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Sample records for rosiglitazone record study

  1. Experience of malignancies with oral glucose-lowering drugs in the randomised controlled ADOPT (A Diabetes Outcome Progression Trial) and RECORD (Rosiglitazone Evaluated for Cardiovascular Outcomes and Regulation of Glycaemia in Diabetes) clinical trials.

    Science.gov (United States)

    Home, P D; Kahn, S E; Jones, N P; Noronha, D; Beck-Nielsen, H; Viberti, G

    2010-09-01

    Observational and mechanistic studies have suggested a possible relationship between treatment with metformin and decreased incidence of cancer in participants with type 2 diabetes. We extracted data for malignancies from the ADOPT (A Diabetes Outcome Progression Trial) and RECORD (Rosiglitazone Evaluated for Cardiovascular Outcomes and Regulation of Glycaemia in Diabetes) randomised controlled clinical trials, in which the efficacy and/or safety of metformin was assessed in comparison with sulfonylureas and rosiglitazone. Neoplasm occurrences were collected as adverse events in these studies. We reviewed and re-analysed the individual participant data in both studies for serious adverse events, malignancies reported as adverse events and related neoplasms of special interest. In ADOPT, 50 participants (3.4%) on metformin and 55 (3.8%) on each of rosiglitazone and glibenclamide (known as glyburide in the USA and Canada) developed serious adverse event malignancies (excluding non-melanoma skin cancers). This corresponds to 1.03, 1.12 and 1.31 per 100 person-years, giving hazard ratios for metformin of 0.92 (95% CI 0.63-1.35) vs rosiglitazone and 0.78 (0.53-1.14) vs glibenclamide. In RECORD, on a background of sulfonylurea, 69 (6.1%) participants developed malignant neoplasms in the metformin group, compared with 56 (5.1%) in the rosiglitazone group (HR 1.22 [0.86-1.74]). On a background of metformin, 74 (6.7%) participants in the sulfonylurea group developed malignant neoplasms, compared with 57 (5.1%) in the rosiglitazone group (HR 1.33 [0.94-1.88]). The malignancy rates in these two randomised controlled clinical trials do not support a view that metformin offers any particular protection against malignancy compared with rosiglitazone. However, they do not refute the possibility of a difference compared with sulfonylureas.

  2. Rosiglitazone, myocardial ischemic risk, and recent regulatory actions.

    Science.gov (United States)

    Bourg, Catherine A; Phillips, Beth Bryles

    2012-02-01

    To review the evidence surrounding rosiglitazone and ischemic cardiovascular risk and discuss the Food and Drug Administration (FDA) decision to revise safety information and restrict access to the drug. A literature search was conducted through MEDLINE (1950-January 2012), PubMed (1966-January 2012), and International Pharmaceutical Abstracts (1970-December 2011) using the search terms rosiglitazone and cardiovascular risk. Regulatory documents from the FDA and the Center for Drug Evaluation and Research, as well as reference citations from publications identified, were reviewed. All articles in English identified from the data sources were evaluated for inclusion. Literature regarding rosiglitazone and ischemic cardiovascular risk has shown inconsistent results. Meta-analyses by the FDA, GlaxoSmithKline, and several independent research groups suggest an increased risk for myocardial infarction (MI), while others have not. Long-term, controlled trials not designed to evaluate cardiovascular outcomes did not find a significant increase in cardiovascular events and had low event rates overall. The RECORD (Rosiglitazone Evaluated for Cardiovascular Outcomes in Oral Agent Combination Therapy for Type 2 Diabetes) trial is the only prospective randomized trial to date designed to evaluate cardiovascular outcomes of rosiglitazone; the results were limited because of issues with study design and event adjudication. The only direct comparisons between rosiglitazone and pioglitazone are observational studies in which pioglitazone had a more favorable MI risk profile. Data involving rosiglitazone and an association with ischemic cardiovascular risk have yielded variable results. The FDA made the decision to restrict access to rosiglitazone in September 2010 by requiring GlaxoSmithKline to submit a risk evaluation and mitigation strategy (REMS). Drug labeling was revised in February 2011, and the rosiglitazone REMS program took full effect in November 2011.

  3. A Study of Effects of Pioglitazone and Rosiglitazone on Various Parameters in Patients of Type-2 Diabetes Mellitus with Special Reference to Lipid Profile.

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    Sharma, S K; Verma, S H

    2016-09-01

    To study the complete fasting lipid profile and other parameters (weight, body mass index, HbA1c, fasting blood sugar and postprandial blood sugar)in Type 2 diabetes mellitus patients on OHA/insulin, to study the effect of addition of pioglitazone on lipid profile and other parameters in Type 2 diabetes mellitus patients on OHA/insulin, to study the effect of addition of rosiglitazone on lipid profile and other parameters in Type 2 diabetes mellitus patients on OHA/insulin and to compare the effect of pioglitazone and rosiglitazone on lipid profile and other parameters in Type 2 diabetes mellitus patients on OHA/insulin. In the study, 100 Type 2 diabetes cases on oral hypoglycemic agent/insulin with deranged lipid profile were chosen and divided into 2 groups 50 and 50 in group A and group B respectively.Pioglitazone was given initially 15mg/day then if required increasing upto 45mg/day in group A for period of 18 weeks and rosiglitazone was given initially 2 mg/day then if required increasing upto 8 mg/day in group B for period of 18 weeks. Detailed clinical history was obtained and thorough physical examination was done and following parameters were established-Age, Height, Weight, Body mass index, Fasting and Postprandial blood sugar, HbA1c levels and fasting complete lipid profile done at 0 and 18 weeks. Each patient itself served as a control for this study. Maximum no. of patients were in sixth decade (53.30%) and minimum patients were in seventh decade (6.6%). Males were 63.3% and females were 36.8%. Fasting blood sugar levels decreased by 23% with pioglitazone in group A and 14.07% with rosiglitazone in group B. The postprandial blood sugar levels decreased by 29.9% with pioglitazone in group A and 20.17% with rosiglitazone in group B.The mean HbA1c decreased by 2.13 % pioglitazone in group A and 3.8% with rosiglitazone in group B after 18 weeks of therapy. The effects of both drugs on BMI and weight were not significant. In group A the total cholesterol

  4. Rosiglitazone evaluated for cardiovascular outcomes in oral agent combination therapy for type 2 diabetes (RECORD): a multicentre, randomised, open-label trial

    DEFF Research Database (Denmark)

    Home, Philip D; Pocock, Stuart J; Beck-Nielsen, Henning

    2009-01-01

    .80-1.63) for myocardial infarction, and 0.72 (0.49-1.06) for stroke. Heart failure causing admission to hospital or death occurred in 61 people in the rosiglitazone group and 29 in the active control group (HR 2.10, 1.35-3.27, risk difference per 1000 person-years 2.6, 1.1-4.1). Upper and distal lower limb fracture rates...... failure and of some fractures, mainly in women. Although the data are inconclusive about any possible effect on myocardial infarction, rosiglitazone does not increase the risk of overall cardiovascular morbidity or mortality compared with standard glucose-lowering drugs. FUNDING: GlaxoSmithKline plc, UK.......BACKGROUND: Rosiglitazone is an insulin sensitiser used in combination with metformin, a sulfonylurea, or both, for lowering blood glucose in people with type 2 diabetes. We assessed cardiovascular outcomes after addition of rosiglitazone to either metformin or sulfonylurea compared...

  5. Assessment on the Prevention of Progression by Rosiglitazone on Atherosclerosis in diabetes patients with Cardiovascular History (APPROACH): study design and baseline characteristics.

    Science.gov (United States)

    Ratner, Robert E; Cannon, Christopher P; Gerstein, Hertzel C; Nesto, Richard W; Serruys, Patrick W; Van Es, Gerrit-Anne; Kolatkar, Nikheel S; Kravitz, Barbara G; Zalewski, Andrew; Fitzgerald, Peter J

    2008-12-01

    Rosiglitazone, a thiazolidinedione, has effects on insulin sensitivity and cardiovascular risk factors that may favorably impact the progression of coronary atherosclerosis. APPROACH is a double-blind randomized clinical trial comparing the effects of the insulin sensitizer rosiglitazone with the insulin secretagogue glipizide on the progression of coronary atherosclerosis. Patients with type 2 diabetes and coronary artery disease undergoing clinically indicated coronary angiography or percutaneous coronary intervention are randomized to receive rosiglitazone or glipizide for 18 months using a titration algorithm designed to provide comparable glycemic control between treatment groups. The primary end point is change in percent atheroma volume from baseline to study completion in a nonintervened coronary artery, as measured by intravascular ultrasound. Cardiovascular events are adjudicated by an end point committee. A total of 672 patients were randomized. The mean age was 61 years, hemoglobin A(1c) (HbA(1c)) 7.2%, body mass index 29.5 kg/m(2), and median duration of diabetes 4.8 years. At baseline, approximately half of the participants were receiving oral antidiabetic monotherapy (53.9%) with 27.5% receiving dual combination therapy and 17.9% treated with diet and exercise alone. Approximately two thirds of the participants (68%) had dyslipidemia, 79.9% hypertension, and 24% prior myocardial infarction. APPROACH has fully enrolled a high-risk patient population and will compare the glucose-independent effects of rosiglitazone and glipizide on the progression of coronary atherosclerosis, as well as provide additional data on the cardiovascular safety of rosiglitazone in patients with type 2 diabetes and coronary artery disease.

  6. Effect of the addition of rosiglitazone to metformin or sulfonylureas versus metformin/sulfonylurea combination therapy on ambulatory blood pressure in people with type 2 diabetes

    DEFF Research Database (Denmark)

    Komajda, Michel; Curtis, Paula; Hanefeld, Markolf

    2008-01-01

    BACKGROUND: Hypertension and type 2 diabetes are common co-morbidities. Preliminary studies suggest that thiazolidinediones reduce blood pressure (BP). We therefore used ambulatory BP to quantify BP lowering at 6-12 months with rosiglitazone used in combination with metformin or sulfonylureas...... compared to metformin and sulfonylureas in people with type 2 diabetes. METHODS: Participants (n = 759) in the multicentre RECORD study were studied. Those taking metformin were randomized (open label) to add-on rosiglitazone or sulfonylureas, and those on sulfonylurea to add-on rosiglitazone or metformin....... RESULTS: 24-Hour ambulatory BP was measured at baseline, 6 months and 12 months. At 6 and 12 months, reductions in 24-hour ambulatory systolic BP (sBP) were greater with rosiglitazone versus metformin (difference at 6 months 2.7 [95% CI 0.5-4.9] mmHg, p = 0.015; 12 months 2.5 [95% CI 0.2-4.8] mmHg, p = 0...

  7. Comparison of the Efficacy of Glimepiride, Metformin, and Rosiglitazone Monotherapy in Korean Drug-Naïve Type 2 Diabetic Patients: The Practical Evidence of Antidiabetic Monotherapy Study

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    Kun Ho Yoon

    2011-02-01

    Full Text Available BackgroundAlthough many anti-diabetic drugs have been used to control hyperglycemia for decades, the efficacy of commonly-used oral glucose-lowering agents in Korean type 2 diabetic patients has yet to be clearly demonstrated.MethodsWe evaluated the efficacy of glimepiride, metformin, and rosiglitazone as initial treatment for drug-naïve type 2 diabetes mellitus patients in a 48-week, double-blind, randomized controlled study that included 349 Korean patients. Our primary goal was to determine the change in HbA1c levels from baseline to end point. Our secondary goal was to evaluate changes in fasting plasma glucose (FPG levels, body weight, frequency of adverse events, and the proportion of participants achieving target HbA1c levels.ResultsHbA1c levels decreased from 7.8% to 6.9% in the glimepiride group (P<0.001, from 7.9% to 7.0% in the metformin group (P<0.001, and from 7.8% to 7.0% (P<0.001 in the rosiglitazone group. Glimepiride and rosiglitazone significantly increased body weight and metformin reduced body weight during the study period. Symptomatic hypoglycemia was more frequent in the glimepiride group and diarrhea was more frequent in the metformin group.ConclusionThe efficacy of glimepiride, metformin, and rosiglitazone as antidiabetic monotherapies in drug-naïve Korean type 2 diabetic patients was similar in the three groups, with no statistical difference. This study is the first randomized controlled trial to evaluate the efficacy of commonly-used oral hypoglycemic agents in Korean type 2 diabetic patients. An additional subgroup analysis is recommended to obtain more detailed information.

  8. Possible modulation of the antidiabetic effect of rosiglitazone by buspirone

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    Wafaa R. Mohamed

    2012-06-01

    Full Text Available Diabetes mellitus (DM is a group of metabolic disorders characterized by chronic hyperglycemia resulting from relative or absolute insulin deficiency with or without insulin resistance. As anxiolytics may have influence on glycemic control in diabetics, the present study was conducted to investigate the possible influence of buspirone in streptozotocin-induced DM and its possible interactions with rosiglitazone, an insulin sensitizer. Diabetes was induced by streptozotocin (50 mg/kg i.p.. Rats were classified into five groups namely: normal control, diabetic control, rosiglitazone (10 mg/kg p.o., buspirone (20 mg/kg i.p. or combination of both rosiglitazone and buspirone, respectively. All groups received daily treatments for 2 weeks after induction of DM including the normal group which received 1% Tween 80. There was no significant interaction between rosiglitazone and buspirone on the levels of serum glucose, insulin and C-peptide or liver glycogen content. Similarly, no interaction was observed between rosiglitazone and buspirone on oxidative stress parameters including serum malondialdehyde and blood glutathione levels or blood superoxide dismutase activity. In conclusion, the present study revealed that co-administration of buspirone with rosiglitazone does not produce serious reactions and buspirone can be safely administered as an anxiolytic in diabetic patients treated with rosiglitazone.

  9. Mechanism of action study to evaluate the effect of rosiglitazone on bone in postmenopausal women with type 2 diabetes mellitus: rationale, study design and baseline characteristics

    Science.gov (United States)

    Fitzpatrick, Lorraine A.; Bilezikian, John P.; Wooddell, Margaret; Paul, Gitanjali; Kolatkar, Nikheel S.; Nino, Antonio J.; Miller, Colin G.; Bogado, Cesar E.; Arnaud, Claude D.; Cobitz, Alexander R.

    2012-01-01

    Objectives Post-hoc analyses have shown an increase incidence of fractures among type 2 diabetes (T2DM) patients treated with thiazolidinediones (TZDs). The mechanisms by which TZDs may be associated with increased fracture risk is not well understood. This article describes the study design and baseline characteristics for a prospective, randomized, double-blind, active-controlled trial to evaluate the effects of rosiglitazone on changes in measures of skeletal structure, surrogates of bone strength and metabolism. Methods Postmenopausal women without osteoporosis and diagnosed with T2DM were randomized in a double-blind design to either rosiglitazone or metformin for 52 weeks, then all subjects received open-label metformin for 24 weeks. Study endpoints included changes in bone mineral density (BMD), quantitative computed tomography (QCT), digitized hip radiography (HXR) and high resolution magnetic resonance imaging (hrMRI). Serum markers of bone metabolism and indices of glycemic control were assessed within and between treatment groups. Results A total of 226 subjects were randomized. Baseline characteristics included: age 63.8 ± 6.5 years; years postmenopausal 16.9 ± 8.4; duration of diabetes 3.5 (1.8–7.8) years; body mass index (BMI) 31.4 ± 5.9 kg/m2; and glycated hemoglobin (HbA1c) 6.4 ± 0.65%. At baseline, mean T-scores were −0.95 ± 0.91 at the femoral neck, −0.02 ± 0.97 at the total hip and −0.55 ± 1.25 at the total spine. Since there are no well recognized techniques to determine bone mass and structure at the distal limbs (cortical bone sites where fractures were reported in RSG subjects), using the femoral neck as a surrogate for these areas may be a potential limitation of the study. Conclusion This is the first randomized trial utilizing multiple techniques to evaluate bone mass, structure, serum markers of bone remodeling, and potential reversibility of changes after discontinuation of rosiglitazone. This

  10. Rosiglitazone: a disappointing DREAM.

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    Nissen, Steven

    2007-09-01

    Dr Steven Nissen is a heart specialist and currently holds the position of chairman of cardiovascular medicine at the Cleveland Clinic, OH, USA. His work has involved the development of miniaturised ultrasound imaging devices that can be threaded into a patient's heart that allow measurement of the size and composition of plaques, which indicate early artery damage. The ability to characterize and measure the size of plaques provided a novel, effective method to evaluate the efficacy of anticholesterol medications, and for the past two decades Dr Nissen has been using these and other techniques to examine the efficacy of drugs. He has also developed a strong interest in drug safety. His work linked COX-2 inhibitors such as Celebrex and Vioxx (Merck, NJ, USA) with heart attacks, and prevented Merck's similar product, Arcoxia, from being approved. He also highlighted the serious heart attack risk associated with the experimental drug Pargluva and the drug was subsequently not approved by the US FDA. More recently, Dr Nissen's work has focused on the drug rosiglitazone, which was shown to have high cardiovascular risks and has since been given a FDA warning. Here, Dr Nissen discusses the publication of the rosiglitazone meta-analysis and why he considers work in this area to be crucially important for patients.

  11. Rosiglitazone attenuates pulmonary fibrosis and radiation-induced intestinal damage

    International Nuclear Information System (INIS)

    Mangoni, M.; Gerini, C.; Sottili, M.; Cassani, S.; Stefania, G.; Biti, G.; Castiglione, F.; Vanzi, E.; Bottoncetti, A.; Pupi, A.

    2011-01-01

    Full text of publication follows: Purpose.-The aim of the study was to evaluate radioprotective effect of rosiglitazone (RGZ) on a murine model of late pulmonary damage and of acute intestinal damage. Methods.- Lung fibrosis: C57 mice were treated with the radiomimetic agent bleomycin, with or without rosiglitazone (5 mg/kg/day). To obtain an independent qualitative and quantitative measure for lung fibrosis we used high resolution CT, performed twice a week during the entire observation period. Hounsfield Units (HU) of section slides from the upper and lower lung region were determined. On day 31 lungs were collected for histological analysis. Acute intestinal damage: mice underwent 12 Gy total body irradiation with or without rosiglitazone. Mice were sacrificed 24 or 72 h after total body irradiation and ileum and colon were collected. Results.- Lung fibrosis: after bleomycin treatment, mice showed typical CT features of lung fibrosis, including irregular septal thickening and patchy peripheral reticular abnormalities. Accordingly, HU lung density was dramatically increased. Rosiglitazone markedly attenuated the radiological signs of fibrosis and strongly inhibited HU lung density increase (60% inhibition at the end of the observation period). Histological analysis revealed that in bleomycin-treated mice, fibrosis involved 50-55% of pulmonary parenchyma and caused an alteration of the alveolar structures in 10% of parenchyma, while in rosiglitazone-treated mice, fibrosis involved only 20-25% of pulmonary parenchyma, without alterations of the alveolar structures. Acute intestinal damage: 24 h after 12 Gy of total body irradiation intestinal mucosa showed villi shortening, mucosal thickness and crypt necrotic changes. Rosiglitazone showed a histological improvement of tissue structure, with villi and crypts normalization and oedema reduction. Conclusion.- These results demonstrate that rosiglitazone displays a protective effect on pulmonary fibrosis and radiation

  12. Rosiglitazone attenuates pulmonary fibrosis and radiation-induced intestinal damage

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    Mangoni, M.; Gerini, C.; Sottili, M.; Cassani, S.; Stefania, G.; Biti, G. [Radiotherapy Unit, Clinical Physiopathology Department, University of Florence, Firenze (Italy); Castiglione, F. [Department of Human Pathology and Oncology, University of Florence, Firenze (Italy); Vanzi, E.; Bottoncetti, A.; Pupi, A. [Nuclear Medicine Unit, Clinical Physiopathology Department, University of Florence, Firenze (Italy)

    2011-10-15

    Full text of publication follows: Purpose.-The aim of the study was to evaluate radioprotective effect of rosiglitazone (RGZ) on a murine model of late pulmonary damage and of acute intestinal damage. Methods.- Lung fibrosis: C57 mice were treated with the radiomimetic agent bleomycin, with or without rosiglitazone (5 mg/kg/day). To obtain an independent qualitative and quantitative measure for lung fibrosis we used high resolution CT, performed twice a week during the entire observation period. Hounsfield Units (HU) of section slides from the upper and lower lung region were determined. On day 31 lungs were collected for histological analysis. Acute intestinal damage: mice underwent 12 Gy total body irradiation with or without rosiglitazone. Mice were sacrificed 24 or 72 h after total body irradiation and ileum and colon were collected. Results.- Lung fibrosis: after bleomycin treatment, mice showed typical CT features of lung fibrosis, including irregular septal thickening and patchy peripheral reticular abnormalities. Accordingly, HU lung density was dramatically increased. Rosiglitazone markedly attenuated the radiological signs of fibrosis and strongly inhibited HU lung density increase (60% inhibition at the end of the observation period). Histological analysis revealed that in bleomycin-treated mice, fibrosis involved 50-55% of pulmonary parenchyma and caused an alteration of the alveolar structures in 10% of parenchyma, while in rosiglitazone-treated mice, fibrosis involved only 20-25% of pulmonary parenchyma, without alterations of the alveolar structures. Acute intestinal damage: 24 h after 12 Gy of total body irradiation intestinal mucosa showed villi shortening, mucosal thickness and crypt necrotic changes. Rosiglitazone showed a histological improvement of tissue structure, with villi and crypts normalization and oedema reduction. Conclusion.- These results demonstrate that rosiglitazone displays a protective effect on pulmonary fibrosis and radiation

  13. Rosiglitazone attenuates inflammation and CA3 neuronal loss following traumatic brain injury in rats

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hao; Rose, Marie E. [Geriatric Research Educational and Clinical Center, V.A. Pittsburgh Healthcare System, PA (United States); Department of Neurology, University of Pittsburgh School of Medicine, PA (United States); Culver, Sherman; Ma, Xiecheng; Dixon, C. Edward [Geriatric Research Educational and Clinical Center, V.A. Pittsburgh Healthcare System, PA (United States); Department of Neurosurgery, University of Pittsburgh, PA 15216 (United States); Department of Critical Care Medicine, University of Pittsburgh, PA 15216 (United States); Graham, Steven H., E-mail: Steven.Graham@va.gov [Geriatric Research Educational and Clinical Center, V.A. Pittsburgh Healthcare System, PA (United States); Department of Neurology, University of Pittsburgh School of Medicine, PA (United States)

    2016-04-15

    Rosiglitazone, a potent peroxisome proliferator-activated receptor (PPAR)-γ agonist, has been shown to confer neuroprotective effects in stroke and spinal cord injury, but its role in the traumatic brain injury (TBI) is still controversial. Using a controlled cortical impact model in rats, the current study was designed to determine the effects of rosiglitazone treatment (6 mg/kg at 5 min, 6 h and 24 h post injury) upon inflammation and histological outcome at 21 d after TBI. In addition, the effects of rosiglitazone upon inflammatory cytokine transcription, vestibulomotor behavior and spatial memory function were determined at earlier time points (24 h, 1–5 d, 14–20 d post injury, respectively). Compared with the vehicle-treated group, rosiglitazone treatment suppressed production of TNFα at 24 h after TBI, attenuated activation of microglia/macrophages and increased survival of CA3 neurons but had no effect on lesion volume at 21 d after TBI. Rosiglitazone-treated animals had improved performance on beam balance testing, but there was no difference in spatial memory function as determined by Morris water maze. In summary, this study indicates that rosiglitazone treatment in the first 24 h after TBI has limited anti-inflammatory and neuroprotective effects in rat traumatic injury. Further study using an alternative dosage paradigm and more sensitive behavioral testing may be warranted. - Highlights: • Effects of rosiglitazone after CCI were evaluated using a rat TBI model. • Rosiglitazone suppressed production of TNFα at 24 h after CCI. • Rosiglitazone inhibited microglial activation at 21 d after CCI. • Rosiglitazone increased survival of CA3 neurons at 21 d after CCI. • Rosiglitazone-treated animals had improved performance in beam balance testing.

  14. Rosiglitazone attenuates inflammation and CA3 neuronal loss following traumatic brain injury in rats

    International Nuclear Information System (INIS)

    Liu, Hao; Rose, Marie E.; Culver, Sherman; Ma, Xiecheng; Dixon, C. Edward; Graham, Steven H.

    2016-01-01

    Rosiglitazone, a potent peroxisome proliferator-activated receptor (PPAR)-γ agonist, has been shown to confer neuroprotective effects in stroke and spinal cord injury, but its role in the traumatic brain injury (TBI) is still controversial. Using a controlled cortical impact model in rats, the current study was designed to determine the effects of rosiglitazone treatment (6 mg/kg at 5 min, 6 h and 24 h post injury) upon inflammation and histological outcome at 21 d after TBI. In addition, the effects of rosiglitazone upon inflammatory cytokine transcription, vestibulomotor behavior and spatial memory function were determined at earlier time points (24 h, 1–5 d, 14–20 d post injury, respectively). Compared with the vehicle-treated group, rosiglitazone treatment suppressed production of TNFα at 24 h after TBI, attenuated activation of microglia/macrophages and increased survival of CA3 neurons but had no effect on lesion volume at 21 d after TBI. Rosiglitazone-treated animals had improved performance on beam balance testing, but there was no difference in spatial memory function as determined by Morris water maze. In summary, this study indicates that rosiglitazone treatment in the first 24 h after TBI has limited anti-inflammatory and neuroprotective effects in rat traumatic injury. Further study using an alternative dosage paradigm and more sensitive behavioral testing may be warranted. - Highlights: • Effects of rosiglitazone after CCI were evaluated using a rat TBI model. • Rosiglitazone suppressed production of TNFα at 24 h after CCI. • Rosiglitazone inhibited microglial activation at 21 d after CCI. • Rosiglitazone increased survival of CA3 neurons at 21 d after CCI. • Rosiglitazone-treated animals had improved performance in beam balance testing.

  15. The effect of trimethoprim on CYP2C8 mediated rosiglitazone metabolism in human liver microsomes and healthy subjects

    Science.gov (United States)

    Hruska, M W; Amico, J A; Langaee, T Y; Ferrell, R E; Fitzgerald, S M; Frye, R F

    2005-01-01

    Aims Rosiglitazone, a thiazolidinedione antidiabetic medication used in the treatment of Type 2 diabetes mellitus, is predominantly metabolized by the cytochrome P450 (CYP) enzyme CYP2C8. The anti-infective drug trimethoprim has been shown in vitro to be a selective inhibitor of CYP2C8. The purpose of this study was to evaluate the effect of trimethoprim on the CYP2C8 mediated metabolism of rosiglitazone in vivo and in vitro. Methods The effect of trimethoprim on the metabolism of rosiglitazone in vitro was assessed in pooled human liver microsomes. The effect in vivo was determined by evaluating rosiglitazone pharmacokinetics in the presence and absence of trimethoprim. Eight healthy subjects (four men and four women) completed a randomized, cross-over study. Subjects received single dose rosiglitazone (8 mg) in the presence and absence of trimethoprim 200 mg given twice daily for 5 days. Results Trimethoprim inhibited rosiglitazone metabolism both in vitro and in vivo. Inhibition of rosiglitazone para-hydroxylation by trimethoprim in vitro was found to be competitive with apparent Ki and IC50 values of 29 µm and 54.5 µm, respectively. In the presence of trimethoprim, rosiglitazone plasma AUC was increased by 31% (P = 0.01) from 2774 ± 645 µg l−1 h to 3643 ± 1051 µg l−1 h (95% confidence interval (Cl) for difference 189, 1549), and half-life was increased by 27% (P = 0.006) from 3.3 ± 0.5 to 4.2 ± 0.8 h (95% Cl for difference 0.36, 1.5). Trimethoprim reduced the para-O-sulphate rosiglitazone/rosiglitazone and the N-desmethylrosiglitazone/rosiglitazone AUC(0–24) ratios by 22% and 38%, respectively. Conclusions These results indicate that trimethoprim is a competitive inhibitor of CYP2C8-mediated rosiglitazone metabolism in vitro and that trimethoprim administration increases plasma rosiglitazone concentrations in healthy subjects. PMID:15606443

  16. Hesperidin and low dose gamma irradiation alleviate rosiglitazone -induced cardiotoxicity in type 2 diabetic rats

    International Nuclear Information System (INIS)

    Morcos, N.Y.; Abdel-Ghaffar, A.B.; Osman, S.A.; Mohamed, M.Kh.; Arbid, M.S.; El-Eraky, W.I.

    2012-01-01

    Aim: The present study was designed to investigate the cardio protective effect of hesperidin and low dose γ- irradiation (LDR) against rosiglitazone cardiotoxicity. Experiment: Type 2 diabetes mellitus (T2DM) was induced in rats by single intraperitoneal injection of streptozotocin (STZ) followed by nicotinamide (NIC) (65 and 110 mg/kg b.wt, respectively). The diabetic rats were divided into 5 groups: untreated, LDR, LDR+ rosiglitazone, LDR + Hesperidin, LDR+ rosiglitazone + Hesperidin for one month, and blood and tissue samples were collected. Results: The diabetic rats showed elevated serum creatine kinase (CK-MB), lactate dehydrogenase (LDH), C-reactive protein (CRP), hyaluronidase activity, and reduced serum nitric oxide (NO) level, hematocrit % as well as final body weight, and pathological alterations in myocardial tissue. Treatment with LDR + rosiglitazone + Hesperidin ameliorated all these abnormalities approaching control levels. Conclusion: Results indicate the possible cardio protective role of hesperidin and LDR against rosiglitazone cardiotoxicity.

  17. Rosiglitazone protects human neuroblastoma SH-SY5Y cells against acetaldehyde-induced cytotoxicity

    International Nuclear Information System (INIS)

    Jung, Tae Woo; Lee, Ji Young; Shim, Wan Sub; Kang, Eun Seok; Kim, Soo Kyung; Ahn, Chul Woo; Lee, Hyun Chul; Cha, Bong Soo

    2006-01-01

    Acetaldehyde, an inhibitor of mitochondrial function, has been widely used as a neurotoxin because it elicits a severe Parkinson's disease-like syndrome with elevation of the intracellular reactive oxygen species level and apoptosis. Rosiglitazone, a peroxisome proliferator-activated receptor-γ agonist, has been known to show various non-hypoglycemic effects, including anti-inflammatory, anti-atherogenic, and anti-apoptotic. In this study, we investigated the protective effects of rosiglitazone on acetaldehyde-induced apoptosis in human neuroblastoma SH-SY5Y cells and attempted to examine its mechanism. Acetaldehyde-induced apoptosis was moderately reversed by rosiglitazone treatment. Our results suggest that the protective effects of rosiglitazone on acetaldehyde-induced apoptosis may be ascribed to ability to induce the expression of anti-oxidant enzymes and to regulate Bcl-2 and Bax expression. These data indicate that rosiglitazone may provide a useful therapeutic strategy for the prevention of progressive neurodegenerative disease such as Parkinson's disease

  18. A pilot study investigating the effects of rosiglitazone on performance in neuropsychological tests in patients with mild-to-moderate Alzheimer's disease

    NARCIS (Netherlands)

    Peers, P.V.; Semple, J.; Lai, R.Y.K.; Smith, G.R.; Altman, J.; Risner, M.; Riedel, W.J.

    2006-01-01

    Background: Rosiglitazone (a PPARg agonist) has shown beneficial effects on memory and executive function tasks in Alzheimer’s disease (AD)[1] Objective(s): To examine the use of standard clinical measures (e.g ADAS-cog) and experimental measures of simple and choice reaction time (examining

  19. Budget impact of rosiglitazone in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Orietta Zaniolo

    2007-03-01

    Full Text Available BACKGROUND: in type 2 diabetes, the maintenance of non-diabetic glycaemic levels has been shown to decrease the onset of long term complications and consequently their high management costs. In order to achieve and maintain normal blood glucose levels, lifestyle interventions are highly cost/effective, but require good compliance, strong motivation and efforts by the patients. For this reason, a majority of patients needs to start pharmacological therapy shortly after diagnosis. Rosiglitazone, an insulin-sensitising drug, is indicated for subjects with inadequate glycaemic control both as monotherapy, in those contraindicated to metformin, especially if overweight, and as combination therapy with metformin, sulphanilureas or both. OBJECTIVES: rosiglitazone offers clinical advantages over the alternatives, decreasing and/or postponing the need for insulin treatment. Its high acquisition cost may therefore be totally or partially offset by the reduction in future health care resources consumption, and by short-term practical advantages, such as the decrease in the need for blood glucose monitoring and of adverse events. Aim of this study was to investigate the impact of the use of rosiglitazone in eligible diabetic patients on the National Health System budget. METHODS: for this scope an analytic model was implemented, which pathway may be summarized as follows: a estimate of the number type 2 diabetes patients living in Italy, grouped according to current therapeutic classes; b estimate of the number of patients with inadequate glycaemic control for each subgroup; c identification of patients eligible to rosiglitazone treatment; d identification of the comparator strategy for each patient sub-group; e comparison of costs for each couple of alternative options; f calculation of budget impact. RESULTS: use of rosiglitazone monotherapy instead of sulphanilurea monotherapy induces a mild costs increase. Combination treatment with rosiglitazone added

  20. Microdialysis combined blood sampling technique for the determination of rosiglitazone and glucose in brain and blood of gerbils subjected to cerebral ischemia.

    Science.gov (United States)

    Sheu, Wayne H-H; Chuang, Hsiu-Chun; Cheng, Shiu-Min; Lee, Maw-Rong; Chou, Chi-Chi; Cheng, Fu-Chou

    2011-03-25

    Rosiglitazone is a potent synthetic peroxisome proliferator-activated receptor-gamma (PPAR-γ) agonist which improves glucose control in the plasma and reduces ischemic brain injury. However, the pharmacokinetics of rosiglitazone in the brain is still unclear. In this study, a method using liquid chromatography-mass spectrometry coupled with microdialysis and an auto-blood sampling system was developed to determine rosiglitazone and glucose concentration in the brain and blood of gerbils subjected to treatment with rosiglitazone (3.0 mg kg(-1), i.p.). The results showed the limit of detection was 0.04 μg L(-1) and the correlation coefficient was 0.9997 for the determination of rosiglitazone in the brain. The mean parameters, maximum drug concentration (C(max)) and the area under the concentration-time curve from time zero to time infinity (AUC(inf)), following rosiglitazone administration were 1.06±0.28 μg L(-1) and 296.82±44.67 μg min L(-1), respectively. The time to peak concentration (C(max) or T(max)) of rosiglitazone occurred at 105±17.10 min, and the mean elimination half-life (t(1/2)) from brain was 190.81±85.18 min after administration of rosiglitazone. The brain glucose levels decreased to 71% of the basal levels in the rosiglitazone-treated group when compared with those in the control (pblood glucose levels to 80% at 1h after pretreatment of rosiglitazone (pglucose concentrations in brain and plasma. Rosiglitazone was effective at penetrating the blood-brain barrier as evidenced by the rapid appearance of rosiglitazone in the brain, and rosiglitazone may contribute to a reduction in the extent of injuries related to cerebral ischemic stroke via its hypoglycemic effect. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. Short-Term Therapy with Rosiglitazone, a PPAR-γ Agonist, Improves Metabolic Profile and Vascular Function in Nonobese Lean Wistar Rats

    OpenAIRE

    Naderali, Mohammad M.; Itua, Imose; Abubakari, Abdul-Razak; Naderali, Ebrahim K.

    2012-01-01

    A number of preclinical and clinical studies have reported blood-pressure-lowering benefits of thiazolidinediones in diabetic subjects and animal models of diabetes. This study was designed to further elucidate vascular effects of rosiglitazone, on healthy nonobese, lean animals. Adult male Wistar rats were randomized and assigned to control and rosiglitazone-treated groups and were dosed daily with either vehicle or rosiglitazone (10 mg kg−1 day−1) by oral gavage for 5 days. Compared with co...

  2. Rosiglitazone delayed weight loss and anorexia while attenuating adipose depletion in mice with cancer cachexia.

    Science.gov (United States)

    Asp, Michelle L; Tian, Min; Kliewer, Kara L; Belury, Martha A

    2011-12-01

    Cachexia is characterized by severe weight loss, including adipose and muscle wasting, and occurs in a large percentage of cancer patients. Insulin resistance contributes to dysregulated metabolism in cachexia and occurs prior to weight loss in mice with colon-26 tumor-induced cachexia. Therefore, we hypothesized that the insulin sensitizer, rosiglitazone, would attenuate the loss of adipose and muscle to result in improved outcomes for mice with late-stage cachexia. Male CD2F1 mice were inoculated with colon-26 adenocarcinoma cells or vehicle. Treatments included vehicle, rosiglitazone (10 mg/kg body weight/day) or rosiglitazone plus pair-feeding to food intake of vehicle-treated mice with tumors. Rosiglitazone delayed weight loss onset by 2 d over the 16 d duration of this aggressive tumor model. This finding was associated, in part, with increased food intake. In addition, adipose mass, adipocyte cross-sectional area and inflammation were improved with rosiglitazone. However, at the time of necropsy 16 d after tumor inoculation rosiglitazone had no effect on retention of muscle mass, strength or proteolysis in late-stage cachexia. We did not measure stamina or endurance in this study. In early-stage cachexia, rosiglitazone normalized PDK4 and PPAR-delta mRNA in quadriceps muscle and rescued the decrease in insulin-stimulated glucose disappearance in mice with tumors. Rosiglitazone may delay weight loss onset by decreasing tumor-induced markers of metabolic change in early-stage cachexia. These changes predict for modest improvement in adipose, but no improvement in muscle strength in late-stage cachexia.

  3. Rosiglitazone

    Science.gov (United States)

    ... manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye ...

  4. Prolonged effect of Rosiglitazone one year after discontinuation

    DEFF Research Database (Denmark)

    Gram-Kampmann, Eva-Marie; Olesen, Thomas Bastholm; Olsen, Michael Hecht

    2015-01-01

    : This study is a continuation of the two-year study SDDS, where 371 patients were randomized to eight groups and treated with Insulin aspart three times daily or NPH insulin once daily, metformin or placebo and Rosiglitazone or placebo, respectively. During a 12-month run-out, use of insulin was continued...... and oral antidiabetics/placebo was changed to 2000 mg of metformin a day. During the following four visits, insulin was adjusted according to a treat-to-target algoritm with avoidance of hypoglycemia. Resultater: After 12 months, there was no difference in HbA1c. As expected, in the group formerly...... receiving insulin and two times placebo, insulindose could be lowered after institution of metformin. Compared to the insulin, metformin and placebo-group, insulin dose was significantly lower in the insulin, rosiglitazone and placebo-group (56,9 IUvs 73,6IU, p =0,05) after 12 months. The Insulin...

  5. Effect of Rosiglitazone on Radiation Damage in Bone Marrow Hemopoiesis

    International Nuclear Information System (INIS)

    Benko', Klara; Pintye, Eva; Szabo, Boglarka; Geresi, Krisztina; Megyeri, Attila; Benko, Ilona

    2008-01-01

    To study radiobiological effects and drugs, which can modify radiation injury, has an importance if we would like to avoid harmful effects of radiation due to emergency situations or treat patients with malignant diseases by radiotherapy. During the long treatment schedules patients may be treated by not only anticancer but many other drugs because of accompanying diseases. These drugs may also modify radiobiological effects. Rosiglitazone pre-treatment proved to be myeloprotective and accelerated recovery of 5-fluorouracil-damaged bone marrow in our previous experiments. Our new studies are designed to evaluate whether rosiglitazone has similar beneficial effects in radiation-damaged hemopoiesis. Bone marrow damage was precipitated by total body irradiation (TBI) using single increasing doses (2-10 Gy) of γ--irradiation in groups of mice. Lethality was well correlated with damage in hemopoiesis measured by cellularity of bone marrow (LD 50 values were 4.8 and 5.3 gray respectively). Rosiglitazone, an insulin-sensitizing drug, had no significant effect on bone marrow cellularity. Insulin resistance associated with obesity or diabetes mellitus type 2 is intensively growing among cancer patients requiring some kind of radiotherapy. Therefore it is important to know whether drugs used for their therapy can modify radiation effects.

  6. Effect of Rosiglitazone on Radiation Damage in Bone Marrow Hemopoiesis

    Science.gov (United States)

    Benkő, Klára; Pintye, Éva; Szabó, Boglárka; Géresi, Krisztina; Megyeri, Attila; Benkő, Ilona

    2008-12-01

    To study radiobiological effects and drugs, which can modify radiation injury, has an importance if we would like to avoid harmful effects of radiation due to emergency situations or treat patients with malignant diseases by radiotherapy. During the long treatment schedules patients may be treated by not only anticancer but many other drugs because of accompanying diseases. These drugs may also modify radiobiological effects. Rosiglitazone pre-treatment proved to be myeloprotective and accelerated recovery of 5-fluorouracil-damaged bone marrow in our previous experiments. Our new studies are designed to evaluate whether rosiglitazone has similar beneficial effects in radiation-damaged hemopoiesis. Bone marrow damage was precipitated by total body irradiation (TBI) using single increasing doses (2-10 Gy) of γ—irradiation in groups of mice. Lethality was well correlated with damage in hemopoiesis measured by cellularity of bone marrow (LD50 values were 4.8 and 5.3 gray respectively). Rosiglitazone, an insulin-sensitizing drug, had no significant effect on bone marrow cellularity. Insulin resistance associated with obesity or diabetes mellitus type 2 is intensively growing among cancer patients requiring some kind of radiotherapy. Therefore it is important to know whether drugs used for their therapy can modify radiation effects.

  7. Inhibitory effect on hepatitis B virus in vitro by a peroxisome proliferator-activated receptor-γ ligand, rosiglitazone

    International Nuclear Information System (INIS)

    Wakui, Yuta; Inoue, Jun; Ueno, Yoshiyuki; Fukushima, Koji; Kondo, Yasuteru; Kakazu, Eiji; Obara, Noriyuki; Kimura, Osamu; Shimosegawa, Tooru

    2010-01-01

    Although chronic infection of hepatitis B virus (HBV) is currently managed with nucleot(s)ide analogues or interferon-α, the control of HBV infection still remains a clinical challenge. Peroxisome proliferator-activated receptor (PPAR) is a ligand-activated transcription factor, that plays a role in glucose and lipid metabolism, immune reactions, and inflammation. In this study, the suppressive effect of PPAR ligands on HBV replication was examined in vitro using a PPARα ligand, bezafibrate, and a PPARγ ligand, rosiglitazone. The effects were examined in HepG2 cells transfected with a plasmid containing 1.3-fold HBV genome. Whereas bezafibrate showed no effect against HBV replication, rosiglitazone reduced the amount of HBV DNA, hepatitis B surface antigen, and hepatitis B e antigen in the culture supernatant. Southern blot analysis showed that the replicative intermediates of HBV in the cells were also inhibited. It was confirmed that GW9662, an antagonist of PPARγ, reduced the suppressive effect of rosiglitazone on HBV. Moreover, rosiglitazone showed a synergistic effect on HBV replication with lamivudine or interferon-α-2b. In conclusion, this study showed that rosiglitazone inhibited the replication of HBV in vitro, and suggested that the combination therapy of rosiglitazone and nucleot(s)ide analogues or interferon could be a therapeutic option for chronic HBV infection.

  8. Inhibitory effect on hepatitis B virus in vitro by a peroxisome proliferator-activated receptor-{gamma} ligand, rosiglitazone

    Energy Technology Data Exchange (ETDEWEB)

    Wakui, Yuta; Inoue, Jun [Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aobaku, Sendai 980-8574 (Japan); Ueno, Yoshiyuki, E-mail: yueno@mail.tains.tohoku.ac.jp [Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aobaku, Sendai 980-8574 (Japan); Fukushima, Koji; Kondo, Yasuteru; Kakazu, Eiji; Obara, Noriyuki; Kimura, Osamu; Shimosegawa, Tooru [Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aobaku, Sendai 980-8574 (Japan)

    2010-05-28

    Although chronic infection of hepatitis B virus (HBV) is currently managed with nucleot(s)ide analogues or interferon-{alpha}, the control of HBV infection still remains a clinical challenge. Peroxisome proliferator-activated receptor (PPAR) is a ligand-activated transcription factor, that plays a role in glucose and lipid metabolism, immune reactions, and inflammation. In this study, the suppressive effect of PPAR ligands on HBV replication was examined in vitro using a PPAR{alpha} ligand, bezafibrate, and a PPAR{gamma} ligand, rosiglitazone. The effects were examined in HepG2 cells transfected with a plasmid containing 1.3-fold HBV genome. Whereas bezafibrate showed no effect against HBV replication, rosiglitazone reduced the amount of HBV DNA, hepatitis B surface antigen, and hepatitis B e antigen in the culture supernatant. Southern blot analysis showed that the replicative intermediates of HBV in the cells were also inhibited. It was confirmed that GW9662, an antagonist of PPAR{gamma}, reduced the suppressive effect of rosiglitazone on HBV. Moreover, rosiglitazone showed a synergistic effect on HBV replication with lamivudine or interferon-{alpha}-2b. In conclusion, this study showed that rosiglitazone inhibited the replication of HBV in vitro, and suggested that the combination therapy of rosiglitazone and nucleot(s)ide analogues or interferon could be a therapeutic option for chronic HBV infection.

  9. Rosiglitazone induces autophagy in H295R and cell cycle deregulation in SW13 adrenocortical cancer cells

    International Nuclear Information System (INIS)

    Cerquetti, Lidia; Sampaoli, Camilla; Amendola, Donatella; Bucci, Barbara; Masuelli, Laura; Marchese, Rodolfo; Misiti, Silvia; De Venanzi, Agostino; Poggi, Maurizio; Toscano, Vincenzo; Stigliano, Antonio

    2011-01-01

    Thiazolidinediones, specific peroxisome proliferator-activated receptor-γ (PPAR-γ) ligands, used in type-2 diabetes therapy, show favourable effects in several cancer cells. In this study we demonstrate that the growth of H295R and SW13 adrenocortical cancer cells is inhibited by rosiglitazone, a thiazolidinediones member, even though the mechanisms underlying this effect appeared to be cell-specific. Treatment with GW9662, a selective PPAR-γ-inhibitor, showed that rosiglitazone acts through both PPAR-γ-dependent and -independent mechanisms in H295R, while in SW13 cells the effect seems to be independent of PPAR-γ. H295R cells treated with rosiglitazone undergo an autophagic process, leading to morphological changes detectable by electron microscopy and an increased expression of specific proteins such as AMPKα and beclin-1. The autophagy seems to be independent of PPAR-γ activation and could be related to an increase in oxidative stress mediated by reactive oxygen species production with the disruption of the mitochondrial membrane potential, triggered by rosiglitazone. In SW13 cells, flow cytometry analysis showed an arrest in the G0/G1 phase of the cell cycle with a decrease of cyclin E and cdk2 activity, following the administration of rosiglitazone. Our data show the potential role of rosiglitazone in the therapeutic approach to adrenocortical carcinoma and indicate the molecular mechanisms at the base of its antiproliferative effects, which appear to be manifold and cell-specific in adrenocortical cancer lines.

  10. Rosiglitazone induces autophagy in H295R and cell cycle deregulation in SW13 adrenocortical cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Cerquetti, Lidia; Sampaoli, Camilla [Endocrinology, Department of Clinical and Molecular Medicine, Sant' Andrea Hospital, Faculty of Medicine and Psychology ' Sapienza' University of Rome, Via di Grottarossa, 1035-00189 Rome (Italy); Research Center S. Pietro Hospital, Via Cassia, 600-00189 Rome (Italy); Amendola, Donatella; Bucci, Barbara [Research Center S. Pietro Hospital, Via Cassia, 600-00189 Rome (Italy); Masuelli, Laura [Department of Experimental Medicine, ' Sapienza' University of Rome, Rome (Italy); Marchese, Rodolfo [Research Center S. Pietro Hospital, Via Cassia, 600-00189 Rome (Italy); Misiti, Silvia [Endocrinology, Department of Clinical and Molecular Medicine, Sant' Andrea Hospital, Faculty of Medicine and Psychology ' Sapienza' University of Rome, Via di Grottarossa, 1035-00189 Rome (Italy); Research Center S. Pietro Hospital, Via Cassia, 600-00189 Rome (Italy); De Venanzi, Agostino; Poggi, Maurizio; Toscano, Vincenzo [Endocrinology, Department of Clinical and Molecular Medicine, Sant' Andrea Hospital, Faculty of Medicine and Psychology ' Sapienza' University of Rome, Via di Grottarossa, 1035-00189 Rome (Italy); Stigliano, Antonio, E-mail: antonio.stigliano@uniroma1.it [Endocrinology, Department of Clinical and Molecular Medicine, Sant' Andrea Hospital, Faculty of Medicine and Psychology ' Sapienza' University of Rome, Via di Grottarossa, 1035-00189 Rome (Italy); Research Center S. Pietro Hospital, Via Cassia, 600-00189 Rome (Italy)

    2011-06-10

    Thiazolidinediones, specific peroxisome proliferator-activated receptor-{gamma} (PPAR-{gamma}) ligands, used in type-2 diabetes therapy, show favourable effects in several cancer cells. In this study we demonstrate that the growth of H295R and SW13 adrenocortical cancer cells is inhibited by rosiglitazone, a thiazolidinediones member, even though the mechanisms underlying this effect appeared to be cell-specific. Treatment with GW9662, a selective PPAR-{gamma}-inhibitor, showed that rosiglitazone acts through both PPAR-{gamma}-dependent and -independent mechanisms in H295R, while in SW13 cells the effect seems to be independent of PPAR-{gamma}. H295R cells treated with rosiglitazone undergo an autophagic process, leading to morphological changes detectable by electron microscopy and an increased expression of specific proteins such as AMPK{alpha} and beclin-1. The autophagy seems to be independent of PPAR-{gamma} activation and could be related to an increase in oxidative stress mediated by reactive oxygen species production with the disruption of the mitochondrial membrane potential, triggered by rosiglitazone. In SW13 cells, flow cytometry analysis showed an arrest in the G0/G1 phase of the cell cycle with a decrease of cyclin E and cdk2 activity, following the administration of rosiglitazone. Our data show the potential role of rosiglitazone in the therapeutic approach to adrenocortical carcinoma and indicate the molecular mechanisms at the base of its antiproliferative effects, which appear to be manifold and cell-specific in adrenocortical cancer lines.

  11. Rosiglitazone Decreases Plasma Levels of Osteoprotegerin in a Randomized Clinical Trial with Type 2 Diabetes Patients

    DEFF Research Database (Denmark)

    Nybo, Mads; Preil, Simone Rørdam; Juhl, Henning Friis

    2011-01-01

    regarding cardiovascular disease. The South Danish Diabetes Study, an investigator-driven, randomized, controlled clinical trial lasting 2 years, was used to test this hypothesis in patient groups with different medication strategies (insulin aspart or NPH insulin, added either metformin...... (R = 0.29, p = 0.0002), while this correlation was poor in those not receiving rosiglitazone (R = 0.06, p = 0.48). Treatment with rosiglitazone among patients with T2DM reduces the concentration of plasma OPG. This is not seen with metformin despite similar reductions in HbA(1c) . Alteration...

  12. Insulinotropic and anti-inflammatory effects of rosiglitazone in experimental autoimmune diabetes.

    Science.gov (United States)

    Awara, Wageh M; el-Sisi, Alaa E; el-Refaei, Mohamed; el-Naa, Mona M; el-Desoky, Karima

    2005-01-01

    Cytokines and nitric oxide (NO) are involved in the pathogenesis of autoimmune diabetes mellitus (DM). Rosiglitazone is an insulin-sensitizing drug that is a ligand for the nuclear receptor peroxisome proliferator-activated receptor-gamma (PPAR-gamma). The anti-inflammatory and immunomodulating properties of PPAR-gamma have been documented. The aim of this study is to investigate the effectiveness of rosiglitazone in autoimmune DM and to clarify the possible mechanism(s) involved. Autoimmune DM was induced in adult male Balb/c mice by co-administration of cyclosporin A and multiple low doses of streptozotocin. Diabetic mice were treated daily with rosiglitazone (7 mg/kg, p.o.) for 21 days. Blood glucose level (BGL), serum insulin level and pancreatic levels of tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) and NO were measured. Histopathological examination and immunohistochemical determination of CD4 and CD8 T lymphocytes in the pancreatic islets were performed. In addition, analysis of pancreatic protein expression was carried out. The results showed that rosiglitazone treatment resulted in a significant decrease in the BGL and the pancreatic levels of TNF-alpha, IFN-gamma and NO compared to diabetic mice. The serum insulin level was significantly increased after rosiglitazone treatment compared to diabetic mice. The destroyed pancreatic islets were regenerated and became free from both CD4 and CD8 T cells after treatment. Furthermore, many changes in pancreatic protein expression were observed. These results suggest that rosiglitazone has a beneficial effect in the treatment of autoimmune diabetes, an effect that seemed to be a secondary consequence of its anti-inflammatory and immunomodulating properties and might be reflected at the level of protein expression.

  13. Effects of rosiglitazone on serum paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Atamer, Y. [Department of Medical Biochemistry, Faculty of Medicine, Dicle University, Diyarbakır (Turkey); Atamer, A. [Ministry of Health Haydarpaşa Numune Training and Research Hospital, Division of Gastroenterology, Department of Internal Medicine, Istanbul, Turkey, Division of Gastroenterology, Department of Internal Medicine, Ministry of Health Haydarpaşa Numune Training and Research Hospital, Istanbul (Turkey); Can, A.S. [Termal Professional School, Yalova University, Yalova (Turkey); Hekimoğlu, A. [Dicle University, Department of Pharmacology, Faculty of Medicine, Diyarbakir, Turkey, Department of Pharmacology, Faculty of Medicine, Dicle University, Diyarbakır (Turkey); Ilhan, N. [Firat University, Department of Medical Biochemistry, Faculty of Medicine, Elaziğ, Turkey, Department of Medical Biochemistry, Faculty of Medicine, Fırat University, Elazığ (Turkey); Yenice, N. [Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Harran University, Urfa (Turkey); Koçyiğit, Y. [Dicle University, Department of Physiology, Faculty of Medicine, Diyarbakir, Turkey, Department of Physiology, Faculty of Medicine, Dicle University, Diyarbakır (Turkey)

    2013-06-25

    Human serum paraoxonase contributes to the anti-atherogenic effect of high-density lipoprotein cholesterol (HDL-C) and has been shown to protect both low-density lipoprotein cholesterol (LDL-C) and HDL-C against lipid peroxidation. We investigated the effects of rosiglitazone on paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus [50 patients (30 males, 20 females); mean±SD age: 58.7±9.2 years, body mass index: 28.2±4.1'kg/m{sup 2}], in whom glucose control could not be achieved despite treatment with metformin, sulphonylurea, and/or insulin. The patients were given 4'mg/day rosiglitazone for 3 months in addition to their usual treatment. Serum paraoxonase activity, malondialdehyde, homocysteine, and lipid profile were measured at the time of initiation and at the end of therapy with rosiglitazone. After rosiglitazone therapy, serum levels of HDL-C, apolipoprotein A-1, and paraoxonase activity increased significantly (P<0.05) and malondialdehyde, homocysteine, lipoprotein(a), and glucose levels decreased significantly (P<0.05), but no significant changes in levels of total cholesterol and apolipoprotein B were observed. Triglyceride levels also increased significantly (P<0.05). Rosiglitazone treatment led to an improvement in glycemic control and to an increase in paraoxonase activity and HDL-C levels. Although rosiglitazone showed favorable effects on oxidant/antioxidant balance and lipid profile, further studies are needed to determine the effect of rosiglitazone on cardiovascular risk factors and cardiovascular morbidity and mortality.

  14. Effects of rosiglitazone on serum paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Atamer, Y.; Atamer, A.; Can, A.S.; Hekimoğlu, A.; Ilhan, N.; Yenice, N.; Koçyiğit, Y.

    2013-01-01

    Human serum paraoxonase contributes to the anti-atherogenic effect of high-density lipoprotein cholesterol (HDL-C) and has been shown to protect both low-density lipoprotein cholesterol (LDL-C) and HDL-C against lipid peroxidation. We investigated the effects of rosiglitazone on paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus [50 patients (30 males, 20 females); mean±SD age: 58.7±9.2 years, body mass index: 28.2±4.1'kg/m 2 ], in whom glucose control could not be achieved despite treatment with metformin, sulphonylurea, and/or insulin. The patients were given 4'mg/day rosiglitazone for 3 months in addition to their usual treatment. Serum paraoxonase activity, malondialdehyde, homocysteine, and lipid profile were measured at the time of initiation and at the end of therapy with rosiglitazone. After rosiglitazone therapy, serum levels of HDL-C, apolipoprotein A-1, and paraoxonase activity increased significantly (P<0.05) and malondialdehyde, homocysteine, lipoprotein(a), and glucose levels decreased significantly (P<0.05), but no significant changes in levels of total cholesterol and apolipoprotein B were observed. Triglyceride levels also increased significantly (P<0.05). Rosiglitazone treatment led to an improvement in glycemic control and to an increase in paraoxonase activity and HDL-C levels. Although rosiglitazone showed favorable effects on oxidant/antioxidant balance and lipid profile, further studies are needed to determine the effect of rosiglitazone on cardiovascular risk factors and cardiovascular morbidity and mortality

  15. The rosiglitazone decision process at FDA and EMA : What should we learn?

    NARCIS (Netherlands)

    Pouwels, Koen B.; van Grootheest, Kees

    2012-01-01

    In September 2010 the EMA decided to suspend the market authorisation of rosiglitazone, while the FDA decided to restrict the use of rosiglitazone. These actions were taken approximately 10 years after the introduction of rosiglitazone, because rosiglitazone might be associated with an increased

  16. Rosiglitazone reverses memory decline and hippocampal glucocorticoid receptor down-regulation in an Alzheimer's disease mouse model

    International Nuclear Information System (INIS)

    Escribano, Luis; Simon, Ana-Maria; Perez-Mediavilla, Alberto; Salazar-Colocho, Pablo; Rio, Joaquin Del; Frechilla, Diana

    2009-01-01

    Clinical trials with rosiglitazone, a potent agonist at peroxisome proliferator-activated receptor gamma (PPARγ) suggest an improvement of cognitive function in Alzheimer's disease (AD) patients. The mechanisms mediating this potential beneficial effect remain to be fully elucidated. In mice overexpressing mutant human amyloid precursor protein (hAPP), a model of AD, we found that memory impairment in the object recognition test was prevented and also reversed by chronic rosiglitazone treatment. Given the possible involvement of glucocorticoid receptors (GR) in the actions of PPARγ-ligands, we studied the effect of chronic rosiglitazone treatment on GR levels in the hippocampus of hAPP mice. An early down-regulation of GR, not related to elevated plasma corticosterone levels, was found in different hippocampal subfields of the transgenic mice and this decrease was prevented by rosiglitazone. In parallel with behavioural studies, rosiglitazone also normalized GR levels in older animals. This effect may contribute to explain the attenuation of memory decline by PPARγ activation in an AD mouse model.

