). Explicit statement of medications initiated with dose and frequency occurred in 47.0% of charts. Our findings provide direction for training and improvement, such as emphasizing the importance of naming labs ordered, medications and doses prescribed, and psychiatric diagnoses in initial assessment clinical notes. We hope this initial assessment helps enhance mental health delivery compliance by prompting creation of BHIS templates, development of audits tools for revisit follow-up visits, and establishment of corrective actions for low-scoring practitioners. These efforts may serve as a model for implementing quality assurance programming in other low resource settings.

  15. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

    OpenAIRE

    Mosam Phirke; Harshal Sathe; Nilesh Shah; Sushma Sonavane; Anup Bharati; Avinash DeSousa

    2015-01-01

    Background: Electroconvulsive therapy (ECT) is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014...

  16. Goal planning: a retrospective audit of rehabilitation process and outcome.

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    Duff, Jane; Evans, Matthew J; Kennedy, Paul

    2004-05-01

    To consider the effectiveness of a goal planning programme for people with spinal cord injury (SCI) and address some of the current evidence gaps in goal setting. Retrospective audit. Consecutive series of 65 newly injured SCI patients. The Needs Assessment Checklist (NAC) has been specifically developed for the SCI population, and is used to assess patient attainment in core rehabilitation areas. A 'Goal Planning Progress' form was also used to specifically detail the goal planning process. Across the 65 patients, 396 goal planning meetings were held with 6176 goals set in total. Seventy-two per cent of the goals set at the first goal planning meeting were achieved by the second meeting. The rate of achievement at subsequent meetings was 68%. Significant differences in the number of planned rehabilitation days, number of goal planning meetings, and goals set were identified between injury categories. Significant positive correlations were found between the number of goals set and achievement, as measured by the NAC, in certain rehabilitation domains. The findings of this study demonstrate that the Needs Assessment and Goal Planning framework is effective in planning SCI rehabilitation. The capacity of this goal planning system to reflect individual need has also been established. Further systematic analyses of this process could potentially lead to more efficient rehabilitation and the identification of care pathways within clinical areas.

  17. Inaccurate Dental Charting in an Audit of 1128 General Dental Practice Records.

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    Brown, Nathan L; Jephcote, Victoria E L

    2017-03-01

    Fourteen dentists at different practices in the UK assessed the dental charts of 1128 patients who were new to the dentist but not new to the practice; 44% of the dental charts were found to be inaccurate. Inaccuracy of the individual practice-based charts ranged between 16% for the best performing practices to 83% for the worst: 5% of dental charts had too many teeth charted and 5% had too few teeth charted; 13% of charts had missed amalgam restorations and 18% had missed tooth-coloured restorations; 5% of charts had amalgam restorations recorded but with the surfaces incorrect (eg an MO restoration charted but a DO restoration actually present); 9% of charts had tooth-coloured restoration surfaces incorrectly recorded. For 7.5% of charts, amalgams were charted but not actually present. Other inaccuracies were also noted. The authors reinforce the requirements of the GDC, the advice of defence organizations, and the forensic importance of accurate dental charts. Clinical relevance: Dental charting forms part of the patient’s dental records, and the GDC requires dentists to maintain complete and accurate dental records.

  18. Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study.

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    Reissing, Elke D; Armstrong, Heather L; Allen, Caroline

    2013-01-01

    Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation.

  19. Timing of Physical Therapy Referral in Adolescent Athletes With Acute Spondylolysis: A Retrospective Chart Review.

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    Selhorst, Mitchell; Fischer, Anastasia; Graft, Kristine; Ravindran, Reno; Peters, Eric; Rodenberg, Richard; Welder, Eric; MacDonald, James

    2017-05-01

    The purposes of this study were (1) to determine whether the duration of rest before referral to physical therapy (PT) affects the time to make a full return to activity for patients with an acute spondylolysis, (2) to assess the safety of an early referral to PT in patients with an acute spondylolysis. Retrospective chart review. Hospital-based sports medicine clinic. The medical charts of 196 adolescent athletes (mean age = 14.3 ± 1.8 years) with an acute spondylolytic injury met the inclusion criteria and were reviewed. Patients were subgrouped based on physician referral to PT. An aggressive referral group (10 weeks). Duration of rest before clearance to a full return to activity and the frequency of adverse reactions during the course of treatment. Safety was assessed by calculating the risk of experiencing an adverse reaction in each group. Median days to a full return to activity for aggressive referral group (115.5 days, interquartile range 98-150 days) and conservative referral group (140.0 days, interquartile range 114.5-168 days) were significantly different (P = 0.002). Eleven patients had adverse reactions during the course of treatment. The risk of adverse reaction was not statistically significant between groups (P = 0.509). Patients with acute spondylolysis in the aggressive referral group were able to make a full return activity almost 25 days sooner. No differences in the risk of adverse reactions were noted between aggressive and conservative referral groups.

  20. The effect of rapid response teams on end-of-life care: A retrospective chart review

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    Tam, Benjamin; Salib, Mary; Fox-Robichaud, Alison

    2014-01-01

    BACKGROUND: A subset of critically ill patients have end-of-life (EOL) goals that are unclear. Rapid response teams (RRTs) may aid in the identification of these patients and the delivery of their EOL care. OBJECTIVES: To characterize the impact of RRT discussion on EOL care, and to examine how a preprinted order (PPO) set for EOL care influenced EOL discussions and outcomes. METHODS: A single-centre retrospective chart review of all RRT calls (January 2009 to December 2010) was performed. The effect of RRT EOL discussions and the effect of a hospital-wide PPO set on EOL care was examined. Charts were from the Ontario Ministry of Health and Long-Term Care Critical Care Information Systemic database, and were interrogated by two reviewers. RESULTS: In patients whose EOL status changed following RRT EOL discussion, there were fewer intensive care unit (ICU) transfers (8.4% versus 17%; PEOL status following the introduction of an EOL PPO, from 20% (before) to 31% (after) (PEOL status following RRT-led EOL discussion was associated with reduced ICU transfers and enhanced access to palliative care services. Further study is required to identify and deconstruct barriers impairing timely and appropriate EOL discussions. PMID:25299222

  1. Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients – a retrospective chart review

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    Yiotakis Ioannis E

    2009-08-01

    Full Text Available Abstract Background The aim of this study is to assess the functional and oncologic results of supracricoid hemilaryngopharyngectomy and report our experience in the technique, local control and overall survival rates. Materials and methods 18 selected patients with pyriform sinus cancer treated by supracricoid hemilaryngopharyngectomy in a University Hospital setting. Retrospective chart review was used to assess functional and oncologic results of the procedure. Results The actuarial 5 year survival rate in our study was 55.56% and the actuarial neck recurrence rate was 16.67%. All patients were successfully decannulated. Aspiration pneumonia was the most common postoperative complication (22.23% and was treated mostly conservatively. One patient required a temporary gastrostomy but no patient needed total laryngectomy in the postoperative period. Conclusion Supracricoid hemilaryngopharyngectomy in experienced hands is a reliable technique for selected patients with pyriform sinus cancer.

  2. Methadone for the treatment of Prescription Opioids Dependence. A retrospective chart review.

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    Barrio, Pablo; Ezzeldin, Mohamed; Bruguera, Pol; Pérez, Ana; Mansilla, Sara; Fàbrega, Marina; Lligoña, Anna; Mondón, Sílvia; Balcells, Mercè

    2016-06-14

    Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample. Eleven patients were included, mostly women (81.8%), with a median age of 50 years. The median duration of dependence was 8 years. Dependence on other substances and psychiatric comorbidities were high. Eight patients were monitored during three months. Of these, 7 (87.5%) were abstinent after that period. The results suggest that methadone deserves further exploration as a potentially efficacious treatment option for PO dependence.

  3. Are primary care practitioners in Barbados following diabetes guidelines? - a chart audit with comparison between public and private care sectors

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    Carter Anne O

    2011-06-01

    Full Text Available Abstract Background Over 19% of the population ≥ 40 years of age in Barbados are diabetic. The quality of diabetes primary care is uncertain. Findings Charts of diabetic and hypertensive patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all diabetic patients ≥ 40 years of age were then selected. Processes of care, and quality targets for blood pressure (BP, fasting blood glucose (FBG and glycosylated haemoglobin (HbA1c were documented. 252 charts of diabetic patients (125 public and 127 private were audited. Patients had the following characteristics: mean age 64 years, female gender 61%, mean duration of diagnosis 9 years, and hypertension diagnosed 78%. Patients had an average of 4.7 clinic visits per year, 66% were prescribed metformin, 68% a sulphonylurea, 25% a statin, 21% insulin, 15% aspirin and 12% a glucosidase inhibitor. Public patients compared to private patients were more likely to be female (77% vs. 46%, p Conclusions Interventions such as body mass assessment, lifestyle advice, screening for retinopathy, monitoring blood glucose control, and achieving BP and glycaemic targets need improvement.

  4. Gender Variance Among Youth with Autism Spectrum Disorders: A Retrospective Chart Review.

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    Janssen, Aron; Huang, Howard; Duncan, Christina

    2016-01-01

    Purpose: Increasing clinical evidence suggests an overrepresentation of gender variance (GV) among patients with autism spectrum disorders (ASDs). This retrospective chart review aims to contribute to the existing literature on co-occurring ASD and gender dysphoria (GD). We compare the rate of parent-reported GV in patients with an ASD diagnosis to that of parent-reported GV in a normative nonreferred data set. Methods: Child Behavior Checklist (CBCL) charts were collected from 492 children and adolescents (409 natal males and 83 natal females) aged 6-18 years who have received a diagnosis of ASD at the New York University Child Study Center. Parent-reported GV was determined through endorsement of CBCL sex item 110, which assesses the presence of gender-related issues. We calculated the odds ratio of endorsement of item 110 between our ASD sample and the CBCL sample data. Results: The subjects diagnosed with ASD were 7.76 times more likely to report GV than the CBCL sample. This finding was statistically significant. About 5.1% of the patients in the ASD group and 0.7% of the CBCL nonreferred group endorsed sex item 110. 5.1% of natal males and 4.8% of natal females endorsed sex item 110. Neither gender nor age influenced the rate of endorsement. Conclusion: This finding supports the growing research suggesting a heightened co-occurrence rate of ASD and GD. Focus should be placed upon improving our understanding of the nature of this co-occurrence and on gender identity development within the atypical development of ASD.

  5. "Waiting for DAAs": A retrospective chart review of patients with untreated hepatitis C in Rwanda.

    Directory of Open Access Journals (Sweden)

    Neil Gupta

    Full Text Available Access to treatment for hepatitis C virus (HCV in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs, highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs.We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65, and 149 (58.9% were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09-1.17, but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus.Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub-Saharan Africa.

  6. A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

    Directory of Open Access Journals (Sweden)

    Carl Magnus Sköld

    2016-07-01

    Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

  7. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Cindy L. Lamerson

    2012-01-01

    Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  8. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

    Directory of Open Access Journals (Sweden)

    Mosam Phirke

    2015-01-01

    Full Text Available Background: Electroconvulsive therapy (ECT is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014, and it was observed that 23 elderly patients (aged ≥60 years had received ECT. Results: The patients received modified bitemporal ECT using a brief pulse ECT machine and had no major complications. A total of 184 ECT treatments were administered at an average of 8 treatments per case. The major diagnoses of patients were schizophrenia and major depression. The main indications of ECT were intolerance to medication, suicidal behavior and aggression. Out of the 23 elderly patients, 18 (78.26% showed a good response to ECT. The only complication noted was memory loss and confusion in 3 cases. Patients with medical illnesses like hypertension, diabetes and both together received ECT without any complications. Conclusions: This study adds to the scarce database on the use of ECT in elderly patients in India and adds evidence to the fact that ECT is a safe and effective treatment in the elderly.

  9. Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

    Science.gov (United States)

    Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

    2013-04-01

    Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

  10. Participation restriction in childhood phenotype of myotonic dystrophy type 1: a systematic retrospective chart review.

    Science.gov (United States)

    Gagnon, Cynthia; Kierkegaard, Marie; Blackburn, Catherine; Chrestian, Nicolas; Lavoie, Mélissa; Bouchard, Marie-Frédéric; Mathieu, Jean

    2017-03-01

    Myotonic dystrophy type 1 (DM1), a neuromuscular disorder, is divided into four clinical phenotypes: congenital; childhood; adult-onset, and late-onset. Publications about the childhood phenotype, especially the long-term outcome, are scarce. The aims of this study were to assess and describe participation outcomes in adults with the childhood phenotype. A retrospective chart methodology. Data were extracted from health records for 63 adults with childhood DM1 (32 males, 31 females; mean age 34y, standard deviation [SD] 11y 6mo; range 18-54y) who had attended the Saguenay Neuromuscular Clinic, Canada. Thirty-four adults (54%) lived with their parents or in foster homes, and most patients needed services or help to live independently. A significant proportion (22%) were isolated in regard to friendship. Very few adults had children, although 33% lived with a spouse. The majority of patients (86%) relied on social security and only one person was currently working. Financial responsibilities were often an issue and 13 (21%) were under legal guardianship. This study showed that patients with the childhood phenotype present a guarded prognosis regarding long-term social participation. These participation restrictions could be related to behavioural, cognitive, and social stigma problems in childhood. This study illustrates the absolute necessity to pursue an interdisciplinary follow-up of these patients when they are reaching adulthood. © 2016 Mac Keith Press.

  11. A Retrospective Chart Review of 10 Hz Versus 20 Hz Repetitive Transcranial Magnetic Stimulation for Depression

    Directory of Open Access Journals (Sweden)

    Kristie L. DeBlasio

    2012-12-01

    Full Text Available We performed a retrospective chart review to examine the progress of patients with depression who received different frequencies of repetitive transcranial magnetic stimulation (rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC. rTMS is a safe and effective alternative treatment for patients with various psychological and medical conditions. During treatment, a coil delivering a time-varying magnetic pulse placed over the scalp penetrates the skull, resulting in clinical improvement. There were 47 patients and three distinct treatment groups found: 10 Hz, 20 Hz, and a separate group who received both frequencies (10/20 Hz. The primary outcome indicator was the difference in Beck Depression Inventory–II (BDI-II scores. Secondary outcomes included categorical indicators of remission, response, and partial response rates as assessed with the BDI-II. In all 3 groups, the majority of patients had depression that remitted, with the highest rate occurring in the 20 Hz group. There were similar response rates in the 10 Hz and 20 Hz groups. There were no patients in the 10/20 Hz group whose depression responded and the highest partial response and nonresponse rates occurred in this group. Although within-group differences were significant from baseline to end of treatment, there were no between-group differences.

  12. A Retrospective Chart Review of Contraceptive Use among Adolescents with Opioid Use Disorder.

    Science.gov (United States)

    Handy, Caitlin J; Lange, Hannah L H; Manos, Brittny E; Berlan, Elise D; Bonny, Andrea E

    2018-04-01

    To describe contraceptive use among female adolescents initiating outpatient treatment for opioid use disorder. Retrospective chart review. Outpatient clinic providing medication-assisted treatment for substance use disorders to adolescents and young adults. Nonpregnant female adolescents who presented for treatment from January 1, 2013 to January 31, 2016 (N = 123). None. Prescription contraceptive use at baseline and initiation of a new method within 90 days. Of 123 female adolescents who presented for treatment of opioid use disorder, 113 (91.9%) reported sexual activity and 80 (65.0%) were not using prescription contraception at intake. Previous pregnancy was reported by 43 (35.0%) and 20 (16.3%) were positive for a sexually transmitted infection. Contraceptive counseling was not documented for 73 (59.3%) patients. Among patients with no prescription contraception at baseline, 56 of 80 (70.0%) initiated a method within the study window. Significant predictors (odds ratio [OR]; 95% confidence interval) of contraceptive initiation included previous pregnancy (8.6; 1.39-52.99), education of less than a high school diploma/general equivalency diploma (7.4; 1.63-33.41), and return for follow-up visit (9.8; 2.18-43.69). Young women who presented for opioid use disorder treatment were at high risk of adverse reproductive health outcomes. Most were sexually active and not using prescription contraception. Findings underscore the need for contraceptive counseling in this patient population. Optimally, these services would be provided in conjunction with substance use treatment. Improved contraceptive counseling documentation will allow evaluation of effective contraceptive counseling strategies for adolescents with opioid use disorders and might serve to inform future interventions. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  13. Transversus abdominis plane block in renal allotransplant recipients: A retrospective chart review.

    Science.gov (United States)

    Gopwani, S R; Rosenblatt, M A

    2016-01-01

    The efficacy of the transversus abdominis plane (TAP) block appears to vary considerably, depending on the surgical procedure and block technique. This study aims to add to the existing literature and provide a more clear understanding of the TAP blocks role as a postoperative analgesic technique, specifically in renal allotransplant recipients. A retrospective chart review was conducted by querying the intraoperative electronic medical record system of a 1200-bed tertiary academic hospital over a 5 months period, and reviewing anesthetic techniques, as well as postoperative morphine equivalent consumption. Fifty renal allotransplant recipients were identified, 13 of whom received TAP blocks while 37 received no regional analgesic technique. All blocks were performed under ultrasound guidance, with 20 mL of 0.25% bupivacaine injected in the transversus abdominis fascial plane under direct visualization. The primary outcome was postoperative morphine equivalent consumption. Morphine consumption was compared with the two-tailed Mann-Whitney U -test. Continuous variables of patient baseline characteristics were analyzed with unpaired t -test and categorical variables with Fischer Exact Test. A P consumption was found in the group that received the TAP block at 6 h (2.46 mg vs. 7.27 mg, P = 0.0010), 12 h (3.88 mg vs. 10.20 mg, P = 0.0005), 24 h (6.96 mg vs. 14.75 mg, P = 0.0013), and 48 h (11 mg vs. 20.13 mg, P = 0.0092). The TAP block is a beneficial postoperative analgesic, opiate-sparing technique in renal allotransplant recipients.

  14. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Slothower Molly P

    2006-08-01

    Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

  15. Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Correia-Melo FS

    2017-06-01

    Full Text Available Fernanda S Correia-Melo,1 Felipe C Argolo,1 Lucas Araújo-de-Freitas,1,2 Gustavo Carneiro Leal,1 Flávio Kapczinski,3 Acioly Luiz Lacerda,4 Lucas C Quarantini1,2 1Psychiatry Service, University Hospital, Federal University of Bahia, Salvador, Brazil; 2Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; 3Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Background: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015. The Montgomery–Åsberg Depression Rating Scale (MADRS was administered to measure and score depressive symptom severity before infusion and at 24 hours, 72 hours, and 7 days after infusion. In addition, Clinical Global Impression scale was administered before and 7 days after esketamine infusion.Results: Esketamine was administered to 30 patients. A total of 27 patients met the inclusion criteria and had MADRS evaluation data, which showed that 23 had unipolar and 4 had bipolar depression. Thirteen patients (48.1% showed therapeutic response (MADRS reduction ≥50% within 1 week (7 days of intervention. Remission (MADRS <7 was observed in 10 patients (37.0% in the same period. Therapeutic response and remission frequencies were seen in 16 (59.3% and 11 (40.7% patients, respectively, within 24 hours following drug infusion. The most relevant side effect observed during

  16. Retrospective audit of patients presenting to our department for venoscintigraphy

    International Nuclear Information System (INIS)

    Kotze, T.; Perumal, N.S.; Vangu, M.D.T.H.W.

    2004-01-01

    Objective: Though a number of studies have attempted to list the risk factors for DVT, there seems to be paucity of information relating to patients in Africa. We realized that a number of patients referred to our department for venoscintigraphy have concomitant tuberculosis and retroviral disease. Therefore, we decided to assess the possible relationship between DVT and the above-mentioned concomitant diseases. Method: A retrospective study of all patients referred for venous scintigraphy of the lower limbs in 2003 was done. Data from 160 patients was available for analysis. We looked at patient age and gender as well as the incidence of concurrent tuberculosis and retro-viral disease. The results are presented in a table. The remaining patients have shown either chronic venous disease or equivocal results. Conclusion: Tuberculosis and retroviral disease may be contributing risk factors in our population. (author)

  17. Cytopathology practice in Kumasi: A 2-year retrospective audit

    Directory of Open Access Journals (Sweden)

    Babatunde M Duduyemi

    2017-01-01

    Full Text Available Aim: Surgical pathology service is generally unavailable in most developing countries and comes with challenges. Cytopathology is a reliable, inexpensive adjunct to surgical histopathology. We present a retrospective review of the various cytopathology cases received at the department. Materials and Methods: A retrospective review of 836 cytopathology cases from January 2010 to December 2011 at the Department of Pathology of our hospital was conducted. All cytopathology reports and records from the department were retrieved and analyzed using the Statistical Package for the Social Sciences version 16 for windows. Results: A total of 836 (mean age 38.18 ± 22.18 cases were reviewed, at an average of approximately 418 cases performed a year (5.7% of the total workload. More than half (58.0% of the cases received had no clinical diagnosis indicated on request forms. Seventy-seven percent (77% of the cases were diagnosed as either definite or nondefinite. The breast was the most aspirated specimen site (20.2%. Benign cases formed 45.0% of all the cases and 29.0% were malignant. There were more benign than malignant cases with respect to all sites aspirated except the breast (18.3%, lymph nodes (35.0%, and soft tissues (11.7% where the reverse occurred. Conclusion: Patronage of cytopathology in Kumasi is increasing and serves as a quick, cheap, and effective alternate means for diagnosis. Improving and expanding on the current practice will ensure that pathologists in practice sustain and improve diagnostic cytopathology and provide material for training young pathologists.

  18. Maternal death audit in Rwanda 2009-2013: a nationwide facility-based retrospective cohort study.

    Science.gov (United States)

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-22

    Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Nationwide facility-based retrospective cohort study. All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. 987 audited cases of maternal death. Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to

  19. Chloral hydrate sedation in radiology: retrospective audit of reduced dose

    International Nuclear Information System (INIS)

    Bracken, Jennifer; Heaslip, Ingrid; Ryan, Stephanie

    2012-01-01

    Chloral hydrate (CH) is safe and effective for sedation of suitable children. The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses. We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose. In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P 1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen. We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival. (orig.)

  20. Chloral hydrate sedation in radiology: retrospective audit of reduced dose

    Energy Technology Data Exchange (ETDEWEB)

    Bracken, Jennifer [Children' s University Hospital, Radiology Department, Dublin (Ireland); Royal Children' s Hospital, Department of Medical Imaging, Parkville, Victoria (Australia); Heaslip, Ingrid; Ryan, Stephanie [Children' s University Hospital, Radiology Department, Dublin (Ireland)

    2012-03-15

    Chloral hydrate (CH) is safe and effective for sedation of suitable children. The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses. We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose. In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P < 0.001). Sedation was successful in 96.7%, and more frequently successful in infants (98.3%) than children >1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen. We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival. (orig.)

  1. Audit

    OpenAIRE

    1991-01-01

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

  2. Retrospective chart review of obesity and episodic and chronic illness among rural Mexican-American adolescents accessing rural health clinic services.

    Science.gov (United States)

    Champion, Jane Dimmitt; Pierce, Sherrie; Collins, Jennifer L

    2015-06-01

    Obesity impacts the physical and psychological health of children and adolescents, and is a risk factor for development of episodic and chronic illness. Rural Mexican-American adolescents are at risk for obesity and associated chronic illnesses.The study used a retrospective chart review of data collected routinely in a rural health clinic setting from 1 January 2005 to 31 December 2010 to assess incidence of overweight/obesity status and episodic or chronic illness among Mexican-American adolescents aged 12-18 years. Analyses included body mass index, age, gender, and episodic or chronic illness diagnoses. Two hundred twelve charts were audited; women (n = 114, 53.8%), men (n = 98 46.2%); normal (n = 105, 49.5%), overweight/obese (n = 107, 50.5%). There were more female normal (n = 61, 53.5%) vs. overweight/obese (n = 53, 46.5%). More male overweight/obese (n = 54, 55.1%) than normal weight (n = 44, 44.9%). Age at first documented overweight/obesity status occurred in early adolescence (median = 13 years, mode = 12 years). Chronic illness incidence was higher among men than women, and overweight/obese vs. normal weight adolescents and in sub-categorizations by weight and specific illness. Incidence of episodic illness was higher among women than men, with variation by weight and specific illness. Disproportionately high incidence of episodic or chronic illness and overweight/obesity identified among rural Mexican-American adolescents compels intervention modification to improve effectiveness. © 2014 Wiley Publishing Asia Pty Ltd.

  3. A retrospective chart study: The pathway to a diagnosis for adults referred for ASD assessment

    NARCIS (Netherlands)

    Geurts, H.M.; Jansen, M.D.

    2012-01-01

    Charts of 125 adults (18 to 82 years), referred to an autism expert team for Autism Spectrum Disorder (ASD) assessment, were reviewed to explore the pathway to an adulthood ASD diagnosis. The participants first contacted the mental health care clinic at a median age of 19 years (range 2 to 78

  4. Microcytosis and possible early iron deficiency in paediatric inpatients: a retrospective audit

    Directory of Open Access Journals (Sweden)

    Kitson Sarah

    2009-05-01

    Full Text Available Abstract Background Iron deficiency anaemia is a common paediatric problem worldwide, with significant neurodevelopmental morbidity if left untreated. A decrease in the mean corpuscular volume (MCV can be used as a surrogate marker for detecting early iron deficiency prior to definitive investigation and treatment. An audit cycle was therefore undertaken to evaluate and improve the identification, follow-up and treatment of abnormally low MCV results amongst the paediatric inpatients in an English district general hospital. Methods The audit cycle was performed retrospectively over two three-month periods (February to April 2006; September to November 2006, amongst patients aged between one month and 16 years that had full blood counts performed whilst admitted on the paediatric ward. Patients with at least one abnormally low MCV result were identified, and their notes reviewed. We looked for any underlying explanation for the result, adequate documentation of the result as abnormal, and instigation of follow-up or treatment. In-between the two audit periods, the results of the first audit period were presented to the medical staff and suggestions were made for improvements in documentation and follow-up of abnormal results. The z-test was used to test for equality of proportions between the two audit samples. Results Out of 701 inpatients across both audit periods that had full blood counts, 61 (8.7% had a low MCV result. Only 15% of patients in each audit period had an identifiable explanation for their low MCV values. Amongst the remaining 85% with either potentially explicable or inexplicable results, there was a significant increase in documentation of results as abnormal from 25% to 91% of cases between the first and second audit periods (p = 0.00 using z-test. However, there was no accompanying increase in the proportion of patients who received follow-up or treatment for their abnormal results. Conclusion Abnormal red cell indices that

  5. CHARTED'AUDIT INTERNE

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

    KPMG

    excellence l'anime dans toutes ses sphères d'activité, à savoir la programmation, la dotation, la gestion et la gouvernance. Par ailleurs, le CRDI est résolu à respecter les normes les plus rigoureuses en matière de reddition de comptes ...

  6. A 5-year retrospective audit of prescribing by a critical care outreach team.

    Science.gov (United States)

    Wilson, Mark

    2018-05-01

    UK prescribing legislation changes made in 2006 and 2012 enabled appropriately qualified nurses to prescribe any licensed medication, and all controlled drugs in schedule 2-5 of the Misuse of Drugs Regulations 2001, for any medical condition within their clinical competence. Critical Care Outreach nurses who are independent nurse prescribers are ideally placed to ensure that acutely ill patients receive treatment without delay. The perceived challenge was how Critical Care Outreach nurses would be able to safely prescribe for a diverse patient group. This study informs this developing area of nurse prescribing in critical care practice. The aims of the audit were to: identify which medications were prescribed; develop a critical care outreach formulary; identify the frequency, timing and number of prescribing decisions being made; identify if prescribing practice changed over the years and provide information for our continuing professional development. This article reports on data collected from a 5-year retrospective audit; of prescribing activity undertaken by nine independent nurse prescribers working in a 24/7 Critical Care Outreach team of a 600-bedded district general hospital in the UK. In total, 8216 medication items were prescribed, with an average of 2·6 prescribed per shift. The most commonly prescribed items were intravenous fluids and analgesia, which were mostly prescribed at night and weekends. The audit has shown that Critical Care Outreach nurse prescribing is feasible in a whole hospital patient population. The majority of prescribing occurred after 16:00 and at night. Further research would be beneficial, particularly looking at patient outcomes following reviews from prescribing critical care outreach nurses. The audit is one of the only long-term studies that describes prescribing practice in Critical Care Outreach teams in the UK. © 2017 British Association of Critical Care Nurses.

  7. Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective Audit

    Directory of Open Access Journals (Sweden)

    Katy Robjant

    2017-06-01

    Full Text Available BackgroundHuman trafficking is a form of modern slavery that involves the forced movement of people internally within countries, or externally across borders. Victims who are trafficked for sexual exploitation are subject to repeated, multiple trauma, and high rates of mental health problems including posttraumatic stress disorder (PTSD have been found. Narrative exposure therapy (NET is an evidence-based treatment for PTSD.MethodsIn this retrospective audit, we record the results of NET to treat 10 women who had been trafficked for sexual exploitation who were diagnosed with PTSD.ResultsAll 10 women completed the therapy and experienced a reduction in PTSD severity scores at posttreatment, with improvements that were maintained or further improved at 3-month follow-up. General distress was also significantly reduced following treatment.ConclusionAlthough limited by sample size and retrospective design, this audit demonstrates that NET is a feasible treatment for PTSD in this population and warrants further evaluation in a randomized controlled trial. Further adjunctive interventions may also be necessary to treat the additional psychological problems experienced by this population.

  8. Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective Audit.

    Science.gov (United States)

    Robjant, Katy; Roberts, Jackie; Katona, Cornelius

    2017-01-01

    Human trafficking is a form of modern slavery that involves the forced movement of people internally within countries, or externally across borders. Victims who are trafficked for sexual exploitation are subject to repeated, multiple trauma, and high rates of mental health problems including posttraumatic stress disorder (PTSD) have been found. Narrative exposure therapy (NET) is an evidence-based treatment for PTSD. In this retrospective audit, we record the results of NET to treat 10 women who had been trafficked for sexual exploitation who were diagnosed with PTSD. All 10 women completed the therapy and experienced a reduction in PTSD severity scores at posttreatment, with improvements that were maintained or further improved at 3-month follow-up. General distress was also significantly reduced following treatment. Although limited by sample size and retrospective design, this audit demonstrates that NET is a feasible treatment for PTSD in this population and warrants further evaluation in a randomized controlled trial. Further adjunctive interventions may also be necessary to treat the additional psychological problems experienced by this population.

  9. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Tri Indah Winarni

    2012-01-01

    Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  10. Treatment Changes in Patients With Moderate to Severe Psoriasis: A Retrospective Chart Review.

    Science.gov (United States)

    Smith, Jaclyn A; Wehausen, Brooke; Richardson, Irma; Zhao, Yang; Li, Yunfeng; Herrera, Vivian; Feldman, Steven R

    Psoriasis treatment involves topical medications, oral medications, phototherapy, and/or biologics. The treatments used depend on a myriad of factors that change over time. To characterise the frequency of and reasons for treatment changes in patients with moderate to severe psoriasis. A chart review examined treatment changes at 902 visits by 116 patients seen between January 1, 2010, and June 30, 2015, for moderate to severe psoriasis and the physicians' justifications for those changes. 'Treatment change' was defined as switching between, adding, or removing medication classes or switching within the oral or biologic class. There were 221 visits with treatment changes identified, and a change occurred every 4.1 visits. On average, there were 1.2 treatment changes per year. Patients treated for at least 1 year averaged 1 treatment change every 16 months. The most common type of change was from one biologic to another biologic (24.9%), followed by adding a nonbiologic to a biologic (18.6%). The most common reason for switching was poor control or flare of psoriasis. Affordability was a more common problem for biologics than for nonbiologic treatments. Biologic treatment options provide a major improvement over older systemic treatments, but patients still undergo frequent treatment changes to help control their disease.

  11. Fine motor and self-care milestones for individuals with Down syndrome using a Retrospective Chart Review.

    Science.gov (United States)

    Frank, K; Esbensen, A J

    2015-08-01

    Developmental milestone markers for fine motor and self-care skills among children with Down syndrome (DS) are either minimal, anecdotal or out-of date. Our goal was to produce normative expectations for the development of fine motor and self-care milestones specific to children with DS. A cross-sectional retrospective chart review was completed on 274 children with DS seen at a specialty clinic that ranged in age from 4 months to 18 years. Specific skills were assessed at occupational therapy assessments as either present or absent, including fine motor, handwriting, scissor usage, self-feeding and clothing management. Fine motor milestones describing when 10-30% ('early achievers') and 75-95% ('representative achievement') of children with DS had mastered each skill were developed based upon descriptive review. As the fine motor and self-care skills advanced in complexity, the range of ages for documented skill acquisition was observed to increase. Age ranges for the mastery of fine motor developmental milestones for early and representative achievement were developed based upon descriptive analysis of cross-sectional retrospective clinical chart reviews. That the age range for mastering fine motor and self-care skills broadens as children with DS get older is in agreement with what is identified in the DS behavioural phenotype with regard to variable motor skills overall. These fine motor and self-care developmental milestone markers contribute to the field by informing parents, caregivers and healthcare providers of potential fine motor and self-care outcomes and describing normative development for children with DS. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  12. A retrospective chart review to identify perinatal factors associated with food allergies.

    Science.gov (United States)

    Dowhower Karpa, Kelly; Paul, Ian M; Leckie, J Alexander; Shung, Sharon; Carkaci-Salli, Nurgul; Vrana, Kent E; Mauger, David; Fausnight, Tracy; Poger, Jennifer

    2012-10-19

    Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005). Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  13. The immediate placement of dental implants into extraction sites with periapical lesions: a retrospective chart review.

    Science.gov (United States)

    Bell, Christopher Lincoln; Diehl, David; Bell, Brian Michael; Bell, Robert E

    2011-06-01

    The purpose of this study was to evaluate the success of dental implants placed immediately into extraction sites in the presence of chronic periapical pathology. The charts of 655 patients who had implants immediately placed into fresh extraction sites were reviewed for the presence or absence of periapical radiolucencies. A total of 922 implants were included. Of the 922 implants, 285 were immediately placed into sockets that had chronic periapical infections. The remaining 637 implants, without signs of periapical pathology, were used as the control group. Success of the implants was defined as successful osseointegration, successful restoration, and absence of evidence of bone loss or peri-implantitis. Other variables such as age, gender, smoking, diabetes, bisphosphonate use, lucencies of adjacent teeth, and implant stability at the time of placement were also evaluated. Of the 922 implants, 285 were placed into sockets with periapical radiolucencies. The success rate of implants placed in the study group was 97.5%, whereas the success rate of the control group was 98.7%. The difference was not found to be statistically significant. The mean follow-up was 19.75 months, with a maximum of 93 months and a minimum of 3 months. A statistically higher failure rate was found for implants placed adjacent to retained teeth with periapical pathology. The placement of implants in sockets affected by chronic periapical pathology can be considered a safe and viable treatment option. There is a risk of implant failure when placing implants adjacent to teeth with periapical radiolucencies. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Maintenance Electroconvulsive Therapy in Severe Bipolar Disorder: A Retrospective Chart Review.

    Science.gov (United States)

    Santos Pina, Laura; Bouckaert, Filip; Obbels, Jasmien; Wampers, Martien; Simons, Wim; Wyckaert, Sabien; Sienaert, Pascal

    2016-03-01

    The aim of this study was to evaluate the effectiveness of continuation and maintenance electroconvulsive therapy (C/M-ECT) in patients with bipolar or schizoaffective disorder. We reviewed the charts of all patients diagnosed with a bipolar or schizoaffective disorder treated with C/M-ECT from August 2009 until December 2013. We gathered demographic data and treatment variables (electrode placement, stimulus dose, and concomitant use of medication; number of C/M-ECT sessions; and number of new ECT courses). Primary outcome measure was the number of hospitalization days during C/M-ECT as compared with an equal period before starting the index course. Twenty women (64.5%) and 11 men (35.5%) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar disorder (n = 22, 71%) or schizoaffective disorder (n = 9, 29%) received C/M-ECT. The mean (SD) age was 51.23 (14.86; range, 28-74) years. Before the start of the index ECT, patients had a mean of 290 hospitalization days (248.4 days, full hospitalization; 41.6 days, partial hospitalization), whereas during C/M-ECT, they had a mean of 214.7 hospitalization days (85.4 days, full hospitalization; 129.3 days, partial hospitalization). The number of readmissions before ECT was 2.13, whereas during C/M-ECT, it decreased to 1.48. Only the decrease in number of full hospitalization days was significant. Most patients (n = 23, 74.19%) needed an acute course of ECT during M-ECT. Maintenance ECT seems to significantly reduce the number of full hospitalization days in patients with severe bipolar or schizoaffective disorder.

  15. Specialist pediatric palliative care prescribing practices: A large 5-year retrospective audit

    Directory of Open Access Journals (Sweden)

    Anuja Damani

    2016-01-01

    Full Text Available Introduction: There is a gradual increasing trend in childhood cancers in India and pediatric palliative care in India is an emerging specialty. Prescribing pain and symptom control drugs in children with cancer requires knowledge of palliative care formulary, dosing schedules, and prescription guidelines. This study is a retrospective audit of prescribing practices of a specialist palliative care service situated in a tertiary cancer center. Methods: A total of 1135 medication records of children receiving specialist pediatric palliative care services were audited for 5 years (2010-2014 to evaluate prescribing practices in children with advanced cancer. Results: A total of 51 types of drugs were prescribed with an average of 4.2 drugs per prescription. 66.9% of the prescriptions had paracetamol, and 33.9% of the prescriptions had morphine. Most common nonsteroidal anti-inflammatory drugs prescribed was ibuprofen (23.9%, and more than 50% of the prescriptions had aperients. The most commonly prescribed aperient was a combination of liquid paraffin and sodium-picosulfate. Dexamethasone was prescribed in 51.9% of patients and in most cases this was part of oral chemotherapy regimen. Generic names in prescription were used only in 33% of cases, and adverse effects of the drugs were documented in only 9% of cases. In 25% of cases, noncompliance to the WHO prescription guidelines was seen, and patient compliance to prescription was seen in 40% of cases. Conclusions: Audit of the prescribing practices in specialist pediatric palliative care service shows that knowledge of pediatric palliative care formulary, rational drug use, dosing, and prescribing guidelines is essential for symptom control in children with advanced life-limiting illness. Noncompliance to WHO prescribing guidelines in one fourth of cases and using nongeneric names in two-thirds of prescription indicates poor prescribing practices and warrants prescriber education. Prescription

  16. Botulinum toxin type A in children and adolescents with severe cerebral palsy: a retrospective chart review.

    Science.gov (United States)

    Mesterman, Ronit; Gorter, Jan Willem; Harvey, Adrienne; Lockhart, Julia; McEwen-Hill, Jenny; Margallo, Karen; Goldie, Nancy

    2014-02-01

    This retrospective cohort study reviewed set goals and their outcomes of children and adolescents with severe cerebral palsy who received botulinum toxin A in 2008 and 2009. Sixty children (36 male, mean age 9 years) were included. They received on average 4 (range 1-7) treatments, with the dosage varying between 20 and 400 units per treatment (3-21 U/kg/body weight). Mild transient side effects were reported in 12 of 242 treatments with botulinum toxin A. Treatment goals were related to lower limb function (82%), range of motion (68%), positioning (33%), upper limb function (33%), and facilitating ease of care in dressing (30%), toileting, and diapering (22%). The treatment goals were reached in 60% to 85% by report of the parent and child dyad. Our findings suggest that botulinum toxin A should be considered as a treatment option in patients with cerebral palsy within Gross Motor Function Classification System levels IV and V.