  17. Serial micro-CT assessment of the therapeutic effects of rosiglitazone in a bleomycin-induced lung fibrosis mouse model

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Eun Jung; Jin, Gong Yong; Bok, Se Mi; Han, Young Min; Lee, Young Sun; Jung, Myung Ja; Kwon, Keun Sang [Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Institute for Medical Sciences, Jeonju (Korea, Republic of)

    2014-08-15

    The aim of this study was to assess the therapeutic effects of rosiglitazone with serial micro-CT findings before and after rosiglitazone administration in a lung fibrosis mouse model induced with bleomycin. We instilled the bleomycin solution directly into the trachea in twenty mice (female, C57BL/6 mice). After the instillation with bleomycin, mice were closely observed for 3 weeks and then all mice were scanned using micro-CT without sacrifice. At 3 weeks, the mice were treated with rosiglitazone on days 21 to 27 if they had abnormal CT findings (n = 9, 45%). For the mice treated with rosiglitazone, we performed micro-CT with mouse sacrifice 2 weeks after the rosiglitazone treatment completion. We assessed the abnormal CT findings (ground glass attenuation, consolidation, bronchiectasis, reticular opacity, and honeycombing) using a five-point scale at 3 and 6 weeks using Wilcoxon-signed ranked test. The micro-CT findings were correlated with the histopathologic results. One out of nine (11.1%) mice improved completely. In terms of consolidation, all mice (100%) showed marked decrease from 3.1 ± 1.4 at 3 weeks to 0.9 ± 0.9 at 6 weeks (p = 0.006). At 6 weeks, mild bronchiectasis (n = 6, 66.7%), mild reticular opacity (n 7, 77.8%) and mild honeycomb patterns (n = 3, 33.3%) appeared. A serial micro-CT enables the evaluation of drug effects in a lung fibrosis mouse model.

  18. Effect of Recombinant Human Growth Hormone and Rosiglitazone for HIV-Associated Abdominal Fat Accumulation on Adiponectin and other Markers of Inflammation

    Science.gov (United States)

    Leung, Vivien; Chiu, Ya-Lin; Kotler, Donald P.; Albu, Jeanine; Zhu, Yuan-Shan; Ham, Kirsis; Engelson, Ellen S.; Hammad, Hoda; Christos, Paul; Donovan, Daniel S.; Ginsberg, Henry N.; Glesby, Marshall J.

    2016-01-01

    Background/Objective In a previous report of HIV-infected patients with fat redistribution, we found that recombinant human growth hormone (rhGH) therapy reduced visceral adipose tissue (VAT) but increased insulin resistance, and that the addition of rosiglitazone reversed the negative effects of rhGH on insulin sensitivity. In this study, we sought to determine the effects of recombinant human growth hormone (rhGH) and rosiglitazone therapy on an array of inflammatory and fibrinolytic markers. Methods 72 patients with HIV-associated abdominal obesity and insulin resistance were randomized to treatment with rhGH, rosiglitazone, the combination of rhGH and rosiglitazone, or placebo for 12 weeks. Subjects with plasma and serum samples available at weeks 0 (n = 63) and 12 (n = 46-48) were assessed for adiponectin, C-reactive protein (CRP), homocysteine, interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), fibrinogen, plasminogen activator inhibitor-1 (PAI-1) antigen, and tissue plasminogen activator (tPA) antigen. Results Treatment with both rosiglitazone alone and the combination of rosiglitazone and rhGH for 12 weeks resulted in significant increases in adiponectin levels from baseline. Adiponectin levels did not change significantly in the rhGH alone arm. There were no significant changes in the other biomarkers amongst the different treatment groups. Discussion In this study of HIV-infected patients with altered fat distribution, treatment with rosiglitazone had beneficial effects on adiponectin concentrations, an effect that was also seen with combination rosiglitazone and rhGH. RhGH administration alone, however, did not demonstrate any significant impact on adiponectin levels despite reductions in VAT. PMID:27077672

  19. Effect of pomegranate peel alone and in combination with rosiglitazone on hyperglycemia and dyslipidemia in type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Shujaat, A.; Hussain, M.M.

    2016-01-01

    To evaluate the effect of pomegranate peel extract with or without rosiglitazone on plasma glucose and lipid profile in insulin resistant diabetic rats. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Physiology, Army Medical College, Rawalpindi, in collaboration with National Institute of Health (N.I.H), Islamabad from 1st January 2011 to 28th May 2011. Material and Methods: Type 2 diabetes mellitus was induced in sixty healthy rats. The diabetic rats were divided into four groups, namely diabetic control group which received intraperitoneal injection of normal saline daily, pomegranate group which was treated similar to control group and also received pomegranate peel extract (200mg/kg body weight) orally once daily, rosiglitazone group which received intraperitoneal injection of rosiglitazone (5mg/kg body weight) daily and the combined group received both pomegranate extract (100 mg/kg body weight, orally) and intraperitoneal injection of rosiglitazone (2.5 mg/kg body weight) daily for 28 days. After four weeks of treatment, terminal intracardiac sampling was done to measure plasma glucose and lipid profile. Results: The plasma glucose and mean serum levels of cholesterol, triglyceride, low density lipoproteins and very low density lipoproteins was significantly reduced (p<0.001) in pomegranate, rosiglitazone and combined groups respectively as compared to the diabetic control. The mean serum levels of high density lipoproteins were significantly (p<0.001) elevated in above mentioned groups as compared to the diabetic control. Conclusion: Pomegranate peel extract is hypoglycemic and hypolipidemic agent in low doses when used alone or in combination with rosiglitazone in type 2 diabetic rats. (author)

  20. Quercetin, ascorbic acid, caffeine and ellagic acid are more efficient than rosiglitazone, metformin and glimepiride in interfering with pathways leading to the development of neurological complications associated with diabetes: A comparative in-vitro study

    Directory of Open Access Journals (Sweden)

    Vineet Mehta

    2017-06-01

    Full Text Available Neuropathy is the least understood and most devastating complication associated with diabetes. Diabetic neuropathy develops in patients despite of regular therapy, indicating that marketed drugs has minimal effect on pathways leading to the development and progression of these complications. Present study was aimed to evaluate natural compounds for their ability to interfere with pathways leading to the development of diabetes mediated neurological complications and compare their efficacy with marketed anti-diabetic drugs. Anti-diabetic potential of ascorbic acid, gallic acid, quercetin, ellagic acid, cinnamic acid, caffeine and piperine was predicted by evaluating in-silico interaction energy (kcal/mol of these compounds with insulin receptor, peroxisome proliferator-activated receptor gamma-γ and dipeptidyl peptidase-4 proteins. Ascorbic acid, gallic acid, quercetin and ellagic acid showed excellent in-vitro antioxidant activity in DPPH radical scavenging and inhibition of lipid peroxidation assay, which was 1.5–3 folds better than the marketed drugs. Quercetin, gallic acid, cinnamic acid, piperine and caffeine efficiently prevented H2O2 induced genotoxicity, which commercial drugs failed to prevent. Further, quercetin, ellagic acid, caffeine and ascorbic acid were 3–4.7 folds better than marketed drugs in inhibiting α-amylase activity. Herbal molecules and rosiglitazone showed comparable results for glucose uptake, which may be attributed to enhanced GLUT4 translocation into primary neuronal culture under hyperglycemic conditions. In conclusion, currently available marketed anti-diabetic drugs have minimal effect on the pathways leading to diabetic neuropathy and supplementing diabetic therapeutics with quercetin, ascorbic acid, caffeine and ellagic acid may be better suited to counter diabetic neuropathy through inhibiting oxidative stress, genotoxicity and improving neuronal glucose utilization.

  1. A novel translabial platform utilizing bioexcipients from Litchi chinesis for the delivery of rosiglitazone maleate

    Directory of Open Access Journals (Sweden)

    N.V. Satheesh Madhav

    2013-12-01

    Full Text Available The aim of this study was to formulate drug-loaded bio-lipstrips using novel bioexcipients isolated from the fruit pulp of Litchi chinesis (biomaterial L and to explore the potentiality of lip skin as a novel translabial drug delivery system. The biomaterial, prepared by a simplified economical process and purified by hot dialysis, was subjected to various physicochemical evaluations along with spectral analysis including UV, FT-IR, Mass and 1H NMR. The lipstrip formulated with the novel bioexcipients was screened for its functional properties, including filmability using a film-casting method, and bio/muco-adhesitivity using a shear-stress method, the Park and Robinson method and a rotating cylinder method. Rosiglitazone-loaded bio-lipstrips were formulated by using biomaterial L as a strip former and dextrose as a flexicizer. The formulated strips were subjected to various evaluations, including thickness, folding endurance, in-vitro release and in-vivo release. The release of rosiglitazone maleate was maintained over 24 h, which was confirmed in in-vitro and in-vivo release experiments. Our results reveal that this biopolymer possesses promising stripability as well as bio-adhesitivity. The formulated bio-lipstrips are feasible for delivering rosiglitazone maleate by translabial administration.

  2. Improvement in psoriasis with rosiglitazone in a diabetic and a nondiabetic patient.

    Science.gov (United States)

    Pershadsingh, Harrihar A; Benson, Steven C; Ellis, Charles N

    2005-01-01

    The authors conducted a prospective, open-label, pilot trial of the effects of the antidiabetic thiazolidinedione (TZD) rosiglitazone in two patients with moderate to severe plaque psoriasis. Case 1: A lean, euglycemic 43-year-old nondiabetic man with a 2-year history of plaque psoriasis presented with lesions involving 10% of his body surface (Figures 1A, 1B, 1C). He had no other chronic or acute medical problems. He had previously been managed sporadically with topical triamcinolone acetonide, an intermediate-strength glucocorticoid, and was off antipsoriatic medication for 5 months. He was started on rosiglitazone p.o., 8 mg q.d. After 10 weeks on rosiglitazone, the lesions developed increased erythema, spreading, and shedding of scale (Figures 2A, 2B, 2C). After an additional 26 weeks, the lesions had largely disappeared (Figures 3A, 3B, 3C). The patient remained euglycemic throughout the study. His liver function enzymes (alanine transferase [ALT] and aspartate transferase [AST]) remained normal throughout the study: ALT, 23 IU/L; AST, 47 IU/L before treatment; ALT, 25 IU/L; AST, 33 IU/L after treatment. There were no adverse events. Case 2: An overweight 68-year-old woman (body mass index, 29 kg/m2; with a 12-year history of type 2 diabetes and 5-year history of psoriasis presented with generalized plaque psoriasis over 20% of her body, including two large, thick, silvery plaques with the texture of leather over the lower part of the back (Figure 4A). She was given rosiglitazone p.o., 4 mg b.i.d. for 24 weeks, which resulted in significant improvement in psoriasis (Figure 4B). After an additional 26 weeks on rosiglitazone, the plaques had cleared on her back (Figure 4C) and over her entire body, including scalp, ears, and posterior forearms (not shown). Her glycemic control improved (hemoglobin A1c decreased from 7.7% to 7.2%) and liver function remained normal throughout the study (ALT, 24 IU/L; AST, 14 IU/L before treatment; and ALT, 26 IU/L; AST, 15 IU

  3. Rosiglitazone evaluated for cardiovascular outcomes--an interim analysis

    DEFF Research Database (Denmark)

    Home, Philip D; Pocock, Stuart J; Beck-Nielsen, Henning

    2007-01-01

    BACKGROUND: A recent meta-analysis raised concern regarding an increased risk of myocardial infarction and death from cardiovascular causes associated with rosiglitazone treatment of type 2 diabetes. METHODS: We conducted an unplanned interim analysis of a randomized, multicenter, open...... group). The primary end point was hospitalization or death from cardiovascular causes. RESULTS: Because the mean follow-up was only 3.75 years, our interim analysis had limited statistical power to detect treatment differences. A total of 217 patients in the rosiglitazone group and 202 patients...... in the control group had the adjudicated primary end point (hazard ratio, 1.08; 95% confidence interval [CI], 0.89 to 1.31). After the inclusion of end points pending adjudication, the hazard ratio was 1.11 (95% CI, 0.93 to 1.32). There were no statistically significant differences between the rosiglitazone...

  4. In vivo metabolic phenotyping of myocardial substrate metabolism in rodents: differential efficacy of metformin and rosiglitazone monotherapy.

    Science.gov (United States)

    Shoghi, Kooresh I; Finck, Brian N; Schechtman, Kenneth B; Sharp, Terry; Herrero, Pilar; Gropler, Robert J; Welch, Michael J

    2009-09-01

    Cardiovascular disease is the leading cause of death among diabetic patients, with alteration in myocardial substrate metabolism being a likely contributor. We aimed to assess noninvasively the efficacy of metformin and rosiglitazone monotherapy in normalizing myocardial substrate metabolism in an animal model of type 2 diabetes mellitus. The study used 18 male ZDF rats (fa/fa) with 6 rats in each group: an untreated group; a group treated with metformin (16.6 mg/kg/d), and a group treated with rosiglitazone (4 mg/kg). Each rat was scanned at age 14 weeks (baseline) and subsequently at 19 weeks with small-animal positron emission tomography to estimate myocardial glucose utilization (MGU) and myocardial utilization (MFAU), oxidation (MFAO), and esterification (MFAE). Treatment lasted for 5 weeks after baseline imaging. At week 19, rats were euthanized and hearts were extracted for expression analysis of select genes encoding for GLUT transporters and fatty acid transport and oxidation genes. In addition, echocardiography measurements were obtained at weeks 13 and 18 to characterize cardiac function. Metformin had no significant effect on either MGU or MFAU and MFAO. In contrast, rosiglitazone tended to enhance MGU and significantly reduced MFAU and MFAO. Rosiglitazone-induced increase in glucose uptake correlated significantly with increased expression of GLUT4, whereas diminished MFAO correlated significantly with decreased expression of FATP-1 and MCAD. Finally, changes in fractional shortening as a measure of cardiac function were unchanged throughout the study. Treatment with rosiglitazone enhanced glucose utilization and diminished MFAO, thus reversing the metabolic phenotype of the diabetic heart.

  5. Effectiveness of rosiglitazone on bleomycin-induced lung fibrosis: Assessed by micro-computed tomography and pathologic scores

    International Nuclear Information System (INIS)

    Jin, Gong Yong; Bok, Se Mi; Han, Young Min; Chung, Myung Ja; Yoon, Kwon-Ha; Kim, So Ri; Lee, Yong Chul

    2012-01-01

    Peroxisome proliferator-activated receptor-γ (PPARγ) agonists exhibit potent anti-fibrotic effects in the lung and other tissues. Recently, micro-computed tomography (CT) has been a useful tool for the investigation of lung diseases in small animals and is now increasingly applied to visualize and quantify the pulmonary structures. However, there is little information on the assessment for therapeutic effects of PPARγ agonists on the pulmonary fibrosis in mice using micro-CT. This study was aimed to determine the capability of micro-CT in examining the effects of rosiglitazone on pulmonary fibrosis. We used a murine model of bleomycin-induced lung fibrosis to evaluate the feasibility of micro-CT in evaluating the therapeutic potential of rosiglitazone on pulmonary fibrosis, comparing with pathologic scores. On micro-CT findings, ground glass opacity (80%) and consolidation (20%) were observed predominantly at 3 weeks after the instillation of bleomycin, and the radiologic features became more complex at 6 weeks. In bleomycin-instilled mice treated with rosiglitazone, the majority (80%) showed normal lung features on micro-CT. Radiological-pathologic correlation analyses revealed that ground glass opacity and consolidation were correlated closely with acute inflammation, while reticular opacity was well correlated with histological honeycomb appearance. These results demonstrate that rosiglitazone displays a protective effect on pulmonary fibrosis in mice and that the visualization of bleomycin-induced pulmonary fibrosis using micro-CT is satisfactory to assess the effects of rosiglitazone. It implies that micro-CT can be applied to evaluate therapeutic efficacies of a variety of candidate drugs for lung diseases.

  6. Repurposing rosiglitazone, a PPAR-γ agonist and oral antidiabetic, as an inhaled formulation, for the treatment of PAH.

    Science.gov (United States)

    Rashid, Jahidur; Alobaida, Ahmad; Al-Hilal, Taslim A; Hammouda, Samia; McMurtry, Ivan F; Nozik-Grayck, Eva; Stenmark, Kurt R; Ahsan, Fakhrul

    2018-06-28

    Peroxisome-proliferator-activated-receptor-gamma (PPAR-γ) is implicated, in some capacity, in the pathogenesis of pulmonary arterial hypertension (PAH). Rosiglitazone, an oral antidiabetic and PPAR-γ agonist, has the potential to dilate pulmonary arteries and to attenuate arterial remodeling in PAH. Here, we sought to test the hypothesis that rosiglitazone can be repurposed as inhaled formulation for the treatment of PAH. We have tested this conjecture by preparing and optimizing poly(lactic-co-glycolic) acid (PLGA) based particles of rosiglitazone, assessing the drug particles for pulmonary absorption, investigating the efficacy of the plain versus particulate drug formulation in improving the respiratory hemodynamics in PAH animals, and finally studying the effect of the drug in regulating the molecular markers associated with PAH pathogenesis. The optimized particles were slightly porous and spherical, and released 87.9% ± 6.7% of the drug in 24 h. The elimination half-life of the drug formulated in PLGA particles was 2.5-fold greater than that of the plain drug administered via the same route at the same dose. The optimized formulation, given via the pulmonary route, produced pulmonary selective vasodilation in PAH animals, but oral rosiglitazone had no effect in pulmonary hemodynamics. Rosiglitazone ameliorates the pathogenesis of PAH by balancing the molecular regulators involved in the vasoconstriction and vasodilation of human pulmonary arterial smooth muscle cells. All in all, data generated using intact animal and cellular models point to the conclusion that PLGA particles of an antidiabetic drug can be used for the treatment of a different disease, PAH. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Effectiveness of rosiglitazone on bleomycin-induced lung fibrosis: Assessed by micro-computed tomography and pathologic scores

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Gong Yong; Bok, Se Mi; Han, Young Min [Department of Radiology, Chonbuk National University Medical School, Jeonju (Korea, Republic of); Chung, Myung Ja [Department of Pathology, Chonbuk National University Medical School, Jeonju (Korea, Republic of); Yoon, Kwon-Ha [Department of Radiology, Iksan Hospital, Iksan (Korea, Republic of); Kim, So Ri [Department of Internal Medicine and Research Center for Pulmonary Disorders, Chonbuk National University Medical School, Jeonju (Korea, Republic of); Lee, Yong Chul, E-mail: leeyc@jbnu.ac.kr [Department of Internal Medicine and Research Center for Pulmonary Disorders, Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2012-08-15

    Peroxisome proliferator-activated receptor-{gamma} (PPAR{gamma}) agonists exhibit potent anti-fibrotic effects in the lung and other tissues. Recently, micro-computed tomography (CT) has been a useful tool for the investigation of lung diseases in small animals and is now increasingly applied to visualize and quantify the pulmonary structures. However, there is little information on the assessment for therapeutic effects of PPAR{gamma} agonists on the pulmonary fibrosis in mice using micro-CT. This study was aimed to determine the capability of micro-CT in examining the effects of rosiglitazone on pulmonary fibrosis. We used a murine model of bleomycin-induced lung fibrosis to evaluate the feasibility of micro-CT in evaluating the therapeutic potential of rosiglitazone on pulmonary fibrosis, comparing with pathologic scores. On micro-CT findings, ground glass opacity (80%) and consolidation (20%) were observed predominantly at 3 weeks after the instillation of bleomycin, and the radiologic features became more complex at 6 weeks. In bleomycin-instilled mice treated with rosiglitazone, the majority (80%) showed normal lung features on micro-CT. Radiological-pathologic correlation analyses revealed that ground glass opacity and consolidation were correlated closely with acute inflammation, while reticular opacity was well correlated with histological honeycomb appearance. These results demonstrate that rosiglitazone displays a protective effect on pulmonary fibrosis in mice and that the visualization of bleomycin-induced pulmonary fibrosis using micro-CT is satisfactory to assess the effects of rosiglitazone. It implies that micro-CT can be applied to evaluate therapeutic efficacies of a variety of candidate drugs for lung diseases.

  8. Interactions of Rosiglitazone and Anti.Arrhythmic Drugs in Animal ...

    African Journals Online (AJOL)

    Interactions of Rosiglitazone and Anti.Arrhythmic Drugs in Animal Model. YM Mohammed, EI Mohammed, N Mohiuddin, SS Syeda. Abstract. Background: Diabetes increases the risk of vascular problems by two times compared with a healthy individual, with deposition of fats in blood vessel and this includes cardiovascular ...

  9. Rosiglitazone and Cardiovascular Risk – A Review | Isa | Bayero ...

    African Journals Online (AJOL)

    The thiazolidinediones (TZDs) are a class of oral drugs used for the management of type 2 diabetes mellitus and act as ligands for the transcription factor Peroxisome Proliferator-Activated Receptor gamma (PPARγ). Rosiglitazone, an example of TZD, is an anti-diabetic agent acting as a potent insulin sensitizer and is used ...

  10. Rosiglitazone treatment of patients with extreme insulin resistance and diabetes mellitus due to insulin receptor mutations has no effects on glucose and lipid metabolism

    DEFF Research Database (Denmark)

    Vestergaard, H; Lund, S; Pedersen, O

    2001-01-01

    Rosiglitazone, a thiazolidinedione (TZD), increases insulin sensitivity by reducing levels of plasma NEFA, triglycerides (TG), glucose and serum insulin. Rosiglitazone treatment decreases insulin resistance in type 2 diabetic patients, but no data exist concerning rosiglitazone treatment...

  11. Synergic effect of n-3 polyunsaturated fatty acids and rosiglitazone in the amelioration of insulin resistance and adipose tissue inflammatinon

    Czech Academy of Sciences Publication Activity Database

    Kuda, Ondřej; Jílková, Zuzana; Rossmeisl, Martin; Flachs, Pavel; Ogston, N. C.; Mohamed-Ali, V.; Cinti, S.; Kopecký, Jan

    2007-01-01

    Roč. 50, Suppl.1 (2007), S260-S260 ISSN 0012-186X. [Annual Meeting of the European Association for the Study of Diabetes /43./. 18.09.2007-21.09.2007, Amsterdam] R&D Projects: GA ČR(CZ) GD303/03/H065 Institutional research plan: CEZ:AV0Z50110509 Keywords : cpo1 * insulin * rosiglitazone * PUFA Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition

  12. Adverse drug effects observed with vildagliptin versus pioglitazone or rosiglitazone in the treatment of patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Bundhun, Pravesh Kumar; Janoo, Girish; Teeluck, Abhishek Rishikesh; Huang, Feng

    2017-10-23

    Vildagliptin and pioglitazone/rosiglitazone are emerging Oral Hypoglycemic Agents (OHAs) which are used to treat patients suffering from Type 2 Diabetes Mellitus (T2DM). In this analysis, we aimed to systematically compare the adverse drug events which were observed with the use of vildagliptin versus pioglitazone or rosiglitazone respectively. Online databases were searched for studies comparing vildagliptin with pioglitazone/rosiglitazone. Adverse drug events were considered as the clinical endpoints in this analysis. We calculated Odds Ratios (OR) with 95% Confidence Intervals (CIs) using the RevMan 5.3 software. All the authors had full access to the data which were used and approved the final version of the manuscript. A total number of 2396 patients were analyzed (1486 and 910 patients were treated with vildagliptin and pioglitazone/rosiglitazone respectively). Vildagliptin and pioglitazone/rosiglitazone were both associated with similar overall adverse drug events (OR: 1.00, 95% CI: 0.81-1.24; P = 1.00). Headache (OR: 0.88, 95% CI: 0.60-1.27; P = 0.49) and upper respiratory tract infection (OR: 0.95, 95% CI: 0.71-1.27; P = 0.75) were similarly observed. However, dizziness was significantly lower with pioglitazone/rosiglitazone (OR: 0.63, 95% CI: 0.43-0.92; P = 0.02). Back pain, diarrhea and nausea were insignificantly lower with pioglitazone/rosiglitazone (OR: 0.81, 95% CI: 0.49-1.33; P = 0.40), (OR: 0.83, 95% CI: 0.48-1.44; P = 0.52) and (OR: 0.52, 95% CI: 0.25-1.05; P = 0.07) respectively, whereas peripheral edema and weight gain were insignificantly higher (OR: 1.21, 95% CI: 0.56-2.62; P = 0.63) and (OR: 2.29, 95% CI: 0.51-10.34; P = 0.28) respectively. Nevertheless, when pioglitazone and rosiglitazone were separately compared with vildagliptin, peripheral edema and weight gain were significantly higher with rosiglitazone (OR: 2.36, 95% CI: 1.40-3.99; P = 0.001) and (OR: 5.20, 95% CI: 2.47-10.92; P = 0.0001) respectively. Both

  13. Effect of rosiglitazone on insulin resistance, growth factors, and reproductive disturbances in women with polycystic ovary syndrome.

    Science.gov (United States)

    Belli, Susana H; Graffigna, Mabel N; Oneto, Adriana; Otero, Patricia; Schurman, Leon; Levalle, Oscar A

    2004-03-01

    To evaluate the effects of rosiglitazone on insulin resistance, growth factors, and reproductive disturbances in women with polycystic ovary syndrome (PCOS). Prospective study. Women with PCOS attending as outpatients of the Endocrine Division, Hospital Durand, Buenos Aires. Twenty-four insulin-resistant women with PCOS. Hormonal evaluations and a standardized oral glucose tolerance test before and after a 3-month trial of 4 mg of rosiglitazone daily. Serum LH, FSH, T, IGF-1, IGFBP-1, IGFBP-3, leptin, 17alpha-hydroxyprogesterone, insulin, and glucose concentrations. The area under insulin curve (AUC-insulin), the HOMA index (insulin resistance), the QUICKI index (insulin sensitivity), and the beta-cell function were calculated. Body mass index (BMI) and the waist/hip ratio were evaluated. A significant decrease was observed in serum fasting insulin, AUC insulin, HOMA index, beta-cell function, IGF-1, LH, and waist/hip ratio. The QUICKI index and IGFBP-1 increased significantly. Serum sex hormone-binding globulin, androgens, leptin, IGFBP-3, and BMI remained unchanged. Twenty-two of 23 females had their menses restored, and three patients became pregnant. One patient was excluded because she became pregnant at the second month. Associated with the decrease in LH, rosiglitazone improved insulin-resistance parameters and normalized the menstrual cycle, which suggests that this drug could improve the endocrine-reproductive condition in insulin-resistant women with PCOS.

  14. Studies in perpendicular magnetic recording

    Science.gov (United States)

    Valcu, Bogdan F.

    This dissertation uses both micromagnetic simulation and analytical methods to analyze several aspects of a perpendicular recording system. To increase the head field amplitude, the recording layer is grown on top of a soft magnetic layer (keeper). There is concern about the ability of the keeper to conduct the magnetic flux from the head at high data rates. We compute numerically the magnetization motion of the soft underlayer during the reversal process. Generation of non-linear spin waves characterizes the magnetization dynamics in the keeper, the spins are oscillating with a frequency higher than that of the reversal current. However, the recording field applied to the data layer follows the time dependence of the input wave form. The written transition shape is determined by the competition between the head field gradient and the demagnetizing field gradient. An analytical slope model that takes into consideration the angular orientation of the applied field is used to estimate the transition parameter; agreement is shown with the micromagnetic results. On the playback side, the reciprocity principle is applied to calculate the read out signal from a single magnetic transition in the perpendicular medium. The pulse shape is close to an error-function, going through zero when the sensor is above the transition center and decaying from the peak to an asymptotic value when the transition center is far away. Analytical closed forms for both the slope in the origin and the asymptotic value show the dependence on the recording geometry parameters. The Signal-to-Noise Ratio is calculated assuming that the noise is dominated by the medium jitter. To keep the SNR at a readable level while increasing the areal density, the average magnetic grain diameter must decrease; consequently grain size fluctuations will affect the thermal decay. We performed Transmission Electron Microscopy measurements and observed differences in the grain size distribution between various types

  15. De besluitvorming over werkzaamheid en veiligheid van rosiglitazon bij de FDA en de EMA. Wat zijn de lessen?

    NARCIS (Netherlands)

    Pouwels, Koen; Van Grootheest, Kees

    2013-01-01

    The rosiglitazone decision process at FDA and EMA. What should we learn? In September 2010 the EMA decided to suspend the market authorisation of rosiglitazone while the FDA decided to restrict its use. These actions were taken because rosiglitazone had been associated with an increased risk of

  16. Insulin Sensitizing and Antioxidant Effects of Hesperidin and Low Dose Gamma Irradiation in Combination with Rosiglitazone in Type 2 Diabetic Rats

    International Nuclear Information System (INIS)

    Morcos, N.Y.; Abdel-Ghaffar, A.B.; Osman, S.A.; Mohamed, M.Kh.; Arbid, M.S.; El-Eraky, W.I.

    2012-01-01

    The present study was designed to investigate the possible ameliorative effect of hesperidin and low dose fÁ-irradiation (LDR) in combination with rosiglitazone in an experimental model of insulin resistance. Type 2 diabetes mellitus (T2DM) was induced in rats by single intraperitoneal injection of streptozotocin (STZ) followed by nicotinamide (NIC) (65 and 110 mg/kg b.wt; i.p respectively). After verifying T2DM in rats, they were subjected to LDR (50 cGy) and then treated with rosiglitazone (4 mg/kg b.wt; p.o) and hesperidin (100 mg/kg b.wt; p.o) for 30 days. Results showed that STZ injection significantly elevated blood glucose, glycosylated hemoglobin (HbA1c), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipid peroxides (TBARS; MDA) accompanied with a reduction in adiponectin plasma level, reduced glutathione (GSH) and superoxide dismutase (SOD) serum level. Treatment of diabetic rats with rosiglitazone, hesperidin and LDR significantly reduced blood glucose, HbA1c, insulin, HOMA-IR and MDA levels. Whereas, plasma adiponectin, SOD in serum and GSH plasma level were significantly elevated. Therefore, our data suggest that hesperidin and LDR might be useful adjuvants with rosiglitazone and attenuate insulin resistance and oxidative stress in T2DM.

  17. Resistin production from adipose tissue is decreased in db/db obese mice, and is reversed by rosiglitazone.

    Directory of Open Access Journals (Sweden)

    Hongying Ye

    Full Text Available OBJECTIVE: This study was designed to (1 investigate the expression profiles of resistin in db/db mice and its dynamic association with metabolic parameters; and (2 evaluate the effects of Rosiglitazone on production of resistin. METHODS: Db/db mice and their lean litter mates were used for this study. Epididymal fat tissue was excised from mice of different age (from 5 to 12 weeks for ex vivo incubation. Resistin,along with adiponectin,in serum and conditioned culture medium of epididymal fat pads were measured with immunoassays. The gene expression of resistin was determined by real-time PCR. Rosiglitazone or the vehicle (PBS was administered into db/db mice by daily intra-gastric gavage. Differentiated 3T3-L1 adipocytes were used for in vitro evaluation. RESULTS: The secretion of resistin from the fat pads in db/db mice was significantly lower than that in lean mice (P<0.01. The mRNA expression of the resistin gene in fat tissue of db/db mice at the age of 5 weeks was decreased by 60.5% compared to lean controls (p<0.05. Serum levels of resistin were comparable between the obese and lean groups, perhaps due to the increased total fat mass in db/db mice. Correlation analysis showed that serum resistin levels were positively correlated to resistin secretion from fat pads(r = 0.844,P = 0.000, while negatively associated with the body weight (r = -0.515, P = 0.000 and fasting glucose level (r = -0.357, P = 0.002. Notably, treatment with rosiglitazone increased the serum resistin levels by 66.4%(P<0.05in db/db mice. In 3T3-L1 adipocytes, Rosiglitazone (10 uM markedly enhanced the secretion of resistin by 120% (P<0.01 and its gene expression by 78.1% (P<0.05. CONCLUSION: Both resistin gene expression and its secretion from the epididymal adipose tissue were decreased in db/db obese mice, while the insulin-sensitizing drug rosiglitazone increased resistin production. Our results do not support the role of resistin as an

  18. Recombinant human growth hormone and rosiglitazone for abdominal fat accumulation in HIV-infected patients with insulin resistance: a randomized, double-blind, placebo-controlled, factorial trial.

    Directory of Open Access Journals (Sweden)

    Marshall J Glesby

    Full Text Available Recombinant human growth hormone (rhGH reduces visceral adipose tissue (VAT volume in HIV-infected patients but can worsen glucose homeostasis and lipoatrophy. We aimed to determine if adding rosiglitazone to rhGH would abrogate the adverse effects of rhGH on insulin sensitivity (SI and subcutaneous adipose tissue (SAT volume.Randomized, double-blind, placebo-controlled, multicenter trial using a 2×2 factorial design in which HIV-infected subjects with abdominal obesity and insulin resistance were randomized to rhGH 3 mg daily, rosiglitazone 4 mg twice daily, combination rhGH + rosiglitazone, or double placebo (control for 12 weeks. The primary endpoint was change in SI by frequently sampled intravenous glucose tolerance test from entry to week 12. Body composition was assessed by whole body magnetic resonance imaging (MRI and dual Xray absorptiometry (DEXA. Seventy-seven subjects were randomized of whom 72 initiated study drugs. Change in SI from entry to week 12 differed across the 4 arms by 1-way ANCOVA (P = 0.02; by pair-wise comparisons, only rhGH (decreasing SI; P = 0.03 differed significantly from control. Changes from entry to week 12 in fasting glucose and glucose area under the curve on 2-hour oral glucose tolerance test differed across arms (1-way ANCOVA P = 0.004, increasing in the rhGH arm relative to control. VAT decreased significantly in the rhGH arms (-17.5% in rhGH/rosiglitazone and -22.7% in rhGH but not in the rosiglitazone alone (-2.5% or control arms (-1.9%. SAT did not change significantly in any arm. DEXA results were consistent with the MRI data. There was no significant rhGH x rosiglitazone interaction for any body composition parameter.The addition of rosiglitazone abrogated the adverse effects of rhGH on insulin sensitivity and glucose tolerance while not significantly modifying the lowering effect of rhGH on VAT.Clinicaltrials.gov NCT00130286.

  19. Recombinant human growth hormone and rosiglitazone for abdominal fat accumulation in HIV-infected patients with insulin resistance: a randomized, double-blind, placebo-controlled, factorial trial.

    Science.gov (United States)

    Glesby, Marshall J; Albu, Jeanine; Chiu, Ya-Lin; Ham, Kirsis; Engelson, Ellen; He, Qing; Muthukrishnan, Varalakshmi; Ginsberg, Henry N; Donovan, Daniel; Ernst, Jerry; Lesser, Martin; Kotler, Donald P

    2013-01-01

    Recombinant human growth hormone (rhGH) reduces visceral adipose tissue (VAT) volume in HIV-infected patients but can worsen glucose homeostasis and lipoatrophy. We aimed to determine if adding rosiglitazone to rhGH would abrogate the adverse effects of rhGH on insulin sensitivity (SI) and subcutaneous adipose tissue (SAT) volume. Randomized, double-blind, placebo-controlled, multicenter trial using a 2×2 factorial design in which HIV-infected subjects with abdominal obesity and insulin resistance were randomized to rhGH 3 mg daily, rosiglitazone 4 mg twice daily, combination rhGH + rosiglitazone, or double placebo (control) for 12 weeks. The primary endpoint was change in SI by frequently sampled intravenous glucose tolerance test from entry to week 12. Body composition was assessed by whole body magnetic resonance imaging (MRI) and dual Xray absorptiometry (DEXA). Seventy-seven subjects were randomized of whom 72 initiated study drugs. Change in SI from entry to week 12 differed across the 4 arms by 1-way ANCOVA (P = 0.02); by pair-wise comparisons, only rhGH (decreasing SI; P = 0.03) differed significantly from control. Changes from entry to week 12 in fasting glucose and glucose area under the curve on 2-hour oral glucose tolerance test differed across arms (1-way ANCOVA P = 0.004), increasing in the rhGH arm relative to control. VAT decreased significantly in the rhGH arms (-17.5% in rhGH/rosiglitazone and -22.7% in rhGH) but not in the rosiglitazone alone (-2.5%) or control arms (-1.9%). SAT did not change significantly in any arm. DEXA results were consistent with the MRI data. There was no significant rhGH x rosiglitazone interaction for any body composition parameter. The addition of rosiglitazone abrogated the adverse effects of rhGH on insulin sensitivity and glucose tolerance while not significantly modifying the lowering effect of rhGH on VAT. Clinicaltrials.gov NCT00130286.

  20. Drospirenone/ethinyl estradiol versus rosiglitazone treatment in overweight adolescents with polycystic ovary syndrome: comparison of metabolic, hormonal, and cardiovascular risk factors.

    Science.gov (United States)

    Tfayli, Hala; Ulnach, Julia Warren; Lee, SoJung; Sutton-Tyrrell, Kim; Arslanian, Silva

    2011-05-01

    Adolescents with polycystic ovary syndrome (PCOS) have insulin resistance and higher rates of the metabolic syndrome. Our objective was to compare the effects of 6 months treatment with drospirenone/ethinyl estradiol (EE) (3 mg/30 μg) vs. rosiglitazone (4 mg) daily on the hormonal and cardiometabolic profiles of overweight/obese adolescents with PCOS. We conducted a randomized, double-blinded, parallel clinical trial in an academic hospital, with n = 46 patients. The primary outcome measure was insulin sensitivity, hepatic with [6,6-(2)H(2)]glucose and peripheral with a 3-h hyperinsulinemic-euglycemic clamp. Other outcome measures included plasma androgen profile and response to ACTH stimulation, glucose and insulin response to oral glucose tolerance test, insulin secretion with a 2-h hyperglycemic clamp, fasting lipid profile, inflammatory markers, intima media thickness, aortic pulse wave velocity, body composition by dual-energy x-ray absorptiometry, and abdominal adiposity by computed tomography scan. Drospirenone/EE resulted in greater reductions in androgenemia. Neither treatment led to change in weight or body mass index, but rosiglitazone led to a significant decrease in visceral adiposity. Compared with drospirenone/EE, treatment with rosiglitazone improved hepatic and peripheral insulin sensitivity and lowered fasting and stimulated insulin levels during the oral glucose tolerance test. Treatment with drospirenone/EE was associated with elevations in total cholesterol, high-sensitivity C-reactive protein and leptin concentrations, whereas treatment with rosiglitazone led to lower triglycerides and higher adiponectin concentrations. Neither treatment affected intima media thickness or pulse wave velocity. In overweight/obese adolescents with PCOS, 6 months treatment with rosiglitazone was superior to drospirenone/EE in improving the cardiometabolic risk profile, and effective but inferior in attenuating hyperandrogenemia. Additional studies are needed to

  1. Two different spectrofluorimetric methods for simultaneous determination of gemfibrozil and rosiglitazone in human plasma.

    Science.gov (United States)

    El-Din, Mohie M K Sharaf; Attia, Khalid A M; Nassar, Mohamed W I; Kaddah, Mohamed M Y

    2010-10-15

    Two accurate, reliable, and highly sensitive spectrofluorimetric methods were developed for simultaneous determination of binary mixture gemfibrozil and rosiglitazone in human plasma without prior separation steps. The first method is based on synchronous fluorescence spectrometry using double scans. At Δλ=27nm, gemfibrozil yields detectable signal that is independent of the presence of rosiglitazone. Similarly, at Δλ=120nm the signal of rosiglitazone is not influenced by the presence of gemfibrozil. Signals at two wavelengths, 301 (Δλ=27nm) and 368nm (Δλ=120nm) vary linearly with gemfibrozil and rosiglitazone concentrations over the range 100-700ngmL(-1) (for gemfibrozil) and 20-140ngmL(-1) (for rosiglitazone), respectively. The limits of detection (LOD) were 2.3 and 2.72ngmL(-1) for gemfibrozil and rosiglitazone, respectively. The second method is based on the technique of simultaneous equations (Vierodt's method), in which 258nm was selected as the excitation wavelength. Two equations are constructed based on the fact that at ( λ(EM)₂=302 nm of gemfibrozil) and (λ(EM)₂=369 nm of rosiglitazone) the fluorescence of the mixture is the sum of the individual fluorescence of gemfibrozil and rosiglitazone. The limits of detection (LOD) were 28.1 and 23.63ngmL(-1) for gemfibrozil and rosiglitazone, respectively. The proposed methods were successfully applied for the determination of the two compounds in synthetic mixtures and in human plasma with a good recovery. Copyright © 2010 Elsevier B.V. All rights reserved.

  2. Effects of metformin, rosiglitazone and insulin on bone metabolism in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Stage, Tore Bjerregaard; Christensen, Mette-Marie Hougaard; Jørgensen, Niklas Rye

    2018-01-01

    BACKGROUND: Fracture risk is increased in individuals with type 2 diabetes (T2D). The pathophysiological mechanisms accentuating fracture risk in T2D are convoluted, incorporating factors such as hyperglycaemia, insulinopenia, and antidiabetic drugs. The objectives of this study were to assess...... treatment in 371 T2D patients. Participants were randomized to short or long-acting human insulin (non-blinded) and then further randomized to metformin + placebo, rosiglitazone + placebo, metformin + rosiglitazone or placebo + placebo (blinded). Fasting bone turnover markers (BTM) representing bone......-up of the trial were analysed in mixed-effects models that included adjustments for age, gender, BMI, renal function and repeated measures of HbA1c. RESULTS: BTMs increased from baseline to month 12 and remained higher at month 24, with CTX and PINP increasing 28.5% and 23.0% (all: p 

  3. Rosiglitazone Suppresses In Vitro Seizures in Hippocampal Slice by Inhibiting Presynaptic Glutamate Release in a Model of Temporal Lobe Epilepsy.

    Directory of Open Access Journals (Sweden)

    Shi-Bing Wong

    Full Text Available Peroxisomal proliferator-activated receptor gamma (PPARγ is a nuclear hormone receptor whose agonist, rosiglitazone has a neuroprotective effect to hippocampal neurons in pilocarpine-induced seizures. Hippocampal slice preparations treated in Mg2+ free medium can induce ictal and interictal-like epileptiform discharges, which is regarded as an in vitro model of N-methyl-D-aspartate (NMDA receptor-mediated temporal lobe epilepsy (TLE. We applied rosiglitazone in hippocampal slices treated in Mg2+ free medium. The effects of rosiglitazone on hippocampal CA1-Schaffer collateral synaptic transmission were tested. We also examined the neuroprotective effect of rosiglitazone toward NMDA excitotoxicity on cultured hippocampal slices. Application of 10 μM rosiglitazone significantly suppressed amplitude and frequency of epileptiform discharges in CA1 neurons. Pretreatment with the PPARγ antagonist GW9662 did not block the effect of rosiglitazone on suppressing discharge frequency, but reverse the effect on suppressing discharge amplitude. Application of rosiglitazone suppressed synaptic transmission in the CA1-Schaffer collateral pathway. By miniature excitatory-potential synaptic current (mEPSC analysis, rosiglitazone significantly suppressed presynaptic neurotransmitter release. This phenomenon can be reversed by pretreating PPARγ antagonist GW9662. Also, rosiglitazone protected cultured hippocampal slices from NMDA-induced excitotoxicity. The protective effect of 10 μM rosiglitazone was partially antagonized by concomitant high dose GW9662 treatment, indicating that this effect is partially mediated by PPARγ receptors. In conclusion, rosiglitazone suppressed NMDA receptor-mediated epileptiform discharges by inhibition of presynaptic neurotransmitter release. Rosiglitazone protected hippocampal slice from NMDA excitotoxicity partially by PPARγ activation. We suggest that rosiglitazone could be a potential agent to treat patients with TLE.

  4. Resistin production from adipose tissue is decreased in db/db obese mice, and is reversed by rosiglitazone.

    Science.gov (United States)

    Ye, Hongying; Zhang, Herbert J; Xu, Aimin; Hoo, Ruby L C

    2013-01-01

    This study was designed to (1) investigate the expression profiles of resistin in db/db mice and its dynamic association with metabolic parameters; and (2) evaluate the effects of Rosiglitazone on production of resistin. Db/db mice and their lean litter mates were used for this study. Epididymal fat tissue was excised from mice of different age (from 5 to 12 weeks) for ex vivo incubation. Resistin,along with adiponectin,in serum and conditioned culture medium of epididymal fat pads were measured with immunoassays. The gene expression of resistin was determined by real-time PCR. Rosiglitazone or the vehicle (PBS) was administered into db/db mice by daily intra-gastric gavage. Differentiated 3T3-L1 adipocytes were used for in vitro evaluation. The secretion of resistin from the fat pads in db/db mice was significantly lower than that in lean mice (Plean controls (plean groups, perhaps due to the increased total fat mass in db/db mice. Correlation analysis showed that serum resistin levels were positively correlated to resistin secretion from fat pads(r = 0.844,P = 0.000), while negatively associated with the body weight (r = -0.515, P = 0.000) and fasting glucose level (r = -0.357, P = 0.002). Notably, treatment with rosiglitazone increased the serum resistin levels by 66.4%(Pproduction. Our results do not support the role of resistin as an etiological link between obesity and diabetes.

  5. Topical Rosiglitazone Treatment Improves Ulcerative Colitis by Restoring Peroxisome Proliferator-Activated Receptor-gamma Activity

    DEFF Research Database (Denmark)

    Pedersen, G.; Brynskov, Jørn

    2010-01-01

    and functional activity in human colonic epithelium and explored the potential of topical treatment with rosiglitazone (a PPAR gamma ligand) in patients with ulcerative colitis. METHODS: Spontaneous and rosiglitazone-mediated PPAR gamma and adipophillin expression (a gene transcriptionally activated by PPAR...... for 14 days. RESULTS: PPAR gamma expression was fourfold reduced in epithelial cells from inflamed compared with uninflamed mucosa and controls. Adipophillin levels were decreased in parallel. Rosiglitazone induced a concentration-dependent increase in adipophillin levels and restored PPAR gamma activity...... in epithelial cells from inflamed mucosa in vitro. Rosiglitazone enema treatment was well tolerated and reduced the Mayo ulcerative colitis score from 8.9 to 4.3 (P levels in the epithelial cells of the patients, indicating PPAR...

  6. Exposure to rosiglitazone, a PPAR-γ agonist, in late gestation reduces the abundance of factors regulating cardiac metabolism and cardiomyocyte size in the sheep fetus.

    Science.gov (United States)

    Lie, Shervi; Hui, Melisa; McMillen, I Caroline; Muhlhausler, Beverly S; Posterino, Giuseppe S; Dunn, Stacey L; Wang, Kimberley C; Botting, Kimberley J; Morrison, Janna L

    2014-03-15

    It is unknown whether cardiomyocyte hypertrophy and the transition to fatty acid oxidation as the main source of energy after birth is dependent on the maturation of the cardiomyocytes' metabolic system, or on the limitation of substrate availability before birth. This study aimed to investigate whether intrafetal administration of a peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist, rosiglitazone, during late gestation can stimulate the expression of factors regulating cardiac growth and metabolism in preparation for birth, and the consequences of cardiac contractility in the fetal sheep at ∼140 days gestation. The mRNA expression and protein abundance of key factors regulating growth and metabolism were quantified using quantitative RT-PCR and Western blot analysis, respectively. Cardiac contractility was determined by measuring the Ca(2+) sensitivity and maximum Ca(2+)-activated force of skinned cardiomyocyte bundles. Rosiglitazone-treated fetuses had a lower cardiac abundance of insulin-signaling molecules, including insulin receptor-β, insulin receptor substrate-1 (IRS-1), phospho-IRS-1 (Tyr-895), phosphatidylinositol 3-kinase (PI3K) regulatory subunit p85, PI3K catalytic subunit p110α, phospho-3-phosphoinositide-dependent protein kinase 1 (Ser-241), protein kinase B (Akt-1), phospho-Akt (Ser-273), PKCζ, phospho-PKCζ(Thr-410), Akt substrate 160 kDa (AS160), phospho-AS160 (Thr-642), and glucose transporter type-4. Additionally, cardiac abundance of regulators of fatty acid β-oxidation, including adiponectin receptor 1, AMPKα, phospho-AMPKα (Thr-172), phospho-acetyl CoA carboxylase (Ser-79), carnitine palmitoyltransferase-1, and PGC-1α was lower in the rosiglitazone-treated group. Rosiglitazone administration also resulted in a decrease in cardiomyocyte size. Rosiglitazone administration in the late-gestation sheep fetus resulted in a decreased abundance of factors regulating cardiac glucose uptake, fatty acid β-oxidation, and

  7. Case study: Managing potentially contaminated records

    International Nuclear Information System (INIS)

    Sprouse, B.S.

    1993-06-01

    For the past 10 or more years, Analytical Laboratory data cards have been generated and stored in the 222-S Laboratory at the Hanford Site in Richland, Washington. These cards are classified as record material and require retention for a minimum of 75 years in an approved storage facility in accordance with Westinghouse Hanford Company procedures. The cards are maintained in records boxes in the attic of the 222-S Laboratory and are subject to potential risk and loss. The most significant potential risks are radiological hazards. Various options are available for removal, cataloging, transmittal, and storage of these long-term records. Because the records are currently stored in a radiation protection zone, they surveyed before being released from the facility. This survey can be arduous and time consuming. Resolutions to the problem of removal and proper storage of the records from the facility need to be addressed. The records were reviewed and inventoried to determine the quantity of information. A study of the various options available was conducted, and based on the information collected, it was determined that the most feasible and cost-effective approach is to microfilm the cards inside the laboratory. This option complies with all applicable company requirements and decreases the estimated radiological survey time from approximately 3.5 years to under 40 hours. This activity will result in a potential savings of $350,000 over the life of the activity

  8. Rosiglitazone attenuates NF-κB-dependent ICAM-1 and TNF-α production caused by homocysteine via inhibiting ERK1/2/p38MAPK activation

    International Nuclear Information System (INIS)

    Bai, Yong-Ping; Liu, Yu-Hui; Chen, Jia; Song, Tao; You, Yu; Tang, Zhen-Yan; Li, Yuan-Jian; Zhang, Guo-Gang

    2007-01-01

    Previous studies demonstrated an important interaction between nuclear factor-kappaB (NF-κB) activation and homocysteine (Hcy)-induced cytokines expression in endothelial cells and vascular smooth muscle cells. However, the underlying mechanism remains illusive. In this study, we investigated the effects of Hcy on NF-κB-mediated sICAM-1, TNF-α production and the possible involvement of ERK 1/2 /p38MAPK pathway. The effects of rosiglitazone intervention were also examined. Our results show that Hcy increased the levels of sICAM-1 and TNF-α in cultured human umbilical vein endothelial cells (HUVECs) in a time- and concentration-dependent manner. This effect was significantly depressed by rosiglitazone and different inhibitors (PDTC, NF-κB inhibitor; PD98059, MEK inhibitor; SB203580, p38MAPK specific inhibitor; and staurosporine, PKC inhibitor). Next, we investigated the effect of Hcy on ERK 1/2 /p38MAPK pathway and NF-κB activity in HUVECs. The results show that Hcy activated both ERK 1/2 /p38MAPK pathway and NF-κB-DNA-binding activity. These effects were markedly inhibited by rosiglitazone as well as other inhibitors (SB203580, PD98059, and PDTC). Further, the pretreatment of staurosporine abrogated ERK 1/2 /p38MAPK phosphorylation, suggesting that Hcy-induced ERK 1/2 /p38MAPK activation is associated with PKC activity. Our results provide evidence that Hcy-induced NF-κB activation was mediated by activation of ERK 1/2 /p38MAPK pathway involving PKC activity. Rosiglitazone reduces the NF-κB-mediated sICAM-1 and TNF-α production induced by Hcy via inhibition of ERK 1/2 /p38MAPK pathway

  9. Evidence Synthesis in Harm Assessment of Medicines Using the Example of Rosiglitazone and Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Charlotte Rietbergen

    2018-02-01

    Full Text Available The current system of harm assessment of medicines has been criticized for relying on intuitive expert judgment. There is a call for more quantitative approaches and transparency in decision-making. Illustrated with the case of cardiovascular safety concerns for rosiglitazone, we aimed to explore a structured procedure for the collection, quality assessment, and statistical modeling of safety data from observational and randomized studies. We distinguished five stages in the synthesis process. In Stage I, the general research question, population and outcome, and general inclusion and exclusion criteria are defined and a systematic search is performed. Stage II focusses on the identification of sub-questions examined in the included studies and the classification of the studies into the different categories of sub-questions. In Stage III, the quality of the identified studies is assessed. Coding and data extraction are performed in Stage IV. Finally, meta-analyses on the study results per sub-question are performed in Stage V. A Pubmed search identified 30 randomized and 14 observational studies meeting our search criteria. From these studies, we identified 4 higher level sub-questions and 4 lower level sub-questions. We were able to categorize 29 individual treatment comparisons into one or more of the sub-question categories, and selected study duration as an important covariate. We extracted covariate, outcome, and sample size information at the treatment arm level of the studies. We extracted absolute numbers of myocardial infarctions from the randomized study, and adjusted risk estimates with 95% confidence intervals from the observational studies. Overall, few events were observed in the randomized studies that were frequently of relatively short duration. The large observational studies provided more information since these were often of longer duration. A Bayesian random effects meta-analysis on these data showed no significant increase

  10. Peroxisome proliferator-activated receptor-gamma agonist rosiglitazone reverses the adverse effects of diet-induced obesity on oocyte quality.

    Science.gov (United States)

    Minge, Cadence E; Bennett, Brenton D; Norman, Robert J; Robker, Rebecca L

    2008-05-01

    Obesity and its physiological consequences are increasingly prevalent among women of reproductive age and are associated with infertility. To investigate, female mice were fed a high-fat diet until the onset of insulin resistance, followed by assessments of ovarian gene expression, ovulation, fertilization, and oocyte developmental competence. We report defects to ovarian function associated with diet-induced obesity (DIO) that result in poor oocyte quality, subsequently reduced blastocyst survival rates, and abnormal embryonic cellular differentiation. To identify critical cellular mediators of ovarian responses to obesity induced insulin resistance, DIO females were treated for 4 d before mating with an insulin-sensitizing pharmaceutical: glucose and lipid-lowering AMP kinase activator, 5-aminoimidazole 4-carboxamide-riboside, 30 mg/kg.d; sodium salicylate, IkappaK inhibitor that reverses insulin resistance, 50 mg/kg.d; or peroxisome proliferator activated receptor-gamma agonist rosiglitazone, 10 mg/kg.d. 5-aminoimidazole 4-carboxamide-riboside or sodium salicylate treatment did not have significant effects on the reproductive parameters examined. However, embryonic development to the blastocyst stage was significantly improved when DIO mice were treated with rosiglitazone, effectively repairing development rates. Rosiglitazone also normalized DIO-associated abnormal blastomere allocation to the inner cell mass. Such improvements to oocyte quality were coupled with weight loss, improved glucose metabolism, and changes in ovarian mRNA expression of peroxisome proliferator activated receptor-regulated genes, Cd36, Scarb1, and Fabp4 cholesterol transporters. These studies demonstrate that peri-conception treatment with select insulin-sensitizing pharmaceuticals can directly influence ovarian functions and ultimately exert positive effects on oocyte developmental competence. Improved blastocyst quality in obese females treated with rosiglitazone before mating

  11. Simple method for the determination of rosiglitazone in human plasma using a commercially available internal standard.

    Science.gov (United States)

    Mamidi, Rao N V S; Benjamin, Biju; Ramesh, Mullangi; Srinivas, Nuggehally R

    2003-09-01

    To the best of our knowledge, bioanalytical methods to determine rosiglitazone in human plasma reported in literature use internal standards that are not commercially available. Our purpose was to develop a simple method for the determination of rosiglitazone in plasma employing a commercially available internal standard (IS). After the addition of celecoxib (IS), plasma (0.25 mL) samples were extracted into ethyl acetate. The residue after evaporation of the organic layer was dissolved in 750 microL of mobile phase and 50 microL was injected on to HPLC. The separation was achieved using a Hichrom KR 100, 250 x 4.6 mm C(18) with a mobile phase composition potassium dihydrogen phosphate buffer (0.01 m, pH 6.5):acetonitrile:methanol (40:50:10, v/v/v). The flow-rate of the mobile phase was set at 1 mL/min. The column eluate was monitored by fluorescence detector set at an excitation wavelength of 247 nm and emission wavelength of 367 nm. Linear relationships (r(2) > 0.99) were observed between the peak area ratio rosiglitazone to IS vs rosiglitazone concentrations across the concentration range 5-1000 ng/mL. The intra-run precision (%RSD) and accuracy (%Dev) in the measurement of rosiglitazone were 80% for both rosiglitazone and IS from human plasma. The lower limit of quantitation of the assay was 5 ng/mL. In summary, the methodology for rosiglitazone measurement in plasma was simple, sensitive and employed a commercially available IS. Copyright 2003 John Wiley & Sons, Ltd.

  12. The role of genetic variants in CYP2C8, LPIN1, PPARGC1A and PPARγ on the trough steady-state plasma concentrations of rosiglitazone and on glycosylated haemoglobin A1c in type 2 diabetes

    DEFF Research Database (Denmark)

    Stage, Tore B; Christensen, Mette M H; Feddersen, Søren

    2013-01-01

    OBJECTIVE: The aim of this study was to examine the effect of single nucleotide polymorphisms in CYP2C8, LPIN1, PPARGC1A and PPARγ on rosiglitazone's (i) trough steady-state plasma concentration (C(ss,min)), (ii) on glycosylated haemoglobin A1c (HbA1c) and (iii) the risk of developing adverse eve...

  13. Inhibitory effect of leptin on rosiglitazone-induced differentiation of primary adipocytes prepared from TallyHO/Jng mice

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Young; Kim, Joo Young; Sung, Yoon-Young; Jung, Won Hoon; Kim, Hee-Youn; Park, Ji Seon; Cheon, Hyae Gyeong [Medicinal Science Division, Korea Research Institute of Chemical Technology, 100 Jang-dong, Yuseong, 305-600 Daejon (Korea, Republic of); Rhee, Sang Dal, E-mail: sdrhee@krict.re.kr [Medicinal Science Division, Korea Research Institute of Chemical Technology, 100 Jang-dong, Yuseong, 305-600 Daejon (Korea, Republic of)

    2011-03-25

    Research highlights: {yields} In this study, we investigated the effects of leptin on adipocyte differentiation prepared from subcutaneous fat of TallyHo mice. {yields} Leptin inhibited the adipocytes differentiation at physiological concentration via inhibition of PPAR{gamma} expression. {yields} Inhibitors of ERK and STAT1 restored the leptin's inhibitory activity both in vitro and in vivo. -- Abstract: The effects of leptin on rosiglitazone-induced adipocyte differentiation were investigated in the primary adipocytes prepared from subcutaneous fat of TallyHO/Jng (TallyHO) mouse, a recently developed model animal for type 2 diabetes mellitus (T2DM). The treatment of leptin inhibited the rosiglitazone-induced adipocyte differentiation with a decreased expression of peroxisome proliferator-activated receptor {gamma} (PPAR{gamma}) a key adipogenic transcription factor, both in mRNA and protein levels. Leptin (10 nM) was sufficient to inhibit the adipocyte differentiation, which seemed to come from increased expression of leptin receptor genes in the fat of TallyHO mice. The inhibition of adipogenesis by leptin was restored by the treatment of inhibitors for extracellular-signal-regulated kinase (ERK) (PD98059) and signal transducer and activator of transcription-1 (STAT1) (fludarabine). Furthermore, in vivo intraperitoneal administration of PD98059 and fludarabine increased the PPAR{gamma} expression in the subcutaneous fat of TallyHO mice. These data suggest that leptin could inhibit the PPAR{gamma} expression and adipocyte differentiation in its physiological concentration in TallyHO mice.

  14. Combination of vildagliptin and rosiglitazone ameliorates nonalcoholic fatty liver disease in C57BL/6 mice.

    Science.gov (United States)

    Mookkan, Jeyamurugan; De, Soumita; Shetty, Pranesha; Kulkarni, Nagaraj M; Devisingh, Vijayaraj; Jaji, Mallikarjun S; Lakshmi, Vinitha P; Chaudhary, Shilpee; Kulathingal, Jayanarayan; Rajesh, Navin B; Narayanan, Shridhar

    2014-01-01

    To evaluate the effect of vildagliptin alone and in combination with metformin or rosiglitazone on murine hepatic steatosis in diet-induced nonalcoholic fatty liver disease (NAFLD). Male C57BL/6 mice were fed with high fat diet (60 Kcal %) and fructose (40%) in drinking water for 60 days to induce NAFLD. After the induction period, animals were divided into different groups and treated with vildagliptin (10 mg/kg), metformin (350 mg/kg), rosiglitazone (10 mg/kg), vildagliptin (10 mg/kg) + metformin (350 mg/kg), or vildagliptin (10 mg/kg) + rosiglitazone (10 mg/kg) orally for 28 days. Following parameters were measured: body weight, food intake, plasma glucose, triglyceride (TG), total cholesterol, liver function tests, and liver TG. Liver histopathology was also examined. Oral administration of vildagliptin and rosiglitazone in combination showed a significant reduction in fasting plasma glucose, hepatic steatosis, and liver TGs. While other treatments showed less or no improvement in the measured parameters. These preliminary results demonstrate that administration of vildagliptin in combination with rosiglitazone could be a promising therapeutic strategy for the treatment of NAFLD.

  15. The Effect of Rosiglitazone on Bone Quality in a Rat Model of Insulin Resistance and Osteoporosis

    Science.gov (United States)

    Sardone, Laura Donata

    Rosiglitazone (RSG) is an insulin-sensitizing drug used to treat Type 2 Diabetes Mellitus (T2DM). Clinical trials show that women taking RSG experience more limb fractures than patients taking other T2DM drugs. The purpose of this study is to understand how RSG (3mg/kg/day and 10mg/kg/day) and the bisphosphonate alendronate (0.7mg/kg/week) alter bone quality in the male, female and female ovariectomized (OVX) Zucker fatty rat model over a 12 week period. Bone quality was evaluated by mechanical testing of cortical and trabecular bone. Microarchitecture, bone mineral density (BMD), cortical bone porosity, bone formation/resorption and mineralization were also measured. Female OVX RSG10mg/kg rats had significantly lower vertebral BMD and compromised trabecular architecture versus OVX controls. Increased cortical porosity and decreased mechanical properties occurred in these rats. ALN treatment prevented these negative effects in the OVX RSG model. Evidence of reduced bone formation and excess bone resorption was detected in female RSG-treated rats.

  16. Rosiglitazone decreases postprandial production of acylation stimulating protein in type 2 diabetics

    Directory of Open Access Journals (Sweden)

    Tan Garry D

    2007-05-01

    Full Text Available Abstract Background We evaluated plasma ASP and its precursor C3 in type 2 diabetic men with/without rosiglitazone (ROSI treatment compared to healthy non-obese men. We tested (1 whether plasma ASP or C3 are altered postprandially in subcutaneous adipose tissue or forearm muscle effluent assessed by arteriovenous (A-V differences in healthy lean men and older obese diabetic men and (2 whether treatment with ROSI changes the arteriovenous gradient of ASP and/or C3. Methods In this ongoing placebo-controlled, crossover, double-blinded study, AV differences following a mixed meal were measured in diabetic men (n = 6 as compared to healthy men (n = 9. Results Postprandial arterial and adipose venous TG and venous NEFA were increased in diabetics vs. controls (p Conclusion Increased postprandial venous production of ASP is specific for adipose tissue (absent in forearm muscle. Increased postprandial C3 and ASP in diabetic subjects is consistent with an ASP resistant state, this state is partially normalized by treatment with ROSI.

  17. Electroacupuncture Reduces Weight Gain Induced by Rosiglitazone through PPARγ and Leptin Receptor in CNS

    Directory of Open Access Journals (Sweden)

    Xinyue Jing

    2016-01-01

    Full Text Available We investigate the effect of electroacupuncture (EA on protecting the weight gain side effect of rosiglitazone (RSG in type 2 diabetes mellitus (T2DM rats and its possible mechanism in central nervous system (CNS. Our study showed that RSG (5 mg/kg significantly increased the body weight and food intake of the T2DM rats. After six-week treatment with RSG combined with EA, body weight, food intake, and the ratio of IWAT to body weight decreased significantly, whereas the ratio of BAT to body weight increased markedly. HE staining indicated that the T2DM-RSG rats had increased size of adipocytes in their IWAT, but EA treatment reduced the size of adipocytes. EA effectively reduced the lipid contents without affecting the antidiabetic effect of RSG. Furthermore, we noticed that the expression of PPARγ gene in hypothalamus was reduced by EA, while the expressions of leptin receptor and signal transducer and activator of transcription 3 (STAT3 were increased. Our results suggest that EA is an effective approach for inhibiting weight gain in T2DM rats treated by RSG. The possible mechanism might be through increased levels of leptin receptor and STAT3 and decreased PPARγ expression, by which food intake of the rats was reduced and RSG-induced weight gain was inhibited.

  18. Gradient HPLC method development and validation for Simultaneous estimation of Rosiglitazone and Gliclazide.

    Directory of Open Access Journals (Sweden)

    Uttam Singh Baghel

    2012-10-01

    Full Text Available Objective: The aim of present work was to develop a gradient RP-HPLC method for simultaneous analysis of rosiglitazone and gliclazide, in a tablet dosage form. Method: Chromatographic system was optimized using a hypersil C18 (250mm x 4.6mm, 5毺 m column with potassium dihydrogen phosphate (pH-7.0 and acetonitrile in the ratio of 60:40, as mobile phase, at a flow rate of 1.0 ml/min. Detection was carried out at 225 nm by a SPD-20A prominence UV/Vis detector. Result: Rosiglitazone and gliclazide were eluted with retention times of 17.36 and 7.06 min, respectively. Beer’s Lambert ’s Law was obeyed over the concentration ranges of 5 to 70 毺 g/ml and 2 to 12 毺 g/ml for rosiglitazone and gliclazide, respectively. Conclusion: The high recovery and low coefficients of variation confirm the suitability of the method for simultaneous analysis of both drugs in a tablets dosage form. Statistical analysis proves that the method is sensitive and significant for the analysis of rosiglitazone and gliclazide in pure and in pharmaceutical dosage form without any interference from the excipients. The method was validated in accordance with ICH guidelines. Validation revealed the method is specific, rapid, accurate, precise, reliable, and reproducible.

  19. Hyper-inflammation and skin destruction mediated by rosiglitazone activation of macrophages in IL-6 deficiency

    DEFF Research Database (Denmark)

    Das, Lopa M; Rosenjack, Julie; Au, Liemin

    2015-01-01

    Injury initiates recruitment of macrophages to support tissue repair; however, excessive macrophage activity may exacerbate tissue damage causing further destruction and subsequent delay in wound repair. Here we show that the peroxisome proliferation-activated receptor-γ agonist, rosiglitazone (R...

  20. Fenofibrate and rosiglitazone improve quality of lipoproteins in patients with type 2 diabetes mellitus

    Czech Academy of Sciences Publication Activity Database

    Vrablík, M.; Dobiášová, Milada; Štulc, T.; Kasalová, Z.; Doležalová, R.; Prázný, M.; Fait, T.; Češka, R.

    2008-01-01

    Roč. 29, č. 1 (2008), s. 146-150 ISSN 0172-780X R&D Projects: GA MZd(CZ) NR8328 Institutional research plan: CEZ:AV0Z50110509 Keywords : fenofibrate * rosiglitazone * type 2 diabetes mellitus Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 1.359, year: 2008

  1. Effects of Rosiglitazone, Glyburide, and Metformin on β-Cell Function and Insulin Sensitivity in ADOPT

    Science.gov (United States)

    Kahn, Steven E.; Lachin, John M.; Zinman, Bernard; Haffner, Steven M.; Aftring, R. Paul; Paul, Gitanjali; Kravitz, Barbara G.; Herman, William H.; Viberti, Giancarlo; Holman, Rury R.

    2011-01-01

    OBJECTIVE ADOPT (A Diabetes Outcome Progression Trial) demonstrated that initial monotherapy with rosiglitazone provided superior durability of glycemic control compared with metformin and glyburide in patients with recently diagnosed type 2 diabetes. Herein, we examine measures of β-cell function and insulin sensitivity from an oral glucose tolerance test (OGTT) over a 4-year period among the three treatments. RESEARCH DESIGN AND METHODS Recently diagnosed, drug-naïve patients with type 2 diabetes (4,360 total) were treated for a median of 4.0 years with rosiglitazone, metformin, or glyburide and were examined with periodic metabolic testing using an OGTT. RESULTS Measures of β-cell function and insulin sensitivity from an OGTT showed more favorable changes over time with rosiglitazone versus metformin or glyburide. Persistent improvements were seen in those who completed 4 years of monotherapy and marked deterioration of β-cell function in those who failed to maintain adequate glucose control with initial monotherapy. CONCLUSIONS The favorable combined changes in β-cell function and insulin sensitivity over time with rosiglitazone appear to be responsible for its superior glycemic durability over metformin and glyburide as initial monotherapy in type 2 diabetes. PMID:21415383

  2. Effects of Rosiglitazone on the Expression of PPAR-γ and on the ...

    African Journals Online (AJOL)

    Purpose: Peroxisome proliferator-activated receptor (PPAR)-γ ligand is known to repress the expression of pro-inflammatory mediators. However, it is unclear how it affects PPAR-γ expression and the inflammatory response in the human lung. We investigated the effects of rosiglitazone (synthetic PPAR-γ ligand) on the ...

  3. Rosiglitazone stimulates the release and synthesis of insulin by enhancing GLUT-2, glucokinase and BETA2/NeuroD expression

    International Nuclear Information System (INIS)

    Kim, Hyo-Sup; Noh, Jung-Hyun; Hong, Seung-Hyun; Hwang, You-Cheol; Yang, Tae-Young; Lee, Myung-Shik; Kim, Kwang-Won; Lee, Moon-Kyu

    2008-01-01

    Peroxisome proliferator-activated receptor (PPAR)-γ is a member of the nuclear receptor superfamily, and its ligands, the thiazolidinediones, might directly stimulate insulin release and insulin synthesis in pancreatic β-cells. In the present study, we examined the effects of rosiglitazone (RGZ) on insulin release and synthesis in pancreatic β-cell (INS-1). Insulin release and synthesis were stimulated by treatment with RGZ for 24 h. RGZ upregulated the expressions of GLUT-2 and glucokinase (GCK). Moreover, it was found that RGZ increased the expression of BETA2/NeuroD gene which could regulate insulin gene expression. These results suggest that RGZ could stimulate the release and synthesis of insulin through the upregulation of GLUT-2, GCK, and BETA2/NeuroD gene expression

  4. Prolonged decrease of adipocyte size after rosiglitazone treatment in high- and low-fat-fed rats.

    Science.gov (United States)

    Johnson, Julia A; Trasino, Steven E; Ferrante, Anthony W; Vasselli, Joseph R

    2007-11-01

    The anti-diabetic thiazolidinediones (TZDs) stimulate adipocyte differentiation and decrease mean adipocyte size. However, whether these smaller, more insulin-sensitive adipocytes maintain their size after TZD therapy is discontinued has not been studied. Adult female Sprague-Dawley rats were fed a low-fat (10% fat) diet or, to elevate body weight (BW), a high-fat (HF) diet (45% fat) for 6 weeks. Rats were initially randomized to groups (n = 12) fed either low-fat or HF diets, with or without the TZD rosiglitazone (ROSI; 5 mg/kg per day), for 6 weeks. ROSI was then discontinued, and all animals were fed HF for another 6 weeks before sacrifice. Retroperitoneal (RP) adipose tissue morphology was determined from tissue collected by serial biopsies before and after 6 weeks of ROSI treatment and at sacrifice. Measures of BW and adiposity did not differ among groups 6 weeks after stopping ROSI treatment. However, during treatment, ROSI in both diets significantly decreased RP adipocyte size and increased RP DNA content, and these effects continued to be observed after discontinuing treatment. ROSI administration also decreased circulating insulin, leptin, and triglycerides and increased circulating adiponectin levels; however, these effects were reversed on stopping treatment. These results demonstrated that TZD-induced effects on adipocyte size and number were maintained after discontinuing treatment, even with consumption of an obesigenic diet. However, additional studies are needed to determine whether TZD-treated animals eventually achieve an adipocyte size similar to that of untreated animals at the expense of a higher BW.

  5. Can modeling of health outcomes facilitate regulatory decision making? The benefit-risk tradeoff for rosiglitazone in 1999 vs. 2007.

    Science.gov (United States)

    Cross, J T; Veenstra, D L; Gardner, J S; Garrison, L P

    2011-03-01

    Rosiglitazone was initially approved for type 2 diabetes monotherapy. We tested health-outcomes modeling as an aid to regulatory decision making by quantifying the incremental net benefit (INB) value of rosiglitazone (relative to a comparator), both at the time of first approval (1999) and at the FDA advisory committee review (2007). Using 1999 data, rosiglitazone was projected to provide an additional 0.639 years of life (0.373 quality-adjusted life years (QALYs)) relative to placebo but a loss of 0.312 years (0.173 QALYs) relative to glyburide, with uncertainty in reduction of hemoglobin A(1c) (HbA(1c)) level having the greatest impact on the benefit-risk profile. By 2007, rosiglitazone was projected to provide an additional 0.222 years (0.091 QALYs) vs. glyburide and 0.026 years vs. metformin (0.009 QALYs). Modeling suggested that the use of rosiglitazone as monotherapy was not initially warranted, given the uncertainty with regard to benefit. Despite similar net benefit (NB) as metformin shown in postmarketing data, residual cardiovascular (CV) concerns did not support the use of rosiglitazone as first-line therapy. We adapted a mathematical diabetes model to estimate NB and uncertainty of diabetes monotherapy.

  6. Structure-activity relationships of rosiglitazone for peroxisome proliferator-activated receptor gamma transrepression.

    Science.gov (United States)

    Toyota, Yosuke; Nomura, Sayaka; Makishima, Makoto; Hashimoto, Yuichi; Ishikawa, Minoru

    2017-06-15

    Anti-inflammatory effects of peroxisome proliferator-activated receptor gamma (PPRAγ) ligands are thought to be largely due to PPARγ-mediated transrepression. Thus, transrepression-selective PPARγ ligands without agonistic activity or with only partial agonistic activity should exhibit anti-inflammatory properties with reduced side effects. Here, we investigated the structure-activity relationships (SARs) of PPARγ agonist rosiglitazone, focusing on transrepression activity. Alkenic analogs showed slightly more potent transrepression with reduced efficacy of transactivating agonistic activity. Removal of the alkyl group on the nitrogen atom improved selectivity for transrepression over transactivation. Among the synthesized compounds, 3l exhibited stronger transrepressional activity (IC 50 : 14μM) and weaker agonistic efficacy (11%) than rosiglitazone or pioglitazone. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Rosiglitazone Reduces Plasma Levels of Inflammatory and Hemostatic Biomarkers and Improves Global Endothelial Function in Habitual Heavy Smokers Without Diabetes Mellitus or Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    I-Chih Chen

    2010-02-01

    Conclusion: Rosiglitazone significantly reduces plasma levels of inflammatory and hemostatic biomarkers, and restores global endothelial dysfunction, independently from insulin sensitization, in healthy smokers.

  8. Effects of rosiglitazone on metabolic parameters and large artery sclerosis in nondiabetic patients with metabolic sydrome

    International Nuclear Information System (INIS)

    Shen Zhenhai; Lu Yun; Feng Yinbo; Jin Xian

    2010-01-01

    Objective: To observe the effects of rosiglitazone on metabolic parameters, carotid intimamedia thickness (IMT), brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) in nondiabetic patients with metabolic syndrome. Methods: Seventy-nine nondiabetic patients with metabolic syndrome were randomly divided into treatment group (n = 41) and control group (n = 38). The patients in treatment group were treated with rosiglitazone on the basis of life-style intervention, those in control group were treated with life-style intervention for 9 months. All patients were followed up every 3 months. Body mass index (BMI) ,waist circumference(WC), systolic blood pressure (SBP), diastolic blood pressure(DBP), fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), highdendity lipoprotein (HDL-C), Low-density lipoprotein (LDL), high sensitivity C-reactive protein (hsCRP), HbA 1 C, fasting insulin (FIns), HOMA-IR, IMT, baPWV and ABI were measured in both groups before treatment and at the 6th, 9th month after treatment. Results: (1) After treatment with rosiglitazone for 6 months, FPG, TG, HDL-C, hsC RP, HbA 1 C, Fins and HOMA-IR in treatment group were improved (P 1 C, Fins and HOMA-IR got further improvement at the 9th month after treatment (P 1 C, Fins and HOMA-IR were changed significantly in treatment group compared to those in control group (P 1 C and HOMA-IR was independently related to the improvement of ABI by multivarient analysis. Conclusion: In nondiabetic patients with metabolic syndrome, rosiglitazone can significantly improve insulin resistance, correct metabolic disorders, has anti-inflammatory effect and retard atherosclerosis at some extent. (authors)

  9. Rosiglitazone delayed weight loss and anorexia while attenuating adipose depletion in mice with cancer cachexia

    OpenAIRE

    Asp, Michelle L.; Tian, Min; Kliewer, Kara L.; Belury, Martha A.

    2011-01-01

    Cachexia is characterized by severe weight loss, including adipose and muscle wasting, and occurs in a large percentage of cancer patients. Insulin resistance contributes to dysregulated metabolism in cachexia and occurs prior to weight loss in mice with colon-26 tumor-induced cachexia. Therefore, we hypothesized that the insulin sensitizer, rosiglitazone, would attenuate the loss of adipose and muscle to result in improved outcomes for mice with late-stage cachexia. Male CD2F1 mice were inoc...

  10. Macrophage PPARγ inhibits Gpr132 to mediate the anti-tumor effects of rosiglitazone

    Science.gov (United States)

    Cheng, Wing Yin; Huynh, HoangDinh; Chen, Peiwen; Peña-Llopis, Samuel; Wan, Yihong

    2016-01-01

    Tumor-associated macrophage (TAM) significantly contributes to cancer progression. Human cancer is enhanced by PPARγ loss-of-function mutations, but inhibited by PPARγ agonists such as TZD diabetes drugs including rosiglitazone. However, it remains enigmatic whether and how macrophage contributes to PPARγ tumor-suppressive functions. Here we report that macrophage PPARγ deletion in mice not only exacerbates mammary tumor development but also impairs the anti-tumor effects of rosiglitazone. Mechanistically, we identify Gpr132 as a novel direct PPARγ target in macrophage whose expression is enhanced by PPARγ loss but repressed by PPARγ activation. Functionally, macrophage Gpr132 is pro-inflammatory and pro-tumor. Genetic Gpr132 deletion not only retards inflammation and cancer growth but also abrogates the anti-tumor effects of PPARγ and rosiglitazone. Pharmacological Gpr132 inhibition significantly impedes mammary tumor malignancy. These findings uncover macrophage PPARγ and Gpr132 as critical TAM modulators, new cancer therapeutic targets, and essential mediators of TZD anti-cancer effects. DOI: http://dx.doi.org/10.7554/eLife.18501.001 PMID:27692066

  11. Comparison of the effects of pioglitazone and rosiglitazone on macrophage foam cell formation

    International Nuclear Information System (INIS)

    Hirakata, Masao; Tozawa, Ryuichi; Imura, Yoshimi; Sugiyama, Yasuo

    2004-01-01

    In order to elucidate the antiatherogenic effects of pioglitazone (a peroxisome proliferator-activated receptor [PPAR]γ agonist with PPARα agonistic activity) and rosiglitazone (a more selective PPARγ agonist), we examined gene expression and cholesteryl ester accumulation in THP-1-derived macrophages. Pioglitazone enhanced the mRNA expression of the proatherogenic factors CD36 and adipophilin, but was approximately 10 times less potent than rosiglitazone. The potencies of the two agents appeared to correspond to their PPARγ agonistic activities in this respect. However, both agents were similarly potent in enhancing the mRNA expression of the antiatherogenic factors liver X receptor α and ATP-binding cassette-transporter A1. Furthermore, both agents enhanced cholesteryl ester hydrolase mRNA expression and inhibited acyl-CoA cholesterol acyltransferase-1 mRNA expression and cholesteryl ester accumulation in macrophages. In this respect, their potencies appeared to correspond to their PPARα agonistic activities. These results suggest that pioglitazone has an equally beneficial effect on antiatherogenic events to rosiglitazone, despite being almost 10 times less potent than a PPARγ agonist

  12. The effects of human CYP2C8 genotype and fluvoxamine on the pharmacokinetics of rosiglitazone in healthy subjects

    DEFF Research Database (Denmark)

    Pedersen, Rasmus S; Damkier, Per; Brosen, Kim

    2006-01-01

    = 0.0066) increase in the AUC(0-infinity) of rosiglitazone, with a geometric mean ratio of 1.21 [95% confidence interval (CI) 1.06-1.39]. The elimination half-life (t(1/2)) was also significantly higher (P = 0.0203) with a geometric mean ratio of 1.38 [95% CI 1.06-1.79]. The coadministration...... of fluvoxamine had no influence on the pharmacokinetics of N-desmethylrosiglitazone. CONCLUSION: The importance of the CYP2C8*3 mutation in the in vivo metabolism of rosiglitazone could not be confirmed. Fluvoxamine increased the AUC(0-infinity) and t(1/2) of rosiglitazone moderately and hence may be a weak...

  13. Determination of glibenclamide, metformin hydrochloride and rosiglitazone maleate by reversed phase liquid chromatographic technique in tablet dosage form

    Directory of Open Access Journals (Sweden)

    Havele Shweta S.

    2014-01-01

    Full Text Available A simple, precise and accurate high performance liquid chromatography (HPLC method was developed for the simultaneous estimation of metformin hydrochloride, rosiglitazone maleate, glibenclamide present in multicomponent dosage forms. Chromatography was performed on a 25 cm × 4.6 mm i.d., 5-μm particle, C18 column with 78:22 (v/v methanol: 20 mM potassium dihydrogen phosphate buffer as mobile phase at a flow rate of 1.0 ml/min and UV detection at 238 nm for metformin hydrochloride, rosiglitazone maleate, and glibenclamide. The total elution time was shorter than 9 min. This method was found to be precise and reproducible. This proposed method was successfully applied for the analysis of metformin hydrochloride, rosiglitazone maleate, glibenclamide as a bulk drug and in pharmaceutical formulation without any interference from the excipients.

  14. Activation of PPAR by Rosiglitazone Does Not Negatively Impact Male Sex Steroid Hormones in Diabetic Rats

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    Mahmoud Mansour

    2009-01-01

    Full Text Available Peroxisome proliferator-activated receptor gamma (PPAR activation decreased serum testosterone (T in women with hyperthecosis and/or polycystic ovary syndrome and reduced the conversion of androgens to estradiol (E2 in female rats. This implies modulation of female sex steroid hormones by PPAR. It is not clear if PPAR modulates sex steroid hormones in diabetic males. Because PPAR activation by thiazolidinedione increased insulin sensitivity in type 2 diabetes, understanding the long term impact of PPAR activation on steroid sex hormones in males is critical. Our objective was to determine the effect of PPAR activation on serum and intratesticular T, luteinizing hormone (LH, follicle stimulating hormone (FSH and E2 concentrations in male Zucker diabetic fatty (ZDF rats treated with the PPAR agonist rosiglitazone (a thiazolidinedione. Treatment for eight weeks increased PPAR mRNA and protein in the testis and elevated serum adiponectin, an adipokine marker for PPAR activation. PPAR activation did not alter serum or intratesticular T concentrations. In contrast, serum T level but not intratesticular T was reduced by diabetes. Neither diabetes nor PPAR activation altered serum E2 or gonadotropins FSH and LH concentrations. The results suggest that activation of PPAR by rosiglitazone has no negative impact on sex hormones in male ZDF rats.

  15. Simpson's paradox visualized: The example of the Rosiglitazone meta-analysis

    Directory of Open Access Journals (Sweden)

    Schumacher Martin

    2008-05-01

    Full Text Available Abstract Background Simpson's paradox is sometimes referred to in the areas of epidemiology and clinical research. It can also be found in meta-analysis of randomized clinical trials. However, though readers are able to recalculate examples from hypothetical as well as real data, they may have problems to easily figure where it emerges from. Method First, two kinds of plots are proposed to illustrate the phenomenon graphically, a scatter plot and a line graph. Subsequently, these can be overlaid, resulting in a overlay plot. The plots are applied to the recent large meta-analysis of adverse effects of rosiglitazone on myocardial infarction and to an example from the literature. A large set of meta-analyses is screened for further examples. Results As noted earlier by others, occurrence of Simpson's paradox in the meta-analytic setting, if present, is associated with imbalance of treatment arm size. This is well illustrated by the proposed plots. The rosiglitazone meta-analysis shows an effect reversion if all trials are pooled. In a sample of 157 meta-analyses, nine showed an effect reversion after pooling, though non-significant in all cases. Conclusion The plots give insight on how the imbalance of trial arm size works as a confounder, thus producing Simpson's paradox. Readers can see why meta-analytic methods must be used and what is wrong with simple pooling.

  16. HOSPITAL INFORMATION SYSTEMS: A STUDY OF ELECTRONIC PATIENT RECORDS

    Directory of Open Access Journals (Sweden)

    Pedro Luiz Cortês

    2011-05-01

    Full Text Available The importance of patient records, also known as medical records, is related to different needs and objectives, as they constitute permanent documents on the health of patients. With the advancement of information technologies and systems, patient records can be stored in databases, resulting in a positive impact on patient care. Based on these considerations, a research question that arises is “what are the benefits and problems that can be seen with the use of electronic versions of medical records?” This question leads to the formulation of the following hypothesis: although problems can be identified during the process of using electronic record systems, the benefits outweigh the difficulties, thereby justifying their use. To respond to the question and test the presented hypothesis, a research study was developed with users of the same electronic record system, consisting of doctors, nurses, and administrative personnel in three hospitals located in the city of São Paulo, Brazil. The results show that, despite some problems in their usage, the benefits of electronic patient records outweigh possible disadvantages.

  17. Rosiglitazone inhibits chlorpyrifos-induced apoptosis via modulation of the oxidative stress and inflammatory response in SH-SY5Y cells

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Eun [Department of Pharmacology, College of Medicine, Hanyang University, Seoul (Korea, Republic of); Hanyang Biomedical Research Institute, Seoul (Korea, Republic of); Park, Jae Hyeon; Jang, Sea Jeong [Hanyang Biomedical Research Institute, Seoul (Korea, Republic of); Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul (Korea, Republic of); Koh, Hyun Chul, E-mail: hckoh@hanyang.ac.kr [Department of Pharmacology, College of Medicine, Hanyang University, Seoul (Korea, Republic of); Hanyang Biomedical Research Institute, Seoul (Korea, Republic of); Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul (Korea, Republic of)

    2014-07-15

    Oxidative stress can lead to expression of inflammatory transcription factors, which are important regulatory elements in the induction of inflammatory responses. One of the transcription factors, nuclear transcription factor kappa-B (NF-κB) plays a significant role in the inflammation regulatory process. Inflammatory cell death has been implicated in neuronal cell death in some neurodegenerative disorders such as Parkinson's disease (PD). In this study, we investigated the molecular mechanisms underlying apoptosis initiated by chlorpyrifos (CPF)-mediated oxidative stress. Based on the cytotoxic mechanism of CPF, we examined the neuroprotective effects of rosiglitazone (RGZ), a peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist, against CPF-induced neuronal cell death. The treatment of SH-SY5Y cells with CPF induced oxidative stress. In addition, CPF activated the p38, JNK and ERK mitogen-activated protein kinases (MAPKs), and induced increases in the inflammatory genes such as COX-2 and TNF-α. CPF also induced nuclear translocation of NF-κB and inhibitors of NF-κB abolished the CPF-induced COX-2 expression. Pretreatment with RGZ significantly reduced ROS generation and enhanced HO-1 expression in CPF-exposed cells. RGZ blocked the activation of both p38 and JNK signaling, while ERK activation was strengthened. RGZ also attenuated CPF-induced cell death through the reduction of NF-κB-mediated proinflammatory factors. Results from this study suggest that RGZ may exert an anti-apoptotic effect against CPF-induced cytotoxicity by attenuation of oxidative stress as well as inhibition of the inflammatory cascade via inactivation of signaling by p38 and JNK, and NF-κB. - Highlights: • CPF induces apoptotic cell death in SH-SY5Y cells • ROS involved in CPF-mediated apoptotic cell death • Inflammation involved in CPF-mediated apoptotic cell death • Rosiglitazone modulates ROS and inflammatory response in CPF-treated cells.

  18. Interactions of Rosiglitazone and Anti‑Arrhythmic Drugs in Animal ...

    African Journals Online (AJOL)

    Background: Diabetes increases the risk of vascular problems by two times compared with a healthy ... Aim: The aim of the study is to compare the influence of Mexiletine and ... analyze mean change in blood glucose between treatments with body weight as co‑variable ... increased the reliability of the results (P < 0.001).

  19. Rosiglitazone inhibits metastasis development of a murine mammary tumor cell line LMM3

    International Nuclear Information System (INIS)

    Magenta, Gabriela; Borenstein, Ximena; Rolando, Romina; Jasnis, María Adela

    2008-01-01

    Activation of peroxisome proliferator-activated receptors γ (PPARγ) induces diverse effects on cancer cells. The thiazolidinediones (TZDs), such as troglitazone and ciglitazone, are PPARγ agonists exhibiting antitumor activities; however, the underlying mechanism remains inconclusive. Rosiglitazone (RGZ), a synthetic ligand of PPARγ used in the treatment of Type 2 diabetes, inhibits growth of some tumor cells and is involved in other processes related to cancer progression. Opposing results have also been reported with different ligands on tumor cells. The purpose of this study was to determine if RGZ and 15d-PGJ 2 induce antitumor effects in vivo and in vitro on the murine mammary tumor cell line LMM3. The effect on LMM3 cell viability and nitric oxide (NO) production of different doses of RGZ, 15-dPGJ 2 , BADGE and GW9662 were determined using the MTS colorimetric assay and the Griess reaction respectively. In vivo effect of orally administration of RGZ on tumor progression was evaluated either on s.c. primary tumors as well as on experimental metastasis. Cell adhesion, migration (wound assay) and invasion in Transwells were performed. Metalloproteinase activity (MMP) was determined by zymography in conditioned media from RGZ treated tumor cells. PPARγ expression was detected by inmunohistochemistry in formalin fixed tumors and by western blot in tumor cell lysates. RGZ orally administered to tumor-bearing mice decreased the number of experimental lung metastases without affecting primary s.c. tumor growth. Tumor cell adhesion and migration, as well as metalloproteinase MMP-9 activity, decreased in the presence of 1 μM RGZ (non-cytotoxic dose). RGZ induced PPARγ protein expression in LMM3 tumors. Although metabolic activity -measured by MTS assay- diminished with 1–100 μM RGZ, 1 μM-treated cells recovered their proliferating capacity while 100 μM treated cells died. The PPARγ antagonist Biphenol A diglicydyl ether (BADGE) did not affect RGZ activity

  20. Beneficial effects of co-enzyme Q10 and rosiglitazone in fructose-induced metabolic syndrome in rats

    Directory of Open Access Journals (Sweden)

    Suzan M. Mansour

    2013-06-01

    Full Text Available Increased fructose consumption is strongly associated with metabolic syndrome (MS. This study was performed to elucidate the role of co-enzyme Q10 (CoQ and/or rosiglitazone (Rosi in fructose induced MS. Four groups of rats (n = 8–10 were fed on fructose-enriched diet (FED for 16 weeks. One served as FED-control while the remaining groups were treated with CoQ (10 mg/kg/day, Rosi (4 mg/kg/day or their combination during the last 6 weeks. Another group was fed on normal laboratory chow (normal control. At the end of the experiment, blood samples were collected for estimation of markers related to MS. In addition, histological examination of liver, kidney and pancreas samples was done. Induction of the MS was associated with increased body weight gain (34% coupled with elevated levels of blood glucose (48%, insulin (86%, insulin resistance (270%, uric acid (69%, urea (155%, creatinine (129% and blood lipids with different degrees. Fructose-induced MS also reduced plasma catalase (62% and glutathione peroxidase (89% activities parallel to increased serum leptin and tumor necrosis factor-alpha (TNF-α levels. These changes were coupled by marked histological changes in the examined tissues. Treatment with CoQ or Rosi attenuated most of MS-induced changes. Besides, the combination of both agents further reduced blood glucose, total cholesterol, triglycerides and urea levels, as well as, normalized serum levels of leptin and TNF-α. In addition, combined therapy of both agents elevated HDL-cholesterol level and glutathione peroxidase activity. In conclusion, the present study proves the benefits of co-supplementation of CoQ and Rosi in a fructose-induced model of insulin resistance.

  1. Activation of peroxisome proliferator-activated receptor gamma by rosiglitazone increases sirt6 expression and ameliorates hepatic steatosis in rats.

    Directory of Open Access Journals (Sweden)

    Soo Jin Yang

    Full Text Available BACKGROUND: Sirt6 has been implicated in the regulation of hepatic lipid metabolism and the development of hepatic steatosis. The aim of this study was to address the potential role of Sirt6 in the protective effects of rosiglitazone (RGZ on hepatic steatosis. METHODS: To investigate the effect of RGZ on hepatic steatosis, rats were treated with RGZ (4 mg·kg⁻¹·day⁻¹ by stomach gavage for 6 weeks. The involvement of Sirt6 in the RGZ's regulation was evaluated by Sirt6 knockdown in AML12 mouse hepatocytes. RESULTS: RGZ treatment ameliorated hepatic lipid accumulation and increased expression of Sirt6, peroxisome proliferator-activated receptor gamma coactivtor-1-α (Ppargc1a/PGC1-α and Forkhead box O1 (Foxo1 in rat livers. AMP-activated protein kinase (AMPK phosphorylation was also increased by RGZ, accompanied by alterations in phosphorylation of LKB1. Interestingly, in free fatty acid-treated cells, Sirt6 knockdown increased hepatocyte lipid accumulation measured as increased triglyceride contents (p = 0.035, suggesting that Sirt6 may be beneficial in reducing hepatic fat accumulation. In addition, Sirt6 knockdown abolished the effects of RGZ on hepatocyte fat accumulation, mRNA and protein expression of Ppargc1a/PGC1-α and Foxo1, and phosphorylation levels of LKB1 and AMPK, suggesting that Sirt6 is involved in RGZ-mediated metabolic effects. CONCLUSION: Our results demonstrate that RGZ significantly decreased hepatic lipid accumulation, and that this process appeared to be mediated by the activation of the Sirt6-AMPK pathway. We propose Sirt6 as a possible therapeutic target for hepatic steatosis.

  2. Recording thoughts while memorizing music: A case study

    Directory of Open Access Journals (Sweden)

    Tania eLisboa

    2015-01-01

    Full Text Available Musicians generally believe that memory differs from one person to the next. As a result, memorizing strategies that could be useful to almost everyone are not widely taught. We describe how an 18-year old piano student (Grade 7, ABRSM, learned to memorize by recording her thoughts, a technique inspired by studies of how experienced soloists memorize. The student, who had previously ignored suggestions that she play from memory, decided to learn to memorize, selecting Schumann’s Der Dichter Spricht for this purpose. Rather than explicitly teaching the student how to memorize, the teacher taught her to record her thoughts while playing by marking them on copies of the score, adapting an approach used previously in research with experienced performers. Over a 6½ week period, the student recorded her thoughts during practice (5 times and while performing from memory for the teacher (3 times. The student also video-recorded three weeks of practice, three performances, and the reconstruction of the piece from memory after a 9½-weeks break. The thoughts that the student reported were prepared during practice, stable over time, and functioned as memory retrieval cues during reconstruction. This suggests that the student memorized in the same way as the more experienced musicians who have been studied previously and that teaching student musicians to record their thoughts may be an effective way to help them memorize. The speed and durability of her memorization surprised the student, inspiring her to perform in public and to use the same technique for new pieces.

  3. Recording thoughts while memorizing music: a case study

    Science.gov (United States)

    Lisboa, Tania; Chaffin, Roger; Demos, Alexander P.

    2015-01-01

    Musicians generally believe that memory differs from one person to the next. As a result, memorizing strategies that could be useful to almost everyone are not widely taught. We describe how an 18-years old piano student (Grade 7, ABRSM), learned to memorize by recording her thoughts, a technique inspired by studies of how experienced soloists memorize. The student, who had previously ignored suggestions that she play from memory, decided to learn to memorize, selecting Schumann’s “Der Dichter Spricht” for this purpose. Rather than explicitly teaching the student how to memorize, the teacher taught her to record her thoughts while playing by marking them on copies of the score, adapting an approach used previously in research with experienced performers. Over a 6½ week period, the student recorded her thoughts during practice (five times) and while performing from memory for the teacher (three times). The student also video-recorded 3 weeks of practice, three performances, and the reconstruction of the piece from memory after a 9½-weeks break. The thoughts that the student reported were prepared during practice, stable over time, and functioned as memory retrieval cues during reconstruction. This suggests that the student memorized in the same way as the more experienced musicians who have been studied previously and that teaching student musicians to record their thoughts may be an effective way to help them memorize. The speed and durability of her memorization surprised the student, inspiring her to perform in public and to use the same technique for new pieces. PMID:25667574

  4. Long-term bird study records Arctic climate change

    Science.gov (United States)

    Zielinski, Sarah

    Alaska's summer of 2005 was the second warmest on record there, with a record retreat of arctic pack ice. As Alaskan temperatures gradually increase, artic birds, such as the black guillemots of Cooper Island, near Barrow, Alaska, are experiencing drastic habitat changes. Though these small black and white birds—the subjects of a long-term study of climate change—fared better this year than they have in the recent past (due to local cool conditions), they are nonetheless struggling to adapt as their artic island summer home becomes subarctic.George Divokyan ornithologist at the Institute of Arctic Biology, University of Alaska Fairbanks, discovered the Cooper Island colony of guillemots in the early 1970s and has spent every summer since 1975 there studying these birds. He presented his latest research during a 3 November talk in Washington, D.C.

  5. Viewpoint: Central adjudication of myocardial infarction in outcome-driven clinical trials--common patterns in TRITON, RECORD, and PLATO?

    Science.gov (United States)

    Serebruany, Victor L; Atar, Dan

    2012-09-01

    Central adjudication in randomised controlled outcome-driven trials represents a traditional approach to maintain data integrity by applying uniformed rules for assessment of clinical events. It was the purpose of this investigation to determine the patterns of myocardial infarction (MI) adjudication in the TRITON, RECORD, and PLATO trials. We were matching centrally-adjudicated MI's (CAMI's) from the official trial publication with the site-reported MI (SRMI's) count from the Food and Drug Administration's secondary analyses for the investigational compounds prasugrel (TRITON), rosiglitazone (RECORD), and ticagrelor (PLATO). CAMI numbers showed a remarkable discrepancy to SRMI's by more than a doubling of the difference: from 72 to 145 events in TRITON favoring prasugrel (from a hazard ratio [HR]=0.76, p=0.08; to a HR=0.76, p<0.001), and from 44 to 89 events in favour of ticagrelor in PLATO (from a HR=0.94, p=0.095; to a HR=0.84, p<0.001). In contrast, in the RECORD trial, the CAMI count was less than the SRMI count (from 24 to 8 events, from a HR=1.42, p=0.93; to a HR=1.14, p=0.96), in this case diminishing cardiovascular hazards in favour of rosiglitazone. In conclusion, central adjudication in the TRITON, the RECORD, and the PLATO trial turned out to have a critical impact on study outcomes. Trial publications should in the future include site-reported major efficacy and safety endpoints to preserve data integrity. The regulatory authorities should consider independent audits when there is a major disagreement between centrally adjudicated and site reported events influencing the results of a major clinical trial.

  6. Selective block of KATP channels: why the anti-diabetic sulphonylureas and rosiglitazone have more in common than we thought

    Science.gov (United States)

    Dart, Caroline

    2012-01-01

    Rosiglitazone, the thiazolidinedione class anti-diabetic withdrawn from Europe in 2010 amid reports of adverse cardiovascular effects, is revealed by Yu et al. in this issue of the British Journal of Pharmacology to be a selective blocker of ATP-sensitive potassium (KATP) channels. This seems little cause for excitement given that the closure of pancreatic KATP channels is integral to insulin secretion; and sulphonylureas, which inhibit KATP channels, are widely used to treat type II diabetes. However, rosiglitazone, whose primary targets are nuclear transcription factors that regulate genes involved in lipid metabolism, blocks KATP channels by a novel mechanism different to that of the sulphonylureas and has a worrying preference for blood flow–regulating vascular KATP channels. Identification of a new molecule that modulates KATP channel gating will not only tell us more about how these complex metabolic sensors work but also raises questions as to whether rosiglitazone suppresses the cardiovascular system's ability to cope with metabolic stress – a claim that has dogged the sulphonylureas for many years. LINKED ARTICLE This article is a commentary on Yu et al., pp. 26–36 of this issue. To view this paper visit http://dx.doi.org/10.1111/j.1476-5381.2012.01934.x PMID:22506686

  7. Rosiglitazone Inhibits Adrenocortical Cancer Cell Proliferation by Interfering with the IGF-IR Intracellular Signaling

    Directory of Open Access Journals (Sweden)

    Luconi Michaela

    2008-07-01

    Full Text Available Rosiglitazone (RGZ, a thiazolidinedione ligand of the peroxisome proliferator-activated receptor (PPAR-γ, has been recently described as possessing antitumoral properties. We investigated RGZ effect on cell proliferation in two cell line models (SW13 and H295R of human adrenocortical carcinoma (ACC and its interaction with the signaling pathways of the activated IGF-I receptor (IGF-IR. We demonstrate a high expression of IGF-IR in the two cell lines and in ACC. Cell proliferation is stimulated by IGF-I in a dose- and time-dependent manner and is inhibited by RGZ. The analysis of the main intracellular signaling pathways downstream of the activated IGF-IR, phosphatidyl inositol 3-kinase (PI3K-Akt, and extracellular signal-regulated kinase (ERK1/2 cascades reveals that RGZ rapidly interferes with the Akt and ERK1/2 phosphorylation/activation which mediates IGF-I stimulated proliferation. In conclusion, our results suggest that RGZ exerts an inhibitory effect on human ACC cell proliferation by interfering with the PI3K/Akt and ERK1/2 signaling pathways downstream of the activated IGF-IR.

  8. Rosiglitazone, a Peroxisome Proliferator-Activated Receptor (PPAR)-γ Agonist, Attenuates Inflammation Via NF-κB Inhibition in Lipopolysaccharide-Induced Peritonitis.

    Science.gov (United States)

    Zhang, Yun-Fang; Zou, Xun-Liang; Wu, Jun; Yu, Xue-Qing; Yang, Xiao

    2015-12-01

    We assessed the anti-inflammatory effect of peroxisome proliferator-activated receptor (PPAR)-γ agonist, rosiglitazone, in a lipopolysaccharide (LPS)-induced peritonitis rat model. LPS was intraperitoneally injected into rats to establish peritonitis model. Male Sprague-Dawley (SD) rats were assigned to normal saline (the solvent of LPS), LPS, rosiglitazone plus LPS, and rosiglitazone alone. A simple peritoneal equilibrium test was performed with 20 ml 4.25 % peritoneal dialysis fluid. We measured the leukocyte count in dialysate and ultrafiltration volume. Peritoneal membrane histochemical staining was performed, and peritoneal thickness was assessed. CD40 and intercellular adhesion molecule-1 messenger RNA (ICAM-1 mRNA) levels in rat visceral peritoneum were detected by reverse transcription (RT)-PCR. IL-6 in rat peritoneal dialysis effluent was measured using enzyme-linked immunosorbent assay. The phosphorylation of NF-κB-p65 and IκBα was analyzed by Western blot. LPS administration resulted in increased peritoneal thickness and decreased ultrafiltration volume. Rosiglitazone pretreatment significantly decreased peritoneal thickness. In addition to CD40 and ICAM-1 mRNA expression, the IL-6, p-p65, and p-IκBα protein expressions were enhanced in LPS-administered animals. Rosiglitazone pretreatment significantly decreased ICAM-1 mRNA upregulation, secretion of IL-6 protein, and phosphorylation of NF-κB-p65 and IκBα without decreasing CD40 mRNA expression. Rosiglitazone has a protective effect in peritonitis, simultaneously decreasing NF-κB phosphorylation, suggesting that NF-κB signaling pathway mediated peritoneal inflammation induced by LPS. PPAR-γ might be considered a potential therapeutic target against peritonitis.

  9. Do physiotherapy staff record treatment time accurately? An observational study.

    Science.gov (United States)

    Bagley, Pam; Hudson, Mary; Green, John; Forster, Anne; Young, John

    2009-09-01

    To assess the reliability of duration of treatment time measured by physiotherapy staff in early-stage stroke patients. Comparison of physiotherapy staff's recording of treatment sessions and video recording. Rehabilitation stroke unit in a general hospital. Thirty-nine stroke patients without trunk control or who were unable to stand with an erect trunk without the support of two therapists recruited to a randomized trial evaluating the Oswestry Standing Frame. Twenty-six physiotherapy staff who were involved in patient treatment. Contemporaneous recording by physiotherapy staff of treatment time (in minutes) compared with video recording. Intraclass correlation with 95% confidence interval and the Bland and Altman method for assessing agreement by calculating the mean difference (standard deviation; 95% confidence interval), reliability coefficient and 95% limits of agreement for the differences between the measurements. The mean duration (standard deviation, SD) of treatment time recorded by physiotherapy staff was 32 (11) minutes compared with 25 (9) minutes as evidenced in the video recording. The mean difference (SD) was -6 (9) minutes (95% confidence interval (CI) -9 to -3). The reliability coefficient was 18 minutes and the 95% limits of agreement were -24 to 12 minutes. Intraclass correlation coefficient for agreement between the two methods was 0.50 (95% CI 0.12 to 0.73). Physiotherapy staff's recording of duration of treatment time was not reliable and was systematically greater than the video recording.

  10. Metformin, but not rosiglitazone, attenuates the increasing plasma levels of a new cardiovascular marker, fibulin-1, in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Skov, Vibe; Cangemi, Claudia; Gram, Jeppe

    2013-01-01

    ObjectiveThe extracellular matrix protein fibulin-1 is upregulated in the arterial wall in type 2 diabetes and circulates in increased concentrations in diabetes. Metformin is an anti-diabetic drug with beneficial CVD effects in diabetes. We hypothesized that metformin would influence the increased...... level of plasma fibulin-1 in diabetes.Research Design and MethodsAfter a four-week run-in period, 371 eligible patients with type 2 diabetes were randomized to treatment groups in a factorial design including insulin alone (control), +metformin, +rosiglitazone, or +both metformin and rosiglitazone...

  11. Rosiglitazone Improves Survival and Hastens Recovery from Pancreatic Inflammation in Obese Mice

    Science.gov (United States)

    Pini, Maria; Rhodes, Davina H.; Castellanos, Karla J.; Cabay, Robert J.; Grady, Eileen F.; Fantuzzi, Giamila

    2012-01-01

    Obesity increases severity of acute pancreatitis (AP) by unclear mechanisms. We investigated the effect of the PPAR-gamma agonist rosiglitazone (RGZ, 0.01% in the diet) on severity of AP induced by administration of IL-12+ IL-18 in male C57BL6 mice fed a low fat (LFD) or high fat diet (HFD), under the hypothesis that RGZ would reduce disease severity in HFD-fed obese animals. In both LFD and HFD mice without AP, RGZ significantly increased body weight and % fat mass, with significant upregulation of adiponectin and suppression of erythropoiesis. In HFD mice with AP, RGZ significantly increased survival and hastened recovery from pancreatic inflammation, as evaluated by significantly improved pancreatic histology, reduced saponification of visceral adipose tissue and less severe suppression of erythropoiesis at Day 7 post-AP. This was associated with significantly lower circulating and pancreas-associated levels of IL-6, Galectin-3, osteopontin and TIMP-1 in HFD + RGZ mice, particularly at Day 7 post-AP. In LFD mice with AP, RGZ significantly worsened the degree of intrapancreatic acinar and fat necrosis as well as visceral fat saponification, without affecting other parameters of disease severity or inflammation. Induction of AP lead to major suppression of adiponectin levels at Day 7 in both HFD and HFD + RGZ mice. In conclusion, RGZ prevents development of severe AP in obese mice even though it significantly increases adiposity, indicating that obesity can be dissociated from AP severity by improving the metabolic and inflammatory milieu. However, RGZ worsens selective parameters of AP severity in LFD mice. PMID:22815875

  12. Electroacupuncture and Rosiglitazone Combined Therapy as a Means of Treating Insulin Resistance and Type 2 Diabetes Mellitus: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Rong-Tsung Lin

    2013-01-01

    Full Text Available Aims. To evaluate the efficacy of rosiglitazone (TZD and electroacupuncture (EA combined therapy as a treatment for type 2 diabetes mellitus (T2DM patients by randomized single-blind placebo controlled clinical trial. Methods. A total of 31 newly diagnostic T2DM patients, who fulfilled the study's eligibility criteria, were recruited. The individuals were randomly assigned into two groups, the control group (TZD, N=15 and the experimental group (TZD + EA, N=16. Changes in their plasma free fatty acid (FFA, glucose, and insulin levels, together with their homeostasis model assessment (HOMA indices, were statistically compared before and after treatment. Hypoglycemic activity (% was also compared between these two groups. Results. There was no significant difference in hypoglycemic activity between the TZD and TZD + EA group. The effectiveness of the combined therapy seems to derive from an improvement in insulin resistance and a significant lowering of the secreted insulin rather than the effect of TZD alone on T2DM. The combined treatment had no significant adverse effects. A lower plasma FFA concentration is likely to be the mechanism that causes this effect. Conclusion. This combined therapy seems to suppress endogenous insulin secretion by improving insulin resistance via a mechanism involving a reduction in plasma FFA. This trial is registered with ClinicalTrials.gov NCT01577095.

  13. A comparative study of the spectra recorded at RRCAT synchrotron ...

    Indian Academy of Sciences (India)

    2013-01-09

    Jan 9, 2013 ... 2Applied Spectroscopy Division, Bhabha Atomic Research Centre, Mumbai 400 085, India. ∗ ... It can be applied not only to crystals, but ... is used and the transmitted beam intensity from the sample is recorded on a position-.

  14. Public Participation: Lessons from the Case Study Record

    Energy Technology Data Exchange (ETDEWEB)

    Beierle, Thomas C.; Cayford, Jerry [Resources for the Future, Washington, DC (United States)

    2001-07-01

    Public participation has received increasing attention in environmental policy making world wide. Yet research has been inadequate to answer fundamental questions about how successful past programs have been, what factors lead to success, and where efforts to improve public involvement should focus. To address these questions, we examine the case study record of public participation efforts in the United States over the last 30 years. We evaluate the success of numerous examples of public participation in environmental decision making and identify the factors that lead to success. The paper deals with a number of themes, including: The extent to which participation can incorporate public values into decision making, improve the substantive quality of decisions, reduce conflict, increase trust in institutions, and educate and inform the public; What can be expected from different approaches to public participation, such as public meetings, advisory committees, and mediation; The relative importance of the participatory process vs. the context in which participation takes place; Procedural features of particular importance; and The relationship between participation and implementation. The paper provides general results that can be used to guide the improvement of public participation programs, support assessment of innovative methods, and advance the theoretical understanding of public participation.

  15. Public Participation: Lessons from the Case Study Record

    International Nuclear Information System (INIS)

    Beierle, Thomas C.; Cayford, Jerry

    2001-01-01

    Public participation has received increasing attention in environmental policy making world wide. Yet research has been inadequate to answer fundamental questions about how successful past programs have been, what factors lead to success, and where efforts to improve public involvement should focus. To address these questions, we examine the case study record of public participation efforts in the United States over the last 30 years. We evaluate the success of numerous examples of public participation in environmental decision making and identify the factors that lead to success. The paper deals with a number of themes, including: The extent to which participation can incorporate public values into decision making, improve the substantive quality of decisions, reduce conflict, increase trust in institutions, and educate and inform the public; What can be expected from different approaches to public participation, such as public meetings, advisory committees, and mediation; The relative importance of the participatory process vs. the context in which participation takes place; Procedural features of particular importance; and The relationship between participation and implementation. The paper provides general results that can be used to guide the improvement of public participation programs, support assessment of innovative methods, and advance the theoretical understanding of public participation

  16. A Delphi study among internal medicine clinicians to determine which therapeutic information is essential to record in a medical record.

    Science.gov (United States)

    van Unen, Robert J; Tichelaar, Jelle; Nanayakkara, Prabath W B; van Agtmael, Michiel A; Richir, Milan C; de Vries, Theo P G M

    2015-12-01

    Several studies have demonstrated that using a template for recording general and diagnostic information in the medical record (MR) improves the completeness of MR documentation, communication between doctors, and performance of doctors. However, little is known about how therapeutic information should be structured in the MR. The aim of this study was to investigate which specific therapeutic information registrars and consultants in internal medicine consider essential to record in the MR. Therefore, we carried out a 2-round Internet Delphi study. Fifty-nine items were assessed on a 5-point scale; an item was considered important if ≥ 80% of the respondents awarded it a score of 4 or 5. In total, 26 registrars and 30 consultants in internal medicine completed both rounds of the study. Overall, they considered it essential to include information about 11 items in the MR. Subgroup analyses revealed that the registrars considered 8 additional items essential, whereas the consultants considered 1 additional item essential to record. Study findings can be used as a starting point to develop a structured section of the MR for therapeutic information for both paper and electronic MRs. This section should contain at least 11 items considered essential by registrars and clinical consultants in internal medicine. © 2015, The American College of Clinical Pharmacology.

  17. Archaeological recording and chemical stratigraphy applied to contaminated land studies.

    Science.gov (United States)

    Photos-Jones, Effie; Hall, Allan J

    2011-11-15

    The method used by archaeologists for excavation and recording of the stratigraphic evidence, within trenches with or without archaeological remains, can potentially be useful to contaminated land consultants (CLCs). The implementation of archaeological practice in contaminated land assessments (CLAs) is not meant to be an exercise in data overkill; neither should it increase costs. Rather, we suggest, that if the excavation and recording, by a trained archaeologist, of the stratigraphy is followed by in-situ chemical characterisation then it is possible that much uncertainty associated with current field sampling practices, may be removed. This is because built into the chemical stratigraphy is the temporal and spatial relationship between different parts of the site reflecting the logic behind the distribution of contamination. An archaeological recording with chemical stratigraphy approach to sampling may possibly provide 'one method fits all' for potentially contaminated land sites (CLSs), just as archaeological characterisation of the stratigraphic record provides 'one method fits all' for all archaeological sites irrespective of period (prehistoric to modern) or type (rural, urban or industrial). We also suggest that there may be practical and financial benefits to be gained by pulling together expertise and resources stemming from different disciplines, not simply at the assessment phase, but also subsequent phases, in contaminated land improvement. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Generating OER by Recording Lectures: A Case Study

    Science.gov (United States)

    Llamas-Nistal, Martín; Mikic-Fonte, Fernando A.

    2014-01-01

    The University of Vigo, Vigo, Spain, has the objective of making all the teaching material generated by its teachers freely available. To attain this objective, it encourages the development of Open Educational Resources, especially videos. This paper presents an experience of recording lectures and generating the corresponding videos as a step…

  19. Multi-objective optimization strategy based on desirability functions used for electrophoratic separation and quantification of rosiglitazone and glimepiride in plasma and formulations.

    Science.gov (United States)

    Hefnawy, Mohamed M; Sultan, Maha A; Al-Johar, Haya I; Kassem, Mohamed G; Aboul-Enein, Hassan Y

    2012-01-01

    Multiple response simultaneous optimization employing Derringer's desirability function was used for the development of a capillary electrophoresis method for the simultaneous determination of rosiglitazone (RSG) and glimepiride (GLM) in plasma and formulations. Twenty experiments, taking the two resolutions, the analysis time, and the capillary current as the responses with three important factors--buffer morality, volte and column temperature--were used to design mathematical models. The experimental responses were fitted into a second order polynomial and the six responses were simultaneously optimized to predict the optimum conditions for the effective separation of the studied compounds. The separation was carried out by using capillary zone electrophoresis (CZE) with a silica capillary column and diode array detector at 210 nm. The optimum assay conditions were 52 mmol l⁻¹ phosphate buffer, pH 7, and voltage of 22 kV at 29 °C. The method showed good agreement between the experimental data and predictive value throughout the studied parameter space. The assay limit of detection was 0.02 µg ml⁻¹ and the effective working range at relative standard deviation (RSD) of ≤ 5% was 0.05-16 µg ml⁻¹ (r = 0.999) for both drugs. Analytical recoveries of the studied drugs from spiked plasma were 97.2-101.9 ± 0.31-3.0%. The precision of the assay was satisfactory; RSD was 1.07 and 1.14 for intra- and inter-assay precision, respectively. The proposed method has a great value in routine analysis of RSG and GLM for its therapeutic monitoring and pharmacokinetic studies. Copyright © 2011 John Wiley & Sons, Ltd.