  17. A novel income security intervention to address poverty in a primary care setting: a retrospective chart review.

    Science.gov (United States)

    Jones, Marcella K; Bloch, Gary; Pinto, Andrew D

    2017-08-17

    To examine the development and implementation of a novel income security intervention in primary care. A retrospective, descriptive chart review of all patients referred to the Income Security Heath Promotion service during the first year of the service (December 2013-December 2014). A multisite interdisciplinary primary care organisation in inner city Toronto, Canada, serving over 40 000 patients. The study population included 181 patients (53% female, mean age 48 years) who were referred to the Income Security Health Promotion service and engaged in care. The Income Security Health Promotion service consists of a trained health promoter who provides a mixture of expert advice and case management to patients to improve income security. An advisory group, made up of physicians, social workers, a community engagement specialist and a clinical manager, supports the service. Sociodemographic information, health status, referral information and encounter details were collected from patient charts. Encounters focused on helping patients with increasing their income (77.4%), reducing their expenses (58.6%) and improving their financial literacy (26.5%). The health promoter provided an array of services to patients, including assistance with taxes, connecting to community services, budgeting and accessing free services. The service could be improved with more specific goal setting, better links to other members of the healthcare team and implementing routine follow-up with each patient after discharge. Income Security Health Promotion is a novel service within primary care to assist vulnerable patients with a key social determinant of health. This study is a preliminary look at understanding the functioning of the service. Future research will examine the impact of the Income Security Health Promotion service on income security, financial literacy, engagement with health services and health outcomes. © Article author(s) (or their employer(s) unless otherwise stated in

  18. “Waiting for DAAs”: A retrospective chart review of patients with untreated hepatitis C in Rwanda

    Science.gov (United States)

    Gupta, Neil; Kabahizi, Jules; Mukabatsinda, Constance; Walker, Timothy David; Musabeyezu, Emmanuel; Kiromera, Athanase; Steiner, Kevin; Mukherjee, Joia; Nsanzimana, Sabin; Mbituyumuremyi, Aimable

    2017-01-01

    Background Access to treatment for hepatitis C virus (HCV) in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs), highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs. Methods and findings We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65), and 149 (58.9%) were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09–1.17), but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus. Conclusions Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub

  19. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Hoffman DA

    2012-06-01

    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  20. High-dose estrogen as salvage hormonal therapy for highly refractory metastatic breast cancer: a retrospective chart review.

    Science.gov (United States)

    Mahtani, Reshma L; Stein, Alisha; Vogel, Charles L

    2009-01-01

    High-dose estrogens (HDEs) are an efficacious but widely overlooked treatment option for patients with metastatic breast cancer (MBC). This is due in part to the introduction of tamoxifen in the 1970s, which was proven to be equivalent in efficacy and associated with fewer adverse events (AEs). The aim of this study was to report our experience with the use of HDE in postmenopausal women with advanced breast cancer. Local institutional review board approval was obtained to conduct a retrospective chart review of patients with MBC treated with HDEs at the Boca Raton Comprehensive Cancer Center, Boca Raton, Florida, from 2001 through March 2009. Demographic information, response rates, and tolerability profiles were collected. Of the 426 patients with MBC identified, we found 26 patients with MBC who were prescribed HDEs as a treatment in any line of therapy for advanced breast cancer. The median age at the start of HDE therapy was 59 years (range, 42-92 years). Three of the 26 patients (11.5%) were human epidermal growth factor receptor 2-positive determined via fluorescent in situ hybridization analysis. With the exception of 1 patient who had received no prior systemic treatment for metastatic disease, all patients received multiple lines of treatment (both chemotherapy and hormonal treatments) in the advanced setting (median, 7 lines; range, 0-12) prior to the initiation of HDE. Five of 20 patients (25%) with measurable metastatic disease (visceral and/or soft tissue metastases) had objective antitumor responses defined as either a partial response (PR) or a complete response (CR). Four additional patients (20%) had prolonged stable disease (SD) for > or =6 months. Three of 6 patients (50%) with nonmeasurable metastatic disease (bone-only) had prolonged SD for > or =6 months. Clinical benefit rate (defined as CR + PR + SD > or =6 months) for all patients was 46% (12/26), with a median duration of 10 months. Overall median progression-free survival for the 26

  1. A retrospective chart review to assess the safety of nonablative fractional laser resurfacing in Fitzpatrick skin types IV to VI.

    Science.gov (United States)

    Clark, Charlotte M; Silverberg, Jonathan I; Alexis, Andrew F

    2013-04-01

    Laser resurfacing in patients with Fitzpatrick skin phototypes (SPT) IV to VI is associated with a higher risk of pigmentary alteration. There is a paucity of studies evaluating optimum treatment parameters for fractional lasers in darkly pigmented skin types. This is a retrospective review of medical records for patients with SPT IV to VI who were treated with a 1,550 nm erbium-doped fractional nonablative laser (Fraxel Re:Store SR 1550; Solta Medical, Hayword, CA). Data were collected from patient charts and the clinic laser logbook from January 2008 to January 2012. The frequency of treatment-associated postinflammatory hyperpigmentation (PIH) and treatment settings used were evaluated. A total of 115 total laser sessions (45 patients) were included in our analysis. Five of the sessions (4%) were accompanied by PIH, 2 of which occurred in a single patient. Only 1 episode of PIH lasted longer than 1 month (2 months). Two of the 5 cases had only transient PIH (≤7 days), one of which was reported by the patient and not clinically evident on examination. The 1,550 nm erbium-doped fractional laser is well tolerated in SPT IV to VI. Fractional laser resurfacing, with the settings used and pretreatment and posttreatment hydroquinone 4% cream, was associated with a low risk of PIH in darker skin types.

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

    Science.gov (United States)

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

    2018-01-01

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

  3. Retrospective chart review for obesity and associated interventions among rural Mexican-American adolescents accessing healthcare services.

    Science.gov (United States)

    Champion, Jane Dimmitt; Collins, Jennifer L

    2013-11-01

    To report a retrospective analysis of data routinely collected in the course of healthcare services at a rural health clinic and to assess obesity incidence and associated interventions among rural Mexican-American adolescents. Two hundred and twelve charts reviewed; 98 (46.2%) males and 114 (53.8%) females. Data extracted included Medicaid exams conducted at the clinic within 5 years. Equal overweight or obese (n = 105, 49.5%), versus normal BMI categorizations (n = 107, 50.5%) documented overall and by gender. Female obesity higher (25.4%) than national norms (17.4%); male rates (25.5%) were within national norm. Interventions provided by nurse practitioners (94%) for 34.8%-80% of overweight/obese had limited follow-up (4%). Obesity incidence markedly increased between 13 and 18 years of age without associated interventions; 51.4%-75.6% without interventions. Obesity is a healthcare problem among rural Mexican-American adolescents accessing care at the rural health clinic. Obesity intervention and follow-up was suboptimal within this setting. Rural and ethnic minority adolescents experience health disparities concerning obesity prevalence and remote healthcare access. Obesity prevention and treatment during adolescence is a national health priority given physiologic and psychological tolls on health and potential for obesity into adulthood. Obesity assessment and translation of evidence-based interventions for rural Mexican-American adolescents at rural health clinics is implicated. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  4. An Audit of Visual Acuity using a Snellen chart for Residents in a Care home, aged 65years or over

    OpenAIRE

    Ward, Hannah

    2012-01-01

    Background: Visual impairment (VI) is highly prevalent, but currently remains untreated and preventable in Britain‟s older population (Evans, Fletcher, Wormald et al. 2002). Eighty percent of all VI can be avoided or treated (WHO, 2011). People in residential or nursing homes are at a higher risk of having their eye problems overlooked (Pols, Bates, McGraw et al. 2000). Aim: To conduct an audit of visual acuity (VA), a measure of VI against a national standard, the British Geriatric Societ...

  5. Antiepileptic drug use and the occurrence of pressure ulcers among bedridden institutionalized elderly patients: a retrospective chart review.

    Science.gov (United States)

    Arinzon, Zeev; Zeilig, Gabriel; Berner, Yitshal N; Adunsky, Abraham

    2005-09-01

    Phenytoin (PH) is indicated primarily for the control of grand mal and psychomotor seizures. However, topical PH has been used for the treatment of various types of ulcers, including pressure ulcers. The aim of this study was to investigate the possibility of a relationship between the use of oral PH and the prevalence of pressure ulcers among bedridden institutionalized elderly patients. This retrospective chart review was conducted in a state-run urban geriatric medical center in Israel and involved long-term bedridden institutionalized patients who were receiving chronic antiepileptic medication during the 7-year period between January 1996 and December 2003. The prevalence of pressure ulcers in patients who received treatment with PH alone or in combination with other antiepileptic drugs was compared with that in patients who received antiepileptic agents other than PH. The study analyzed data from the medical charts of 153 patients, 72 of whom received PH alone or in combination with other antiepileptic drugs, and 81 of whom received antiepileptic agents other than PH. Patients' mean (SD) age was 78.5 (7.2) years; 106 (69.3%) were women. All patients were totally dependent with respect to activities of daily living (mean Katz score, 2.0 [2.0]) and had severe cognitive decline (mean Mini-Mental State Examination score, 3.5 [3.3]). Pressure ulcers occurred in 9.7% of PH recipients and 27.2% of non-PH recipients (P = 0.006; chi2 = 7.55). In PH recipients, 85.7% of pressure ulcers were of mild to moderate severity (stage I or II), compared with 59.1% of ulcers in non-PH recipients; the difference between groups was not statistically significant. Four (18.2%) non-PH recipients and no PH recipients had stage IV pressure ulcers. In the PH group, 71.4% of patients had a pressure ulcer in only 1 anatomic location, compared with 22.7% of the non-PH group (P = 0.023; chi2 = 5.13); 28.6% of PH recipients and 63.6% of non-PH recipients had pressure ulcers in 2 or 3

  6. A retrospective audit of bacterial culture results of donated human milk in Perth, Western Australia.

    Science.gov (United States)

    Almutawif, Yahya; Hartmann, Benjamin; Lloyd, Megan; Erber, Wendy; Geddes, Donna

    2017-02-01

    The bacterial content of donated human milk is either endogenous or introduced via contamination. Defining milk bank bacterial content will allow researchers to devise appropriate tests for significant and commonly encountered organisms. A retrospective audit was conducted on data recorded from the Perron Rotary Express Milk Bank, King Edward Memorial Hospital, Subiaco, Western Australia. This aimed to describe the incidence of bacterial species detected in donated human milk and to identify potentially pathogenic bacteria. The data comprised of 2890 batches donated by 448 women between 2007 and 2011. Coagulase negative Staphylococcus (CoNS) represented the highest prevalence of bacteria in donated milk, isolated from 85.5% of batches (range: 20 to 650,000CFU/mL) followed by Acinetobacter species in 8.1% of batches (range: 100 to 180,000CFU/mL). Staphylococcus aureus was the most prevalent potentially pathogenic bacteria in 5% of batches (range: 40 to 100,000CFU/mL). Further investigation is warranted to better define the risks posed by the presence of toxin-producing S. aureus in raw and pasteurized human milk which may allow minimization of risk to the preterm infants. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Factors Influencing Clinical Performance of Baccalaureate Nursing Majors: A Retrospective Audit.

    Science.gov (United States)

    Johnston, Sandra; Fox, Amanda; Coyer, Fiona Maree

    2018-06-01

    Transition of nursing student to new graduate depends on successful completion of clinical work placement during an undergraduate course. Supporting students during the clinical placement is imperative. This study examined associations between grade point average, domestic or international status, course entry qualification, and single or dual nursing degree to successful completion of clinical placement. A retrospective audit of 665 students in a baccalaureate nursing program was conducted to examine factors influencing clinical performance of baccalaureate nursing students. A significant association between entry qualification, lower grade point average, international status, and receipt of a constructive note was found: χ 2 = 8.678, df = 3, p = .034, t(3.862), df = 663, p ⩽ .001, and Fisher's exact test = 8.581, df = 1, p = .003, respectively. Understanding factors that affect clinical performance may help early identification of students at risk and allow for supportive intervention during placement and subsequent program completion. [J Nurs Educ. 2018;57(6):333-338.]. Copyright 2018, SLACK Incorporated.

  8. Clinical management issues vary by specialty in the Victorian Audit of Surgical Mortality: a retrospective observational study

    OpenAIRE

    Vinluan, Jessele; Retegan, Claudia; Chen, Andrew; Beiles, Charles Barry

    2014-01-01

    Objective Clinical management issues are contributory factors to mortality. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM), an educational peer-review process for surgeons, to discover differences in the incidence of these issues between surgical specialties in order to focus attention to areas of care that might be improved. Design This study used retrospectively analysed observational data from VASM. Clinical management issues between eight speci...

  9. Management of eight labor and delivery patients dependent on buprenorphine (Subutex™: A retrospective chart review [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Solina Tith

    2018-02-01

    Full Text Available Background: Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by “The American College of Obstetrics and Gynecology” as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists’ unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia. We reviewed our management and outcomes in this medically complex population. Methods: An Institutional Review Board (IRB approved retrospective chart review was conducted of women admitted to the University of Washington Medical Center Labor and Delivery unit from July 2012 to November 2013 using buprenorphine. All deliveries, including intrauterine fetal demise, were included. Results: Eight women were admitted during this period to our L&D floor on buprenorphine. All required peri-partum anesthetic management either for labor and/or cesarean delivery management. Analgesic management included dilaudid or fentanyl PCA and/or continued epidural infusion, and in one instance ketamine infusion, while the pre-admission buprenorphine regimen was continued. Five babies were viable, two women experienced intrauterine fetal death at 22 and 36 weeks gestational age (GSA, respectively, and one neonate died shortly after delivery due to a congenital diaphragmatic hernia. Conclusions: This case series illuminates the medical complexity of parturients using buprenorphine. Different treatment modalities in the absence of evidence-based guidelines included additional opioid administration and continued epidural analgesia. The management of post-cesarean pain in patients on partial μ-opioid agonists remains complex and variable, and evidence-based guidelines could be useful for clinicians to direct care.

  10. Retrospective audit of the acute management of stroke in two district general hospitals in the uk.

    Science.gov (United States)

    Faluyi, O O; Omodara, J A; Tay, K H; Muhiddin, K

    2008-06-01

    There is some evidence to suggest that the standard of acute medical care provided to patients with cerebrovascular disease is a major determinant of the eventual outcome. Consequently, the Royal College of Physicians (RCP) of London issues periodic guidelines to assist healthcare providers in the management of patients presenting with stroke. An audit of the acute management of stroke in two hospitals belonging to the same health care trust in the UK. Retrospective review of 98 randomly selected case-notes of patients managed for cerebrovascular disease in two acute hospitals in the UK between April and June 2004. The pertinent guidelines of RCP (London) are highlighted while audit targets were set at 70%. 84% of patients presenting with cerebrovascular disease had a stroke rather than a TIA, anterior circulation strokes were commonest. All patients with stroke were admitted while those with TIAs were discharged on the same day but most patients with TIA were not followed up by Stroke specialists. Most CT-imaging of the head was done after 24 hours delaying the commencement of anti-platelets for patients with ischaemic stroke or neurosurgical referral for haemorrhagic stroke. Furthermore, there was a low rate of referral for carotid ultrasound in patients with anterior circulation strokes. Anti-platelets and statins were commenced for most patients with ischaemic stroke while diabetes was well controlled in most of them. However, ACE-inhibitors and diuretics such as indapamide were under-utilized for secondary prevention in such patients. Warfarin anti-coagulation was underutilized in patients with ischaemic stroke who had underlying chronic atrial fibrillation. While there was significant multi-disciplinary team input, dysphagia and physiotherapy assessments were delayed. Similarly, occupational therapy input and psychological assesment were omitted from the care of most patients. Hospital service provision for the management of cerebrovascular disease needs to

  11. Retrospective audit of the investigation of patients with suspected acute subarachnoid haemorrhage

    International Nuclear Information System (INIS)

    Muhammed, O.; Teubnet, D.; Jones, D.N.; Slavotinek, J.P.

    2010-01-01

    Recommended investigational care (RIC) of emergency department (ED) patients with suspected subarachnoid haemorrhage comprises lumbar puncture (LP) to detect xanthochromia if the preceding CT scan is negative. Retrospective audit of the investigational care of 100 consecutive ED patients presenting with possible subarachnoid haemorrhage. Of the 100 patients, 91 had negative CT, and 36 (39.6%) of these patients had an LP performed to detect xanthochromia (i.e. RIC). Fifty-five of 91 (60.4%) patients did not receive RIC. Of the 55 patients who did not receive RIC, 25 (45.5%) had a documented senior clinical decision not to perform an LP; 15 (27.3%) had no documented reason; five (9.1%) refused consent; two (3.6%) had an LP but no xanthochromia requested, one patient did not have an LP because of technical issues, six patients underwent CT angiography (CTA), and one patient underwent magnetic resonance angiography (MRA), in the absence of a LP, following a negative CT. Two patients underwent CTA following a negative xanthochromia result. Patients admitted to the emergency extended care unit had 6.85 times the odds of receiving RIC (95% CI 2.20-21.4). Fifty-five (55) of 91 (60%) ED patients did not receive RIC. Fifteen of the 55 did not have any documented justification for not performing an LP with xanthochromia testing. Admission to an emergency extended care unit was a predictor of receiving RIC. Inappropriate use of CTA and MRA was identified. These findings have important implications for patient safety. Multifaceted strategies are required to close this evidence-practice gap.

  12. THE EFFECTS OF AMOXICILLIN WITH OR WITHOUT CLAVULANIC ACID ON THE POSTOPERATIVE COMPLAINTS AFTER THIRD MOLAR SURGERY: A RETROSPECTIVE CHART ANALYSIS

    Directory of Open Access Journals (Sweden)

    Alparslan ESEN

    2017-04-01

    Full Text Available Purpose: The aim of this chart-based retrospective study was to evaluate the effects of orally administered amoxicillin alone or amoxicillin combined with clavulanic acid on the frequency of post-operative complications and patients’ comfort after mandibular third molar surgery. Materials and Methods: The records of patients who had undergone lower third molar surgery between October 2014 and December 2015 were examined. A total of 62 patients who had fully impacted teeth in mesioangular position and who had been prescribed same type and dose of anti-inflammatory drug were included in this study. Among them, 32 subjects were found to have been prescribed 500 mg amoxicillin trihydrate orally every 8 h for 5 days (Group A and 30 patients 500 mg amoxicillin trihydrate plus 125 mg potassium clavulanate orally every 8 h for 5 days postoperatively (Group AC. Post-operative pain levels, swelling, presence of trismus, frequency of alveolar osteitis and quality of life (QoL scores were gathered from patients’ charts and were statistically compared. Results: Analysis of the variables showed that there were no significant differences between the Groups A and AC regarding pain levels, swelling, trismus and QoL scores. The frequency of alveolar osteitis was found to be 1.6% in the Group A, however, no significant difference was observed among study groups. Conclusion: Within the limitations of this retrospective chart review, it can be stated that amoxicillin and amoxicillin with clavulanic acid might provide similar outcome in terms of patient comfort following third molar surgery.

  13. A retrospective audit on usage of Diatrizoate Meglumine (Gastrografin®) for intestinal obstruction or constipation in patients with advanced neoplasms.

    Science.gov (United States)

    Heng, Sharon; Hardy, Janet; Good, Phillip

    2018-01-01

    Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these conditions without good quality evidence of its effectiveness and safety. This audit aimed to assess the usage, effectiveness and adverse effects of Diatrizoate Meglumine for intestinal obstruction and constipation in patients with advanced neoplasms. A retrospective chart review was undertaken. Descriptive statistics were utilised. All patients with known advanced neoplasms admitted to Mater Health Services and St Vincent's Private Hospital Brisbane between January 2013 and October 2015; who were administered Diatrizoate Meglumine were included. Seventy-one patients received Diatrizoate Meglumine. The most common diagnoses were ovarian or primary peritoneal neoplasms (33.8%). Diatrizoate Meglumine was most commonly used for intestinal obstruction (59.2%). The median dose used per patient episode was 50 mL (range: 15-500 mL). Thirty-two patients (45%) had imaging 4-24 h post-dose with Diatrizoate Meglumine being present in the large intestine in 75% of these images. Intestinal obstruction or constipation resolved in 90% of patients post-dose. Most clinicians used 50 mL of Diatrizoate Meglumine as a single dose and repeated imaging after 4-24 h. Diatrizoate Meglumine was well tolerated and may be effective in resolving intestinal obstruction and constipation in patients with advanced neoplasms. Quality controlled studies are needed to further guide the use of Diatrizoate Meglumine in intestinal obstruction and constipation in patients with advanced neoplasms.

  14. Radiologically defining horizontal gaze using EOS imaging-a prospective study of healthy subjects and a retrospective audit.

    Science.gov (United States)

    Hey, Hwee Weng Dennis; Tan, Kimberly-Anne; Ho, Vivienne Chien-Lin; Azhar, Syifa Bte; Lim, Joel-Louis; Liu, Gabriel Ka-Po; Wong, Hee-Kit

    2018-06-01

    As sagittal alignment of the cervical spine is important for maintaining horizontal gaze, it is important to determine the former for surgical correction. However, horizontal gaze remains poorly-defined from a radiological point of view. The objective of this study was to establish radiological criteria to define horizontal gaze. This study was conducted at a tertiary health-care institution over a 1-month period. A prospective cohort of healthy patients was used to determine the best radiological criteria for defining horizontal gaze. A retrospective cohort of patients without rigid spinal deformities was used to audit the incidence of horizontal gaze. Two categories of radiological parameters for determining horizontal gaze were tested: (1) the vertical offset distances of key identifiable structures from the horizontal gaze axis and (2) imaginary lines convergent with the horizontal gaze axis. Sixty-seven healthy subjects underwent whole-body EOS radiographs taken in a directed standing posture. Horizontal gaze was radiologically defined using each parameter, as represented by their means, 95% confidence intervals (CIs), and associated 2 standard deviations (SDs). Subsequently, applying the radiological criteria, we conducted a retrospective audit of such radiographs (before the implementation of a strict radioimaging standardization). The mean age of our prospective cohort was 46.8 years, whereas that of our retrospective cohort was 37.2 years. Gender was evenly distributed across both cohorts. The four parameters with the lowest 95% CI and 2 SD were the distance offsets of the midpoint of the hard palate (A) and the base of the sella turcica (B), the horizontal convergents formed by the tangential line to the hard palate (C), and the line joining the center of the orbital orifice with the internal occipital protuberance (D). In the prospective cohort, good sensitivity (>98%) was attained when two or more parameters were used. Audit using Criterion B

  15. An audit of risk assessments for suicide and attempted suicide in ED: a retrospective review of quality.

    Science.gov (United States)

    de Beer, Wayne; DeWitt, Bernard; Schofield, Jules; Clark, Helen; Gibbons, Veronique

    2018-02-23

    The primary aim of this audit was to determine the quality of psychiatric risk assessments conducted by Mental Health & Addiction Services clinicians for patients presenting to the emergency department, Waikato Hospital, Hamilton, New Zealand following an attempted suicide. A retrospective, randomised audit of 376 files of patients who had presented to the ED over a 12-month period from 1 July 2015 to 30 June 2016 was conducted, following the standards outlined in the present New Zealand Ministry of Health Clinical Practice Guideline for Deliberate Self Harm (DSH). It was found that clinicians routinely focused on the historical features of the suicide attempt presentation while failing to record judgements about future suicidal behaviours. Interactions with family members were recorded in less than half of the cases. The guideline most poorly adhered to was checking whether Māori patients wanted culturally appropriate services during the assessment and treatment planning, with this recorded in less than 10% of the clinical records. To improve the quality of the suicide risk assessments, and to better align with Clinical Practice Guidelines, the authors propose redevelopment of clinician training, including focus on cultural competence, and training in confidentiality and privacy relating to an attempted suicide episode.

  16. A Retrospective Audit of In-Hospital 30-day Mortality from Acute Myocardial Infarction in Connolly Hospital Blanchardstown

    LENUS (Irish Health Repository)

    Hensey, M

    2017-09-01

    In 2015, The Department of Health published the first annual report of the “National Healthcare Quality Reporting System.” Connolly Hospital was reported to a mortality rate within 30 days post-Acute Myocardial Infarction (AMI) of 9.87 per 100 cases which was statistically significantly higher than the national rate. We carried out a retrospective audit of patients who were HIPE-coded as having died within 30 days of AMI from 2011-2013 and identified 42 patients. On review, only 23 patients (54.8%) were confirmed as having had an AMI. We identified 12 patients who had AMI included on death certificate without any evidence for same. If the 22 patients incorrectly coded were excluded, the mortality rate within 30 days post-AMI in CHB would fall to 4.14 deaths per 100 cases, well below the national average. Inaccuracies of data collection can lead to erroneous conclusions when examining healthcare data.

  17. Part C and Part D - Program Audit Results

    Data.gov (United States)

    U.S. Department of Health & Human Services — The chart lists the overall audit score of each sponsor audited and provides additional detail on the number of audit elements tested during each audit, the number...

  18. Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

    Directory of Open Access Journals (Sweden)

    Greenblatt JM

    2011-09-01

    Full Text Available James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a referenced electroencephalographic (EEG database analysis to help guide medication selection.Method: We examined 33 charts for patients with the primary psychiatric diagnosis of an eating disorder and comorbid major depressive disorder or bipolar disorder who underwent a quantitative EEG database assessment to provide additional information for choices of medication. The current analysis includes data from 22 subjects who accepted treatments based on information from the referenced-EEG medication database. Hamilton Depression Rating Scale, Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and hospitalization data were examined for these patients.Results: Patients whose EEG data was used for clinical treatment reported significant decreases in associated depressive symptoms (HDRS scores, overall severity of illness (Clinical Global Impression-Severity, and overall clinical global improvement (Clinical Global Impression-Improvement. This cohort also reported fewer inpatient, residential, and partial hospitalization program days following referenced-EEG compared with the two-year period prior to treatment.Conclusion: These findings are consistent with previously reported data for patients with eating disorders and suggest the need for future studies using EEG data correlated with those from other patients with similar quantitative EEG features.Keywords: eating disorders, anorexia, bulimia, depression, referenced-EEG, chart review

  19. Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: a retrospective chart review.

    Science.gov (United States)

    Waldorf, Barbara; Gill, Christopher; Crosby, Sondra S

    2014-10-01

    In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines.

  20. Diabetes Self-Management Education and Medical Nutrition Therapy Improve Patient Outcomes: A Pilot Study Documenting the Efficacy of Registered Dietitian Nutritionist Interventions through Retrospective Chart Review.

    Science.gov (United States)

    Marincic, Patricia Z; Hardin, Amie; Salazar, Maria V; Scott, Susan; Fan, Shirley X; Gaillard, Philippe R

    2017-08-01

    Diabetes self-management education (DSME) and medical nutrition therapy (MNT) improve patient outcomes; poor reimbursement limits access to care. Our aim was to develop methodology for tracking patient outcomes subsequent to registered dietitian nutritionist interventions, document outcomes for patients with type 2 diabetes attending an American Diabetes Association-recognized program, and obtain outcome data to support reimbursement and public policy initiatives to improve patient access to DSME and MNT. Retrospective chart review. A random sample of 100 charts was chosen from the electronic medical records of patients with type 2 diabetes completing DSME and individualized MNT, June 2013 to 2014. Data were extracted on body mass index (calculated as kg/m 2 ), weight, hemoglobin A1c, blood glucose, and lipids. Mixed-model analysis of variance was used to determine differences between means for continuous variables; McNemar's tests and γ-statistic trend analysis were used to assess frequency of patients reaching glycemic targets. Significant weight loss was observed from baseline (94.3±21.1 kg) to end of program (91.7±21.2 kg [-1.6±3.9 kg]; P0.05). Significant hemoglobin A1c reduction was observed from baseline (8.74%±2.30%) to end of program (6.82%±1.37% [-1.92%±2.25%]; Phemoglobin A1c targets (≤7.0%) vs 27% at baseline (P=0.008). When stratified by diet alone and diet plus drug therapy, patients exhibited a 1.08%±1.20% (Phemoglobin A1c, respectively. Triglycerides decreased from baseline 181.6±75.5 mg/dL (2.0±0.9 mmol/L) to 115.8±48.1 mg/dL (1.3±0.5mmol/L) (P=0.023). High-density lipoprotein increased from 41.4±12.4 mg/dL (1.1±0.3 mmol/L) to 47.3±12.4 mg/dL (1.2±0.3 mmol/L) (P=0.007). Retrospective chart review provides an operational model for abstracting existing patient outcome data subsequent to registered dietitian nutritionist interventions. In support of universal reimbursement and patient access to DSME with supplemental individualized

  1. Postoperative Survival for Patients with Thymoma Complicating Myasthenia Gravis
- Preliminary Retrospective Results of the ChART Database

    Directory of Open Access Journals (Sweden)

    Fangrui WANG

    2016-07-01

    Full Text Available Background and objective It is so far not clear that how myasthenia gravis (MG affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG. Methods The Chinese Alliance for Research in Thymomas (ChART registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, Patients were followed and their survival status were analyzed. Results There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05. There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05 in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5 year and 10 year OS rates were both higher in MG group (93% vs 88%; 83% vs 81%, P=0.034 respectively. The survival rate was significantly higher in patients with MG when the Masaoka staging was III/IV (P=0.003. Among patients with advanced stage thymoma (stage III, IVa, IVb, the constituent ratios of III, IVa, IVb were similar between MG and Non-MG group. Histologically, however, there were significantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000. Univariate analyses for all patients showed that MG, WHO classification, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were significant factors, and multivariate analysis showed WHO Classification, Masaoka stage, and resectability were strong independent prognostic indicators. Conclusion Although MG is not an independent prognostic factor, the survival of patients with thymoma was superior when MG was present, especially in late

  2. Trends in stroke admissions to a Tanzanian hospital over four decades: a retrospective audit.

    Science.gov (United States)

    Walker, Richard W; Viney, Rachel; Green, Laura; Mawanswila, Manasseh; Maro, Venance P; Gjertsen, Charlotte; Godfrey, Hannah; Smailes, Rosanna; Gray, William K

    2015-10-01

    The aim of this study was to record stroke admissions to a tertiary referral hospital in Tanzania over four decades. We audited the medical records held at a large teaching and tertiary referral hospital in northern Tanzania over four decades. We collected records for the years 1974-1976, 1984-1986, 1994-1995 and 2008. All patients admitted as inpatients with a primary diagnosis of stroke were included in the study. Data collected included age, sex, stroke subtype, predominant side of symptoms and survival to discharge. The number of stroke admissions rose from just four in the three-year period 1974-1976 (mean 1.3 cases annually) to 153 cases annually in 2008. The mean age of those admitted rose steadily during this period, as did the proportion of females admitted. The burden of stroke on health services in Tanzania appears to have increased rapidly. If this increase is to be slowed, then sustainable primary preventative measures to target known stroke risk factors will be required. © 2015 John Wiley & Sons Ltd.

  3. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    DEFF Research Database (Denmark)

    Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard

    2016-01-01

    with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support......Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality...... assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern...

  4. An audit of the outcome of amblyopia treatment: a retrospective analysis of 322 children.

    Science.gov (United States)

    Awan, M; Proudlock, F A; Grosvenor, D; Choudhuri, I; Sarvanananthan, N; Gottlob, I

    2010-08-01

    Little is known about the effectiveness of occlusion therapy in hospital settings. A retrospective analysis was conducted to assess modalities, outcome and hospital costs of children treated for amblyopia with patching in a UK clinic. Notes of 322 children with amblyopia discharged after occlusion treatment were selected consecutively and reviewed. Data collated included age at presentation, amblyopia type, visual acuity (VA; before/after occlusion and at discharge), number of prescribed hours of occlusion, duration of patching treatment, number of glasses prescribed and number of visits attended or failed to attend. Hospital treatment costs were estimated. Mixed amblyopes were prescribed the longest amount of patching (mean 2815 h over 23 months) followed by strabismic (1984 h) and anisometropic (1238 h) amblyopes. 319 amblyopes received glasses and five atropine treatment. The percentage of patients reaching VA of 6/12 was best in the anisometropic and strabismic groups (>75%) and worse in mixed amblyopia (64%). Average hospital costs were estimated at pound1365. Although the mean duration of treatment was long, involving many hospital visits, the visual outcome was variable, unsatisfactory (amblyopia treatment are needed, possibly by using educational/motivational intervention.

  5. Effectiveness of a Medifast meal replacement program on weight, body composition and cardiometabolic risk factors in overweight and obese adults: a multicenter systematic retrospective chart review study.

    Science.gov (United States)

    Coleman, Christopher D; Kiel, Jessica R; Mitola, Andrea H; Langford, Janice S; Davis, Kevin N; Arterburn, Linda M

    2015-08-06

    Recent medical guidelines emphasize the importance of actively treating overweight and obesity with diet and lifestyle intervention to achieve ≥ 5% weight loss in a 6-month period. Commercial programs offer one approach provided there is evidence of their efficacy and safety. This study was conducted to evaluate the effectiveness of the Medifast® 4 & 2 & 1 Plan™ on weight loss, body composition and cardiometabolic risk factors in overweight and obese adults. A systematic retrospective chart review of 310 overweight and obese clients following the Medifast 4 & 2 & 1 Plan at one of 21 Medifast Weight Control Centers® was conducted. Data were recorded electronically and key data points were independently verified. The primary endpoint was change from baseline body weight at 12 weeks. Within group paired t-tests were used to examine changes from baseline in a completers population. Differences between gender and age subgroups were examined using bivariate t-tests and mixed model regression analyses. For the primary endpoint at 12 weeks, body weight among completers (n = 185) was reduced by a mean of 10.9 ± 5.6 kg (-10.1%, p meal plan was well tolerated, and program adherence was >85%. The 4 & 2 & 1 Plan used at Medifast Weight Control Centers was effective for weight loss, preservation of lean mass and improvement in cardiometabolic risk factors. The plan was generally well tolerated in a broad population of overweight and obese adults. #NCT02150837.

  6. Pressure Injury Progression and Factors Associated With Different End-Points in a Home Palliative Care Setting: A Retrospective Chart Review Study.

    Science.gov (United States)

    Artico, Marco; D'Angelo, Daniela; Piredda, Michela; Petitti, Tommasangelo; Lamarca, Luciano; De Marinis, Maria Grazia; Dante, Angelo; Lusignani, Maura; Matarese, Maria

    2018-07-01

    Patients with advanced illnesses show the highest prevalence for pressure injuries. In the palliative care setting, the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. To describe the course of healing for pressure injuries in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement. Four-year retrospective chart review of 669 patients cared for in a home palliative care service, of those 124 patients (18.5%) had at least one pressure injury with a survival rate less than or equal to six months. The proportion of healed pressure injuries was 24.4%. Of the injuries not healed, 34.0% were in a maintenance phase, whereas 63.6% were in a process of deterioration. Body mass index (P = 0.0014), artificial nutrition (P = 0.002), and age pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Morbidity and Mortality in Preterm Infants following Antacid Use: A Retrospective Audit

    Directory of Open Access Journals (Sweden)

    Natasha Singh

    2016-01-01

    Full Text Available Background and Objectives. Antacids are often prescribed to preterm infants due to misdiagnosis of gastro-oesophageal reflux. This suppresses gastric acidity, a major defence mechanism against infection. This study aims to determine if ranitidine and omeprazole use in very low birth weight (VLBW neonates, <1500 grams, is associated with increased risk of late onset sepsis, necrotising enterocolitis (NEC, and mortality. Methods. Retrospective analysis was conducted on neonates, <1500 grams, born and admitted into the Neonatal Intensive Care Unit at The Canberra Hospital during the period from January 2008 to December 2012. Information regarding late onset sepsis, NEC, mortality, ranitidine/omeprazole use, and other neonatal/hospital factors was collected for each neonate. Results. 360 neonates were evaluated, 64 received ranitidine and/or omeprazole, and 296 had not. There were no statistically significant differences in incidence of late onset sepsis (OR = 0.52, CI = 0.24–1.1, and p = 0.117, NEC Stage 2 and above (OR = 0.4, CI = 0.05–3.2, and p = 0.7, or mortality (OR = 0.35, CI = 0.08–1.5, and p = 0.19 between the two groups. After adjusting significant differences in neonatal and hospital factors, risk of late onset sepsis was significantly lower in those that received ranitidine/omeprazole (OR = 0.28, CI = 0.13–0.65, and p = 0.003. Conclusions. Ranitidine and omeprazole use in VLBW preterm infants may not be associated with an increased risk of infection, NEC, and mortality.

  8. A retrospective audit of the first screening round of the Maltese breast screening programme

    International Nuclear Information System (INIS)

    Mizzi, D.; Zarb, F.; Dennis, A.

    2017-01-01

    Purpose: To analyse whether the screening performance parameters of the Maltese National Breast Screening Programme first screening round met requirements set by European standards. The association between screening age and results of screening performance parameters was also investigated. Method: Quantitative methodology was used to review examinations of women who were recalled for a technical recall or further assessment rates. All accessible members of the population recalled during the first round were retrospectively reviewed resulting in a sample of 2300 recalled examinations. Results: Malta's first screening round met the European Guidelines recommendations for technical repeat rate (0.26%), early recall rate (0.45%), breast cancer detection rate (13.77 per 1000 women) and Positive Predictive Value of screening test (7.58%). However, local recall rate (18.53%) and further assessment rate (18.27%) were higher than recommended. The Chi square test showed a statistically significant difference (p ≤ 0.05) in recall rates between the compared age groups, as younger women (51–55 years) were more likely to have a negative diagnosis after the initial mammogram whereas older women (56–60 years) were more likely to be recalled. There was no age discrepancy (p ≥ 0.05) in local breast cancer detection rate and positive predictive value of screening test. Conclusion: Although the Maltese first screening round performed well, this study found deficiencies in recall and further assessment rates, which according to literature may result in psychological morbidity and inefficient use of screening resources. This study also concluded that when a cohort is analysed, age is not as significant as the screening round itself (first/subsequent). - Highlights: • The Maltese technical and early recall rates complied with European guidelines. • Breast cancer detection rate and positive predictive value conformed to guidelines. • The recall and further

  9. In vitro fertilisation with recombinant follicle stimulating hormone requires less IU usage compared with highly purified human menopausal gonadotrophin: results from a European retrospective observational chart review

    Directory of Open Access Journals (Sweden)

    Blackmore Stuart

    2010-11-01

    Full Text Available Abstract Background Previous studies have reported conflicting results for the comparative doses of recombinant follicle stimulating hormone (rFSH and highly purified human menopausal gonadotrophin (hMG-HP required per cycle of in vitro fertilisation (IVF; the aim of this study was to determine the average total usage of rFSH versus hMG-HP in a 'real-world' setting using routine clinical practice. Methods This retrospective chart review of databases from four European countries investigated gonadotrophin usage, oocyte and embryo yield, and pregnancy outcomes in IVF cycles (± intra-cytoplasmic sperm injection using rFSH or hMG-HP alone. Included patients met the National Institute for Health and Clinical Excellence (NICE guideline criteria for IVF and received either rFSH or hMG-HP. Statistical tests were conducted at 5% significance using Chi-square or t-tests. Results Of 30,630 IVF cycles included in this review, 74% used rFSH and 26% used hMG-HP. A significantly lower drug usage per cycle for rFSH than hMG-HP (2072.53 +/- 76.73 IU vs. 2540.14 +/- 883.08 IU, 22.6% higher for hMG-HP; p Conclusions Based on these results, IVF treatment cycles with rFSH yield statistically more oocytes (and more mature oocytes, using significantly less IU per cycle, versus hMG-HP. The incidence of all OHSS and hospitalisations due to OHSS was significantly higher in the rFSH cycles compared to the hMG-HP cycles. However, the absolute incidence of hospitalisations due to OHSS was similar to that reported previously. These results suggest that the perceived required dosage with rFSH is currently over-estimated, and the higher unit cost of rFSH may be offset by a lower required dosage compared with hMG-HP.