  20. [Study for portable dynamic ECG monitor and recorder].

    Science.gov (United States)

    Yang, Pengcheng; Li, Yongqin; Chen, Bihua

    2012-09-01

    This Paper presents a portable dynamic ECG monitor system based on MSP430F149 microcontroller. The electrocardiogram detecting system consists of ECG detecting circuit, man-machine interaction module, MSP430F149 and upper computer software. The ECG detecting circuit including a preamplifier, second-order Butterworth low-pass filter, high-pass filter, and 50Hz trap circuit to detects electrocardiogram and depresses various kinds of interference effectively. A microcontroller is used to collect three channel analog signals which can be displayed on TFT LCD. A SD card is used to record real-time data continuously and implement the FTA16 file system. In the end, a host computer system interface is also designed to analyze the ECG signal and the analysis results can provide diagnosis references to clinical doctors.

  1. Characterization of alendronic- and undecylenic acid coated magnetic nanoparticles for the targeted delivery of rosiglitazone to subcutaneous adipose tissue.

    Science.gov (United States)

    Saatchi, Katayoun; Tod, Sarah E; Leung, Donna; Nicholson, Kenton E; Andreu, Irene; Buchwalder, Christian; Schmitt, Veronika; Häfeli, Urs O; Gray, Sarah L

    2017-02-01

    Obesity is a state of positive energy balance where excess white adipose tissue accumulates to the detriment of metabolic health. Improving adipocyte function with systemic administration of thiazolidinediones (TZDs) improves metabolic outcomes in obesity, however TZD use is limited clinically due to undesirable side effects. Here we evaluate magnetic nanoparticles (MNPs) as a tool to target rosiglitazone (Rosi) specifically to adipose tissue. Results show Rosi can be adsorbed to MNPs (Rosi-MNPs) with hydrophobic coatings for which we present binding and release kinetics. Rosi adsorbed to MNPs retained the ability to induce PPARγ target gene expression in cells. Biodistribution analysis of radiolabeled Rosi-MNPs revealed a fat-implanted magnet significantly enhanced localization of Rosi to the targeted adipose tissue when administered by subcutaneous injection to obese mice. We propose MNPs for targeted delivery of anti-diabetic agents to superficially located subcutaneous adipose tissue. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. The effect of recombinant human growth hormone with or without rosiglitazone on hepatic fat content in HIV-1-infected individuals: a randomized clinical trial.

    Science.gov (United States)

    Kotler, Donald P; He, Qing; Engelson, Ellen S; Albu, Jeanine B; Glesby, Marshall J

    2016-01-01

    Hepatic fat is related to insulin resistance (IR) and visceral adipose tissue (VAT) in HIV+ and uninfected individuals. Growth hormone (GH) reduces VAT but increases IR. We evaluated the effects of recombinant human GH (rhGH) and rosiglitazone (Rosi) on hepatic fat in a substudy of a randomized controlled trial. HIV+ subjects with abdominal obesity and IR (QUICKI≤0.33) were randomized to rhGH 3 mg daily, Rosi 4 mg twice daily, the combination or double placebo. Hepatic fat was measured by magnetic resonance spectroscopy, visceral fat by MRI and IR by frequently sampled intravenous glucose tolerance tests at baseline and week 12. 31 subjects were studied at both time points. Significant correlations between hepatic fat and VAT (r=0.41; P=0.02) and QUICKI (r=0.39; P<0.05) were seen at baseline. IR rose with rhGH but not Rosi. When rhGH treatment groups were combined, hepatic fat expressed as percentage change decreased significantly (P<0.05) but did not change in Rosi (P=0.71). There were no correlations between changes in hepatic fat and VAT (P=0.4) or QUICKI (P=0.6). In a substudy of 21 subjects, a trend was noticed between changes in hepatic fat and serum insulin-like growth factor-1 (IGF-1; P=0.09). Hepatic fat correlates significantly with both VAT and IR, but changes in hepatic fat do not correlate with changes in VAT and glucose metabolism. Hepatic fat content is reduced by rhGH but Rosi has no effect. These results suggest an independent effect of GH or IGF-1 on hepatic fat. The study was registered at Clinicaltrials.gov (NCT00130286).

  3. The effect of recombinant human growth hormone with or without rosiglitazone on hepatic fat content in HIV-1 infected individuals; a randomized clinical trial

    Science.gov (United States)

    Kotler, Donald P; He, Qing; Engelson, Ellen S; Albu, Jeanine B; Glesby, Marshall J

    2016-01-01

    Background Hepatic fat is related to insulin resistance (IR) and visceral adipose tissue (VAT) in HIV+ and uninfected individuals. Growth hormone (GH) reduces VAT but increases IR. We evaluated the effects of recombinant human GH (rhGH) and rosiglitazone (Rosi) on hepatic fat in a substudy of a randomized controlled trial. Methods HIV+ subjects with abdominal obesity and IR (QUICKI ≤ 0.33) were randomized to rhGH 3 mg daily, Rosi 4 mg twice daily, the combination, or double placebo. Hepatic fat was measured by magnetic resonance spectroscopy (MRS), visceral fat by MRI, and IR by frequently sampled IV glucose tolerance tests at baseline and week 12. Results 31 subjects were studied at both time points. Significant correlations between hepatic fat and VAT (r = 0.41, p=0.02) and QUICKI (r = 0.39, p<0.05) were seen at baseline. Insulin resistance rose with rhGH but not Rosi. When rhGH treatment groups were combined, hepatic fat expressed as percent change decreased significantly (p<0.05) but did not change in Rosi (p=0.71). There were no correlations between changes in hepatic fat and VAT (p=0.4) or QUICKI (p=0.6). In a substudy of 21 subjects, a trend was noticed between changes in hepatic fat and serum IGF-1 (p=0.09). Conclusions Hepatic fat correlates significantly with both VAT and IR, but changes in hepatic fat do not correlate with changes in VAT and glucose metabolism. Hepatic fat content is reduced by rhGH but Rosi has no effect. These results suggest an independent effect of growth hormone or IGF-1 on hepatic fat. The study was registered at Clinicaltrials.gov (NCT00130286). PMID:25536669

  4. Textile Electrodes for EEG Recording — A Pilot Study

    Directory of Open Access Journals (Sweden)

    Johan Löfhede

    2012-12-01

    Full Text Available The overall aim of our research is to develop a monitoring system for neonatal intensive care units. Long-term EEG monitoring in newborns require that the electrodes don’t harm the sensitive skin of the baby, an especially relevant feature for premature babies. Our approach to EEG monitoring is based on several electrodes distributed over the head of the baby, and since the weight of the head always will be on some of them, any type of hard electrode will inevitably cause a pressure-point that can irritate the skin. Therefore, we propose the use of soft conductive textiles as EEG electrodes, primarily for neonates, but also for other kinds of unobtrusive long-term monitoring. In this paper we have tested two types of textile electrodes on five healthy adults and compared them to standard high quality electrodes. The acquired signals were compared with respect to morphology, frequency distribution, spectral coherence, correlation and power line interference sensitivity, and the signals were found to be similar in most respects. The good measurement performance exhibited by the textile electrodes indicates that they are feasible candidates for EEG recording, opening the door for long-term EEG monitoring applications.

  5. Abscisic acid synergizes with rosiglitazone to improve glucose tolerance, down-modulate macrophage accumulation in adipose tissue: possible action of the cAMP/PKA/PPAR γ axis

    Science.gov (United States)

    Guri, Amir J; Hontecillas, Raquel; Bassaganya-Riera, Josep

    2010-01-01

    Background & Aims Abscisic acid (ABA) is effective in preventing insulin resistance and obesity-related inflammation through a PPAR γ-dependent mechanism. The objective of this study was to assess the efficacy ABA in improving glucose homeostasis and suppress inflammation when administered in combination with rosiglitazone (Ros) and to determine whether PPAR γ activation by ABA is initiated via cAMP/protein kinase A (PKA) signaling. Methods Obese db/db mice were fed high-fat diets containing 0, 10, or 70 mg/kg Ros with and without racemic ABA (100 mg/kg) for 60 days. Glucose tolerance and fasting insulin levels were assessed at 6 and 8 weeks, respectively, and adipose tissue macrophage (ATM) infiltration was examined by flow cytometry. Gene expression was examined on white adipose tissue (WAT) and stromal vascular cells (SVCs) cultured with ABA, Ros, or an ABA/Ros combination. Results Both Ros and ABA improved glucose tolerance, and ABA decreased plasma insulin levels while having no effect on Ros-induced weight gain. ABA in combination with low-dose Ros (10 mg/kg; Roslo) synergistically inhibited ATM infiltration. Treatment of SVCs with Ros, ABA or ABA/Ros suppressed expression of the M1 marker CCL17. ABA and Ros synergistically increased PPAR γ activity and pretreatment with a cAMP-inhibitor or a PKA-inhibitor abrogated ABA-induced PPAR γ activation. Conclusions ABA and Ros act synergistically to modulate PPAR γ activity and macrophage accumulation in WAT and ABA enhances PPAR γ activity through a membrane-initiated mechanism dependent on cAMP/PKA signaling. PMID:20207056

  6. Record linkage for pharmacoepidemiological studies in cancer patients.

    Science.gov (United States)

    Herk-Sukel, Myrthe P P van; Lemmens, Valery E P P; Poll-Franse, Lonneke V van de; Herings, Ron M C; Coebergh, Jan Willem W

    2012-01-01

    An increasing need has developed for the post-approval surveillance of (new) anti-cancer drugs by means of pharmacoepidemiology and outcomes research in the area of oncology. To create an overview that makes researchers aware of the available database linkages in Northern America and Europe which facilitate pharmacoepidemiology and outcomes research in cancer patients. In addition to our own database, i.e. the Eindhoven Cancer Registry (ECR) linked to the PHARMO Record Linkage System, we considered database linkages between a population-based cancer registry and an administrative healthcare database that at least contains information on drug use and offers a longitudinal perspective on healthcare utilization. Eligible database linkages were limited to those that had been used in multiple published articles in English language included in Pubmed. The HMO Cancer Research Network (CRN) in the US was excluded from this review, as an overview of the linked databases participating in the CRN is already provided elsewhere. Researchers who had worked with the data resources included in our review were contacted for additional information and verification of the data presented in the overview. The following database linkages were included: the Surveillance, Epidemiology, and End-Results-Medicare; cancer registry data linked to Medicaid; Canadian cancer registries linked to population-based drug databases; the Scottish cancer registry linked to the Tayside drug dispensing data; linked databases in the Nordic Countries of Europe: Norway, Sweden, Finland and Denmark; and the ECR-PHARMO linkage in the Netherlands. Descriptives of the included database linkages comprise population size, generalizability of the population, year of first data availability, contents of the cancer registry, contents of the administrative healthcare database, the possibility to select a cancer-free control cohort, and linkage to other healthcare databases. The linked databases offer a longitudinal

  7. A study of recording possibilities of emulsions in autoradiography conditions

    International Nuclear Information System (INIS)

    Bogomolov, C.S.; Razorenova, I.F.; Ruditskaya, I.A.; Khruliova, L.S.

    1976-01-01

    The autoradiography method is widely used in various fields of science and technique and particularly, in medico-biological and medical researches. Combination of autoradiography method and electron microscopy allowed to carry out researches with qualitatively new level and to study radioactive labels, for example, in separate elements of a cell structure. In the present paper there has been carried out a study of nuclear emulsion properties with reference to electron-microscopic autoradiography conditions. (orig./ORU) [de

  8. n-3 Fatty acids and rosiglitazone improve insulin sensitivity through additive stimulatory effects on muscle glycogen synthesis in mice fed a high-fat diet

    Czech Academy of Sciences Publication Activity Database

    Kuda, Ondřej; Jeleník, Tomáš; Jílková, Zuzana; Flachs, Pavel; Rossmeisl, Martin; Hensler, Michal; Kazdová, L.; Ogston, N.; Baranowski, M.; Gorski, J.; Janovská, Petra; Kůs, Vladimír; Polák, J.; Mohamed-Ali, V.; Burcelin, R.; Cinti, S.; Bryhn, M.; Kopecký, Jan

    2009-01-01

    Roč. 52, č. 5 (2009), s. 941-951 ISSN 0012-186X R&D Projects: GA ČR(CZ) GA303/08/0664; GA MŠk(CZ) 1M0520; GA MŠk(CZ) OC08007 Grant - others:EC(XE) LSMH-CT-2004005272 Institutional research plan: CEZ:AV0Z50110509 Keywords : fish oil * rosiglitazone * obesity Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 6.551, year: 2009

  9. Treatment of spontaneously hypertensive rats with rosiglitazone and/or enalapril restores balance between vasodilator and vasoconstrictor actions of insulin with simultaneous improvement in hypertension and insulin resistance.

    Science.gov (United States)

    Potenza, Maria A; Marasciulo, Flora L; Tarquinio, Mariela; Quon, Michael J; Montagnani, Monica

    2006-12-01

    Spontaneously hypertensive rats (SHRs) exhibit endothelial dysfunction and insulin resistance. Reciprocal relationships between endothelial dysfunction and insulin resistance may contribute to hypertension by causing imbalanced regulation of endothelial-derived vasodilators (e.g., nitric oxide) and vasoconstrictors (e.g., endothelin-1 [ET-1]). Treatment of SHRs with rosiglitazone (insulin sensitizer) and/or enalapril (ACE inhibitor) may simultaneously improve hypertension, insulin resistance, and endothelial dysfunction by rebalancing insulin-stimulated production of vasoactive mediators. When compared with WKY control rats, 12-week-old vehicle-treated SHRs were hypertensive, overweight, and insulin resistant, with elevated fasting levels of insulin and ET-1 and reduced serum adiponectin levels. In mesenteric vascular beds (MVBs) isolated from vehicle-treated SHRs and preconstricted with norepinephrine (NE) ex vivo, vasodilator responses to insulin were significantly impaired, whereas the ability of insulin to oppose vasoconstrictor actions of NE was absent (versus WKY controls). Three-week treatment of SHRs with rosiglitazone and/or enalapril significantly reduced blood pressure, insulin resistance, fasting insulin, and ET-1 levels and increased adiponectin levels to values comparable with those observed in vehicle-treated WKY controls. By restoring phosphatidylinositol 3-kinase-dependent effects, rosiglitazone and/or enalapril therapy of SHRs also significantly improved vasodilator responses to insulin in MVB preconstricted with NE ex vivo. Taken together, our data provide strong support for the existence of reciprocal relationships between endothelial dysfunction and insulin resistance that may be relevant for developing novel therapeutic strategies for the metabolic syndrome.

  10. Comparative study of digital laser film and analog paper image recordings

    International Nuclear Information System (INIS)

    Lee, K.R.; Cox, G.G.; Templeton, A.W.; Preston, D.F.; Anderson, W.H.; Hensley, K.S.; Dwyer, S.J.

    1987-01-01

    The increase in the use of various imaging modalities demands higher quality and more efficacious analog image recordings. Laser electronic recordings with digital array prints of 4,000 x 5,000 x 12 bits obtained using laser-sensitive film or paper are being evaluated. Dry silver paper recordings are being improved and evaluated. High-resolution paper dot printers are being studied to determine their gray-scale capabilities. The authors evaluated the image quality, costs, clinical utilization, and acceptability of CT scans, MR images, digital subtraction angiograms, digital radiographs, and radionuclide scans recorded by seven different printers (three laser, three silver paper, and one dot) and compared the same features in conventional film recording. This exhibit outlines the technical developments and instrumentation of digital laser film and analog paper recorders and presents the results of the study

  11. Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

    Science.gov (United States)

    Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

    2018-04-01

    Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

  12. Rosiglitazone attenuates the metalloprotease/anti-metalloprotease imbalance in emphysema induced by cigarette smoke: involvement of extracellular signal-regulated kinase and NFκB signaling

    Directory of Open Access Journals (Sweden)

    Hou G

    2015-04-01

    Full Text Available Gang Hou, Yan Yin, Dan Han, Qiu-yue Wang, Jian Kang Department of Respiratory Medicine, the First Hospital of China Medical University, Shenyang, People’s Republic of China Objective: We investigated how rosiglitazone attenuated cigarette smoke (CS-induced emphysema in a rat model. In particular, we focused on its possible effects on the imbalance between metalloprotease (MMP and anti-MMP activity, mitogen-activated protein kinase (MAPK phosphorylation, and nuclear factor kappa-light-chain-enhancer of activated B cell (NFκB signaling pathway over-activation.Methods: A total of 36 Wistar rats were divided into three groups (n=12 each: animals were exposed to CS for 12 weeks in the absence (the CS group or presence of 30 mg/kg rosiglitazone (the rosiglitazone-CS [RCS] group; a control group was treated with the rosiglitazone vehicle only, without any CS exposure. Histopathology of lung tissue in all groups was evaluated to grade severity of the disease. Expression levels of peroxisome proliferator-activated receptor γ (PPARγ, MMP2, and MMP9 in lung tissue were determined and compared using Western blotting and immunohistochemistry. Activation of MAPKs, NFκB, and the nuclear factor of kappa light polypeptide gene enhancer in B-cell inhibitor, alpha (IκBα phosphorylation in lung tissue was examined by Western blotting.Results: Emphysema-related pathology, based on inter-alveolar wall distance and alveolar density, was less severe in the RCS group than in the CS group. Compared with the CS group, levels of PPARγ were higher in the RCS group, and levels of MMP2 and MMP9 proteins were lower in the RCS rats. Levels of activated MAPKs and NFκB were also lower, while the IκBαphosphorylation was increased in the lung tissue of RCS rats.Conclusion: Our findings suggest that oral administration of rosiglitazone attenuates the metalloprotease activity induced by CS, and the underlying mechanism might involve the activation of signaling pathways

  13. [Value of the study of cochlear microphonic recordings in deep and severe deafness].

    Science.gov (United States)

    Moatti, L; Busquet, D; Cotin, G

    1983-01-01

    A study was conducted to assess the contribution of cochlear microphonic potential recordings during electrophysiologic audiometry examinations. Amplitude of microphonic recordings were correlated with the degree of deafness, its etiology, and the prosthetic prognosis in 38 electrocochleographic examinations. Preliminary results are analyzed.

  14. Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

    Science.gov (United States)

    Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

    2017-04-01

    Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

  15. Hanford site: A guide to record series supporting epidemiologic studies conducted for the Department of Energy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-06

    The primary purpose of this guide is to describe each series of records which pertains to studies of worker health and mortality funded by the U.S. Department of Energy (DOE) at the Hanford site. Additionally, the guide provides information on the location and classification of the records and how they may be accessed. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project, HAI`s role in the project, the history of the DOE and the Hanford site, and Hanford`s organizational structure. It provides information on the methodology used to inventory and describe pertinent records stored in various onsite offices, in Hanford`s Records Holding Area (RHA), and at the Seattle Federal Records Center (SFRC). Other topics include the methodology used to produce the guide, the arrangement of the record Series descrimations, and information on accessing records repositories.

  16. Social housing of non-rodents during cardiovascular recordings in safety pharmacology and toxicology studies.

    Science.gov (United States)

    Prior, Helen; Bottomley, Anna; Champéroux, Pascal; Cordes, Jason; Delpy, Eric; Dybdal, Noel; Edmunds, Nick; Engwall, Mike; Foley, Mike; Hoffmann, Michael; Kaiser, Robert; Meecham, Ken; Milano, Stéphane; Milne, Aileen; Nelson, Rick; Roche, Brian; Valentin, Jean-Pierre; Ward, Gemma; Chapman, Kathryn

    2016-01-01

    The Safety Pharmacology Society (SPS) and National Centre for the Replacement, Refinement & Reduction of Animals in Research (NC3Rs) conducted a survey and workshop in 2015 to define current industry practices relating to housing of non-rodents during telemetry recordings in safety pharmacology and toxicology studies. The aim was to share experiences, canvas opinion on the study procedures/designs that could be used and explore the barriers to social housing. Thirty-nine sites, either running studies (Sponsors or Contract Research Organisations, CROs) and/or outsourcing work responded to the survey (51% from Europe; 41% from USA). During safety pharmacology studies, 84, 67 and 100% of respondents socially house dogs, minipigs and non-human primates (NHPs) respectively on non-recording days. However, on recording days 20, 20 and 33% of respondents socially house the animals, respectively. The main barriers for social housing were limitations in the recording equipment used, study design and animal temperament/activity. During toxicology studies, 94, 100 and 100% of respondents socially house dogs, minipigs and NHPs respectively on non-recording days. However, on recording days 31, 25 and 50% of respondents socially house the animals, respectively. The main barriers for social housing were risk of damage to and limitations in the recording equipment used, food consumption recording and temperament/activity of the animals. Although the majority of the industry does not yet socially house animals during telemetry recordings in safety pharmacology and toxicology studies, there is support to implement this refinement. Continued discussions, sharing of best practice and data from companies already socially housing, combined with technology improvements and investments in infrastructure are required to maintain the forward momentum of this refinement across the industry. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  17. An exploratory study on the management of business records by knowledge workers

    Directory of Open Access Journals (Sweden)

    Adeline du Toit

    2011-12-01

    Full Text Available Purpose: The purpose of this exploratory study was to determine how knowledge workers could align the creation and management of business records with organisational records management needs. Problem investigated: Knowledge workers are employed by more than one organisation at the same time. This creates problems in managing and preserving the business records created and received by knowledge workers. This article investigates how organisations should manage and preserve their business records that are created and received by knowledge workers who are employed by more than one organisation. Methodology: The importance of the management of business records in the knowledge economy was discussed and in the empirical survey data was collected through a questionnaire survey of 122 knowledge workers at an investment management company. Findings: The results of the empirical survey revealed that the majority of respondents always save business records that they create on their own personal filing systems and that they are familiar with the concept of records management. The findings provided support for the hypothesis that knowledge workers take control of managing the business records of various organisations, as their careers consist of a series of projects or assignments, irrespective of the organisation employing them. Value of research: The active role that knowledge workers can play in the management of strategic business records, underlines its key position as an information management function in organisations. Further research is needed to clarify the importance of records management in the knowledge economy. Conclusion: Knowledge workers take control of managing the business records of various organisations, as their careers consist of a series of projects or assignments while working at different organisations.

  18. Cancer patients' attitudes and experiences of online access to their electronic medical records: A qualitative study.

    Science.gov (United States)

    Rexhepi, Hanife; Åhlfeldt, Rose-Mharie; Cajander, Åsa; Huvila, Isto

    2018-06-01

    Patients' access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients' attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital.

  19. Privacy Impact Assessment for the Medical and Research Study Records of Human Volunteers

    Science.gov (United States)

    The Medical & Research Study Records of Human Volunteers System collects demographic and medical information on subjects who participate in research. Learn how this data is collected, used, access to the data, and the purpose of data collection.

  20. The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD statement.

    Directory of Open Access Journals (Sweden)

    Eric I Benchimol

    2015-10-01

    Full Text Available Routinely collected health data, obtained for administrative and clinical purposes without specific a priori research goals, are increasingly used for research. The rapid evolution and availability of these data have revealed issues not addressed by existing reporting guidelines, such as Strengthening the Reporting of Observational Studies in Epidemiology (STROBE. The REporting of studies Conducted using Observational Routinely collected health Data (RECORD statement was created to fill these gaps. RECORD was created as an extension to the STROBE statement to address reporting items specific to observational studies using routinely collected health data. RECORD consists of a checklist of 13 items related to the title, abstract, introduction, methods, results, and discussion section of articles, and other information required for inclusion in such research reports. This document contains the checklist and explanatory and elaboration information to enhance the use of the checklist. Examples of good reporting for each RECORD checklist item are also included herein. This document, as well as the accompanying website and message board (http://www.record-statement.org, will enhance the implementation and understanding of RECORD. Through implementation of RECORD, authors, journals editors, and peer reviewers can encourage transparency of research reporting.

  1. Recording blood pressure and eGFR in primary care after the Belgrade screening study.

    Science.gov (United States)

    Lezaic, Visnja; Marinkovic, Jelena; Milutinovic, Zoran; Jovanovic-Vasiljevic, Nada; Vujicic, Vesna; Pejovic, Branka; Kalabic, Snezana; Djukanovic, Ljubica

    2018-11-01

    In 2009, Belgrade nephrologists and general practitioners from thirteen health centers carried out screening for chronic kidney disease (CKD). Three years later, medical records of patients from four health centers participating in the screening study were retrospectively analyzed in order to check whether general practitioners had continued to control patients at risk for CKD in accordance with the recommendations provided. The study included 460 patients who visited their doctor at least once in the three-year period. Data on blood pressure, ACEI use, estimated glomerular filtration rate (eGFR) and comorbidities were taken from patients' medical records. Blood pressure was not recorded in any of the three years in 42.8% and eGFR in 36.7% of the patients, but blood pressure was registered every year in 7.8% and eGFR in 4.3% of them. Over the three years, the relative number of patients with recorded blood pressure decreased from 41.7% to 17.8%, and with recorded eGFR from 41.7% to 21.5%. Multivariate linear regression found that Health Center, systolic and diastolic blood pressure and presence of hypertension were negatively associated with number of years with recorded blood pressure. Health Center, systolic blood pressure and sum of years with recorded eGFR below 60 ml/min/1.73m 2 were associated with number of years with recorded eGFR. Under-recording of blood pressure and eGFR in primary care health centers suggests lack of adherence to current guidelines and insufficient care of CKD patients. This implies the necessity for continuous education of physicians.

  2. Medical Record Clerk Training Program, Course of Study; Student Manual: For Medical Record Personnel in Small Rural Hospitals in Colorado.

    Science.gov (United States)

    Community Health Service (DHEW/PHS), Arlington, VA. Div. of Health Resources.

    The manual provides major topics, objectives, activities and, procedures, references and materials, and assignments for the training program. The topics covered are hospital organization and community role, organization and management of a medical records department, international classification of diseases and operations, medical terminology,…

  3. MFM study of magnetic interaction between recording and soft magnetic layers

    International Nuclear Information System (INIS)

    Honda, Yukio; Tanahashi, Kiwamu; Hirayama, Yoshiyuki; Kikukawa, Atsushi; Futamoto, Masaaki

    2001-01-01

    Magnetic force microscopy was used to study the magnetic interaction between the recording and the soft magnetic layers in double-layer perpendicular media by observing the magnetization structure from the soft magnetic layer side. There was a strong magnetic interaction between the recording and the soft magnetic layers. Introducing a thin nonmagnetic intermediate layer between the two layers greatly reduced the magnetic interaction and drastically reduced the medium noise

  4. Patient experiences with full electronic access to health records and clinical notes through the My HealtheVet Personal Health Record Pilot: qualitative study.

    Science.gov (United States)

    Woods, Susan S; Schwartz, Erin; Tuepker, Anais; Press, Nancy A; Nazi, Kim M; Turvey, Carolyn L; Nichol, W Paul

    2013-03-27

    Full sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports. A qualitative study with purposeful sampling sought to examine patients' views and experiences with reading their health records, including their clinical notes, online. Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions. Four themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits. Patients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared

  5. Jaundice in primary care: a cohort study of adults aged >45 years using electronic medical records.

    Science.gov (United States)

    Taylor, Anna; Stapley, Sally; Hamilton, William

    2012-08-01

    Jaundice is a rare but important symptom of malignant and benign conditions. When patients present in primary care, understanding the relative likelihood of different disease processes can help GPs to investigate and refer patients appropriately. To identify and quantify the various causes of jaundice in adults presenting in primary care. Historical cohort study using electronic primary care records. UK General Practice Research Database. Participants (186 814 men and women) aged >45 years with clinical events recorded in primary care records between 1 January 2005 and 31 December 2007. Data were searched for episodes of jaundice and explanatory diagnoses identified within the subsequent 12 months. If no diagnosis was found, the patient's preceding medical record was searched for relevant chronic diseases. From the full cohort, 277 patients had at least one record of jaundice between 1 January 2005 and 31 December 2006. Ninety-two (33%) were found to have bile duct stones; 74 (27%) had an explanatory cancer [pancreatic cancer 34 (12%), cholangiocarcinoma 13 (5%) and other diagnosed primary malignancy 27 (10%)]. Liver disease attributed to excess alcohol explained 26 (9%) and other diagnoses were identified in 24 (9%). Sixty-one (22%) had no diagnosis related to jaundice recorded. Although the most common cause of jaundice is bile duct stones, cancers are present in over a quarter of patients with jaundice in this study, demonstrating the importance of urgent investigation into the underlying cause.

  6. Rosiglitazone Affects Nitric Oxide Synthases and Improves Renal Outcome in a Rat Model of Severe Ischemia/Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Boris Betz

    2012-01-01

    Full Text Available Background. Nitric oxide (NO-signal transduction plays an important role in renal ischemia/reperfusion (I/R injury. NO produced by endothelial NO-synthase (eNOS has protective functions whereas NO from inducible NO-synthase (iNOS induces impairment. Rosiglitazone (RGZ, a peroxisome proliferator-activated receptor (PPAR-γ agonist exerted beneficial effects after renal I/R injury, so we investigated whether this might be causally linked with NOS imbalance. Methods. RGZ (5 mg/kg was administered i.p. to SD-rats (f subjected to bilateral renal ischemia (60 min. Following 24 h of reperfusion, inulin- and PAH-clearance as well as PAH-net secretion were determined. Morphological alterations were graded by histopathological scoring. Plasma NOx-production was measured. eNOS and iNOS expression was analyzed by qPCR. Cleaved caspase 3 (CC3 was determined as an apoptosis indicator and ED1 as a marker of macrophage infiltration in renal tissue. Results. RGZ improves renal function after renal I/R injury (PAH-/inulin-clearance, PAH-net secretion and reduces histomorphological injury. Additionally, RGZ reduces NOx plasma levels, ED-1 positive cell infiltration and CC3 expression. iNOS-mRNA is reduced whereas eNOS-mRNA is increased by RGZ. Conclusion. RGZ has protective properties after severe renal I/R injury. Alterations of the NO pathway regarding eNOS and iNOS could be an explanation of the underlying mechanism of RGZ protection in renal I/R injury.

  7. Why live recording sounds better: A case study of Schumann’s Träumerei

    Directory of Open Access Journals (Sweden)

    Haruka eShoda

    2015-01-01

    Full Text Available We explore the concept that artists perform best in front of an audience. The negative effects of performance anxiety are much better known than their related cousin on the other shoulder: the positive effects of social facilitation. The present study, however, reveals a listener's preference for performances recorded in front of an audience. In Study 1, we prepared two types of recordings of Träumerei performed by 13 pianists: recordings in front of an audience and those with no audience. According to the evaluation by 153 listeners, the recordings performed in front of an audience sounded better, suggesting that the presence of an audience enhanced or facilitated the performance. In Study 2, we analyzed pianists' durational and dynamic expressions. According to the functional principal components analyses, we found that the expression of Träumerei consisted of three components: the overall quantity, the cross-sectional contrast between the final and the remaining sections, and the control of the expressive variability. Pianists' expressions were targeted more to the average of the cross-sectional variation in the audience-present than in the audience-absent recordings. In Study 3, we explored a model that explained listeners' responses induced by pianists' acoustical expressions, using path analyses. The final model indicated that the cross-sectional variation of the duration and that of the dynamics determined listeners' evaluations of the quality and the emotionally moving experience, respectively. In line with human's preferences for commonality, the more average the durational expressions were in live recording, the better the listeners' evaluations were regardless of their musical experiences. Only the well-experienced listeners (at least 16 years of musical training were moved more by the deviated dynamic expressions in live recording, suggesting a link between the experienced listener's emotional experience and the unique dynamics in

  8. Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study

    Science.gov (United States)

    Hanson, Darlene S.

    2013-01-01

    The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined.…

  9. Condylar guidance: correlation between protrusive interocclusal record and panoramic radiographic image: a pilot study.

    Science.gov (United States)

    Tannamala, Pavan Kumar; Pulagam, Mahesh; Pottem, Srinivas R; Swapna, B

    2012-04-01

    The purpose of this study was to compare the sagittal condylar angles set in the Hanau articulator by use of a method of obtaining an intraoral protrusive record to those angles found using a panoramic radiographic image. Ten patients, free of signs and symptoms of temporomandibular disorder and with intact dentition were selected. The dental stone casts of the subjects were mounted on a Hanau articulator with a springbow and poly(vinyl siloxane) interocclusal records. For all patients, the protrusive records were obtained when the mandible moved forward by approximately 6 mm. All procedures for recording, mounting, and setting were done in the same session. The condylar guidance angles obtained were tabulated. A panoramic radiographic image of each patient was made with the Frankfurt horizontal plane parallel to the floor of the mouth. Tracings of the radiographic images were made. The horizontal reference line was marked by joining the orbitale and porion. The most superior and most inferior points of the curvatures were identified. These two lines were connected by a straight line representing the mean curvature line. Angles made by the intersection of the mean curvature line and the horizontal reference line were measured. The results were subjected to statistical analysis with a significance level of p record method. The mean condylar guidance angle between the right and left side by both the methods was not statistically significant. The comparison of mean condylar guidance angles between the right side of the protrusive record method and the right side of the panoramic radiographic method and the left side of the protrusive record method and the left side of the panoramic radiographic method (p= 0.071 and p= 0.057, respectively) were not statistically significant. Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used in programming semi-adjustable articulators. © 2012

  10. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.

    Science.gov (United States)

    Morley, Lara C; Tang, Thomas; Yasmin, Ephia; Norman, Robert J; Balen, Adam H

    2017-11-29

    Polycystic ovary syndrome (PCOS) is characterised by infrequent or absent ovulation, and high levels of androgens and insulin (hyperinsulinaemia). Hyperinsulinaemia occurs secondary to insulin resistance and is associated with increased risk of cardiovascular disease and diabetes mellitus. Insulin-sensitising agents such as metformin may be effective in treating PCOS-related anovulation. To evaluate the effectiveness and safety of insulin-sensitising drugs in improving reproductive and metabolic outcomes for women with PCOS undergoing ovulation induction. We searched the following databases from inception to January 2017: Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL. We searched registers of ongoing trials and reference lists from relevant studies. We included randomised controlled trials of insulin-sensitising drugs compared with placebo, no treatment, or an ovulation-induction agent for women with oligo and anovulatory PCOS. Two review authors independently assessed studies for eligibility and bias. Primary outcomes were live birth rate and gastrointestinal adverse effects. Secondary outcomes included other pregnancy outcomes, menstrual frequency and metabolic effects. We combined data to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). We assessed statistical heterogeneity using the I 2 statistic and reported quality of the evidence for primary outcomes using GRADE methodology. We assessed the interventions metformin, clomiphene citrate, metformin plus clomiphene citrate, D-chiro-inositol, rosiglitazone and pioglitazone. We compared these with each other, placebo or no treatment. We included 48 studies (4451 women), 42 of which investigated metformin (4024 women). Evidence quality ranged from very low to moderate. Limitations were risk of bias (poor reporting of methodology and incomplete outcome data), imprecision and inconsistency. Metformin versus placebo or no treatment

  11. Published intimate partner violence studies often differ from their trial registration records.

    Science.gov (United States)

    Madden, Kim; Tai, Kerry; Ali, Zak; Schneider, Patricia; Singh, Mahip; Ghert, Michelle; Bhandari, Mohit

    2017-12-27

    Registering study protocols in a trial registry is important for methodologic transparency and reducing selective reporting bias. The objective of this investigation was to determine whether published studies of intimate partner violence (IPV) that had been registered matched the registration record on key study design elements. We systematically searched three trial registries to identify registered IPV studies and the published literature for the associated publication. Two authors independently determined for each study whether key study elements in the registry matched those in the published paper. We included 66 studies published between 2006 and 2017. Nearly half (29/66, 44%) were registered after study completion. Many (26/66, 39%) had discrepancies regarding the primary outcome, and nearly two-thirds (42/66, 64%) had discrepancies in secondary outcomes. Discrepancies in study design were less frequent (13/66, 20%). However, large changes in sample size (26/66, 39%) and discrepancies in funding source (28/66, 42%) were frequently observed. Trial registries are important tools for research transparency and identifying and preventing outcome switching and selective outcome reporting bias. Published IPV studies often differ from their records in trial registries. Researchers should pay close attention to the accuracy of trial registry records.

  12. A retrospective cohort study on lifestyle habits of cardiovascular patients: how informative are medical records?

    NARCIS (Netherlands)

    Fouwels, Annemarie J.; Bredie, Sebastiaan J. H.; Wollersheim, Hub; Schippers, Gerard M.

    2009-01-01

    ABSTRACT: BACKGROUND: To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of

  13. A retrospective cohort study on lifestyle habits of cardiovascular patients: how informative are medical records?

    NARCIS (Netherlands)

    Fouwels, A.J.; Bredie, S.J.H.; Wollersheim, H.C.H.; Schippers, G.M.

    2009-01-01

    BACKGROUND: To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of the

  14. 76 FR 71601 - Record of Decision, Long Walk National Historic Trail Feasibility Study/Abbreviated Final...

    Science.gov (United States)

    2011-11-18

    ... fully meet the criteria for national historic trails. The overall nature of public comments during the... support the no action alternative as the selected action is based on the lack of support for designation... Record of Decision because the study involved no park resources. FOR FURTHER INFORMATION CONTACT: Sharon...

  15. Electronic Records Management and Archives in International Organizations: A RAMP Study with Guidelines.

    Science.gov (United States)

    Dollar, Charles M.

    This study is a review of trends in information-handling technology and significant developments which are changing or will change the general environment within which archivists and records managers in international organizations will have to work. Trends in microelectronics, electronic storage, software, data transmission, computer architecture,…

  16. What Is Next for Functional Requirements for Bibliographic Records? A Delphi Study

    Science.gov (United States)

    Zhang, Yin; Salaba, Athena

    2009-01-01

    This article reports on a Delphi study conducted to determine key issues and challenges facing Functional Requirements for Bibliographic Records (FRBR) research and practice. The Delphi panel consisted of thirty-three experts in the field who participated in a three-round issue-raising and consensus-building process via a Web-based survey…

  17. Cell Phone Video Recording Feature as a Language Learning Tool: A Case Study

    Science.gov (United States)

    Gromik, Nicolas A.

    2012-01-01

    This paper reports on a case study conducted at a Japanese national university. Nine participants used the video recording feature on their cell phones to produce weekly video productions. The task required that participants produce one 30-second video on a teacher-selected topic. Observations revealed the process of video creation with a cell…

  18. Study of the rates of dissemination of elastic waves with diffraction transformation of seismic recordings. [USSR

    Energy Technology Data Exchange (ETDEWEB)

    Telegin, A.N.; Bulatov, M.G.

    1982-01-01

    An algorithm is proposed for determining effective velocities in the process of diffraction transformation of seismic waves. It is based on summation with conjugate recordings. Results of the study of velocities are indicated in materials of Sakhalin. A difference is noted in the procedures for computing effective velocities in the OGT method and diffraction transformation.

  19. Paper-Based Medical Records: the Challenges and Lessons Learned from Studying Obstetrics and Gynaecological Post-Operation Records in a Nigerian Hospital

    Directory of Open Access Journals (Sweden)

    Adekunle Yisau Abdulkadir

    2010-10-01

    Full Text Available AIM: With the background knowledge that auditing of Medical Records (MR for adequacy and completeness is necessary if it is to be useful and reliable in continuing patient care; protection of the legal interest of the patient, physicians, and the Hospital; and meeting requirements for researches, we scrutinized theatre records of our hospital to identify routine omissions or deficiencies, and correctable errors in our MR system. METHOD: Obstetrics and Gynaecological post operation theatre records between January 2006 and December 2008 were quantitatively and qualitatively analyzed for details that included: hospital number; Patients age; diagnosis; surgery performed; types and modes of anesthesia; date of surgery; patients’ ward; Anesthetists names; surgeons and attending nurses names, and abbreviations used with SPSS 15.0 for Windows. RESULTS: Hardly were any of the 1270 surgeries during the study period documented without an omission or an abbreviation. Hospital numbers and patients’ age were not documented in 21.8% (n=277 and 59.1% (n=750 respectively. Diagnoses and surgeries were recorded with varying abbreviations in about 96% of instances. Surgical team names were mostly abbreviated or initials only given. CONCLUSION: To improve the quality of Paper-based Medical Record, regular auditing, training and good orientation of medical personnel for good record practices, and discouraging large volume record book to reduce paper damages and sheet loss from handling are necessary else what we record toady may neither be useful nor available tomorrow. [TAF Prev Med Bull 2010; 9(5.000: 427-432

  20. Web application for recording learners’ mouse trajectories and retrieving their study logs for data analysis

    Directory of Open Access Journals (Sweden)

    Yoshinori Miyazaki

    2012-03-01

    Full Text Available With the accelerated implementation of e-learning systems in educational institutions, it has become possible to record learners’ study logs in recent years. It must be admitted that little research has been conducted upon the analysis of the study logs that are obtained. In addition, there is no software that traces the mouse movements of learners during their learning processes, which the authors believe would enable teachers to better understand their students’ behaviors. The objective of this study is to develop a Web application that records students’ study logs, including their mouse trajectories, and to devise an IR tool that can summarize such diversified data. The results of an experiment are also scrutinized to provide an analysis of the relationship between learners’ activities and their study logs.

  1. Sharing Annotated Audio Recordings of Clinic Visits With Patients-Development of the Open Recording Automated Logging System (ORALS): Study Protocol.

    Science.gov (United States)

    Barr, Paul J; Dannenberg, Michelle D; Ganoe, Craig H; Haslett, William; Faill, Rebecca; Hassanpour, Saeed; Das, Amar; Arend, Roger; Masel, Meredith C; Piper, Sheryl; Reicher, Haley; Ryan, James; Elwyn, Glyn

    2017-07-06

    Providing patients with recordings of their clinic visits enhances patient and family engagement, yet few organizations routinely offer recordings. Challenges exist for organizations and patients, including data safety and navigating lengthy recordings. A secure system that allows patients to easily navigate recordings may be a solution. The aim of this project is to develop and test an interoperable system to facilitate routine recording, the Open Recording Automated Logging System (ORALS), with the aim of increasing patient and family engagement. ORALS will consist of (1) technically proficient software using automated machine learning technology to enable accurate and automatic tagging of in-clinic audio recordings (tagging involves identifying elements of the clinic visit most important to patients [eg, treatment plan] on the recording) and (2) a secure, easy-to-use Web interface enabling the upload and accurate linkage of recordings to patients, which can be accessed at home. We will use a mixed methods approach to develop and formatively test ORALS in 4 iterative stages: case study of pioneer clinics where recordings are currently offered to patients, ORALS design and user experience testing, ORALS software and user interface development, and rapid cycle testing of ORALS in a primary care clinic, assessing impact on patient and family engagement. Dartmouth's Informatics Collaboratory for Design, Development and Dissemination team, patients, patient partners, caregivers, and clinicians will assist in developing ORALS. We will implement a publication plan that includes a final project report and articles for peer-reviewed journals. In addition to this work, we will regularly report on our progress using popular relevant Tweet chats and online using our website, www.openrecordings.org. We will disseminate our work at relevant conferences (eg, Academy Health, Health Datapalooza, and the Institute for Healthcare Improvement Quality Forums). Finally, Iora Health, a

  2. Instant availability of patient records, but diminished availability of patient information: A multi-method study of GP's use of electronic patient records

    Directory of Open Access Journals (Sweden)

    Grimsmo Anders

    2008-03-01

    Full Text Available Abstract Background In spite of succesful adoption of electronic patient records (EPR by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship. Methods A combined qualitative and quantitative study that uses data collected from focus groups, observations of primary care encounters and a questionnaire survey of a random sample of general practitioners to describe their use of EPR in primary care. Results The overall availability of individual patient records had improved, but the availability of the information within each EPR was not satisfactory. GPs' use of EPRs were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians. We found no indications of disturbance of the clinician-patient relationship by use of computers in this study. Conclusion Although GPs are generally satisfied with their EPRs systems, there are still unmet needs and functionality to be covered. It is urgent to find methods that can make a better representation of information in large patient records as well as prevent EPRs from contributing to increased administrative workload of physicians.

  3. Validation of de-identified record linkage to ascertain hospital admissions in a cohort study

    Directory of Open Access Journals (Sweden)

    English Dallas R

    2011-04-01

    Full Text Available Abstract Background Cohort studies can provide valuable evidence of cause and effect relationships but are subject to loss of participants over time, limiting the validity of findings. Computerised record linkage offers a passive and ongoing method of obtaining health outcomes from existing routinely collected data sources. However, the quality of record linkage is reliant upon the availability and accuracy of common identifying variables. We sought to develop and validate a method for linking a cohort study to a state-wide hospital admissions dataset with limited availability of unique identifying variables. Methods A sample of 2000 participants from a cohort study (n = 41 514 was linked to a state-wide hospitalisations dataset in Victoria, Australia using the national health insurance (Medicare number and demographic data as identifying variables. Availability of the health insurance number was limited in both datasets; therefore linkage was undertaken both with and without use of this number and agreement tested between both algorithms. Sensitivity was calculated for a sub-sample of 101 participants with a hospital admission confirmed by medical record review. Results Of the 2000 study participants, 85% were found to have a record in the hospitalisations dataset when the national health insurance number and sex were used as linkage variables and 92% when demographic details only were used. When agreement between the two methods was tested the disagreement fraction was 9%, mainly due to "false positive" links when demographic details only were used. A final algorithm that used multiple combinations of identifying variables resulted in a match proportion of 87%. Sensitivity of this final linkage was 95%. Conclusions High quality record linkage of cohort data with a hospitalisations dataset that has limited identifiers can be achieved using combinations of a national health insurance number and demographic data as identifying variables.

  4. Radiology Reporting System Data Exchange With the Electronic Health Record System: A Case Study in Iran.

    Science.gov (United States)

    Ahmadi, Maryam; Ghazisaeidi, Marjan; Bashiri, Azadeh

    2015-03-18

    In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. This study provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with the electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. This is a cross-sectional study that was conducted in 2013. The study population was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also Visual Paradigm software was used to design a conceptual model. Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, with providing the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

  5. The PHARMS (Patient Held Active Record of Medication Status) feasibility study: a research proposal.

    LENUS (Irish Health Repository)

    Walsh, Elaine

    2018-01-08

    Medication errors are a major source of preventable morbidity, mortality and cost and many occur at the times of hospital admission and discharge. Novel interventions (such as new methods of recording medication information and conducting medication reconciliation) are required to facilitate accurate transfer of medication information. With existing evidence supporting the use of information technology and the patient representing the one constant in the care process, an electronic patient held medication record may provide a solution. This study will assess the feasibility of introducing a patient held electronic medication record in primary and secondary care using the Consolidated Framework for Implementation Research (CFIR).This feasibility study is a mixed method study of community dwelling older adult patients admitted to an urban secondary care facility comprising a non-randomised intervention and qualitative interviews with key stakeholders. Outcomes of interest include clinical outcomes and process evaluation.This study will yield insights pertaining to feasibility, acceptability and participation for a more definitive evaluation of the intervention. The study also has the potential to contribute to knowledge of implementation of technology in a healthcare context and to the broader area of implementation science.

  6. Structuring and coding in health care records: a qualitative analysis using diabetes as a case study

    Directory of Open Access Journals (Sweden)

    Ann R R Robertson

    2015-03-01

    Full Text Available Background   Globally, diabetes mellitus presents a substantial burden to individuals and healthcare systems. Structuring and/or coding of medical records underpin attempts to improve information sharing and searching, potentially bringing clinical and secondary uses benefits.Aims and objectives   We investigated if, how and why records for adults with diabetes were structured and/or coded, and explored stakeholders’ perceptions of current practice.Methods   We carried out a qualitative, theoretically-informed case study of documenting healthcare information for diabetes patients in family practice and hospital settings, using semi-structured interviews, observations, systems demonstrations and documentary data.Results   We conducted 22 interviews and four on-site observations, and reviewed 25 documents. For secondary uses – research, audit, public health and service planning – the benefits of highly structured and coded diabetes data were clearly articulated. Reported clinical benefits in terms of managing and monitoring diabetes, and perhaps encouraging patient self-management, were modest. We observed marked differences in levels of record structuring and/or coding between settings, and found little evidence that these data were being exploited to improve information sharing between them.Conclusions   Using high levels of data structuring and coding in medical records for diabetes patients has potential to be exploited more fully, and lessons might be learned from successful developments elsewhere in the UK.

  7. Recurrent unexplained palpitations (RUP) study comparison of implantable loop recorder versus conventional diagnostic strategy.

    Science.gov (United States)

    Giada, Franco; Gulizia, Michele; Francese, Maura; Croci, Francesco; Santangelo, Lucio; Santomauro, Maurizio; Occhetta, Eraldo; Menozzi, Carlo; Raviele, Antonio

    2007-05-15

    The aim of the study was to compare the diagnostic yield and the costs of implantable loop recorder (ILR) with those of the conventional strategy in patients with unexplained palpitations. In patients with unexplained palpitations, especially in those with infrequent symptoms, the conventional strategy, including short-term ambulatory electrocardiogram (ECG) monitoring and electrophysiological study, sometimes fails to establish a diagnosis. We studied 50 patients with infrequent (1 min) palpitations. Before enrollment, patients had a negative initial evaluation, including history, physical examination, and ECG. Patients were randomized either to conventional strategy (24-h Holter recording, a 4-week period of ambulatory ECG monitoring with an external recorder, and electrophysiological study) (n = 24) or to ILR implantation with 1-year monitoring (n = 26). Hospital costs of the 2 strategies were calculated. A diagnosis was obtained in 5 patients in the conventional strategy group, and in 19 subjects in the ILR group (21% vs. 73%, p < 0.001). Despite the higher initial cost, the cost per diagnosis in the ILR group was lower than in the conventional strategy group (euro 3,056 +/- euro 363 vs. euro 6,768 +/- euro 6,672, p = 0.012). In subjects without severe heart disease and with infrequent palpitations, ILR is a safe and more cost-effective diagnostic approach than conventional strategy.

  8. Studies on preparation of the database system for clinical records of atomic bomb survivors

    International Nuclear Information System (INIS)

    Nakamura, Tsuyoshi

    1981-01-01

    Construction of the database system aimed at multipurpose application of data on clinical medicine was studied through the preparation of database system for clinical records of atomic bomb survivors. The present database includes the data about 110,000 atomic bomb survivors in Nagasaki City. This study detailed: (1) Analysis of errors occurring in a period from generation of data in the clinical field to input into the database, and discovery of a highly precise, effective method of input. (2) Development of a multipurpose program for uniform processing of data on physical examinations from many organizations. (3) Development of a record linkage method for voluminous files which are essential in the construction of a large-scale medical information system. (4) A database model suitable for clinical research and a method for designing a segment suitable for physical examination data. (Chiba, N.)

  9. Preservation of metabolic flexibility in skeletal muscle by a combined use of n-3 PUFA and rosiglitazone in dietary obese mice.

    Directory of Open Access Journals (Sweden)

    Olga Horakova

    Full Text Available Insulin resistance, the key defect in type 2 diabetes (T2D, is associated with a low capacity to adapt fuel oxidation to fuel availability, i.e., metabolic inflexibility. This, in turn, contributes to a further damage of insulin signaling. Effectiveness of T2D treatment depends in large part on the improvement of insulin sensitivity and metabolic adaptability of the muscle, the main site of whole-body glucose utilization. We have shown previously in mice fed an obesogenic high-fat diet that a combined use of n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA and thiazolidinediones (TZDs, anti-diabetic drugs, preserved metabolic health and synergistically improved muscle insulin sensitivity. We investigated here whether n-3 LC-PUFA could elicit additive beneficial effects on metabolic flexibility when combined with a TZD drug rosiglitazone. Adult male C57BL/6N mice were fed an obesogenic corn oil-based high-fat diet (cHF for 8 weeks, or randomly assigned to various interventions: cHF with n-3 LC-PUFA concentrate replacing 15% of dietary lipids (cHF+F, cHF with 10 mg rosiglitazone/kg diet (cHF+ROSI, cHF+F+ROSI, or chow-fed. Indirect calorimetry demonstrated superior preservation of metabolic flexibility to carbohydrates in response to the combined intervention. Metabolomic and gene expression analyses in the muscle suggested distinct and complementary effects of the interventions, with n-3 LC-PUFA supporting complete oxidation of fatty acids in mitochondria and the combination with n-3 LC-PUFA and rosiglitazone augmenting insulin sensitivity by the modulation of branched-chain amino acid metabolism. These beneficial metabolic effects were associated with the activation of the switch between glycolytic and oxidative muscle fibers, especially in the cHF+F+ROSI mice. Our results further support the idea that the combined use of n-3 LC-PUFA and TZDs could improve the efficacy of the therapy of obese and diabetic patients.

  10. Structuring and coding in health care records: a qualitative analysis using diabetes as a case study.

    Science.gov (United States)

    Robertson, Ann R R; Fernando, Bernard; Morrison, Zoe; Kalra, Dipak; Sheikh, Aziz

    2015-03-27

    Globally, diabetes mellitus presents a substantial and increasing burden to individuals, health care systems and society. Structuring and coding of information in the electronic health record underpin attempts to improve sharing and searching for information. Digital records for those with long-term conditions are expected to bring direct and secondary uses benefits, and potentially to support patient self-management. We sought to investigate if how and why records for adults with diabetes were structured and coded and to explore a range of UK stakeholders' perceptions of current practice in the National Health Service. We carried out a qualitative, theoretically informed case study of documenting health care information for diabetes in family practice and hospital settings in England, using semi-structured interviews, observations, systems demonstrations and documentary data. We conducted 22 interviews and four on-site observations. With respect to secondary uses - research, audit, public health and service planning - interviewees clearly articulated the benefits of highly structured and coded diabetes data and it was believed that benefits would expand through linkage to other datasets. Direct, more marginal, clinical benefits in terms of managing and monitoring diabetes and perhaps encouraging patient self-management were also reported. We observed marked differences in levels of record structuring and/or coding between family practices, where it was high, and the hospital. We found little evidence that structured and coded data were being exploited to improve information sharing between care settings. Using high levels of data structuring and coding in records for diabetes patients has the potential to be exploited more fully, and lessons might be learned from successful developments elsewhere in the UK. A first step would be for hospitals to attain levels of health information technology infrastructure and systems use commensurate with family practices.

  11. Implementing Electronic Health Record Default Settings to Reduce Opioid Overprescribing: A Pilot Study.

    Science.gov (United States)

    Zivin, Kara; White, Jessica O; Chao, Sandra; Christensen, Anna L; Horner, Luke; Petersen, Dana M; Hobbs, Morgan R; Capreol, Grace; Halbritter, Kevin A; Jones, Christopher M

    2018-01-09

    To pilot test the effectiveness, feasibility, and acceptability of instituting a 15-pill quantity default in the electronic health record for new Schedule II opioid prescriptions. A mixed-methods pilot study in two health systems, including pre-post analysis of prescribed opioid quantity and focus groups or interviews with prescribers and health system administrators. We implemented a 15-pill electronic health record default for new Schedule II opioids and assessed opioid quantity before and after implementation using electronic health record data on 6,390 opioid prescriptions from 448 prescribers. We then analyzed themes from focus groups and interviews with four staff members and six prescribers. The proportion of opioid prescriptions for 15 pills increased at both sites after adding an electronic health record default, with one reaching statistical significance (from 4.1% to 7.2% at CHC, P = 0.280, and 15.9% to 37.2% at WVU, P default, although ease of implementation varied by electronic health record vendor. Most prescribers were not aware of the default change and stated that they made prescribing decisions based on patient clinical characteristics rather than defaults. This pilot provides initial evidence that changing default settings can increase the number of prescriptions at the default level. This low-cost and relatively simple intervention could have an impact on opioid overprescribing. However, default settings should be selected carefully to avoid unintended consequences. © 2018 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  12. Expectations for the next generation of electronic patient records in primary care: a triangulated study

    Directory of Open Access Journals (Sweden)

    Tom Christensen

    2008-05-01

    Conclusions Progress toward a problem-oriented EPR system based on episodes of care that includes decision support is necessary to satisfy the needs expressed by GPs. Further research could solve the problem of integration of functionality for consultation with specialists and integration with patient held records. Results from this study could contribute to further development of the next generation of EPRs in primary care, as well as inspire the application of EPRs in other parts of the health sector.

  13. Potential of dinoflagellate cyst records for Quaternary climate studies in the New Zealand region

    International Nuclear Information System (INIS)

    Crouch, E.M.

    2003-01-01

    This report summarises the results of a pilot study aimed at investigating the potential of using dinoflagellate cyst (dinocyst) records in the New Zealand region for contributing to high-resolution Quaternary climate studies. Dinocyst assemblages were recorded through a rapid interval of climate change, from glacial Marine Isotope Stage (MIS) 6 to interglacial MIS 5 (∼ 160 to 80 kyr), in ODP Site 1123, offshore eastern New Zealand. Twenty-one samples were examined and dinocyst assemblages, along with other palynomorphs such as spores and pollen, were generally well preserved, abundant and diverse. The relative and absolute abundance of dinocysts is highest in MIS 6, with Brigantedinium spp. and Nematosphaeropsis labyrinthus being the dominant taxa. Moreover, the higher concentration of peridinioid and total dinocysts during the glacial suggests that, in comparison with MIS 5, increased nutrient availability in surface waters was present in MIS 6. Other dinocysts that show an affinity with cool oceanic conditions include Impagidinium pallidum and Selenopemphix Antarctica, while Impagidinium paradoxum, I. patulum, I. plicatum, I. strialatum, I. variaseptum and Spiniferites mirabilis are more common during the interglacial MIS 5. Land-derived spore and pollen microfossils are abundant in Site 1123 and notable peaks in absolute abundance are recorded during MIS 5, with two of the peaks being approximately coeval with the warmer phases of Substage 5e and 5a. This pilot study highlights the increasing potential for marine palynology to contribute to Quaternary paleoclimate research in the New Zealand region. (author). 45 refs., 10 figs

  14. Awareness And Perception Of Nurses Towards E – Health Records: A Hospital Study

    Directory of Open Access Journals (Sweden)

    Roopalekha Jathanna

    2017-07-01

    Full Text Available As a part of pre-implementation of Electronic Health Record (EHR as communicating tool, the study aims at investigating the awareness, perception, and usability of EHR among nurses working in 2032 bedded hospital in southern India. A cross sectional descriptive study with convenient sampling method of 296 nurses was used. The validated questionnaire contained questions related to perception of the nurses about the existing system of record keeping and their effect on patient care; Usefulness of EMR for their practice; relative important of features of EMR; acceptance level and training needs. For analysis SPSS 10.0 version was used. The results of this study is promising in terms of nurses’ views for adoption of EHR. Also, suggests, nurses are beginning to perceive benefits in areas of quality in decision making; patient care and practice; enhance timely access to medical records; efficiency; productivity. Strategies are needed for improving the EHR knowledge among nurses who have a negative perception of and attitude towards it.

  15. Non-volant mammals recorded in environmental evaluation studies in southern Brazil

    Directory of Open Access Journals (Sweden)

    Jorge J. Cherem

    2005-11-01

    Full Text Available Studies to evaluate environmental impacts have become both a need and a requirement of environmental agencies due to great alteration of the native environments provoked by man. Many of these studies are short-termed, but reporting the acquired data is very important in order to increase knowledge about specific biotic groups. Thus, this paper presents the results of the non-volant mammal surveys arising from seven environmental studies in southern Brazil. The following methodologies were employed: (1 interviews with local residents; (2 visual observations and recording; (3 identification of vestiges; and (4 capture with live traps. A total of 46 mammal species were recorded (5 marsupials, 4 xenarthrans, 2 primates, 13 carnivores, 2 artiodactylans, 2 lagomorphs and 18 rodents. Some species, such as the jaguar (Panthera onca, giant otter (Pteronura brasiliensis, Brazilian tapir (Tapirus terrestris and white-lipped peccary (Tayassu pecari, are possibly extinct or seriously threatened. The records obtained and the possibilities of the occurrence of other species are discussed.

  16. Computerized micrographics in processing hard-copy records for an epidemiologic study

    International Nuclear Information System (INIS)

    Robie, D.M.; Fry, S.A.

    1983-01-01

    The availability of computers with increasing capabilities has made feasibile epidemiologic studies involving large populations such as those utilized to evaluate the health effects of occupational exposure to radiation. However, the storage and retrieval of data from the large numbers of hard-copy personnel, health physics, employment medical, historical or anecdotal documents that are the bases of such studies pose major logistics problems to investigators. The potential value of such records to epidemiologic studies depends, not only on their accuracy and completeness, but also on ease of accessibility. To address the latter problem, we are using a stand-alone user-oriented electronic filing system that records, stores, and secures hard-copy documents micrographically. This system is controlled by a computer that provides retrieval of a document image and printed copy (if desired) in less than 30 seconds from a maximum of eight fields. One thousand documents are randomly filmed and indexed on computer storage diskettes in two hours. Manual sorting and filing of the same number of documents takes over a day. At present two thousand documents can be recorded on each microfilm roll and 85,000 documents indexed on each diskette. Simultaneous searching for documents can be done using up to ten terminals while indexing is being done at the main terminal. The micrographics system provides the space-saving and security advantages of microfilm with the speed of computerized data retrieval

  17. Phenological Records

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Phenology is the scientific study of periodic biological phenomena, such as flowering, breeding, and migration, in relation to climatic conditions. The few records...

  18. Passive monitoring using traffic noise recordings - case study on the Steinachtal Bridge

    Science.gov (United States)

    Salvermoser, Johannes; Stähler, Simon; Hadziioannou, Céline

    2015-04-01

    Civil structures age continuously. The early recognition of potentially critical damages is an important economical issue, but also one of public safety. Continuous tracking of small changes in the medium by using passive methods would offer an extension to established active non-destructive testing procedures at relatively low cost. Here we present a case study of structural monitoring using continuous recordings of traffic noise on a 200 meter long reinforced concrete highway bridge in Germany. Over two months of continuos geophone records are used in the frequency range of 2-8 Hz. Using passive image interferometry, evaluation of hourly cross-correlations between recordings at pairs of receivers yield velocity variations in the range of -1.5% to +2.1%. We were able to correlate our outcomes with temperature measurements of the same two month period. The measured velocity changes scale with the temperature variations with on average a dv/v of 0.064% per degree Celsius. This value is in accordance with other studies of concrete response to temperature, confirming that we are able to observe subtle changes with physical origin. It is shown that traffic noise is temporally homogenenous enough to fulfill the requirements of passive image interferometry.

  19. Improving the Recording of Diagnoses in Primary Care with Team Incentives: A Controlled Longitudinal Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Tuomo Lehtovuori

    2018-01-01

    Full Text Available Introduction. We studied whether primary care teams respond to financial group bonuses by improving the recording of diagnoses, whether this intervention leads to diagnoses reflecting the anticipated distribution of diseases, and how the recording of a significant chronic disease, diabetes, alters after the application of these bonuses. Methods. We performed an observational register-based retrospective quasi-experimental follow-up study with before-and-after setting and two control groups in primary healthcare of a Finnish town. We studied the rate of recorded diagnoses in visits to general practitioners with interrupted time series analysis. The distribution of these diagnoses was also recorded. Results. After group bonuses, the rate of recording diagnoses increased by 17.9% (95% CI: 13.6–22.3 but not in either of the controls (−2.0 to −0.3%. The increase in the rate of recorded diagnoses in the care teams varied between 14.9% (4.7–25.2 and 33.7% (26.6–41.3. The distribution of recorded diagnoses resembled the respective distribution of diagnoses in the former studies of diagnoses made in primary care. The rate of recorded diagnoses of diabetes did not increase just after the intervention. Conclusions. In primary care, the completeness of diagnosis recording can be, to varying degrees, influenced by group bonuses without guarantee that recording of clinically significant chronic diseases is improved.

  20. Recording injuries among World Cup skiers and snowboarders: a methodological study.

    Science.gov (United States)

    Flørenes, T W; Nordsletten, L; Heir, S; Bahr, R

    2011-04-01

    No long-term injury surveillance programs exist for competitive skiing or snowboarding. The objective of this study was, therefore, to compare different methods to record injuries among World Cup athletes in alpine, freestyle, and cross-country skiing, snowboarding, ski jumping and Nordic combined. Information regarding injuries sustained during the 2006-2007 winter season was recorded through three separate and independent systems: prospective injury reports by technical delegates (TD) from the International Ski Federation, prospective medical team registration by selected teams, and retrospective athlete interviews at the end of the season. A total of 100 unique injuries to 602 World Cup athletes were identified from any of the three recording methods. Of these, 91% were registered through the athlete interviews, 47% by the medical team registration and 27% by the TD reports. Only 20 injuries (20%) were captured by all three methods. A total of 64 time-loss injuries were registered. The interviews captured 60 (94%), the medical team registration 39 (61%), and the TD reports 23 (36%) time-loss injuries, while 18 (28%) were registered by all three systems. Retrospective interviews with athletes/coaches regarding injuries during the last 6 months gave the most complete picture of injuries to World Cup skiers and snowboarders. © 2009 John Wiley & Sons A/S.

  1. Sonography-guided recording for superficial peroneal sensory nerve conduction study.

    Science.gov (United States)

    Kim, Ki Hoon; Park, Byung Kyu; Kim, Dong Hwee; Kim, Yuntae

    2018-04-01

    We sought to establish the optimal recording position for antidromic conduction of the superficial peroneal nerve (SPN) by using ultrasonography (USG). The sensory nerve action potentials (SNAPs) of the intermediate dorsal cutaneous nerve (IDCN) and medial dorsal cutaneous nerve (MDCN) in 64 limbs of 32 healthy participants were recorded (nerve conduction study [NCS]-1). Both nerves were identified by using USG, and the SNAPs were obtained from the USG-guided repositioned electrodes (NCS-2). The IDCN and MDCN were located at 29.3% ± 5.1% and 43.9% ± 4.9% of the intermalleolar distance from the lateral malleolus, respectively. Significantly greater amplitude was shown for SNAPs of both nerves in NCS-2 versus NCS-1. The optimal recording position is likely to be lateral, one-third from the lateral malleolus for the IDCN, and just lateral to the midpoint of the intermalleolar line for the MDCN. When the SPN response is unexpectedly attenuated, USG-guided repositioning of the electrodes should be considered. Muscle Nerve 57: 628-633, 2018. © 2017 Wiley Periodicals, Inc.

  2. A study of general practitioners' perspectives on electronic medical records systems in NHSScotland.

    Science.gov (United States)

    Bouamrane, Matt-Mouley; Mair, Frances S

    2013-05-21

    Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs' perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees' responses, using Normalisation Process Theory as the underpinning conceptual framework. The majority of GPs' interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities - for example: in relation to usability, system navigation and information visualisation. Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs' interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors.

  3. Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

    Science.gov (United States)

    Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

    2018-04-18

    The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a

  4. Clinical and Para Clinical Information Needs of Infertility Electronic Health Records in Iran: A Delphi Study.

    Science.gov (United States)

    Farzandipour, Mehrdad; Jeddi, Fateme Rangraz; Gilasi, Hamid Reza; Shirzadi, Diana

    2017-09-01

    infertility is referred to the person's inability to conceive pregnancy after one year of intercourse without using protection. This study paves the ground for creating a complete, united, and coherent source of patients' medical information. this is an applied research of descriptive-cross sectional type which has been carried out through qualitative - quantitative methods. The sample of the present study was 50 specialists in the field of infertility which has been chosen based on purposive sampling method. Designing the questionnaire was done based on library studies and Gathering experts' views was done based on Delphi technique. 261 items from clinical and Para clinical information of infertile patients' electronic health records were subjected to an opinion poll by experts. During this process 223 items were accepted and 38 items have been rejected after two sessions of surveys by infertility experts. Para clinical information section consisted of 57 items that all of them have been accepted by the experts. Also, clinical information section consisted of 242 items from which 204 items were accepted and 38 items were rejected by the experts. existence of a structured electronic record system of infertile patients' information leads to the integration of patients' information, improvement of health care services and a decrease in treatment costs: all working to increase information safety. Furthermore, only essential and relevant information would be provided for the specialists and it will facilitate and direct the future infertility related studies due to the coherence, unity and relevance of the information.

  5. A pilot study on the views of elderly regional Australians of personally controlled electronic health records.

    Science.gov (United States)

    Kerai, Paresh; Wood, Pene; Martin, Mary

    2014-03-01

    Australia introduced its version of personal health records in July 2012. Success of the personally controlled electronic health record (PCEHR) relies on acceptance during the early stages. The main aim of this study was to investigate the views of a sample of elderly people in a non-metropolitan region in Australia on the PCEHR, and to assess their acceptance levels of this concept. A self-administered questionnaire was distributed to a non-probability convenience sample of respondents recruited from meetings of Probus, a community club for active business and professional retirees. Approximately three-quarters of the respondents had computer and Internet access at home. If not accessed at home a computer at a general practitioner's practice was seen as beneficial in accessing the PCEHR. Respondents felt that access to their health record would help them make decisions about their own health and improve their communication with healthcare providers. The majority of respondents were in favour of the PCEHR although some expressed concerns about the security of their PCEHR. There was mixed opinion surrounding the access by health professionals to an individual's PCEHR. This study has revealed important information about views of the PCEHR. While the respondents were generally in favour of the concept, there were still some concerns about the security of the PCEHR suggesting further reassurance may be required. The study also highlighted some measures, in particular provision of General Practitioner computer access points and print-out facilities that may need to be considered during these initial implementation stages in order to improve adoption rates once the technology is fully available. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Abscisic acid synergizes with rosiglitazone to improve glucose tolerance and down-modulate macrophage accumulation in adipose tissue: possible action of the cAMP/PKA/PPAR γ axis.

    Science.gov (United States)

    Guri, Amir J; Hontecillas, Raquel; Bassaganya-Riera, Josep

    2010-10-01

    Abscisic acid (ABA) is effective in preventing insulin resistance and obesity-related inflammation through a PPAR γ-dependent mechanism. The objective of this study was to assess the efficacy ABA in improving glucose homeostasis and suppress inflammation when administered in combination with rosiglitazone (Ros) and to determine whether PPAR γ activation by ABA is initiated via cAMP/protein kinase A (PKA) signaling. Obese db/db mice were fed high-fat diets containing 0, 10, or 70 mg/kg Ros with and without racemic ABA (100 mg/kg) for 60 days. Glucose tolerance and fasting insulin levels were assessed at 6 and 8 weeks, respectively, and adipose tissue macrophage (ATM) infiltration was examined by flow cytometry. Gene expression was examined on white adipose tissue (WAT) and stromal vascular cells (SVCs) cultured with ABA, Ros, or an ABA/Ros combination. Both Ros and ABA improved glucose tolerance, and ABA decreased plasma insulin levels while having no effect on Ros-induced weight gain. ABA in combination with low-dose Ros (10 mg/kg; Roslo) synergistically inhibited ATM infiltration. Treatment of SVCs with Ros, ABA or ABA/Ros suppressed expression of the M1 marker CCL17. ABA and Ros synergistically increased PPAR γ activity and pretreatment with a cAMP-inhibitor or a PKA-inhibitor abrogated ABA-induced PPAR γ activation. ABA and Ros act synergistically to modulate PPAR γ activity and macrophage accumulation in WAT and ABA enhances PPAR γ activity through a membrane-initiated mechanism dependent on cAMP/PKA signaling. Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  7. The next generation of precision medicine: observational studies, electronic health records, biobanks, and continuous monitoring.

    Science.gov (United States)

    Glicksberg, Benjamin S; Johnson, Kipp W; Dudley, Joel T

    2018-04-12

    Precision medicine can utilize new techniques in order to more effectively translate research findings into clinical practice. In this article, we first explore the limitations of traditional study designs, which stem from (to name a few): massive cost for the assembly of large patient cohorts; non-representative patient data; and the astounding complexity of human biology. Second, we propose that harnessing electronic health records and mobile device biometrics coupled to longitudinal data may prove to be a solution to many of these problems by capturing a "real world" phenotype. We envision that future biomedical research utilizing more precise approaches to patient care will utilize continuous and longitudinal data sources.

  8. Recently studied sedimentary records from the eastern Arabian Sea: Implications to Holocene monsoonal variability

    Digital Repository Service at National Institute of Oceanography (India)

    Agnihotri, R.; Kurian, S.

    stream_size 72460 stream_content_type text/plain stream_name Earth_Sci_India_1_258.pdf.txt stream_source_info Earth_Sci_India_1_258.pdf.txt Content-Encoding UTF-8 Content-Type text/plain; charset=UTF-8 Agnihotri http://www....earthscienceindia.info/Agnihotri.htm 1 of 14 10/15/2008 9:41 AM Earth Science India Vol.1 (IV), October, 2008, pp. 258-287 http://www.earthscienceindia.info/ Recently studied sedimentary records from the eastern Arabian Sea: Implications to Holocene monsoonal variability Rajesh...

  9. The use of convent archival records in medical research: the School Sisters of Notre Dame archives and the nun study.

    Science.gov (United States)

    Patzwald, Gari-Anne; Wildt, Sister Carol Marie

    2004-01-01

    The School Sisters of Notre Dame (SSND) archives program in a cooperative system for the arrangement and preservation of the records of the SSND provinces in North America, including records of individual sisters. Archival records include autobiographies, school and college transcripts, employment histories, and family socioeconomic data. The Nun Study, a longitudinal study of Alzheimer's disease and aging in 678 SSND sisters, compares data extracted from these records with data on late-life cognitive and physical function and postmortem brain neuropathology to explore early life factor that may affect late-life cognitive function and longevity.

  10. Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study

    NARCIS (Netherlands)

    Jaarsveld, C.H.M. van; Gulliford, M.C.

    2015-01-01

    OBJECTIVE: This study aimed to use primary care electronic health records to evaluate the prevalence of overweight and obesity in 2-15-year-old children in England and compare trends over the last two decades. DESIGN: Cohort study of primary care electronic health records. SETTING: 375 general

  11. Equine trypanosomosis in the Central River Division of the Gambia: A study of veterinary gate-clinic consultation records

    NARCIS (Netherlands)

    Dhollander, S.; Jallow, A.; Mbodge, K.; Kora, S.; Sanneh, M.; Gaye, M.; Bos, J.F.F.P.; Leak, S.; Berkvens, D.; Geerts, S.

    2006-01-01

    The objective of this,study was to provide epidemiological information of equine trypanosomosis in the Central River Division (CRD) of The Gambia. Therefore, 2285 consultations records of equines, admitted in a gate-clinic at Sololo in CRD, were studied retrospectively. The data were recorded in the

  12. Observing the Testing Effect using Coursera Video-recorded Lectures: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Paul Zhihao eYONG

    2016-01-01

    Full Text Available We investigated the testing effect in Coursera video-based learning. One hundred and twenty-three participants either (a studied an instructional video-recorded lecture four times, (b studied the lecture three times and took one recall test, or (c studied the lecture once and took three tests. They then took a final recall test, either immediately or a week later, through which their learning was assessed. Whereas repeated studying produced better recall performance than did repeated testing when the final test was administered immediately, testing produced better performance when the final test was delayed until a week after. The testing effect was observed using Coursera lectures. Future directions are documented.

  13. New South Wales Child Development Study (NSW-CDS): an Australian multiagency, multigenerational, longitudinal record linkage study.

    Science.gov (United States)

    Carr, Vaughan J; Harris, Felicity; Raudino, Alessandra; Luo, Luming; Kariuki, Maina; Liu, Enwu; Tzoumakis, Stacy; Smith, Maxwell; Holbrook, Allyson; Bore, Miles; Brinkman, Sally; Lenroot, Rhoshel; Dix, Katherine; Dean, Kimberlie; Laurens, Kristin R; Green, Melissa J

    2016-02-11

    The initial aim of this multiagency, multigenerational record linkage study is to identify childhood profiles of developmental vulnerability and resilience, and to identify the determinants of these profiles. The eventual aim is to identify risk and protective factors for later childhood-onset and adolescent-onset mental health problems, and other adverse social outcomes, using subsequent waves of record linkage. The research will assist in informing the development of public policy and intervention guidelines to help prevent or mitigate adverse long-term health and social outcomes. The study comprises a population cohort of 87,026 children in the Australian State of New South Wales (NSW). The cohort was defined by entry into the first year of full-time schooling in NSW in 2009, at which time class teachers completed the Australian Early Development Census (AEDC) on each child (with 99.7% coverage in NSW). The AEDC data have been linked to the children's birth, health, school and child protection records for the period from birth to school entry, and to the health and criminal records of their parents, as well as mortality databases. Descriptive data summarising sex, geographic and socioeconomic distributions, and linkage rates for the various administrative databases are presented. Child data are summarised, and the mental health and criminal records data of the children's parents are provided. In 2015, at age 11 years, a self-report mental health survey was administered to the cohort in collaboration with government, independent and Catholic primary school sectors. A second record linkage, spanning birth to age 11 years, will be undertaken to link this survey data with the aforementioned administrative databases. This will enable a further identification of putative risk and protective factors for adverse mental health and other outcomes in adolescence, which can then be tested in subsequent record linkages. Published by the BMJ Publishing Group Limited. For

  14. Medical records documentation of constipation preceding Parkinson disease: A case-control study.

    Science.gov (United States)

    Savica, R; Carlin, J M; Grossardt, B R; Bower, J H; Ahlskog, J E; Maraganore, D M; Bharucha, A E; Rocca, W A

    2009-11-24

    Parkinson disease (PD) may affect the autonomic nervous system and may cause constipation; however, few studies have explored constipation preceding the motor onset of PD. We investigated constipation preceding PD using a case-control study design in a population-based sample. Using the medical records-linkage system of the Rochester Epidemiology Project, we identified 196 subjects who developed PD in Olmsted County, MN, from 1976 through 1995. Each incident case was matched by age (+/-1 year) and sex to a general population control. We reviewed the complete medical records of cases and controls in the medical records-linkage system to ascertain the occurrence of constipation preceding the onset of PD (or index year). Constipation preceding PD or the index year was more common in cases than in controls (odds ratio [OR] 2.48; 95% confidence interval [CI] 1.49 to 4.11; p = 0.0005). This association remained significant after adjusting for smoking and coffee consumption (ever vs never), and after excluding constipation possibly induced by drugs. In addition, the association remained significant in analyses restricted to constipation documented 20 or more years before the onset of motor symptoms of PD. Although the association was stronger in women than in men and in patients with PD with rest tremor compared with patients with PD without rest tremor, these differences were not significant. Our findings suggest that constipation occurring as early as 20 or more years before the onset of motor symptoms is associated with an increased risk of Parkinson disease.

  15. Validation of fragility fractures in primary care electronic medical records: A population-based study.

    Science.gov (United States)

    Martinez-Laguna, Daniel; Soria-Castro, Alberto; Carbonell-Abella, Cristina; Orozco-López, Pilar; Estrada-Laza, Pilar; Nogues, Xavier; Díez-Perez, Adolfo; Prieto-Alhambra, Daniel

    2017-11-28

    Electronic medical records databases use pre-specified lists of diagnostic codes to identify fractures. These codes, however, are not specific enough to disentangle traumatic from fragility-related fractures. We report on the proportion of fragility fractures identified in a random sample of coded fractures in SIDIAP. Patients≥50 years old with any fracture recorded in 2012 (as per pre-specified ICD-10 codes) and alive at the time of recruitment were eligible for this retrospective observational study in 6 primary care centres contributing to the SIDIAP database (www.sidiap.org). Those with previous fracture/s, non-responders, and those with dementia or a serious psychiatric disease were excluded. Data on fracture type (traumatic vs fragility), skeletal site, and basic patient characteristics were collected. Of 491/616 (79.7%) patients with a registered fracture in 2012 who were contacted, 331 (349 fractures) were included. The most common fractures were forearm (82), ribs (38), and humerus (32), and 225/349 (64.5%) were fragility fractures, with higher proportions for classic osteoporotic sites: hip, 91.7%; spine, 87.7%; and major fractures, 80.5%. This proportion was higher in women, the elderly, and patients with a previously coded diagnosis of osteoporosis. More than 4 in 5 major fractures recorded in SIDIAP are due to fragility (non-traumatic), with higher proportions for hip (92%) and vertebral (88%) fracture, and a lower proportion for fractures other than major ones. Our data support the validity of SIDIAP for the study of the epidemiology of osteoporotic fractures. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  16. How the Internet Facilitates the Activity within a Consumer Culture : - A Study of the Online Vinyl Record Network

    OpenAIRE

    Söderlindh, Stefan; Broman, David

    2009-01-01

    The purpose of this thesis is to describe and analyze how the online vinyl record network functions from both a consumer and retailer perspective, in order to gain an understanding of how the Internet facilitates the activity within a consumer culture. The vinyl record industry is experiencing a revival, with an upswing in sales and media attention and a significant increase in the amount of online trading. This inductive study contains data from qualitative interviews with ten vinyl record c...

  17. Secondary bilateral synchrony due to fronto-mesial lesions: an invasive recording study

    Directory of Open Access Journals (Sweden)

    CUKIERT ARTHUR

    1999-01-01

    Full Text Available Frontal lobe epilepsies may present difficulties in focus localization in the pre-operative work-up for epilepsy surgery. This is specially true in patients with normal MRIs. We report on a 16 years-old girl that started with seizures by the age of 8 years. They were brief nocturnal episodes with automatisms such as bicycling and boxing. Seizure frequency ranged from 4-10 per night. Scalp EEG showed few right frontal convexity spiking and intense secondary bilateral syncrhony (SBS. High resolution MRI directed to the frontal lobes was normal. Ictal SPECT suggested a right fronto-lateral focus. Ictal video-EEG showed no focal onset. She was submitted to invasive recordings after subdural plates implantation. Electrodes covered all the frontal convexity and mesial surface bilaterally. Ictal recordings disclosed stereotyped seizures starting from the right mesial frontal. Using a high-resolution tool to measure intra and interhemispheric latencies, the timing and direction of seizure spread from the right fronto-mesial region were studied. Motor strip mapping was performed by means of electrical stimulation. She was submitted to a right frontal lobe resection, 1.5 cm ahead of the motor strip and has been seizure free since surgery (8 months. Pathological examination found a 4 mm area of cortical dysplasia. Invasive studies are needed to allow adequate localization in patients with non-localizatory non-invasive work-up and may lead to excellent results in relation to seizures after surgery.

  18. EDRMS for Academic Records Management: A Design Study in a Malaysian University

    Science.gov (United States)

    Miah, Shah Jahan; Samsudin, Ahmad Zam Hariro

    2017-01-01

    Higher education institutes such as universities suffer from a range of issues in managing their academic records and relevant digital contents. Many universities nowadays use specific software applications for their effective mechanism in records management. The effective provision of enterprises records management (ERM) software for managing…

  19. The electronic locum record for general practitioners: Outcome of an evaluation study in the Netherlands

    NARCIS (Netherlands)

    Dumay, A.C.M.; Haaker, T.I.

    2010-01-01

    Background: A locum practitioner is an out-of-hours general practitioner who needs access to the electronic health record of visiting patients. The electronic locum record is a summary of the electronic health record available to the locum practitioner and includes the most significant health

  20. Defining disease phenotypes using national linked electronic health records: a case study of atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Katherine I Morley

    Full Text Available National electronic health records (EHR are increasingly used for research but identifying disease cases is challenging due to differences in information captured between sources (e.g. primary and secondary care. Our objective was to provide a transparent, reproducible model for integrating these data using atrial fibrillation (AF, a chronic condition diagnosed and managed in multiple ways in different healthcare settings, as a case study.Potentially relevant codes for AF screening, diagnosis, and management were identified in four coding systems: Read (primary care diagnoses and procedures, British National Formulary (BNF; primary care prescriptions, ICD-10 (secondary care diagnoses and OPCS-4 (secondary care procedures. From these we developed a phenotype algorithm via expert review and analysis of linked EHR data from 1998 to 2010 for a cohort of 2.14 million UK patients aged ≥ 30 years. The cohort was also used to evaluate the phenotype by examining associations between incident AF and known risk factors.The phenotype algorithm incorporated 286 codes: 201 Read, 63 BNF, 18 ICD-10, and four OPCS-4. Incident AF diagnoses were recorded for 72,793 patients, but only 39.6% (N = 28,795 were recorded in primary care and secondary care. An additional 7,468 potential cases were inferred from data on treatment and pre-existing conditions. The proportion of cases identified from each source differed by diagnosis age; inferred diagnoses contributed a greater proportion of younger cases (≤ 60 years, while older patients (≥ 80 years were mainly diagnosed in SC. Associations of risk factors (hypertension, myocardial infarction, heart failure with incident AF defined using different EHR sources were comparable in magnitude to those from traditional consented cohorts.A single EHR source is not sufficient to identify all patients, nor will it provide a representative sample. Combining multiple data sources and integrating information on treatment and

  1. Los Alamos National Laboratory: A guide to records series supporting epidemiologic studies conducted for the Department of Energy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-01-01

    The purpose of this guide is to describe each series of records that pertains to the epidemiologic studies conducted by the Epidemiology Section of the Occupational Medicine Group (ESH-2) at the Department of Energy`s (DOE) Los Alamos National Laboratory (LANL) in Los Alamos, New Mexico. The records described in this guide relate to occupational studies performed by the Epidemiology Section, including those pertaining to workers at LANL, Mound Plant, Oak Ridge Reservation, Pantex Plant, Rocky Flats Plant, and Savannah River Site. Also included are descriptions of other health-related records generated or collected by the Epidemiology Section and a small set of records collected by the Industrial Hygiene and Safety Group. This guide is not designed to describe the universe of records generated by LANL which may be used for epidemiologic studies of the LANL work force. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project, HAI`s role in the project, the history of LANL the history and functions of LANL`s Health Division and Epidemiology Section, and the various epidemiologic studies performed by the Epidemiology Section. It provides information on the methodology that HAI used to inventory and describe records housed in the offices of the LANL Epidemiology Section in Technical Area 59 and at the LANL Records Center. Other topics include the methodology used to produce the guide, the arrangement of the detailed record series descriptions, and information concerning access to records repositories.

  2. Geomicrobiological study of modern microbialites from Mexico: towards a better understanding of the ancient fossil record

    Directory of Open Access Journals (Sweden)

    Benzerara K.

    2014-02-01

    Full Text Available Microbialites are sedimentary formations that are found throughout the geological record and are usually considered as one of the oldest traces of life on Earth. Although they have been known for more than a century and hold as an emblematic object in Earth Sciences, we yet do not understand in details how they form and how microbial processes impact their chemistry, structure and macroscopic morphology. Here, we show recent advances achieved owing to funding provided by the EPOV program on the formation of modern microbialites in the crater Lake Alchichica (Mexico. We first show that very diverse microbial communities populate these microbialites, including diverse microbial groups able to induce carbonate precipitation. We demonstrate that this microbial diversity can be preserved for several years in laboratory aquaria offering a nice opportunity for future studies to assess the relationships between biodiversity and microbialite formation. We then detail the textural modifications affecting cyanobacterial cells during the first steps of fossilization as captured in Alchichica microbialites. Finally, we report the discovery of a new deepbranching cyanobacterium species, Candidatus Gloeomargarita lithophora, able to form intracellular Ca-, Mg-, Sr- and Ba-rich carbonates and discuss the implications for the interpretation of the fossil record.

  3. Performance of automated and manual coding systems for occupational data: a case study of historical records.

    Science.gov (United States)

    Patel, Mehul D; Rose, Kathryn M; Owens, Cindy R; Bang, Heejung; Kaufman, Jay S

    2012-03-01

    Occupational data are a common source of workplace exposure and socioeconomic information in epidemiologic research. We compared the performance of two occupation coding methods, an automated software and a manual coder, using occupation and industry titles from U.S. historical records. We collected parental occupational data from 1920-40s birth certificates, Census records, and city directories on 3,135 deceased individuals in the Atherosclerosis Risk in Communities (ARIC) study. Unique occupation-industry narratives were assigned codes by a manual coder and the Standardized Occupation and Industry Coding software program. We calculated agreement between coding methods of classification into major Census occupational groups. Automated coding software assigned codes to 71% of occupations and 76% of industries. Of this subset coded by software, 73% of occupation codes and 69% of industry codes matched between automated and manual coding. For major occupational groups, agreement improved to 89% (kappa = 0.86). Automated occupational coding is a cost-efficient alternative to manual coding. However, some manual coding is required to code incomplete information. We found substantial variability between coders in the assignment of occupations although not as large for major groups.

  4. Novel acoustic technology for studying free-ranging shark social behaviour by recording individuals' interactions.

    Directory of Open Access Journals (Sweden)

    Tristan L Guttridge

    Full Text Available Group behaviours are widespread among fish but comparatively little is known about the interactions between free-ranging individuals and how these might change across different spatio-temporal scales. This is largely due to the difficulty of observing wild fish groups directly underwater over long enough time periods to quantify group structure and individual associations. Here we describe the use of a novel technology, an animal-borne acoustic proximity receiver that records close-spatial associations between free-ranging fish by detection of acoustic signals emitted from transmitters on other individuals. Validation trials, held within enclosures in the natural environment, on juvenile lemon sharks Negaprion brevirostris fitted with external receivers and transmitters, showed receivers logged interactions between individuals regularly when sharks were within 4 m ( approximately 4 body lengths of each other, but rarely when at 10 m distance. A field trial lasting 17 days with 5 juvenile lemon sharks implanted with proximity receivers showed one receiver successfully recorded association data, demonstrating this shark associated with 9 other juvenile lemon sharks on 128 occasions. This study describes the use of acoustic underwater proximity receivers to quantify interactions among wild sharks, setting the scene for new advances in understanding the social behaviours of marine animals.

  5. Epileptogenicity of cortical dysplasia in temporal lobe dual pathology: an electrophysiological study with invasive recordings.

    Science.gov (United States)

    Fauser, Susanne; Schulze-Bonhage, Andreas

    2006-01-01

    Hippocampal sclerosis is often associated with macroscopic or microscopic dysplasia in the temporal neocortex (TN). The relevance of such a dual pathology with regard to epileptogenesis is unclear. This study investigates the role of both pathologies in the generation of ictal and interictal activity. Ictal (113 seizures) and interictal data from invasive EEG recordings with simultaneous depth electrodes in the hippocampus and subdural electrodes over the TN were analysed retrospectively in 12 patients with variable degrees of hippocampal sclerosis and different types of histologically confirmed temporal cortical dysplasia [all male, age at epilepsy onset 25 Hz) and repetitive sharp waves. The interictal patterns over the TN were similar to those seen over extratemporal focal cortical dysplasias. Simultaneous recordings from the hippocampus and the TN strongly suggest that dysplastic tissue in the TN is often epileptogenic. The quantitative contribution of the hippocampus to seizure generation corresponded with the degree of hippocampal pathology, whereas different subtypes of cortical dysplasia did not affect its relative contribution to seizure generation and even mild forms of dysplasia were epileptogenic.

  6. Objectively recorded physical activity in early pregnancy: a multiethnic population-based study.

    Science.gov (United States)

    Berntsen, S; Richardsen, K R; Mørkrid, K; Sletner, L; Birkeland, K I; Jenum, A K

    2014-06-01

    This study aimed to compare objectively recorded physical activity (PA) levels and walking steps among pregnant women. Cross-sectional data from a multiethnic cohort (n = 823) of pregnant women consisting of 44% from Western countries, 24% from South Asia, 14% from Middle East, and 18% from other countries. PA and steps were recorded by the activity monitor SenseWear™ Pro3 Armband. A total of 678 women were included in the analysis. Western women walked significantly more steps and had higher moderate-to-vigorous-intensity physical activity (MVPA) levels compared with South Asian women per weekday and weekend day. Interaction terms (P = 0.008) between ethnicity (Western vs South Asian) and parity, and education, respectively, were identified: having ≥ 1 children was positively associated with steps during weekends in South Asians in contrast to Western women. Having pregnancy and South Asian women without children and with higher education may have an elevated risk for an inactive lifestyle during pregnancy. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. The dynamic relationship between emotional and physical states: an observational study of personal health records

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    Lee YS

    2017-02-01

    Full Text Available Ye-Seul Lee,1 Won-Mo Jung,1 Hyunchul Jang,2 Sanghyun Kim,2 Sun-Yong Chung,3 Younbyoung Chae1 1Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, 2Mibyeong Research Center, Korean Institute of Oriental Medicine, Daejeon, 3Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea Objectives: Recently, there has been increasing interest in preventing and managing diseases both inside and outside medical institutions, and these concerns have supported the development of the individual Personal Health Record (PHR. Thus, the current study created a mobile platform called “Mind Mirror” to evaluate psychological and physical conditions and investigated whether PHRs would be a useful tool for assessment of the dynamic relationship between the emotional and physical conditions of an individual.Methods: Mind Mirror was used to collect 30 days of observational data about emotional valence and the physical states of pain and fatigue from 20 healthy participants, and these data were used to analyze the dynamic relationship between emotional and physical conditions. Additionally, based on the cross-correlations between these three parameters, a multilevel multivariate regression model (mixed linear model [MLM] was implemented.Results: The strongest cross-correlation between emotional and physical conditions was at lag 0, which implies that emotion and body condition changed concurrently. In the MLM, emotional valence was negatively associated with fatigue (β =-0.233, P<0.001, fatigue was positively associated with pain (β =0.250, P<0.001, and pain was positively associated with fatigue (β =0.398, P<0.001.Conclusion: Our study showed that emotional valence and one’s physical condition negatively influenced one another, while fatigue and pain positively affected each other. These findings suggest that the mind and body interact instantaneously, in

  8. Introduction of shared electronic records: multi-site case study using diffusion of innovation theory.

    Science.gov (United States)

    Greenhalgh, Trisha; Stramer, Katja; Bratan, Tanja; Byrne, Emma; Mohammad, Yara; Russell, Jill

    2008-10-23

    To explore the introduction of a centrally stored, shared electronic patient record (the summary care record (SCR)) in England and draw wider lessons about the implementation of large scale information technology projects in health care. Multi-site, mixed method case study applying utilisation focused evaluation. Four early adopter sites for the SCR in England-three in urban areas of relative socioeconomic deprivation and the fourth in a relatively affluent rural area. Data sources and analysis Data included 250 staff interviews, 1500 hours of ethnographic observation, interviews and focus groups with 170 patients and carers, 2500 pages of correspondence and documentary evidence, and incorporation of relevant surveys and statistics produced by others. These were analysed by using a thematic approach drawing on (and extending) a theoretical model of complex change developed in a previous systematic review. Main findings The mixed fortunes of the SCR programme in its first year were largely explained by eight interacting influences. The first was the SCR's material properties (especially technical immaturity and lack of interoperability) and attributes (especially the extent to which potential adopters believed the benefits outweighed the risks). The second was adopters' concerns (especially about workload and the ethicality of sharing "confidential" information on an implied consent model). The third influence was interpersonal influence (for example, opinion leaders, champions, facilitators), and the fourth was organisational antecedents for innovation (for example past experience with information technology projects, leadership and management capacity, effective data capture systems, slack resources). The fifth was organisational readiness for the SCR (for example, innovation-system fit, tension for change, power balances between supporters and opponents, baseline data quality). The sixth was the implementation process (including the nature of the change model and

  9. Coordinated Oxygen Isotopic and Petrologic Studies of CAIS Record Varying Composition of Protosolar

    Science.gov (United States)

    Simon, Justin I.; Matzel, J. E. P.; Simon, S. B.; Weber, P. K.; Grossman, L.; Ross, D. K.; Hutcheon, I. D.

    2012-01-01

    Ca-, Al-rich inclusions (CAIs) record the O-isotope composition of Solar nebular gas from which they grew [1]. High spatial resolution O-isotope measurements afforded by ion microprobe analysis across the rims and margin of CAIs reveal systematic variations in (Delta)O-17 and suggest formation from a diversity of nebular environments [2-4]. This heterogeneity has been explained by isotopic mixing between the O-16-rich Solar reservoir [6] and a second O-16-poor reservoir (probably nebular gas) with a "planetary-like" isotopic composition [e.g., 1, 6-7], but the mechanism and location(s) where these events occur within the protoplanetary disk remain uncertain. The orientation of large and systematic variations in (Delta)O-17 reported by [3] for a compact Type A CAI from the Efremovka reduced CV3 chondrite differs dramatically from reports by [4] of a similar CAI, A37 from the Allende oxidized CV3 chondrite. Both studies conclude that CAIs were exposed to distinct, nebular O-isotope reservoirs, implying the transfer of CAIs among different settings within the protoplanetary disk [4]. To test this hypothesis further and the extent of intra-CAI O-isotopic variation, a pristine compact Type A CAI, Ef-1 from Efremovka, and a Type B2 CAI, TS4 from Allende were studied. Our new results are equally intriguing because, collectively, O-isotopic zoning patterns in the CAIs indicate a progressive and cyclic record. The results imply that CAIs were commonly exposed to multiple environments of distinct gas during their formation. Numerical models help constrain conditions and duration of these events.

  10. Month of Conception and Learning Disabilities: A Record-Linkage Study of 801,592 Children.

    Science.gov (United States)

    Mackay, Daniel F; Smith, Gordon C S; Cooper, Sally-Ann; Wood, Rachael; King, Albert; Clark, David N; Pell, Jill P

    2016-10-01

    Learning disabilities have profound, long-lasting health sequelae. Affected children born over the course of 1 year in the United States of America generated an estimated lifetime cost of $51.2 billion. Results from some studies have suggested that autistic spectrum disorder may vary by season of birth, but there have been few studies in which investigators examined whether this is also true of other causes of learning disabilities. We undertook Scotland-wide record linkage of education (annual pupil census) and maternity (Scottish Morbidity Record 02) databases for 801,592 singleton children attending Scottish schools in 2006-2011. We modeled monthly rates using principal sine and cosine transformations of the month number and demonstrated cyclicity in the percentage of children with special educational needs. Rates were highest among children conceived in the first quarter of the year (January-March) and lowest among those conceived in the third (July-September) (8.9% vs 7.6%; P disabilities, and learning difficulties (e.g., dyslexia) and were absent for sensory or motor/physical impairments and mental, physical, or communication problems. Seasonality accounted for 11.4% (95% confidence interval: 9.0, 13.7) of all cases. Some biologically plausible causes of this variation, such as infection and maternal vitamin D levels, are potentially amendable to intervention. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Deep-sea ciliates: Recorded diversity and experimental studies on pressure tolerance

    Science.gov (United States)

    Schoenle, Alexandra; Nitsche, Frank; Werner, Jennifer; Arndt, Hartmut

    2017-10-01

    Microbial eukaryotes play an important role in biogeochemical cycles not only in productive surface waters but also in the deep sea. Recent studies based on metagenomics report deep-sea protistan assemblages totally different from continental slopes and shelf waters. To give an overview about the ciliate fauna recorded from the deep sea we summarized the available information on ciliate occurrence in the deep sea. Our literature review revealed that representatives of the major phylogenetic groups of ciliates were recorded from the deep sea (> 1000 m depth): Karyorelictea, Heterotrichea, Spirotrichea (Protohypotrichia, Euplotia, Oligotrichia, Choreotrichia, Hypotrichia), Armophorea (Armophorida), Litostomatea (Haptoria), Conthreep (Phyllopharyngea incl. Cyrtophoria, Chonotrichia, Suctoria; Nassophorea incl. Microthoracida, Synhymeniida, Nassulida; Colpodea incl. Bursariomorphida, Cyrtolophosidida; Prostomatea; Plagiopylea incl. Plagiopylida, Odontostomatida; Oligohymenophorea incl. Peniculia, Scuticociliatia, Hymenostomatia, Apostomatia, Peritrichia, Astomatia). Species occurring in both habitats, deep sea and shallow water, are rarely found to our knowledge to date. This indicates a high deep-sea specific ciliate fauna. Our own studies of similar genotypes (SSU rDNA and cox1 gene) revealed that two small scuticociliate species (Pseudocohnilembus persalinus and Uronema sp.) could be isolated from surface as well as deep waters (2687 m, 5276 m, 5719 m) of the Pacific. The adaptation to deep-sea conditions was investigated by exposing the ciliate isolates directly or stepwise to different hydrostatic pressures ranging from 1 to 550 atm at temperatures of 2 °C and 13 °C. Although the results indicated no general barophilic behavior, all four isolated strains survived the highest established pressure. A better survival at 550 atm could be observed for the lower temperature. Among microbial eukaryotes, ciliates should be considered as a diverse and potentially

  12. Validation of verbal autopsy methods using hospital medical records: a case study in Vietnam.

    Science.gov (United States)

    Tran, Hong Thi; Nguyen, Hoa Phuong; Walker, Sue M; Hill, Peter S; Rao, Chalapati

    2018-05-18

    Information on causes of death (COD) is crucial for measuring the health outcomes of populations and progress towards the Sustainable Development Goals. In many countries such as Vietnam where the civil registration and vital statistics (CRVS) system is dysfunctional, information on vital events will continue to rely on verbal autopsy (VA) methods. This study assesses the validity of VA methods used in Vietnam, and provides recommendations on methods for implementing VA validation studies in Vietnam. This validation study was conducted on a sample of 670 deaths from a recent VA study in Quang Ninh province. The study covered 116 cases from this sample, which met three inclusion criteria: a) the death occurred within 30 days of discharge after last hospitalisation, and b) medical records (MRs) for the deceased were available from respective hospitals, and c) the medical record mentioned that the patient was terminally ill at discharge. For each death, the underlying cause of death (UCOD) identified from MRs was compared to the UCOD from VA. The validity of VA diagnoses for major causes of death was measured using sensitivity, specificity and positive predictive value (PPV). The sensitivity of VA was at least 75% in identifying some leading CODs such as stroke, road traffic accidents and several site-specific cancers. However, sensitivity was less than 50% for other important causes including ischemic heart disease, chronic obstructive pulmonary diseases, and diabetes. Overall, there was 57% agreement between UCOD from VA and MR, which increased to 76% when multiple causes from VA were compared to UCOD from MR. Our findings suggest that VA is a valid method to ascertain UCOD in contexts such as Vietnam. Furthermore, within cultural contexts in which patients prefer to die at home instead of a healthcare facility, using the available MRs as the gold standard may be meaningful to the extent that recall bias from the interval between last hospital discharge and death

  13. A Competition between Care Teams Improved Recording of Diagnoses in Primary Dental Care: A Longitudinal Follow-Up Study.

    Science.gov (United States)

    Kallio, Jouko; Kauppila, Timo; Suominen, Lasse; Heikkinen, Anna Maria

    2017-01-01

    A playful competition was launched in a primary dental health care system to improve the recording of diagnoses into an electronic patient chart system and to study what diagnoses were used in primary dental care. This was a longitudinal follow-up study with public sector primary dental care practices in a Finnish city. A one-year-lasting playful competition between the dental care teams was launched and the monthly percentage of dentists' visits with recorded diagnosis before, during, and after the intervention was recorded. The assessed diagnoses were recorded with the International Classification of Diseases (ICD-10). Before the competition, the level of diagnosis recordings was practically zero. At the end of this intervention, about 25% of the visits had a recorded diagnosis. Two years after the competition, this percentage was 35% without any additional measures. The most frequent diagnoses were dental caries (K02, 38.6%), other diseases of hard tissues of teeth (K03, 14.8%), and diseases of pulp and periapical tissues (K04, 11.4%). Commitment to the idea that recording of diagnoses was beneficial improved the recording of dental diagnoses. However, the diagnoses obtained did not accurately reflect the reputed prevalence of oral diseases in the Finnish population.

  14. A Competition between Care Teams Improved Recording of Diagnoses in Primary Dental Care: A Longitudinal Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Jouko Kallio

    2017-01-01

    Full Text Available Introduction. A playful competition was launched in a primary dental health care system to improve the recording of diagnoses into an electronic patient chart system and to study what diagnoses were used in primary dental care. Methods. This was a longitudinal follow-up study with public sector primary dental care practices in a Finnish city. A one-year-lasting playful competition between the dental care teams was launched and the monthly percentage of dentists’ visits with recorded diagnosis before, during, and after the intervention was recorded. The assessed diagnoses were recorded with the International Classification of Diseases (ICD-10. Results. Before the competition, the level of diagnosis recordings was practically zero. At the end of this intervention, about 25% of the visits had a recorded diagnosis. Two years after the competition, this percentage was 35% without any additional measures. The most frequent diagnoses were dental caries (K02, 38.6%, other diseases of hard tissues of teeth (K03, 14.8%, and diseases of pulp and periapical tissues (K04, 11.4%. Conclusions. Commitment to the idea that recording of diagnoses was beneficial improved the recording of dental diagnoses. However, the diagnoses obtained did not accurately reflect the reputed prevalence of oral diseases in the Finnish population.

  15. Childhood Health and Educational Outcomes Associated With Maternal Sleep Apnea: A Population Record-Linkage Study.

    Science.gov (United States)

    Bin, Yu Sun; Cistulli, Peter A; Roberts, Christine L; Ford, Jane B

    2017-11-01

    Sleep apnea in pregnancy is known to adversely affect birth outcomes. Whether in utero exposure to maternal sleep apnea is associated with long-term childhood consequences is unclear. Population-based longitudinal study of singleton infants born during 2002-2012 was conducted using linked birth, hospital, death, developmental, and educational records from New South Wales, Australia. Maternal sleep apnea during pregnancy was identified from hospital records. Outcomes were mortality and hospitalizations up to age 6, developmental vulnerability in the first year of school (aged 5-6 years), and performance on standardized tests in the third year of school (aged 7-9 years). Cox proportional hazards and modified Poisson regression models were used to calculate hazard and risk ratios for outcomes in children exposed to maternal apnea compared with those not exposed. Two hundred nine of 626188 singleton infants were exposed to maternal sleep apnea. Maternal apnea was not significantly associated with mortality (Fisher's exact p = .48), developmental vulnerability (adjusted RR 1.29; 95% CI 0.75-2.21), special needs status (1.58; 0.61-4.07), or low numeracy test scores (1.03; 0.63-1.67) but was associated with low reading test scores (1.55; 1.08-2.23). Maternal apnea significantly increased hospitalizations in the first year of life (adjusted HR 1.81; 95% CI 1.40-2.34) and between the first and sixth birthdays (1.41; 1.14-1.75). This is partly due to admissions for suspected pediatric sleep apnea. Maternal sleep apnea during pregnancy is associated with poorer childhood health. Its impact on developmental and cognitive outcomes warrants further investigation. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  16. Displays of authority in the clinical consultation: a linguistic ethnographic study of the electronic patient record.

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    Swinglehurst, Deborah

    2014-10-01

    The introduction of computers into general practice settings has profoundly changed the dynamics of the clinical consultation. Previous research exploring the impact of the computer (in what has been termed the 'triadic' consultation) has shown that computer use and communication between doctor and patient are intricately coordinated and inseparable. Swinglehurst et al. have recently been critical of the ongoing tendency within health communication research to focus on 'the computer' as a relatively simple 'black box', or as a material presence in the consultation. By re-focussing on the electronic patient record (EPR) and conceptualising this as a complex collection of silent but consequential voices, they have opened up new and more nuanced possibilities for analysis. This orientation makes visible a tension between the immediate contingencies of the interaction as it unfolds moment-by-moment and the more standardised, institutional demands which are embedded in the EPR ('dilemma of attention'). In this paper I extend this work, presenting an in-depth examination of how participants in the consultation manage this tension. I used linguistic ethnographic methods to study 54 video recorded consultations from a dataset collected between 2007 and 2008 in two UK general practices, combining microanalysis of the consultation with ethnographic attention to the wider organisational and institutional context. My analysis draws on the theoretical work of Erving Goffman and Mikhail Bakhtin, incorporating attention to the 'here and now' of the interaction as well as an appreciation of the 'distributed' nature of the EPR, its role in hosting and circulating new voices, and in mediating participants' talk and social practices. It reveals - in apparently fleeting moments of negotiation and contestation - the extent to which the EPR shapes the dynamic construction, display and circulation of authority in the contemporary consultation. Copyright © 2014 The Author. Published by

  17. Effect of chromium enriched fermentation product of barley and brewer’s yeast and its combination with rosiglitazone on experimentally induced hyperglycaemia in mice

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    Cekić Vlada

    2011-01-01

    Full Text Available Introduction. In the recent years, herbal preparations have been more used to treat diabetes. Dietetic supplement based on barley and beer yeast enriched with chromium (BBCr is registered in Serbia as a supplement in the treatment of type 2 diabetes. Objective. To investigate the effect of the preparation based on barley and brewer’s yeast with chromium (BBCr, rosiglitazone (R and their combination (BBCr+R on fasting glycaemia and glycaemia in mice after glucose, adrenalin and alloxan application. Methods. The animals were divided into three groups: glucose 500 mg/kg (I; adrenalin 0.2 mg/kg (II; and alloxan 100 mg/kg (III and into subgroups according to the substance they received (BBCr: 750 mg/kg, R: 0.75 mg/kg and BBCr+R. Each animal was its own control in respect of glycaemia before and after the treatment with test substances, except for group III which contained a placebo subgroup. Results. BBCr caused a significant decrease of fasting glycaemia and significant reduction of glycaemia after glucose load compared to the values before treatment (7.4±0.6 mmol/l vs 9.2±0.6 mmol/l; p=0.01. R and BBCr+R significantly decreased glycaemia after adrenalin load (R: 8.6±1.8 mmol/l vs 15.4±3.2 mmol/l; p=0.004; BBCr+R: 9.6±2.4 mmol/l vs 15.0±4.4 mmol/l; p=0.04. After alloxan application the glycaemia was significantly lower in the subgroups treated with BBCr, R and BBCr+R compared to placebo subgroup (10.1±8.0 mmol/l vs 6.8±2.7 mmol/l vs 13.5±9.7 mmol/l vs 24.5±4.7 mmol/l; p=0.001. Conclusion. Pretreatment with BBCr caused a significant reduction of fasting glycaemia and glycaemia after glucose load. Rosiglitazone and BBCr+R caused a significant reduction of glycaemia after adrenalin load. Pretreatment with BBCr, R and BBCr+R prevented the onset of experimental diabetes caused by alloxan, which was confirmed by histological analysis of pancreas tissue.

  18. Preliminary study of technical terminology for the retrieval of scientific book metadata records

    DEFF Research Database (Denmark)

    Larsen, Birger; Lioma, Christina; Frommholz, Ingo

    2012-01-01

    Books only represented by brief metadata (book records) are particularly hard to retrieve. One way of improving their retrieval is by extracting retrieval enhancing features from them. This work focusses on scientific (physics) book records. We ask if their technical terminology can be used...

  19. STUDIES IN WORKMEN'S COMPENSATION AND RADIATION INJURY. VOLUME III, A REPORT ON IONIZING RADIATION RECORD KEEPING.

    Science.gov (United States)

    Atomic Energy Commission, Washington, DC.

    THE SUCCESSFUL OPERATION OF THE PERMISSIBLE LEVEL CONCEPT OF RADIATION CONTROL NECESSARILY ENTAILS A COMPREHENSIVE SYSTEM UNDER WHICH EXPOSURE MUST BE RECORDED AND EMPLOYEES NOTIFIED OF THEIR EXPOSURE HISTORY. IN AN INVESTIGATION OF RECORD KEEPING NECESSARY TO PROCESS RADIATION CLAIMS, QUESTIONNAIRES OR LETTERS WERE RECEIVED FROM 45 STATE AGENCIES…

  20. Self-reported stressors among patients with Exhaustion Disorder: an exploratory study of patient records

    Science.gov (United States)

    2014-01-01

    Background Several researchers imply that both work-related and non-work-related stress exposure are likely to contribute to stress-related mental illness. Yet empirical studies investigating both domains seem to be limited, particularly in a clinical population. The purpose of this study was to a) explore which stressors (non-work and work-related) are reported as important for the onset of illness by patients seeking medical care for stress-related exhaustion and b) explore the prevalence of each stressor and examine whether the pattern differs between men and women. Methods This is an exploratory mixed method study, comprising patients at a specialist outpatient stress clinic. Information from medical records of 20 patients was initially used in a first qualitative step to construct the instrument, using a combination of a conventional content analysis and a directed content analysis. In the second phase patient records from 50 men and 50 women were selected and coded in accordance with the coding instrument. Frequency statistics were calculated for all stressors. Results A total of 24 categories of stressors (11 related to work and 13 related to private life) were identified in the first qualitative step. A median of four stressors, usually both work and non-work-related was reported by the patients. The most common stressors were 1) quantitative demands at work, 2) private relational conflicts and 3) emotional demands at work. Conclusions Work demands are, by far, the most prevalent stressor, followed by relational problems in private life. The pattern was similar for women and men, with a slight difference in the distribution between work and non-work stressors. Men and women also show similar patterns when comparing the occurrence of each stressor. Slight differences were seen, in particular with regard to managerial responsibility that was reported by 6% of the women compared to 36% of the men. One important practical implication of this study is that

  1. Taxonomic studies of centric diatoms (Diatomeae: unusual nanoplanktonic forms and new records for Brazil

    Directory of Open Access Journals (Sweden)

    Kaoli Pereira Cavalcante

    2013-06-01

    Full Text Available There have been few taxonomic studies of centric diatoms in lotic freshwater environments in Brazil, especially in terms of those including nanoplanktonic forms, which are often neglected in studies of local floras, because of their small size or confusing taxonomy. This is the first study focusing on centric diatoms in the flora of the state of Bahia, in northeastern Brazil. Plankton and periphyton attached to Eichornia crassipes were collected in the winter of 2009 in the Cachoeira River. The diatoms were analyzed and described under light and electron microscopies. Seventeen infrageneric taxa were identified. Cyclotella was represented by five taxa, and concerning of similarities between diacritical features of species in this genus, their descriptions were thoroughly detailed. This was the first time that Cyclotella atomus var. marina, previously recorded only in coastal areas of Japan and Korea, has been documented in a river in South America. We also identified two diatom taxa previously unrecorded in the flora of Brazil: C. cryptica and C. meduanae. Finally, we present a detailed light, transmission and scanning electron microscopy analysis of Skeletonema potamos, a diatom rarely found in the Brazilian literature.

  2. The preglacial sediment record of Lake Ladoga, NW Russia - first results from a multi-proxy study on a 23 m sediment record

    Science.gov (United States)

    Gromig, R.; Melles, M.; Wagner, B.; Krastel, S.; Andreev, A.; Fedorov, G.; Just, J.; Wennrich, V.; Savelieva, L.; Subetto, D.; Shumilovskikh, L.

    2016-12-01

    The joint German-Russian project 'PLOT - Paleolimnological Transect' aims to recover lake sediment sequences along a more than 6000 km long longitudinal transect across the Eurasian Arctic in order to study the Late Quaternary climatic and environmental history. The eastern end of the PLOT transect is formed by the well-studied record from Lake El'gygytgyn (NE Siberia). Lake Ladoga (N 60°50' E 31°30') is Europe's largest lake, both by size and volume and forms the westernmost end of the transect. Whereas modern sedimentation as well as the Holocene and Late Glacial history of Lake Ladoga have intensely been studied, the preglacial history of the lake is poorly studied to date by sediment cores drilled in the 1930's. A seismic survey of Lake Ladoga in summer 2013 revealed unconformities in the western lake basin, which may separate preglacial sediments in isolated depressions from Late Glacial and Holocene sediment successions above. A 23 m long sediment core (Co1309) was retrieved from one of these depressions. Core Co1309 was investigated by XRF-scanning, magnetic susceptibility measurements, as well as pollen, grain-size, and bio-geochemical analyses. An age-depth model combining radiocarbon, OSL, and paleomagnetic dates is in progress. Both, the pollen results and the OSL ages from the base of the record indicate a deposition during MIS 5e (Eemian). The well sorted reddish sands from this interval contain dinoflagellates suggesting at least brackish conditions, likely due to the existence of a gateway connecting a precursor of the Baltic Sea with the White Sea via Lake Ladoga. The Late Glacial sequence consists of greyish varved clays of decreasing thickness upwards with sporadically intercalated sand layers. The Holocene sequence is composed of brownish diatomaceous silty clay with minor proportions of sand.

  3. Testing the Molecular Clock Using the Best Fossil Record: Case Studies from the Planktic Foraminifera

    Science.gov (United States)

    Steel, B. A.; Kucera, M.; Darling, K.