  10. A Retrospective Chart Review of Two Different Insulin Administration Systems on Glycemic Control in Older Adults in Long-Term Care.

    Science.gov (United States)

    Boonin, Alan; Balinski, Brenda; Sauter, Jerry; Martinez, Joe; Abbott, Scott

    2017-01-01

    The current retrospective chart review compared glycemic control and cost impact of two insulin administration systems, V-Go ® versus usual care with standard of care (SOC) insulin injections, in eight patients residing in a nursing home (NH). A total of 1,937 blood glucose (BG) values were collected over 61 days. Significant improvements were observed for the V-Go versus SOC group in time in range 100 mg/dL to 200 mg/dL (V-Go 59.09% vs. SOC 34.02%; p < 0.001), reduced BG fluctuations as measured by standard deviation (V-Go 61.2 vs. SOC 92.1; p < 0.001), and improved mean daily BG (V-Go 159.38 mg/dL vs. SOC 223.86 mg/dL; p < 0.001). The estimated A1c change, calculated from BG values, decreased from 8.9% to 7.2% in the V-Go group and increased from 9.0% to 9.4% in the SOC group. Compared to SOC, use of V-Go decreased the mean time for insulin administration by nursing staff by 26.3 minutes per patient per day and associated labor costs by $328.75 per patient per month. Insulin administration with V-Go may improve glycemic control and reduce administration costs compared to existing care in the NH setting. [Journal of Gerontological Nursing, 43(1), 10-16.]. Copyright 2017, SLACK Incorporated.

  11. Surgical care for the aged: a retrospective cross-sectional study of a national surgical mortality audit

    Science.gov (United States)

    Allen, Jennifer; North, John B; Ware, Robert S

    2015-01-01

    Objectives It is assumed that increased age signifies increased surgical care. Few surgical studies describe the differences in care provided to older patients compared with younger patients. We aimed to examine the relationships between increasing age, preoperative factors and markers of postoperative care in adults who died in-hospital after surgery in Australia. Design This retrospective cross-sectional study extracted data from a national surgical mortality audit—an independent, peer-reviewed process. Setting From January 2009 to December 2012, 111 public and 61 private Australian hospitals notified the audit of in-hospital deaths after general anaesthetic surgery or if the patient was admitted under a surgeon. Participants Notified deaths totalled 19 723. We excluded deaths if patients were brain dead, younger than 17 years or never had an operation (n=11 376). From this baseline population, we divided 11 201 deaths into three patient age groups: youngest (17–64 years), medium (65–79 years) and oldest (≥80 years). Outcome measures Univariable and multivariable logistic regression analyses determined the relationships between increasing age and the measured preoperative factors and postoperative variables. Results The baseline population's median age was 78 years (IQR 66–85), 43.7% (4892/11 201) were 80 years or older and 83.4% (9319/11 173) had emergency admissions. The oldest group had increased trauma and emergency admissions than the medium and youngest age groups. Seven of the eight measured markers of postoperative care demonstrate strong and significant relationships with increasing age. The oldest group compared with the medium group had decreased rates of: unplanned returns to theatre (11.2% (526/4709) vs 20.2% (726/3586)), unplanned intensive care admissions (16.3% (545/3350) vs 24.0% (601/2504)) and treatment in intensive care units (59.7% (2689/4507) vs 76.7% (2754/3590)). Conclusions The oldest patients received

  12. Retrospective audit of antimicrobial prescribing practices for acute exacerbations of chronic obstructive pulmonary diseases in a large regional hospital.

    Science.gov (United States)

    Brownridge, D J; Zaidi, S T R

    2017-06-01

    Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines. To evaluate the antibiotic prescribing practices in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients, and to compare the differences in clinical outcomes (primarily mean length of stay and the rate of unplanned readmissions) between patients who received broad- vs. narrow-spectrum antibiotics in a large regional hospital. Retrospective audit of medical records for patients admitted with uncomplicated AECOPD during January-September, 2014 in a 224 acute bed regional hospital in Victoria, Australia. Fifty-nine per cent of patients received broad-spectrum antibiotics (ceftriaxone), whereas only 10% of prescriptions were concordant with current Australian guideline recommendations. Patients receiving a broad-spectrum regimen were more likely to be older (74·9 vs. 69·9 years; P = 0·009), have a higher COPD severity score (i.e. BAP-65 score, 1·55 vs. 1·06; P = 0·002) and a higher CRP (59·2 vs. 25·5 mg/L; P = 0·003) on admission. The mean LOS was not significantly different between those who received ceftriaxone and those who did not (5·09 vs. 4·55 days; P = 0·47). There was no significant difference between the groups in rates of readmissions. The antibiotic prescribing patterns for AECOPD in rural and regional Australian hospitals have not previously been examined in the current literature. In the study hospital, the majority of patients received broad

  13. Radar Chart

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Radar Chart collection is an archived product of summarized radar data. The geographic coverage is the 48 contiguous states of the United States. These hourly...

  14. Chart Series

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) offers several different Chart Series with data on beneficiary health status, spending, operations, and quality...

  15. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review.

    Science.gov (United States)

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin

    2016-07-01

    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P < 0.0001), lower time to positivity (P < 0.0001), immunosuppression (P = 0.03), and recommendation made by an infectious disease consultant (P = 0.0005). On multivariable analysis, infectious diseases consultation (P = 0.03), higher number of positive blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs

  16. Frequency and Type of Prosthetic Complications Associated with Interim, Immediately Loaded Full-Arch Prostheses: A 2-Year Retrospective Chart Review.

    Science.gov (United States)

    Drago, Carl

    2016-08-01

    The purpose of this report was to retrospectively evaluate implant and immediate full-arch prosthesis survival rates over a 24-month period; patients were consecutively treated with immediate occlusal loading. Dental arch, gender, and implant orientation (vertical vs. tilted) were also noted. All Brånemark System implants (Nobel Active) and interim, all-acrylic resin prostheses placed in patients following an All-on-Four™ protocol, in a single private practice were assessed by retrospective patient chart review. The amount of space provided surgically for implant restorative components and prostheses was determined from measurements of the vertical heights of the interim prostheses in the right/left anterior and posterior segments. These measurements were made in the laboratory. Interim prosthetic repairs (type, frequency, length of time from insertion) were analyzed by type, arch, gender, and implant orientation. Implant survival and insertion torque values were also measured. Inclusion criteria consisted of all Brånemark System implants placed with the All-on-Four protocol from September 1, 2011, until August 31, 2013. Specific dietary instructions were given for the first 7 days immediately postoperatively and for the weeks prior to insertion of the definitive prostheses. One hundred twenty-nine patients, comprising 191 arches (766 implants) from September 1, 2011, until August 31, 2013, were included in the study. One patient experienced implant failure yielding an overall implant survival rate (SR) of 99.5% (762 of 766). Four hundred twenty-six of 430 maxillary implants and 336 of 336 mandibular implants survived for SRs of 99.1% and 100%, respectively. Regarding implant orientation, 415 of 417 tilted implants (SR 99.5%) and 343 of 345 (CSR 95.6%) vertical implants were noted to be clinically stable. Interim, all-acrylic resin prostheses were in place for a mean of 199.2 days; mandibular prostheses were in place for an average of 195.4 days; maxillary

  17. Retrospective

    Science.gov (United States)

    Brooks, David A.

    Charting a course toward an uncertain future is always a risky business, especially among shoals of fiscal restraint or national tragedy, and the prudent navigator is well advised to remember where he's been as he looks ahead. The ocean and space sciences are poised for grand joint adventures, but shrinking budgets and the lingering Challenger numbness are restrictive lee shores that must be considered when laying plans. To sharpen the focus on future choices, it may be helpful to glance in the geophysical rearview mirror and remember some of the challenges and opportunities of a different era.A quarter century is a long time, but many images from 25 years ago can still be recalled in crisp detail, like photographs in a scrapbook. In 1961, results from the International Geophysical Year (IGY) filled the pages of the Transactions of the American Geophysical Union, and the U.S. program of space exploration finally was underway with conviction. The Indian Ocean Expedition, conceived during the IGY, ushered in a new era of international oceanography. The TIROS III satellite beamed to earth fuzzy pictures of tropical storms and revealed the intricate writhings of the Gulf Stream. Forecasters and fluid dynamicists suddenly saw new horizons, and geophysical turbulence became a major topic at the IUGG Symposium in Marseilles, France. Papers with prescient themes were presented at the AGU Ocean Section meeting: June Pattullo (then at Oregon State College, Corvallis) on heat storage in the Pacific; Ferris Webster (then at Woods Hole Oceanographic Institution, Woods Hole, Mass.) on Gulf Stream meanders. Polar oceanography was well represented in AGU journals: Kenneth Hunkins (at what was then called the Lamont Geological Observatory, Palisades, N.Y.) described the Alpha Rise, discovered from a drifting Arctic ice island, and Edward Thiel (then at the University of Minnesota, Minneapolis) and his co-workers discussed open ocean tides, gravimetrically measured from Antarctic

  18. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Sadosky A

    2013-02-01

    Full Text Available Alesia Sadosky,1 Caroline Schaefer,2 Rachael Mann,3 Felicia Bergstrom,2 Rebecca Baik,2 Bruce Parsons,1 Srinivas Nalamachu,4 Edward Nieshoff,5 Brett R Stacey,6 Alan Anschel,7 Michael Tuchman81Pfizer Inc, New York, NY, 2Covance Market Access Services Inc, Gaithersburg, MD, 3Covance Market Access Services Inc, San Diego, CA, 4International Clinical Research Institute, Overland Park, KS, 5Rehabilitation Institute of Michigan/Wayne State University, Detroit, MI, 6Oregon Health and Science University, Portland, OR, 7Rehabilitation Institute of Chicago, Chicago, IL, 8Palm Beach Neurological Center, Palm Beach Gardens, FL, USABackground: The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN seeking treatment in the US.Methods: This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.Results: The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%, depressive symptoms (41.1%, and anxiety (35.7%. The mean pain severity score was 5.2 (0–10 scale, and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0–10 scale overall, with 2.0 among mild, 5.1 among moderate, and 7

  19. Risk stratification and stroke prevention therapy care gaps in Canadian atrial fibrillation patients (from the Co-ordinated National Network to Engage Physicians in the Care and Treatment of Patients With Atrial Fibrillation chart audit).

    Science.gov (United States)

    Patel, Ashish D; Tan, Mary K; Angaran, Paul; Bell, Alan D; Berall, Murray; Bucci, Claudia; Demchuk, Andrew M; Essebag, Vidal; Goldin, Lianne; Green, Martin S; Gregoire, Jean C; Gross, Peter L; Heilbron, Brett; Lin, Peter J; Ramanathan, Krishnan; Skanes, Allan; Wheeler, Bruce H; Goodman, Shaun G

    2015-03-01

    The objectives of this national chart audit (January to June 2013) of 6,346 patients with atrial fibrillation (AF; ≥18 years without a significant heart valve disorder) from 647 primary care physicians were to (1) describe the frequency of stroke and bleed risk assessments in patients with nonvalvular AF by primary care physicians, including the accuracy of these assessments relative to established predictive indexes; (2) outline contemporary methods of anticoagulation used; and (3) report the time in the therapeutic range among patients prescribed warfarin. An annual stroke risk assessment was not undertaken in 15% and estimated without a formal risk tool in 33%; agreement with CHADS2 score estimation was seen in 87% of patients. Major bleeding risk assessment was not undertaken in 25% and estimated without a formal risk tool in 47%; agreement with HAS-BLED score estimation was observed in 64% with physician overestimation in 26% of patients. Antithrombotic therapy included warfarin (58%), dabigatran (22%), rivaroxaban (14%), and apixaban (risk for stroke. There is apparent overestimation of bleeding risk in many patients. Warfarin was the dominant stroke prevention treatment; however, the suggested TTR target was achieved in only 55% of these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    LENUS (Irish Health Repository)

    Gorman, Sharon

    2009-05-28

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

  1. Major surgery in south India: a retrospective audit of hospital claim data from a large community health insurance programme.

    Science.gov (United States)

    Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand

    2015-04-27

    Information about use of major surgery in India is scarce. This study aims to bridge this gap by auditing hospital claims from the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) that provides access to free tertiary care for major surgery through state-funded insurance to 68 million beneficiaries with limited household incomes-81% of population in states of Telangana and Andhra Pradesh (combined Human Development Index 0·485). Beneficiary households receive an annual coverage of INR 200 000 (US$3333) for admissions to any empanelled public or private hospital. Publicly available deidentified hospital claim data for all surgical procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. 677 332 surgical admissions (80% at private hospitals) were recorded at a mean annual rate of 259 per 100 000 beneficiaries (95% CI 235-283), excluding cataract and caesarean sections as these were not covered under the insurance programme. Men accounted for 56% of admissions. Injury was the most common cause for surgical admission (185 733; 27%) with surgical correction of long bone fractures being the most common procedure (144 997; 20%) identified in the audit. Diseases of digestive (110 922; 16%), genitourinary (82 505; 12%), and musculoskeletal system (70 053; 10%) were other leading causes for surgical admissions. Most hospital bed-days were used for injuries (584 days per 100 000 person years; 31%), digestive diseases (314 days; 17%), and musculoskeletal system (207 days; 11%), costing 19% (INR 4·4 billion), 13% (3·03 billion), and 11% (2·5 billion) of claims, respectively. Cardiovascular surgeries (53 023; 8%) alone accounted for 21% (INR 4·9 billion) of cost. Annual per capita cost of surgical claims was US$1·49 (95% CI 1·32-1·65). Our findings are limited to a population socioeconomically representative of India and other countries with low-income and middle

  2. Post resuscitation management of cardiac arrest patients in the critical care environment: A retrospective audit of compliance with evidence based guidelines.

    Science.gov (United States)

    Milonas, Annabel; Hutchinson, Ana; Charlesworth, David; Doric, Andrea; Green, John; Considine, Julie

    2017-11-01

    There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation. A retrospective audit of medical records of patients who met the criteria for survivors of cardiac arrest was conducted at two health services in Melbourne, Australia. Criteria audited were: primary cardiac arrest characteristics, oxygenation and ventilation management, cardiovascular care, neurological care and patient outcomes. The four major findings were: (i) use of fraction of inspired oxygen (FiO 2 ) of 1.0 and hyperoxia was common during the first 24h of post resuscitation management, (ii) there was variability in cardiac care, with timely 12 lead Electrocardiograph and majority of patients achieving systolic blood pressure (SBP) greater than 100mmHg, but delays in transfer to cardiac catheterisation laboratory, (iii) neurological care was suboptimal with a high incidence of hyperglycaemia and failure to provide therapeutic hypothermia in almost 50% of patients and (iv) there was an association between in-hospital mortality and specific elements of post resuscitation care during the first 24h of hospital admission. Evidence-based context-specific guidelines for post resuscitation care that span the whole patient journey are needed. Reliance on national guidelines does not necessarily translate to evidence based care at a local level, so

  3. Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

    Science.gov (United States)

    Gupta, Deepak; Haber, Halim

    2014-06-01

    Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had

  4. A Retrospective Audit of Dental Treatment Provided to Special Needs Patients under General Anesthesia During a Ten-Year Period.

    Science.gov (United States)

    Mallineni, Sreekanth Kumar; Yiu, Cynthia Kar Y

    The purpose of this study was to perform a comprehensive audit of dental treatment provided to special needs patients (SNP) under general anesthesia (GA) over a ten-year period. Special needs patients who received dental treatment under GA as an in-patient at Queen Mary Hospital, Hong Kong SAR during the time period January 2002 and December 2011 were included in the study. The study population was divided into three groups, based on age (12 years). One-way ANOVA was used to evaluate the effect of "age group" on duration of treatment, post-recovery time, treatment procedures and utilization of different restorative materials. Kappa statistics were used for intra-examiner reliability. A total of 275 patients (174 males and 101 females) were included in the study. The mean age of the patients at the time they received GA was 12.37±10.18 years. Dental procedures performed were mostly restorative in nature (47%). The >12 years group had significantly shorter treatment duration (pdifference in post-operative recovery time was observed among the three age groups (p>0.05). The group received significantly less preventive, but more restorative procedures (pgroup (puse of composite restorations was significantly higher in the group; while amalgam restorations were more frequently used in the >12 years group (Page (page, had longer treatment time under GA. Composite restorations and stainless steel crowns were more frequently used in the primary dentition and amalgam restorations were more frequently employed in the permanent dentition.

  5. A comparison of the efficacy and tolerability of oxcarbazepine oral suspension between infants and children with epilepsy: a retrospective chart review at a single medical center in Taiwan.

    Science.gov (United States)

    Wei, Shu-Hao; Liu, Cheng-Chao; Fan, Pi-Chuan

    2014-02-01

    Few clinical studies have assessed the efficacy and safety of oxcarbazepine (OXC) oral suspension in Asian pediatric patients and particularly in infants. The aim of this study was to investigate and compare the efficacy, tolerability, and side effects of OXC oral suspension in Taiwanese infants and children with various types of epilepsy. A retrospective review of the efficacy, tolerability, and side effects of OXC oral suspension in a tertiary medical center in Taiwan was conducted and included children (1-9 years old) and infants (effects (30 vs. 21 %, p = 0.525) after OXC oral suspension treatment. The efficacy was significantly correlated with the epilepsy subtype (p effective and well tolerated in both infants and children with partial epilepsy in Taiwan. Treatment efficacy was related to epilepsy subtype and number of combined AEDs before OXC treatment. Monotherapy had an excellent therapeutic response in partial epilepsy but not in multifocal epilepsy.

  6. Retrospective Chart Review of Skin-to-Skin Contact in the Operating Room and Administration of Analgesic and Anxiolytic Medication to Women After Cesarean Birth.

    Science.gov (United States)

    Wagner, Debra L; Lawrence, Stephen; Xu, Jing; Melsom, Janice

    2018-04-01

    Transporting a newborn out of the operating room after cesarean birth can contribute to maternal awareness of discomfort, anxiety, and the need for administration of analgesics and anxiolytics for relief. This retrospective study analyzed the association between skin-to-skin contact in the operating room and administration of analgesics and anxiolytics to women in the operating and recovery rooms after cesarean birth. Our results indicated a trend toward decreased medication administration for women who experienced skin-to-skin contact and add to evidence supporting the incorporation of skin-to-skin contact in the operating room as the standard of care for cesarean birth. This practice has the potential to enhance the birth experience, promote breastfeeding, and provide greater safety with less exposure to opioids and benzodiazepines for women and their newborns. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  7. A retrospective clinical audit of general practices in Australia to determine the motivation for switch to dolutegravir/abacavir/lamivudine and clinical outcomes.

    Science.gov (United States)

    Ferrer, Pedro E; Bloch, Mark; Roth, Norman; Finlayson, Robert; Baker, David; Koh, Ken; Orth, David; Urbaityte, Rimgaile; Brown, Dannae; Drummond, Fraser

    2018-03-01

    The most common reasons for switching HIV-1 therapy in patients with virologic suppression are treatment regimen simplification and resolving tolerability issues. Single-pill regimens that include an integrase inhibitor are recommended options. A retrospective clinical audit was performed to determine the motivations for switching to dolutegravir (DTG)/abacavir (ABC)/lamivudine (3TC) at high HIV-caseload general practice clinics in Australia. The most common reasons for switching from a prior suppressive therapy to DTG/ABC/3TC were simplification of regimen, resolving toxicity/intolerance and patient preference (73%, 13% and 12%, respectively). Kaplan-Meier analysis showed that the probability of patients remaining on DTG/ABC/3TC therapy at 12 months was 95.1%. Switching to DTG/ABC/3TC from a range of other regimens was associated with a discontinuation rate of 3.2%, with 2.5% of patients discontinuing due to adverse events and no patients discontinuing due to virologic failure. Switching to DTG/ABC/3TC was a viable treatment strategy in this cohort of Australian patients.

  8. Lateral compression open cap splint with circummandibular wiring for management of pediatric mandibular fractures: a retrospective audit of 10 cases.

    Science.gov (United States)

    Bhola, Nitin; Jadhav, Anendd; Borle, Rajiv; Khemka, Gaurav; Adwani, Nitin; Bhattad, Mayur

    2014-03-01

    Mandibular fractures are relatively less frequent in children when compared to adults. Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning and in their functional needs. We currently describe our experience with lateral compression open cap splint with circummandibular wiring as a treatment modality which involves fewer risks in treating pediatric symphysis/parasymphysis/body mandibular fractures. A retrospective analysis of pediatric patients with mandibular symphysis/parasymphysis/body fractures operated from January 2007 to January 2012 was performed. Clinical photographs and orthopantomogram assessment at the time of presentation, after treatment, and at 6 months postoperatively were evaluated. All the 10 patients were followed up until the period of 6 months, and none of them had any major complications. Postoperatively, there was satisfactory healing and union of fracture fragments in all the patients. Only one patient developed infection at submental region. The 6-month follow-up showed good occlusion, without interference in teeth eruption and no signs of temporomandibular joint problems. Lateral compression open cap splints for treatment of pediatric mandibular symphysis/parasymphysis/body fractures are reliable treatment modalities with regard to occlusion-guided fracture reduction.

  9. Endoscopic ultrasound in the evaluation of chronic upper abdominal pain of unknown etiology: a retrospective chart review examining the efficacy of EUS in determining a new diagnosis.

    Science.gov (United States)

    Thompson, Michelle B; Ramirez, Jonathan C; De La Rosa, Lisa M; Wood, Adam S; Desai, Shiv; Arjunan, Ananth; Song, Juhee; Erickson, Richard A

    2015-02-01

    To explore the utility of endoscopic ultrasound (EUS) in the evaluation of chronic upper abdominal pain (UAP) of undetermined etiology. Chronic UAP is a common problem with a challenging diagnosis and management. The role of EUS in the diagnosis of UAP may minimize additional testing; however, few studies describe the percentage of new diagnoses yielded in these patients. We conducted a retrospective analysis by reviewing electronic medical records at Scott and White Memorial Hospital, Texas A&M Health Sciences Center for patients with abdominal pain for ≥ 12 months not explained by previous workup referred for EUS for chronic UAP from January 1, 1998 through October 1, 2007. Patients with previous EUS in past 12 months were excluded from the study. Patient demographic data and imaging performed 6 months before and 24 months after EUS were reviewed and results documented. EUS was successful at diagnosing a new clinical etiology of chronic UAP in 33 patients (8.89%) with previous workup that was unrevealing for a definitive diagnosis. The most frequent diagnoses included pancreaticobiliary tree abnormalities, chronic pancreatitis, and fatty liver disease. Our results support the fact that the majority of patients UAP with prior imaging will have no identifiable organic etiology found on EUS to explain their pain; however, we suggest that EUS be considered in patients with suspected pancreatic or biliary pathology.

  10. Prevalence of Skin Tears in Elderly Patients: A Retrospective Chart Review of Incidence Reports in 6 Long-term Care Facilities.

    Science.gov (United States)

    Hawk, Joyce; Shannon, Mary

    2018-04-01

    The incidence and prevalence of skin tears in long-term care (LTC) facilities has not been well established. To ascertain the point prevalence of reported skin tears, a retrospective review of incident reports was performed in 6 LTC facilities in western Pennsylvania from November 1, 2016 through December 31, 2016. Report data, including resident age; gender; mobility limitations; skin tear location, number, and cause (if known); occurrence time (7 am to 3 pm, 3 pm to 11 pm, or 11 pm to 7 am nursing shift); and history of previous skin tears, were abstracted. All data were entered into a statistical analysis program and analyzed using descriptive statistics. Period prevalence was used to determine prevalence rate; an independent t test was used to compare the presence of skin tears between genders. Differences between location and cause of skin tears were evaluated using a multinomial test of related proportions. A test of proportions was used to evaluate skin tear occurrence time (nursing shift) differences. The overall point prevalence rate was 9% (N = 1253 residents) ranging from 6 to 28 skin tears per facility. The average age of residents with a skin tear (n = 119) was 83.5 years. The majority (111, 93%) had mobility limitations. Falls accounted for 38 skin tears (31.9%), followed by propelling in a wheelchair (18, 15.1%; X2 =7.14; P = .008). Forearm skin tears (37, 31.1%) occurred significantly more frequently than lower leg skin tears (19, 16%; P = .016). Significantly more skin tears occurred during the 7 am to 3 pm shift (47, 39.5%) and 3 pm to 11 pm shift (49, 41.2%) than during the 11 pm to 7 am shift (23, 19.3%; X2 = 5.78; P skin tears are a significant problem among elderly residents in LTC, especially because the reported rate is likely lower than the actual rate. Research to further elucidate the incidence and prevalence of skin tears and associated risk factors is needed to help develop evidence-based risk assessment, classification systems

  11. Evaluation of costs accrued through inadvertent continuation of hospital-initiated proton pump inhibitor therapy for stress ulcer prophylaxis beyond hospital discharge: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Shin S

    2015-04-01

    Full Text Available Sooyoung Shin Ajou University College of Pharmacy, Yeongtong-gu, Suwon-si, Gyeonggi-do, South Korea Background: Stress ulcers and related upper gastrointestinal bleeding are well-known complications in intensive care unit (ICU patients. Proton pump inhibitor (PPI-based stress ulcer prophylaxis (SUP has been widely prescribed in noncritically ill patients who are at low risk for clinically significant bleeding, which is then injudiciously continued after hospital discharge. This study aimed to evaluate the incidence of inappropriate prescribing of PPI-based preventative therapy in ICU versus non-ICU patients that subsequently continued postdischarge, and to estimate the costs incurred by the unwarranted outpatient continuation of PPI therapy.Methods: A retrospective review of patient data at a major teaching hospital in Korea was performed. During the 4-year study period, adult patients who were newly initiated on PPI-based SUP during hospital admission and subsequently discharged on a PPI without a medical indication for such therapy were captured for data analysis. The incidence rates of inappropriate prescribing of PPIs were compared between ICU and non-ICU patients, and the costs associated with such therapy were also examined.Results: A total of 4,410 patients, more than half of the inpatient-initiated PPI users, were deemed to have been inadvertently prescribed a PPI at discharge in the absence of a medical need for acid suppression. The incidence of inappropriate outpatient continuation of the prophylaxis was higher among ICU patients compared with non-ICU patients (57.7% versus 52.2%, respectively; P=0.001. The total expenditure accrued through the continuation of nonindicated PPI therapy was approximately US$40,175.Conclusion: This study confirmed that excess usage of PPIs for SUP has spread to low-risk, non-ICU patients. The overuse of unwarranted PPI therapy can incur large health care expenditure, as well as clinical complications

  12. Comparative effectiveness of everolimus-based therapy versus endocrine monotherapy among postmenopausal women with HR+/HER2- metastatic breast cancer: a retrospective chart review in community oncology practices in the US.

    Science.gov (United States)

    Xie, Jipan; Hao, Yanni; Li, Nanxin; Lin, Peggy L; Ohashi, Erika; Koo, Valerie; Signorovitch, James E; Wu, Eric Q; Yardley, Denise A

    2015-06-01

    Everolimus-based therapy and endocrine monotherapy are used among postmenopausal women with hormone receptor-positive human epidermal growth factor receptor-2 negative (HR+/HER2-) metastatic breast cancer (mBC) whose disease progressed or recurred on a non-steroidal aromatase inhibitor (NSAI). However, limited evidence exists regarding the real-world comparative effectiveness of these agents. This retrospective chart review examined postmenopausal HR+/HER2- mBC patients in community-based oncology practices who received everolimus-based therapy or endocrine monotherapy (index therapy) as any line of therapy for mBC between 1 July 2012 and 15 April 2013 after NSAI failure. Time on treatment (TOT), progression-free survival (PFS), and time to chemotherapy (TTC) from index therapy initiation were compared using Kaplan-Meier analyses and Cox proportional hazards models adjusting for baseline characteristics. A total of 243 and 270 patients received everolimus-based therapy or endocrine monotherapy in a quota-based sample. Patients treated with everolimus-based therapy had a higher proportion of visceral metastases, high tumor burden, and use of prior chemotherapies for mBC. After adjusting for baseline characteristics, everolimus-based therapy was associated with significantly longer TOT (HR = 0.67, 95% CI: 0.51-0.87) and PFS (HR = 0.75, 95% CI: 0.57-0.98) than endocrine monotherapy. No significant difference was found between everolimus-based therapy and endocrine monotherapy in TTC (HR = 0.81, 95% CI: 0.52-1.27). Results stratified by line of therapy were generally consistent with the overall results. Limitations include recall and information bias with potentially absent or erroneous chart data, unobserved factors due to non-randomization, inability to measure outcome assessments paired with measuring outcomes prior to exposures, and potential patient selection bias associated with chart review. Among a nationwide sample of postmenopausal HR+/HER2- m

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

    Science.gov (United States)

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

    2018-02-01

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

  14. Retrospective audit of clinico-pathologic features and treatment outcomes in a cohort of elderly non-Hodgkin's lymphoma patients in a tertiary cancer center.

    Science.gov (United States)

    Nair, C K; Patil, V M; Raghavan, V; Babu, S; Nayanar, S

    2015-01-01

    There is limited data from India regarding elderly non-Hodgkin's lymphomas (NHL) patients. Hence, this audit was planned to study the clinic-pathological features and treatment outcomes in elderly NHL patients. Retrospective analysis of all NHL patients above age of 59 years treated at the author's institute, between December 2010 and December 2013 was done. Case records were reviewed for baseline details, staging details, prognostic factors, treatment delivered, response, toxicity and efficacy. SPSS version 16 (IBM, Newyork) was used for analysis. Descriptive statistics was performed. Kaplan-Meir survival analysis was done for estimation of progression-free survival (PFS) and overall survival (OS). Univariate analysis was done for identifying factors affecting PFS and OS. Out of 141 NHL patients, 67 patients were identified subjected to the inclusion criteria. The median age was 68 years (60-92). Majority were B-cell NHL (86.6%). The commonest subtype in B-cell was diffuse large B-cell lymphoma (55.2%). Fifty-four patients took treatment. The treatment intent was curative in 41 patients (61.2%). Among the patients receiving curative treatment, 16 patients couldn't receive treatment in accordance with NCCN guidelines due to financial issues. Two years PFS was 55%. Two years PFS for B-cell NHL and T-cell NHL were 55% and 50% respectively (P = 0.982). Two years PFS for standard Rx and nonstandard Rx were 62% and 50% respectively, but it didn't reach statistical significance (P = 0.537). Two years OS for the entire cohort was 84%. Standard treatment in accordance with guidelines can be delivered in elderly patients irrespective of age. There is a need for creating financial assistance for patients, so that potentially curative treatments are not denied.

  15. Use of pre-travel vaccine-preventable disease serology as a screening tool to identify patients in need of pre-travel vaccination: a retrospective audit.

    Science.gov (United States)

    Turner, David P; McGuinness, Sarah L; Cohen, Jonathan; Waring, Lynette J; Leder, Karin

    2017-05-01

    Vaccination is a safe and effective public health intervention that not only protects individual travellers from vaccine-preventable diseases (VPDs), but prevents them from becoming a source of disease in their destination and on their return. Obtaining an accurate vaccination history from travellers during a pre-travel review can be difficult; serology may be used to identify patients who are non-immune to specific diseases in order to guide vaccination requirements. Clinically relevant data about the usefulness of serology in this setting are lacking. We performed a retrospective audit of pre-travel VPD serology requested by practitioners of a busy community-based travel clinic. All serological results for measles, mumps, rubella, varicella zoster virus, hepatitis A and B requested over a 5-year period were extracted and analysed. Results were stratified by gender and year of birth and compared using Stata. Four thousand four hundred and fifty-one serological assays from 1445 individual were assessed. Overall, 47% of patients tested had at least one negative serological result. High rates of seropositivity for measles, mumps and rubella were seen in those born prior to 1966 but >10% of travellers born after 1966 lacked serological evidence of protection against these diseases. Hepatitis A and B serological results revealed broadly lower rates of immunity in our community likely reflecting the absence of these vaccines from historical vaccine protocols. Serology can be a useful tool in the identification of non-immune travellers to enable targeted vaccination prior to travel. We recommend that travel health clinicians assess patients' vaccination and infection histories, and strongly consider serology or vaccination where there is doubt about immunity. This will help protect the traveller and prevent importation of disease into destination or home communities. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights

  16. Management of hip fractures in older people in Beijing: a retrospective audit and comparison with evidence-based guidelines and practice in the UK.

    Science.gov (United States)

    Tian, M; Gong, X; Rath, S; Wei, J; Yan, L L; Lamb, S E; Lindley, R I; Sherrington, C; Willett, K; Norton, R

    2016-02-01

    Despite the high burden of hip fracture in China, there is limited information on its management. This study investigated the management of hip fractures in a Beijing tertiary hospital and compared practice with that in 180 hospitals in the UK. The findings show a significant gap exists between the countries. The purpose of this study was to determine if the management of older people with hip fractures in a Beijing tertiary hospital is comparable with the UK best practice guidelines for hip fracture management and the UK National Hip Fracture Database 2012, obtained from 180 hospitals. A retrospective audit was undertaken in a large tertiary care hospital in Beijing. Data were compared with the National Hip Fracture Database 2012 collected in 180 hospitals in the UK on the proportion of patients managed according to the UK Blue Book standards. Sixty-six percent of patients were admitted to an orthopaedic ward within 24 h of fracture, while 100 % of patients in the UK were admitted to an orthopaedic ward within 24 h of arrival to an accident and emergency department. Only 8 % of patients received surgery within 48 h of admission compared with 83 % in the UK; 10 % received no surgery compared with 2.5 % in the UK; and 27 % received orthogeriatrician assessment compared with 70 % in the UK. New pressure ulcers developed in 2 % of patients compared with 3.7 % of those in the UK; whereas, 0.3 % of patients were assessed for osteoporosis treatment and 3.8 % received falls assessment, and comparable figures for the UK were 94 and 92 %, respectively. Significant gaps exist in hip fracture management in the Beijing hospital compared with the best practice achieved in 180 UK hospitals, highlighting the need to implement and evaluate proactive strategies to increase the uptake of best practice hip fracture care in China.

  17. Impact of a rapid molecular test for positive blood cultures from neonatal intensive care patients on clinical management: a retrospective audit.

    Science.gov (United States)

    Koh, L L; O'Rourke, S; Brennan, M; Clooney, L; Cafferkey, M; McCallion, N; Drew, R J

    2018-05-01

    Both Staphylococcus aureus and coagulase negative Staphylococci are common causes of late-onset neonatal sepsis in the neonatal intensive care unit (NICU), usually relating to intravascular access device infections. This project aimed to review the impact on antimicrobial treatment and clinical outcome in the NICU setting, of the introduction of the Xpert MRSA/SA BC test (Cepheid, USA) for the identification of staphylococci in blood cultures. A retrospective audit was carried out of the pre- and post-intervention periods; the intervention was the introduction of the Xpert MRSA/SA BC test. In total, 88 neonates had positive blood cultures with Staphylococcus spp., comprising 42 neonates in the pre-intervention and 46 in the post-intervention groups. The pre-intervention group had a higher birth weight (1.541 kg vs. 1.219 kg, p = 0.05) and higher platelet count (288 vs. 224 × 10 9 /L, p = 0.05). There was a trend towards a shorter duration of antimicrobial therapy in term infants and in the length of admission; however, this was not statistically significant (p = 0.2). All of the nine infants post-intervention with significant bacteraemia (S. aureus =3, CoNS =6) were changed to the optimal antimicrobial at the time the result was available. This study shows that the introduction of the Xpert MRSA/SA BC test can lead to a reduction in the length of admission and duration of antimicrobials in term infants; however, the difference was not statistically significant. All nine infants with clinically significant bacteraemia were treated with the appropriate antimicrobial when the Xpert MRSA/SA BC test result was available.

  18. Qualities of dental chart recording and coding.

    Science.gov (United States)

    Chantravekin, Yosananda; Tasananutree, Munchulika; Santaphongse, Supitcha; Aittiwarapoj, Anchisa

    2013-01-01

    Chart recording and coding are the important processes in the healthcare informatics system, but there were only a few reports in the dentistry field. The objectives of this study are to study the qualities of dental chart recording and coding, as well as the achievement of lecture/workshop on this topic. The study was performed by auditing the patient's charts at the TU Dental Student Clinic from July 2011-August 2012. The chart recording mean scores ranged from 51.0-55.7%, whereas the errors in the coding process were presented in the coder part more than the doctor part. The lecture/workshop could improve the scores only in some topics.

  19. Exploring post-fall audit report data in an acute care setting.

    Science.gov (United States)

    Tzeng, Huey-Ming; Yin, Chang-Yi

    2015-06-01

    This retrospective, descriptive, chart review study was done to demonstrate one strategy for communicating aggregated and actionable fall data to bedside nurses. It was conducted at a nonprofit acute care hospital in the northwestern United States to analyze the quantitative data captured in post-fall audit reports of patient falls (March 1-December 31, 2012, N = 107 falls). Descriptive and binary statistical analyses were used. The quarterly National Database of Nursing Quality Indicators 2011 and 2012 reports showed that implementation of post-fall audit reports can lead to a lower overall fall rate and a lower fall-injury rate. Increased nursing hours could be a confounding factor of the positive impact of conducting post-fall audits in this study. It is concluded that timely and systematic reporting, analysis, and interpretation of fall data in an electronic format can facilitate prevention of falls and fall injuries. © The Author(s) 2014.

  20. Use and effectiveness of a fixed-ratio combination of insulin degludec/liraglutide (IDegLira) in a real-world population with type 2 diabetes: Results from a European, multicentre, retrospective chart review study.