    2004-12-01

    Criticism of molecular clock studies often centres on inadequate calibration and a perceived lack of correlation between reproductive isolation and recognisable morphological evolution. Since many major groups (e.g. birds, mammals, reptiles) have a poor fossil record, it is often difficult to test and refute these limitations. Planktic foraminifera represent an exception to this rule. Deep-sea sediments are super-abundant in foraminifera, and large numbers of specimens and occurrences are easily garnered from Ocean Drilling Programme cores. Planktic foraminifera therefore represent an ideal model group with which to test and refine molecular clock studies. Since the 1990AƒAøAøâ_sA¬Aøâ_zAøs, genetic sequences (principally 18S r-RNA) have been extracted from living planktic foraminifera, and a large genetic library has developed. Our study attempts to contextualise and test molecular data, particularly AƒAøAøâ_sA¬Agenetic studies have suggested that these two AƒAøAøâ_sA¬A<Å"super-speciesAƒAøAøâ_sA¬Aøâ_zAø in fact consist of a number of isolated forms, with contrasting ecologies and longevities, which in Recent and sub-Recent sediments can be distinguished either on the basis of pore ultrastructure (Gl. siphonifera) or test colouration (Gs. ruber). In both cases, molecular clock estimates are indicative of ancient (7-11 Ma) intra-species cryptic divergences, which seem to be considerably older than fossil dates. In particular, the calculated molecular split between the two forms of Gs. ruber (AƒAøAøâ_sA¬A<Å"whiteAƒAøAøâ_sA¬Aøâ_zAø and AƒAøAøâ_sA¬A<Å"pinkAƒAøAøâ_sA¬Aøâ_zAø) of around 11 Ma is considerably discordant with the fossil date of around 0.7 Ma. At first glance, this may appear to be a classic case of molecular over-estimation, often a feature of clock models, especially where, as in the foraminifera, substitution rates may vary widely. However, there is good reason to suspect that fossil range of the

  4. Cretaceous honeycomb oysters (Pycnodonte vesicularis) as palaeoseasonality records: A multi-proxy study

    Science.gov (United States)

    de Winter, Niels J.; Vellekoop, Johan; Vorsselmans, Robin; Golreihan, Asefeh; Petersen, Sierra V.; Meyer, Kyle W.; Speijer, Robert P.; Claeys, Philippe

    2017-04-01

    trace element and stable isotope records allow discussion of the degree to which Pycnodonte shells record their palaeoenvironment and can be used to reconstruct past sea water conditions. Preliminary results indicate that stable isotope and trace element ratios in Pynodonte shells record different seasonally changing sea water conditions in the Maastrichtian and reconstructed temperatures are consistent with results from clumped isotope analysis on the same shells and TEX86 analysis on the surrounding rocks. This multi-proxy study sheds light on the shell structure of Pycnodonte oysters, their chemical signature and growth pattern and investigates the expression of palaeoenvironmental proxies in the pristine shell calcite of these bivalves. This investigation shows the potential of using fossil Pycnodonte bivalves as a new archive for palaeoclimate reconstruction on a seasonal scale over a wide range of palaeolatitudes from the Cretaceous until the Pleistocene. References Huyghe et al. (2015) J. Geol Soc 172.5: 576-587. Videt (2003) Diss. Université Rennes 1. Wisshak, et al. (2009) Deep-Sea Res Pt I 56.3: 374-407.

  5. An Interoperability Platform Enabling Reuse of Electronic Health Records for Signal Verification Studies

    Directory of Open Access Journals (Sweden)

    Mustafa Yuksel

    2016-01-01

    Full Text Available Depending mostly on voluntarily sent spontaneous reports, pharmacovigilance studies are hampered by low quantity and quality of patient data. Our objective is to improve postmarket safety studies by enabling safety analysts to seamlessly access a wide range of EHR sources for collecting deidentified medical data sets of selected patient populations and tracing the reported incidents back to original EHRs. We have developed an ontological framework where EHR sources and target clinical research systems can continue using their own local data models, interfaces, and terminology systems, while structural interoperability and Semantic Interoperability are handled through rule-based reasoning on formal representations of different models and terminology systems maintained in the SALUS Semantic Resource Set. SALUS Common Information Model at the core of this set acts as the common mediator. We demonstrate the capabilities of our framework through one of the SALUS safety analysis tools, namely, the Case Series Characterization Tool, which have been deployed on top of regional EHR Data Warehouse of the Lombardy Region containing about 1 billion records from 16 million patients and validated by several pharmacovigilance researchers with real-life cases. The results confirm significant improvements in signal detection and evaluation compared to traditional methods with the missing background information.

  6. Cigarette smoking and tooth loss experience among young adults: a national record linkage study

    Directory of Open Access Journals (Sweden)

    Tanaka Keiko

    2007-11-01

    Full Text Available Abstract Background Various factors affect tooth loss in older age including cigarette smoking; however, evidence regarding the association between smoking and tooth loss during young adulthood is limited. The present study examined the association between cigarette smoking and tooth loss experience among adults aged 20–39 years using linked data from two national databases in Japan. Methods Two databases of the National Nutrition Survey (NNS and the Survey of Dental Diseases (SDD, which were conducted in 1999, were obtained from the Ministry of Health, Labor and Welfare with permission for analytical use. In the NNS, participants received physical examinations and were interviewed regarding dietary intake and health practices including cigarette smoking, whereas in the SDD, participants were asked about their frequency of daily brushing, and received oral examinations by certified dentists. Among 6,805 records electronically linked via household identification code, 1314 records of individuals aged 20 to 39 years were analyzed. The prevalence of 1+ tooth loss was compared among non-, former, and current smokers. Multiple logistic regression models were constructed including confounders: frequency of tooth brushing, body mass index, alcohol consumption, and intake of vitamins C and E. Results Smoking rates differed greatly in men (53.3% and women (15.5%. The overall prevalence of tooth loss was 31.4% (31.8% men and 31.1% women. Tooth loss occurred more frequently among current smokers (40.6% than former (23.1% and non-smokers (27.9%. Current smoking showed a significant association with 1+ tooth loss in men (adjusted OR = 2.21 [1.40–3.50], P = 0.0007 and women (1.70 [1.13–2.55], P = 0.0111. A significant positive exposure-related relationship between cigarette smoking status and tooth loss was observed (P for trend Conclusion An association between cigarette smoking and tooth loss was evident among young adults throughout Japan. Due to

  7. Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study.

    Science.gov (United States)

    Lee, Wei Wei; Alkureishi, Maria A; Ukabiala, Obioma; Venable, Laura Ruth; Ngooi, Samantha S; Staisiunas, Daina D; Wroblewski, Kristen E; Arora, Vineet M

    2016-11-01

    While concerns remain regarding Electronic Medical Records (EMR) use impeding doctor-patient communication, resident and faculty patient perspectives post-widespread EMR adoption remain largely unexplored. We aimed to describe patient perspectives of outpatient resident and faculty EMR use and identify positive and negative EMR use examples to promote optimal utilization. This was a prospective mixed-methods study. Internal medicine faculty and resident patients at the University of Chicago's primary care clinic participated in the study. In 2013, one year after EMR implementation, telephone interviews were conducted with patients using open-ended and Likert style questions to elicit positive and negative perceptions of EMR use by physicians. Interview transcripts were analyzed qualitatively to develop a coding classification. Satisfaction with physician EMR use was examined using bivariate statistics. In total, 108 interviews were completed and analyzed. Two major themes were noted: (1) Clinical Functions of EMR and (2) Communication Functions of EMR; as well as six subthemes: (1a) Clinical Care (i.e., clinical efficiency), (1b) Documentation (i.e., proper record keeping and access), (1c) Information Access, (1d) Educational Resource, (2a) Patient Engagement and (2b) Physical Focus (i.e., body positioning). Overall, 85 % (979/1154) of patient perceptions of EMR use were positive, with the majority within the "Clinical Care" subtheme (n = 218). Of negative perceptions, 66 % (115/175) related to the "Communication Functions" theme, and the majority of those related to the "Physical Focus" subtheme (n = 71). The majority of patients (90 %, 95/106) were satisfied with physician EMR use: 59 % (63/107) reported the computer had a positive effect on their relationship and only 7 % (8/108) reported the EMR made it harder to talk with their doctors. Despite concerns regarding EMRs impeding doctor-patient communication, patients reported largely positive

  8. An alternative method to record rising temperatures during dental implant site preparation: a preliminary study using bovine bone

    Directory of Open Access Journals (Sweden)

    Domenica Laurito

    2010-12-01

    Full Text Available Overheating is constantly mentioned as a risk factor for bone necrosis that could compromise the dental implant primary stability. Uncontrolled thermal injury can result in a fibrous tissue, interpositioned at the implant-bone interface, compromising the long-term prognosis. The methods used to record temperature rise include either direct recording by thermocouple instruments or indirect estimating by infrared thermography. This preliminary study was carried out using bovine bone and a different method of temperatures rising estimation is presented. Two different types of drills were tested using fluoroptic thermometer and the effectiveness of this alternative temperature recording method was evaluated.

  9. A simple clinical coding strategy to improve recording of child maltreatment concerns: an audit study.

    Science.gov (United States)

    McGovern, Andrew Peter; Woodman, Jenny; Allister, Janice; van Vlymen, Jeremy; Liyanage, Harshana; Jones, Simon; Rafi, Imran; de Lusignan, Simon; Gilbert, Ruth

    2015-01-14

    Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE) but there is evidence of substantial under-recording. To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records. Clinical audit of rates of maltreatment-related coding before January 2010-December 2011 and after January-December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code 'Child is cause for concern'. A total of 25,106 children aged 0-18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording. Outcomes were recording of 1) any maltreatment-related codes, 2) child protection proceedings and 3) child was a cause for concern. We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1-1.6), child protection procedures (RR 1.4; 95% CI 1.1-1.6) and cause for concern (RR 2.5; 95% CI 1.8-3.4) after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation. This simple coding strategy improved clinician's recording of maltreatment-related concerns in a small sample of practices with some 'buy-in'. Further research should investigate how recording can best support the doctor-patient relationship. HOW THIS FITS IN: Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE), but there is evidence of substantial under-recording. We describe a simple clinical coding strategy that helped general practitioners to improve recording of maltreatment-related concerns

  10. Study about geomagnetic variations from data recorded at Surlari Geomagnetic Observatory

    Science.gov (United States)

    Asimopolos, Laurentiu; Asimopolos, Natalia-Silvia; Sandulescu, Agata Monica; Niculici, Eugen

    2013-04-01

    This paper presents statistical and spectral analysis of data from Surlari Geomagnetic Observatory that contributing to study of geomagnetic variations. Thus were highlighted, for long series of records over several solar cycles, periodicities of 22 years and 11 years. Following the same procedures for medium recording series (multi-annual) have highlighted annual, seasonal and monthly periodicities. For shorter data series, we highlighted diurnal, semidiurnal, 8 hours and even lower periodicities. For very short series with a high sample rate and for few magnetotellurics records, we highlight different types of pulsations (Pc2 - Pc5 and Pi 2). Geomagnetic signals are the convolution product of the atomic stationary signals mono-frequential of different amplitudes associated to phenomena with a very broad band of periodicities and nondeterministic signals associated with geomagnetic disturbances and non-periodic phenomena. Among analysis processes used for discrete series of geomagnetic data with different lengths and sampling rates, can conclude the following: Moving average works as a low pass filter in frequency or high pass in time. By eliminating high frequency components (depending on mobile window size used) can be studied preferential periodicities greater than a given value. Signal linearization (using least squares) provides information on linear trend of the entire series analyzed. Thus, for the very long data series (several decades) we extracted the secular variation slope for each geomagnetic component, separately. The numeric derivative of signal versus time proved to be a very reliable indicator for geomagnetic disturbed periods. Thus, the derivative value may be increased by several orders of magnitude during periods of agitation in comparisons to calm periods. The correlation factor shows significant increases when between two time series a causal relationship exists. Variation of the correlation factor, calculated for a mobile window containing k

  11. A case study on better iconographic design in electronic medical records' user interface.

    Science.gov (United States)

    Tasa, Umut Burcu; Ozcan, Oguzhan; Yantac, Asim Evren; Unluer, Ayca

    2008-06-01

    It is a known fact that there is a conflict between what users expect and what user interface designers create in the field of medical informatics along with other fields of interface design. The objective of the study is to suggest, from the 'design art' perspective, a method for improving the usability of an electronic medical record (EMR) interface. The suggestion is based on the hypothesis that the user interface of an EMR should be iconographic. The proposed three-step method consists of a questionnaire survey on how hospital users perceive concepts/terms that are going to be used in the EMR user interface. Then icons associated with the terms are designed by a designer, following a guideline which is prepared according to the results of the first questionnaire. Finally the icons are asked back to the target group for proof. A case study was conducted with 64 medical staff and 30 professional designers for the first questionnaire, and with 30 medical staff for the second. In the second questionnaire 7.53 icons out of 10 were matched correctly with a standard deviation of 0.98. Also, all icons except three were matched correctly in at least 83.3% of the forms. The proposed new method differs from the majority of previous studies which are based on user requirements by leaning on user experiments instead. The study demonstrated that the user interface of EMRs should be designed according to a guideline that results from a survey on users' experiences on metaphoric perception of the terms.

  12. Feasibility of extracting data from electronic medical records for research: an international comparative study.

    Science.gov (United States)

    van Velthoven, Michelle Helena; Mastellos, Nikolaos; Majeed, Azeem; O'Donoghue, John; Car, Josip

    2016-07-13

    Electronic medical records (EMR) offer a major potential for secondary use of data for research which can improve the safety, quality and efficiency of healthcare. They also enable the measurement of disease burden at the population level. However, the extent to which this is feasible in different countries is not well known. This study aimed to: 1) assess information governance procedures for extracting data from EMR in 16 countries; and 2) explore the extent of EMR adoption and the quality and consistency of EMR data in 7 countries, using management of diabetes type 2 patients as an exemplar. We included 16 countries from Australia, Asia, the Middle East, and Europe to the Americas. We undertook a multi-method approach including both an online literature review and structured interviews with 59 stakeholders, including 25 physicians, 23 academics, 7 EMR providers, and 4 information commissioners. Data were analysed and synthesised thematically considering the most relevant issues. We found that procedures for information governance, levels of adoption and data quality varied across the countries studied. The required time and ease of obtaining approval also varies widely. While some countries seem ready for secondary uses of data from EMR, in other countries several barriers were found, including limited experience with using EMR data for research, lack of standard policies and procedures, bureaucracy, confidentiality, data security concerns, technical issues and costs. This is the first international comparative study to shed light on the feasibility of extracting EMR data across a number of countries. The study will inform future discussions and development of policies that aim to accelerate the adoption of EMR systems in high and middle income countries and seize the rich potential for secondary use of data arising from the use of EMR solutions.

  13. Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study.

    Science.gov (United States)

    Karusisi, Noëlla; Thomas, Frédérique; Méline, Julie; Chaix, Basile

    2013-04-20

    Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various individual socio-demographic characteristics and neighborhood socioeconomic variables. Data from the RECORD Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Four categories of sports were studied: team sports, racket sports, swimming and related activities, and fitness. Spatial accessibility to sport facilities was measured with two complementary approaches that both take into account the street network (distance to the nearest facility and count of facilities around the dwelling). Associations between the spatial accessibility to sport facilities and the practice of the corresponding sports were assessed using multilevel logistic regression after adjusting for individual and contextual characteristics. High individual education and high household income were associated with the practice of racket sports, swimming or related activities, and fitness over the previous 7 days. The spatial accessibility to swimming pools was associated with swimming and related sports, even after adjustment for individual/contextual factors. The spatial accessibility to facilities was not related to the practice of other sports. High neighborhood income was associated with the practice of a racket sport and fitness. Accessibility is a multi-dimensional concept that integrates educational, financial, and geographical aspects. Our work supports the evidence that strategies to increase participation in sport activities should improve the spatial and

  14. Adverse hepatic and cardiac responses to rosiglitazone in a new mouse model of type 2 diabetes: relation to dysregulated phosphatidylcholine metabolism.

    Science.gov (United States)

    Pan, Huei-Ju; Lin, Yiming; Chen, Yuqing E; Vance, Dennis E; Leiter, Edward H

    2006-07-01

    Given the heterogeneous nature of metabolic dysfunctions associated with insulin resistance and type 2 diabetes (T2D), a single pharmaceutical cannot be expected to provide complication-free therapy in all patients. Thiazolidinediones (TZD) increase insulin sensitivity, reduce blood glucose and improve cardiovascular parameters. However, in addition to increasing fat mass, TZD have the potential in certain individuals to exacerbate underlying hepatosteatosis and diabetic cardiomyopathy. Pharmacogenetics should allow patient selection to maximize therapy and minimize risk. To this end, we have combined two genetically diverse inbred strains, NON/Lt and NZO/Lt, to produce a "negative heterosis" increasing the frequency of T2D in F1 males. As in humans with T2D, treatment of diabetic and hyperlipemic F1 males with rosiglitazone (Rosi), an agonist of peroxisome proliferator-activated gamma receptor (PPARgamma), reverses these disease phenotypes. However, the hybrid genome perturbed both major pathways for phosphatidylcholine (PC) biosynthesis in the liver, and effected remarkable alterations in the composition of cardiolipin in heart mitochondria. These metabolic defects severely exacerbated an underlying hepatosteatosis and increased levels of the adipokine, plasminogen activator inhibitor-1 (PAI-1), a risk factor for cardiovascular events. This model system demonstrates how the power of mouse genetics can be used to identify the metabolic signatures of individuals who may be prone to drug side effects.

  15. Coordinate Transcriptomic and Metabolomic Effects of the Insulin Sensitizer Rosiglitazone on Fundamental Metabolic Pathways in Liver, Soleus Muscle, and Adipose Tissue in Diabetic db/db Mice

    Directory of Open Access Journals (Sweden)

    Sabrina Le Bouter

    2010-01-01

    Full Text Available Rosiglitazone (RSG, developed for the treatment of type 2 diabetes mellitus, is known to have potent effects on carbohydrate and lipid metabolism leading to the improvement of insulin sensitivity in target tissues. To further assess the capacity of RSG to normalize gene expression in insulin-sensitive tissues, we compared groups of 18-day-treated db/db mice with increasing oral doses of RSG (10, 30, and 100 mg/kg/d with untreated non-diabetic littermates (db/+. For this aim, transcriptional changes were measured in liver, inguinal adipose tissue (IAT and soleus muscle using microarrays and real-time PCR. In parallel, targeted metabolomic assessment of lipids (triglycerides (TGs and free fatty acids (FFAs in plasma and tissues was performed by UPLC-MS methods. Multivariate analyses revealed a relationship between the differential gene expressions in liver and liver trioleate content and between blood glucose levels and a combination of differentially expressed genes measured in liver, IAT, and muscle. In summary, we have integrated gene expression and targeted metabolomic data to present a comprehensive overview of RSG-induced changes in a diabetes mouse model and improved the molecular understanding of how RSG ameliorates diabetes through its effect on the major insulin-sensitive tissues.

  16. A simple clinical coding strategy to improve recording of child maltreatment concerns: an audit study

    Directory of Open Access Journals (Sweden)

    Andrew Peter McGovern

    2015-01-01

    Full Text Available Background Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE but there is evidence of substantial under-recording.Aim To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records.Design and Setting Clinical audit of rates of maltreatment-related coding before January 2010–December 2011 and after January–December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code ‘Child is cause for concern’. A total of 25,106 children aged 0–18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording.Method Outcomes were recording of 1 any maltreatment-related codes, 2 child protection proceedings and 3 child was a cause for concern.Results We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1–1.6, child protection procedures (RR 1.4; 95% CI 1.1–1.6 and cause for concern (RR 2.5; 95% CI 1.8–3.4 after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation.Conclusion This simple coding strategy improved clinician’s recording of maltreatment-related concerns in a small sample of practices with some ‘buy-in’. Further research should investigate how recording can best support the doctor–patient relationshipHow this fits in Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE, but there is evidence of substantial underrecording. We describe a simple clinical coding

  17. The study of insect blood-feeding behaviour: 2. Recording techniques and the use of flow charts

    Directory of Open Access Journals (Sweden)

    J. J. B. Smith

    1987-01-01

    Full Text Available This paper continues a discussion of approaches and methodologies we have used in our studies of feeding in haematophagous insects. Described are techniques for directly monitoring behaviour: electrical recording of feeding behaviour via resistance changes in the food canal, optical methods for monitoring mouthpart activity, and a computer technique for behavioural event recording. Also described is the use of "flow charts" or "decision diagrams" to model interrelated sequences of behaviours.

  18. The Study of Understanding a Child through "Episodic Recording Method" : Focusing on the relation of contents of childcare "Language"

    OpenAIRE

    岡花, 祈一郎

    2010-01-01

    The objective of this study is to clarify influence of colleagues in childcare upon the process of understanding a child. Now day, "Episodic Recording Method" is not only childcare recordings but refleective practice in Childcare. The results are as follows. First, there exist both verbal and nonverbal types of information. Second, there are four types of information to modify the teacher's understanding. Third, the information has both quantitative and qualitative effects. The colleagues hav...

  19. A qualitative study of Australians' opinions about personally controlled electronic health records.

    Science.gov (United States)

    Lehnbom, Elin C; McLachlan, Andrew; Brien, Jo-Anne E

    2012-01-01

    A personally controlled electronic health record (PCEHR) system is being implemented in Australia. Every Australian that wants a PCEHR will be able to opt-in from July 2012. To explore the opinions of Australian consumers and healthcare providers about the PCEHR. In this qualitative study, consumers and healthcare providers were interviewed using a semi-structured interview guide. Perceived benefits identified by participants regarding the PCEHR included instant access to clinical information, and safer and more efficient healthcare delivery. The risk of unauthorised access and breaches of privacy were some of the perceived drawbacks. Although consumers seemed unwilling to opt-in to have a PCEHR, the vast majority of healthcare providers were positive towards this development and predicted better and safer healthcare as a result. Consumers and healthcare providers appeared uniformed about the imminent PCEHR. The wide-spread unwillingness among participants to opt-in to have a PCEHR could potentially jeopardise successful implementation and uptake of this system. A well-designed system without security glitches and with individualised information from trusted healthcare providers regarding the benefits of having a PCEHR appears critical in engaging consumer opt-in.

  20. A 30+ Year AVHRR LAI and FAPAR Climate Data Record: Algorithm Description, Validation, and Case Study

    Science.gov (United States)

    Claverie, Martin; Matthews, Jessica L.; Vermote, Eric F.; Justice, Christopher O.

    2016-01-01

    In- land surface models, which are used to evaluate the role of vegetation in the context ofglobal climate change and variability, LAI and FAPAR play a key role, specifically with respect to thecarbon and water cycles. The AVHRR-based LAIFAPAR dataset offers daily temporal resolution,an improvement over previous products. This climate data record is based on a carefully calibratedand corrected land surface reflectance dataset to provide a high-quality, consistent time-series suitablefor climate studies. It spans from mid-1981 to the present. Further, this operational dataset is availablein near real-time allowing use for monitoring purposes. The algorithm relies on artificial neuralnetworks calibrated using the MODIS LAI/FAPAR dataset. Evaluation based on cross-comparisonwith MODIS products and in situ data show the dataset is consistent and reliable with overalluncertainties of 1.03 and 0.15 for LAI and FAPAR, respectively. However, a clear saturation effect isobserved in the broadleaf forest biomes with high LAI (greater than 4.5) and FAPAR (greater than 0.8) values.

  1. Multi-level analysis of electronic health record adoption by health care professionals: A study protocol

    Directory of Open Access Journals (Sweden)

    Labrecque Michel

    2010-04-01

    Full Text Available Abstract Background The electronic health record (EHR is an important application of information and communication technologies to the healthcare sector. EHR implementation is expected to produce benefits for patients, professionals, organisations, and the population as a whole. These benefits cannot be achieved without the adoption of EHR by healthcare professionals. Nevertheless, the influence of individual and organisational factors in determining EHR adoption is still unclear. This study aims to assess the unique contribution of individual and organisational factors on EHR adoption in healthcare settings, as well as possible interrelations between these factors. Methods A prospective study will be conducted. A stratified random sampling method will be used to select 50 healthcare organisations in the Quebec City Health Region (Canada. At the individual level, a sample of 15 to 30 health professionals will be chosen within each organisation depending on its size. A semi-structured questionnaire will be administered to two key informants in each organisation to collect organisational data. A composite adoption score of EHR adoption will be developed based on a Delphi process and will be used as the outcome variable. Twelve to eighteen months after the first contact, depending on the pace of EHR implementation, key informants and clinicians will be contacted once again to monitor the evolution of EHR adoption. A multilevel regression model will be applied to identify the organisational and individual determinants of EHR adoption in clinical settings. Alternative analytical models would be applied if necessary. Results The study will assess the contribution of organisational and individual factors, as well as their interactions, to the implementation of EHR in clinical settings. Conclusions These results will be very relevant for decision makers and managers who are facing the challenge of implementing EHR in the healthcare system. In addition

  2. Road, rail, and air transportation noise in residential and workplace neighborhoods and blood pressure (RECORD Study).

    Science.gov (United States)

    Méline, Julie; Van Hulst, Andraea; Thomas, Frederique; Chaix, Basile

    2015-01-01

    Associations between road traffic noise and hypertension have been repeatedly documented, whereas associations with rail or total road, rail, and air (RRA) traffic noise have rarely been investigated. Moreover, most studies of noise in the environment have only taken into account the residential neighborhood. Finally, few studies have taken into account individual/neighborhood confounders in the relationship between noise and hypertension. We performed adjusted multilevel regression analyses using data from the 7,290 participants of the RECORD Study to investigate the associations of outdoor road, rail, air, and RRA traffic noise estimated at the place of residence, at the workplace, and in the neighborhoods around the residence and workplace with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension. Associations were documented between higher outdoor RRA and road traffic noise estimated at the workplace and a higher SBP [+1.36 mm of mercury, 95% confidence interval (CI): +0.12, +2.60 for 65-80 dB(A) vs 30-45 dB(A)] and DBP [+1.07 (95% CI: +0.28, +1.86)], after adjustment for individual/neighborhood confounders. These associations remained after adjustment for risk factors of hypertension. Associations were documented neither with rail traffic noise nor for hypertension. Associations between transportation noise at the workplace and blood pressure (BP) may be attributable to the higher levels of road traffic noise at the workplace than at the residence. To better understand why only noise estimated at the workplace was associated with BP, our future work will combine Global Positioning System (GPS) tracking, assessment of noise levels with sensors, and ambulatory monitoring of BP.

  3. Road, rail, and air transportation noise in residential and workplace neighborhoods and blood pressure (RECORD Study

    Directory of Open Access Journals (Sweden)

    Julie Méline

    2015-01-01

    Full Text Available Associations between road traffic noise and hypertension have been repeatedly documented, whereas associations with rail or total road, rail, and air (RRA traffic noise have rarely been investigated. Moreover, most studies of noise in the environment have only taken into account the residential neighborhood. Finally, few studies have taken into account individual/neighborhood confounders in the relationship between noise and hypertension. We performed adjusted multilevel regression analyses using data from the 7,290 participants of the RECORD Study to investigate the associations of outdoor road, rail, air, and RRA traffic noise estimated at the place of residence, at the workplace, and in the neighborhoods around the residence and workplace with systolic blood pressure (SBP, diastolic blood pressure (DBP, and hypertension. Associations were documented between higher outdoor RRA and road traffic noise estimated at the workplace and a higher SBP [+1.36 mm of mercury, 95% confidence interval (CI: +0.12, +2.60 for 65-80 dB(A vs 30-45 dB(A] and DBP [+1.07 (95% CI: +0.28, +1.86], after adjustment for individual/neighborhood confounders. These associations remained after adjustment for risk factors of hypertension. Associations were documented neither with rail traffic noise nor for hypertension. Associations between transportation noise at the workplace and blood pressure (BP may be attributable to the higher levels of road traffic noise at the workplace than at the residence. To better understand why only noise estimated at the workplace was associated with BP, our future work will combine Global Positioning System (GPS tracking, assessment of noise levels with sensors, and ambulatory monitoring of BP.

  4. Preliminary results of a study of four successive sedimentary geomagnetic reversal records from the Mediterranean (Upper Thvera, Lower and Upper Sidufjall, and Lower Nunivak)

    OpenAIRE

    Linssen, J.H.

    1988-01-01

    The results of a study of four successive Early Pliocene geomagnetic reversal records are presented. The polarity transitions have been recorded in the Trubi formation of Calabria (S. Italy). The lower Sidufjall and Lower Nunivak records are nearly identical and have a zonal harmonic content similar to records reported for the Matuyama—Brunhes polarity transition.

  5. Adoption of electronic health records: a qualitative study of academic and private physicians and health administrators.

    Science.gov (United States)

    Grabenbauer, L; Fraser, R; McClay, J; Woelfl, N; Thompson, C B; Cambell, J; Windle, J

    2011-01-01

    Less than 20% of hospitals in the US have an electronic health record (EHR). In this qualitative study, we examine the perspectives of both academic and private physicians and administrators as stakeholders, and their alignment, to explore their perspectives on the use of technology in the clinical environment. Focus groups were conducted with 74 participants who were asked a series of open-ended questions. Grounded theory was used to analyze the transcribed data and build convergent themes. The relevance and importance of themes was constructed by examining frequency, convergence, and intensity. A model was proposed that represents the interactions between themes. Six major themes emerged, which include the impact of EHR systems on workflow, patient care, communication, research/outcomes/billing, education/learning, and institutional culture. Academic and private physicians were confident of the future benefits of EHR systems, yet cautious about the current implementations of EHR, and its impact on interactions with other members of the healthcare team and with patients, and the amount of time necessary to use EHR's. Private physicians differed on education and were uneasy about the steep learning curve necessary for use of new systems. In contrast to physicians, university and hospital administrators are optimistic, and value the availability of data for use in reporting. The results of our study indicate that both private and academic physicians concur on the need for features that maintain and enhance the relationship with the patient and the healthcare team. Resistance to adoption is related to insufficient functionality and its potential negative impact on patient care. Integration of data collection into clinical workflows must consider the unexpected costs of data acquisition.

  6. Limnological controls on stable isotope records of late-holocene palaeoenvironment change in sw greenland: A paired lake study

    DEFF Research Database (Denmark)

    Olsen, Jesper; John Anderson, N.; Leng, M.J.

    2013-01-01

    Stable isotope records are increasingly being used in palaeoenvironmental studies of Arctic lakes. Here we compare stable isotope and elemental records (δ13C, δ15N, C/N) with high resolution XRF-derived geochemical and colour data from low Arctic lakes (SS1220 and SS85) in southwest Greenland. Lake...... SS1220 sediments are laminated gyttja whereas SS85 consist of homogeneous gyttja, both records cover the last c. 5000 years. d13C and carbon content suggest that organic matter in both lakes is predominantly autochthonous. The C/N variability, ranging between 11 and 15, is interpreted...... composition of lake sediments when there is a reasonable understanding of limnological processes, and records may be lake specific....

  7. Pre-recorded instructional audio vs. dispatchers’ conversational assistance in telephone cardiopulmonary resuscitation: A randomized controlled simulation study

    Science.gov (United States)

    Birkun, Alexei; Glotov, Maksim; Ndjamen, Herman Franklin; Alaiye, Esther; Adeleke, Temidara; Samarin, Sergey

    2018-01-01

    BACKGROUND: To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation (CPR) guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation. METHODS: It was a prospective, blind, randomised controlled study involving 109 medical students without previous CPR training. In a standardized mannequin scenario, after the step of dispatcher-assisted cardiac arrest recognition, the participants performed compression-only resuscitation guided over the telephone by either: (1) the pre-recorded instructional audio (n=57); or (2) verbal dispatcher assistance (n=52). The simulation video records were reviewed to assess the CPR performance using a 13-item checklist. The interval from call reception to the first compression, total number and rate of compressions, total number and duration of pauses after the first compression were also recorded. RESULTS: There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score (5.6±2.2 vs. 5.1±1.9, P>0.05) or individual criteria of the CPR performance checklist. The recording-assisted group demonstrated significantly shorter time interval from call receipt to the first compression (86.0±14.3 vs. 91.2±14.2 s, PCPR. Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.

  8. [Benefits and usability of a pharmaceutical record in medical practice. A survey of hospital doctors and pharmacists (MATRIX study)].

    Science.gov (United States)

    Schuers, M; Timsit, M; Gillibert, A; Fred, A; Griffon, N; Bénichou, J; Darmoni, S J; Staccini, P

    2016-09-01

    To evaluate the impact of the pharmaceutical patient record use in emergency, geriatric and anaesthesia and intensive care departments, an experimentation was launched in 2013 in 55 hospitals. The purpose of the study was to assess the opinions of physicians and pharmacists about the benefits and usability of the patient pharmaceutical record. An e-mailed self-administered questionnaire was sent to all the pharmacists, anaesthesiologists, geriatricians and emergency physicians of the 55 hospitals involved in the patient pharmaceutical record experimentation. The questionnaire assessed the usability of the patient pharmaceutical record using the "System Usability Scale", as well as its use, its benefits and limitations perceived in clinical practice, and overall user satisfaction. Questionnaires were collected from November 2014 to January 2015. Ninety-six questionnaires were collected, from 47 hospitals, representing 86% of the hospitals involved in the experimentation. The patient pharmaceutical record was effectively operational in 36 hospitals. Data from 73 questionnaires filled by physicians and pharmacists with potential experience with the patient pharmaceutical record were used for evaluation. Forty-two respondents were pharmacists (57%) and 31 were physicians (43%), including 13 geriatricians, 11 emergency physicians and 7 anaesthesiologists. Patient pharmaceutical record overall usability score was 62.5 out of 100. It did not vary with the profession or seniority of the respondent. It was positively correlated with the frequency of use. More than half of respondents reported that they never or uncommonly used the patient pharmaceutical record. The length of access to data period was considered as insufficient. Main obstacles to more utilization of the patient pharmaceutical record were the lack of information about the dosage of dispensed drugs, the low number of patients in possession of their health card and the low number of patients with an activated

  9. Study of national registration systems for health records of radiation workers. National radiation dose registration system

    International Nuclear Information System (INIS)

    Nakagawa, Haruo; Kanda, Keiji

    1999-01-01

    A national radiation dose registration system is proposed in this paper. In Japan, only one radiation dose registration system is partly effective. It is applied for workers in nuclear power plants which are under control of regulatory laws for nuclear reactors. The total system was proposed previously by the Committee for Compensation Claims of Nuclear Accidents. The reason for the delay in establishing a registration system for all radiation workers is supposedly a lack of effort to adjust differences among items in radiation protection laws and the promotion of public acceptance to atomic power. Items about dose recordings, record keeping and dose-record reporting in all of the radiation regulatory laws are compared to each other, and items were extracted for revision. (author)

  10. Do coxibs reduce prescription of gastroprotective agents? Results of a record linkage study

    Directory of Open Access Journals (Sweden)

    Violante Andrea

    2006-03-01

    Full Text Available Abstract Background Coxibs are claimed to be cost-effective drugs and reduced prescription of gastroprotective agents is assumed to be one of their major benefits. Real life prescription of these drugs may be substantially different than that considered in pharmacoeconomic analyses or claimed by drug companies, yet. Our objective was to evaluate whether coxibs were associated with reduced prescription of gastro-protective agents (GPAs, specifically proton pump inhibitors, H2 blockers and misoprostol compared to non selective NSAIDs. Methods A record-linkage study was performed using 2001 outpatient prescription data from the province of Modena (about 632,000 inhabitants, in Northern Italy. Logistic regression was used to calculate the odds ratio of GPA prescription for coxib and non-selective NSAID adult users (> 14 years. Three categories of users were further investigated: "acute", "chronic and "incident or new". Main outcome measures were same-day co-prescription and 30 days prescription of GPAs in coxibs and non selective NSAIDs users. To limit selection bias, data were adjusted for age, sex, DDD of coxibs and non selective NSAIDs received during 2001, DDD of GPAs and (for non-incident users DDD of NSAIDs received during the previous 4 years Results Same day co-prescription rates were similar considering the overall population and "acute" users. Chronic coxibs users instead showed higher co-prescription rates than chronic NSAIDs users (OR = 1.2, p Conclusion Assumptions made in pharmacoeconomic analyses on coxibs (lower GPA prescription associated with coxibs use may be overly optimistic. Claims made through cost-effectiveness data should be carefully interpreted, and mechanisms for attributing drug prices revised accordingly.

  11. Examining the symptom of fatigue in primary care: a comparative study using electronic medical records

    Directory of Open Access Journals (Sweden)

    Kathryn Nicholson

    2015-01-01

    Full Text Available Background The symptom of fatigue is one of the top five most frequently presented health complaints in primary care, yet it remains underexplored in the Canadian primary care context.Objective The objective of this study was to examine the prevalence and impact of patients presenting with fatigue in primary care, using the only known electronic database in Canada to capture patient-reported symptoms.Methods Data were extracted from the Deliver Primary Healthcare Information (DELPHI database, an electronic medical record database located in Ontario, Canada. Patients were identified using the International Classification of Primary Care, Revised Second Edition coding system. Two groups of patients (fatigue or non-fatigue symptom were followed for one year and compared. Both descriptive and multivariable analyses were conducted.Results A total of 103 fatigue symptom patients, and 103 non-fatigue symptom patients, were identified in the DELPHI database. The period prevalence of fatigue presentation was 8.2%, with the majority of patients being female and over 60 years of age. These patients experienced numerous co-occurring morbidities, in addition to the fatigue itself. During the one year follow-up period, fatigue symptom patients had significantly higher rates of subsequent visits (IRR = 1.19, p = 0.038 and investigations (IRR = 1.68, p < 0.001, and markedly high levels of referrals following their index visit.Conclusions This research used an electronic database to examine the symptom, fatigue. Using these data, fatigue symptom patients were found to have higher rates of health care utilisation, compared to non-fatigue symptom patients.

  12. Financial position and adoption of electronic health records: a retrospective longitudinal study.

    Science.gov (United States)

    Shen, Jay J; Ginn, Gregory O

    2012-01-01

    Financial barriers are a major factor of slow electronic health record (EHR) adoption among US hospitals. All existing literature focuses on relationships between current or short-term financial position and EHR adoption. This study examines relationship between financial position in previous years and the current level of EHR adoption. Retrospective longitudinal data were extracted from (1) the 2009 American Hospital Association (AHA) EHR implementation survey; (2) the 2002 and 2006 Centers for Medicare & Medicaid Cost Reports; and (3) the 2002 and 2006 AHA Annual Survey containing organizational and operational data. The final sample was 2,701 acute care hospitals in the United States. General ordinal logistic regression was used for data analysis with a three-level dependent variable to measure adoption, five independent variables to measure financial position, and 11 control variables to measure structure and environment. For 2006, higher total margin was significantly and positively associated with EHR adoption, but higher asset turnover was significantly and negatively associated with EHR adoption. For 2002, higher total margin was significantly and positively associated with EHR adoption, but higher asset turnover and higher equity multiplier were both significantly and negatively associated with EHR adoption. In addition, lower net days revenue in accounts receivable was significantly and positively associated with EHR adoption. For both the 2002 and 2006 control variables, human resource intensity and bed size were significant and positively related to adoption, and percentage Medicare patients and investor ownership were significant and negatively related to adoption. Financial position does relate to EHR adoption in mid-term and long-term planning.

  13. Usability Evaluation of Electronic Health Record System around Clinical Notes Usage-An Ethnographic Study.

    Science.gov (United States)

    Rizvi, Rubina F; Marquard, Jenna L; Hultman, Gretchen M; Adam, Terrence J; Harder, Kathleen A; Melton, Genevieve B

    2017-10-01

    Background A substantial gap exists between current Electronic Health Record (EHR) usability and potential optimal usability. One of the fundamental reasons for this discrepancy is poor incorporation of a User-Centered Design (UCD) approach during the Graphical User Interface (GUI) development process. Objective To evaluate usability strengths and weaknesses of two widely implemented EHR GUIs for critical clinical notes usage tasks. Methods Twelve Internal Medicine resident physicians interacting with one of the two EHR systems (System-1 at Location-A and System-2 at Location-B) were observed by two usability evaluators employing an ethnographic approach. User comments and observer findings were analyzed for two critical tasks: (1) clinical notes entry and (2) related information-seeking tasks. Data were analyzed from two standpoints: (1) usability references categorized by usability evaluators as positive, negative, or equivocal and (2) usability impact of each feature measured through a 7-point severity rating scale. Findings were also validated by user responses to a post observation questionnaire. Results For clinical notes entry, System-1 surpassed System-2 with more positive (26% vs. 12%) than negative (12% vs. 34%) usability references. Greatest impact features on EHR usability (severity score pertaining to each feature) for clinical notes entry were: autopopulation (6), screen options (5.5), communication (5), copy pasting (4.5), error prevention (4.5), edit ability (4), and dictation and transcription (3.5). Both systems performed equally well on information-seeking tasks and features with greatest impacts on EHR usability were navigation for notes (7) and others (e.g., looking for ancillary data; 5.5). Ethnographic observations were supported by follow-up questionnaire responses. Conclusion This study provides usability-specific insights to inform future, improved, EHR interface that is better aligned with UCD approach.

  14. An automatic recording system for the study of escape from fear in rats.

    Science.gov (United States)

    Li, Ming; He, Wei

    2013-11-01

    Escape from fear (EFF) is an active response to a conditioned stimulus (CS) previously paired with an unconditioned fearful stimulus (US), which typically leads to the termination of the CS. In this paradigm, animals acquire two distinct associations: S-S [CS-US] and R-O [response-outcome] through Pavlovian and instrumental conditioning, respectively. The present study describes a computer controlled automatic recording system that captures the development of EFF and allows the determination of the respective roles of S-S and R-O associations in this process. We validated this system by showing that only rats subjected to a simultaneous CS-US conditioning (i.e., CS and US occur together at the beginning of each trial) acquired EFF, not those subjected to an unpaired CS-US conditioning. Paired rats had a progressively increased number of EFF and significantly shorter escape latencies than unpaired rats across the 5-trial blocks on the test day. However, during the conditioning phase, the unpaired rats emitted more 22kHz ultrasonic vocalizations, a validated measure of conditioned reactive fear responses. Our results demonstrate that the acquisition of EFF is contingent upon pairing of the CS with the US, not simply the consequence of a high level of generalized fear. Because this commercially available system is capable of examining both conditioned active and reactive fear responses in a single setup, it could be used to determine the relative roles of S-S and R-O associations in EFF, the neurobiology of conditioned active fear response and neuropharmacology of psychotherapeutic drugs. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. A study of user requests regarding the fully electronic health record system at Seoul National University Bundang Hospital: challenges for future electronic health record systems.

    Science.gov (United States)

    Yoo, Sooyoung; Kim, Seok; Lee, Seungja; Lee, Kee-Hyuck; Baek, Rong-Min; Hwang, Hee

    2013-05-01

    Although the adoption rates for Electronic Health Records (EHRs) are growing, significant opportunities for further advances in EHR system design remain. The goal of this study was to identify issues that should be considered in the design process for the successful development of future systems by analyzing end users' service requests gathered during a recent three-year period after a comprehensive EHR system was implemented at Seoul National University's Bundang Hospital in South Korea. Data on 11,400 service requests from end users of the EHR system made from 2008 through 2010 were used in this study. The requests were categorized as program modification/development, data request, insurance-fee identification/generation, patient-record merging, or other. The authors further subcategorized the requests for program modification/development into the following nine areas of concern: (1) indicators and statistics, (2) patient safety and quality of care, (3) special task-oriented functionalities, (4) ease of use and user interface, (5) system speed, (6) interoperability and integration, (7) privacy and security, (8) customer service, and (9) miscellaneous. The system users were divided into four groups--direct care, care support, administrative/insurance, and general management--to identify each group's needs and concerns. The service requests for program modification/development, data request, insurance-fee identification/generation, patient-record merging, and other issues constituted approximately 49.2%, 33.9%, 11.4%, 4.0%, and 1.5% of the total data set, respectively. The number of data-request service requests grew over the three years studied. Different groups of users were found to have different concerns according to their activities and tasks. Within the program-modification/development category, end users were most frequently concerned with ease of use and user interface (38.1% of the total) and special task-oriented functionalities (29.3% of the total) in

  16. Readability Formulas and User Perceptions of Electronic Health Records Difficulty: A Corpus Study.

    Science.gov (United States)

    Zheng, Jiaping; Yu, Hong

    2017-03-02

    Electronic health records (EHRs) are a rich resource for developing applications to engage patients and foster patient activation, thus holding a strong potential to enhance patient-centered care. Studies have shown that providing patients with access to their own EHR notes may improve the understanding of their own clinical conditions and treatments, leading to improved health care outcomes. However, the highly technical language in EHR notes impedes patients' comprehension. Numerous studies have evaluated the difficulty of health-related text using readability formulas such as Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning-Fog Index (GFI). They conclude that the materials are often written at a grade level higher than common recommendations. The objective of our study was to explore the relationship between the aforementioned readability formulas and the laypeople's perceived difficulty on 2 genres of text: general health information and EHR notes. We also validated the formulas' appropriateness and generalizability on predicting difficulty levels of highly complex technical documents. We collected 140 Wikipedia articles on diabetes and 242 EHR notes with diabetes International Classification of Diseases, Ninth Revision code. We recruited 15 Amazon Mechanical Turk (AMT) users to rate difficulty levels of the documents. Correlations between laypeople's perceived difficulty levels and readability formula scores were measured, and their difference was tested. We also compared word usage and the impact of medical concepts of the 2 genres of text. The distributions of both readability formulas' scores (Preadability predictions and laypeople's perceptions were weak. Furthermore, despite being graded at similar levels, documents of different genres were still perceived with different difficulty (Preadability formulas' predictions did not align with perceived difficulty in either text genre. The widely used readability formulas were

  17. Patients Know Best: Qualitative Study on How Families Use Patient-Controlled Personal Health Records

    Science.gov (United States)

    Schneider, Hanna; Hill, Susan

    2016-01-01

    Background Self-management technologies, such as patient-controlled electronic health records (PCEHRs), have the potential to help people manage and cope with disease. Objective This study set out to investigate patient families’ lived experiences of working with a PCEHR. Methods We conducted a semistructured qualitative field study with patient families and clinicians at a children’s hospital in the UK that uses a PCEHR (Patients Know Best). All families were managing the health of a child with a serious chronic condition, who was typically under the care of multiple clinicians. As data gathering and analysis progressed, it became clear that while much of the literature assumes that patients are willing and waiting to take more responsibility for and control over their health management (eg, with PCEHRs), only a minority of participants in our study responded in this way. Their experiences with the PCEHR were diverse and strongly shaped by their coping styles. Theory on coping identifies a continuum of coping styles, from approach to avoidance oriented, and proposes that patients’ information needs depend on their style. Results We identified 3 groups of patient families and an outlier, distinguished by their coping style and their PCEHR use. We refer to the outlier as controlling (approach oriented, highly motivated to use PCEHR), and the 3 groups as collaborating (approach oriented, motivated to use PCEHR), cooperating (avoidance oriented, less motivated to use PCEHR), and avoiding (very avoidance oriented, not motivated to use PCEHR). Conclusions The PCEHR met the needs of controller and collaborators better than the needs of cooperators and avoiders. We draw on the Self-Determination Theory to propose ways in which a PCEHR design might better meet the needs of avoidance-oriented users. Further, we highlight the need for families to also relinquish control at times, and propose ways in which PCEHR design might support a better distribution of control

  18. A Retrospective Analysis of the Burn Injury Patients Records in the Emergency Department, an Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Nilgün Aksoy

    2014-08-01

    Full Text Available Introduction: Burns can be very destructive, and severely endanger the health and lives of humans. It maybe cause disability and even psychological trauma in individuals. . Such an event can also lead to economic burden on victim’s families and society. The aim of our study is to evaluate epidemiology and outcome of burn patients referring to emergency department. Methods: This is a cross-sectional study was conducted by evaluation of patients’ files and forensic reports of burned patients’ referred to the emergency department (ED of Akdeniz hospital, Turkey, 2008. Demographic data, the season, place, reason, anatomical sites, total body surface area, degrees, proceeding treatment, and admission time were recorded. Multinomial logistic regression was used to compare frequencies’ differences among single categorized variables. Stepwise logistic regression was applied to develop a predictive model for hospitalization. P<0.05 was defined as a significant level. Results: Two hundred thirty patients were enrolled (53.9% female. The mean of patients' ages was 25.3 ± 22.3 years. The most prevalence of burn were in the 0-6 age group and most of which was hot liquid scalding (71.3%. The most affected parts of the body were the left and right upper extremities. With increasing the severity of triage level (OR=2.2; 95% CI: 1.02-4.66; p=0.046, intentional burn (OR=4.7; 95% CI: 1.03-21.8; p=0.047, referring from other hospitals or clinics (OR=3.4; 95% CI: 1.7-6.6; p=0.001, and percentage of burn (OR=18.1; 95% CI: 5.42-62.6; p<0.001 were independent predictive factor for hospitalization. In addition, odds of hospitalization was lower in patients older than 15 years (OR=0.7; 95% CI: 0.5-0.91; p=0.035. Conclusion: This study revealed the most frequent burns are encountered in the age group of 0-6 years, percentage of <10%, second degree, upper extremities, indoor, and scalding from hot liquids. Increasing ESI severity, intentional burn, referring from

  19. Enhancing the power of genetic association studies through the use of silver standard cases derived from electronic medical records.

    Directory of Open Access Journals (Sweden)

    Andrew McDavid

    Full Text Available The feasibility of using imperfectly phenotyped "silver standard" samples identified from electronic medical record diagnoses is considered in genetic association studies when these samples might be combined with an existing set of samples phenotyped with a gold standard technique. An analytic expression is derived for the power of a chi-square test of independence using either research-quality case/control samples alone, or augmented with silver standard data. The subset of the parameter space where inclusion of silver standard samples increases statistical power is identified. A case study of dementia subjects identified from electronic medical records from the Electronic Medical Records and Genomics (eMERGE network, combined with subjects from two studies specifically targeting dementia, verifies these results.

  20. The RecordAF study: design, baseline data, and profile of patients according to chosen treatment strategy for atrial fibrillation

    DEFF Research Database (Denmark)

    Le Heuzey, Jean-Yves; Breithardt, Günter; Camm, John

    2010-01-01

    The REgistry on Cardiac rhythm disORDers assessing the control of Atrial Fibrillation (RecordAF) is the first worldwide, 1-year observational, longitudinal study of the management of paroxysmal/persistent atrial fibrillation (AF) in recently diagnosed patients. The study was conducted at 532 sites...

  1. Organizational Change and How It Affects Healthcare Employees: A Study on Employee Resistance to Change in Electronic Medical Record Implementation

    Science.gov (United States)

    Adeyemi, Oluwakemi A.

    2017-01-01

    The purpose of the exploratory qualitative study was to explore the strategies for reducing employee resistance to Electronic Medical Record (EMR) technology changes in a healthcare organization during implementation. The study focused on EPIC as the EMR application. Ten healthcare participants who had experienced a change to EMR were selected in…

  2. The Study of Electronic Medical Record Adoption in a Medicare Certified Home Health Agency Using a Grounded Theory Approach

    Science.gov (United States)

    May, Joy L.

    2013-01-01

    The purpose of this qualitative grounded theory study was to examine the experiences of clinicians in the adoption of Electronic Medical Records in a Medicare certified Home Health Agency. An additional goal for this study was to triangulate qualitative research between describing, explaining, and exploring technology acceptance. The experiences…

  3. Use of large electronic health record databases for environmental epidemiology studies.

    Science.gov (United States)

    Background: Electronic health records (EHRs) are a ubiquitous component of the United States healthcare system and capture nearly all data collected in a clinic or hospital setting. EHR databases are attractive for secondary data analysis as they may contain detailed clinical rec...

  4. Behavioral Health Providers and Electronic Health Records: An Exploratory Beliefs Elicitation and Segmentation Study

    Science.gov (United States)

    Shank, Nancy

    2011-01-01

    The widespread adoption of electronic health records (EHRs) is a public policy strategy to improve healthcare quality and reduce accelerating health care costs. Much research has focused on medical providers' perceptions of EHRs, but little is known about those of behavioral health providers. This research was informed by the theory of reasoned…

  5. Exploring Workarounds Related to Electronic Health Record System Usage: A Study Protocol

    NARCIS (Netherlands)

    Blijleven, Vincent; Koelemeijer, Kitty; Jaspers, Monique

    2017-01-01

    Health care providers resort to informal temporary practices known as workarounds for handling exceptions to normal workflow that are unintentionally imposed by electronic health record (EHR) systems. Although workarounds may seem favorable at first sight, they are generally suboptimal and may

  6. 77 FR 25152 - Privacy Act of 1974; System of Records-National Longitudinal Transitions Study-2012

    Science.gov (United States)

    2012-04-27

    ... attended; and scores on reading and mathematics achievement tests. The system of records also includes... congressionally mandated national assessment of Individuals with Disability Education Act (IDEA). It will be... characteristics? Compare Current Transition-Age Students With an IEP to Their Peers in Prior Cohorts How do the...

  7. Cross-validation of independent ultra-low-frequency magnetic recording systems for active fault studies

    Science.gov (United States)

    Wang, Can; Bin, Chen; Christman, Lilianna E.; Glen, Jonathan M. G.; Klemperer, Simon L.; McPhee, Darcy K.; Kappler, Karl N.; Bleier, Tom E.; Dunson, J. Clark

    2018-04-01

    When working with ultra-low-frequency (ULF) magnetic datasets, as with most geophysical time-series data, it is important to be able to distinguish between cultural signals, internal instrument noise, and natural external signals with their induced telluric fields. This distinction is commonly attempted using simultaneously recorded data from a spatially remote reference site. Here, instead, we compared data recorded by two systems with different instrumental characteristics at the same location over the same time period. We collocated two independent ULF magnetic systems, one from the QuakeFinder network and the other from the United States Geological Survey (USGS)-Stanford network, in order to cross-compare their data, characterize data reproducibility, and characterize signal origin. In addition, we used simultaneous measurements at a remote geomagnetic observatory to distinguish global atmospheric signals from local cultural signals. We demonstrated that the QuakeFinder and USGS-Stanford systems have excellent coherence, despite their different sensors and digitizers. Rare instances of isolated signals recorded by only one system or only one sensor indicate that caution is needed when attributing specific recorded signal features to specific origins.[Figure not available: see fulltext.

  8. Studies on Fourier amplitude spectra of accelerograms recorded on rock sites

    International Nuclear Information System (INIS)

    Ghosh, A.K.; Rao, K.S.

    1990-01-01

    Fourier spectra of 54 earthquake accelerograms recorded on rock sites in the U.S.A. have been analysed. These could be used in generation of synthetic accelerogramms for seismic design. (author). 19 figs., 1 tab., 1 appendix, 19 re fs

  9. The role of electronic healthcare record databases in paediatric drug safety surveillance: A retrospective cohort study

    NARCIS (Netherlands)

    S. de Bie (Sandra); P.M. Coloma (Preciosa); C. Ferrajolo (Carmen); K.M.C. Verhamme (Katia); G. Trifirò (Gianluca); M.J. Schuemie (Martijn); S.M.J.M. Straus (Sabine); R. Gini (Rosa); R.M.C. Herings (Ron); G. Mazzaglia (Giampiero); G. Picelli (Gino); A. Ghirardi (Arianna); L. Pedersen (Lars); B.H.Ch. Stricker (Bruno); J. van der Lei (Johan); M.C.J.M. Sturkenboom (Miriam)

    2015-01-01

    textabstractAim Electronic healthcare record (EHR)-based surveillance systems are increasingly being developed to support early detection of safety signals. It is unknown what the power of such a system is for surveillance among children and adolescents. In this paper we provide estimates of the

  10. Project Management Series Case Study: The Office of Registration and Records

    Science.gov (United States)

    Burgher, Karl E.; Snyder, Michael

    2012-01-01

    This is the third in a series of eight articles on project management (PM) in the academy. In this article, the authors describe the step-by-step implementation of a structural change to Indiana State University's (ISU's) Office of Registration and Records (ORR). The process described may vary as it is implemented elsewhere, but the authors…

  11. Speech auditory brainstem response (speech ABR) characteristics depending on recording conditions, and hearing status: an experimental parametric study.

    Science.gov (United States)

    Akhoun, Idrick; Moulin, Annie; Jeanvoine, Arnaud; Ménard, Mikael; Buret, François; Vollaire, Christian; Scorretti, Riccardo; Veuillet, Evelyne; Berger-Vachon, Christian; Collet, Lionel; Thai-Van, Hung

    2008-11-15

    Speech elicited auditory brainstem responses (Speech ABR) have been shown to be an objective measurement of speech processing in the brainstem. Given the simultaneous stimulation and recording, and the similarities between the recording and the speech stimulus envelope, there is a great risk of artefactual recordings. This study sought to systematically investigate the source of artefactual contamination in Speech ABR response. In a first part, we measured the sound level thresholds over which artefactual responses were obtained, for different types of transducers and experimental setup parameters. A watermelon model was used to model the human head susceptibility to electromagnetic artefact. It was found that impedances between the electrodes had a great effect on electromagnetic susceptibility and that the most prominent artefact is due to the transducer's electromagnetic leakage. The only artefact-free condition was obtained with insert-earphones shielded in a Faraday cage linked to common ground. In a second part of the study, using the previously defined artefact-free condition, we recorded speech ABR in unilateral deaf subjects and bilateral normal hearing subjects. In an additional control condition, Speech ABR was recorded with the insert-earphones used to deliver the stimulation, unplugged from the ears, so that the subjects did not perceive the stimulus. No responses were obtained from the deaf ear of unilaterally hearing impaired subjects, nor in the insert-out-of-the-ear condition in all the subjects, showing that Speech ABR reflects the functioning of the auditory pathways.