    Science.gov (United States)

    Price, Hermione; Blüher, Matthias; Prager, Rudolf; Phan, Tra-Mi; Thorsted, Brian L; Schultes, Bernd

    2018-04-01

    To describe the real-world use and effectiveness of IDegLira, a fixed-ratio combination of the basal insulin degludec, and the glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide. This European, multicentre, retrospective chart review comprised adults (n = 611) with type 2 diabetes, who started IDegLira ≥6 months before data collection. Clinical characteristics were assessed at baseline (defined as the most recent recording during the 6 months before the first IDegLira prescription) and 3, 6, 9 and 12 months (± 45 days for each time point) after commencing IDegLira, where data were available. Baseline regimens included non-injectable medications (19%), basal insulin (19%), GLP-1RA (10%), free combination therapy (insulin/GLP-1RA, 24%) and multiple daily-dose insulin injections (MDI, 28%), all ± oral antidiabetic drugs. After 6 months, significant glycated haemoglobin (HbA1c) reductions were observed in patients overall and in all subgroups (-10 mmol/mol [-0.9%] overall; P world practice, after 6 months and at a moderate dose, IDegLira resulted in substantial reductions in HbA1c and body weight, with a reduced risk of hypoglycaemia. © 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  1. An observational, retrospective, UK and Ireland audit of patient adherence to subcutaneous interferon beta-1a injections using the RebiSmart® injection device

    Directory of Open Access Journals (Sweden)

    Willis H

    2014-06-01

    Full Text Available Helen Willis,1 Julie Webster,1 Anne Marie Larkin,2 Laura Parkes,31Broomfield Hospital, Chelmsford, Essex, United Kingdom; 2MySupport Nurse, Quintiles Ireland Ltd, Dublin, Ireland; 3Medical Affairs, Merck Serono Ltd, Feltham, United KingdomBackground: Poor adherence to disease-modifying drugs is associated with an increased risk of relapse in patients with multiple sclerosis. However, adherence is difficult to assess objectively. RebiSmart® (Merck Serono SA, Geneva, Switzerland, a device for subcutaneous (sc injection of interferon (IFN β-1a, features an electronic injection log that can assist in objective monitoring of adherence.Objective: To assess adherence to sc IFN β-1a injections using data from RebiSmart®.Methods: This was a single-group, observational, retrospective audit. Adherence data were collected from patients with relapsing multiple sclerosis in the United Kingdom and Ireland who had been prescribed sc IFN β-1a and had been using RebiSmart® for a minimum of 24 months.Results: In total, 225 patients were included in the full analysis set; 72% were in the United Kingdom, and 28% were in Ireland. Overall, the mean age was 44.1 years, and 73% were women. Patients received sc IFN β-1a 44 µg (68% or 22 µg (32% three times per week. Mean adherence over the course of 24 months was 95.0% (median, 99.4%, and similar values were observed across all periods. The proportion of patients with 80% or higher adherence was 92.0% at 12 months and 91.1% at 24 months.Conclusion: High adherence to sc IFN β-1a was observed across all patient groups using RebiSmart®, according to 2-year treatment adherence data. This may be partly attributed to the expert support patients received, supplemented by routine and regular contact from the MySupport patient-support program, as well as the self-motivation of patients who persisted with treatment for 2 or more years.Keywords: multiple sclerosis, support program, persistence, objective

  2. Temporal patterns of hypoglycaemia and burden of sulfonylurea-related hypoglycaemia in UK hospitals: a retrospective multicentre audit of hospitalised patients with diabetes.

    Science.gov (United States)

    Rajendran, Rajesh; Kerry, Christopher; Rayman, Gerry

    2014-07-09

    To determine whether temporal patterns of hypoglycaemia exist in inpatients with diabetes 'at risk' of hypoglycaemia (those on insulin and/or sulfonylureas), and if so whether patterns differ between hospitals and between these treatments. Retrospective multicentre audit of inpatients with diabetes involving 11 acute UK National Health Service (NHS) trusts. Capillary blood glucose readings of 3.9 mmol/L or less (hypoglycaemia) for all adult (≥18 years) inpatients with diabetes 'at risk' of hypoglycaemia were extracted from the Abbott PrecisionWeb Point-of-Care Data Management System over a 4-week period. Overall, 2521 readings of 3.9 mmol/L or less (hypoglycaemia) occurring in 866 participants between 1 June 2013 and 29 June 2013 were analysed. The majority (65%) occurred between 21:00 and 08:59, a pattern common to all Trusts. This was more frequent in sulfonylurea-treated than insulin-treated participants (75.3% vs 59.3%, p=0.0001). Furthermore, hypoglycaemic readings were more frequent between 5:00 and 7:59 in sulfonylurea-treated than insulin-treated participants (46.7% vs 22.7% of readings for respective treatments, p=0.0001). Sulfonylureas accounted for 31.8% of all hypoglycaemic readings. As a group, sulfonylurea-treated participants were older (median age 78 vs 73 years, p=0.0001) and had lower glycated haemoglobin (median 56 (7.3%) vs 69 mmol/mol (8.5%), p=0.0001). Hypoglycaemic readings per participant were as frequent for sulfonylurea-treated participants as for insulin-treated participants (median=2 for both) as were the proportions in each group with ≥5 hypoglycaemic readings (17.3% vs 17.7%). In all Trusts, hypoglycaemic readings were more frequent between 21:00 and 08:59 in 'at risk' inpatients with diabetes, with a greater frequency in the early morning period (5:00-7:59) in sulfonylurea-treated inpatients. This may have implications for the continuing use of sulfonylureas in the inpatient setting. Published by the BMJ Publishing Group

  3. Surface Prognostic Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Surface Prognostic Charts are historical surface prognostic (forecast) charts created by the United States Weather Bureau. They include fronts, isobars, cloud, and...

  4. A retrospective chart review of the clinical and psychosocial profile of psychotic adolescents with co-morbid substance use disorders presenting to acute adolescent psychiatric services at Tygerberg Hospital

    Directory of Open Access Journals (Sweden)

    Anusha Lachman

    2012-05-01

    Full Text Available Background. A large number of adolescents meet criteria for ‘dual diagnosis’ (a psychiatric disorder plus co-morbid substance use disorder (SUD, which prolongs treatment response and complicates intervention strategies. The current service model in Cape Town divides the care of such patients into psychiatric treatment and a separate substance use intervention. Child and adolescent mental health services face the challenge of high rates of readmission of adolescents into psychiatric facilities before utilisation of community-based substance abuse services. Objective. There is a scarcity of available treatment guidelines for dual-diagnosis adolescents, and a lack of systematically documented epidemiological and clinical data in South African adolescent populations. Method. A retrospective chart review of adolescent psychiatric admissions to the Tygerberg Adolescent Psychiatric Unit during 2010 was conducted. Relevant epidemiological, clinical and demographic data for those presenting with a dual diagnosis (specifically psychotic disorders and SUD was recorded. Results. Results suggest a high prevalence of SUD among adolescents presenting with a first-episode psychosis. Statistically significant correlations with lower levels of education were found in those with ongoing substance abuse (specifically cannabis and methamphetamine, and a significant relationship between choice of debut drug and ongoing drug use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages, risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described. Conclusions. This cohort had an enhanced risk as a result of genetic vulnerability and environmental availability of substances, and the findings emphasise the differences in presentation, choice of drugs of abuse and psychosocial difficulties of adolescents with a dual

  5. Growth Charts (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Growth Charts KidsHealth / For Parents / Growth Charts What's in ... Problem? Print en español Tablas de crecimiento About Growth Charts Look at any class picture, and you' ...

  6. How Accurately Do Consecutive Cohort Audits Predict Phase III Multisite Clinical Trial Recruitment in Palliative Care?

    Science.gov (United States)

    McCaffrey, Nikki; Fazekas, Belinda; Cutri, Natalie; Currow, David C

    2016-04-01

    Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. To compare the accuracy of estimates of potential recruitment from a retrospective consecutive cohort audit of actual participating sites and recruitment to four Phase III multisite clinical RCTs. The proportion of potentially eligible study participants estimated from an inpatient chart review of people with life-limiting illnesses referred to six Australian specialist palliative care services was compared with recruitment data extracted from study prescreening information from three sites that participated fully in four Palliative Care Clinical Studies Collaborative RCTs. The predominant reasons for ineligibility in the audit and RCTs were analyzed. The audit overestimated the proportion of people referred to the palliative care services who could participate in the RCTs (pain 17.7% vs. 1.2%, delirium 5.8% vs. 0.6%, anorexia 5.1% vs. 0.8%, and bowel obstruction 2.8% vs. 0.5%). Approximately 2% of the referral base was potentially eligible for these effectiveness studies. Ineligibility for general criteria (language, cognition, and geographic proximity) varied between studies, whereas the reasons for exclusion were similar between the audit and pain and anorexia studies but not for delirium or bowel obstruction. The retrospective consecutive case note audit in participating sites did not predict realistic recruitment rates, mostly underestimating the impact of study-specific inclusion criteria. These findings have implications for the applicability of the results of RCTs. Prospective pilot studies are more likely to predict actual recruitment. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Research Electronic Data Capture (REDCap®) used as an audit tool with a built-in database.

    Science.gov (United States)

    Kragelund, Signe H; Kjærsgaard, Mona; Jensen-Fangel, Søren; Leth, Rita A; Ank, Nina

    2018-05-01

    The aim of this study was to develop an audit tool with a built-in database using Research Electronic Data Capture (REDCap®) as part of an antimicrobial stewardship program at a regional hospital in the Central Denmark Region, and to analyse the need, if any, to involve more than one expert in the evaluation of cases of antimicrobial treatment, and the level of agreement among the experts. Patients treated with systemic antimicrobials in the period from 1 September 2015 to 31 August 2016 were included, in total 722 cases. Data were collected retrospectively and entered manually. The audit was based on seven flow charts regarding: (1) initiation of antimicrobial treatment (2) infection (3) prescription and administration of antimicrobials (4) discontinuation of antimicrobials (5) reassessment within 48 h after the first prescription of antimicrobials (6) microbiological sampling in the period between suspicion of infection and the first administration of antimicrobials (7) microbiological results. The audit was based on automatic calculations drawing on the entered data and on expert assessments. Initially, two experts completed the audit, and in the cases in which they disagreed, a third expert was consulted. In 31.9% of the cases, the two experts agreed on all elements of the audit. In 66.2%, the two experts reached agreement by discussing the cases. Finally, 1.9% of the cases were completed in cooperation with a third expert. The experts assessed 3406 flow charts of which they agreed on 75.8%. We succeeded in creating an audit tool with a built-in database that facilitates independent expert evaluation using REDCap. We found a large inter-observer difference that needs to be considered when constructing a project based on expert judgements. Our two experts agreed on most of the flow charts after discussion, whereas the third expert's intervention did not have any influence on the overall assessment. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. IT auditing

    NARCIS (Netherlands)

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

    2008-01-01

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

  9. Fractional smith chart theory

    KAUST Repository

    Shamim, Atif

    2011-03-01

    For the first time, a generalized Smith chart is introduced here to represent fractional order circuit elements. It is shown that the standard Smith chart is a special case of the generalized fractional order Smith chart. With illustrations drawn for both the conventional integer based lumped elements and the fractional elements, a graphical technique supported by the analytical method is presented to plot impedances on the fractional Smith chart. The concept is then applied towards impedance matching networks, where the fractional approach proves to be much more versatile and results in a single element matching network for a complex load as compared to the two elements in the conventional approach. © 2010 IEEE.

  10. Initiation of antiretroviral therapy in patients with a CD4 count of less than 350 cells: a retrospective audit against key indicators from the CQUIN payment framework.

    Science.gov (United States)

    Mercer, R M; Olarinde, O; Ryan, C; Greig, J; Yeeles, H; Walker, A; Walker, H; Meardon, N C

    2011-12-01

    A proportion of funding for the South Yorkshire HIV Network is dependant on meeting the targets of the Commissioning for Quality and Innovation (CQUIN) payment framework. This states that 85% of patients with a CD4 count below 350 should be on antiretroviral therapy (ART). We also audited how many patients we started on treatment within six weeks. We found 88% of the 243 patients were on ART at the end of the audit, but significantly less had been started on treatment within six weeks of their CD4 count falling below 350. Although the target was achieved, there were patients who should be excluded as shown by other clinical guidelines, for example patients on treatment for tuberculosis. If these patients were excluded and the threshold level increased, it would help emphasize the at-risk patient group and lead to a fairer allocation of funding.

  11. Guideline implementation in clinical practice: Use of statistical process control charts as visual feedback devices

    Directory of Open Access Journals (Sweden)

    Fahad A Al-Hussein

    2009-01-01

    Conclusions: A process of audits in the context of statistical process control is necessary for any improvement in the implementation of guidelines in primary care. Statistical process control charts are an effective means of visual feedback to the care providers.

  12. Control of control charts

    NARCIS (Netherlands)

    Sri Nurdiati, S.N.

    2005-01-01

    Although the Shewhart chart is widely used in practice because of its simplicity, applying this control chart to monitor the mean of a process may lead to two types of problems. The first concerns the typically unknown parameters involved in the distribution, while the second concerns the validity

  13. NNDC Chart of Nuclides

    International Nuclear Information System (INIS)

    Sonzogni, A.

    2008-01-01

    The National Nuclear Data Center has recently developed an interactive chart of nuclides, http://www.nndc.bnl.gov/chart/, that provides nuclear structure and decay data. Since its implementation, it has proven to be one of the most popular web products. The information presented is derived from the ENSDF and Nuclear Wallet Card databases. Experimentally known nuclides are represented by a cell in chart with the number of neutrons on the horizontal axis and the number of protons on the vertical axis. The color of the cell is used to indicate the ground state half-life or the ground state predominant decay mode. (author)

  14. STATUTORY AUDIT AND PERFORMANCE AUDIT

    Directory of Open Access Journals (Sweden)

    Suciu Gheorghe

    2012-06-01

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

  15. Winning a prudence audit

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  16. Smart Book Charts

    Science.gov (United States)

    Chinnapongse, Ronald L.

    2015-01-01

    Smart book charts for TPSM: Heatshield for Extreme Entry Environment Technology (HEEET), Conformal Ablative TPS (CA-TPS), 3D Woven Multifunctional Ablative TPS (3D MAT), and Adaptable, Deployable, Entry and Placement Technology (ADEPT).

  17. CDC Child Growth Charts

    Data.gov (United States)

    U.S. Department of Health & Human Services — CDC child growth charts consist of a series of percentile curves that illustrate the distribution of selected body measurements in U.S. children. Pediatric growth...

  18. Barograms / Barograph Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Barograms are weekly rectangular charts recording barometric pressure at a given station. The barograph is an instrument that makes a continuous pen and ink trace of...

  19. Great Lakes Ice Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Charts show ice extent and concentration three times weekly during the ice season, for all lakes except Ontario, from the 1973/74 ice season through the 2001/2002...

  20. Use of major surgery in south India: A retrospective audit of hospital claim data from a large, community health insurance program.

    Science.gov (United States)

    Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand

    2015-05-01

    Information on the use of major surgery in India is scarce. In this study we aimed to bridge this gap by auditing hospital claims from Rajiv Aarogyasri Community Health Insurance Scheme, which provides access to free hospital care through state-funded insurance to 68 million beneficiaries, an estimated 81% of population in the states of Telangana and Andhra Pradesh. Publicly available deidentified hospital claim data for all surgery procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. A total of 677,332 operative admissions (80% at private hospitals) were recorded at an annual rate of 259 per 100,000 beneficiaries, with male subjects accounting for 56% of admissions. Injury was the most common cause for operative admission (27%) with operative correction of long bone fractures being the most common procedure (20%) identified in the audit. Diseases of the digestive (16%), genitourinary (12%), and musculoskeletal (10%) systems were other leading causes for operative admissions. Most hospital bed-days were used by admissions for injuries (31%) and diseases of the digestive (17%) and musculoskeletal system (11%) costing 19%, 13%, and 11% of reimbursement. Operations on the circulatory system (8%) accounted for 21% of reimbursements. Annual per capita cost of operative claims was US$1.48. The use of surgery by an insured population in India continued to be low despite access to financing comparable with greater spending countries, highlighting need for strategies, beyond traditional health financing, that prioritize improvement in access, delivery, and use of operative care. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  2. Chart of the nuclides

    International Nuclear Information System (INIS)

    Yoshizawa, Y.; Horiguchi, T.; Yamada, M.

    1980-01-01

    In this chart, four colors are use to classify nuclides according to their half-lives. The different symbols are also to show the decay modes and their percentage in each nuclide. Four tables are provided on the back of the chart. Table 1 is the ordinary periodic Table. Table 2 provides fundamental constants used for nuclear physics. Tables 3 lists the physical constants (mean density, ionization potential, melting point, and boiling point) of all elements. Table 4 provides the gamma-ray intensity standards. Half-lives, energy, relative intensity, and intensity per decay are list for 33 nuclides. (J.P.N.)

  3. Nuclear industry chart

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    As part of a survey on Switzerland a pull-out organisation chart is presented of the nuclear industry showing Swiss government bodies and industrial concerns. Their interests, connections with each other and their associations with international and other national organizations and firms are indicated. (U.K.)

  4. National Forecast Charts

    Science.gov (United States)

    code. Press enter or select the go button to submit request Local forecast by "City, St" or Prediction Center on Twitter NCEP Quarterly Newsletter WPC Home Analyses and Forecasts National Forecast to all federal, state, and local government web resources and services. National Forecast Charts

  5. Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted P charts.

    Science.gov (United States)

    Cockings, Jerome G L; Cook, David A; Iqbal, Rehana K

    2006-02-01

    A health care system is a complex adaptive system. The effect of a single intervention, incorporated into a complex clinical environment, may be different from that expected. A national database such as the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme in the UK represents a centralised monitoring, surveillance and reporting system for retrospective quality and comparative audit. This can be supplemented with real-time process monitoring at a local level for continuous process improvement, allowing early detection of the impact of both unplanned and deliberately imposed changes in the clinical environment. Demographic and UK Acute Physiology and Chronic Health Evaluation II (APACHE II) data were prospectively collected on all patients admitted to a UK regional hospital between 1 January 2003 and 30 June 2004 in accordance with the ICNARC Case Mix Programme. We present a cumulative expected minus observed (E-O) plot and the risk-adjusted p chart as methods of continuous process monitoring. We describe the construction and interpretation of these charts and show how they can be used to detect planned or unplanned organisational process changes affecting mortality outcomes. Five hundred and eighty-nine adult patients were included. The overall death rate was 0.78 of predicted. Calibration showed excess survival in ranges above 30% risk of death. The E-O plot confirmed a survival above that predicted. Small transient variations were seen in the slope that could represent random effects, or real but transient changes in the quality of care. The risk-adjusted p chart showed several observations below the 2 SD control limits of the expected mortality rate. These plots provide rapid analysis of risk-adjusted performance suitable for local application and interpretation. The E-O chart provided rapid easily visible feedback of changes in risk-adjusted mortality, while the risk-adjusted p chart allowed statistical evaluation. Local analysis of

  6. Data audit as a management tool.

    Science.gov (United States)

    Baldwin, J K; Hoover, B K

    1989-09-01

    Management faces the three basic challenges of achieving cost efficiency, successfully applying new technology, and minimizing risk. This paper examines the ways in which data audits can help managers come to terms with each of these challenges. It emphasizes the role of data audits in providing reliable information on which to base decisions and stresses the importance of auditing data in process rather than retrospectively. The paper examines frequently encountered sources of error and discusses the ways audits benefit management by assuring the integrity of experimental design, by preventing misassignment of observations, and by preventing the loss of data.

  7. INIS: Terminology charts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1970-08-01

    This document is one in a series of publications known as the INIS Reference Series. It is to be used in conjunction with the INIS indexing manual and the INIS thesaurus for the preparation of input to the INIS database. The thesaurus and terminology charts in their first edition (Rev.0) were produced as the result of an agreement between the International Atomic Energy Agency (IAEA) and the European Atomic Energy Community (Euratom). Except for minor changes the terminology and the interrelationships between terms are those of the December 1969 edition of the Euratom Thesaurus. The purpose of the terminology harts is to display the descriptors of the thesaurus in the context of their hierarchical and other semantic relationships. Hierarchically related terms are grouped in clusters, each representing one of the principal concepts of a subject field. The descriptors are grouped around or under the broadest term of the clusters which is printed in upper case. The hierarchical relationships within the clusters are shown by the arrangement of the terms in smaller boxes within the larger boxes circumscribing the clusters. The clusters are connected by lines of various thickness, representing the other (mostly non-hierarchical) relationships. These connections are the equivalent to 'see also' and 'related term' cross-references. The thickness of the lines represents the strength of the semantic relations, or, in the practice of a retrieval system the probability that one term replacing a connected term in a query, will still yield pertinent references. The figures accompanying the descriptors represent their frequency of assignment to the first 987,000 documents stored in the Euratom system (May 1970). They are presented in order to show the relative importance of the descriptors within the subject field. The asterisks (*) accompanying descriptors in the charts refer to descriptors, for which a scope note can be found in the INIS: Thesaurus at the time the charts went

  8. INIS: Terminology charts

    International Nuclear Information System (INIS)

    1970-08-01

    This document is one in a series of publications known as the INIS Reference Series. It is to be used in conjunction with the INIS indexing manual and the INIS thesaurus for the preparation of input to the INIS database. The thesaurus and terminology charts in their first edition (Rev.0) were produced as the result of an agreement between the International Atomic Energy Agency (IAEA) and the European Atomic Energy Community (Euratom). Except for minor changes the terminology and the interrelationships between terms are those of the December 1969 edition of the Euratom Thesaurus. The purpose of the terminology harts is to display the descriptors of the thesaurus in the context of their hierarchical and other semantic relationships. Hierarchically related terms are grouped in clusters, each representing one of the principal concepts of a subject field. The descriptors are grouped around or under the broadest term of the clusters which is printed in upper case. The hierarchical relationships within the clusters are shown by the arrangement of the terms in smaller boxes within the larger boxes circumscribing the clusters. The clusters are connected by lines of various thickness, representing the other (mostly non-hierarchical) relationships. These connections are the equivalent to 'see also' and 'related term' cross-references. The thickness of the lines represents the strength of the semantic relations, or, in the practice of a retrieval system the probability that one term replacing a connected term in a query, will still yield pertinent references. The figures accompanying the descriptors represent their frequency of assignment to the first 987,000 documents stored in the Euratom system (May 1970). They are presented in order to show the relative importance of the descriptors within the subject field. The asterisks (*) accompanying descriptors in the charts refer to descriptors, for which a scope note can be found in the INIS: Thesaurus at the time the charts went

  9. Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

    Science.gov (United States)

    Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

    2018-02-09

    Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P international standards, a new insulin chart was developed to overcome these quality hurdles.

  10. A multicenter, retrospective chart review study comparing index therapy change rates in open-angle glaucoma or ocular hypertension patients newly treated with latanoprost or travoprost-Z monotherapy

    Directory of Open Access Journals (Sweden)

    Edward Deepak P

    2011-06-01

    Full Text Available Abstract Background Because latanoprost and the original formulation of travoprost that included benzalkonium chloride (BAK have been shown to be similar with regard to tolerability, we compared initial topical intraocular pressure (IOP-lowering medication change rates in patients newly treated with latanoprost or travoprost-Z monotherapy. Methods At 14 clinical practice sites, medical records were abstracted for patients with a diagnosis of open-angle glaucoma or ocular hypertension and who were ≥40 years of age, had a baseline and at least one follow-up visit, and had no prior history of ocular prostaglandin use. Data regarding demographics, ocular/systemic medical histories, clinical variables, therapy initiations and reasons for changes, adverse events, and resource utilization were recorded from randomly chosen eligible charts. Primary outcomes were rates of and reasons for changing from the initial therapy within six months and across the full study period (1000 days. Results Data from 900 medical charts (latanoprost, 632; travoprost-Z, 268 were included. For both cohorts, average follow-up was >1 year. Cohorts were similar with regard to age (median ~67 years, gender distribution (>50% female, and diagnosis (~80% with open-angle glaucoma. Within six months, rates of index therapy change for latanoprost versus travoprost-Z were 21.2% (134/632 and 28.7% (77/268, respectively (p = 0.0148; across the full study period, rates were 34.5% (218/632 and 45.2% (121/268, respectively (p = 0.0026. Among those who changed their index therapy, insufficient IOP control was the most commonly reported reason followed by adverse events; hyperemia was the most commonly reported adverse event at index therapy change. Conclusions In this "real world" study of changes in therapy in patients prescribed initial monotherapy with latanoprost with BAK or travoprost-Z with SofZia, medication changes were common in both treatment groups but statistically

  11. A multicenter, retrospective chart review study comparing index therapy change rates in open-angle glaucoma or ocular hypertension patients newly treated with latanoprost or travoprost-Z monotherapy.

    Science.gov (United States)

    Fain, Joel M; Kotak, Sameer; Mardekian, Jack; Bacharach, Jason; Edward, Deepak P; Rauchman, Steven; Brevetti, Teresa; Fox, Janet L; Lovelace, Cherie

    2011-06-13

    Because latanoprost and the original formulation of travoprost that included benzalkonium chloride (BAK) have been shown to be similar with regard to tolerability, we compared initial topical intraocular pressure (IOP)-lowering medication change rates in patients newly treated with latanoprost or travoprost-Z monotherapy. At 14 clinical practice sites, medical records were abstracted for patients with a diagnosis of open-angle glaucoma or ocular hypertension and who were ≥40 years of age, had a baseline and at least one follow-up visit, and had no prior history of ocular prostaglandin use. Data regarding demographics, ocular/systemic medical histories, clinical variables, therapy initiations and reasons for changes, adverse events, and resource utilization were recorded from randomly chosen eligible charts. Primary outcomes were rates of and reasons for changing from the initial therapy within six months and across the full study period (1000 days). Data from 900 medical charts (latanoprost, 632; travoprost-Z, 268) were included. For both cohorts, average follow-up was >1 year. Cohorts were similar with regard to age (median ~67 years), gender distribution (>50% female), and diagnosis (~80% with open-angle glaucoma). Within six months, rates of index therapy change for latanoprost versus travoprost-Z were 21.2% (134/632) and 28.7% (77/268), respectively (p = 0.0148); across the full study period, rates were 34.5% (218/632) and 45.2% (121/268), respectively (p = 0.0026). Among those who changed their index therapy, insufficient IOP control was the most commonly reported reason followed by adverse events; hyperemia was the most commonly reported adverse event at index therapy change. In this "real world" study of changes in therapy in patients prescribed initial monotherapy with latanoprost with BAK or travoprost-Z with SofZia, medication changes were common in both treatment groups but statistically significantly more frequent with travoprost-Z.

  12. The Energy Chart'93

    International Nuclear Information System (INIS)

    Shervashidze, N.

    1993-01-01

    The Energy Chart'93 is developed with respect to forthcoming restructuring of energy sector in Bulgaria and contains its main directions for both short- and long-term periods. The priorities are given to: energy supply, stabilization of the existing units, ecological development, domestic energy sources, atomic energy, gas energy, utilization of the available hydrological potential. The leading role of legislation in this area is also pointed out, as well as the regulating function of the Committee of Energy. (author)

  13. Understanding Charts and Graphs.

    Science.gov (United States)

    1987-07-28

    Farenheit degrees, which have no Onaturalo zero ); finally, ratio scales have numbers that are ordered so that the magnitudes of differences are important and...system. They have to do with the very nature of how marks serve as meaningful symbols. In the ideal case, a chart or graph will be absolutely unambiguous...and these laws comprise this principle (see Stevens, 1974). Absolute discriminability: A minimal magnitude of a mark is necessary for it to be detected

  14. NOAA Raster Navigational Charts (RNC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA, National Ocean Service, Office of Coast Survey, Marine Chart Division is responsible to build and maintain a suite of more than 1000 nautical charts that are...

  15. Weighing Rain Gauge Recording Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Weighing rain gauge charts record the amount of precipitation that falls at a given location. The vast majority of the Weighing Rain Gauge Recording Charts...

  16. Depreciation Accounting in the Uniform Chart of Accounts.

    Science.gov (United States)

    1982-12-01

    footage of building occupied. Reason( s ) for Compute full cost of Rate setting, cash accounting for patient care flow generation and fund- depreciation ing... Horngren , Charles T., Cost Accounting ; A Managerial Emphasis, Prentice-Hall Inc., 1972. 32. Sawyer, Lawrence B., The Practice of Modern Internal Auditing...Awd ubtlft) S . TYPE or RE PORT a PE*IoO CovIERWO Master’s Thesis; Depreciation Accounting in the Uniform Dembr18 Chart of Accounts .PSOiwON.EORlumm

  17. A 1 year retrospective audit of quality indicators of clinical pharmacological advice for personalized linezolid dosing: one stone for two birds?

    Science.gov (United States)

    Pea, Federico; Cojutti, Piergiorgio; Dose, Lucia; Baraldo, Massimo

    2016-02-01

    This study explored the clinical and economic impact of clinical pharmacological advice (CPA) (based on therapeutic drug monitoring [TDM] results, and on patients' characteristics and co-medications) on personalized linezolid therapy in a tertiary care hospital. A 1 year retrospective analysis of quality indicators of CPA (clinicians' adherence rate to CPA, pre-post rate of linezolid trough concentrations within the desired range and cost balance analysis) was conducted. Five hundred and forty-four CPAs were provided to clinicians during 2014 for personalizing linezolid therapy in 168 patients. Clinicians' adherence to CPAs was very high (94.7%). The pre-post rate of linezolid Cmin distribution showed a favourable impact of CPA on patient care (pre-post ratio of Cmin within the desired range + 23.4%, pre, 51.2% vs. post, 74.6%). Overall, linezolid dosage was mainly reduced (56.9% of cases), whereas dose augmentation was needed only in a minority of cases (7.7%). Cost balance analysis showed that overall 1258 standard doses of linezolid (unitary dose 600 mg) were spared for treating 168 patients with a personalized dosage for a median duration of 11 days (range 3-128 days) with a cost saving of 60038.05 €. Active computerized advice elaborated by the clinical pharmacologist on the basis of TDM results and of patient's pathophysiological data and co-medications may be cost-effective for personalizing linezolid treatment. © 2015 The British Pharmacological Society.

  18. Auditing wildlife

    Directory of Open Access Journals (Sweden)

    B.K. Reilly

    2003-12-01

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

  19. Flaw evaluation charts

    International Nuclear Information System (INIS)

    Korosec, D.; Vojvodic Tuma, J.

    1999-01-01

    The structural integrity of the primary components in pressurized water reactor nuclear power plant is very important in the respect of safe and efficient operation. These components have to be subjected to periodic controls. In the light of fracture mechanics concept, the acceptance criteria for defects (flaws) are developed. Flaw evaluation procedure is necessary, to evaluate the defects regarding their acceptability for further operation. The objective of the flaw evaluation charts is to provide a series of simple graphs as decision maps. that immediate decision may be taken regarding the acceptability of a detected defects, on the basis of ASME Code XI criteria.(author)

  20. Children's vomiting following posterior fossa surgery: A retrospective study

    Directory of Open Access Journals (Sweden)

    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  1. Internal Audit Service | Internal Audit Service

    Science.gov (United States)

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

  2. Safety Auditing and Assessments

    Science.gov (United States)

    Goodin, James Ronald (Ronnie)

    2005-01-01

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

  3. Spin density projection-assisted R2 magnetic resonance imaging of the liver in the management of body iron stores in patients receiving multiple red blood cell transfusions: an audit and retrospective study in South Australia.

    Science.gov (United States)

    Brown, G C; Patton, W N; Tapp, H E; Taylor, D J; St Pierre, T G

    2012-09-01

    To assess the impact of non-invasive monitoring of liver iron concentration (LIC) on management of body iron stores in patients receiving multiple blood transfusions. A retrospective audit was conducted on clinical data from 40 consecutive subjects with haemolytic anaemias or ineffective haematopoiesis who had been monitored non-invasively for LIC over a period of at least 1 year. LIC was measured with spin density projection-assisted proton transverse relaxation rate-magnetic resonance imaging. Nineteen clinical decisions were explicitly documented in the case notes as being based on LIC results. Decisions comprised initiation of chelation therapy, increasing chelator dose, decreasing chelator dose and change of mode of delivery of deferioxamine from subcutaneous to intravenous. The geometrical mean LIC for the cohort dropped significantly (P= 0.008) from 6.8 mg Fe/g dry tissue at initial measurement to 4.8 mg Fe/g dry tissue at final measurement. The proportion of subjects with LIC in the range associated with greatly increased risk of cardiac disease and death (>15 mg Fe/g dry tissue) dropped significantly (P= 0.01) from 14 of 40 subjects at initial measurement to 5 of 40 subjects at final measurement. No significant changes in the geometrical mean of serum ferritin or the proportion of subjects with serum ferritin above 2500 or 1500 µg/L were observed. The data are consistent with previous observations that introduction of non-invasive monitoring of LIC can contribute to a decreased body iron burden through improved clinical decision making and improved feedback to patients and hence improved adherence to chelation therapy.

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

    OpenAIRE

    Shaw, C D

    1980-01-01

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

  5. Spectral Imaging of Portolan Charts

    Science.gov (United States)

    France, Fenella G.; Wilson, Meghan A.; Ghez, Anita

    2018-05-01

    Spectral imaging of Portolan Charts, early nautical charts, provided extensive new information about their construction and creation. The origins of the portolan chart style have been a continual source of perplexity to numerous generations of cartographic historians. The spectral imaging system utilized incorporates a 50 megapixel mono-chrome camera with light emitting diode (LED) illumination panels that cover the range from 365 nm to 1050 nm to capture visible and non-visible information. There is little known about how portolan charts evolved, and what influenced their creation. These early nautical charts began as working navigational tools of medieval mariners, initially made in the 1300s in Italy, Portugal and Spain; however the origin and development of the portolan chart remained shrouded in mystery. Questions about these early navigational charts included whether colorants were commensurate with the time period and geographical location, and if different, did that give insight into trade routes, or possible later additions to the charts? For example; spectral data showed the red pigment on both the 1320 portolan chart and the 1565 Galapagos Islands matched vermillion, an opaque red pigment used since antiquity. The construction of these charts was also of great interest. Spectral imaging with a range of illumination modes revealed the presence of a "hidden circle" often referred to in relation to their construction. This paper will present in-depth analysis of how spectral imaging of the Portolans revealed similarities and differences, new hidden information and shed new light on construction and composition.

  6. AUDIT BISNIS

    Directory of Open Access Journals (Sweden)

    Yulius Jogi Cristiawan

    1999-01-01

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

  7. Concise nuclear isobar charts

    Energy Technology Data Exchange (ETDEWEB)

    Bucka, H.

    1986-01-01

    In the Concise Nuclear Isobar Charts, data on binding energies of protons and neutrons in the ground state and excitation energies for low-lying nuclear energy levels are displayed, both of which are of great interest for transition processes as well as for questions of nuclear structure. Also, quantum numbers for angular momentum and parity are shown for these energy levels. For the stable nuclei, data for the relative abundances, and for unstable nucleon configurations, the transition probabilities are included in the data displayed. Due to the representation chosen for the atomic nuclei, in many cases a very clear first survey of systematic properties of nuclear energy states as well as spontaneous decay processes is achieved.

  8. Charting Ingredients for Life

    Science.gov (United States)

    2005-01-01

    [figure removed for brevity, see original site] Figure 1: Spectrum Charts Light from a Faraway Galaxy This graph, or spectrum, charts light from a faraway galaxy located 10 billion light years from Earth. It tracks mid-infrared light from an extremely luminous galaxy when the universe was only 1/4 of its current age. Spectra are created when an instrument called a spectrograph spreads light out into its basic parts, like a prism turning sunlight into a rainbow. They reveal the signatures, or 'fingerprints,' of molecules that make up a galaxy and contribute to its light. Spitzer's infrared spectrometer identified characteristic fingerprints of complex organic molecules called polycyclic aromatic hydrocarbons, illustrated in the artist's concept in the inset. These large molecules comprised of carbon and hydrogen, are considered among the building blocks of life. Scientists determined it took 10 billion years for photons from this galaxy to reach Spitzer's infrared eyes. These complex carbon and hydrogen molecules are from a young galaxy which is undergoing intense star formation, at the time the universe was only 3.5 billion years old. These distant galaxies with enormous amounts of gas being converted into young stars are some of the most luminous objects in the sky. Enshrouded by dust, they are only faint, inconspicuous little dots in optical images. They are as bright as 10 trillion suns put together and 10 times brighter than starburst galaxies seen in our local universe. This prompts a fascinating question as to what physical process is driving such enormous energy production in these galaxies when the universe is so young. These data were taken by Spitzer's infrared spectrograph in August and September 2004.

  9. Treatment of MRSA pneumonia: Clinical and economic comparison of linezolid vs. vancomycin – a retrospective analysis of medical charts and re-imbursement data of real-life patient populations

    Directory of Open Access Journals (Sweden)

    Wilke, Michael H.

    2017-01-01

    Full Text Available Objectives: To supplement the data collected in randomized clinical trials, the present study in patients with methicillin resistant (MRSA pneumonia was conducted to explore the clinical effectiveness of linezolid and vancomycin in a routine clinical setting. Further, the overall costs of the patients' stay in the intensive care unit (ICU were compared.Methods: This was a retrospective analysis of medical and reimbursement data of adult patients who were treated for MRSA pneumonia with linezolid or vancomycin. Since the subjects were not randomly assigned to treatments, propensity score adjustment was applied to reduce a potential selection bias.Results: In total, 226 patients were included; 95 received linezolid and 131 received vancomycin as initial therapy for MRSA pneumonia. Switches to another antibiotic were observed in 4 patients (4.2% receiving linezolid and in 23 patients (17.6% receiving vancomycin (logistic regression analysis; odds ratio linezolid/vancomycin: 0.183; 95% confidence interval [CI]: 0.052–0.647; p<0.01. All-cause in-hospital mortality was also lower in patients receiving linezolid (22 patients [23.2%] vs. 54 patients [41.2%] (logistic regression analysis; odds ratio linezolid/vancomycin: 0.351; 95% CI: 0.184–0.671; p<0.01. The analysis of the total costs of stay in ICU did not reveal any major differences between the two treatment groups (cost ratio linezolid/vancomycin: 1.29; 95% CI: 0.84–1.98; p=0.24.Conclusions: These findings confirm in a routine clinical setting that linezolid is a valuable therapeutic alternative to vancomycin for the treatment of MRSA pneumonia. However, prospective studies in real-life patient populations are warranted.

  10. WWW chart of the nuclides

    International Nuclear Information System (INIS)

    Huang Xiaolong; Zhou Chunmei; Zhuang Youxiang; Zhao Zhixiang; Golashvili, T.V.; Chechev, V.P.

    2000-01-01

    WWW chart of the nuclides was established on the basis of the latest evaluations of nuclear structure and decay data. By viewing WWW chart of the nuclides, one can retrieve the fundamental data of nuclide such as atomic mass, abundance, spin and parity; the decay mode, branching ratio, half-life and Q-value of radioactive nuclide, energy and intensity of strong γ-ray, etc. The URL (Uniform Resource Locator) of WWW chart of the nuclides is: http://myhome.py.gd.cn/chart/index,asp

  11. AUDIT INFORMATION CONTENT

    OpenAIRE

    Ioan Rus

    2012-01-01

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

  12. Alternative Auditing Approaches

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-09-15

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

  13. Performing of quality audits

    International Nuclear Information System (INIS)

    Rausch, W.P.

    1980-01-01

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

  14. Growth charts of human development

    NARCIS (Netherlands)

    Van Buuren, Stef

    2014-01-01

    This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate

  15. Adherence to the Australian National Inpatient Medication Chart: the efficacy of a uniform national drug chart on improving prescription error.

    Science.gov (United States)

    Atik, Alp

    2013-10-01

    In 2006, the National Inpatient Medication Chart (NIMC) was introduced as a uniform medication chart in Australian public hospitals with the aim of reducing prescription error. The rate of regular medication prescription error in the NIMC was assessed. Data was collected using the NIMC Audit Tool and analyzed with respect to causes of error per medication prescription and per medication chart. The following prescription requirements were assessed: date, generic drug name, route of administration, dose, frequency, administration time, indication, signature, name and contact details. A total of 1877 medication prescriptions were reviewed. 1653 prescriptions (88.07%) had no contact number, 1630 (86.84%) did not have an indication, 1230 and 675 (35.96%) used a drug's trade name. Within 261 medication charts, all had at least one entry, which did not include an indication, 258 (98.85%) had at least one entry, which did not have a contact number and 200 (76.63%) had at least one entry, which used a trade name. The introduction of a uniform national medication chart is a positive step, but more needs to be done to address the root causes of prescription error. © 2012 John Wiley & Sons Ltd.