  12. Records Group. The problem of fonds in the American archival studies

    Directory of Open Access Journals (Sweden)

    Bartosz Nowożycki

    2017-12-01

    Full Text Available The term record group means a group of fonds (records and it is a type of archival fonds rarely described in Polish archival literature. Most often it is associated with the complex archival fonds, due to its comlicated structure and blurred borderlines – an effect of administrative system varying from the Polish one. The post-war attempts to modify and broaden the meaning of the complex fonds caused its resemblance to the term record group. Irena Radtke in her paper given during the 6th Archival Methods Conference in Warsaw in 1970 proposed, that the complex fonds should be one comprising records of foreign provenance that are an effect of passive succession. Bohdan Ryszewski, addressing Radtke’s idea, noticed that passive succession might be a source of complications. However, this conceptualization of the definition of the complex fonds did not correspond with the American understanding of it as an above-fonds structure.Bogdan Kroll has touched the core of the problem; he noticed that an archival construction comprising materials of various provenances cannot be seen neither as an archival fonds, nor as a complex fonds. He saw a discrepancy between the structure and partition of archival holdings and archival theory; thus Kroll proposed abandoning the term complex fonds and implementation of the term archival complex. The archival complex was supposed to be archival materials of various origins merged (in or outside of an archive into fonds, or parts of archival fonds of different institutions having the same characteristic – function. The complex was supposed to make up a separate entity in logic structure of archival holdings, comprising of all archival fonds and/or their pieces being parts of the main fonds of the complex. The problem of lack of above-fonds forms in the Polish archival theory has been also noticed by Józef Siemieński, who has formulated the term of higher-order fonds. According to his idea the higher

  13. The State of Open Source Electronic Health Record Projects: A Software Anthropology Study.

    Science.gov (United States)

    Alsaffar, Mona; Yellowlees, Peter; Odor, Alberto; Hogarth, Michael

    2017-02-24

    Electronic health records (EHR) are a key tool in managing and storing patients' information. Currently, there are over 50 open source EHR systems available. Functionality and usability are important factors for determining the success of any system. These factors are often a direct reflection of the domain knowledge and developers' motivations. However, few published studies have focused on the characteristics of free and open source software (F/OSS) EHR systems and none to date have discussed the motivation, knowledge background, and demographic characteristics of the developers involved in open source EHR projects. This study analyzed the characteristics of prevailing F/OSS EHR systems and aimed to provide an understanding of the motivation, knowledge background, and characteristics of the developers. This study identified F/OSS EHR projects on SourceForge and other websites from May to July 2014. Projects were classified and characterized by license type, downloads, programming languages, spoken languages, project age, development status, supporting materials, top downloads by country, and whether they were "certified" EHRs. Health care F/OSS developers were also surveyed using an online survey. At the time of the assessment, we uncovered 54 open source EHR projects, but only four of them had been successfully certified under the Office of the National Coordinator for Health Information Technology (ONC Health IT) Certification Program. In the majority of cases, the open source EHR software was downloaded by users in the United States (64.07%, 148,666/232,034), underscoring that there is a significant interest in EHR open source applications in the United States. A survey of EHR open source developers was conducted and a total of 103 developers responded to the online questionnaire. The majority of EHR F/OSS developers (65.3%, 66/101) are participating in F/OSS projects as part of a paid activity and only 25.7% (26/101) of EHR F/OSS developers are, or have been

  14. Under-ascertainment of Aboriginality in records of cardiovascular disease in hospital morbidity and mortality data in Western Australia: a record linkage study

    Directory of Open Access Journals (Sweden)

    Katzenellenbogen Judy M

    2010-12-01

    Full Text Available Abstract Background Measuring the real burden of cardiovascular disease in Australian Aboriginals is complicated by under-identification of Aboriginality in administrative health data collections. Accurate data is essential to measure Australia's progress in its efforts to intervene to improve health outcomes of Australian Aboriginals. We estimated the under-ascertainment of Aboriginal status in linked morbidity and mortality databases in patients hospitalised with cardiovascular disease. Methods Persons with public hospital admissions for cardiovascular disease in Western Australia during 2000-2005 (and their 20-year admission history or who subsequently died were identified from linkage data. The Aboriginal status flag in all records for a given individual was variously used to determine their ethnicity (index positive, and in all records both majority positive or ever positive and stratified by region, age and gender. The index admission was the baseline comparator. Results Index cases comprised 62,692 individuals who shared a total of 778,714 hospital admissions over 20 years, of which 19,809 subsequently died. There were 3,060 (4.9% persons identified as Aboriginal on index admission. An additional 83 (2.7% Aboriginal cases were identified through death records, increasing to 3.7% when cases with a positive Aboriginal identifier in the majority (≥50% of previous hospital admissions over twenty years were added and by 20.8% when those with a positive flag in any record over 20 years were incorporated. These results equated to underestimating Aboriginal status in unlinked index admission by 2.6%, 3.5% and 17.2%, respectively. Deaths classified as Aboriginal in official records would underestimate total Aboriginal deaths by 26.8% (95% Confidence Interval 24.1 to 29.6%. Conclusions Combining Aboriginal determinations in morbidity and official death records increases ascertainment of unlinked cardiovascular morbidity in Western Australian

  15. Development of a clinical information tool for the electronic medical record: a case study.

    Science.gov (United States)

    Epstein, Barbara A; Tannery, Nancy H; Wessel, Charles B; Yarger, Frances; LaDue, John; Fiorillo, Anthony B

    2010-07-01

    What is the process of developing a clinical information tool to be embedded in the electronic health record of a very large and diverse academic medical center? The development took place at the University of Pittsburgh Health Sciences Library System. The clinical information tool developed is a search box with subject tabs to provide quick access to designated full-text information resources. Each subject tab offers a federated search of a different pool of resources. Search results are organized "on the fly" into meaningful categories using clustering technology and are directly accessible from the results page. After more than a year of discussion and planning, a clinical information tool was embedded in the academic medical center's electronic health record. The library successfully developed a clinical information tool, called Clinical-e, for use at the point of care. Future development will refine the tool and evaluate its impact and effectiveness.

  16. Pemanfaatan Data ARR (Automatic Rainfall Recorder) untuk Peningkatan Efektifitas Model Hujan Satelit (Studi Kasus DAS Indragiri)

    OpenAIRE

    Hendra, Yuli; Fauzi, Manyuk; Sutikno, Sigit

    2015-01-01

    The availability of data on hydrological modeling always become a problem considering the incompleteness and the imprecision of data. As the development of technology, many models of hidrology using data acquired from the satellite have emerged. The accuracy and the model correlation was still unachieved from the previous research using satellite data. This problems was caused by the unstable weather conditions thus the process of recording and dowloading of the satellite data become less opt...

  17. Exploiting Academic Records for Predicting Student Drop Out: a case study in Brazilian higher education

    OpenAIRE

    Sales, Allan; Balby, Leandro; Cajueiro, Adalberto

    2017-01-01

    Students’ dropout is a major concern of the Brazilian higher education institutions as it may cause waste of resources and decrease graduation rates. The early detection of students with high probability of dropping out, as well as understanding the underlying causes, are crucial for defining more effective actions toward preventing this problem. In this paper, we cast the dropout detection problem as a classification problem. We use a large sample of academic records of students across 76 co...

  18. Record breaking achievements by spiders and the scientists who study them.

    Science.gov (United States)

    Mammola, Stefano; Michalik, Peter; Hebets, Eileen A; Isaia, Marco

    2017-01-01

    Organismal biology has been steadily losing fashion in both formal education and scientific research. Simultaneous with this is an observable decrease in the connection between humans, their environment, and the organisms with which they share the planet. Nonetheless, we propose that organismal biology can facilitate scientific observation, discovery, research, and engagement, especially when the organisms of focus are ubiquitous and charismatic animals such as spiders. Despite being often feared, spiders are mysterious and intriguing, offering a useful foundation for the effective teaching and learning of scientific concepts and processes. In order to provide an entryway for teachers and students-as well as scientists themselves-into the biology of spiders, we compiled a list of 99 record breaking achievements by spiders (the "Spider World Records"). We chose a world-record style format, as this is known to be an effective way to intrigue readers of all ages. We highlighted, for example, the largest and smallest spiders, the largest prey eaten, the fastest runners, the highest fliers, the species with the longest sperm, the most venomous species, and many more. We hope that our compilation will inspire science educators to embrace the biology of spiders as a resource that engages students in science learning. By making these achievements accessible to non-arachnologists and arachnologists alike, we suggest that they could be used: (i) by educators to draw in students for science education, (ii) to highlight gaps in current organismal knowledge, and (iii) to suggest novel avenues for future research efforts. Our contribution is not meant to be comprehensive, but aims to raise public awareness on spiders, while also providing an initial database of their record breaking achievements.

  19. How is adult patient adherence recorded in orthodontists’ clinical notes? A mixed-method case-note study

    Directory of Open Access Journals (Sweden)

    Al Shammary N

    2017-10-01

    Full Text Available Nawaf Al Shammary,1 Koula Asimakopoulou,1 Fraser McDonald,2 Jonathon T Newton,1 Sasha Scambler1 1Division of Population and Patient Health, 2Craniofacial Development and Stem Cell Biology Department, King’s College London Dental Institute, London, UKBackground: Patient adherence in orthodontic treatment is extremely important as it is linked with better treatment outcomes. Despite its importance, however, there is no shared definition of the concept. This makes the recording of adherence-related behaviors in patient notes difficult. The current study explored how, and to what extent adherence is recorded in adult patients’ medical records by orthodontists working in a large National Health Service (NHS London hospital.Materials and methods: A mixed-methods approach was used. A total of 17 clinicians with a mean age of 31 years (SD =4.87 provided N=20 case notes spanning N=324 appointments with patients they judged to be non-adherent. The notes were inspected for evidence of recording of patient adherence using adherence indicators identified in the literature.Results: The term “adherence” did not feature in any notes. The quantitative analysis showed that the three most frequent adherence-related behaviors recorded in notes were “oral hygiene,” “appointment attendance” and “breakages of appliances.” Qualitative analysis not only confirmed these factors but also showed that 1 the clinical aspects of treatment, 2 clinician–patient interaction factors and 3 patient attitudes also featured. This part of the analysis also highlighted inconsistencies across case notes in terms of the amount of information being recorded.Conclusion: Adherence as a term does not feature in the clinical case notes of clinician-identified non-adherent adult patients, while predictors of adherence are recorded with varying degrees of consistency. Keywords: adherence, adults, orthodontic treatment

  20. Are they really refusing to travel? A qualitative study of prehospital records

    Directory of Open Access Journals (Sweden)

    Christopher Sarah

    2006-09-01

    Full Text Available Abstract Background Refusal by the patient to travel after calling an emergency ambulance may lead to a preventable waste of scarce resources if it can be shown that an alternative more appropriate response could be employed. A greater understanding is required of the reasons behind 'refusal to travel' (RTT in order to find appropriate solutions to address this issue. We sought to investigate the reasons why patients refuse to travel following emergency call-out in a rural county. Methods Written records made by ambulance crews for patients (n = 397 who were not transported to hospital following an emergency call-out during October 2004 were retrospectively analysed. Results Twelve main themes emerged for RTT which included non injury or minor injury, falls and recovery after treatment on scene; other themes included alternative supervision, follow-up and treatment arrangements or patients arranging their own transport. Importantly, only 8% of the sample was recorded by ambulance crews as truly refusing to travel against advice. Conclusion A system that facilitates standardised recording of RTT information including social reasons for non-transportation needs to be designed. 'Refused to travel' disclaimers need to reflect instances when crew and patient are satisfied that not going to hospital is the right outcome. These recommendations should be considered within the context of the plans for widening the role of ambulance services.

  1. The distinguishing motor features of cataplexy: a study from video-recorded attacks.

    Science.gov (United States)

    Pizza, Fabio; Antelmi, Elena; Vandi, Stefano; Meletti, Stefano; Erro, Roberto; Baumann, Christian R; Bhatia, Kailash P; Dauvilliers, Yves; Edwards, Mark J; Iranzo, Alex; Overeem, Sebastiaan; Tinazzi, Michele; Liguori, Rocco; Plazzi, Giuseppe

    2018-05-01

    To describe the motor pattern of cataplexy and to determine its phenomenological differences from pseudocataplexy in the differential diagnosis of episodic falls. We selected 30 video-recorded cataplexy and 21 pseudocataplexy attacks in 17 and 10 patients evaluated for suspected narcolepsy and with final diagnosis of narcolepsy type 1 and conversion disorder, respectively, together with self-reported attacks features, and asked expert neurologists to blindly evaluate the motor features of the attacks. Video documented and self-reported attack features of cataplexy and pseudocataplexy were contrasted. Video-recorded cataplexy can be positively differentiated from pseudocataplexy by the occurrence of facial hypotonia (ptosis, mouth opening, tongue protrusion) intermingled by jerks and grimaces abruptly interrupting laughter behavior (i.e. smile, facial expression) and postural control (head drops, trunk fall) under clear emotional trigger. Facial involvement is present in both partial and generalized cataplexy. Conversely, generalized pseudocataplexy is associated with persistence of deep tendon reflexes during the attack. Self-reported features confirmed the important role of positive emotions (laughter, telling a joke) in triggering the attacks, as well as the more frequent occurrence of partial body involvement in cataplexy compared with pseudocataplexy. Cataplexy is characterized by abrupt facial involvement during laughter behavior. Video recording of suspected cataplexy attacks allows the identification of positive clinical signs useful for diagnosis and, possibly in the future, for severity assessment.

  2. Electrical stunning and exsanguination decrease the extracellular volume in the broiler brain as studied with brain impedance recordings

    NARCIS (Netherlands)

    Savenije, B; Lambooij, E; Pieterse, C; Korf, J

    Electrical stunning in the process of slaughtering poultry is used to induce unconsciousness and immobilize the animal for easier processing. Unconsciousness is a function of brain damage. Brain damage has been studied with brain impedance recordings under ischemic conditions. This experiment

  3. Data-driven drug safety signal detection methods in pharmacovigilance using electronic primary care records: A population based study

    Directory of Open Access Journals (Sweden)

    Shang-Ming Zhou

    2017-04-01

    Data-driven analytic methods are a valuable aid to signal detection of ADEs from large electronic health records for drug safety monitoring. This study finds the methods can detect known ADE and so could potentially be used to detect unknown ADE.

  4. Reusability of coded data in the primary care electronic medical record : A dynamic cohort study concerning cancer diagnoses

    NARCIS (Netherlands)

    Sollie, Annet; Sijmons, Rolf H.; Helsper, Charles W.; Numans, Mattijs E.

    Objectives: To assess quality and reusability of coded cancer diagnoses in routine primary care data. To identify factors that influence data quality and areas for improvement. Methods: A dynamic cohort study in a Dutch network database containing 250,000 anonymized electronic medical records (EMRs)

  5. Using death certificates and medical examiner records for adolescent occupational fatality surveillance and research: a case study.

    Science.gov (United States)

    Rauscher, Kimberly J; Runyan, Carol W; Radisch, Deborah

    2012-01-01

    Death certificates and medical examiner records have been useful yet imperfect data sources for work-related fatality research and surveillance among adult workers. It is unclear whether this holds for work-related fatalities among adolescent workers who suffer unique detection challenges in part because they are not often thought of as workers. This study investigated the utility of using these data sources for surveillance and research pertaining to adolescent work-related fatalities. Using the state of North Carolina as a case study, we analyzed data from the death certificates and medical examiner records of all work-related fatalities data among 11- to 17-year-olds between 1990-2008 (N = 31). We compared data sources on case identification, of completeness, and consistency information. Variables examined included those on the injury (e.g., means), occurrence (e.g., place), demographics, and employment (e.g., occupation). Medical examiner records (90%) were more likely than death certificates (71%) to identify adolescent work-related fatalities. Data completeness was generally high yet varied between sources. The most marked difference being that in medical examiner records, type of business/industry and occupation were complete in 72 and 67% of cases, respectively, while on the death certificates these fields were complete in 90 and 97% of cases, respectively. Taking the two sources together, each field was complete in upward of 94% of cases. Although completeness was high, data were not always of good quality and sometimes conflicted across sources. In many cases, the decedent's occupation was misclassified as "student" and their employer as "school" on the death certificate. Even though each source has its weaknesses, medical examiner records and death certificates, especially when used together, can be useful for conducting surveillance and research on adolescent work-related fatalities. However, extra care is needed by data recorders to ensure that

  6. Review of approaches to the recording of background lesions in toxicologic pathology studies in rats.

    Science.gov (United States)

    McInnes, E F; Scudamore, C L

    2014-08-17

    Pathological evaluation of lesions caused directly by xenobiotic treatment must always take into account the recognition of background (incidental) findings. Background lesions can be congenital or hereditary, histological variations, changes related to trauma or normal aging and physiologic or hormonal changes. This review focuses on the importance and correct approach to recording of background changes and includes discussion on sources of variability in background changes, the correct use of terminology, the concept of thresholds, historical control data, diagnostic drift, blind reading of slides, scoring and artifacts. The review is illustrated with background lesions in Sprague Dawley and Wistar rats. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Old stellar populations how to study the fossil record of galaxy formation

    CERN Document Server

    Cassisi, Santi

    2013-01-01

    The book discusses the theoretical path to decoding the information gathered from observations of old stellar systems. It focuses on old stellar systems because these are the fossil record of galaxy formation and provide invaluable information ont he evolution of cosmic structures and the universe as a whole. The aim is to present results obtained in the past few years for theoretical developments in low mass star research and in advances in our knowledge of the evolution of old stellar systems. A particularly representative case is the recent discovery of multiple stellar populations in galac

  8. [Study on medical records of acupuncture-moxibustion in The Twenty-four Histories].

    Science.gov (United States)

    Huang, Kai-Wen

    2012-03-01

    Through the combination of manual retrieval and computerized retrieval, medical records of acupuncture-moxibustion in The Twenty-Four Histories were collected. Acupuncture cases from the Spring and Autumn Period (770-476 B.C.) to the end of the Ming Dynasty (1368-1644)were retrieved. From the medical records of acupuncture-moxibustion in Chinese official history books, it can be found that systematic diseases or emergent and severe diseases were already treated by physicians with the combination of acupuncture and medicine as early as in the Spring and Autumn Period as well as the Warring States Period(475-221 B.C.). CANG Gong, a famous physician of the Western Han Dynasty (206 B. C.-A. D. 24), cured diseases by selecting points along the running courses of meridians where the illness inhabited, which indicates that the theory of meridians and collaterals was served as a guide for clinical practice as early as in the Western Han Dynasty. Blood letting therapy, which has surprising effect, was often adopted by physicians of various historical periods to treat diseases. And treatment of diseases with single point was approved to be easy and effective.

  9. The Role of Anterior Nuclei of the Thalamus: A Subcortical Gate in Memory Processing: An Intracerebral Recording Study.

    Directory of Open Access Journals (Sweden)

    Klára Štillová

    Full Text Available To study the involvement of the anterior nuclei of the thalamus (ANT as compared to the involvement of the hippocampus in the processes of encoding and recognition during visual and verbal memory tasks.We studied intracerebral recordings in patients with pharmacoresistent epilepsy who underwent deep brain stimulation (DBS of the ANT with depth electrodes implanted bilaterally in the ANT and compared the results with epilepsy surgery candidates with depth electrodes implanted bilaterally in the hippocampus. We recorded the event-related potentials (ERPs elicited by the visual and verbal memory encoding and recognition tasks.P300-like potentials were recorded in the hippocampus by visual and verbal memory encoding and recognition tasks and in the ANT by the visual encoding and visual and verbal recognition tasks. No significant ERPs were recorded during the verbal encoding task in the ANT. In the visual and verbal recognition tasks, the P300-like potentials in the ANT preceded the P300-like potentials in the hippocampus.The ANT is a structure in the memory pathway that processes memory information before the hippocampus. We suggest that the ANT has a specific role in memory processes, especially memory recognition, and that memory disturbance should be considered in patients with ANT-DBS and in patients with ANT lesions. ANT is well positioned to serve as a subcortical gate for memory processing in cortical structures.

  10. The Role of Anterior Nuclei of the Thalamus: A Subcortical Gate in Memory Processing: An Intracerebral Recording Study.

    Science.gov (United States)

    Štillová, Klára; Jurák, Pavel; Chládek, Jan; Chrastina, Jan; Halámek, Josef; Bočková, Martina; Goldemundová, Sabina; Říha, Ivo; Rektor, Ivan

    2015-01-01

    To study the involvement of the anterior nuclei of the thalamus (ANT) as compared to the involvement of the hippocampus in the processes of encoding and recognition during visual and verbal memory tasks. We studied intracerebral recordings in patients with pharmacoresistent epilepsy who underwent deep brain stimulation (DBS) of the ANT with depth electrodes implanted bilaterally in the ANT and compared the results with epilepsy surgery candidates with depth electrodes implanted bilaterally in the hippocampus. We recorded the event-related potentials (ERPs) elicited by the visual and verbal memory encoding and recognition tasks. P300-like potentials were recorded in the hippocampus by visual and verbal memory encoding and recognition tasks and in the ANT by the visual encoding and visual and verbal recognition tasks. No significant ERPs were recorded during the verbal encoding task in the ANT. In the visual and verbal recognition tasks, the P300-like potentials in the ANT preceded the P300-like potentials in the hippocampus. The ANT is a structure in the memory pathway that processes memory information before the hippocampus. We suggest that the ANT has a specific role in memory processes, especially memory recognition, and that memory disturbance should be considered in patients with ANT-DBS and in patients with ANT lesions. ANT is well positioned to serve as a subcortical gate for memory processing in cortical structures.

  11. The posterior medial cortex is involved in visual but not in verbal memory encoding processing: an intracerebral recording study.

    Science.gov (United States)

    Stillová, K; Jurák, P; Chládek, J; Halámek, J; Telecká, S; Rektor, I

    2013-03-01

    The objective is to study the involvement of the posterior medial cortex (PMC) in encoding and retrieval by visual and auditory memory processing. Intracerebral recordings were studied in two epilepsy-surgery candidates with depth electrodes implanted in the retrosplenial cingulate, precuneus, cuneus, lingual gyrus and hippocampus. We recorded the event-related potentials (ERP) evoked by visual and auditory memory encoding-retrieval tasks. In the hippocampus, ERP were elicited in the encoding and retrieval phases in the two modalities. In the PMC, ERP were recorded in both the encoding and the retrieval visual tasks; in the auditory modality, they were recorded in the retrieval task, but not in the encoding task. In conclusion, the PMC is modality dependent in memory processing. ERP is elicited by memory retrieval, but it is not elicited by auditory encoding memory processing in the PMC. The PMC appears to be involved not only in higher-order top-down cognitive activities but also in more basic, rather than bottom-up activities.

  12. Changes in walking associated with perceived neighborhood safety and police-recorded crime: The multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Kerr, Zachary; Evenson, Kelly R; Moore, Kari; Block, Richard; Diez Roux, Ana V

    2015-04-01

    To explore the association of changes in perceived safety and police-recorded crime with changes in transport and leisure walking using longitudinal data from Chicago residents participating in the Multi-Ethnic Study of Atherosclerosis (2000-2012). Main exposures included perceived safety (self-reported as feeling safe walking in the neighborhood and reporting violence to be a problem in the neighborhood), and one-year counts of police-recorded crime occurring within a one-mile buffer of participants' residences. Main outcomes included transport and leisure walking (self-reported and calculated as total minutes/week across four study visits). Fixed effects models assessed the association of change in perceived safety and police-recorded crime with changes in transport and leisure walking over a 10-year period for 796 adults. No associations were found between changes in perceived safety and either changes in transport or leisure walking. Residing in areas with increases in murder was associated with decreases in transport walking. However, no other associations were found with police-recorded crime. There continues to be a need to explore the benefits of cultivating safe neighborhoods that enhance resident health and well-being. Research should continue examining how community initiatives may build safe environments and community identity that promote walking. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Time Pressure, Time Autonomy, and Sickness Absenteeism in Hospital Employees: A Longitudinal Study on Organizational Absenteeism Records

    OpenAIRE

    Maria U. Kottwitz; Volker Schade; Christian Burger; Lorenz Radlinger; Achim Elfering

    2018-01-01

    Background: Although work absenteeism is in the focus of occupational health, longitudinal studies on organizational absenteeism records in hospital work are lacking. This longitudinal study tests time pressure and lack of time autonomy to be related to higher sickness absenteeism. Methods: Data was collected for 180 employees (45% nurses) of a Swiss hospital at baseline and at follow-up after 1 year. Absent times (hours per month) were received from the human resources department of the hosp...

  14. A record linkage study of outcomes in patients with mild primary hyperparathyroidism: the Parathyroid Epidemiology and Audit Research Study (PEARS).

    Science.gov (United States)

    Yu, Ning; Donnan, Peter T; Leese, Graham P

    2011-08-01

    Primary hyperparathyroidism (PHPT) is a common endocrine disorder, but the majority of cases are perceived to be mild and remain untreated. To determine the risk of mortality and morbidities in patients with mild PHPT. Tayside, Scotland, 1997-2006. A historical, prospective, record-linkage, population-based, matched cohort study. All patients with diagnosed but untreated, mild PHPT. METHOD AND OUTCOME MEASURES: Each patient with PHPT was matched with five population-based comparators, by age, gender and calendar year of PHPT diagnosis, selected from the general population. Primary outcomes were all-cause mortality, fatal and nonfatal cardiovascular disease (CVD). Secondary outcomes were cancer-related deaths and other hospital admitted morbidities, including cerebrovascular disease, fractures, hypertension, psychiatric disease, renal complications, cancer and diabetes. The risk was assessed using the Cox proportional hazards model, adjusting for confounding factors of pre-existing co-morbidities, previous prescription of bisphosphonates, socio-economic deprivation score and the probability of having a calcium check. Compared to the matched cohort, the risk of all cause mortality, fatal and nonfatal CVD was increased in patients with asymptomatic PHPT: adjusted hazard ratios (HR) 1·64 (95% CI: 1·43-1·87), 1·64 (95% CI: 1·32-2·04) and 2·48 (95% CI: 2·13-2·89), respectively. The risk was also increased in all secondary outcomes, with the risk of renal failure and renal stones being the highest, adjusted HRs being 13·83 (95% CI: 10·41-18·37) and 5·15 (95% CI: 2·69-9·83), respectively. Patients with mild PHPT had an increased risk of mortality, fatal and nonfatal CVD, and the risk of developing other co-morbidities was also increased. © 2011 Blackwell Publishing Ltd.

  15. Constructing a population-based research database from routine maternal screening records: a resource for studying alloimmunization in pregnant women.

    Directory of Open Access Journals (Sweden)

    Brian K Lee

    Full Text Available BACKGROUND: Although screening for maternal red blood cell antibodies during pregnancy is a standard procedure, the prevalence and clinical consequences of non-anti-D immunization are poorly understood. The objective was to create a national database of maternal antibody screening results that can be linked with population health registers to create a research resource for investigating these issues. STUDY DESIGN AND METHODS: Each birth in the Swedish Medical Birth Register was uniquely identified and linked to the text stored in routine maternal antibody screening records in the time window from 9 months prior to 2 weeks after the delivery date. These text records were subjected to a computerized search for specific antibodies using regular expressions. To illustrate the research potential of the resulting database, selected antibody prevalence rates are presented as tables and figures, and the complete data (from more than 60 specific antibodies presented as online moving graphical displays. RESULTS: More than one million (1,191,761 births with valid screening information from 1982-2002 constitute the study population. Computerized coverage of screening increased steadily over time and varied by region as electronic records were adopted. To ensure data quality, we restricted analysis to birth records in areas and years with a sustained coverage of at least 80%, representing 920,903 births from 572,626 mothers in 17 of the 24 counties in Sweden. During the study period, non-anti-D and anti-D antibodies occurred in 76.8/10,000 and 14.1/10,000 pregnancies respectively, with marked differences between specific antibodies over time. CONCLUSION: This work demonstrates the feasibility of creating a nationally representative research database from the routine maternal antibody screening records from an extended calendar period. By linkage with population registers of maternal and child health, such data are a valuable resource for addressing important

  16. Genome-wide association study for ketosis in US Jerseys using producer-recorded data.

    Science.gov (United States)

    Parker Gaddis, K L; Megonigal, J H; Clay, J S; Wolfe, C W

    2018-01-01

    Ketosis is one of the most frequently reported metabolic health events in dairy herds. Several genetic analyses of ketosis in dairy cattle have been conducted; however, few have focused specifically on Jersey cattle. The objectives of this research included estimating variance components for susceptibility to ketosis and identification of genomic regions associated with ketosis in Jersey cattle. Voluntary producer-recorded health event data related to ketosis were available from Dairy Records Management Systems (Raleigh, NC). Standardization was implemented to account for the various acronyms used by producers to designate an incidence of ketosis. Events were restricted to the first reported incidence within 60 d after calving in first through fifth parities. After editing, there were a total of 42,233 records from 23,865 cows. A total of 1,750 genotyped animals were used for genomic analyses using 60,671 markers. Because of the binary nature of the trait, a threshold animal model was fitted using THRGIBBS1F90 (version 2.110) using only pedigree information, and genomic information was incorporated using a single-step genomic BLUP approach. Individual single nucleotide polymorphism (SNP) effects and the proportion of variance explained by 10-SNP windows were calculated using postGSf90 (version 1.38). Heritability of susceptibility to ketosis was 0.083 [standard deviation (SD) = 0.021] and 0.078 (SD = 0.018) in pedigree-based and genomic analyses, respectively. The marker with the largest associated effect was located on chromosome 10 at 66.3 Mbp. The 10-SNP window explaining the largest proportion of variance (0.70%) was located on chromosome 6 beginning at 56.1 Mbp. Gene Ontology (GO) and Medical Subject Heading (MeSH) enrichment analyses identified several overrepresented processes and terms related to immune function. Our results indicate that there is a genetic component related to ketosis susceptibility in Jersey cattle and, as such, genetic selection for

  17. Impact of a computerized system for evidence-based diabetes care on completeness of records: a before–after study

    Directory of Open Access Journals (Sweden)

    Roshanov Pavel S

    2012-07-01

    Full Text Available Abstract Background Physicians practicing in ambulatory care are adopting electronic health record (EHR systems. Governments promote this adoption with financial incentives, some hinged on improvements in care. These systems can improve care but most demonstrations of successful systems come from a few highly computerized academic environments. Those findings may not be generalizable to typical ambulatory settings, where evidence of success is largely anecdotal, with little or no use of rigorous methods. The purpose of our pilot study was to evaluate the impact of a diabetes specific chronic disease management system (CDMS on recording of information pertinent to guideline-concordant diabetes care and to plan for larger, more conclusive studies. Methods Using a before–after study design we analyzed the medical record of approximately 10 patients from each of 3 diabetes specialists (total = 31 who were seen both before and after the implementation of a CDMS. We used a checklist of key clinical data to compare the completeness of information recorded in the CDMS record to both the clinical note sent to the primary care physician based on that same encounter and the clinical note sent to the primary care physician based on the visit that occurred prior to the implementation of the CDMS, accounting for provider effects with Generalized Estimating Equations. Results The CDMS record outperformed by a substantial margin dictated notes created for the same encounter. Only 10.1% (95% CI, 7.7% to 12.3% of the clinically important data were missing from the CDMS chart compared to 25.8% (95% CI, 20.5% to 31.1% from the clinical note prepared at the time (p p  Conclusions The CDMS chart captured information important for the management of diabetes more often than dictated notes created with or without its use but we were unable to detect a difference in completeness between notes dictated in CDMS-associated and usual-care encounters. Our sample of

  18. Preliminary results of a study of four successive sedimentary geomagnetic reversal records from the Mediterranean (Upper Thvera, Lower and Upper Sidufjall, and Lower Nunivak)

    NARCIS (Netherlands)

    Linssen, J.H.

    1988-01-01

    The results of a study of four successive Early Pliocene geomagnetic reversal records are presented. The polarity transitions have been recorded in the Trubi formation of Calabria (S. Italy). The lower Sidufjall and Lower Nunivak records are nearly identical and have a zonal harmonic content

  19. Measuring the performance of electronic health records: a case study in residential aged care in Australia.

    Science.gov (United States)

    Yu, Ping; Qian, Siyu; Yu, Hui; Lei, Jianbo

    2013-01-01

    Measuring the performance of electronic health records (EHR) is an important, yet un-resolved challenge. Various measurements have addressed different aspects of EHR success, yet a holistic, comprehensive measurement tool needs to be developed to capture the potential EHR success variables completely. A self-administered questionnaire survey instrument was developed based on the theoretical framework of the DeLone and McLean Information Systems Success Model. It measures nigh variables of EHR success: system quality, information quality, service quality, training, self efficacy, intention to use, use, user satisfaction and net benefits. The instrument was used to measure the performance of aged care EHR systems in three aged care organizations. The results suggest that the instrument was reliable.

  20. The study and development of magnetic recording heads. A thin film integrated magnetic head

    International Nuclear Information System (INIS)

    Lazzari, Jean-Pierre

    1970-01-01

    A new integrated magnetic head is described. The head was made by vacuum deposition using a mask. A magnetically coupled multilayer construction led to high performance. The results obtained indicate that the device functions equally well, for reading and writing. A set of calculations was developed which could simulate and optimize the behavior of the recording head. The results obtained with the writing were in good agreement with those obtained from experiments and quite different from results which have been several times previously published. In addition a new method was developed for measuring high fields in confined spaces; a 1000 A diameter probe was used in conjunction with a low angle diffraction procedure. The measurements give results which are very different from those obtained by current theories based on the magnetic potentials at the surface. (author) [fr

  1. Benefits of Record Management For Scientific Writing (Study of Metadata Reception of Zotero Reference Management Software in UIN Malang

    Directory of Open Access Journals (Sweden)

    Moch Fikriansyah Wicaksono

    2018-01-01

    Full Text Available Record creation and management by individuals or organizations grows rapidly, particularly the change from print to electronics, and the smallest part of record (metadata. Therefore, there is a need to perform record management metadata, particularly for students who have the needs of recording references and citation. Reference management software (RMS is a software to help reference management, one of them named zotero. The purpose of this article is to describe the benefits of record management for the writing of scientific papers for students, especially on biology study program in UIN Malik Ibrahim Malang. The type of research used is descriptive with quantitative approach. To increase the depth of respondents' answers, we used additional data by conducting interviews. The selected population is 322 students, class of 2012 to 2014, using random sampling. The selection criteria were chosen because the introduction and use of reference management software, zotero have started since three years ago.  Respondents in this study as many as 80 people, which is obtained from the formula Yamane. The results showed that 70% agreed that using reference management software saved time and energy in managing digital file metadata, 71% agreed that if digital metadata can be quickly stored into RMS, 65% agreed on the ease of storing metadata into the reference management software, 70% agreed when it was easy to configure metadata to quote and bibliography, 56.6% agreed that the metadata stored in reference management software could be edited, 73.8% agreed that using metadata will make it easier to write quotes and bibliography.

  2. Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study.

    Science.gov (United States)

    van Jaarsveld, Cornelia H M; Gulliford, Martin C

    2015-03-01

    This study aimed to use primary care electronic health records to evaluate the prevalence of overweight and obesity in 2-15-year-old children in England and compare trends over the last two decades. Cohort study of primary care electronic health records. 375 general practices in England that contribute to the UK Clinical Practice Research Datalink. Individual participants were sampled if they were aged between 2 and 15 years during the period 1994-2013 and had one or more records of body mass index (BMI). Prevalence of overweight (including obesity) was defined as a BMI equal to or greater than the 85th centile of the 1990 UK reference population. Data were analysed for 370 544 children with 507 483 BMI records. From 1994 to 2003, the odds of overweight and obesity increased by 8.1% per year (95% CI 7.2% to 8.9%) compared with 0.4% (-0.2% to 1.1%) from 2004 to 2013. Trends were similar for boys and girls, but differed by age groups, with prevalence stabilising in 2004 to 2013 in the younger (2-10 year) but not older (11-15 year) age group, where rates continued to increase. Primary care electronic health records in England may provide a valuable resource for monitoring obesity trends. More than a third of UK children are overweight or obese, but the prevalence of overweight and obesity may have stabilised between 2004 and 2013. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. A qualitative study of how patients with type 2 diabetes use an electronic stand-alone personal health record.

    Science.gov (United States)

    Fuji, Kevin T; Abbott, Amy A; Galt, Kimberly A

    2015-04-01

    Patient use of personal health records (PHRs) to manage their health information has been proposed to enhance patient knowledge and empower patients to make changes in their self-care behaviors. However, there remains a gap in understanding about patients' actual PHR use behaviors. The purpose of this qualitative study was to explore how patients with type 2 diabetes used a PHR to manage their diabetes-related health information for self-care. Fifty-nine patients with type 2 diabetes were interviewed 3-6 months after receiving initial training on a free-of-charge, Web-based PHR. Interviews were audio-recorded, transcribed, and analyzed using an iterative process of in vivo coding, categorization, and theme development. Nine themes emerged, three of which expressed positive experiences: complete and accessible record; increased awareness; and behavioral changes. The remaining six themes expressed negative experiences: out of sight, out of mind; I would have used it if I were sicker; economic, infrastructure, and computer literacy barriers; lack of patient-provider engagement; double tracking; and privacy and security concerns. Despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. Provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.

  4. A preliminary study for investigating idiopatic normal pressure hydrocephalus by means of statistical parameters classification of intracranial pressure recordings.

    Science.gov (United States)

    Calisto, A; Bramanti, A; Galeano, M; Angileri, F; Campobello, G; Serrano, S; Azzerboni, B

    2009-01-01

    The objective of this study is to investigate Id-iopatic Normal Pressure Hydrocephalus (INPH) through a multidimensional and multiparameter analysis of statistical data obtained from accurate analysis of Intracranial Pressure (ICP) recordings. Such a study could permit to detect new factors, correlated with therapeutic response, which are able to validate a predicting significance for infusion test. The algorithm developed by the authors computes 13 ICP parameter trends on each of the recording, afterward 9 statistical information from each trend is determined. All data are transferred to the datamining software WEKA. According to the exploited feature-selection techniques, the WEKA has revealed that the most significant statistical parameter is the maximum of Single-Wave-Amplitude: setting a 27 mmHg threshold leads to over 90% of correct classification.

  5. Quality of diagnosis and monitoring of tuberculosis in Northern Ethiopia: medical records-based retrospective study.

    Science.gov (United States)

    Mala, George; Spigt, Mark G; Gidding, Luc G; Blanco, Roman; Dinant, Geert-Jan

    2015-10-01

    To determine quality of diagnosis and monitoring of treatment response of patients with smear-negative pulmonary tuberculosis (TB) compared with smear-positive cases in Ethiopia. A retrospective analysis of medical records of newly diagnosed pulmonary TB cases that were registered for taking anti-TB medication and had completed treatment between 2010 and 2012. We evaluated the percentage of cases that were managed according to the International Standards of Tuberculosis Care (ISTC) and compared smear-negative with smear-positive cases. We analysed 1168 cases of which 742 (64%) were sputum smear-negative cases. Chest radiography examination at diagnosis and microbiological testing at the end of the intensive phase of treatment was performed in a smaller proportion than in smear-positive TB cases (70% vs. 79%, P value ISTC are of greatest importance in minimising pitfalls in care of smear-negative TB yet were performed less often in smear-negative than smear-positive TB cases. © The Author(s) 2015.

  6. Electronic health record case studies to advance environmental public health tracking.

    Science.gov (United States)

    Namulanda, Gonza; Qualters, Judith; Vaidyanathan, Ambarish; Roberts, Eric; Richardson, Max; Fraser, Alicia; McVeigh, Katharine H; Patterson, Scott

    2018-03-01

    Data from traditional public health surveillance systems can have some limitations, e.g., timeliness, geographic level, and amount of data accessible. Electronic health records (EHRs) could present an opportunity to supplement current sources of routinely collected surveillance data. The National Environmental Public Health Tracking Program (Tracking Program) sought to explore the use of EHRs for advancing environmental public health surveillance practices. The Tracking Program funded four state/local health departments to obtain and pilot the use of EHR data to address several issues including the challenges and technical requirements for accessing EHR data, and the core data elements required to integrate EHR data within their departments' Tracking Programs. The results of these pilot projects highlighted the potential of EHR data for public health surveillance of rare diseases that may lack comprehensive registries, and surveillance of prevalent health conditions or risk factors for health outcomes at a finer geographic level. EHRs therefore, may have potential to supplement traditional sources of public health surveillance data. Published by Elsevier Inc.

  7. Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study.

    Science.gov (United States)

    van Gelder, Marleen M H J; Schouten, Naomi P E; Merkus, Peter J F M; Verhaak, Chris M; Roeleveld, Nel; Roukema, Jolt

    2015-06-16

    Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations. The aim of this study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners. Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012. These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies. In case of inconsistencies between these 2 data sources, medical records from the woman's general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points. Agreement between the baseline questionnaire and the obstetric record was substantial (κ=.61) for any chronic condition and moderate for any allergy (κ=.51). For specific conditions, we found high observed proportions of negative agreement (range 0.88-1.00) and on average moderate observed proportions of positive agreement with a wide range (range 0.19-0.90). Using the reference standard, the sensitivity of the Web-based questionnaire for chronic conditions and allergies was comparable to or even better than the sensitivity of the obstetric records, in particular for migraine (0.90 vs 0.40, P=.02), asthma (0.86 vs 0.61, P=.04), inhalation allergies (0

  8. Anonymous non-response analysis in the ABCD cohort study enabled by probabilistic record linkage

    NARCIS (Netherlands)

    Tromp, M.; van Eijsden, M.; Ravelli, A. C. J.; Bonsel, G. J.

    2009-01-01

    Selective non-response is an important threat to study validity as it can lead to selection bias. The Amsterdam Born Children and their Development study (ABCD-study) is a large cohort study addressing the relationship between life style, psychological conditions, nutrition and sociodemographic

  9. Do electronic health records affect the patient-psychiatrist relationship? A before & after study of psychiatric outpatients

    Directory of Open Access Journals (Sweden)

    Schuyler Mark

    2010-01-01

    Full Text Available Abstract Background A growing body of literature shows that patients accept the use of computers in clinical care. Nonetheless, studies have shown that computers unequivocally change both verbal and non-verbal communication style and increase patients' concerns about the privacy of their records. We found no studies which evaluated the use of Electronic Health Records (EHRs specifically on psychiatric patient satisfaction, nor any that took place exclusively in a psychiatric treatment setting. Due to the special reliance on communication for psychiatric diagnosis and evaluation, and the emphasis on confidentiality of psychiatric records, the results of previous studies may not apply equally to psychiatric patients. Method We examined the association between EHR use and changes to the patient-psychiatrist relationship. A patient satisfaction survey was administered to psychiatric patient volunteers prior to and following implementation of an EHR. All subjects were adult outpatients with chronic mental illness. Results Survey responses were grouped into categories of "Overall," "Technical," "Interpersonal," "Communication & Education,," "Time," "Confidentiality," "Anxiety," and "Computer Use." Multiple, unpaired, two-tailed t-tests comparing pre- and post-implementation groups showed no significant differences (at the 0.05 level to any questionnaire category for all subjects combined or when subjects were stratified by primary diagnosis category. Conclusions While many barriers to the adoption of electronic health records do exist, concerns about disruption to the patient-psychiatrist relationship need not be a prominent focus. Attention to communication style, interpersonal manner, and computer proficiency may help maintain the quality of the patient-psychiatrist relationship following EHR implementation.

  10. Studying Hospitalizations and Mortality in the Netherlands: Feasible and Valid Using Two-Step Medical Record Linkage with Nationwide Registers.

    Directory of Open Access Journals (Sweden)

    Elske Sieswerda

    Full Text Available In the Netherlands, the postal code is needed to study hospitalizations of individuals in the nationwide hospitalization register. Studying hospitalizations longitudinally becomes troublesome if individuals change address. We aimed to report on the feasibility and validity of a two-step medical record linkage approach to examine longitudinal trends in hospitalizations and mortality in a study cohort. First, we linked a study cohort of 1564 survivors of childhood cancer with the Municipal Personal Records Database (GBA which has postal code history and mortality data available. Within GBA, we sampled a reference population matched on year of birth, gender and calendar year. Second, we extracted hospitalizations from the Hospital Discharge Register (LMR with a date of discharge during unique follow-up (based on date of birth, gender and postal code in GBA. We calculated the agreement of death and being hospitalized in survivors according to the registers and to available cohort data. We retrieved 1477 (94% survivors from GBA. Median percentages of unique/potential follow-up were 87% (survivors and 83% (reference persons. Characteristics of survivors and reference persons contributing to unique follow-up were comparable. Agreement of hospitalization during unique follow-up was 94% and agreement of death was 98%. In absence of unique identifiers in the Dutch hospitalization register, it is feasible and valid to study hospitalizations and mortality of individuals longitudinally using a two-step medical record linkage approach. Cohort studies in the Netherlands have the opportunity to study mortality and hospitalization rates over time. These outcomes provide insight into the burden of clinical events and healthcare use in studies on patients at risk of long-term morbidities.

  11. London atmospheric Hydrogen and Carbon Monoxide: 12 year record, fluxes, and diurnal studies.

    Science.gov (United States)

    Lanoisellé, M.; Fisher, R. E.; Sriskantharajah, S.; Lowry, D.; Fowler, C. M. R.; Nisbet, E. G.

    2009-04-01

    Atmospheric hydrogen (H2) and carbon monoxide (CO) have been measured at the Royal Holloway site, 30km WSW of London, for 12 years. This site receives air that has passed over London when there are easterly winds and cleaner, background air when the wind comes from the SW. H2 and CO mixing ratios are measured continuously at 30 minute intervals on a Trace Analytical Reduction Gas Detector coupled to a HP5890 GC since September 1996, and on a Peak Performer I (or PP1) since July 2007 at 5 minute intervals. Both instruments use 2 1/8" packed columns in series: a Unibeads 1S and a Molecular Sieve 5A. The PP1 detector (Reduced Compound Photometer) is an updated version of the old RGD2, and both use zero air as the carrier gas. CO is calibrated twice a month against NOAA-CMDL standards (mixing ratios range: 186 to 300 ppb). H2 was uncalibrated until 2006, but is now calibrated monthly against internal standards (range 530 to 750 ppb) measured at MPI-Jena as part of the Eurohydros project. A linearity correction is applied to each instrument, based on the standard measurements. A secondary standard is measured before each sample on the GC-RGD and another one is measured 4 to 6 times in a row twice a day on the PP1. A target gas is measured daily on both instruments since September 2008. The secondary standards and the target gas are dry ambient air in 70L stainless steel tanks filled to a pressure of 8 bars. Comparison of results from the two instruments suggests that for the most part the data are in good agreement, but an interlaboratory round robin comparison exercise for the Eurohydros project showed that the RGD is not linear at low values of CO. This is particularly noticeable for CO levels below 150 ppb. The long-term record of CO at Royal Holloway shows a significant decline since the start of the record: the annual mean CO mixing ratio in 2008 was three times lower than in 1997. Flux calculations, by ratio against 222Rn, CH4 and CO2, suggest CO emissions

  12. Reorganizing Care With the Implementation of Electronic Medical Records: A Time-Motion Study in the PICU.

    Science.gov (United States)

    Roumeliotis, Nadia; Parisien, Geneviève; Charette, Sylvie; Arpin, Elizabeth; Brunet, Fabrice; Jouvet, Philippe

    2018-04-01

    To assess caregivers' patient care time before and after the implementation of a reorganization of care plan with electronic medical records. A prospective, observational, time-motion study. A level 3 PICU. Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008-2009) and after (2016) implementation of reorganization of care in 2013. The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare). Time spent completing various work tasks was recorded by direct observation, and proportion of time in tasks was compared for each study period. A total of 153.7 hours was observed from 22 nurses and 14 orderlies. There was no significant difference in the proportion of nursing patient care time before (68.8% [interquartile range, 48-72%]) and after (55% [interquartile range, 51-57%]) (p = 0.11) the reorganization with electronic medical record. Direct patient care task time for nurses was increased from 27.0% (interquartile range, 30-37%) before to 34.7% (interquartile range, 33-75%) (p = 0.336) after, and indirect patient care tasks decreased from 33.6% (interquartile range, 23-41%) to 18.6% (interquartile range, 16-22%) (p = 0.036). Documentation time significantly increased from 14.5% (interquartile range, 12-22%) to 26.2% (interquartile range, 23-28%) (p = 0.032). Nursing productivity ratio improved from 28.3 to 26.0. A survey revealed that nursing staff was satisfied with the electronic medical record, although there was a concern for the maintenance of oral communication in the unit. The reorganization of care with the implementation of an ICU-specific electronic medical record in the PICU did not change total patient care provided but improved nursing productivity, resulting in improved efficiency. Documentation time was significantly

  13. The study of key issues about integration of GNSS and strong-motion records for real-time earthquake monitoring

    Science.gov (United States)

    Tu, Rui; Zhang, Pengfei; Zhang, Rui; Liu, Jinhai

    2016-08-01

    This paper has studied the key issues about integration of GNSS and strong-motion records for real-time earthquake monitoring. The validations show that the consistence of the coordinate system must be considered firstly to exclude the system bias between GNSS and strong-motion. The GNSS sampling rate is suggested about 1-5 Hz, and we should give the strong-motion's baseline shift with a larger dynamic noise as its variation is very swift. The initialization time of solving the baseline shift is less than one minute, and ambiguity resolution strategy is not greatly improved the solution. The data quality is very important for the solution, we advised to use multi-frequency and multi-system observations. These ideas give an important guide for real-time earthquake monitoring and early warning by the tight integration of GNSS and strong-motion records.

  14. Updates on information about free-living marine nematodes in Brazil: new records and comments on problems in taxonomic studies.

    Science.gov (United States)

    Venekey, Virág

    2017-10-17

    New records of nematode species in Brazil, which appeared after or were not mentioned in the last review, are shown in this paper. All environments were considered, including the continental margin. In addition, all studies on marine nematodes in Brazil, including grey literature, ecological papers and book chapters, are listed. Furthermore, information on genera/species richness, dominant genera, and densities is also presented. A total of 11 orders, 72 families, 372 genera, and 450 species of nematodes were recorded in Brazilian marine environments by April 2017. Following problems are discussed: taxonomic lists available only in grey literature, use of outdated identification keys (leading to incorrect identifications), and identifications mostly to putative species or to the genus level.

  15. Survey of patient and public perceptions of electronic health records for healthcare, policy and research: Study protocol

    Directory of Open Access Journals (Sweden)

    Luchenski Serena

    2012-05-01

    Full Text Available Abstract Background Immediate access to patients’ complete health records via electronic databases could improve healthcare and facilitate health research. However, the possible benefits of a national electronic health records (EHR system must be balanced against public concerns about data security and personal privacy. Successful development of EHR requires better understanding of the views of the public and those most affected by EHR: users of the National Health Service. This study aims to explore the correlation between personal healthcare experience (including number of healthcare contacts and number and type of longer term conditions and views relating to development of EHR for healthcare, health services planning and policy and health research. Methods/design A multi-site cross-sectional self-complete questionnaire designed and piloted for use in waiting rooms was administered to patients from randomly selected outpatients’ clinics at a university teaching hospital (431 beds and general practice surgeries from the four primary care trusts within the catchment area of the hospital. All patients entering the selected outpatients clinics and general practice surgeries were invited to take part in the survey during August-September 2011. Statistical analyses will be conducted using descriptive techniques to present respondents’ overall views about electronic health records and logistic regression to explore associations between these views and participants’ personal circumstances, experiences, sociodemographics and more specific views about electronic health records. Discussion The study design and implementation were successful, resulting in unusually high response rates and overall recruitment (85.5%, 5336 responses. Rates for face-to-face recruitment in previous work are variable, but typically lower (mean 76.7%, SD 20. We discuss details of how we collected the data to provide insight into how we obtained this unusually high

  16. Analytic turnaround time study for integrated reporting of pathology results on electronic medical records using the Illuminate system

    Directory of Open Access Journals (Sweden)

    Tawfik O

    2016-09-01

    Full Text Available Timely pathology results are critical for appropriate diagnosis and management of patients. Yet workflows in laboratories remain ad hoc and involve accessing multiple systems with no direct linkage between patient history and prior or pending pathology records for the case being analyzed. A major hindrance in timely reporting of pathology results is the need to incorporate/interface with multiple electronic health records (EHRs. We evaluated the Illuminate PatientView software (Illuminate integration into pathologist's workflow. Illuminate is a search engine architecture that has a repository of textual information from many hospital systems. Our goal was to develop a comprehensive, user friendly patient summary display to integrate the current fractionated subspecialty specific systems. An analytical time study noting changes in turnaround time (TAT before and after Illuminate implementation was recorded for reviewers, including pathologists, residents and fellows. Reviewers' TAT for 359 cases was recorded (200 cases before and 159 after implementation. The impact of implementing Illuminate on transcriptionists’ workflow was also studied. Average TAT to retrieve EHRs prior to Illuminate was 5:32 min (range 1:35-10:50. That time was significantly reduced to 35 seconds (range 10 sec-1:10 min using Illuminate. Reviewers were very pleased with the ease in accessing information and in eliminating the draft paper documents of the pathology reports, eliminating up to 65 min/day (25-65 min by transcriptionists matching requisition with paperwork. Utilizing Illuminate improved workflow, decreased TAT and minimized cost. Patient care can be improved through a comprehensive patient management system that facilitates communications between isolated information systems.

  17. Meteorological and hydrological extremes derived from taxation records: case study for south-western Moravia (Czech Republic)

    Science.gov (United States)

    Chromá, Kateřina; Brázdil, Rudolf; Valášek, Hubert; Zahradníček, Pavel

    2013-04-01

    Meteorological and hydrological extremes (MHEs) cause great material damage or even loss of human lives in the present time, similarly as it was in the past. In the Czech Lands (recently the Czech Republic), systematic meteorological and hydrological observations started generally in the latter half of the 19th century. Therefore, in order to create long-term series of such extremes, it is necessary to search for other sources of information. Different types of documentary evidence are used in historical climatology and hydrology to find such information. Some of them are related to records connected with taxation system. The taxation system in Moravia allowed farmers to request tax relief if their crops have been damaged by MHEs. The corresponding documents contain information about the type of extreme event and the date of its occurrence; often also impacts on crops or land may be derived. The nature of events leading to damage include particularly hailstorms, torrential rain, flash floods, floods (in regions along larger rivers), less frequently windstorms, late frosts and in some cases also information about droughts or extreme snow depths. However, the results obtained are influenced by uncertainties related to taxation records - their temporal and spatial incompleteness, limitation of the MHEs occurrence in the period of main agricultural work (May-August) and the purpose for which they were originally collected (primarily tax alleviation, i.e. information about MHEs was of secondary importance). All these aspects related to the study of MHEs from taxation records are demonstrated for five estates (Bítov, Budkov, Jemnice with Staré Hobzí, Nové Syrovice and Uherčice) in the south-western part of Moravia for the 18th-19th centuries. The analysis shows importance of taxation records for the study of past MHEs as well as great potential for their use.

  18. The Value of Electronic Medical Record Implementation in Mental Health Care: A Case Study.

    Science.gov (United States)

    Riahi, Sanaz; Fischler, Ilan; Stuckey, Melanie I; Klassen, Philip E; Chen, John

    2017-01-05

    Electronic medical records (EMR) have been implemented in many organizations to improve the quality of care. Evidence supporting the value added to a recovery-oriented mental health facility is lacking. The goal of this project was to implement and customize a fully integrated EMR system in a specialized, recovery-oriented mental health care facility. This evaluation examined the outcomes of quality improvement initiatives driven by the EMR to determine the value that the EMR brought to the organization. The setting was a tertiary-level mental health facility in Ontario, Canada. Clinical informatics and decision support worked closely with point-of-care staff to develop workflows and documentation tools in the EMR. The primary initiatives were implementation of modules for closed loop medication administration, collaborative plan of care, clinical practice guidelines for schizophrenia, restraint minimization, the infection prevention and control surveillance status board, drug of abuse screening, and business intelligence. Medication and patient scan rates have been greater than 95% since April 2014, mitigating the adverse effects of medication errors. Specifically, between April 2014 and March 2015, only 1 moderately severe and 0 severe adverse drug events occurred. The number of restraint incidents decreased 19.7%, which resulted in cost savings of more than Can $1.4 million (US $1.0 million) over 2 years. Implementation of clinical practice guidelines for schizophrenia increased adherence to evidence-based practices, standardizing care across the facility. Improved infection prevention and control surveillance reduced the number of outbreak days from 47 in the year preceding implementation of the status board to 7 days in the year following. Decision support to encourage preferential use of the cost-effective drug of abuse screen when clinically indicated resulted in organizational cost savings. EMR implementation allowed Ontario Shores Centre for Mental Health

  19. Decreasing perinatal mortality in the Netherlands, 2000-2006: a record linkage study

    OpenAIRE

    Ravelli , Anita C J; Tromp , Miranda; Van Huis , Marian M; Steegers , Eric A P; Tamminga , Pieter; Eskes , Martine; Bonsel , Gouke J

    2009-01-01

    Abstract Background: The European PERISTAT-1 study showed that in 1999 perinatal mortality, especially fetal mortality, was substantially higher in the Netherlands when compared to other European countries. The aim of this study was to analyze the recent trend in Dutch perinatal mortality and the influence of risk factors. Methods: A nationwide retrospective cohort study of 1,246,440 singleton births in 2000-2006 in the Netherlands. The source data were available fro...

  20. Maternal and perinatal factors associated with hospitalised infectious mononucleosis in children, adolescents and young adults: record linkage study

    Science.gov (United States)

    2011-01-01

    Background There is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life. Infectious mononucleosis (IM) can follow late primary infection with Epstein-Barr virus (EBV), and has been shown to increase the risk of multiple sclerosis and Hodgkin's disease. Little is known about maternal or perinatal factors associated with IM or its sequelae. Methods We investigated perinatal risk factors for hospitalised IM using a prospective record-linkage study in a population in the south of England. The dataset used, the Oxford record linkage study (ORLS), includes abstracts of birth registrations, maternities and in-patient hospital records, including day case care, for all subjects in a defined geographical area. From these sources, we identified cases of hospitalised IM up to the age of 30 years in people for whom the ORLS had a maternity record; and we compared perinatal factors in their pregnancy with those in the pregnancy of children who had no hospital record of IM. Results Our data showed a significant association between hospitalised IM and lower social class (p = 0.02), a higher risk of hospitalised IM in children of married rather than single mothers (p < 0.001), and, of marginal statistical significance, an association with singleton birth (p = 0.06). The ratio of observed to expected cases of hospitalised IM in each season was 0.95 in winter, 1.02 in spring, 1.02 in summer and 1.00 in autumn. The chi-square test for seasonality, with a value of 0.8, was not significant. Other factors studied, including low birth weight, short gestational age, maternal smoking, late age at motherhood, did not increase the risk of subsequent hospitalised IM. Conclusions Because of the increasing tendency of women to postpone childbearing, it is useful to know that older age at motherhood is not associated with an increased risk of hospitalised IM in their children. We have no explanation for the finding that children of married women

  1. Digitizing and Preserving Law School Recordings: A Duke Law Case Study

    Science.gov (United States)

    White, Hollie; Bordo, Miguel; Chen, Sean

    2015-01-01

    Written as a case study, this article outlines Duke Law School Information Services' video digitization, preservation, and access initiative. This article begins with a discussion of the case study environment and the cross-departmental evaluation of in-house video production and processing workflows. The in-house preservation reformatting process…

  2. A Long-Term and Reproducible Passive Microwave Sea Ice Concentration Data Record for Climate Studies and Monitoring

    Science.gov (United States)

    Peng, G.; Meier, W. N.; Scott, D. J.; Savoie, M. H.