  16. An Audit of Surgical Antibiotic Prophylaxis at the Veterinary ...

    African Journals Online (AJOL)

    An audit of surgical antibiotic prophylaxis at the Veterinary Teaching Hospital, Ibadan between 2008 and 2011 was conducted to evaluate the level of compliance with standard practices. The study involved retrospective case note audit of surgical procedures performed during the period. A total number of 108 operations ...

  17. Guideline implementation in clinical practice: use of statistical process control charts as visual feedback devices.

    Science.gov (United States)

    Al-Hussein, Fahad A

    2009-01-01

    To use statistical control charts in a series of audits to improve the acceptance and consistant use of guidelines, and reduce the variations in prescription processing in primary health care. A series of audits were done at the main satellite of King Saud Housing Family and Community Medicine Center, National Guard Health Affairs, Riyadh, where three general practitioners and six pharmacists provide outpatient care to about 3000 residents. Audits were carried out every fortnight to calculate the proportion of prescriptions that did not conform to the given guidelines of prescribing and dispensing. Simple random samples of thirty were chosen from a sampling frame of all prescriptions given in the two previous weeks. Thirty six audits were carried out from September 2004 to February 2006. P-charts were constructed around a parametric specification of non-conformities not exceeding 25%. Of the 1081 prescriptions, the most frequent non-conformity was failure to write generic names (35.5%), followed by the failure to record patient's weight (16.4%), pharmacist's name (14.3%), duration of therapy (9.1%), and the use of inappropriate abbreviations (6.0%). Initially, 100% of prescriptions did not conform to the guidelines, but within a period of three months, this came down to 40%. A process of audits in the context of statistical process control is necessary for any improvement in the implementation of guidelines in primary care. Statistical process control charts are an effective means of visual feedback to the care providers.

  18. The Internal Audit Outsourcing

    Directory of Open Access Journals (Sweden)

    Grzegorz Gołębiowski

    2010-06-01

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

  19. Auditing hazardous waste incineration

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  20. Features partnership in auditing

    Directory of Open Access Journals (Sweden)

    V.P. Bondar

    2015-06-01

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

  1. Auditing Quality in China

    OpenAIRE

    Ding, Shengyan

    2012-01-01

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

  2. Inland Electronic Navigational Charts (IENC)

    Data.gov (United States)

    Army Corps of Engineers, Department of the Army, Department of Defense — These Inland Electronic Navigational Charts (IENCs) were developed from available data used in maintenance of Navigation channels. Users of these IENCs should be...

  3. Charting Transnational Native American Studies

    Directory of Open Access Journals (Sweden)

    Hsinya Huang

    2012-06-01

    Full Text Available Introduction to the Special Forum entitled "Charting Transnational Native American Studies: Aesthetics, Politics, Identity," edited by Hsinya Huang, Philip J. Deloria, Laura M. Furlan, and John Gamber

  4. Borehole DC-12 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart identifies the basic stratigraphy and preliminary hydrologic testing results for Borehole DC-12. This borehole was cored through the Saddle Mountains and Wanapum basalt formations and into the Grande Ronde. Selected zones were hydrologically tested during coring

  5. Borehole DC-14 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart identifies the basic stratigraphy and preliminary hydrologic testing results for Borehole DC-14. This borehole was cored through the Saddle Mountains and Wanapum basalt formations and into the Grande Ronde. Selected zones were hydrologically tested during coring

  6. Borehole DC-15 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart identifies the basic stratigraphy and preliminary hydrologic testing results for Borehole DC-15. This borehole was cored through the Saddle Mountains and Wanapum basalt formations and into the Grande Ronde. Selected zones were hydrologically tested during coring

  7. NOAA Electronic Navigational Charts (ENC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Coast Survey (OCS) has been involved in the development of a NOAA Electronic Navigational Chart (NOAA ENC) suite to support the marine transportation...

  8. A retrospective chart review of the clinical and psychosocial profile ...

    African Journals Online (AJOL)

    A large number of adolescents meet criteria for 'dual diagnosis' (a psychiatric ... The current service model in Cape Town divides the care of such patients into ... We aim to influence role-players to provide more integrated services, and ...

  9. Multivariate Statistical Process Control Charts: An Overview

    OpenAIRE

    Bersimis, Sotiris; Psarakis, Stelios; Panaretos, John

    2006-01-01

    In this paper we discuss the basic procedures for the implementation of multivariate statistical process control via control charting. Furthermore, we review multivariate extensions for all kinds of univariate control charts, such as multivariate Shewhart-type control charts, multivariate CUSUM control charts and multivariate EWMA control charts. In addition, we review unique procedures for the construction of multivariate control charts, based on multivariate statistical techniques such as p...

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

    Science.gov (United States)

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

    2017-10-01

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

  11. Flowcharting with D-charts

    Science.gov (United States)

    Meyer, D.

    1985-01-01

    A D-Chart is a style of flowchart using control symbols highly appropriate to modern structured programming languages. The intent of a D-Chart is to provide a clear and concise one-for-one mapping of control symbols to high-level language constructs for purposes of design and documentation. The notation lends itself to both high-level and code-level algorithmic description. The various issues that may arise when representing, in D-Chart style, algorithms expressed in the more popular high-level languages are addressed. In particular, the peculiarities of mapping control constructs for Ada, PASCAL, FORTRAN 77, C, PL/I, Jovial J73, HAL/S, and Algol are discussed.

  12. From joint to single audits

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2018-01-01

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

  13. The UK radiotherapy dosimetry audit network

    International Nuclear Information System (INIS)

    Thwaites, D.I.

    2002-01-01

    : S Powley, Lincoln), of one representative from each group and one from NPL. It reviews experience and results and oversees standards. It makes recommendations on minimum frequencies and content (current aim:at least every two years). This ensures uniformity for intergroup comparison of audit performance. In addition, the group uses collaboration with the NPL to co-ordinate first level dosimetry audits in at least one centre per group at 2-yearly intervals. This is to audit the dissemination of chamber calibration factors from NPL to the centres and links the network groups at the level of basic dosimetry. The normal minimum group audits cover megavoltage photons and include ion chamber and beam calibration, beam quality, beam modifiers and other single field parameters, geometric parameters and simple multi-field planned irradiations. Various groups have extended the scope of the audits to kV x-rays, electrons and brachytherapy. A number are using more sophisticated phantoms to audit more complex, more realistic treatment situations. Some of these use phantoms developed for clinical trial audit (eg head-and-neck, lung (CHART), breast (START), prostate (RTO1), eg. ref. Others have developed specific phantoms for the audit group programme. Some audits follow the process through from simulator or CT scanner to volume delineation to planning to delivery. Some groups are currently developing audits for conformal and other sophisticated treatments. In addition to practical measurement audit, there is always also procedural audit, considering dosimetry, quality control, etc. in the visited centre in terms of procedures, documentation and records. As an example the Scottish+ group (including centres in Scotland, northern England, Northern Ireland) is using a semi-anatomic epoxy-resin-based phantom which has enabled audits of irradiations representative of 'treatments' for breast, lung/thorax and three head-and-neck situations. The group has audited kV x-rays and electrons

  14. Resident participation in neighbourhood audit tools — a scoping review

    Science.gov (United States)

    Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

    2018-01-01

    Abstract Background Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. Methods A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. Results In total, 13 participatory instruments were identified. The role of residents in most instruments was as ‘data collectors’; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. Conclusions The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. PMID:29346663

  15. Weldability charts for constructional steels

    International Nuclear Information System (INIS)

    Ion, J C; Ashby, M F

    2012-01-01

    The weldability of materials is still a poorly understood concept; a quantitative assessment remains elusive. The variables associated with welding are reduced here into two groups - processing parameters and material properties - from which two characteristic indices are defined and used as the basis of weldability charts. For the case of constructional steels, a carbon equivalent characterises both heat affected zone hardenability and the maximum hardness developed after solid state phase transformations. The welding process is characterised by its energy input. A mathematical model is used to establish relationships between the indices, which are displayed on charts as contours of microstructure and hardness.

  16. Inter-rater reliability of case-note audit: a systematic review.

    Science.gov (United States)

    Lilford, Richard; Edwards, Alex; Girling, Alan; Hofer, Timothy; Di Tanna, Gian Luca; Petty, Jane; Nicholl, Jon

    2007-07-01

    The quality of clinical care is often assessed by retrospective examination of case-notes (charts, medical records). Our objective was to determine the inter-rater reliability of case-note audit. We conducted a systematic review of the inter-rater reliability of case-note audit. Analysis was restricted to 26 papers reporting comparisons of two or three raters making independent judgements about the quality of care. Sixty-six separate comparisons were possible, since some papers reported more than one measurement of reliability. Mean kappa values ranged from 0.32 to 0.70. These may be inflated due to publication bias. Measured reliabilities were found to be higher for case-note reviews based on explicit, as opposed to implicit, criteria and for reviews that focused on outcome (including adverse effects) rather than process errors. We found an association between kappa and the prevalence of errors (poor quality care), suggesting alternatives such as tetrachoric and polychoric correlation coefficients be considered to assess inter-rater reliability. Comparative studies should take into account the relationship between kappa and the prevalence of the events being measured.

  17. The Future of Audit

    Directory of Open Access Journals (Sweden)

    Danielle Lombardi

    2014-10-01

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

  18. Audit Information Management System

    Data.gov (United States)

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

  19. Georgia : Accounting and Auditing

    OpenAIRE

    World Bank

    2007-01-01

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

  20. CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit.

    Science.gov (United States)

    Oppenheimer, Maylin; Rezwan, Nivin

    2015-01-01

    Urinary tract infections (UTI) are a common presentation in a medical assessment unit, and we wanted to check compliance with hospital guidelines for antibiotic prescribing in patients presenting to hospital with urinary tract infection. The guidelines are based on local organisms and sensitivities. A retrospective audit of 40 patient records with positive urine cultures from July to August 2013 showed that 20% of patients with culture confirmed UTI were not given antibiotics at all. Of those prescribed antibiotics, 25% were non-compliant with local policy, and nearly one in two patients received more than one antibiotic. Furthermore, stop dates were not stated on 77% of the drug charts and duration of treatment ranged from one to 11 days. Interventions were then introduced in the form of group teaching sessions, proactive checks by Trust pharmacists and widely distributed posters, and the same data sets collected for April to March 2014 to assess for efficacy of the interventions. On re-auditing, 35% patients were not prescribed any antibiotics. However, compliance with local policy was 100%, including 100% drug charts having a stop/review date stated. The overall duration of treatment now ranged from one to seven days, and fewer than one in four patients had more than one antibiotic. Our results showed that improvement was needed in antibiotic stewardship, in particular with regards to compliance with the local guidelines and documentation of prescription. We have demonstrated that it is possible to improve compliance through teaching, by displaying information prominently, and vigilance by the clinical team. The outcome of this is a decreased number and duration of antibiotics prescribed, which has benefits for the patients, the hospital, and the community as a whole. Further work would include interventions to improve the number of patients who are missing antibiotic prescriptions altogether.

  1. Safe Minimum Internal Temperature Chart

    Science.gov (United States)

    ... Internal Temperature Chart Safe steps in food handling, cooking, and storage are essential in preventing foodborne illness. You can't see, smell, or taste harmful bacteria that may cause illness. In every step of food preparation, follow the four guidelines to keep food safe: ...

  2. Borehole DC-6 hydrostratigraphic chart

    International Nuclear Information System (INIS)

    Gephart, R.E.

    1981-09-01

    This hydrostratigraphic chart for Borehole DC-6 identifies the basic stratigraphy and preliminary hydrologic test results. This borehole was cored for obtaining stratigraphic data and only that portion within the Grande Ronde formation remains open for hydrologic testing. The upper two formations were cased and cemented off

  3. AMDIS and CHART update. 1

    International Nuclear Information System (INIS)

    Murakami, I.; Kato, T.; Igarashi, A.

    2002-10-01

    A working group for updating atomic and molecular collision data in the NIFS database AMDIS (electron scattering) and CHART (ion scattering) has been organized. This group has searched and reviewed literatures for collecting relevant atomic data with are to be included into the database. This is a summary report of the activities of this working group. (author)

  4. About the National Forecast Chart

    Science.gov (United States)

    code. Press enter or select the go button to submit request Local forecast by "City, St" or Prediction Center on Twitter NCEP Quarterly Newsletter WPC Home Analyses and Forecasts National Forecast to all federal, state, and local government web resources and services. The National Forecast Charts

  5. Exploring audit assistants decision to leave the audit profession

    OpenAIRE

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

    2017-01-01

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

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

    OpenAIRE

    Velte, Patrick; Azibi, Jamel

    2015-01-01

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

  7. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

    Directory of Open Access Journals (Sweden)

    Harald Schrem

    Full Text Available The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers.1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences.Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21. Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46, post-transplant lymphoproliferative disorder (SIR = 8.36, prostate cancer (SIR = 2.22, bladder cancer (SIR = 3.24, thyroid cancer (SIR = 10.13 and melanoma (SIR = 3.08. Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29, polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD (p = 0.001, HR: 0.68, high body mass index in kg/m2 (p<0.001, HR: 1.04, ADPKD (p = 0.008, HR: 1.26 and diabetic nephropathy (p = 0.004, HR = 1.51. G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05.Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes

  8. Creation of Auditing Knowledge:

    DEFF Research Database (Denmark)

    Liempd, Dennis van

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

  9. Audits Made Simple

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-09

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

  10. Audit mode change, corporate governance

    OpenAIRE

    Limei Cao; Wanfu Li; Limin Zhang

    2015-01-01

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

  11. Pengaruh Gender dan Pengalaman Audit terhadap Audit Judgment

    Directory of Open Access Journals (Sweden)

    Erna Pasanda

    2013-12-01

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

  12. ENERGY AUDIT ANALYSIS BY BUSINESS INTELLIGENCE APPLICATION

    Directory of Open Access Journals (Sweden)

    Alfa Firdaus

    2015-12-01

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

  13. 46 CFR Sec. 12 - Audit.

    Science.gov (United States)

    2010-10-01

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

  14. Defense Contract Audit Agency Compensation Audits

    National Research Council Canada - National Science Library

    1999-01-01

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

  15. Single Audit: Single Audit Act Effectiveness Issues

    National Research Council Canada - National Science Library

    Thompson, Sally

    2002-01-01

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

  16. Air Emissions Sources, Charts and Maps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Air Emissions provides (1) interactive charts supporting national, state, or county charts, (2) county maps of criteria air pollutant emissions for a state, and (3)...

  17. NOAA Seamless Raster Navigational Charts (RNC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Seamless Raster Chart Server provides a seamless collarless mosaic of the NOAA Raster Navigational Charts (RNC). The RNC are a collection of approximately...

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

    Science.gov (United States)

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

    2016-01-01

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

  19. International chart of the nuclides. 2001

    International Nuclear Information System (INIS)

    Golashvili, T.V.; Kupriyanov, V.M.; Lbov, A.A.

    2002-01-01

    The International Chart of Nuclides - 2001 has been developed taking into account the data obtained in 1998-2001. Unlike widespread nuclide charts the present Chart of Nuclides contains EVALUATED values of the main characteristics. These values are supplied with the standard deviations. (author)

  20. Shewhart control charts in new perspective

    NARCIS (Netherlands)

    Albers, Willem/Wim; Kallenberg, W.C.M.

    2007-01-01

    The effects of estimating parameters and the violation of the assumption of normality when dealing with control charts are discussed. Corrections for estimating errors and extensions of the normal control chart to parametric and nonparametric charts are investigated. The underlying theory is

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

    OpenAIRE

    Darius Vaicekauskas, Jonas Mackevičius

    2014-01-01

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

  2. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

    Science.gov (United States)

    Schrem, Harald; Schneider, Valentin; Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

    2016-01-01

    The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (pKaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers.

  3. A 6-month audit of epidural analgesia in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Shahla Siddiqui

    2016-01-01

    Full Text Available Introduction: Major laparotomies generally herald high pain scores postoperatively and have high intraoperative hemodynamic shifts. Traditional analgesic regimens with intravenous opioids were supplanted with the superior epidural analgesia (EA in the mid-1980s. This was based on the perception that EA provided highly effective postoperative analgesia for patients undergoing major abdominal surgery. However, recent literature points to a high failure rate. We aimed to retrospectively audit our EA performance in terms of success and complications and take an in-depth look at factors associated with failure. Methods: We retrospectively reviewed charts and our EA forms over 6 months. Results: Our results show a low rate of mortality and neurological morbidity. However we have a high rate of failure of 37% as judged by high pain scores, use of adjuvant analgesics and also an unacceptably high rate of hypotension from epidural infusions, requiring fluid boluses, inotropes and Intensive Care Unit admission. Registrar level and senior insertion did not show any difference in failure rate. Conclusion: Level of training per se does not equate to experiential skip and prior level of experience with administration of this type of anesthesia. We can conclude that EA in our setting is safe but not effective and requires further and frequent scrutiny in terms of procedures, technical skill, education and perhaps looking at its cost-effectiveness and need for standardization.

  4. AUDIT plan documenting method

    International Nuclear Information System (INIS)

    Cornecsu, M.

    1995-01-01

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

  5. Computer Assisted Audit Techniques

    OpenAIRE

    Eugenia Iancu; Mihaela Tulvinschi; Veronica Grosu

    2007-01-01

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

  6. Audit Management System

    CERN Document Server

    Alconada, Federico

    2015-01-01

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

  7. Auditing radiation sterilization facilities

    Science.gov (United States)

    Beck, Jeffrey A.

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

  8. Internal Audit Charter, Mar2018

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

    Jessica Perkins

    2018-03-02

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

  9. Qlikview Audit Tool (QLIKVIEW) -

    Data.gov (United States)

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

  10. Complex logistics audit system

    Directory of Open Access Journals (Sweden)

    Zuzana Marková

    2010-02-01

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

  11. Audit mode change, corporate governance

    Directory of Open Access Journals (Sweden)

    Limei Cao

    2015-12-01

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

  12. A Development of Automatic Audit System for Written Informed Consent using Machine Learning.

    Science.gov (United States)

    Yamada, Hitomi; Takemura, Tadamasa; Asai, Takahiro; Okamoto, Kazuya; Kuroda, Tomohiro; Kuwata, Shigeki

    2015-01-01

    In Japan, most of all the university and advanced hospitals have implemented both electronic order entry systems and electronic charting. In addition, all medical records are subjected to inspector audit for quality assurance. The record of informed consent (IC) is very important as this provides evidence of consent from the patient or patient's family and health care provider. Therefore, we developed an automatic audit system for a hospital information system (HIS) that is able to evaluate IC automatically using machine learning.

  13. Radiation safety audit

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  14. Time to audit.

    Science.gov (United States)

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

    2012-09-01

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

  15. Rural anaesthetic audit 2006 to 2010.

    Science.gov (United States)

    Mills, P D; Newbury, J

    2012-03-01

    In order to review anaesthetic morbidity in our remote rural hospital, a retrospective audit of all anaesthetic records was undertaken for a five-year period between 2006 and 2010. Eight hundred and eighty-nine anaesthetic records were reviewed. The patients were all American Society of Anaesthesiologists physical status I to III. Ninety-eight percent of the anaesthetics were performed by general practitioner (non-specialist) anaesthetists. There were no anaesthetic deaths or serious adverse outcomes reported over this period. Sixteen intraoperative and seven postoperative problems were documented, but all were resolved uneventfully. The most common problems documented were difficult intubation (n=9) and respiratory depression (n=3). Within the limitations of this retrospective audit, these findings indicate that general practitioner anaesthetists provided safe anaesthesia in a remote rural hospital. It is our opinion that the case selection, prior experience of anaesthetic and theatre staff, stable nursing workforce and the use of protocols were important factors in determining the low rate of adverse events. However, we caution against over-interpretation of the data, given its retrospective nature, relatively small sample size, reliance on case records and the absence of agreed definitions for adverse events. We would also like to encourage all anaesthetic services, however remote, to audit their results as part of ongoing quality assurance.

  16. Inclusion of extremes of prematurity in ventricular index centile charts.

    Science.gov (United States)

    Boyle, M; Shim, R; Gnanasekaran, R; Tarrant, A; Ryan, S; Foran, A; McCallion, N

    2015-06-01

    To assess the relationship between ventricular index (VI) measurements and postmenstrual age in preterm infants and to generate centile charts and normal ranges for frontal horn ratio (FHR) for a large contemporary cohort of preterm infants. A retrospective cohort study of 253 infants with birth gestation less than 32 weeks admitted between January 2009 and December 2011 to a tertiary NICU in Ireland. A total of 816 cranial ultrasounds were reviewed. Data collected were grouped according to postmenstrual age at the time of scan from 23 weeks to 45 weeks. Median values for VI show a general trend to increase with gestation. FHR did not significantly change with postmenstrual age at scan with a median value of 0.31. There is a slight increase in VI as gestation at the time of scans increases. These results provide the basis for updated centile charts which we propose for current practice.

  17. Growth charts of human development.

    Science.gov (United States)

    van Buuren, Stef

    2014-08-01

    This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate score measuring global development. The relations between the indicators should be consistent with the Rasch model. If true, the D-score is a measure with interval scale properties, and allows for the calculation of meaningful differences both within and across age. The stage line diagram describes the natural development of ordinal indicators. The method models the transition probabilities between successive stages of the indicator as smoothly varying functions of age. The location of each stage is quantified by the mid-P-value. Both types of diagrams assist in identifying early and delayed development, as well as finding differences in tempo. The relevant techniques are illustrated to track global development during infancy and early childhood (0-2 years) and Tanner pubertal stages (8-21 years). New reference values for both applications are provided. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Improving the quality of endodontic record keeping through clinical audit.

    Science.gov (United States)

    King, E; Shekaran, L; Muthukrishnan, A

    2017-03-10

    Introduction Record keeping is an essential part of day-to-day practice and plays an important role in treatment, audit and dento-legal procedures. Creating effective endodontic records is challenging due to the scope of information required for comprehensive notes. Two audits were performed to assess the standards of endodontic record keeping by dentists in a restorative dentistry department and students on an endodontic MSc course.Methods Fifty sets of departmental records and 10 sets of student records were retrospectively evaluated against the European Society of Endodontology 2006 guidelines. Results of the first cycle of both audits were presented to departmental staff and MSc students, alongside an educational session. Additionally, departmental guidelines, consent leaflets and endodontic record keeping forms were developed. Both audits were repeated using the same number of records, thus completing both audit cycles.Results The most commonly absent records included consent, anaesthetic details, rubber dam method, working length reference point, irrigation details and obturation technique. Almost all areas of record keeping improved following the second audit cycle, with some areas reaching 100% compliance when record keeping forms were used. Statistically significant improvements were seen in 24 of the 29 areas in the departmental audit and 14 of the 29 areas in the MSc audit (P = 0.05).Conclusions Significant improvements in endodontic record keeping can be achieved through the provision of education, departmental guidelines, consent leaflets and endodontic record keeping forms.

  19. Clinical audit training improves undergraduates' performance in root canal therapy.

    Science.gov (United States)

    Fong, J Y M; Tan, V J H; Lee, J R; Tong, Z G M; Foong, Y K; Tan, J M E; Parolia, A; Pau, A

    2017-12-20

    To evaluate the effectiveness of clinical audit-feedback cycle as an educational tool in improving the technical quality of root canal therapy (RCT) and compliance with record keeping performed by dental undergraduates. Clinical audit learning was introduced in Year 3 of a 5-year curriculum for dental undergraduates. During classroom activities, students were briefed on clinical audit, selected their audit topics in groups of 5 or 6 students, and prepared and presented their audit protocols. One chosen topic was RCT, in which 3 different cohorts of Year 3 students conducted retrospective audits of patients' records in 2012, 2014 and 2015 for their compliance with recommended record keeping criteria and their performance in RCT. Students were trained by and calibrated against an endodontist (κ ≥ 0.8). After each audit, the findings were reported in class, and recommendations were made for improvement in performance of RCT and record keeping. Students' compliance with published guidelines was presented and their RCT performances in each year were compared using the chi-square test. Overall compliance with of record keeping guidelines was 44.1% in 2012, 79.6% in 2014 and 94.6% in 2015 (P = .001). In the 2012 audit, acceptable extension, condensation and the absence of mishap were observed in 72.4, 75.7% and 91.5%; in the 2014 audit, 95.1%, 64.8% and 51.4%; and in 2015 audit, 96.4%, 82.1% and 92.8% of cases, respectively. In 2015, 76.8% of root canal fillings met all 3 technical quality criteria when compared to 48.6% in 2014 and 44.7% in 2012 (P = .001). Clinical audit-feedback cycle is an effective educational tool for improving dental undergraduates' compliance with record keeping and performance in the technical quality of RCT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Ghana : Accounting and Auditing

    OpenAIRE

    World Bank

    2004-01-01

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

  1. Auditing measurement control programs

    International Nuclear Information System (INIS)

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

    1979-10-01

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

  2. Quality audit in design

    International Nuclear Information System (INIS)

    Horton, G.T.

    1976-01-01

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

  3. Peru : Accounting and Auditing

    OpenAIRE

    World Bank

    2004-01-01

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

  4. Audit Validation Using Ontologies

    Directory of Open Access Journals (Sweden)

    Ion IVAN

    2015-01-01

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

  5. Hungary : Accounting and Auditing

    OpenAIRE

    World Bank

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Darius Vaicekauskas, Jonas Mackevičius

    2014-02-01

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

  7. Aktivitas Komite Audit, Kepemilikan Institusional dan Biaya Audit

    Directory of Open Access Journals (Sweden)

    Linda Kusumaning Wedari

    2015-01-01

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

  8. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan

    2015-01-01

    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  9. Growth charts for Australian children with achondroplasia.

    Science.gov (United States)

    Tofts, Louise; Das, Sandeep; Collins, Felicity; Burton, Karen L O

    2017-08-01

    Achondroplasia is an autosomal dominant disorder, the most common genetic cause of short stature in humans. Reference curves for head circumference, weight, height, and BMI are needed in clinical practice but none exist for the Australian population. This study aimed to produce head circumference, height, weight, and BMI reference percentile curves for Australian children and adolescents with achondroplasia. Measurements of head circumference, height and weight taken at clinical visits were retrospectively extracted from the electronic medical record. Age was corrected for prematurity. Patients were excluded from head circumference analysis if they had significant neurosurgical complications and from the weight and BMI analysis when they had a clinical diagnosis of overweight. Measurements were available on 138 individuals (69 males and 69 females) taken between 1970 and 2015, with over 50% collected since 2005. A total of 3,352 data points were available. The LMS method was used to produce growth charts with estimated centiles (10, 25, 50, 75, and 90th) separately for males and females. For females birth weight was 3 kg (2.5-3.5 kg), birth length 48 cm (44-50 cm) and head circumference 37.5 cm (36-39 cm), adult height was 125 cm (116-132 cm), weight 42 kg (34-54 kg), and head circumference 58 cm (55.5-60.5 cm) all 50th centile (10-90th). For males birth weight was 3.5 kg (3-4 kg), length 49 cm (46-52 cm) and head circumference 38.5 cm (36-41 cm), adult height was 134 cm (125-141 cm), weight 41 kg (24.5-57 kg) and head circumference 61 cm (58-64 cm). The curves are similar to previously published reference data from the USA and have expected population wide variation from curves from an Argentinian population. Despite limitations of our curves for adolescents (12 years and older) due to data paucity, these Australian growth charts for children and adolescents with achondroplasia will be a useful reference in clinical

  10. Preventable deaths following emergency medical dispatch - an audit study

    DEFF Research Database (Denmark)

    Andersen, Mikkel S; Johnsen, Søren; Hansen, Andreas

    2014-01-01

    an ambulance with lights and sirens by the Emergency Medical Communication Centre (EMCC).MethodsAn audit was performed by an external panel of experienced prehospital consultant anaesthesiologists. The panel focused exclusively on the role of the EMCC, assessing whether same-day deaths among 112 callers could...... have been prevented if the EMCC had assessed the situations as highly urgent. The panels¿ assessments were based on review of patient charts and voice-log recordings of 112 calls. All patient related material was reviewed by the audit panel and all cases where then scored as preventable, potentially......¿100 years) and 45.4% were female. The audit panel found no definitively preventable deaths; however, 18 (11.8%) of the analysed same-day deaths (0.02% of all non-high-acuity callers) were found to be potentially preventable. In 13 of these 18 cases, the dispatch protocol was either not used or not used...

  11. Internal audit consider the implications.

    Science.gov (United States)

    Baumgartner, Grant D; Hamilton, Angela

    2004-06-01

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

  12. A pediatric death audit in a large referral hospital in Malawi.

    Science.gov (United States)

    Fitzgerald, Elizabeth; Mlotha-Mitole, Rachel; Ciccone, Emily J; Tilly, Alyssa E; Montijo, Jennie M; Lang, Hans-Joerg; Eckerle, Michelle

    2018-02-21

    Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for the foundation of quality improvement initiatives. Malawi, located in sub-Saharan Africa, currently has an Under-5 mortality rate of 64/1000. Kamuzu Central Hospital, in the capital city Lilongwe, is a busy government referral hospital, which admits up to 3000 children per month. A study published in 2013 reported mortality rates as high as 9%. This is the first known audit of pediatric death files conducted at this hospital. A retrospective chart review on all pediatric deaths that occurred at Kamuzu Central Hospital (excluding deaths in the neonatal nursery) during a 13-month period was done using a standardized death audit form. A descriptive analysis was completed, including patient demographics, HIV and nutritional status, and cause of death. Modifiable factors were identified that may have contributed to mortality, including a lack of vital sign collection, poor documentation, and delays in the procurement or results of tests, studies, and specialist review. Seven hundred forty three total pediatric deaths were recorded and 700 deceased patient files were reviewed. The mortality rate by month ranged from a low of 2.2% to a high of 4.4%. Forty-four percent of deaths occurred within the first 24 h of admission, and 59% occurred within the first 48 h. The most common causes of death were malaria, malnutrition, HIV-related illnesses, and sepsis. The mortality rate for this pediatric referral center has dramatically decreased in the 6 years since the last published mortality data, but remains high. Areas identified for continued development include improved record keeping, improved patient assessment and monitoring, and more timely and reliable provision of testing and treatment. This study demonstrates that in low-resource settings, where reliable record keeping is often difficult

  13. Audits of radiopharmaceutical formulations

    International Nuclear Information System (INIS)

    Castronovo, F.P. Jr.

    1992-01-01

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

  14. Making SPC easier with zone control charts

    International Nuclear Information System (INIS)

    Lanning, B.

    1995-01-01

    The zone control chart is a simple, easy to learn statistical process control (SPC) tool that can be applied to any process where the data are normally distributed. Several Shewhart runs rules are incorporated into a simple scoring system, with a single rule to determine when a process is out of control. Zone charts have average run lengths (ARLs) for detecting shifts in the process mean which, for most cases, are uniformly better than the standard control charts. This paper presents the simplified methodology behind the zone control chart

  15. de Sitter relativity in static charts

    Energy Technology Data Exchange (ETDEWEB)

    Cotaescu, Ion I. [West University of Timisoara, Timisoara (Romania)

    2018-02-15

    The relative geodesic motion in static (and spherically symmetric) local charts on the (1 + 3)-dimensional de Sitter spacetimes is studied in terms of conserved quantities. The Lorentzian isometries are derived, relating the coordinates of the local chart of a fixed observer with the coordinates of a mobile chart considered as the rest frame of a massive particle freely moving on a timelike geodesic. The time dilation and Lorentz contraction are discussed pointing out some notable features of the de Sitter relativity in static charts. (orig.)

  16. Randomized controlled trial of the effect of medical audit on AIDS prevention in general practice

    DEFF Research Database (Denmark)

    Sandbæk, Annelli

    1999-01-01

    OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including a p...... of such consultations initiated by the GPs. CONCLUSIONS: Medical audit had no observed effect on AIDS prevention in general practice. Udgivelsesdato: 1999-Oct......OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including....... One hundred and thirty-three GPs completed the project. The main outcome measures were the number of consultations involving AIDS prevention and the number of talks about AIDS initiated by the GP, and some elements of the content were registered on a chart. RESULTS: No statistically significant...

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

    Science.gov (United States)

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

    2015-11-01

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

  18. Resident participation in neighbourhood audit tools - a scoping review.

    Science.gov (United States)

    Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

    2018-02-01

    Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. In total, 13 participatory instruments were identified. The role of residents in most instruments was as 'data collectors'; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Audit culture revisited

    DEFF Research Database (Denmark)

    Shore, Cris; Wright, Susan

    2015-01-01

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

  20. Recovery Audit Program

    Data.gov (United States)

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

  1. Materiality in Financial Audit

    OpenAIRE

    Adriana Claudia GHIMIS

    2012-01-01

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

  2. Harmonisation of Audit Practice

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  3. TTVP Audit Database

    Data.gov (United States)

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

  4. INTERNAL AUDIT CHARTER

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

    Sandra Blanchard

    2013-03-26

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

  5. Isomers chart; Table des isomeres

    Energy Technology Data Exchange (ETDEWEB)

    Dupont-Gautier, P; Chantelot, S; Moisson, N [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1967-07-01

    The nuclear isomers are nuclides offering the same mass number and the same atomic number, but different energy levels. In the following chart the zero energy ground states are omitted and the metastable isomers, i.e. of non-zero energy, known and of measurable lifetime, are listed. The lower limit of this lifetime was set here to 0.1 x 10{sup -6} s. The various isomers were classified in increasing lifetimes. (authors) [French] Les isomeres nucleaires sont des nucleides presentant le meme nombre de masse et le meme numero atomique, mais des niveaux energetiques differents. Dans la table suivante, on a neglige les etats fondamentaux d'energie nulle et on a recense les isomeres metastables, c'est-a-dire d'energie non nulle, connus et de periode mesurable. La limite inferieure de cette periode a ete fixee ici a 0,1 x 10{sup -6} s. Les differents isomeres ont ete classes par periodes croissantes. (auteurs)

  6. Isomers chart; Table des isomeres

    Energy Technology Data Exchange (ETDEWEB)

    Dupont-Gautier, P.; Chantelot, S.; Moisson, N. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1967-07-01

    The nuclear isomers are nuclides offering the same mass number and the same atomic number, but different energy levels. In the following chart the zero energy ground states are omitted and the metastable isomers, i.e. of non-zero energy, known and of measurable lifetime, are listed. The lower limit of this lifetime was set here to 0.1 x 10{sup -6} s. The various isomers were classified in increasing lifetimes. (authors) [French] Les isomeres nucleaires sont des nucleides presentant le meme nombre de masse et le meme numero atomique, mais des niveaux energetiques differents. Dans la table suivante, on a neglige les etats fondamentaux d'energie nulle et on a recense les isomeres metastables, c'est-a-dire d'energie non nulle, connus et de periode mesurable. La limite inferieure de cette periode a ete fixee ici a 0,1 x 10{sup -6} s. Les differents isomeres ont ete classes par periodes croissantes. (auteurs)

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

    OpenAIRE

    Ismail, Hashanah; Theng, Ung Chui

    2015-01-01

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

  8. Oneida Tribe Energy Audits

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-08-15

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

  9. Color Charts, Esthetics, and Subjective Randomness

    Science.gov (United States)

    Sanderson, Yasmine B.

    2012-01-01

    Color charts, or grids of evenly spaced multicolored dots or squares, appear in the work of modern artists and designers. Often the artist/designer distributes the many colors in a way that could be described as "random," that is, without an obvious pattern. We conduct a statistical analysis of 125 "random-looking" art and design color charts and…

  10. Obtaining the Andersen's chart, triangulation algorithm

    DEFF Research Database (Denmark)

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation or stabilizing soil response. The process of obtaining the original chart has...

  11. Software tool for physics chart checks.

    Science.gov (United States)

    Li, H Harold; Wu, Yu; Yang, Deshan; Mutic, Sasa

    2014-01-01

    Physics chart check has long been a central quality assurance (QC) measure in radiation oncology. The purpose of this work is to describe a software tool that aims to accomplish simplification, standardization, automation, and forced functions in the process. Nationally recognized guidelines, including American College of Radiology and American Society for Radiation Oncology guidelines and technical standards, and the American Association of Physicists in Medicine Task Group reports were identified, studied, and summarized. Meanwhile, the reported events related to physics chart check service were analyzed using an event reporting and learning system. A number of shortfalls in the chart check process were identified. To address these problems, a software tool was designed and developed under Microsoft. Net in C# to hardwire as many components as possible at each stage of the process. The software consists of the following 4 independent modules: (1) chart check management; (2) pretreatment and during treatment chart check assistant; (3) posttreatment chart check assistant; and (4) quarterly peer-review management. The users were a large group of physicists in the author's radiation oncology clinic. During over 1 year of use the tool has proven very helpful in chart checking management, communication, documentation, and maintaining consistency. The software tool presented in this work aims to assist physicists at each stage of the physics chart check process. The software tool is potentially useful for any radiation oncology clinics that are either in the process of pursuing or maintaining the American College of Radiology accreditation.

  12. SMART AERONAUTICAL CHART MANAGEMENT SYSTEM DESIGN

    Directory of Open Access Journals (Sweden)

    M. E. Pakdil

    2015-10-01

    Full Text Available Civil aviation is developing rapidly, and the number of domestic and international operations is increasing exponentially every year than the previous one. Airline companies with increased air traffic and the number of passengers increase the demand of new aircrafts. An aircraft needs not only fuel but also pilot and aeronautical information (charts, digital navigation information, flight plan, and etc. to perform flight operation. One of the most important components in aeronautical information is the terminal chart. Authorized institution in every state is responsible to publish their terminal charts for certain periods. Although these charts are produced in accordance with ICAO’s Annex 4 and Annex 15, cartographic representation and page layout differs in each state’s publication. This situation makes difficult to read them by pilots. In this paper, standard instrument departure (SID charts are analysed to produce by use of cutting-edge and competitive technologies instead of classical computer-aided drawing and vector based graphic applications that are currently used by main chart producers. The goal is to design efficient and commercial chart management system that is able to produce aeronautical charts with same cartographic representation for all states.

  13. 49 CFR 236.718 - Chart, dog.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  14. Robust control charts in statistical process control

    NARCIS (Netherlands)

    Nazir, H.Z.

    2014-01-01

    The presence of outliers and contaminations in the output of the process highly affects the performance of the design structures of commonly used control charts and hence makes them of less practical use. One of the solutions to deal with this problem is to use control charts which are robust

  15. Robust Control Charts for Time Series Data

    NARCIS (Netherlands)

    Croux, C.; Gelper, S.; Mahieu, K.

    2010-01-01

    This article presents a control chart for time series data, based on the one-step- ahead forecast errors of the Holt-Winters forecasting method. We use robust techniques to prevent that outliers affect the estimation of the control limits of the chart. Moreover, robustness is important to maintain

  16. Chart of the nuclides - Strasbourg 1990

    International Nuclear Information System (INIS)

    Antony, M.S.

    1991-01-01

    Data were compiled for a nuclide chart over the last two years. The compilation is complete to the end of September 1990. The chart includes about 30000 data. Decay modes are represented by colours. Announcement capabilities and prices are given. (G.P.) 3 refs

  17. Stocking chart for upland central hardwoods

    Science.gov (United States)

    Martin E. Dale; Donald E. Hilt

    1989-01-01

    The upland hardwoods stocking chart, introduced by Gingrich in 1967, has become one of the forest manager's most useful tools. The chart allows you to determine the condition of the present stand in relation to a stocking standard. The stocking of a stand is extremely helpful in prescribing various silvicultural treatments such as intermediate thinnings,...

  18. The Conjugate Acid-Base Chart.

    Science.gov (United States)

    Treptow, Richard S.

    1986-01-01

    Discusses the difficulties that beginning chemistry students have in understanding acid-base chemistry. Describes the use of conjugate acid-base charts in helping students visualize the conjugate relationship. Addresses chart construction, metal ions, buffers and pH titrations, and the organic functional groups and nonaqueous solvents. (TW)

  19. 47 CFR 73.333 - Engineering charts.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Engineering charts. 73.333 Section 73.333 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES FM Broadcast Stations § 73.333 Engineering charts. This section consists of the following Figures 1, 1a, 2, and...

  20. Computer Assisted Audit Techniques

    Directory of Open Access Journals (Sweden)

    Eugenia Iancu

    2007-01-01

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

  1. Predictive factors for pharyngocutaneous fistulization after total laryngectomy: a Dutch Head and Neck Society audit.

    Science.gov (United States)

    Lansaat, Liset; van der Noort, Vincent; Bernard, Simone E; Eerenstein, Simone E J; Plaat, Boudewijn E C; Langeveld, Ton A P M; Lacko, Martin; Hilgers, Frans J M; de Bree, Remco; Takes, Robert P; van den Brekel, Michiel W M

    2018-03-01

    Incidences of pharyngocutaneous fistulization (PCF) after total laryngectomy (TL) reported in the literature vary widely, ranging from 2.6 to 65.5%. Comparison between different centers might identify risk factors, but also might enable improvements in quality of care. To enable this on a national level, an audit in the 8 principle Dutch Head and Neck Centers (DHNC) was initiated. A retrospective chart review of all 324 patients undergoing laryngectomy in a 2-year (2012 and 2013) period was performed. Overall PCF%, PCF% per center and factors predictive for PCF were identified. Furthermore, a prognostic model predicting the PCF% per center was developed. To provide additional data, a survey among the head and neck surgeons of the participating centers was carried out. Overall PCF% was 25.9. The multivariable prediction model revealed that previous treatment with (chemo)radiotherapy in combination with a long interval between primary treatment and TL, previous tracheotomy, near total pharyngectomy, neck dissection, and BMI model. PCF performance rate (difference between the PCF% and the predicted PCF%) per DHNC, though, shows that not all differences are explained by factors established in the prediction model. However, these factors explain enough of the differences that, compensating for these factors, hospital is no longer independently predictive for PCF. This nationwide audit has provided valid comparative PCF data confirming the known risk factors from the literature which are important for counseling on PCF risks. Data show that variations in PCF% in the DHNCs (in part) are explainable by the variations in these predictive factors. Since elective neck dissection is a major risk factor for PCF, it only should be performed on well funded indication.

  2. The Value of Electronically Extracted Data for Auditing Outpatient Antimicrobial Prescribing.

    Science.gov (United States)

    Livorsi, Daniel J; Linn, Carrie M; Alexander, Bruce; Heintz, Brett H; Tubbs, Traviss A; Perencevich, Eli N

    2018-01-01

    OBJECTIVE The optimal approach to auditing outpatient antimicrobial prescribing has not been established. We assessed how different types of electronic data-including prescriptions, patient-visits, and International Classification of Disease, Tenth Revision (ICD-10) codes-could inform automated antimicrobial audits. DESIGN Outpatient visits during 2016 were retrospectively reviewed, including chart abstraction, if an antimicrobial was prescribed (cohort 1) or if the visit was associated with an infection-related ICD-10 code (cohort 2). Findings from cohorts 1 and 2 were compared. SETTING Primary care clinics and the emergency department (ED) at the Iowa City Veterans Affairs Medical Center. RESULTS In cohort 1, we reviewed 2,353 antimicrobial prescriptions across 52 providers. ICD-10 codes had limited sensitivity and positive predictive value (PPV) for validated cases of cystitis and pneumonia (sensitivity, 65.8%, 56.3%, respectively; PPV, 74.4%, 52.5%, respectively). The volume-adjusted antimicrobial prescribing rate was 13.6 per 100 ED visits and 7.5 per 100 primary care visits. In cohort 2, antimicrobials were not indicated in 474 of 851 visits (55.7%). The antimicrobial overtreatment rate was 48.8% for the ED and 59.7% for primary care. At the level of the individual prescriber, there was a positive correlation between a provider's volume-adjusted antimicrobial prescribing rate and the individualized rates of overtreatment in both the ED (r=0.72; P<.01) and the primary care setting (r=0.82; P=0.03). CONCLUSIONS In this single-center study, ICD-10 codes had limited sensitivity and PPV for 2 infections that typically require antimicrobials. Electronically extracted data on a provider's rate of volume-adjusted antimicrobial prescribing correlated with the frequency at which unnecessary antimicrobials were prescribed, but this may have been driven by outlier prescribers. Infect Control Hosp Epidemiol 2018;39:64-70.

  3. Leaving a joint audit system

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2014-01-01

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

  4. Obstacles faced when conducting a clinical audit in Botswana ...

    African Journals Online (AJOL)

    This led to abandonment of a retrospective pilot of the audit. When the medical records were available, the documentation was poor and unsatisfactory for the purposes of the study. Lack of local criteria and guidelines for ICU admission resulted in inappropriate referrals. Proposed guidelines had still not been adopted after ...

  5. Auditing of environmental management system

    Directory of Open Access Journals (Sweden)

    Čuchranová Katarína

    2001-12-01

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

  6. FEATURES OF ACCOUNTING AND AUDIT OF INSURANCE ORGANIZATIONS IN UKRAINE

    Directory of Open Access Journals (Sweden)

    А. Sholoiko

    2015-04-01

    Full Text Available Features of accounting and audit of insurance organizations in Ukraine that are based on the specific characteristics of the insurance activity and legislation are considered. The main of them are the next: the proper organization of accounting is a necessary condition of the activity of the financial institution; there are three groups of requirements to accounting of insurer, including: accounting of contracts; accounting of insurance reserves, formation financial reports in the Ukrainian insurance legislation; the use of IFRS instead of national accounting standards in preparing financial reports of insurance organizations in Ukraine is obligatory and despite of this compilation of primary documents and application of National Chart of Accounts by insurance organizations of Ukraine remains mandatory; it is necessary to follow the frequency of reporting according to national legislation; insurance companies are classified as institutions that must necessarily publish annual financial statements together with the auditor’s report about its accuracy, and this category of institutions are prohibited from using such form of organization of accounting and reporting as directly by the owner or the head of organization; audit of the annual financial statements and consolidated financial statements of insurance companies is mandatory and conducted in accordance with International quality control, auditing, review, other assurance, and related services pronouncements which adopted as national auditing standards by the Audit Chamber of Ukraine. These generalizations are done to make possible the further investigations of developing and improving in this field.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-03-15

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

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  9. FusionCharts Beginner's Guide The Official Guide for FusionCharts Suite

    CERN Document Server

    Nadhani, Sanket; Bhattacharya, Shamasis

    2012-01-01

    The book is written as a practical, step-by-step guide to using FusionCharts Suite. The book not only teaches you the fundamentals and implementation of FusionCharts Suite, but also makes you the data visualization guru among your friends and colleagues by teaching how to select the right chart type and usability tips. Filled with examples, code samples and practical tips in a no-nonsense way, the book is a breeze to read.This book is both for beginners and advanced web developers who need to create interactive charts for their web applications. No previous knowledge of FusionCharts Suite is a

  10. Communication of Audit Risk to Students.

    Science.gov (United States)

    Alderman, C. Wayne; Thompson, James H.

    1986-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stelian Selisteanu

    2015-09-01

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

  12. Audit result and its users

    Directory of Open Access Journals (Sweden)

    Shalimova Nataliya S.

    2014-01-01

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

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

    OpenAIRE

    ANA MARIA JOLDOŞ; IONELA CORNELIA STANCIU; GABRIELA GREJDAN

    2010-01-01

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

  14. Pengaruh Gender dan Pengalaman Audit terhadap Audit Judgment

    OpenAIRE

    Erna Pasanda; Natalia Paranoan

    2013-01-01

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

  15. Google Charts Testing | CRDI - Centre de recherches pour le ...

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

    Google Charts Testing. The following item is a demo of Google GeoChart. Please note that geo chart can only recognize country name or city name rather than location or address (that is google my map's expertise). Additionally, Geo chart does support title and legend. To render geo chart properly, please get a ...

  16. 10 CFR 603.1295 - Periodic audit.

    Science.gov (United States)

    2010-01-01

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

  17. 7 CFR 1773.7 - Audit standards.

    Science.gov (United States)

    2010-01-01

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

  18. Effective quality auditing

    International Nuclear Information System (INIS)

    Sivertsen, Terje

    2004-01-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    user

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

  1. Recovery Audit Contractor audits and appeals at three academic medical centers.

    Science.gov (United States)

    Sheehy, Ann M; Locke, Charles; Engel, Jeannine Z; Weissburg, Daniel J; Mackowiak, Stephanie; Caponi, Bartho; Gangireddy, Sreedevi; Deutschendorf, Amy

    2015-04-01

    Outpatient (observation) and inpatient status determinations for hospitalized Medicare beneficiaries have generated increasing concern for hospitals and patients. Recovery Audit Contractor (RAC) activity alleging improper status, however, has received little attention, and there are conflicting federal and hospital reports of RAC activity and hospital appeals success. To detail complex Medicare Part A RAC activity. Retrospective descriptive study of complex Medicare Part A audits at 3 academic hospitals from 2010 to 2013. Complex Part A audits, outcome of audits, and hospital workforce required to manage this process. Of 101,862 inpatient Medicare encounters, RACs audited 8110 (8.0%) encounters, alleged overpayment in 31.3% (2536/8110), and hospitals disputed 91.0% (2309/2536). There was a nearly 3-fold increase in RAC overpayment determinations in 2 years, although the hospitals contested and won a larger percent of cases each year. One-third (645/1935, 33.3%) of settled claims were decided in the discussion period, which are favorable decisions for the hospitals not reported in federal appeals data. Almost half (951/1935, 49.1%) of settled contested cases were withdrawn by the hospitals and rebilled under Medicare Part B to avoid the lengthy (mean 555 [SD 255] days) appeals process. These original inpatient claims are considered improper payments recovered by the RAC. The hospitals also lost appeals (0.9%) by missing a filing deadline, yet there was no reciprocal case concession when the appeals process missed a deadline. No overpayment determinations contested the need for care delivered, rather that care should have been delivered under outpatient, not inpatient, status. The institutions employed an average 5.1 full-time staff in the audits process. These findings suggest a need for RAC reform, including improved transparency in data reporting. © 2015 Society of Hospital Medicine.

  2. External audit in radiotherapy dosimetry

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  3. Field Audit Checklist Tool (FACT)

    Science.gov (United States)

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

  4. Corporate social responsibility audit: Theoretical aspects

    Directory of Open Access Journals (Sweden)

    Artem Koldovskyi

    2015-08-01

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

  5. Internal Audit and Risk Management

    OpenAIRE

    Constantin Nicolae Vasile; Alexandru Georgiana

    2011-01-01

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

  6. Software Engineering Reviews and Audits

    CERN Document Server

    Summers, Boyd L

    2011-01-01

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

  7. UPDATES REGARDING AUDIT REPORTING

    Directory of Open Access Journals (Sweden)

    Daniel Botez

    2017-07-01

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

  8. Proof Auditing Formalised Mathematics

    Directory of Open Access Journals (Sweden)

    Mark Miles Adams

    2016-01-01

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

  9. ICT in Auditing

    DEFF Research Database (Denmark)

    Kacanski, Slobodan

    2016-01-01

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

  10. Electronic growth charts: watching our patients grow.

    Science.gov (United States)

    Murphy, Cynthia A; Carstens, Kimberly; Villamayor, Precy

    2005-01-01

    Pediatric Growth Charts have been used in the pediatric community since 1977. The first growth charts were developed by the National Center for Health Statistics as a clinical tool for health care professionals. The growth charts, revised in 2000, by the Center for Disease Control consists of a series of percentile curves for selected body measurements in children [1]. Capitalizing on the benefits of our Electronic Medical Record (EMR), and as a byproduct of nursing electronic documentation of routine heights, weights, and frontal occipital circumferences, our system plots the routine measurements without additional intervention by the staff. Clinicians can view the graphs online or generate printed reports as needed during routine examination for outpatient or hospitalized care. This abstract outlines the background, design process, programming rules utilized to plot growth curves, and the evaluation of the electronic CDC growth charts in our organization.

  11. Karlsruhe nuclide chart - new 9. edition 2015

    Energy Technology Data Exchange (ETDEWEB)

    Soti, Zsolt [European Commission, Joint Research Centre (JRC), Institute for Transuranium Elements (ITU), Postfach 2340, DE-76125 Karlsruhe, (Germany); Magill, Joseph; Pfennig, Gerda; Derher, Raymond [Nucleonica GmbH, c/o European Commission, Postfach 2340, DE-76125 Karlsruhe, (Germany)

    2015-07-01

    Following the success of the 8. Edition of the Karlsruhe Nuclide Chart 2012, a new edition is planned for 2015. Since the 2012 edition, more than 100 nuclides have been discovered and about 1400 nuclides have been updated. In summary, the new 9. edition contains decay and radiation data on approximately 3230 ground state nuclides and 740 isomers from 118 chemical elements. The accompanying booklet provides a detailed explanation of the nuclide box structure used in the Chart. An expanded section contains many additional nuclide decay schemes to aid the user to interpret the highly condensed information in the nuclide boxes. The booklet contains - in addition to the latest values of the physical constants and physical properties - a periodic table of the elements, tables of new and updated nuclides, and a difference chart showing the main changes in the Chart graphically. (authors)

  12. Handbook of thermodynamic tables and charts

    International Nuclear Information System (INIS)

    Raznjevic, K.

    1976-01-01

    A compilation of thermodynamic and thermophysical tables and charts is presented. Numerical values are cited in both technical and SI units. Solid, liquid, vapor, and gaseous forms of organic and inorganic materials are included. 12 figures, 137 tables

  13. Nuclear industry chart no. 21 - France

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    A fold-out chart shows the relationship between the government bodies and industrial concerns. Nuclear power plant orders under the 1970-84 programme are tabulated. A directory is included of national bodies, firms and establishments. (U.K.)

  14. Interactive Financial Charts- Agency Financial Reports

    Data.gov (United States)

    General Services Administration — For a visual depiction of GSA's Balance Sheet and Statement of Net Cost, please use the interactive charts to view the financial results for fiscal years 2007-2013.

  15. Chart Supplements - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — The Chart Supplements are searchable by individual airport in PDF format. They contain data on public and joint use airports, seaplane bases, heliports, VFR airport...

  16. Karlsruhe nuclide chart - new 9. edition 2015

    International Nuclear Information System (INIS)

    Soti, Zsolt; Magill, Joseph; Pfennig, Gerda; Derher, Raymond

    2015-01-01

    Following the success of the 8. Edition of the Karlsruhe Nuclide Chart 2012, a new edition is planned for 2015. Since the 2012 edition, more than 100 nuclides have been discovered and about 1400 nuclides have been updated. In summary, the new 9. edition contains decay and radiation data on approximately 3230 ground state nuclides and 740 isomers from 118 chemical elements. The accompanying booklet provides a detailed explanation of the nuclide box structure used in the Chart. An expanded section contains many additional nuclide decay schemes to aid the user to interpret the highly condensed information in the nuclide boxes. The booklet contains - in addition to the latest values of the physical constants and physical properties - a periodic table of the elements, tables of new and updated nuclides, and a difference chart showing the main changes in the Chart graphically. (authors)

  17. Research in auditing: main themes

    Directory of Open Access Journals (Sweden)

    Marcelo Porte

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

  18. Conducting One's Own Communication Audit.

    Science.gov (United States)

    Rogers, Donald P.; Goldhaber, Gerald M.

    1978-01-01

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

  19. Finding charts for southern IRAS galaxies

    International Nuclear Information System (INIS)

    Sutherland, W.J.; Maddox, S.J.; Saunders, W.

    1991-01-01

    Using the APM Galaxy Survey, we have generated a collection of finding charts for 4614 sources with non-stellar colours in the IRAS Faint Source Catalogue south of δ= -17.5 o . Over 90 per cent of the sources are reliably identified with an optical object, and we provide 1-arcsec positions and B J magnitudes for these. We will provide paper copies of the charts on request, at a small charge to cover photocopying costs. (author)

  20. The European chart of territorial planning

    International Nuclear Information System (INIS)

    1998-01-01

    In this chapter the European chart of territorial planning is included. This European chart contains next chapters: Introduction; The mission of the territorial planning; The basic aims; Realization of aims of the territorial planning; The confirmation of the European co-operation. In the Appendix the Specific aims: (1) The village territory; (2) The urban territory; (3) The boundary territory; (4) The mountain territory; (5) The structurally weak territory; (6) The decaying territory; (7) The coastal territories and islands

  1. Environmental auditing at Ranger

    International Nuclear Information System (INIS)

    Armstrong, A.; Reid, A.

    1989-01-01

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

  2. Sticker charts: a method for improving adherence to treatment of chronic diseases in children.

    Science.gov (United States)

    Luersen, Kara; Davis, Scott A; Kaplan, Sebastian G; Abel, Troy D; Winchester, Woodrow W; Feldman, Steven R

    2012-01-01

    Poor adherence is a common problem and may be an underlying cause of poor clinical outcomes. In pediatric populations, positive reinforcement techniques such as sticker charts may increase motivation to adhere to treatment regimens. To review the use of sticker charts to improve adherence in children with chronic disease, Medline and PsycINFO searches were conducted using the key words "positive reinforcement OR behavior therapy" and "adherence OR patient compliance" and "child." Randomized controlled retrospective cohort or single-subject-design studies were selected. Studies reporting adherence to the medical treatment of chronic disease in children using positive reinforcement techniques were included in the analysis. The systematic search was supplemented by identifying additional studies identified through the reference lists and authors of the initial articles found. Positive reinforcement techniques such as sticker charts increase adherence to medical treatment regimens. In several studies, this effect was maintained for months after the initial intervention. Better adherence correlated with better clinical outcomes in some, but not all, studies. Few studies examining the use of sticker charts were identified. Although single-subject-design studies are useful in establishing the effect of a behavioral intervention, larger randomized controlled trials would help determine the precise efficacy of sticker chart interventions. Adherence to medical treatments in children can be increased using sticker charts or other positive reinforcement techniques. This may be an effective means to encourage children with atopic dermatitis to apply their medications and improve clinical outcomes. © 2012 Wiley Periodicals, Inc.

  3. Development of Markup Language for Medical Record Charting: A Charting Language.

    Science.gov (United States)

    Jung, Won-Mo; Chae, Younbyoung; Jang, Bo-Hyoung

    2015-01-01

    Nowadays a lot of trials for collecting electronic medical records (EMRs) exist. However, structuring data format for EMR is an especially labour-intensive task for practitioners. Here we propose a new mark-up language for medical record charting (called Charting Language), which borrows useful properties from programming languages. Thus, with Charting Language, the text data described in dynamic situation can be easily used to extract information.

  4. Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

    Science.gov (United States)

    Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

    2014-07-01

    Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (pcontrol limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Audit and account billing process in a private general hospital: a case study

    Directory of Open Access Journals (Sweden)

    Raquel Silva Bicalho Zunta

    2017-12-01

    Full Text Available Our study aimed to map, describe and, validate the audit, account billing and billing reports processes in a large, private general hospital.  An exploratory, descriptive, case report study. We conducted non-participatory observation moments in Internal Audit Sectors and  Billing Reports from the hospital, aiming to map the processes which were the study objects. The data obtained was validated by internal and external audit specialists in hospital bills. The described and illustrated processes in three flow-charts favor professionals to rationalize their activities and the time spent in hospital billing, avoiding or minimizing the occurrence of flaws and, generating more effective financial results. The mapping, the description and the audit validation process and billing and, the billing reports propitiated more visibility and legitimacy to actions developed by auditor nurses.

  6. The use of safety audits

    International Nuclear Information System (INIS)

    Waldram, I.M.

    1991-01-01

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

  7. Environmental audits: A lawyer's perspective

    International Nuclear Information System (INIS)

    Walls, S.K.

    1992-01-01

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

  8. Information Systems Security Audit

    OpenAIRE

    Gheorghe Popescu; Veronica Adriana Popescu; Cristina Raluca Popescu

    2007-01-01

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

  9. INTERNAL AUDIT CHARTER

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

    sblanchard

    2015-03-30

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

  10. Conducting a Technology Audit

    Science.gov (United States)

    Flaherty, William

    2011-01-01

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

  11. FEATURES ROAD SAFETY AUDIT

    Directory of Open Access Journals (Sweden)

    L. Abramova

    2015-07-01

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

  12. Auditing with incomplete logs

    NARCIS (Netherlands)

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

    2015-01-01

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

  13. Audit of referrals for concern regarding labial appearance at the Royal Children's Hospital: 2000-2012.

    Science.gov (United States)

    McQuillan, Sarah K; Jayasinghe, Yasmin; Grover, Sonia R

    2018-04-01

    To audit the clinical features and outcomes for all patients referred to our centre with concerns regarding labial appearance. Young females referred to a paediatric/adolescent gynaecology tertiary centre between 2000 and 2012 with concerns regarding their labial appearance were retrospectively identified. Adolescents presenting with anomalies were excluded. Retrospective chart review was undertaken to identify reasons for referral, patient characteristics, outcome of referral and concurrent health problems. In total, 46 females presenting with concerns about labial appearance were identified. Five were excluded. Median age of the study population was 14.5 years (range 5-21 years). Only four (9.8%) underwent surgery after a minimum of five consultations each, with mental health review in three of four cases prior to surgery. None of the 41 patients had documented abnormal labia; however, 6 patients had asymmetry, and 3 had a labial width of >5 cm. Of mothers, 24% (n = 10) raised the initial concern regarding labial appearance to a physician, of whom, 50% of patients had a comorbid condition. In total, 70.7% initially reported interference with daily activities, and 87.8% were reassured following discussion. With appropriate education and counselling, the majority of girls with concerns regarding labial appearance can be managed without surgery. Overall, our data support current international policy that female cosmetic genital surgery not be performed in mature minors unless there are specific indications. More research about characteristics of patients referred with labial concerns, definition of labial size and long-term satisfaction of conservative versus surgical methods is necessary to determine the best approach. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  14. THE AUDIT OF RECEPTION PROCESS

    Directory of Open Access Journals (Sweden)

    Dorina MOCUŢA

    2013-01-01

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

  15. A survey of community child health audit.

    Science.gov (United States)

    Spencer, N J; Penlington, E

    1993-03-01

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

  16. POSITIONINGS AND DELIMITATIONS CONCERNING THE PERFORMANCE AUDIT

    OpenAIRE

    Victoria FIRESCU

    2014-01-01

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

  17. Transmission Line Adapted Analytical Power Charts Solution

    Science.gov (United States)

    Sakala, Japhet D.; Daka, James S. J.; Setlhaolo, Ditiro; Malichi, Alec Pulu

    2017-08-01

    The performance of a transmission line has been assessed over the years using power charts. These are graphical representations, drawn to scale, of the equations that describe the performance of transmission lines. Various quantities that describe the performance, such as sending end voltage, sending end power and compensation to give zero voltage regulation, may be deduced from the power charts. Usually required values are read off and then converted using the appropriate scales and known relationships. In this paper, the authors revisit this area of circle diagrams for transmission line performance. The work presented here formulates the mathematical model that analyses the transmission line performance from the power charts relationships and then uses them to calculate the transmission line performance. In this proposed approach, it is not necessary to draw the power charts for the solution. However the power charts may be drawn for the visual presentation. The method is based on applying derived equations and is simple to use since it does not require rigorous derivations.

  18. Chart of nuclides relating to neutron activation

    International Nuclear Information System (INIS)

    Okada, Minoru

    1981-09-01

    This chart is for frequent use in the prediction of the product species of neutron activation. The first edition of the chart has been made in 1976 after the repeated trial preparation. It has the following good points. (1) Any letter in chart is as large as one can read easily. [This condition has been obtained by the selection of items to be shown in chart. They are the name (the symbol of element, mass number, and half-life) of nuclide or of isomer, and the type of decay.]. (2) Decay product has been shown indirectly for branchings with two-step decay via short-lived daughter in an excited state. [This matter has been realized by use of the new mode of indication.] (3) Nuclides shown in chart are (a) naturally occurring nuclides and (b) nuclides formed from naturally occurring nuclides through one of the following reactions: (n, γ), (n, n'), (n, p), (n, α), (n, 2n), (n, pn), (n, 3n), (n, αn), (n, t), (n, 3 He), (n, 2p), and (n, γ)(n, γ). In the revision of the first edition, some modes of indication have become a little simpler, and the isomers of shorter half-lives (0.1 - 1 μs) have been added. (author)

  19. A PIP chart for nuclear plant safety

    International Nuclear Information System (INIS)

    Suzuki, Tatsujiro; Yamaoka, Taiji

    1992-01-01

    While it is known that social and political aspects of nuclear safety issues are important, little study has been done on identifying the breadth of stakeholders whose policies have important influences over nuclear plant safety in a comprehensive way. The objectives of this study are to develop a chart that visually identifies important stakeholders and their policies and illustrates these influences in a hierarchical representation so that the relationship between stakeholders and nuclear safety will be better understood. This study is based on a series of extensive interviews with major stakeholders, such as nuclear plant managers, corporate planning vice presidents, state regulators, news media, and public interest groups, and focuses on one US nuclear power plant. Based on the interview results, the authors developed a conceptual policy influence paths (PIP) chart. The PIP chart illustrates the hierarchy of influence among stakeholders. The PIP chart is also useful in identifying possible stakeholders who can be easily overlooked without the PIP chart. In addition, it shows that influence flow is circular rather than linear in one direction

  20. Quality audit--a review of the literature concerning delivery of continence care.

    Science.gov (United States)

    Swaffield, J

    1995-09-01

    This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

  1. MODEL REVISI KEYAKINAN DAN KEPUTUSAN AUDIT: SUATU PENGUJIAN EKSPERIMENTAL

    Directory of Open Access Journals (Sweden)

    Tri Ika Ayuananda

    2015-12-01

    Full Text Available The purpose of the research is to assess the recency effect about sequence, manner of presentation and form of information on audit decisions when the information is presented sequentially or simultaneously. Recency effect is a biased decision of the auditor when information is given in sequence and auditors tend to weigh the last information greater than the earlier information. The research used a 2x2x2 experimental design with 80 participants between the subject of undergraduate students majoring in accounting. The results of the research showed that: (i belief revision occurs when information is presented in the sequential method; and (ii in the audit decision-making, reviews effects occur in the form of a chart.

  2. Italian cardiovascular mortality charts of the CUORE project: are they comparable with the SCORE charts?

    LENUS (Irish Health Repository)

    Donfrancesco, Chiara

    2010-08-01

    The aim of this study was to build risk charts for the assessment of cardiovascular mortality of the CUORE project, an Italian longitudinal study, and to compare them with the systematic coronary risk evaluation (SCORE) project charts for low risk European countries.

  3. APPLICATION OF U-CHART AND C-CHART IN TECHNOLOGICAL PROCESS OF PRIMARY WOOD PROCESSING

    Directory of Open Access Journals (Sweden)

    Damjan Stanojević

    2014-01-01

    Full Text Available Control charts are statistical methods of quality control. Basically it is a graph where the abscissa represents the order of control, and the ordinate is marked with parameter values, which are controled by samples over a certain size. Using charts determine varying quality and also related the stability and capacity of the production process in relation to the established control limits. Dr. Schuchardt, which can be regarded as the creator of control charts, says that their mission: to maintain the production process in a state of control, to lead the production process into a state of control, to show that the state of control has been achieved. According to Dr. Schuchardt „for a phenomenon is said to be controlled if based on current data we can predict, at least within certain limits, how the phenomenon will change in the future. Here, under certain prediction within limits means that we can determine, at least approximately, the probability that the phenomenon is found within the given limits“. Control charts for attribute quality characteristics are: p- control chart, m- control chart, u- control chart, c- control chart.

  4. Two-dimensional phase fraction charts

    International Nuclear Information System (INIS)

    Morral, J.E.

    1984-01-01

    A phase fraction chart is a graphical representation of the amount of each phase present in a system as a function of temperature, composition or other variable. Examples are phase fraction versus temperature charts used to characterize specific alloys and as a teaching tool in elementary texts, and Schaeffler diagrams used to predict the amount of ferrite in stainless steel welds. Isothermal-transformation diagrams (TTT diagrams) are examples that give phase (or microconstituent) amount versus temperature and time. The purpose of this communication is to discuss the properties of two-dimensional phase fraction charts in more general terms than have been reported before. It is shown that they can represent multi-component, multiphase equilibria in a way which is easier to read and which contains more information than the isotherms and isopleths of multi-component phase diagrams

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

    OpenAIRE

    Mahpiansyah Mahpiansyah

    2017-01-01

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

  6. 29 CFR 96.12 - Audit requirements.

    Science.gov (United States)

    2010-07-01

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

  7. 29 CFR 99.230 - Audit costs.

    Science.gov (United States)

    2010-07-01

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

  8. 11 CFR 9038.1 - Audit.

    Science.gov (United States)

    2010-01-01

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

  9. 30 CFR 725.19 - Audit.

    Science.gov (United States)

    2010-07-01

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

  10. 32 CFR 37.1325 - Periodic audit.

    Science.gov (United States)

    2010-07-01

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

  11. 30 CFR 735.22 - Audit.

    Science.gov (United States)

    2010-07-01

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

  12. A tale of two audits: statistical process control for improving diabetes care in primary care settings.

    Science.gov (United States)

    Al-Hussein, Fahad Abdullah

    2008-01-01

    Diabetes constitutes a major burden of disease globally. Both primary and secondary prevention need to improve in order to face this challenge. Improving management of diabetes in primary care is therefore of fundamental importance. The objective of these series of audits was to find means of improving diabetes management in chronic disease mini-clinics in primary health care. In the process, we were able to study the effect and practical usefulness of different audit designs - those measuring clinical outcomes, process of care, or both. King Saud City Family and Community Medicine Centre, Saudi National Guard Health Affairs in Riyadh city, Saudi Arabia. Simple random samples of 30 files were selected every two weeks from a sampling frame of file numbers for all diabetes clients seen over the period. Information was transferred to a form, entered on the computer and an automated response was generated regarding the appropriateness of management, a criterion mutually agreed upon by care providers. The results were plotted on statistical process control charts, p charts, displayed for all employees. Data extraction, archiving, entry, analysis, plotting and design and preparation of p charts were managed by nursing staff specially trained for the purpose by physicians with relevant previous experience. Audit series with mixed outcome and process measures failed to detect any changes in the proportion of non-conforming cases over a period of one year. The process measures series, on the other hand, showed improvement in care corresponding to a reduction in the proportion non-conforming by 10% within a period of 3 months. Non-conformities dropped from a mean of 5.0 to 1.4 over the year (P process audits and feedbacks. Frequent process audits in the context of statistical process control should be supplemented with concurrent outcome audits, once or twice a year.

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

    Science.gov (United States)

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

    2018-04-13

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

  14. Clinical audit of patients with cerebrovascular accident and transient ischemic attack in our lady of lourdes hospital drogheda, ireland

    International Nuclear Information System (INIS)

    Nagi, D.; Aamar, A.; Rahim, I.; Sadaf, M.I.

    2012-01-01

    Stroke is a major health problem and is one of leading causes of morbidity and mortality. Methods: A clinical audit comprising retrospective chart review of 101 patients randomly selected from admission register in Our Lady of Lourdes Hospital Drogheda, Ireland, was done during the first quarter of 2009. Keeping in view the recommendations, in this audit the following areas were evaluated: type of event, time of event and arrival to hospital, thrombolytic therapy, past medical history, investigations, smoking history, utilization of multidisciplinary services (physiotherapy and occupational therapy, speech and language therapy), medications, referral to GP, carotid pathology, and outcome. Results: Of the 101 patients, 43 (42.5%) were males and 58 (57.4%) were females. 47.5% (48/101) had TIA while 52.5% (53/101) had CVA. Of the total patients, 62.8% males and 56.8% females were hypertensive and 48.8% of males and 36.2% of females had hypercholesterolemia. Of the total number of patients, 23% of males and 15.5% of females were smokers. Utilization of different multidisciplinary services for males and females was following: physical therapy (46.5% and 45.8%); occupational therapy (11.6% and 15.3%); speech and language therapy (13.9% and 22%). Of all the patients 5% died in the hospital, 77.2% were discharged home and 17.8% were sent to Nursing home for long term care. Conclusion: The commonest risk factor for CVA / TIA is hypertension followed by hypercholesterolemia. Smoke cessation advice should be given to all at risk. (author)

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

    Directory of Open Access Journals (Sweden)

    ANA MARIA JOLDOŞ

    2010-01-01

    Full Text Available The purpose of this article is to present the issues of materiality andaudit risk within the activity of financial audit. The concepts of materiality and audit risk aredescribed from a theoretical perspective, providing approaches found within the national andinternational literature and within the specific legislation. A case study on the calculation ofmateriality and audit risk for an entity is presented in the last part of the article. Through thetheoretical approach and the case study, it was concluded that materiality has an importantrole in determining the type of report to be issued, that is why it can be considered helpful forthose involved in the audit process.

  16. Audit in forensic pathology.

    Science.gov (United States)

    Burke, M P; Opeskin, K

    2000-09-01

    Autopsy numbers in Australian hospitals have declined markedly during the past decade despite evidence of a relatively static rate of demonstrable clinical misdiagnosis during this time. The reason for this decrease in autopsy numbers is multifactorial and may include a general lack of clinical and pathologic interest in the autopsy with a possible decline in autopsy standard, a lack of clinicopathologic correlation after autopsies, and an increased emphasis on surgical biopsy reporting within hospital pathology departments. Although forensic autopsies are currently maintaining their numbers, it is incumbent on forensic pathologists to demonstrate the wealth of important information a carefully performed postmortem examination can reveal. To this end, the Pathology Division of the Victorian Institute of Forensic Medicine has instituted a program of minimum standards in varied types of coroner cases and commenced a system of internal and external audit. The minimum standard for a routine, sudden, presumed natural death is presented and the audit system is discussed.

  17. Auditing nuclear materials statements

    International Nuclear Information System (INIS)

    Anon.

    1973-01-01

    A standard that may be used as a guide for persons making independent examinations of nuclear materials statements or reports regarding inventory quantities on hand, receipts, production, shipment, losses, etc. is presented. The objective of the examination of nuclear materials statements by the independent auditor is the expression of an opinion on the fairness with which the statements present the nuclear materials position of a nuclear materials facility and the movement of such inventory materials for the period under review. The opinion is based upon an examination made in accordance with auditing criteria, including an evaluation of internal control, a test of recorded transactions, and a review of measured discards and materials unaccounted for (MUF). The standard draws heavily upon financial auditing standards and procedures published by the American Institute of Certified Public Accountants

  18. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

    Directory of Open Access Journals (Sweden)

    Gorwill R Hugh

    2004-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  19. Audit risk assessment model

    OpenAIRE

    Jodelienė, Rita

    2010-01-01

    The recent changes of the global scale caused by the development of business and an excessive use of subjective decisions and estimates when drawing up financial statements have caused an increased pressure that may lead to fraudulent financial reporting. Audit firms are obligated to express an independent opinion on the truthfulness and fairness of the information presented in financial statements to enable the users to take informed economic decisions. Therefore, it is important to further ...

  20. FY 2012 Audit Plan

    Science.gov (United States)

    2011-10-01

    September 30, 2012 and 2011 Objective: Determine whether KPMG complied, in all material respects, with U.S. generally accepted government auditing...reported the same 13 material internal control weaknesses as the previous year. These pervasive and longstanding financial management issues...Defense Contract Management Agency’s Investigation and Control of Nonconforming Materials (D2011-D000CD-0264.000) Objective: Examine the Defense

  1. Auditing Organizational Security

    Science.gov (United States)

    2017-01-01

    Organi- zation for Standardiza- tion ( ISO ): ISO 27000 : Information Systems Se- curity Management. A robust program of internal auditing of a...improvement is the basis and underpinning of the ISO . All processes must be considered ongoing and never at an “end state.” Top management develops a...security management system, including security policies and security objectives, plus threats and risks. Orga- nizations already working with ISO 9000

  2. Assessment of paediatric clinical audit.

    LENUS (Irish Health Repository)

    Perrem, L M

    2012-02-01

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

  3. (W)righting women: constructions of gender, sexuality and race in the psychiatric chart.

    Science.gov (United States)

    Daley, Andrea; Costa, Lucy; Ross, Lori

    2012-01-01

    This paper examines the interpretative nature of psychiatry in relation to gender, sexuality and race within the particular time and place of one urban, Canadian, clinical psychiatric setting. We bring women's psychiatric inpatient charts and a critical feminist perspective into dialogue in an effort to focus on gender, sexuality and race in psychiatric narratives on women's madness. The research used a qualitative, retrospective research design to examine the psychiatric narrative as a technique of power as it operates on women. This paper focuses on the overarching theme of 'medicalisation', identified from the analysis of women's psychiatric inpatient charts, including two subthemes: (1) language and composition and (2) decontextualisation. Our analysis suggests that psychiatric chart documentation practices that reproduce gendered, sexualised, and racialised biases and assumptions and decontextualise the social and structural context of women's experiences of madness serve to create the paradox of women's visibility/erasure in psychiatric charts. The paper concludes with an exploration of the significance of women's authorship legitimacy in psychiatric chart documentation.

  4. Analisis Pengaruh Keahlian, Independensi, Perencanaan Audit dan Supervisi Audit terhadap Kualitas Audit pada Inspektorat Provinsi Sumatera Utara

    OpenAIRE

    Pohan, Nur Aisah

    2015-01-01

    The objective of the research was to analyze the influence of skill, independence, audit planning, and audit supervision on audit quality simultaneously and partially and to find out that motivation could moderate the correlation of skill, independence, audit planning, and audit supervision with audit quality at the Inspectorate of North Sumatera Province office. The research used causal research method. The population and the samples consisted of 66 supervision officials at the Inspectorate ...

  5. INTERNAL AUDIT AND RISK MANAGEMENT

    OpenAIRE

    Elena RUSE; Georgiana SUSMANSCHI (BADEA); Daniel DĂNECI-PĂTRĂU

    2014-01-01

    The existence of risk in economic activity can not be denied. In fact, the risk is a concept which exists in every activity, the term of risk being identified with uncertainty, respectively the (un)chance to produce an undesirable event. Internal audit and risk management aim at the same goal, namely the control of risks. Internal Audit performs several roles in risk management plan. The objectives of the internal audit function varies from company to company, but in all economic entities int...

  6. The ambiguous identity of auditing

    DEFF Research Database (Denmark)

    Lindeberg, Tobias

    2007-01-01

    This paper analyses the identity of auditing by comparing performance auditing to financial auditing and programme evaluation. Based on an analysis of textbooks, it is concluded that these evaluative practices are situated on a continuum. This implies that studies that rely on ‘audit’ as a label...... to attribute identity to a distinct evaluative practice become insensitive to issues concerning the relevance of their results to evaluative practices in general and their relation to specific characteristic of certain evaluative practices...

  7. ICAO Aeronautical chart production: aerodrome obstruction charts from small–format aerial digital imagery

    Directory of Open Access Journals (Sweden)

    Jorge Padro Molina

    2012-11-01

    Full Text Available Aeronautical charts and aerodrome obstruction charts, provide information about obstacles around the airport, so pilots and air traffic controllers can comply with the procedures and limitations of its utilization. Safety in aviation demands updated and precise aeronautical charts production, adopting the standards of the International Civil Aviation Organization (ICAO. In this paper the methodology employed to generate obstruction charts for five airports in Mexico, using aerial digital imagery obtained with small–format cameras, is described. Through two aerial surveys on each airport, from 10 000 and 5 000 feet above ground level, two orthomosaics were generated covering the airport influence area, the runway, and the obstacle limitation surfaces: approach/Take–off climb, transitional, inner horizontal, and conical. Using stereopair photointerpretation most of the obstacles were identified, and by means of the orthomosaics; aerodrome charts, and aerodrome obstruction charts types A, B and C, were generated. Using satellite geodetic receivers, 18 points were surveyed on each runway in order to obtain its dimensions, and to establish ground control points for mosaics generation. Throughout detailed field work, height and location of the obstacles were verified, and finally, after several reviewing processes by aeronautical authorities, generation of ICAO charts was concluded when all airport maps were integrated in a Geographical Information System.

  8. Impact of clinical audits on cesarean section rate.

    Science.gov (United States)

    Peng, Fu-Shiang; Lin, Hsien-Ming; Lin, Ho-Hsiung; Tu, Fung-Chao; Hsiao, Chin-Fen; Hsiao, Sheng-Mou

    2016-08-01

    Many countries have noted a substantial increase in the cesarean section rate (CSR). Several methods for lowering the CSR have been described. Understanding the impact of clinical audits on the CSR may aid in lowering CSR. Thus, our aim is to elucidate the effect of clinical audits on the CSR. We retrospectively analyzed 3781 pregnant women who gave birth in a medical center between January 2008 and January 2011. Pregnant women who delivered between January 2008 and July 2009 were enrolled as the pre-audit group (n = 1592). After August 2009, all cesarean section cases that were audited were enrolled in the audit group (n = 2189). The CSR was compared between groups. The overall CSR (34.5% vs. 31.1%, adjusted odds ratio [OR] = 0.83, p = 0.008) and the cesarean section rate due to dystocia (9.6% vs. 6.2%, p strategy for reducing the CSR. Therefore, we recommend strict monitoring of the indications in dystocia for cesarean section to reduce the CSR. Copyright © 2016. Published by Elsevier B.V.

  9. Progress in the technology of nautical charting

    Digital Repository Service at National Institute of Oceanography (India)

    Joseph, A.

    ". The article skims through the various aspects of safety of navigation such as nautical charts created by the Arabs in the medieval days of stellar navigation in the Indian Ocean; the contributions by the Chinese, the British, and the Portuguese; hydrographic...

  10. 7 CFR 51.2276 - Color chart.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... Walnut Color Chart) to which reference is made in §§ 51.2281 and 51.2282 illustrates the four shades of...

  11. Nuclear industry chart no. 20 - Sweden

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    A folding chart is presented of the Swedish nuclear industry, which shows the government bodies, companies, utilities and other groups who participate in the nuclear field. Their special interests and activities and affiliations with each other and with international organisations are indicated. (U.K.)

  12. Body Mass Index (BMI) Charts (For Parents)

    Science.gov (United States)

    ... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for ... charts for boys and girls to account for differences in growth rates and amounts of body fat as the two genders mature. That information is recorded in your child's ...

  13. A robust standard deviation control chart

    NARCIS (Netherlands)

    Schoonhoven, M.; Does, R.J.M.M.

    2012-01-01

    This article studies the robustness of Phase I estimators for the standard deviation control chart. A Phase I estimator should be efficient in the absence of contaminations and resistant to disturbances. Most of the robust estimators proposed in the literature are robust against either diffuse

  14. Charting environmental pollution. [by noise measurements

    Science.gov (United States)

    Halpert, E.; Bizo, F.; Karacsonyi, Z.

    1974-01-01

    It is found that areas affected by different noxious agents are within the limits traced for high noise level areas; consequently, it is suggested that high noise pressure levels should be used as the primary indication of environmental pollution. A complex methodology is reported for charting environmental pollution due to physical, chemical and biological noxious agents on the scale of an industrial district.

  15. ICS International Chronostratigraphic Chart 2016/04

    NARCIS (Netherlands)

    Cohen, K.M.|info:eu-repo/dai/nl/185633374; Finney, S.C.; Gibbard, P.L.

    Units of all ranks are in the process of being defined by Global Boundary Stratotype Section and Points (GSSP) for their lowerboundaries, including those of the Archean and Proterozoic, long defined by Global Standard Stratigraphic Ages (GSSA). Charts and detailed information on ratified GSSPs are

  16. ICS International Chronostratigraphic Chart 2017/02

    NARCIS (Netherlands)

    Cohen, K.M.|info:eu-repo/dai/nl/185633374; Harper, D.A.T.; Gibbard, P.L.

    Units of all ranks are in the process of being defined by Global Boundary Stratotype Section and Points (GSSP) for their lowerboundaries, including those of the Archean and Proterozoic, long defined by Global Standard Stratigraphic Ages (GSSA). Charts and detailed information on ratified GSSPs are

  17. ICS International Chronostratigraphic Chart 2015/01

    NARCIS (Netherlands)

    Cohen, K.M.|info:eu-repo/dai/nl/185633374; Finney, S.C.; Gibbard, P.L.

    Units of all ranks are in the process of being defined by Global Boundary Stratotype Section and Points (GSSP) for their lower boundaries, including those of the Archean and Proterozoic, long defined by Global Standard Stratigraphic Ages (GSSA). Charts and detailed information on ratified GSSPs are

  18. Charts for interpreting wildland fire behavior characteristics

    Science.gov (United States)

    Patricia L. Andrews; Richard C. Rothermel

    1982-01-01

    The fire characteristics chart is proposed as a graphical method ofpresenting two primary characteristics of fire behavior – spread rate and intensity. Its primary use is communicating and interpreting either site-specific predictions of fire behavior or National Fire-Danger Rating System (NFDRS) indexes and components. Rate of spread, heat per unit area, flame length...

  19. 7 CFR 4284.18 - Audit requirements.

    Science.gov (United States)

    2010-01-01

    ... Grant Programs § 4284.18 Audit requirements. Grantees must comply with the audit requirements of 7 CFR part 3052. The audit requirements apply to the years in which grant funds are received and years in...

  20. 7 CFR 1290.10 - Audit requirements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Audit requirements. 1290.10 Section 1290.10 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... audit, a copy of the audit results. ...

  1. The ICA Communication Audit: Process, Status, Critique

    Science.gov (United States)

    Goldhaber, Gerald M.; Krivonos, Paul D.

    1977-01-01

    Explores the International Communication Association (ICA) Audit process including goals, products, instruments, audit logistics and timetable, feedback of results and follow-up, costs, current status and audits conducted to date. (ED.)

  2. Internal Audits of QMS (COTS) -

    Data.gov (United States)

    Department of Transportation — This is an internal audit workflow application used to automate business processes that support the AVS Quality Management System (QMS) and several Flight Standards...

  3. A national house-staff audit of medical prophylaxis in medical patients for the PREVENTion of Venous ThromboEmbolism (PREVENT-VTE).

    Science.gov (United States)

    Adamali, H; Suliman, A M; Zaid, H; O'Donoghue, E; Burke, A; Suliman, A W; Salem, M; O'Toole, A; Yearoo, A Ibrahim; Javid, S; Ullah, I; Bolger, K; Dunican, E; McCullagh, B; Curtin, D; Lonergan, M T; Dillon, L; Murphy, A W; Gaine, S

    2013-01-01

    We established a national audit to assess the thromboprophylaxis rate for venous thromoembolism (VTE) in at risk medical patients in acute hospitals in the Republic of Ireland and to determine whether the use of stickers to alert physicians regarding thromboprophylaxis would double the rate prophylaxis in a follow-up audit. 651 acute medical admission patients in the first audit and 524 in the second re-audit were recruited. The mean age was 66.5 yrs with similar numbers of male and female patients and 265 (22.6%) patients were active smokers. The first and second audits identified 549 (84%) and 487 (93%) of patients at-risk for VTE respectively. Of the at-risk patients, 163 (29.7%) and 132 (27.1%) received LMWH in the first and second audit respectively. Mechanical thromboprophylaxis was instigated in 75 (13.6%) patients in the first and 86 (17.7%) patients in the second audit. The placement of stickers in patient charts didn't produce a significant increase in the number of at risk patients treated in the second audit. There is unacceptably low adherence to the ACCP guidelines in Ireland and more complex intervention than chart reminders are required to improve compliance.

  4. An analysis of two separate quality audits in UK radiotherapy centres

    International Nuclear Information System (INIS)

    Aird, E G A

    1995-01-01

    The CHART quality assurance programme has been used to audit 2 groups of radiotherapy centres for the delivery of radiotherapy: 1. those involved in the CHART Clinical Trial (1991-1995) 2. all London radiotherapy centres (1994-1996) Machinery Tests This paper will seek to illustrate improvements in meeting the criteria set by the QA programme as older linear accelerators are replaced. Phantom Tests The residual errors between measured and calculated doses in anatomical phantoms will be analysed to demonstrate where there are still weaknesses in treatment planning and delivery of radiotherapy

  5. A Review on Audit Quality Factors

    OpenAIRE

    Hosseinniakani, Seyed; Inácio, Coelho Helena; Mota, Rui

    2014-01-01

    Audit Quality” is not easy to define because of many diverse factors affecting quality. According to the consultation paper of the International Auditing and Assurance Standards Board (IAASB), audit quality is the significant issue that requires more considerable attention. Understanding how audit quality is important requires investigating audit quality factors more precisely. So, the present article aims to review and summarize the different audit quality factors, comparing the results ach...

  6. Audit Expectation Gap: Perspectives of Auditors and Audited ...

    African Journals Online (AJOL)

    This study empirically examined Audit Expectation Gap: Perspectives of Auditors and Audited Account Users. For the purpose of this study primary and secondary data were used. Data were sourced through the examination of vast array of relevant literature like journals, standard textbooks, magazine and questionnaires.

  7. NEVER AUDIT ALONE--THE CASE FOR AUDIT TEAMS

    Science.gov (United States)

    On-site audits conducted by technical and quality assurance (QA) experts at the data-gathering location are the core of an effective QA program. However, inadequate resources for such audits are the bane of a QA program, and the proposed solution frequently is to send only one au...

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

    African Journals Online (AJOL)

    user

    auditor derives a high proportion of revenue from a particular client creates economic ... identified in prior bank audit fee studies holds for Ethiopian commercial .... firms as smaller firms have fewer clients and so each client represents a larger ...... higher level of liquid assets relative to their total assets pay lower audit fees.

  9. Evaluation of the Acquisition Audit Process

    National Research Council Canada - National Science Library

    Smolenyak, Barbara

    1997-01-01

    The objectives were to evaluate the efficiency and effectiveness of the acquisition audit process, determine whether reductions can be achieved by improvements in prioritizing audits, and determine...

  10. Audit Database and Information Tracking System

    Data.gov (United States)

    Social Security Administration — This database contains information about the Social Security Administration's audits regarding SSA agency performance and compliance. These audits can be requested...

  11. On the nature of auditing: The audit partner effect : Research on the effect of individual audit partners on audit quality and the information dynamics of accounting data

    OpenAIRE

    Buuren, van, J.P.

    2009-01-01

    This doctoral thesis is about whether auditing is ‘static and mechanic’ of nature or the opposite: ‘dynamic and organic’. If auditing is considered ‘static and mechanic’ of nature, this implies that standard audit solutions are available and can uniformly be applied by the audit partners. Moreover, it suggests that the level of audit quality can be guaranteed to a large extent by the audit firm’s control and governance structures. In such an environment, audit firm size and the actual audit q...

  12. Environmental auditing: Theory and applications

    Science.gov (United States)

    Thompson, Dixon; Wilson, Melvin J.

    1994-07-01

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

  13. Short- and long-term effects of clinical audits on compliance with procedures in CT scanning.

    Science.gov (United States)

    Oliveri, Antonio; Howarth, Nigel; Gevenois, Pierre Alain; Tack, Denis

    2016-08-01

    To test the hypothesis that quality clinical audits improve compliance with the procedures in computed tomography (CT) scanning. This retrospective study was conducted in two hospitals, based on 6950 examinations and four procedures, focusing on the acquisition length in lumbar spine CT, the default tube current applied in abdominal un-enhanced CT, the tube potential selection for portal phase abdominal CT and the use of a specific "paediatric brain CT" procedure. The first clinical audit reported compliance with these procedures. After presenting the results to the stakeholders, a second audit was conducted to measure the impact of this information on compliance and was repeated the next year. Comparisons of proportions were performed using the Chi-square Pearson test. Depending on the procedure, the compliance rate ranged from 27 to 88 % during the first audit. After presentation of the audit results to the stakeholders, the compliance rate ranged from 68 to 93 % and was significantly improved for all procedures (P ranging from audit (P ranging from 0.114 to 0.999). Quality improvement through repeated compliance audits with CT procedures durably improves this compliance. • Compliance with CT procedures is operator-dependent and not perfect. • Compliance differs between procedures and hospitals, even within a unified department. • Compliance is improved through audits followed by communication to the stakeholders. • This improvement is sustainable over a one-year period.

  14. Concordance of chart and billing data with direct observation in dental practice.

    Science.gov (United States)

    Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen

    2008-10-01

    The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating

  15. Construction and validation of a Tamil logMAR chart.

    Science.gov (United States)

    Varadharajan, Srinivasa; Srinivasan, Krithica; Kumaresan, Brindha

    2009-09-01

    To design, construct and validate a new Tamil logMAR visual acuity chart based on current recommendations. Ten Tamil letters of equal legibility were identified experimentally and were used in the chart. Two charts, one internally illuminated and one externally illuminated, were constructed for testing at 4 m distance. The repeatability of the two charts was tested. For validation, the two charts were compared with a standard English logMAR chart (ETDRS). When compared to the ETDRS chart, a difference of 0.06 +/- 0.07 and 0.07 +/- 0.07 logMAR was found for the internally and externally illuminated charts respectively. Limits of agreement between the internally illuminated Tamil logMAR chart and ETDRS chart were found to be (-0.08, 0.19), and (-0.07, 0.20) for the externally illuminated chart. The test - retest results showed a difference of 0.02 +/- 0.04 and 0.02 +/- 0.06 logMAR for the internally and externally illuminated charts respectively. Limits of agreement for repeated measurements for the internally illuminated Tamil logMAR chart were found to be (-0.06, 0.10), and (-0.10, 0.14) for the externally illuminated chart. The newly constructed Tamil logMAR charts have good repeatability. The difference in visual acuity scores between the newly constructed Tamil logMAR chart and the standard English logMAR chart was within acceptable limits. This new chart can be used for measuring visual acuity in the literate Tamil population.

  16. Audit quality and the audit partner effect : Evidence from European listed companies

    OpenAIRE

    Buuren, van, J.P.

    2009-01-01

    The main objective of this study is to provide evidence on the differences in audit quality amongst audit partners. I attribute these dissimilarities to (i) differences in the audit risk perception and the risk appetite of individual audit partners and (ii) to differences in the personal business case of audit partners. As a result, three audit partner archetypes have been identified: liberal, high quality and conservative. This paper will provide evidence that 50% of the audit partners (53% ...

  17. Common energy audit report

    Energy Technology Data Exchange (ETDEWEB)

    Kolesnikov, A.I.; Sheina, L.S.; Ivanov, N.S. [RDIEE, Moswoc (Russian Federation); Draborg, S.; Oestergaard, T. [Dansk Energi Analyse A/S, Vanloese (Denmark)

    1998-12-31

    The project encompassed following activities: Elaboration of a description of the Russian dairy sector including a mapping of the entire sector in respect of production capacity, actual production, products, production technologies and energy consumption; Energy audits at twelve selected dairies with different typical productions; Elaboration of an `Energy Audit Guidance` which describes how to perform energy audits in dairies and where to expect energy saving possibilities. The energy savings possibilities are often due to the same kind of problems, e.g. low production, inefficient equipment or manually control of the process equipment. The main problems that Russian dairies faces can be divided into the following categories: Old and inefficient technological equipment which is operated at low capacity with very low energy efficiency; Lack of knowledge about new energy efficient technologies; Financial problems which causes low interest and few possibilities for using funds for investment in energy efficient equipment; Energy savings do not lead to personal gains for the persons in the dairy management or other employees which causes low interst in energy savings. At some dairies it seemed to be a problem for the management to adapt to the new and very different conditions for enterprises in Russian today, where sales, production, production capacity and raw milk available are interconnected. With respect to energy matters it was often a wish to replace existing oversized equipment with new equipment of the same size no matter that it is unlikely that the production will increase considerable in the future. The project has discovered that there is a need for demonstrating energy saving measures by implementation because it was in many ways hard for the dairy management`s to believe that, the energy consumption could be reduced dramatically without affecting could production or the processes. Furthermore, the project has discovered a need for transferring to the

  18. Common energy audit report

    Energy Technology Data Exchange (ETDEWEB)

    Kolesnikov, A I; Sheina, L S; Ivanov, N S [RDIEE, Moswoc (Russian Federation); Draborg, S; Oestergaard, T [Dansk Energi Analyse A/S, Vanloese (Denmark)

    1999-12-31

    The project encompassed following activities: Elaboration of a description of the Russian dairy sector including a mapping of the entire sector in respect of production capacity, actual production, products, production technologies and energy consumption; Energy audits at twelve selected dairies with different typical productions; Elaboration of an `Energy Audit Guidance` which describes how to perform energy audits in dairies and where to expect energy saving possibilities. The energy savings possibilities are often due to the same kind of problems, e.g. low production, inefficient equipment or manually control of the process equipment. The main problems that Russian dairies faces can be divided into the following categories: Old and inefficient technological equipment which is operated at low capacity with very low energy efficiency; Lack of knowledge about new energy efficient technologies; Financial problems which causes low interest and few possibilities for using funds for investment in energy efficient equipment; Energy savings do not lead to personal gains for the persons in the dairy management or other employees which causes low interst in energy savings. At some dairies it seemed to be a problem for the management to adapt to the new and very different conditions for enterprises in Russian today, where sales, production, production capacity and raw milk available are interconnected. With respect to energy matters it was often a wish to replace existing oversized equipment with new equipment of the same size no matter that it is unlikely that the production will increase considerable in the future. The project has discovered that there is a need for demonstrating energy saving measures by implementation because it was in many ways hard for the dairy management`s to believe that, the energy consumption could be reduced dramatically without affecting could production or the processes. Furthermore, the project has discovered a need for transferring to the

  19. [Ophthalmologic reading charts : Part 2: Current logarithmically scaled reading charts].

    Science.gov (United States)

    Radner, W

    2016-12-01

    To analyze currently available reading charts regarding print size, logarithmic print size progression, and the background of test-item standardization. For the present study, the following logarithmically scaled reading charts were investigated using a measuring microscope (iNexis VMA 2520; Nikon, Tokyo): Eschenbach, Zeiss, OCULUS, MNREAD (Minnesota Near Reading Test), Colenbrander, and RADNER. Calculations were made according to EN-ISO 8596 and the International Research Council recommendations. Modern reading charts and cards exhibit a logarithmic progression of print sizes. The RADNER reading charts comprise four different cards with standardized test items (sentence optotypes), a well-defined stop criterion, accurate letter sizes, and a high print quality. Numbers and Landolt rings are also given in the booklet. The OCULUS cards have currently been reissued according to recent standards and also exhibit a high print quality. In addition to letters, numbers, Landolt rings, and examples taken from a timetable and the telephone book, sheet music is also offered. The Colenbrander cards use short sentences of 44 characters, including spaces, and exhibit inaccuracy at smaller letter sizes, as do the MNREAD cards. The MNREAD cards use sentences of 60 characters, including spaces, and have a high print quality. Modern reading charts show that international standards can be achieved with test items similar to optotypes, by using recent technology and developing new concepts of test-item standardization. Accurate print sizes, high print quality, and a logarithmic progression should become the minimum requirements for reading charts and reading cards in ophthalmology.

  20. The dutch surgical colorectal audit

    NARCIS (Netherlands)

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

    2013-01-01

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

  1. Effective planning for internal audit

    OpenAIRE

    Cirtautas, Marius

    2016-01-01

    The purpose of this thesis is to find a way to effectively plan for internal audit. Conditions necessary for effective planning are formulated by using analysis of scientific literature. In second part author suggests a model for effective internal audit planning. In third part model is applied and analyzed using a case study.

  2. Fuzzy audit risk modeling algorithm

    Directory of Open Access Journals (Sweden)

    Zohreh Hajihaa

    2011-07-01

    Full Text Available Fuzzy logic has created suitable mathematics for making decisions in uncertain environments including professional judgments. One of the situations is to assess auditee risks. During recent years, risk based audit (RBA has been regarded as one of the main tools to fight against fraud. The main issue in RBA is to determine the overall audit risk an auditor accepts, which impact the efficiency of an audit. The primary objective of this research is to redesign the audit risk model (ARM proposed by auditing standards. The proposed model of this paper uses fuzzy inference systems (FIS based on the judgments of audit experts. The implementation of proposed fuzzy technique uses triangular fuzzy numbers to express the inputs and Mamdani method along with center of gravity are incorporated for defuzzification. The proposed model uses three FISs for audit, inherent and control risks, and there are five levels of linguistic variables for outputs. FISs include 25, 25 and 81 rules of if-then respectively and officials of Iranian audit experts confirm all the rules.

  3. Your Audit and Financial Controls.

    Science.gov (United States)

    Hatch, Mary B.; And Others

    Audits should be performed on school accounting systems because they are required by law and they provide independent reviews of school financial procedures and suggestions for improvement. A licensed certified public accountant, public accountant, or an accountant who has met the Continuation of Education requirement should perform the audit.…

  4. The Dutch surgical colorectal audit

    NARCIS (Netherlands)

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

    2013-01-01

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

  5. A "Quick & Dirty" Strategic Audit

    Science.gov (United States)

    Brawley, Dorothy E.

    2016-01-01

    In teaching Strategic Management, it is imperative that students first learn how to audit the firm before they begin analysis, planning and implementation. Unfortunately this is a step often overlooked. Without a complete and up to date audit, any analysis conducted would have questionable validity and reliability. This report focuses on an…

  6. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...

  7. Fundamentals of Financial Statements Audit

    OpenAIRE

    World Bank

    2011-01-01

    The purpose of an audit is to enhance the degree of confidence of intended users in the financial statements. The objective of an audit of financial statements is to enable an auditor to express an opinion as to whether the financial statements are prepared, in all material respects, in accordance with International Financial Reporting Standards or another identified financial reporting fr...

  8. Defining a Forensic Audit

    Directory of Open Access Journals (Sweden)

    Stevenson G. Smith

    2009-03-01

    Full Text Available Disclosures about new financial frauds and scandals are continually appearing in the press.  As a consequence, the accounting profession's traditional methods of monitoring corporate financial activities are under intense scrutiny.  At the same time, there is recognition that principles-based GAAP from the International Accounting Standards Board will become the recognized standard in the U.S.  The authors argue that these two factors will change the practices used to fight corporate malfeasance as investigators adapt the techniques of accounting into a forensic audit engagement model.

  9. Practical energy auditing

    Energy Technology Data Exchange (ETDEWEB)

    Jones, C. D.E.

    1979-07-01

    Graphs are shown depicting energy consumption over a period to illustrate the impact various factors have on energy consumption. Some recommendations are made to improve consumption including weatherization of the building; proper operation of equipment; and insulating pipelines, etc. Formulas are given from which can be determined the factors (seasonal variations, heat losses, etc.) causing fuel consumption variations. Electric power usage for space HVAC systems and for processes is dealt with separately and can usually be audited separately. Some payback times for specific conservation measures are given. (MCW)

  10. Design chart of optimum current leads

    International Nuclear Information System (INIS)

    Ishibashi, K.; Katase, A.; Maechata, K.

    1986-01-01

    The heat flow through current leads is one of major heat losses in a superconducting magnet system. To reduce the heat flow, current leads have been optimized in a complex way by varying such quantities as conductor length, cross-sectional area, heat transfer coefficient and cooling perimeter. Therefore, this study is made to simplify the design procedure, and to explain the general characteristics of the current leads. A new combined parameter which takes turbulent flow into account is introduced in the present work to enable us to draw a useful design chart. This chart gives, to a wide variety of current leads, detailed information about the optimum design-viz. geometric dimensions, heat flow into liquid helium, and pressure drop of the cooling gas. Change of the cross-sectional area along the conductor may improve the current lead performance. The effects of this area change are examined in detail

  11. Jean Rotz and the Marine Chart, 1542

    Science.gov (United States)

    Taylor, E. G. R.

    This paper was first published in the Journal in 1954 (Vol. 7, p. 138). It is followed by comments from Michael Richey.At the time (1542) when Jean Rotz presented Henry VIII with a variation compass, and an accompanying treatise on its making and use, the question of magnetic variation was an acute one. It formed part of a wider controversy concerning the general validity of the sea-chart which had been raised among seamen. As to this, Dr Pedro Nunez, writing a treatise in 1537 addressed to his friend and pupil the Infante Dom Luys of Portugal, said that there were skilled pilots who derided the chart and declared it to be - the falsest thing in the world. Hastening to its defence, Nunez dealt at length with the navigating errors introduced by ignoring the convergence of the meridians, and showed besides that a rhumb, or line of constant bearing was a spiral curve on the globe.

  12. Subtle Nonlinearity in Popular Album Charts

    Science.gov (United States)

    Bentley, R. Alexander; Maschner, Herbert D. G.

    Large-scale patterns of culture change may be explained by models of self organized criticality, or alternatively, by multiplicative processes. We speculate that popular album activity may be similar to critical models of extinction in that interconnected agents compete to survive within a limited space. Here we investigate whether popular music albums as listed on popular album charts display evidence of self-organized criticality, including a self-affine time series of activity and power-law distributions of lifetimes and exit activity in the chart. We find it difficult to distinguish between multiplicative growth and critical model hypotheses for these data. However, aspects of criticality may be masked by the selective sampling that a "Top 200" listing necessarily implies.

  13. APLIKASI GANTT CHART PADA ALGORITMA PENJADUALAN PROSES

    Directory of Open Access Journals (Sweden)

    Sri Handayani

    2014-01-01

    Full Text Available Operating system is a compulsory subject taken in the Information Technology Student FTIK - USM . In the discussion of the material management process of the operating systems course , there are some scheduling algorithm which processes need to be understood and any existing process scheduling algorithm presented in the form of Grantt Charts . Because of the difficulties experienced by students in understanding the process of scheduling algorithms by an Operating System become researchers inspiration to conduct this study to make an application Grantt Chart.. This study uses a waterfall system development , where the flow will follow the research the phase in waterfall . This application will be built using Visual Basic 6 .  The purpose of this research is to produce an application of learning are presented in graphical form to facilitate students in understanding the material scheduling process performed by an operating system so that students can also understand how a computer can do multiple processes simultaneously.

  14. JDATAVIEWER – JAVA-Based Charting Library

    CERN Document Server

    Kruk, G

    2009-01-01

    The JDataViewer is a Java-based charting library developed at CERN, with powerful, extensible and easy to use function editing capabilities. Function edition is heavily used in Control System applications, but poorly supported in products available on the market. The JDataViewer enables adding, removing and modifying function points graphically (using a mouse) or by editing a table of values. Custom edition strategies are supported: developer can specify an algorithm that reacts to the modification of a given point in the function by automatically adapting all other points. The library provides all typical 2D plotting types (scatter, polyline, area, bar, HiLo, contour), as well as data point annotations and data indicators. It also supports common interactors to zoom and move the visible view, or to select and highlight function segments. A clear API is provided to configure and customize all chart elements (colors, fonts, data ranges ...) programmatically, and to integrate non-standard rendering types, inter...

  15. Introducing students to clinical audit.

    Science.gov (United States)

    Parkes, Jacqueline; O'Dell, Cindy

    2015-11-01

    It is more than a decade since the UK Central Council for Nursing Midwifery and Health Visiting said that engaging with clinical audit is 'the business of every registered practitioner', yet there appears to be little evidence that nursing has embraced the process. To address this issue, Northampton General Hospital and the University of Northampton implemented a pilot project in which two third-year adult nursing students worked on a 'real life' audit. Supported by the hospital's audit department, and supervised by academic tutors with the relevant experience, the students worked on a pressure-ulcer care audit for their final year dissertation. This article describes the process undertaken by the hospital audit team and the university academic team to develop the pilot project and support the students. Based on the positive evaluations, the university has extended the project to a second phase, incorporating two new partner organisations.

  16. Intelligent Bar Chart Plagiarism Detection in Documents

    Directory of Open Access Journals (Sweden)

    Mohammed Mumtaz Al-Dabbagh

    2014-01-01

    Full Text Available This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR. By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts.

  17. Paperless chart recording helps cut costs

    International Nuclear Information System (INIS)

    Collier, K.; Sullivan, M.E.

    1997-01-01

    Turbine generator data acquisition systems using personal computers have been installed at the Limerick BWR power plant to replace paper-based chart recorders. This plant is already one of the lowest cost nuclear power plants in the US and this innovation will boost operating efficiency still further. The Limerick control room now has wall-mounted touch screen video displays which provide operators with real-time, electronically achieved information and improving information flow, with a consolidated, consistent user interface. (UK)

  18. Intelligent bar chart plagiarism detection in documents.

    Science.gov (United States)

    Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Rehman, Amjad; Alkawaz, Mohammed Hazim; Saba, Tanzila; Al-Rodhaan, Mznah; Al-Dhelaan, Abdullah

    2014-01-01

    This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR). By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts.

  19. Intelligent Bar Chart Plagiarism Detection in Documents

    Science.gov (United States)

    Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Alkawaz, Mohammed Hazim; Saba, Tanzila; Al-Rodhaan, Mznah; Al-Dhelaan, Abdullah

    2014-01-01

    This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR). By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts. PMID:25309952

  20. Marketingový audit

    OpenAIRE

    Čevelová, Petra

    2007-01-01

    Diplomová práce je zpracování na téma marketingový audit. Jejím cílem provedení marketingového auditu ve firmě XX. Předmětem auditu je jejich nejstarší produkt, a to v plné šíři, tj. celkové zhodnocení marketingové činnosti firmy. Marketingový audit je nástroj analýzy v této diplomové práci. Poznatky shrnuji v analýze SWOT, na jejímž základě jsem vypracovala seznam doporučení s cílem vylepšení fungování marketingových činností, následně jsem sestavila přibližný rozpočet pro tyto kroky, stejně...

  1. Reaktivní audit

    OpenAIRE

    Hlísta, Juraj

    2010-01-01

    Tato diplomová práce se zabývá návrhem a implementací rozšíření auditu v Linuxu, kterým je reaktivní audit. Tento mechanizmus přináší novou funkcionalitu ve formě možnosti spouštění reakcí na určité události generované auditem. Reaktivní audit je implementován jako plugin a jeho použití je volitelné. Tato práce se zabývá také pluginem, který ukládá některé události a na základě jejich analýzy poskytuje časově závislé statistiky pro první plugin. Výsledkem je, že mechanizmus reaktivního auditu...

  2. The internal audit dilemma : The impact of executive directors versus audit committees on internal auditing work

    NARCIS (Netherlands)

    Eulerich, Marc; Henseler, Jörg; Koehler, Annette

    2017-01-01

    Purpose The purpose of this study is to analyze how internal audit function (IAF) activities differ, depending on the impact of executive boards (EBs) and audit committees (ACs). Design/methodology/approach This study is based on data collected from the Common Body of Knowledge (CBOK) study

  3. Can virtual streetscape audits reliably replace physical streetscape audits?

    Science.gov (United States)

    Badland, Hannah M; Opit, Simon; Witten, Karen; Kearns, Robin A; Mavoa, Suzanne

    2010-12-01

    There is increasing recognition that the neighborhood-built environment influences health outcomes, such as physical activity behaviors, and technological advancements now provide opportunities to examine the neighborhood streetscape remotely. Accordingly, the aims of this methodological study are to: (1) compare the efficiencies of physically and virtually conducting a streetscape audit within the neighborhood context, and (2) assess the level of agreement between the physical (criterion) and virtual (test) audits. Built environment attributes associated with walking and cycling were audited using the New Zealand Systematic Pedestrian and Cycling Environment Scan (NZ-SPACES) in 48 street segments drawn from four neighborhoods in Auckland, New Zealand. Audits were conducted physically (on-site) and remotely (using Google Street View) in January and February 2010. Time taken to complete the audits, travel mileage, and Internet bandwidth used were also measured. It was quicker to conduct the virtual audits when compared with the physical audits (χ = 115.3 min (virtual), χ = 148.5 min (physical)). In the majority of cases, the physical and virtual audits were within the acceptable levels of agreement (ICC ≥  0.70) for the variables being assessed. The methodological implication of this study is that Google Street View is a potentially valuable data source for measuring the contextual features of neighborhood streets that likely impact on health outcomes. Overall, Google Street View provided a resource-efficient and reliable alternative to physically auditing the attributes of neighborhood streetscapes associated with walking and cycling. Supplementary data derived from other sources (e.g., Geographical Information Systems) could be used to assess the less reliable streetscape variables.

  4. Comparison of customised growth charts v. standard population

    African Journals Online (AJOL)

    pregnant diabetic population using population-based growth charts and customised growth charts. Methods. ... Of the patients, 44 had type 1, 66 type 2 and 173 gestational diabetes. The growth of .... with diabetic ketoacidosis, of whom one.

  5. Arctic Sea Ice Charts from Danish Meteorological Institute, 1893 - 1956

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — From 1893 to 1956, the Danish Meteorological Institute (DMI) created charts of observed and inferred sea ice extent for each summer month. These charts are based on...

  6. U.S. Pacific Command > Organization > Organization Chart

    Science.gov (United States)

    Responsibility USPACOM Previous Commanders Organization Organization Chart Media News Flickr Photos Video Directory Media Inquiries Home : Organization : Organization Chart About DoD DoD Careers Join the Military

  7. Chesapeake Highway Advisories Routing Traffic, Chart, Business Plan

    Science.gov (United States)

    1996-10-01

    THE BUSINESS PLAN IS ORGANIZED INTO FOUR MAJOR SECTIONS. THE FIRST SECTION IS INTRODUCTORY IN NATURE AND PROVIDES BACKGROUND INFORMATION ON ITS AND THE CHART PROGRAM IN MARYLAND. IT INCLUDES THE CHART MISSION, GOALS AND OBJECTIVES, AS WELL AS OVERVIE...

  8. A new Snellen's visual acuity chart with 'Indian' numerals.

    OpenAIRE

    Al-Salem, M

    1987-01-01

    'Indian' numerals, which are popular among the Arab population, were used to devise a new Snellen's visual acuity chart. The new chart has the advantages of a reading chart. It keeps the patient's interest, does not miss alexic patients, and is quicker to perform. It is also devoid of the many disadvantages of a kinetic response chart (the capital E letter or Landolt's broken rings), especially that of the limited option of test objects.

  9. Epilepsy audit: do we document everything?

    LENUS (Irish Health Repository)

    Iqbal, M

    2012-02-01

    BACKGROUND: An audit of the hospital notes and letters of patients with epilepsy sent to general practitioners was undertaken. AIMS: (a) To examine the frequency of important omissions in history taking and role of precipitants in seizure control, (b) to determine whether appropriate investigations had been performed and their results, (c) to assess whether letters sent to GPs contain all the appropriate information and advice, and to evaluate the waiting time for out-patient clinics and investigations. METHODS: This retrospective study was conducted in a teaching hospital setting. A computerised search of the clinical database of a consultant neurologist was performed on patients with epilepsy. The notes of the first 100 names selected randomly by the computer were analysed. The study period was during the years 1998-2005. Age range was from 17-72 years. The male:female ratio was 1:1. CONCLUSION: Major deficiencies in documentation were identified in this study.

  10. The Strategic Options of Supreme Audit Institutions

    DEFF Research Database (Denmark)

    Klarskov Jeppesen, Kim; Carrington, Thomas; Catasús, Bino

    2017-01-01

    Based on the theory of professional competition, this paper identifies and investigates four strategic options of supreme audit institutions (SAIs) through a case study of four Nordic national audit offices: a performance auditing strategy; a financial auditing strategy; a portfolio strategy...

  11. 7 CFR 1948.96 - Audit requirements.

    Science.gov (United States)

    2010-01-01

    ... Program § 1948.96 Audit requirements. (a) Audit requirements for Site Development and Acquisition Grants will be made in accordance with FmHA Instruction 1942-G. (b) Audits for planning grants made in... 7 Agriculture 13 2010-01-01 2009-01-01 true Audit requirements. 1948.96 Section 1948.96...

  12. 7 CFR 3052.230 - Audit costs.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit costs. 3052.230 Section 3052.230 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.230 Audit costs...

  13. 29 CFR 99.200 - Audit requirements.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirements. 99.200 Section 99.200 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.... Guidance on determining Federal awards expended is provided in § 99.205. (b) Single audit. Non-Federal...

  14. 29 CFR 99.510 - Audit findings.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit... schedule of prior audit findings prepared by the auditee in accordance with § 99.315(b) materially...

  15. Factors Affecting the Internal Audit Effectiveness

    OpenAIRE

    Mustika, Adhista Cahya

    2015-01-01

    This study tests the factors that influence the internal audit effectiveness, including internal auditor competencies, internal auditor independence, auditee support to internal audit activity, and the internal and external auditor relationship. Using the internal auditor inspectorate in Java Province, Indonesia, we found that the internal audit effectiveness can be attained through increase internal audit competence, independence and strong relationship between internal and external auditor....

  16. 20 CFR 655.180 - Audit.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit. 655.180 Section 655.180 Employees... United States (H-2A Workers) Integrity Measures § 655.180 Audit. The CO may conduct audits of applications for which certifications have been granted. (a) Discretion. The applications selected for audit...

  17. 38 CFR 41.230 - Audit costs.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit costs. 41.230 Section 41.230 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.230 Audit costs. (a) Allowable...

  18. 9 CFR 149.4 - Spot audit.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Spot audit. 149.4 Section 149.4... LIVESTOCK IMPROVEMENT VOLUNTARY TRICHINAE CERTIFICATION PROGRAM § 149.4 Spot audit. (a) In addition to regularly scheduled site audits, certified production sites will be subject to spot audits. (1) Random spot...

  19. 24 CFR 236.901 - Audit.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Audit. 236.901 Section 236.901... AND INTEREST REDUCTION PAYMENT FOR RENTAL PROJECTS Audits § 236.901 Audit. Where a State or local... mortgagor of a mortgage insured or held by the Commissioner under this part, it shall conduct audits in...

  20. On the nature of auditing: The audit partner effect : Research on the effect of individual audit partners on audit quality and the information dynamics of accounting data

    NARCIS (Netherlands)

    Buuren, van J.P.

    2009-01-01

    This doctoral thesis is about whether auditing is ‘static and mechanic’ of nature or the opposite: ‘dynamic and organic’. If auditing is considered ‘static and mechanic’ of nature, this implies that standard audit solutions are available and can uniformly be applied by the audit partners. Moreover,

  1. 28 CFR 33.51 - Audit.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Audit. 33.51 Section 33.51 Judicial... Additional Requirements § 33.51 Audit. Pursuant to Office of Management and Budget Circular A-128 “Audits of State and Local Governments,” all grantees and subgrantees must provide for an independent audit of...

  2. Towards a framework for auditing environmental reports

    NARCIS (Netherlands)

    Kamp, A.E.M.

    2002-01-01

    Audits of environmental reports first appeared about ten years ago. Both the number of environmental reports and the audit of these reports is still increasing. Audit firms perform a major part of these audits, but other professionals are also active in this field. Even today there are still

  3. Annexing new audit spaces: challenges and adaptations

    NARCIS (Netherlands)

    Andon, P.; Free, C.; O'Dwyer, B.

    2015-01-01

    Purpose - The purpose of this paper is to examine attempts at jurisdictional expansion in the audit field. Specifically, the authors critically analyse the professional implications of "new audit spaces", that is, novel auditing and assurance services that have emerged at intersections between audit

  4. 21 CFR 820.22 - Quality audit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality audit. 820.22 Section 820.22 Food and... QUALITY SYSTEM REGULATION Quality System Requirements § 820.22 Quality audit. Each manufacturer shall establish procedures for quality audits and conduct such audits to assure that the quality system is in...

  5. Pengaruh Struktur Organisasi Terhadapkomunikasi dalam Tim Audit

    OpenAIRE

    Muhammad, Rifqi

    2009-01-01

    Some audit researchers suggest that high levels of audit team structure may encumber communication within audit teams by impeding information-gathering activities. Others suggest that structure benefits communication by coordinating controlling information flows. This study evaluated these arguments by examining the relationship between the structure of audit teams and selected communication variables (information overload, boundary spanning, satisfaction with supervision, and accuracy of inf...

  6. Approach to chronic low back pain in a Rural Mission Hospital: An audit report

    Directory of Open Access Journals (Sweden)

    Tapan Kumar Paraseth

    2018-01-01

    Full Text Available Background: Challenging psychological and ergonomic burden demands a streamlined approach to Chronic low back pain (LBP in rural population. Methodology: All patients with chronic LBP managed in the outpatient physiotherapy and occupational therapy clinic at the rural mission hospital from July 2015 to June 2016 were included in a retrospective chart audit. Patients' demographic data and diagnosis were statistically analyzed with t-test. Results: One hundred and fifty five patients were included in the study. 65 patients (42% had mechanical LBP, 46 patients (30% had chronic LBP with lumbar radiculopathy, 22 patients (14% had discogenic chronic LBP, 15 patients (10% had chronic LBP due to osteoporosis, 5 patients (3% had chronic infective spondylitis and 2 patients (1% had post-traumatic chronic LBP. 25 patients (16% were less than 30 years old, 106 patients (68% were between 30 and 60 years and 24 patients (16% were older than 60 years. Higher incidence of mechanical chronic LBP was noted in younger group (t [129] = 1.36, P = 0.17 and higher incidence of chronic LBP with lumbar radiculopathy (t [129] =1.181, P = 0.239 was noted in middle aged patients, respectively. Gender prevalence of osteoporosis was statistically significant (t [153] =2.188, P = 0.03. Conclusion: Chronic LBP constituted 23% of all patients managed at the PT/OT outpatient clinic and mechanical chronic LBP was the most common diagnosis. Highest incidence of chronic LBP was noted in the middle aged 'working class' group of patients. Higher proportion of osteoporosis was detected among the female patients.

  7. Increased auditor independence by external rotation and separating audit and non audit duties? - A note on the European audit regulation

    OpenAIRE

    Patrick Velte; Marc Eulerich

    2015-01-01

    The European audit reform contains the implementation of an external mandatory auditor rotation (audit firm rotation) and a separation of audit and non audit duties to increase auditor independence. The central question is, whether these regulation measures are connected with an increased accounting and audit quality. First, this article presents an agency theoretical foundation of auditor independence. Then, a state of the art analysis of empirical research illustrates these ambivalent resul...

  8. A Guide to Energy Audits

    Energy Technology Data Exchange (ETDEWEB)

    Baechler, Michael C.

    2011-09-01

    Energy audits are a powerful tool for uncovering operational and equipment improvements that will save energy, reduce energy costs, and lead to higher performance. Energy audits can be done as a stand-alone effort or as part of a larger analysis across a group of facilities, or across an owner's portfolio. The purpose of an energy audit (sometimes called an 'energy assessment' or 'energy study') is to determine where, when, why and how energy is used in a facility, and to identify opportunities to improve efficiency. Energy auditing services are offered by energy services companies (ESCOs), energy consultants and engineering firms. The energy auditor leads the audit process but works closely with building owners, staff and other key participants throughout to ensure accuracy of data collection and appropriateness of energy efficiency recommendation. The audit typically begins with a review of historical and current utility data and benchmarking of your building's energy use against similar buildings. This sets the stage for an onsite inspection of the physical building. The main outcome of an energy audit is a list of recommended energy efficiency measures (EEMs), their associated energy savings potential, and an assessment of whether EEM installation costs are a good financial investment.

  9. Archaeology audit program final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-04-15

    In order to review oil and gas companies' archaeological management systems, the British Columbia Oil and Gas Commission (OGC) introduced its archaeology audit program (AAP) in April 2008. As part of this audit, twenty six oil and gas companies were selected for an office documentation review and a corresponding field audit. This document presented and described these audit results. The purpose of the final audit report was to provide information to assist oil and gas companies to improve their management systems by increasing the emphasis of the preservation of cultural resources. This report presented an overview of the AAP scope and methodology and provided examples from the audit of both good management practices encountered and practices in which opportunities for improvement to archaeological management systems could be implemented. Recommendations to address improvement opportunities were also discussed. It was concluded that the oil and gas companies subject to the audit were found to have met or exceeded OGC expectations for maintaining archaeological management systems. 2 tabs., 7 figs.

  10. Auditing as method of QA programme evaluation

    International Nuclear Information System (INIS)

    Wilhelm, H.

    1980-01-01

    The status and adequacy of a quality assurance programme should be regularly reviewed by the cognizant management. The programme audit is an independent review to determine the compliance with respective quality assurance requirements and to determine the effectiveness of that programme. This lecture gives an introduction of the method to perform audits under the following topics: 1. Definition and purpose of quality audits. 2. Organization of the quality audit function. 3. Unique requirements for auditors. 4. Audit preparation and planning. 5. Conduct of the audit. 6. Reporting the audit results. 7. Follow-up activities. (RW)

  11. Memory-type control charts for monitoring the process dispersion

    NARCIS (Netherlands)

    Abbas, N.; Riaz, M.; Does, R.J.M.M.

    2014-01-01

    Control charts have been broadly used for monitoring the process mean and dispersion. Cumulative sum (CUSUM) and exponentially weighted moving average (EWMA) control charts are memory control charts as they utilize the past information in setting up the control structure. This makes CUSUM and

  12. 15 CFR 738.3 - Commerce Country Chart structure.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Commerce Country Chart structure. 738.3 Section 738.3 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade... COMMERCE CONTROL LIST OVERVIEW AND THE COUNTRY CHART § 738.3 Commerce Country Chart structure. (a) Scope...

  13. A PCT-wide collaborative clinical audit selecting recall intervals for patients according to risk.

    Science.gov (United States)

    Cannell, P J

    2011-03-26

    This audit was carried out to assess the level to which recall intervals were individually and appropriately selected for patients attending dental practices across a primary care trust (PCT) area in Essex. A retrospective audit was carried out by reference to patient records to assess various criteria, including whether patients were categorised according to risk of oral disease, whether an appropriate recall had been selected and whether a discussion regarding a recall interval had been undertaken. An educational event highlighting the issue of recall intervals was held. Subsequent to this a prospective audit was undertaken to assess relevant criteria. Prospective audit data showed a marked increase in the use of patient risk assessments for caries, periodontal disease, oral cancer and non-carious tooth surface loss (NCTSL). Recall intervals were also more often selected based on a patient's risk status and discussed with the patient compared to that observed in the retrospective audit data. This audit was successful as a tool to bring about change in the behaviour of dentists regarding their determination of appropriate recall intervals for patients. Whether that change in behaviour is long-term or transient requires further investigation.

  14. Towards an integration of affiliated companies energy audit process system at P.T Astra International

    Science.gov (United States)

    Telaga, Abdi Suryadinata; Hartanto, Indra Dwi; Audina, Debby Rizky; Prabowo, Fransiscus Dimas

    2017-06-01

    Environmental awareness, stringent regulation and soaring energy costs, together make energy efficiency as an important pillar for every company. Particularly, in 2020, the ministry of energy and mineral resources of Indonesia has set a target to reduce carbon emission by 26%. For that reason, companies in Indonesia have to comply with the emission target. However, there is trade-off between company's productivity and carbon emission. Therefore, the companies' productivity must be weighed against the environmental effect such as carbon emission. Nowadays, distinguish excessive energy in a company is still challenging. The company rarely has skilled person that capable to audit energy consumed in the company. Auditing energy consumption in a company is a lengthy and time consuming process. As PT Astra International (AI) have 220 affiliated companies (AFFCOs). Occasionally, direct visit to audit energy consumption in AFFCOs is inevitable. However, capability to conduct on-site energy audit was limited by the availability of PT AI energy auditors. For that reason, PT AI has developed a set of audit energy tools or Astra green energy (AGEn) tools to aid the AFFCOs auditor to be able to audit energy in their own company. Fishbone chart was developed as an analysis tool to gather root cause of audit energy problem. Following the analysis results, PT AI made an improvement by developing an AGEn web-based system. The system has capability to help AFFCOs to conduct energy audit on-site. The system was developed using prototyping methodology, object-oriented system analysis and design (OOSAD), and three-tier architecture. The implementation of system used ASP.NET, Microsoft SQL Server 2012 database, and web server IIS 8.

  15. Auditor's Guide to IT Auditing

    CERN Document Server

    Cascarino, Richard E

    2012-01-01

    Step-by-step guide to successful implementation and control of IT systems—including the Cloud Many auditors are unfamiliar with the techniques they need to know to efficiently and effectively determine whether information systems are adequately protected. Now in a Second Edition, Auditor's Guide to IT Auditing presents an easy, practical guide for auditors that can be applied to all computing environments.Follows the approach used by the Information System Audit and Control Association's model curriculum, making this book a practical approach to IS auditingServes as an excellent study gu

  16. Audit in small and medium business

    OpenAIRE

    Marešová, Edita

    2009-01-01

    The subject of this thesis is a theoretical introduction to audit of the financial statements. The main part is the audit process, particularly the implementation of procedures to assess the adoption of a new contract, the design's overall performance audit, risk assessment, conducting a further audit procedures, analyzing the information obtained, and finally preparing the auditor's report. The last chapter is devoted to the audit program for fixed assets.

  17. The New Architecture for Auditing Standards

    OpenAIRE

    Sorin-Sandu Vînătoru; Sorinel Domnişoru; Daniela Giurescu

    2009-01-01

    The purpose of this paper is to challenge the conceptual basis upon which the current auditing standards are based. The paper critically appraises the Auditors’ Code published by the Auditing Practices Board and containing the nine fundamental and enduring principles upon which current auditing standards are based. It is argued that the nine enduring principles should be replaced by seven enduring tensions – the fault lines of auditing - so as to rethink the conceptual basis of auditing stand...

  18. Auditing IT Governance

    Directory of Open Access Journals (Sweden)

    Florin-Mihai ILIESCU

    2010-01-01

    Full Text Available Effective IT governance helps ensure that IT supports business goals, optimizes business investment in IT, and appropriately manages IT-related risks and opportunities. Organizations that realize the IT is no longer a support process and embeds value and risks need a structured approach for better managing Information Technology, enable its capability to deliver added value enterprise wide and for setting up a risk management program to address new risks arising for usage of IT in business processes. In order to assess if IT Governance is in line with industry practices, IT Auditors need a good understanding of processes and applicable standards, particular audit work programs and experience in assessing potential problem indicators.

  19. Fraud Auditing and CPA Auditing Reform in American and Japanese

    OpenAIRE

    張, 影; ZHANG, Ying

    2006-01-01

    The public company audit is expected to detect frauds in the financial reporting of entity. But, if senior management of corporation want to perpetrate frauds, the auditors have a risk of material misstatement due to fraud. In this paper, I consider the history of public company auditing to improve the prevention and detection of material fraud and to educate financial statement users about frauds in financial statement of American corporation and Japanese corporation. The history also is sho...

  20. Pengaruh Anggaran Waktu Audit, Kompleksitas Dokumen Audit dan Pengalaman Auditor terhadap Pertimbangan Audit Sampling pada Badan Pemeriksaan Keuangan (Bpk) Republik Indonesia Perwakilan Provinsi Aceh

    OpenAIRE

    Nadirsyah, Nadirsyah; Indriani, Mirna; Usman, Iskandar

    2011-01-01

    This research is done at BPK branch office Aceh Province which aim to know the influence of time budget audit, complexsity of audit document and audit experience toward judgement audit sampling either simultaneously or partially. Responden of this research is auditors at BPK branch office Aceh Province. The objective of this research is to be able to seek the causality between the time budget audit, complexsity of audit document and audit experience toward judgement audit sampling wi...

  1. Oversight Review: Quality Control Review of Air Force Audit Agency's Special Access Program Audits

    National Research Council Canada - National Science Library

    2005-01-01

    .... The Government Auditing Standards (GAS) require that an audit organization performing audits and/or attestation engagements in accordance with GAS should have an appropriate internal quality control system in place and undergo an external...

  2. Oversight Review: Quality Control Review of Naval Audit Service's Special Access Program Audits

    National Research Council Canada - National Science Library

    2005-01-01

    .... The Government Auditing Standards (GAS) require that an audit organization performing audits and/or attestation engagements in accordance with GAS should have an appropriate internal quality control system in place and undergo an external...

  3. Control Chart on Semi Analytical Weighting

    Science.gov (United States)

    Miranda, G. S.; Oliveira, C. C.; Silva, T. B. S. C.; Stellato, T. B.; Monteiro, L. R.; Marques, J. R.; Faustino, M. G.; Soares, S. M. V.; Ulrich, J. C.; Pires, M. A. F.; Cotrim, M. E. B.

    2018-03-01

    Semi-analytical balance verification intends to assess the balance performance using graphs that illustrate measurement dispersion, trough time, and to demonstrate measurements were performed in a reliable manner. This study presents internal quality control of a semi-analytical balance (GEHAKA BG400) using control charts. From 2013 to 2016, 2 weight standards were monitored before any balance operation. This work intended to evaluate if any significant difference or bias were presented on weighting procedure over time, to check the generated data reliability. This work also exemplifies how control intervals are established.

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

    Science.gov (United States)

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

    2018-04-25

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

  5. Short- and long-term effects of clinical audits on compliance with procedures in CT scanning

    International Nuclear Information System (INIS)

    Oliveri, Antonio; Howarth, Nigel; Gevenois, Pierre Alain; Tack, Denis

    2016-01-01

    To test the hypothesis that quality clinical audits improve compliance with the procedures in computed tomography (CT) scanning. This retrospective study was conducted in two hospitals, based on 6950 examinations and four procedures, focusing on the acquisition length in lumbar spine CT, the default tube current applied in abdominal un-enhanced CT, the tube potential selection for portal phase abdominal CT and the use of a specific ''paediatric brain CT'' procedure. The first clinical audit reported compliance with these procedures. After presenting the results to the stakeholders, a second audit was conducted to measure the impact of this information on compliance and was repeated the next year. Comparisons of proportions were performed using the Chi-square Pearson test. Depending on the procedure, the compliance rate ranged from 27 to 88 % during the first audit. After presentation of the audit results to the stakeholders, the compliance rate ranged from 68 to 93 % and was significantly improved for all procedures (P ranging from <0.001 to 0.031) in both hospitals and remained unchanged during the third audit (P ranging from 0.114 to 0.999). Quality improvement through repeated compliance audits with CT procedures durably improves this compliance. (orig.)

  6. Improving patient safety through a clinical audit spiral: prevention of wrong tooth extraction in orthodontics.

    Science.gov (United States)

    Anwar, H; Waring, D

    2017-07-07

    Introduction With an increasing demand to improve patient safety within the NHS, it is important to ensure that measures are undertaken to continually improve patient care. Wrong site surgery has been defined as a 'never event'. This article highlights the importance of preventing wrong tooth extraction within orthodontics through an audit spiral over five years investigating the accuracy and clarity of orthodontic extraction letters at the University Dental Hospital of Manchester.Aims To examine compliance with the standards for accuracy and clarity of extraction letters and the incidence of wrong tooth extractions, and to increase awareness of the errors that can occur with extraction letters and of the current guidelines.Method A retrospective audit was conducted examining extraction letters sent to clinicians outside the department.Results It can be seen there has been no occurrence of a wrong site tooth extraction. The initial audit highlighted issues in conformity, with it falling below expected standards. Cycle two generally demonstrated a further reduction in compliance. Cycle three appeared to result in an increase in levels of compliance. Cycles 4 and 5 have demonstrated gradual improvements. However, it is noteworthy that in all cycles the audit standards were still not achieved, with the exception of no incidences of the incorrect tooth being extracted.Conclusion This audit spiral demonstrates the importance of long term re-audit to aim to achieve excellence in clinical care. There has been a gradual increase in standards through each audit.

  7. Analisis Pengaruh Ukuran Kantor Akuntan Publik, Audit Fee, Audittenure, Dan Karakteristik Komite Audit Terhadap Audit Quality Pada Perusahaan Manufaktur Yang Terdaftar Di Bursa Efek Indonesia

    OpenAIRE

    William, Richi

    2017-01-01

    130503129 Penelitian ini bertujuan untuk mengetahui dan menganalisis pengaruh ukuran kantor akuntan publik, audit fee, audit tenure, dan karakteristik komite audit terhadap kualitas audit pada perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia. Indikator karakteristik komite audit yaitu gender dan usia komite audit. Populasi penelitian ini sebanyak 151 perusahaan manufaktur. Metode pengambilan sampel yang digunakan adalah purposive sampling, sehingga diperoleh 27 perusahaan s...

  8. CRITERIA AND FACTORS THAT INSURE THE QUALITY IN PROVISION OF AUDIT SERVICES, DIFFERENT FROM AUDIT

    OpenAIRE

    Antoniuk O.

    2018-01-01

    Introduction. Quality management of audit services requires further theoretical research and development in the field of audit activity and quality of audit, continuous improvement of the organization and methodology in providing audit services. Purpose. The article deals with the theoretical and practical questions of assessing the quality of audit services that are different from the audit in order to identify ways to improve the methodological quality assurance in the provision of thes...

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

    OpenAIRE

    Darius Vaicekauskas; Jonas Mackevičius

    2014-01-01

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

  10. TAX AUDIT AS A SEPARATE ITEM IN THE SYSTEM OF GENERAL AUDIT

    Directory of Open Access Journals (Sweden)

    Aleksey F. Akhmetshin

    2014-01-01

    Full Text Available The article describes General concepts of the audit, the purpose and the essence of the tax audit, determines the methods of calculation of the tax burden, describes the ratio of the total and tax audit. Comparative analysis with the purpose of definition of tax audit as a separate element of the system of General audit is given. Conclusion about expediency of holding events for tax audit for the purpose of reduction of tax risks of economic entities is made.

  11. Pelatihan Logika dan Pertimbangan Audit

    Directory of Open Access Journals (Sweden)

    Lisa Martiah

    2011-08-01

    Full Text Available Logical Training and Audit Judgement. The study is aimed to know the effect of training in logic towards audit judgment. The data collection was performed by quasi experiment method to 134 respondent (divided into 4 groups. First group consists of students with training in logic and the rest of the groups were without training in logic: students in an auditing course(the second group,students who have completed second course in auditing (the third groups and accountant (the fourth group. Data were collected using questionnaire based on 20 scenarios and tested by using ANOVA. The result showed: 1 the students in Group 1 performed better than the subjects in the other three groups, 2 there was no statistically significant difference between groups 4, 3 and 2, suggesting that the group without training in logic does not significantly improve individual’s critical thinking ability, 3 group 4 outperformed all three of the student groups on this dimension.

  12. Investigation of risk management auditing

    International Nuclear Information System (INIS)

    Cao Lu

    2012-01-01

    2004, COSO published 'Enterprise Risk Management Framework', 2009, SASAC issued the 'central enterprise-wide risk management guidelines' to promote risk management within the formal state-owned enterprises in medium and large. Nuclear Group, which risk management in all branches to carry out the project homeopathic, and A Ⅱ will carry out risk management program as the first unit has accumulated more experience. This article from the perspective of internal control, based on the company's risk management practices carried out to try for the nuclear power enterprise risk management audit to describe and propose new ideas. Which expounds the significance of risk management, audit, risk management audit of the ways and means, for practical application of risk management audit of a representative summary of the issues and the ways and means to solve the problem of forward-looking recommendations. (authors)

  13. Environmental audit guidelines for pipelines

    International Nuclear Information System (INIS)

    1991-01-01

    Environmental auditing is a form of management control which provides an objective basis by which a company can measure the degree of compliance with environmental regulations. Other benefits of this type of auditing include improved environmental management, furthering communication on environmental issues of concern within the company, and provision of documentation on environmental diligence. A series of environmental audit guidelines for pipelines is presented in the form of lists of questions to be asked during an environmental audit followed by recommended actions in response to those questions. The questions are organized into seven main categories: environmental management and planning; operating procedures; spill prevention; management of wastes and hazardous materials; environmental monitoring; construction of pipelines; and pipeline abandonment, decommissioning and site reclamation

  14. INTERNAL AUDIT AND RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Elena RUSE

    2014-04-01

    Full Text Available The existence of risk in economic activity can not be denied. In fact, the risk is a concept which exists in every activity, the term of risk being identified with uncertainty, respectively the (unchance to produce an undesirable event. Internal audit and risk management aim at the same goal, namely the control of risks. Internal Audit performs several roles in risk management plan. The objectives of the internal audit function varies from company to company, but in all economic entities internal audit department aims to improve performance management, enterprise performance and thus improve the internal control system. This paper aims to demonstrate, among other things, that any event that may result in failure is unquestionably classified as risk.

  15. ASSESSMENT METHODS OF INTERNAL AUDIT

    Directory of Open Access Journals (Sweden)

    Elena RUSE

    2015-12-01

    Full Text Available Internal audit services are more and more needed within economic entities, because on one hand they are directly subordinated to the general manager, on the other hand there is an increase in credit to its recommendations, estimating that internal audit is more than just a simple compliance check based on an established referral system. Our research focuses on evaluating the impact of theory and practice in the application of internal audit process. The added value brought by internal audit function to the economic entity it is pretty difficult to establish and requires effective ways and criteria of measured. In this regard, we will try to present ways to analyze internal audit’s activity by reference to some performance indicators or other specific methods. We used as research techniques: literature review, applied research and constructive research.

  16. Internal Audit Charter, Mar2017

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

    Jessica Perkins

    March 2017 ... Assurance and Advice to Support Innovating for Development ... IDRC's Board of Governors approves the Internal Audit Charter which ... Performing advisory services related to governance, risk management and control, at the.

  17. Vendor audits: A cooperative program

    International Nuclear Information System (INIS)

    White, S.C.

    1989-01-01

    The litany of recent problems with substandard, fraudulent, or counterfeit materials has led to much scrutiny regarding the adequacy and effectiveness of licensee-performed vendor audits. To address these problems in the audit process, most licensees have dedicated significant additional technical and qualitative resources. In response to the limited availability of sufficient resources and expertise to perform more comprehensive and effective vendor audits, many licensees have recognize the advantages of cooperative programs to perform joint audits with other licensees on a regional basis. The Nuclear Procurement Issues Council (NUPIC) provides such a program on a national level, which has proven to be of significant benefit not only to licensees but also to vendors of nuclear safety-related items and services

  18. Audit Quality of Government Auditor

    Directory of Open Access Journals (Sweden)

    Agus Setiawaty

    2013-12-01

    Full Text Available This study explores the relationship between government’s auditors’ personal characteristics and acceptance of dysfunctional behavior situational factors on government’s audit quality. Data collection was conducted by distributing questionnaires to 111 government’s auditors. The data was analyzed using PLS application. The results showed that government’s auditors who increasingly accept dysfunctional behavior tend to have characteristic of external locus of control and that government’s auditors with external locus of control tend to have low organizational commitment. Leadership style of the audit team leader during the audit process improved the government’s auditors’ commitment to their organization which leads to high-quality audit.

  19. The Professionalization of Internal Auditing

    OpenAIRE

    Tomasz Gacoń

    2013-01-01

    Purpose: This paper attempts to examine the meaning of professionalization, the conditions required for professionalization and whether internal auditing can be recognized as a profession. The paper makes use of study results in the fi eld of internal auditing conducted in Europe and the USA, as well as Andrew Abbott’s theory on the system of professions. Professions have common characteristics which differentiate them from other occupations. These characteristics were used to determine the c...

  20. INTERNAL AUDIT IN CORPORATE GOVERNANCE

    Directory of Open Access Journals (Sweden)

    Felicia Gabriela UNGUREANU

    2010-03-01

    Full Text Available Internal Audit, compared with verification of transactions and compliance with established procedures, identify risks and assess the effectiveness of risk management.Internal audit based on risk analysis assesses the adequacy and effectiveness of internal control in all areas of activity, helps management in its task by analyzing the causes and consequences, with recommendations concerning the activities examined, whereas both shareholders and existing and potential investors are interested in how the entity is governed.

  1. Quality control chart for crushed granite concrete

    Directory of Open Access Journals (Sweden)

    Ewa E. DESMOND

    2016-07-01

    Full Text Available A chart for assessing in-situ grade (strength of concrete, has been developed in this study. Four grades of concrete after the Nigerian General Specification for Roads and bridges (NGSRB-C20, C25, C30 and C35, is studied at different water-cement ratios for medium and high slump range. The concrete mixes are made from crushed granite rock as coarse aggregate with river sand as fine aggregate. Compression test on specimens are conducted at curing age of 1, 3, 7, 14, 21, 28 and 56 days. Results on concrete workability from slump values, and water-cement ratios revealed that specimens with lower water-cement ratio were less workable but had higher strength, compared to mixes with higher water cement ratio. A simple algorithm using nonlinear regression analysis performed on each experimental data set produced Strength-Age (S-A curves which were used to establish a quality control chart. The accuracy of these curves were evaluated by computing average absolute error (AAS, the error of estimate (EoE and the average absolute error of estimate (Abs EoE for each concrete mix. These were done based on the actual average experimental strengths to measure how close the predicted values are to the experimental data set. The absolute average error of estimate (Abs. EoE recorded was less than ±10% tolerance zone for concrete works.

  2. Orientations of BCFW charts on the Grassmannian

    International Nuclear Information System (INIS)

    Olson, Timothy M.

    2015-01-01

    The Grassmannian formulation of N=4 super Yang-Mills theory expresses tree-level scattering amplitudes as linear combinations of residues from certain contour integrals. BCFW bridge decompositions using adjacent transpositions simplify the evaluation of individual residues, but orientation information is lost in the process. We present a straightforward algorithm to compute relative orientations between the resulting coordinate charts, and we show how to generalize the technique for charts corresponding to sequences of any not-necessarily-adjacent transpositions. As applications of these results, we demonstrate the existence of a signed boundary operator that manifestly squares to zero and prove via our algorithm that any residues appearing in the tree amplitude sum are decorated with appropriate signs so all poles that appear twice cancel exactly, not just mod 2 as in previous works. We also identify other non-physical poles in the boundary of Grassmannian representations of the amplitude and justify their removal so that the final result contains only physical local poles.

  3. A spectral chart of synchrotron orbital radiation

    International Nuclear Information System (INIS)

    Hiramatsu, Nobuyasu; Yoneda, Yasuharu

    1977-01-01

    This paper introduces a chart of the spectrum of synchrotron orbital radiation. The radiation from high energy electrons has been used for various purposes. The formulas to express the spectrum have been presented. The parameters which determine the spectrum are the acceleration energy E, the deflection radius R, the wavelength of photons, the photon energy, and the harmonics. The chart in this paper determines the field intensity H to be applied on an accelerator when E and R are freely selected, and either the wavelength or the harmonics is obtained from the other one. Then, the spectrum distribution can be obtained. A.A. Sokolov and I.M. Ternov modified the formula for the emitted energy from an electron which had been given by G.A. Schott. The modified formula is used to obtain the number of photons per 1 eV. The relation between R and the harmonics is expressed by parallel lines in a log-log graph. The relation among R, H and E is also expressed in the same graph by parallel lines. The spectroscopic intensity is also shown in the same graph by a curved line. (Kato, T.)

  4. A paediatric X-ray exposure chart

    Energy Technology Data Exchange (ETDEWEB)

    Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au [Department of Medical Imaging, Royal Children' s Hospital, Brisbane, Queensland (Australia)

    2014-09-15

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.

  5. ADAKAH KANDUNGAN INFORMASI LAPORAN AUDIT WTP DENGAN PARAGRAF PENJELAS DAN LAPORAN AUDIT WDP?

    Directory of Open Access Journals (Sweden)

    Arie Wicaksono

    2012-03-01

    Full Text Available Penelitian ini bertujuan untuk menyelidiki konten informasi modified audit opinion pada penilaian pasar. Modified audit opinion dianggap sebagai titik awal laporan standar. Modified audit opinion mengacu pada laporan audit wajar tanpa pengecualian dengan paragraf penjelasan dan laporan audit wajar dengan pengecualian pada reaksi pasar. Penelitian ini dilakukan dengan menggunakan metode studi peristiwa. Sampelnya adalah perusahaan yang memiliki laporan audit wajar tanpa pengecualian dengan paragraf penjelasan dan laporan audit wajar dengan pengecualian yang terdaftar di Bursa Efek Indonesia pada periode 2004-2009. Hasil penelitian menunjukkan bahwa pe-ngumuman laporan audit wajar tanpa pengecualian dengan paragraf penjelasan dan laporan audit wajar dengan pengecualian tidak secara signifikan mempengaruhi abnormal return. This study aims to investigate the information content of modified audit opinion on market valuation. Modified audit opinions are considered the least departure of standard report. The term modified audit opinion refers to both unqualified audit report with explanatory paragraph and qualified audit report on market reaction. The research was done by using event study method. The sample are companies that have unqualified audit report with explanatory paragraph and qualified audit report that listed in Indonesia Stock Exchange in the period of 2004-2009.The results show that the announcement of unqualified audit report with explanatory paragraph and qualified audit report did not significantly affect the abnormal return.

  6. The Hill Chart Calculation for Pelton Runner Models using the HydroHillChart - Pelton Module Software

    Directory of Open Access Journals (Sweden)

    Adelina Bostan

    2015-07-01

    Full Text Available The Pelton turbines industrial design is based on the hill chart characteristics obtained by measuring the models. Primary data measurements used to obtain the hill chart can be processed graphically, by hand or by using graphic programs respectively CAD programs; the HydroHillChart - Pelton module software is a specialized tool in achieving the hill chart, using interpolation cubic spline functions. Thereby, based on measurements of several models of Pelton turbines, a computerized library, used to design industrial Pelton turbines can be created. The paper presents the universal characteristics calculated by using the HydroHillChart - Pelton module software for a series of Pelton runners.

  7. GENERAL METHOD OF STOCKS AUDIT

    Directory of Open Access Journals (Sweden)

    Iryna Galushchak

    2017-03-01

    Full Text Available The article deals with the organization and methodology of accounting and auditing inventory enterprises. Suggestions for improvement of accounting permit to raise processing and presenting economic information to a higher level for making the economic and management decisions. Theory and practice problems of stocks audit were investigated. The basic directions of improvement of  stock audit were defined. The auditor can form an opinion about the state of business transactions of accounting of goods, define shortcomings in its organization and possible directions of elimination of violations and abuses. Program of audit of operations accounting with stocks should include the investigation of the preservation of property, valuation and posting costs, correct evaluation of purchased tangible assets, using of stocks in production. It is worth  to use techniques and methods of verification such as inventory, comparative control,  comparison of documentary evidence, counter check, check arithmetic for  audit of goods. Keywords: audit, stocks, activities of the company.

  8. Increased auditor independence by external rotation and separating audit and non audit duties? - A note on the European audit regulation

    Directory of Open Access Journals (Sweden)

    Patrick Velte

    2015-05-01

    Full Text Available The European audit reform contains the implementation of an external mandatory auditor rotation (audit firm rotation and a separation of audit and non audit duties to increase auditor independence. The central question is, whether these regulation measures are connected with an increased accounting and audit quality. First, this article presents an agency theoretical foundation of auditor independence. Then, a state of the art analysis of empirical research illustrates these ambivalent results, so that the economic need for the audit market regulation in Europe is controversial

  9. Audit committee: Some evidence from Malaysia.

    Directory of Open Access Journals (Sweden)

    Zulkarnain Muhamad Sori

    2006-11-01

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

  10. Development of National Technology Audit Policy

    Directory of Open Access Journals (Sweden)

    Subiyanto Subiyanto

    2017-07-01

    Full Text Available The Laws have mandated implementation of technology audit, nevertheless such implementation needs an additional policy that is more technical. The concept of national audit technology policy shall make technology audit as a tool to ensure the benefit of technology application for society and technology advance for nation independency. This article discusses on technology audit policy concept especially infrastructure requirement, with emphasis on regulation, implementation tools, and related institution. The development of technology audit policy for national interest requires provision of mandatory audit implementation, accompanied by tools for developing technology auditor’s competence and technology audit institutional’s mechanism. To guide technology auditor’s competence, concept of national audit technology policy shall classify object of technology audit into product technology, production technology, and management of technology, accompanied by related parameters of technology performance evaluation.

  11. POSITIONINGS AND DELIMITATIONS CONCERNING THE PERFORMANCE AUDIT

    Directory of Open Access Journals (Sweden)

    Victoria FIRESCU

    2014-12-01

    Full Text Available The objectives of the present research are related to the approaches concerning the “performance audit” concept in the specialized literature and practice as well as the clear delimitation of this concept of financial audit and internal audit. For a clear emphasis of the objectives and principles of the performance audit, I highlighted the similarities and differences among the three types of audit by means of several criteria such as: audit standards, audited subjects, nature of the audit evidence, manners of assessment. Within this basically predominant research, I used several research methods and techniques such as: the critical analysis of the bibliographic sources concerning the performance audit, the documentation related to the international audit standards, comparative studies.

  12. Audits as a Vaccine or Just Aspirin?

    Directory of Open Access Journals (Sweden)

    Jagrič Timotej

    2017-12-01

    Full Text Available This paper examines the impact of audits on voluntary tax compliance in the area of value added tax in Slovenia. The analyses argues that audited taxpayers with additional tax assessments as the result of an audit display a higher level of tax compliance within the year of the audit as within the year before audit, while audited taxpayers with no irregularities on the basis of an audit do not change their behavior significantly within the same period. However, regarding the longterm effect, the results reveal the possibility of worsening tax compliance with respect to audits where an additional tax assessment was imposed and where no irregularities were discovered during an audit.

  13. Audit of cases with uterine rupture: A process indicator of quality of ...

    African Journals Online (AJOL)

    Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of obstetric care. Records of UR cases at a referral maternity in Luanda were studied retrospectively (n=43) and prospectively (n=67) including basic obstetric information, maternal and foetal outcome, ...

  14. Dental Charting. Learning Activities, Unit Tests, Progress Chart, and Work Sheet.

    Science.gov (United States)

    Texas Univ., Austin. Center for Occupational Curriculum Development.

    These materials are part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. These student materials, designed to be used with the Dental Charting Student Manual, consist of learning activities, unit…

  15. Software Assists in Extensive Environmental Auditing

    Science.gov (United States)

    Callac, Christopher; Matherne, Charlie

    2003-01-01

    The Base Environmental Management System (BEMS) is a Web-based application program for managing and tracking audits by the Environmental Office of Stennis Space Center in conformity with standard 14001 of the International Organization for Standardization (ISO 14001). (This standard specifies requirements for an environmental-management system.) BEMS saves time by partly automating what were previously manual processes for creating audit checklists; recording and tracking audit results; issuing, tracking, and implementing corrective-action requests (CARs); tracking continuous improvements (CIs); and tracking audit results and statistics. BEMS consists of an administration module and an auditor module. As its name suggests, the administration module is used to administer the audit. It helps administrators to edit the list of audit questions; edit the list of audit locations; assign mandatory questions to locations; track, approve, and edit CARs; and edit completed audits. The auditor module is used by auditors to perform audits and record audit results: it helps the auditors to create audit checklists, complete audits, view completed audits, create CARs, record and acknowledge CIs, and generate reports from audit results.

  16. The Implications of Diagnosis of Small for Gestational Age Fetuses Using European and South Asian Growth Charts: An Outcome-Based Comparative Study

    Directory of Open Access Journals (Sweden)

    Gianpaolo Maso

    2014-01-01

    Full Text Available The antenatal condition of small for gestational age (SGA is significantly associated with perinatal morbidity and mortality and it is known that there are significant differences in birth weight and fetal size among different populations. The aim of our study was to assess the impact on outcomes of the diagnosis of SGA according to Bangladeshi and European antenatal growth charts in Sri Lankan population. The estimated fetal weight before delivery was retrospectively reviewed according to Bangladeshi and European growth references. Three groups were identified: Group 1-SGA according to Bangladeshi growth chart; Group 2-SGA according to European growth chart but not having SGA according to Bangladeshi growth chart; Group 3-No SGA according to both charts. There was a difference in prevalence of SGA between Bangladeshi and European growth charts: 12.7% and 51.7%, respectively. There were statistically significant higher rates in emergency cesarean section, fetal distress in labour, and intrauterine death (P<0.001 in Group 1 compared with Group, 2 and 3. No differences of outcomes occurred between Groups 2 and 3. Our study demonstrated that only cases diagnosed as SGA according to population-based growth charts are at risk of adverse outcome. The use of inappropriate prenatal growth charts might lead to misdiagnosis and potential unnecessary interventions.

  17. Adherence to Canadian C-Spine Rule in a regional hospital: a retrospective study of 406 cases.

    Science.gov (United States)

    Paxton, Mark; Heal, Clare F; Drobetz, Herwig

    2012-10-01

    Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule. This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography. Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography. Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

  18. National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand: The PRiZED 1 Study.

    Science.gov (United States)

    2017-04-01

    Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006-2012) from 26 New Zealand public hospital EDs. Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30-134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45-57%); however, there was some variation between hospitals for both outcomes. Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Senior Audit and Risk Management Officer | CRDI - Centre de ...

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

    Primary Duties or Responsibilities Internal Audit Engagements Planning the Audit ... Develops professional quality audit working papers to support observations and findings; ... Corporate Risk, Advisory Services and Internal Audit Planning.

  20. THE CHART ROMANIA-NATO-UE

    Directory of Open Access Journals (Sweden)

    Duduială Popescu Lorena

    2009-05-01

    Full Text Available viewed in the context of geopolitical and geostrategic current and through the elements of distinction in terms of identity and cultural institutions, chart Romania - NATO / Israel - EU stands under the sign of the common interest channel, firstly, on common values and hence the collective interests of the partners involved in the two organizational structures. Noteworthy in this context is the extent of bilateral involvement of Romania in the bodies and the politico-military, represented by NATO (the North Atlantic Treaty Organization, which is primarily military values and the construction superstate permanent expansion and development - European Union , both generating as much for our country as obligations of a politico-military security, and economic, social, institutional, cultural.