    2013-01-01

    A long-term, consistent, and reproducible satellite-based passive microwave sea ice concentration climate data record (CDR) is available for climate studies, monitoring, and model validation with an initial operation capability (IOC). The daily and monthly sea ice concentration data are on the National Snow and Ice Data Center (NSIDC) polar stereographic grid with nominal 25 km × 25 km grid cells in both the Southern and Northern Hemisphere polar regions from 9 July 1987 to 31 December 2007. The data files are available in the NetCDF data format at http://nsidc.org/data/g02202.html and archived by the National Climatic Data Center (NCDC) of the National Oceanic and Atmospheric Administration (NOAA) under the satellite climate data record program (http://www.ncdc.noaa.gov/cdr/operationalcdrs.html). The description and basic characteristics of the NOAA/NSIDC passive microwave sea ice concentration CDR are presented here. The CDR provides similar spatial and temporal variability as the heritage products to the user communities with the additional documentation, traceability, and reproducibility that meet current standards and guidelines for climate data records. The data set, along with detailed data processing steps and error source information, can be found at http://dx.doi.org/10.7265/N5B56GN3.

  3. Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study

    OpenAIRE

    Karusisi, No?lla; Thomas, Fr?d?rique; M?line, Julie; Chaix, Basile

    2013-01-01

    International audience; BACKGROUND: Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various i...

  4. MORBIDITY PROFILE OF WOMEN DURING PREGNANCY: A HOSPITAL RECORD BASED STUDY IN WESTERN UP

    Directory of Open Access Journals (Sweden)

    Ranjana Singh

    2012-12-01

    Full Text Available Objective: To study the morbidity pattern and relationship of these morbidities with socio-economic and demographic factors. Material and method: Present study was conducted at the Saraswathi Institute of Medical Sciences,Hapur,(U.P. among pregnant patients during the study period of one year. Data were analyzed using SPSS 16, using tabulation with percentage and Pearson's chi-square test was used for testing the crude associations. Results: In the present study a total of 338 pregnant women were included for the study material, out of which 67.46% of the antenatal women reported illness during antenatal period and majority 277(81.95% of the pregnant women were anemic.Thecommon non-obstetric morbidities reported were gastrointestinal disorder (24.68%, genital tuberculosis (16.88%, renal & gall bladder disease (7.79% and congenital anomaly (6.49% ect. (ii The obstetric morbidities included were pre-eclampsia(14.56%, urinary tract infection(9.71%, rupture of membrane(8.74%,hyperemesis gravidarum(9.22%and abnormal presentation in (2.43%patients . Conclusion: Maternal morbidity is notably high, although most of the common problems were not life-threatening. They are more likely to have marked influence on their wellbeing and health status in the long run. Most conditions could be addressed through provision of health promotion and preventive interventions.

  5. MORBIDITY PROFILE OF WOMEN DURING PREGNANCY: A HOSPITAL RECORD BASED STUDY IN WESTERN UP.

    Directory of Open Access Journals (Sweden)

    Ranjana Singh

    2013-01-01

    Full Text Available Objective: To study the morbidity pattern and relationship of these morbidities with socio-economic and demographic factors. Material and method: Present study was conducted at the Saraswathi Institute of Medical Sciences,Hapur,(U.P. among pregnant patients during the study period of one year. Data were analyzed using SPSS 16, using tabulation with percentage and Pearson's chi-square test was used for testing the crude associations. Results: In the present study a total of 338 pregnant women were included for the study material, out of which 67.46% of the antenatal women reported illness during antenatal period and majority 277(81.95% of the pregnant women were anemic.Thecommon non-obstetric morbidities reported were gastrointestinal disorder (24.68%, genital tuberculosis (16.88%, renal & gall bladder disease (7.79% and congenital anomaly (6.49% ect. (ii The obstetric morbidities included were pre-eclampsia(14.56%, urinary tract infection(9.71%, rupture of membrane(8.74%,hyperemesis gravidarum(9.22%and abnormal presentation in (2.43%patients . Conclusion: Maternal morbidity is notably high, although most of the common problems were not life-threatening. They are more likely to have marked influence on their wellbeing and health status in the long run. Most conditions could be addressed through provision of health promotion and preventive interventions.

  6. Cancer in the offspring of radiation workers: A summary of the record linkage study

    Energy Technology Data Exchange (ETDEWEB)

    Draper, G.J. [University of Oxford (United Kingdom). Childhood Cancer Research Group; Little, M.P. [National Radiological Protection Board, Chilton (United Kingdom); Sorahan, T. [Birmingham University (United Kingdom). Inst. of Occupational Health] [and others

    1997-12-01

    A national study has been conducted to test the Gardner hypothesis`, that childhood leukaemia and non-Hodgkin lymphoma can be caused by paternal exposure to ionising radiation before the conception of the child, and, more generally, to investigate whether preconception radiation exposure of either parent is a cause of childhood cancer. (UK).

  7. A multidisciplinary study of Holocene sediment records from Hjort Sø on Store Koldewey, Northeast Greenland

    NARCIS (Netherlands)

    Wagner, B.; Bennike, O.; Bos, J.A.A.; Cremer, H.; Lotter, A.F.; Melles, M.

    2008-01-01

    Two sediment cores of 70 and 252 cm length were recovered from Hjort Sø, a small lake on Store Koldewey, Northeast Greenland, and studied with a multidisciplinary approach in order to reconstruct the local environmental history and to test the relevance of proxies for paleoenvironmental information.

  8. DNS Lame delegations: A case-study of public reverse DNS records in the African Region

    CSIR Research Space (South Africa)

    Phokeer, A

    2016-12-01

    Full Text Available The DNS, as one of the oldest components of the modern Internet, has been studied multiple times. It is a known fact that operational issues such as mis-configured name servers affect the responsiveness of the DNS service which could lead to delayed...

  9. 76 FR 31682 - Agency Information Collection (Time Record (Work-Study Program)) Activity Under OMB Review

    Science.gov (United States)

    2011-06-01

    ... work-study hours a claimant has completed. When a claimant elects to receive an advance payment, VA will advance payment for 50 hours, but will withhold benefits (to recoup the advance payment) until the...), Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of...

  10. Effects of Child Maltreatment and Inherited Liability on Antisocial Development: An Official Records Study

    Science.gov (United States)

    Jonson-Reid, Melissa; Presnall, Ned; Drake, Brett; Fox, Louis; Bierut, Laura; Reich, Wendy; Kane, Phyllis; Todd, Richard D.; Constantino, John N.

    2010-01-01

    Objective: Evidence is steadily accumulating that a preventable environmental hazard, child maltreatment, exerts causal influences on the development of long-standing patterns of antisocial behavior in humans. The relationship between child maltreatment and antisocial outcome, however, has never previously been tested in a large-scale study in…

  11. Validation of questionnaire-reported hearing with medical records: A report from the Swiss Childhood Cancer Survivor Study.

    Directory of Open Access Journals (Sweden)

    Annette Weiss

    Full Text Available Hearing loss is a potential late effect after childhood cancer. Questionnaires are often used to assess hearing in large cohorts of childhood cancer survivors and it is important to know if they can provide valid measures of hearing loss. We therefore assessed agreement and validity of questionnaire-reported hearing in childhood cancer survivors using medical records as reference.In this validation study, we studied 361 survivors of childhood cancer from the Swiss Childhood Cancer Survivor Study (SCCSS who had been diagnosed after 1989 and had been exposed to ototoxic cancer treatment. Questionnaire-reported hearing was compared to the information in medical records. Hearing loss was defined as ≥ grade 1 according to the SIOP Boston Ototoxicity Scale. We assessed agreement and validity of questionnaire-reported hearing overall and stratified by questionnaire respondents (survivor or parent, sociodemographic characteristics, time between follow-up and questionnaire and severity of hearing loss.Questionnaire reports agreed with medical records in 85% of respondents (kappa 0.62, normal hearing was correctly assessed in 92% of those with normal hearing (n = 249, and hearing loss was correctly assessed in 69% of those with hearing loss (n = 112. Sensitivity of the questionnaires was 92%, 74%, and 39% for assessment of severe, moderate and mild bilateral hearing loss; and 50%, 33% and 10% for severe, moderate and mild unilateral hearing loss, respectively. Results did not differ by sociodemographic characteristics of the respondents, and survivor- and parent-reports were equally valid.Questionnaires are a useful tool to assess hearing in large cohorts of childhood cancer survivors, but underestimate mild and unilateral hearing loss. Further research should investigate whether the addition of questions with higher sensitivity for mild degrees of hearing loss could improve the results.

  12. Validation of questionnaire-reported hearing with medical records: A report from the Swiss Childhood Cancer Survivor Study

    Science.gov (United States)

    Scheinemann, Katrin; Grotzer, Michael; Kompis, Martin; Kuehni, Claudia E.

    2017-01-01

    Background Hearing loss is a potential late effect after childhood cancer. Questionnaires are often used to assess hearing in large cohorts of childhood cancer survivors and it is important to know if they can provide valid measures of hearing loss. We therefore assessed agreement and validity of questionnaire-reported hearing in childhood cancer survivors using medical records as reference. Procedure In this validation study, we studied 361 survivors of childhood cancer from the Swiss Childhood Cancer Survivor Study (SCCSS) who had been diagnosed after 1989 and had been exposed to ototoxic cancer treatment. Questionnaire-reported hearing was compared to the information in medical records. Hearing loss was defined as ≥ grade 1 according to the SIOP Boston Ototoxicity Scale. We assessed agreement and validity of questionnaire-reported hearing overall and stratified by questionnaire respondents (survivor or parent), sociodemographic characteristics, time between follow-up and questionnaire and severity of hearing loss. Results Questionnaire reports agreed with medical records in 85% of respondents (kappa 0.62), normal hearing was correctly assessed in 92% of those with normal hearing (n = 249), and hearing loss was correctly assessed in 69% of those with hearing loss (n = 112). Sensitivity of the questionnaires was 92%, 74%, and 39% for assessment of severe, moderate and mild bilateral hearing loss; and 50%, 33% and 10% for severe, moderate and mild unilateral hearing loss, respectively. Results did not differ by sociodemographic characteristics of the respondents, and survivor- and parent-reports were equally valid. Conclusions Questionnaires are a useful tool to assess hearing in large cohorts of childhood cancer survivors, but underestimate mild and unilateral hearing loss. Further research should investigate whether the addition of questions with higher sensitivity for mild degrees of hearing loss could improve the results. PMID:28333999

  13. Taxation records as a source of information for the study of historical floods in Southern Moravia, Czech Republic

    Science.gov (United States)

    Brázdil, Rudolf; Valášek, Hubert; Chromá, Kateřina; Dolák, Lukáš; Řezníčková, Ladislava; Dobrovolný, Petr

    2014-05-01

    The taxation system in Moravia allowed farmers to request tax relief if their crop yields had been negatively affected by hydrometeorological extremes. Firstly, the owners of land or individual farmers sent basic information about what had taken place, together with a detailed description of the damage, to the state executive (regional offices). After this, commissioners appointed by the regional administrator were obliged to inspect the places affected personally (in situ) and make records. Finally, the state executive made its decision as to whether to allow or reject the tax relief requested. The whole process was reflected in various surviving archival documents which contain information about the type of extreme event and the date of its occurrence, while the impact on crops may often be derived. Taxation documents of 201 estates in Southern Moravia, Czech Republic, prevailingly located in Moravian Land Archives in Brno, were studied to find information about hydrometeorological extremes. Such information is included for 84 of them. These data covering mainly the 18th-19th centuries were used for the study of historical floods (flash floods) complemented by other documentary sources and systematic hydrological observations (water stages, discharges) in the instrumental period (from the 1880s). Obtained flood data are analysed with respect to their temporal (frequency, seasonality) and spatial changes. Finally, uncertainties related to taxation records, such as their temporal and spatial incompleteness, the limits of the period of outside agricultural work (i.e. mainly May-August) and the purpose for which they were originally collected (primarily tax alleviation, i.e. information about hydrometeorological extremes was of secondary importance) are discussed with respect to results obtained. Taxation records constitute an important source of data for the study of historical floods with a great potential to be used in many European countries.

  14. Risk of venous thromboembolism in people admitted to hospital with selected immune-mediated diseases: record-linkage study

    Directory of Open Access Journals (Sweden)

    Handel Adam E

    2011-01-01

    Full Text Available Abstract Background Venous thromboembolism (VTE is a common complication during and after a hospital admission. Although it is mainly considered a complication of surgery, it often occurs in people who have not undergone surgery, with recent evidence suggesting that immune-mediated diseases may play a role in VTE risk. We, therefore, decided to study the risk of deep vein thrombosis (DVT and pulmonary embolism (PE in people admitted to hospital with a range of immune-mediated diseases. Methods We analysed databases of linked statistical records of hospital admissions and death certificates for the Oxford Record Linkage Study area (ORLS1:1968 to 1998 and ORLS2:1999 to 2008 and the whole of England (1999 to 2008. Rate ratios for VTE were determined, comparing immune-mediated disease cohorts with comparison cohorts. Results Significantly elevated risks of VTE were found, in all three populations studied, in people with a hospital record of admission for autoimmune haemolytic anaemia, chronic active hepatitis, dermatomyositis/polymyositis, type 1 diabetes mellitus, multiple sclerosis, myasthenia gravis, myxoedema, pemphigus/pemphigoid, polyarteritis nodosa, psoriasis, rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus. Rate ratios were considerably higher for some of these diseases than others: for example, for systemic lupus erythematosus the rate ratios were 3.61 (2.36 to 5.31 in the ORLS1 population, 4.60 (3.19 to 6.43 in ORLS2 and 3.71 (3.43 to 4.02 in the England dataset. Conclusions People admitted to hospital with immune-mediated diseases may be at an increased risk of subsequent VTE. Our findings need independent confirmation or refutation; but, if confirmed, there may be a role for thromboprophylaxis in some patients with these diseases.

  15. ABO Blood Group and Dementia Risk--A Scandinavian Record-Linkage Study

    DEFF Research Database (Denmark)

    Vasan, Senthil K; Rostgaard, Klaus; Ullum, Henrik

    2015-01-01

    ,615 cases of Alzheimer's disease, 1,842 cases of vascular dementia, and 9,091 cases of unspecified dementia. Overall, our study showed no association between ABO blood group and risk of Alzheimer's disease, vascular dementia or unspecified dementia. This was also true when analyses were restricted to donors......BACKGROUND: Dementia includes a group of neuro-degenerative disorders characterized by varying degrees of cognitive impairment. Recent data indicates that blood group AB is associated with impaired cognition in elderly patients. To date there are no large-scale studies that have examined...... the relationship between ABO blood group and dementia-related disorders in detail. METHODS: We used data from the SCANDAT2 database that contains information on over 1.6 million blood donors from 1968 in Sweden and 1981 from Denmark. The database was linked with health outcomes data from nationwide patient...

  16. Linking a research register to clinical records in older adults' mental health services:a mixed-methods study

    OpenAIRE

    Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

    2015-01-01

    INTRODUCTION: Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities.METHODS: This was a two-stage cross-s...

  17. Study protocol: Addressing evidence and context to facilitate transfer and uptake of consultation recording use in oncology: A knowledge translation implementation study

    Directory of Open Access Journals (Sweden)

    Ruether J Dean

    2011-03-01

    Full Text Available Abstract Background The time period from diagnosis to the end of treatment is challenging for newly diagnosed cancer patients. Patients have a substantial need for information, decision aids, and psychosocial support. Recordings of initial oncology consultations improve information recall, reduce anxiety, enhance patient satisfaction with communication, and increase patients' perceptions that the essential aspects of their disease and treatment have been addressed during the consultation. Despite the research evidence supporting the provision of consultation recordings, uptake of this intervention into oncology practice has been slow. The primary aim of this project is to conduct an implementation study to explicate the contextual factors, including use of evidence, that facilitate and impede the transfer and uptake of consultation-recording use in a sample of patients newly diagnosed with breast or prostate cancer. Methods Sixteen oncologists from cancer centres in three Canadian cities will participate in this three-phase study. The preimplementation phase will be used to identify and address those factors that are fundamental to facilitating the smooth adoption and delivery of the intervention during the implementation phase. During the implementation phase, breast and prostate cancer patients will receive a recording of their initial oncology consultation to take home. Patient interviews will be conducted in the days following the consultation to gather feedback on the benefits of the intervention. Patients will complete the Digital Recording Use Semi-Structured Interview (DRUSSI and be invited to participate in focus groups in which their experiences with the consultation recording will be explored. Oncologists will receive a summary letter detailing the benefits voiced by their patients. The postimplementation phase includes a conceptual framework development meeting and a seven-point dissemination strategy. Discussion Consultation

  18. Congenital anomalies in children with cerebral palsy: a population-based record linkage study

    DEFF Research Database (Denmark)

    Rankin, Judith; Cans, Christine; Garne, Ester

    2009-01-01

    Aim Our aim was to determine the proportion of children with cerebral palsy (CP) who have a congenital anomaly (CA) in three regions (Isère Region, French Alps; Funen County, Denmark; Northern Region, England) where population-based CP and CA registries exist, and to classify the children according...... to CA subtype. Method Data for children born between 1991 and 1999 were linked using electronic matching of cases. All potential matches were checked manually by each centre and verified as true matches. Results A total of 1104 children with CP were born during the study period (663 males, 441 females...

  19. Do women top managers help women advance? A panel study using EEO-1 records

    OpenAIRE

    Kurtulus, Fidan Ana; Tomaskovic-Devey, Donald

    2011-01-01

    The goal of this study is to examine whether women in the highest levels of firms' management ranks help reduce barriers to women's advancement in the workplace. Using a panel of over 20,000 private-sector firms across all industries and states during 1990-2003 from the U.S. Equal Employment Opportunity Commission, we explore the influence of women in top management on subsequent female representation in lower-level managerial positions in U.S. firms. Our key findings show that an increase in...

  20. Use of emergency department electronic medical records for automated epidemiological surveillance of suicide attempts: a French pilot study.

    Science.gov (United States)

    Metzger, Marie-Hélène; Tvardik, Nastassia; Gicquel, Quentin; Bouvry, Côme; Poulet, Emmanuel; Potinet-Pagliaroli, Véronique

    2017-06-01

    The aim of this study was to determine whether an expert system based on automated processing of electronic health records (EHRs) could provide a more accurate estimate of the annual rate of emergency department (ED) visits for suicide attempts in France, as compared to the current national surveillance system based on manual coding by emergency practitioners. A feasibility study was conducted at Lyon University Hospital, using data for all ED patient visits in 2012. After automatic data extraction and pre-processing, including automatic coding of medical free-text through use of the Unified Medical Language System, seven different machine-learning methods were used to classify the reasons for ED visits into "suicide attempts" versus "other reasons". The performance of these different methods was compared by using the F-measure. In a test sample of 444 patients admitted to the ED in 2012 (98 suicide attempts, 48 cases of suicidal ideation, and 292 controls with no recorded non-fatal suicidal behaviour), the F-measure for automatic detection of suicide attempts ranged from 70.4% to 95.3%. The random forest and naïve Bayes methods performed best. This study demonstrates that machine-learning methods can improve the quality of epidemiological indicators as compared to current national surveillance of suicide attempts. Copyright © 2016 John Wiley & Sons, Ltd.

  1. QTc interval prolongation in HIV-infected patients: a case–control study by 24-hour Holter ECG recording

    Directory of Open Access Journals (Sweden)

    Fiorentini Alessandra

    2012-12-01

    Full Text Available Abstract Background Aim of the study was to assess QTc interval by a 24-hour ECG recording in a group of HIV-infected individuals with a basal prolonged QTc. The risk factors associated with QTc prolongation and the indices of cardiovascular autonomic control were also evaluated. Methods A case–control study was performed using as cases 32 HIV-infected patients with prolonged (>440 msec QTc interval as assessed by Holter ECG, and as controls 64 HIV-infected subjects with normal QTc interval. Autonomic function was evaluated by heart rate variability analysis during 24-hour recording. Results Duration of HIV disease was significantly longer among cases than among controls (p=0.04. Waist/hip ratio was also higher among cases than among controls (p=0.05. Frequency domain analysis showed the absence of physiologic decrease of low frequency (LF in the night period in both cases and controls. The LF night in cases showed a statistically significant reduction when compared with controls (p=0.007. Conclusions In our study group, QTc interval prolongation was associated with a longer duration of HIV infection and with a greater waist/hip ratio. HIV patients with QTc interval prolongation and with a longer duration of HIV infection were more likely to have an impairment of parasympathetic and sympathetic cardiac component.

  2. Cancer in the offspring of radiation workers - a record linkage study

    Energy Technology Data Exchange (ETDEWEB)

    Draper, G.J. [Childhood Cancer Research Group, University of Oxford (United Kingdom); Little, M.P. [National Radiological Protection Board, Chilton (United Kingdom); Sorahan, T. [Institute of Occupational Health, University of Birmingham (United Kingdom)] [and others

    1997-12-31

    The objectives of this study were to test the `Gardner hypothesis` that childhood leukaemia and non-Hodgkin lymphoma can be caused by paternal exposure to ionising radiation before the conception of the child, and more generally, to investigate whether such radiation exposure of either parent is a cause of childhood cancer. This was a case-control study, conducted in Great Britain, that involved 35,949 children diagnosed as having cancer, together with matched controls. Examination was made of: parental employment as radiation worker as defined by inclusion in the National Registry for Radiation Workers and being monitored for external radiation before conception of child; cumulative dose of external ionising radiation for various periods of employment before conception; pregnancy dose. It is concluded that the results do not support the hypothesis that paternal preconception irradiation is a cause of childhood leukaemia and non-Hodgkin lymphoma; the observed associations may be chance or result from exposure to infective or other agents. If there is any increased risk for the children of fathers who are radiation workers it is small in absolute terms: in Britain the average risk by age 15 years is 6.5 per 10,000; our best estimate, using all available data, is that the increase is 5.4 per 10,000. For mothers, the numbers are too small for reliable estimates of the risk, if any, to be made. (author).

  3. Cancer in the offspring of radiation workers - a record linkage study

    International Nuclear Information System (INIS)

    Draper, G.J.; Little, M.P.; Sorahan, T.

    1997-01-01

    The objectives of this study were to test the 'Gardner hypothesis' that childhood leukaemia and non-Hodgkin lymphoma can be caused by paternal exposure to ionising radiation before the conception of the child, and more generally, to investigate whether such radiation exposure of either parent is a cause of childhood cancer. This was a case-control study, conducted in Great Britain, that involved 35,949 children diagnosed as having cancer, together with matched controls. Examination was made of: parental employment as radiation worker as defined by inclusion in the National Registry for Radiation Workers and being monitored for external radiation before conception of child; cumulative dose of external ionising radiation for various periods of employment before conception; pregnancy dose. It is concluded that the results do not support the hypothesis that paternal preconception irradiation is a cause of childhood leukaemia and non-Hodgkin lymphoma; the observed associations may be chance or result from exposure to infective or other agents. If there is any increased risk for the children of fathers who are radiation workers it is small in absolute terms: in Britain the average risk by age 15 years is 6.5 per 10,000; our best estimate, using all available data, is that the increase is 5.4 per 10,000. For mothers, the numbers are too small for reliable estimates of the risk, if any, to be made. (author)

  4. A comparative study of surface waves inversion techniques at strong motion recording sites in Greece

    Science.gov (United States)

    Panagiotis C. Pelekis,; Savvaidis, Alexandros; Kayen, Robert E.; Vlachakis, Vasileios S.; Athanasopoulos, George A.

    2015-01-01

    Surface wave method was used for the estimation of Vs vs depth profile at 10 strong motion stations in Greece. The dispersion data were obtained by SASW method, utilizing a pair of electromechanical harmonic-wave source (shakers) or a random source (drop weight). In this study, three inversion techniques were used a) a recently proposed Simplified Inversion Method (SIM), b) an inversion technique based on a neighborhood algorithm (NA) which allows the incorporation of a priori information regarding the subsurface structure parameters, and c) Occam's inversion algorithm. For each site constant value of Poisson's ratio was assumed (ν=0.4) since the objective of the current study is the comparison of the three inversion schemes regardless the uncertainties resulting due to the lack of geotechnical data. A penalty function was introduced to quantify the deviations of the derived Vs profiles. The Vs models are compared as of Vs(z), Vs30 and EC8 soil category, in order to show the insignificance of the existing variations. The comparison results showed that the average variation of SIM profiles is 9% and 4.9% comparing with NA and Occam's profiles respectively whilst the average difference of Vs30 values obtained from SIM is 7.4% and 5.0% compared with NA and Occam's.

  5. Continuous blood pressure recordings simultaneously with functional brain imaging: studies of the glymphatic system

    Science.gov (United States)

    Zienkiewicz, Aleksandra; Huotari, Niko; Raitamaa, Lauri; Raatikainen, Ville; Ferdinando, Hany; Vihriälä, Erkki; Korhonen, Vesa; Myllylä, Teemu; Kiviniemi, Vesa

    2017-03-01

    The lymph system is responsible for cleaning the tissues of metabolic waste products, soluble proteins and other harmful fluids etc. Lymph flow in the body is driven by body movements and muscle contractions. Moreover, it is indirectly dependent on the cardiovascular system, where the heart beat and blood pressure maintain force of pressure in lymphatic channels. Over the last few years, studies revealed that the brain contains the so-called glymphatic system, which is the counterpart of the systemic lymphatic system in the brain. Similarly, the flow in the glymphatic system is assumed to be mostly driven by physiological pulsations such as cardiovascular pulses. Thus, continuous measurement of blood pressure and heart function simultaneously with functional brain imaging is of great interest, particularly in studies of the glymphatic system. We present our MRI compatible optics based sensing system for continuous blood pressure measurement and show our current results on the effects of blood pressure variations on cerebral brain dynamics, with a focus on the glymphatic system. Blood pressure was measured simultaneously with near-infrared spectroscopy (NIRS) combined with an ultrafast functional brain imaging (fMRI) sequence magnetic resonance encephalography (MREG, 3D brain 10 Hz sampling rate).

  6. The Moon as a recorder of organic evolution in the early solar system: a lunar regolith analog study.

    Science.gov (United States)

    Matthewman, Richard; Court, Richard W; Crawford, Ian A; Jones, Adrian P; Joy, Katherine H; Sephton, Mark A

    2015-02-01

    The organic record of Earth older than ∼3.8 Ga has been effectively erased. Some insight is provided to us by meteorites as well as remote and direct observations of asteroids and comets left over from the formation of the Solar System. These primitive objects provide a record of early chemical evolution and a sample of material that has been delivered to Earth's surface throughout the past 4.5 billion years. Yet an effective chronicle of organic evolution on all Solar System objects, including that on planetary surfaces, is more difficult to find. Fortunately, early Earth would not have been the only recipient of organic matter-containing objects in the early Solar System. For example, a recently proposed model suggests the possibility that volatiles, including organic material, remain archived in buried paleoregolith deposits intercalated with lava flows on the Moon. Where asteroids and comets allow the study of processes before planet formation, the lunar record could extend that chronicle to early biological evolution on the planets. In this study, we use selected free and polymeric organic materials to assess the hypothesis that organic matter can survive the effects of heating in the lunar regolith by overlying lava flows. Results indicate that the presence of lunar regolith simulant appears to promote polymerization and, therefore, preservation of organic matter. Once polymerized, the mineral-hosted newly formed organic network is relatively protected from further thermal degradation. Our findings reveal the thermal conditions under which preservation of organic matter on the Moon is viable.

  7. Use and Limitations of a Climate-Quality Data Record to Study Temperature Trends on the Greenland Ice Sheet

    Science.gov (United States)

    Hall, Dorothy K.; Comiso, Josefino C.; Shuman, Christopher A.; Koenig, Lora S.; DiGirolamo, Nicolo E.

    2011-01-01

    Enhanced melting of the Greenland Ice Sheet has been documented in recent literature along with surface-temperature increases measured using infrared satellite data since 1981. Using a recently-developed climate-quality data record, 11- and 12-year trends in the clear-sky ice-surface temperature (IST) of the Greenland Ice Sheet have been studied using the Moderate-Resolution Imaging Spectroradiometer (MODIS) IST product. Daily and monthly MODIS ISTs of the Greenland Ice Sheet beginning on 1 March 2000 and continuing through 31 December 2010 are now available at 6.25-km spatial resolution on a polar stereographic grid as described in Hall et al. (submitted). This record will be elevated in status to a climate-data record (CDR) when more years of data become available either from the MODIS on the Terra or Aqua satellites, or from the Visible Infrared Imager Radiometer Suite (VIIRS) to be launched in October 2011. Maps showing the maximum extent of melt for the entire ice sheet and for the six major drainage basins have been developed from the MODIS IST dataset. Twelve-year trends of the duration of the melt season on the ice sheet vary in different drainage basins with some basins melting progressively earlier over the course of the study period. Some (but not all) of the basins also show a progressively-longer duration of melt. IST 12-year trends are compared with in-situ data, and climate data from the Modern Era Retrospective-Analysis for Research and Applications (MERRA) Reanalysis.

  8. Mortality following Stroke, the Weekend Effect and Related Factors: Record Linkage Study.

    Directory of Open Access Journals (Sweden)

    Stephen E Roberts

    Full Text Available Increased mortality following hospitalisation for stroke has been reported from many but not all studies that have investigated a 'weekend effect' for stroke. However, it is not known whether the weekend effect is affected by factors including hospital size, season and patient distance from hospital.To assess changes over time in mortality following hospitalisation for stroke and how any increased mortality for admissions on weekends is related to factors including the size of the hospital, seasonal factors and distance from hospital.A population study using person linked inpatient, mortality and primary care data for stroke from 2004 to 2012. The outcome measures were, firstly, mortality at seven days and secondly, mortality at 30 days and one year.Overall mortality for 37 888 people hospitalised following stroke was 11.6% at seven days, 21.4% at 30 days and 37.7% at one year. Mortality at seven and 30 days fell significantly by 1.7% and 3.1% per annum respectively from 2004 to 2012. When compared with week days, mortality at seven days was increased significantly by 19% for admissions on weekends, although the admission rate was 21% lower on weekends. Although not significant, there were indications of increased mortality at seven days for weekend admissions during winter months (31%, in community (81% rather than large hospitals (8% and for patients resident furthest from hospital (32% for distances of >20 kilometres. The weekend effect was significantly increased (by 39% for strokes of 'unspecified' subtype.Mortality following stroke has fallen over time. Mortality was increased for admissions at weekends, when compared with normal week days, but may be influenced by a higher stroke severity threshold for admission on weekends. Other than for unspecified strokes, we found no significant variation in the weekend effect for hospital size, season and distance from hospital.

  9. ABO Blood Group and Dementia Risk--A Scandinavian Record-Linkage Study.

    Directory of Open Access Journals (Sweden)

    Senthil K Vasan

    Full Text Available Dementia includes a group of neuro-degenerative disorders characterized by varying degrees of cognitive impairment. Recent data indicates that blood group AB is associated with impaired cognition in elderly patients. To date there are no large-scale studies that have examined the relationship between ABO blood group and dementia-related disorders in detail.We used data from the SCANDAT2 database that contains information on over 1.6 million blood donors from 1968 in Sweden and 1981 from Denmark. The database was linked with health outcomes data from nationwide patient and cause of death registers to investigate the relationship between blood groups and risk of different types of dementia. The incident rate ratios were estimated using log-linear Poisson regression models.Among 1,598,294 donors followed over 24 million person-years of observation we ascertained 3,615 cases of Alzheimer's disease, 1,842 cases of vascular dementia, and 9,091 cases of unspecified dementia. Overall, our study showed no association between ABO blood group and risk of Alzheimer's disease, vascular dementia or unspecified dementia. This was also true when analyses were restricted to donors aged 70 years or older except for a slight, but significantly decreased risk of all dementia combined in subjects with blood group A (IRR, 0.93; 95% confidence interval [CI], 0.88-0.98, compared to those with blood group O.Our results provide no evidence that ABO blood group influences the risk of dementia.

  10. A population-based study of homicide deaths in Ontario, Canada using linked death records.

    Science.gov (United States)

    Lachaud, James; Donnelly, Peter D; Henry, David; Kornas, Kathy; Calzavara, Andrew; Bornbaum, Catherine; Rosella, Laura

    2017-07-24

    Homicide - a lethal expression of violence - has garnered little attention from public health researchers and health policy makers, despite the fact that homicides are a cause of preventable and premature death. Identifying populations at risk and the upstream determinants of homicide are important for addressing inequalities that hinder population health. This population-based study investigates the public health significance of homicides in Ontario, Canada, over the period of 1999-2012. We quantified the relative burden of homicides by comparing the socioeconomic gradient in homicides with the leading causes of death, cardiovascular disease (CVD) and neoplasm, and estimated the potential years of life lost (PYLL) due to homicide. We linked vital statistics from the Office of the Registrar General Deaths register (ORG-D) with Census and administrative data for all Ontario residents. We extracted all homicide, neoplasm, and cardiovascular deaths from 1999 to 2012, using International Classification of Diseases codes. For socioeconomic status (SES), we used two dimensions of the Ontario Marginalization Index (ON-Marg): material deprivation and residential instability. Trends were summarized across deprivation indices using age-specific rates, rate ratios, and PYLL. Young males, 15-29 years old, were the main victims of homicide with a rate of 3.85 [IC 95%: 3.56; 4.13] per 100,000 population and experienced an upward trend over the study period. The socioeconomic neighbourhood gradient was substantial and higher than the gradient for both cardiovascular and neoplasms. Finally, the PYLL due to homicide were 63,512 and 24,066 years for males and females, respectively. Homicides are an important cause of death among young males, and populations living in disadvantaged neighbourhoods. Our findings raise concerns about the burden of homicides in the Canadian population and the importance of addressing social determinants to address these premature deaths.

  11. Quantification of clinical scores through physiological recordings in low-responsive patients: a feasibility study

    Directory of Open Access Journals (Sweden)

    Wieser Martin

    2012-05-01

    Full Text Available Abstract Clinical scores represent the gold standard in characterizing the clinical condition of patients in vegetative or minimally conscious state. However, they suffer from problems of sensitivity, specificity, subjectivity and inter-rater reliability. In this feasibility study, objective measures including physiological and neurophysiological signals are used to quantify the clinical state of 13 low-responsive patients. A linear regression method was applied in nine patients to obtain fixed regression coefficients for the description of the clinical state. The statistical model was extended and evaluated with four patients of another hospital. A linear mixed models approach was introduced to handle the challenges of data sets obtained from different locations. Using linear backward regression 12 variables were sufficient to explain 74.4% of the variability in the change of the clinical scores. Variables based on event-related potentials and electrocardiogram account for most of the variability. These preliminary results are promising considering that this is the first attempt to describe the clinical state of low-responsive patients in such a global and quantitative way. This new model could complement the clinical scores based on objective measurements in order to increase diagnostic reliability. Nevertheless, more patients are necessary to prove the conclusions of a statistical model with 12 variables.

  12. Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study

    Directory of Open Access Journals (Sweden)

    Sudeshna Chatterjee

    2016-01-01

    Full Text Available Aims: 1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Settings and Design: Comparative, cross-sectional and non-interventional study. Methods and Material: It is retrospective, record-based study conducted upon inpatients (n = 200 of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Statistical Analysis Used: Comparative analysis of specific and selective gaps were estimated in terms of percentage (%. Results: Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. Conclusions: The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

  13. Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study.

    Science.gov (United States)

    Chatterjee, Sudeshna; Ray, Krishnangshu; Das, Anup Kumar

    2016-01-01

    1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Comparative, cross-sectional and non-interventional study. It is retrospective, record-based study conducted upon inpatients ( n = 200) of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Comparative analysis of specific and selective gaps were estimated in terms of percentage (%). Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

  14. Evaluation of pseudoephedrine pharmacy sales before and after mandatory recording requirements in Western Australia: a case study.

    Science.gov (United States)

    Hattingh, Hendrika Laetitia; Varsani, Janki; Kachouei, Leila Ataei; Parsons, Richard

    2016-08-30

    A community pharmacy real-time electronic recording program, ProjectSTOP, enables Australian community pharmacists to verify pseudoephedrine requests. In Western Australia the program was available for voluntary use from April 2007 and became mandatory November 2010. This case study explores the effectiveness of the program by reviewing the total requests for pseudoephedrine products, and the proportion of requests which were classified as 'denied sales' before and after mandatory implementation. Seasonal and annual trends in these measures are also evaluated. ProjectSTOP data recordings for Western Australia pharmacies between 1 December 2007 and 28 February 2014 were analysed. Data included a de-identified pharmacy number and date of each pseudoephedrine product request. The total number of requests and sale classification (allowed, denied, safety, or not recorded) were calculated for each month/pharmacy. The potential influence of mandatory reporting using ProjectSTOP was investigated using a Regression Discontinuity Design. Correlations between sales from the same pharmacy were taken into account by classifying the pharmacy number as a random effect. The main effects of year (continuous variable), and season (categorical variable) were also included in the model. There was a small but steady decline in the total requests for pseudoephedrine per month per 100,000 population (per pharmacy) from the time of mandatory reporting. The number of denied sales showed a steady increase up until mandatory reporting, after which it showed a significant decline over time. Total sales were heavily influenced by season, as expected (highest in winter, least in summer). The seasonal pattern was less pronounced for denied sales, which were highest in winter and similar across other seasons. The pattern over time for safety sales was similar to that for denied sales, with a clear change occurring around the time of mandatory reporting. Results indicate a decrease in

  15. A study of local site effects in Benevento(Southern Italy by the analysis of seismic records of explosions

    Directory of Open Access Journals (Sweden)

    L. Mirabile

    1995-06-01

    Full Text Available In this paper we evalllate the seismic amplification effects in the town of Benevento llsing records of an explo- sion of 500 kg fired at abollt 7 km. Seismic records were obtained at 43 selected sites in the city by digital three-component stations. A data selection performed on the signal-to-noise ratio reduced the available data to 26 stations. We used the spectral ratio techniques to evaluate the amplification effects of each recording site compared both to the average spectrum calculated over 26 stations and to a reference seismic station. The shapes of the spectral ratios were classified according to the geological characteristics of the site. A characteristic shape of the spectral ratio was observed to be related to the specific structure of the subsoil. In particular, the sites on basin sediments (Lagonegro Unit and Middle Pleistocene conglomerates failed to show amplification effects; the sites on thick alluvial deposits showed amplification in the 5-9 Hz range; finally, sites on alluvial-lacustrine deposits amplified the seismic signal at frequencies depending on the characteristics and the thickness of the deposit. In addition, damage distribution caused by the 1688 earthquake in Benevento was related to the thickness of the surface layers in the ancient built-up area of the town. The study of the spectral ra- tios showed that these deposits amplify ground motion at frequencies between 9 and 12 Hz, i.e. frequencies close to the natural period of the most widespread buildings at that time in Benevento. Geological and seismic data were jointly used to carry out a zonation of the urban area of Benevento on the basis of homogeneous seismic responses. The validity of this analysis is limited to the main frequency band and amplitude of ground motion produced by the explosions.

  16. Comparing the Use of Books with Enhanced Records versus Those Without Enhancements: Methodology Leads to Questionable Conclusions. A review of: Madarash‐Hill, Cherie and J.B. Hill. “Electronically Enriched Enhancements in Catalog Records: A Use Study of Books Described on Records With URL Enhancements Versus Those Without.” Technical Services Quarterly 23.2 (2005: 19‐31.

    Directory of Open Access Journals (Sweden)

    Susan Haigh

    2007-06-01

    Full Text Available Objective – To compare the use of books described by catalogue records that are enhanced with URL links to such information as dust jackets, tables of contents, sample text, and publishers’ descriptions, with the use of books described by records that are not enhanced with such links.Design – Use study.Setting – Academic library (Southeastern Louisiana University, Sims Memorial Library.Subjects – 180 records with enhancements and 180 records (different titles without enhancements.Methods – The study identified the sample of unenhanced records by conducting searches of the broad subject terms “History”, “United States”, “Education”,and “Social” and limiting the searches to books. The enhanced sample was derived in the same manner, but with additional search limiters to identify only those records that had URL enhancements. An equal sample of enhanced and unenhanced records (50 or 30 of each was tracked for each of four search terms. Only records for books that could be checked out were included, as use statistics were based on whether or not a book was borrowed. While half of the enhanced records had full‐text elements (such as descriptions that were indexed and thus searchable, the rate of use for these records was not tracked separately from the enhanced records that only had URL enhancements.Main results – Books described on records with URL enhancements for publisher descriptions, tables of contents, book reviews, or sample text had higher use than those without URL enhancements. Only 7% of titles with URLs, compared with 21% of those without, had not been borrowed. 74.67% of titles with URLs had been checked out one or two times, compared with 69.5% of those without URLs. The number of titles with enhanced records that had 3 or more checkouts was almost double the rate of unenhanced titles (18% to 9.5%.Conclusion – The authors conclude that catalogue records that have electronic links to book reviews, cover

  17. Contrıbutıon to Study of Turkey Mycobiota IV. The New Records of Microfungi with Asci To Forest Phytocoenose of Rize Province

    Directory of Open Access Journals (Sweden)

    Faruk Selçuk

    2010-11-01

    Full Text Available In this study which carried out on trees and shrubs in forest phytocoenose of Rize province, fifty-one microfungi species have been identified as new record for mycobiota of our country. Sixteen genera have been determined as new record on level of genera among these species.

  18. RECORDS REACHING RECORDING DATA TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    G. W. L. Gresik

    2013-07-01

    Full Text Available The goal of RECORDS (Reaching Recording Data Technologies is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

  19. Records Reaching Recording Data Technologies

    Science.gov (United States)

    Gresik, G. W. L.; Siebe, S.; Drewello, R.

    2013-07-01

    The goal of RECORDS (Reaching Recording Data Technologies) is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

  20. Integrating a health-related-quality-of-life module within electronic health records: a comparative case study assessing value added

    Directory of Open Access Journals (Sweden)

    Shea Christopher M

    2012-03-01

    Full Text Available Abstract Background Health information technology (HIT applications that incorporate point-of-care use of health-related quality of life (HRQL assessments are believed to promote patient-centered interactions between seriously ill patients and physicians. However, it is unclear how willing primary care providers are to use such HRQL HIT applications. The specific aim of this study was to explore factors that providers consider when assessing the value added of an HRQL application for their geriatric patients. Methods Three case studies were developed using the following data sources: baseline surveys with providers and staff, observations of staff and patients, audio recordings of patient-provider interactions, and semi-structured interviews with providers and staff. Results The primary factors providers considered when assessing value added were whether the HRQL information from the module was (1 duplicative of information gathered via other means during the encounter; (2 specific enough to be useful and/or acted upon, and; (3 useful for enough patients to warrant time spent reviewing it for all geriatric patients. Secondary considerations included level of integration of the HRQL and EHR, impact on nursing workflow, and patient reluctance to provide HRQL information. Conclusions Health-related quality of life modules within electronic health record systems offer the potential benefit of improving patient centeredness and quality of care. However, the modules must provide benefits that are substantial and prominent in order for physicians to decide that they are worthwhile and sustainable. Implications of this study for future research include the identification of perceived "costs" as well as a foundation for operationalizing the concept of "usefulness" in the context of such modules. Finally, developers of these modules may need to make their products customizable for practices to account for variation in EHR capabilities and practice

  1. Systolic Blood Pressure Trajectory, Frailty, and All-Cause Mortality >80 Years of Age: Cohort Study Using Electronic Health Records.

    Science.gov (United States)

    Ravindrarajah, Rathi; Hazra, Nisha C; Hamada, Shota; Charlton, Judith; Jackson, Stephen H D; Dregan, Alex; Gulliford, Martin C

    2017-06-13

    Clinical trials show benefit from lowering systolic blood pressure (SBP) in people ≥80 years of age, but nonrandomized epidemiological studies suggest lower SBP may be associated with higher mortality. This study aimed to evaluate associations of SBP with all-cause mortality by frailty category >80 years of age and to evaluate SBP trajectories before death. A population-based cohort study was conducted using electronic health records of 144 403 participants ≥80 years of age registered with family practices in the United Kingdom from 2001 to 2014. Participants were followed for ≤5 years. Clinical records of SBP were analyzed. Frailty status was classified using the e-Frailty Index into the categories of fit, mild, moderate, and severe. All-cause mortality was evaluated by frailty status and mean SBP in Cox proportional-hazards models. SBP trajectories were evaluated using person months as observations, with mean SBP and antihypertensive treatment status estimated for each person month. Fractional polynomial models were used to estimate SBP trajectories over 5 years before death. During follow-up, 51 808 deaths occurred. Mortality rates increased with frailty level and were greatest at SBP mortality was 7.7 per 100 person years at SBP 120 to 139 mm Hg, 15.2 at SBP 110 to 119 mm Hg, and 22.7 at SBP mortality may be accounted for by reverse causation if participants with lower blood pressure values are closer, on average, to the end of life. © 2017 The Authors.

  2. Nursing Student Experiences Regarding Safe Use of Electronic Health Records: A Pilot Study of the Safety and Assurance Factors for EHR Resilience Guides.

    Science.gov (United States)

    Whitt, Karen J; Eden, Lacey; Merrill, Katreena Collette; Hughes, Mckenna

    2017-01-01

    Previous research has linked improper electronic health record configuration and use with adverse patient events. In response to this problem, the US Office of the National Coordinator for Health Information Technology developed the Safety and Assurance Factors for EHR Resilience guides to evaluate electronic health records for optimal use and safety features. During the course of their education, nursing students are exposed to a variety of clinical practice settings and electronic health records. This descriptive study evaluated 108 undergraduate and 51 graduate nursing students' ratings of electronic health record features and safe practices, as well as what they learned from utilizing the computerized provider order entry and clinician communication Safety and Assurance Factors for EHR Resilience guide checklists. More than 80% of the undergraduate and 70% of the graduate students reported that they experienced user problems with electronic health records in the past. More than 50% of the students felt that electronic health records contribute to adverse patient outcomes. Students reported that many of the features assessed were not fully implemented in their electronic health record. These findings highlight areas where electronic health records can be improved to optimize patient safety. The majority of students reported that utilizing the Safety and Assurance Factors for EHR Resilience guides increased their understanding of electronic health record features.

  3. Supplementing electronic health records through sample collection and patient diaries: A study set within a primary care research database.

    Science.gov (United States)

    Joseph, Rebecca M; Soames, Jamie; Wright, Mark; Sultana, Kirin; van Staa, Tjeerd P; Dixon, William G

    2018-02-01

    To describe a novel observational study that supplemented primary care electronic health record (EHR) data with sample collection and patient diaries. The study was set in primary care in England. A list of 3974 potentially eligible patients was compiled using data from the Clinical Practice Research Datalink. Interested general practices opted into the study then confirmed patient suitability and sent out postal invitations. Participants completed a drug-use diary and provided saliva samples to the research team to combine with EHR data. Of 252 practices contacted to participate, 66 (26%) mailed invitations to patients. Of the 3974 potentially eligible patients, 859 (22%) were at participating practices, and 526 (13%) were sent invitations. Of those invited, 117 (22%) consented to participate of whom 86 (74%) completed the study. We have confirmed the feasibility of supplementing EHR with data collected directly from patients. Although the present study successfully collected essential data from patients, it also underlined the requirement for improved engagement with both patients and general practitioners to support similar studies. © 2017 The Authors. Pharmacoepidemiology & Drug Safety published by John Wiley & Sons Ltd.

  4. Does increasing the size of bi-weekly samples of records influence results when using the Global Trigger Tool? An observational study of retrospective record reviews of two different sample sizes.

    Science.gov (United States)

    Mevik, Kjersti; Griffin, Frances A; Hansen, Tonje E; Deilkås, Ellen T; Vonen, Barthold

    2016-04-25

    To investigate the impact of increasing sample of records reviewed bi-weekly with the Global Trigger Tool method to identify adverse events in hospitalised patients. Retrospective observational study. A Norwegian 524-bed general hospital trust. 1920 medical records selected from 1 January to 31 December 2010. Rate, type and severity of adverse events identified in two different samples sizes of records selected as 10 and 70 records, bi-weekly. In the large sample, 1.45 (95% CI 1.07 to 1.97) times more adverse events per 1000 patient days (39.3 adverse events/1000 patient days) were identified than in the small sample (27.2 adverse events/1000 patient days). Hospital-acquired infections were the most common category of adverse events in both the samples, and the distributions of the other categories of adverse events did not differ significantly between the samples. The distribution of severity level of adverse events did not differ between the samples. The findings suggest that while the distribution of categories and severity are not dependent on the sample size, the rate of adverse events is. Further studies are needed to conclude if the optimal sample size may need to be adjusted based on the hospital size in order to detect a more accurate rate of adverse events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Cancer recording in patients with and without type 2 diabetes in the Clinical Practice Research Datalink primary care data and linked hospital admission data: a cohort study.

    Science.gov (United States)

    Williams, Rachael; van Staa, Tjeerd-Pieter; Gallagher, Arlene M; Hammad, Tarek; Leufkens, Hubert G M; de Vries, Frank

    2018-05-26

    Conflicting results from studies using electronic health records to evaluate the associations between type 2 diabetes and cancer fuel concerns regarding potential biases. This study aimed to describe completeness of cancer recording in UK primary care data linked to hospital admissions records. Patients aged 40+ years with insulin or oral antidiabetic prescriptions in Clinical Practice Research Datalink (CPRD) primary care without type 1 diabetes were matched by age, sex and general practitioner practice to non-diabetics. Those eligible for linkage to Hospital Episode Statistics Admitted Patient Care (HES APC), and with follow-up during April 1997-December 2006 were included. Cancer recording and date of first record of cancer were compared. Characteristics of patients with cancer most likely to have the diagnosis recorded only in a single data source were assessed. Relative rates of cancer estimated from the two datasets were compared. 53 585 patients with type 2 diabetes matched to 47 435 patients without diabetes were included. Of all cancers (excluding non-melanoma skin cancer) recorded in CPRD, 83% were recorded in HES APC. 94% of cases in HES APC were recorded in CPRD. Concordance was lower when restricted to same-site cancer records, and was negatively associated with increasing age. Relative rates for cancer were similar in both datasets. Good concordance in cancer recording was found between CPRD and HES APC among type 2 diabetics and matched controls. Linked data may reduce misclassification and increase case ascertainment when analysis focuses on site-specific cancers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Examining Agencies' Satisfaction with Electronic Record Management Systems in e-Government: A Large-Scale Survey Study

    Science.gov (United States)

    Hsu, Fang-Ming; Hu, Paul Jen-Hwa; Chen, Hsinchun; Hu, Han-Fen

    While e-government is propelling and maturing steadily, advanced technological capabilities alone cannot guarantee agencies’ realizing the full benefits of the enabling computer-based systems. This study analyzes information systems in e-government settings by examining agencies’ satisfaction with an electronic record management system (ERMS). Specifically, we investigate key satisfaction determinants that include regulatory compliance, job relevance, and satisfaction with support services for using the ERMS. We test our model and the hypotheses in it, using a large-scale survey that involves a total of 1,652 government agencies in Taiwan. Our results show significant effects of regulatory compliance on job relevance and satisfaction with support services, which in turn determine government agencies’ satisfaction with an ERMS. Our data exhibit a reasonably good fit to our model, which can explain a significant portion of the variance in agencies’ satisfaction with an ERMS. Our findings have several important implications to research and practice, which are also discussed.

  7. EC Study: Radioactive waste and spent fuel data collection, reporting, record keeping and knowledge transfer by EU Member States

    International Nuclear Information System (INIS)

    Hilden, Wolfgang; )

    2012-01-01

    Preservation of RK and M starts in the pre-closure phase. A comprehensive waste inventory is required which needs to be maintained over significantly long time spans before RWM has reached the step of disposal. Since long term management solutions are often not clearly defined, disposal acceptance criteria are and cannot be known beforehand, at least not in early stages of disposal programs. Thus a Preservation of RK and M should therefore be approached within the rationale of life cycle analysis. There is a wide variety of approaches with regard to waste inventories at EU level, and retrieving data is often lengthy and difficult. The Commission dedicated a study to identify good practices and formulate recommendations. There are two main issues; firstly waste data collection, recording and reporting, and secondly record keeping and knowledge transfer. One concerns the present time, while the other is concerned with long periods of time. With regard to the analysis of data requirements, it was found that they depend on the context of their use, be it safe treatment, storage and disposal, policy making and capacity planning or funding. The study identifies for each use relevant data sets. Thus, the question of the purpose of RK and M preservation heavily influences the question of which records need to be maintained (cf. the RK and M Vision Document). This is also true with regard to the potential need to cope with changes of the regulatory system or overall RWM policy, which requires to preserve raw data in continuously accessible form. On the other hand the contextualization of data is needed, for which the safety case may be a useful tool. With regard to legacy waste, re-assessment or re-conditioning campaigns should aim at maximum information gain. Agreements on how to coherently account for the total volume of the waste need to be made. A balance needs to be found between completeness and overload (watch out for 'Keep everything, find nothing'). Data security

  8. Variability Analysis of the Horizontal Geomagnetic Component: A Case Study Based on Records from Vassouras Observatory (Brazil)

    Science.gov (United States)

    Klausner, Virginia; Papa, Andres; Mendes, Odim; Oliveira Domingues, Margarete

    It is well known that any of the components of the magnetic field measured on the Earth's surface presents characteristic frequencies with 24, 12, 8 and 6-hour period. Those typical kinds of oscillations of the geomagnetic field are known as solar quiet variation and are primary due to the global thermotidal wind systems which conduct currents flowing in the "dynamo region" of the ionosphere, the E-region. In this study, the horizontal component amplitude observed by ground-based observatories belonged to the INTERMAGNET network have been used to analyze the global pattern variance of the Sq variation. In particular we focused our attention on Vassouras Observatory (VSS), Rio de Janeiro, Brazil, which has been active since 1915. In the next years, a brazilian network of magnetometers will be implemented and VSS can be used as reference. This work aims mainly to highlight and interpret these quiet daily variations over the Brazilian sector compared to the features from other magnetic stations reasonably distributed over the whole Earth's surface. The methodological approach is based on wavelet cross-correlation technique. This technique is useful to isolate the period of the spectral components of geomagnetic field in each station and to correlate them as function of scale (period) between VSS and the other stations. The wavelet cross-correlation coefficient strongly depends on the scale. We study the geomagnetically quiet days at equinox and solstice months during low and high solar activity. As preliminary remarks, the results show that the records in the magnetic stations have primary a latitudinal dependence affected by the time of year and level of solar activity. On the other hand, records of magnetic stations located at the same dip latitude but at different longitude presented some peculiarities. These results indicated that the winds driven the dynamo are very sensitive of the location of the geomagnetic station, i. e., its effects depend upon the direction

  9. Increased planned delivery contributes to declining rates of pregnancy hypertension in Australia: a population-based record linkage study.

    Science.gov (United States)

    Roberts, Christine L; Algert, Charles S; Morris, Jonathan M; Ford, Jane B

    2015-10-05

    Since the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declining pregnancy hypertension rates in Australia. Population-based record linkage study utilising linked birth and hospital records. A cohort of 1,076,122 deliveries in New South Wales, Australia, 2001-2012. Pregnancy hypertension (including gestational hypertension, pre-eclampsia and eclampsia) was the main outcome; pre-eclampsia was a secondary outcome. From 2001 to 2012, pregnancy hypertension rates declined by 22%, from 9.9% to 7.7%, and pre-eclampsia by 27%, from 3.3% to 2.4% (trend prate was predicted to increase to 10.5%. Examination of annual gestational age distributions showed that pregnancy hypertension rates actually declined from 38 weeks gestation and were steepest from 41 weeks; at least 36% of the decrease could be attributed to planned deliveries. The risk factors for pregnancy hypertension were also risk factors for planned delivery. It appears that an unanticipated consequence of increasing early planned deliveries is a decline in the incidence of pregnancy hypertension. Women with risk factors for hypertension were relatively more likely to be selected for early delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Early life risk factors for testicular cancer: a case-cohort study based on the Copenhagen School Health Records Register.

    Science.gov (United States)

    Piltoft, Johanne Spanggaard; Larsen, Signe Benzon; Dalton, Susanne Oksbjerg; Johansen, Christoffer; Baker, Jennifer L; Cederkvist, Luise; Andersen, Ingelise

    2017-02-01

    One established risk factors for testicular cancer is cryptorchidism. However, it remains unclear whether cryptorchidism is a risk factor in itself or whether the two conditions share common causes in early life (estrogen hypothesis), such as birth weight and birth order. The objective of this study is to utilize data from the Copenhagen School Health Records Register (CSHRR) to evaluate cryptorchidism, birth weight and birth order as risk factors for testicular cancer. The study population consisted of 408 cases of testicular cancer identified by a government issued identification number linkage of the entire CSHRR with the Danish Cancer Registry and a random subsample of 4819 males from the CSHRR. The study design was case-cohort and the period of follow-up between 2 April 1968 and 31 December 2003. Cryptorchidism was significantly associated with testicular cancer in crude analyses [hazard ratio (HR) = 3.60, 95% CI 2.79-4.65]. Birth weight was inversely associated with testicular cancer and no clear association with birth order was observed. The positive association between cryptorchidism and testicular cancer was only slightly attenuated controlling for birth weight and birth order and stratified on birth cohort (HR = 3.46, 95% CI 2.67-4.48). This study confirmed the robustness of the association between cryptorchidism and testicular cancer even after adjustment for birth weight and birth order. Furthermore, the study showed an inverse association between birth weight and testicular cancer.

  11. Interoperability of clinical decision-support systems and electronic health records using archetypes: a case study in clinical trial eligibility.

    Science.gov (United States)

    Marcos, Mar; Maldonado, Jose A; Martínez-Salvador, Begoña; Boscá, Diego; Robles, Montserrat

    2013-08-01

    Clinical decision-support systems (CDSSs) comprise systems as diverse as sophisticated platforms to store and manage clinical data, tools to alert clinicians of problematic situations, or decision-making tools to assist clinicians. Irrespective of the kind of decision-support task CDSSs should be smoothly integrated within the clinical information system, interacting with other components, in particular with the electronic health record (EHR). However, despite decades of developments, most CDSSs lack interoperability features. We deal with the interoperability problem of CDSSs and EHRs by exploiting the dual-model methodology. This methodology distinguishes a reference model and archetypes. A reference model is represented by a stable and small object-oriented model that describes the generic properties of health record information. For their part, archetypes are reusable and domain-specific definitions of clinical concepts in the form of structured and constrained combinations of the entities of the reference model. We rely on archetypes to make the CDSS compatible with EHRs from different institutions. Concretely, we use archetypes for modelling the clinical concepts that the CDSS requires, in conjunction with a series of knowledge-intensive mappings relating the archetypes to the data sources (EHR and/or other archetypes) they depend on. We introduce a comprehensive approach, including a set of tools as well as methodological guidelines, to deal with the interoperability of CDSSs and EHRs based on archetypes. Archetypes are used to build a conceptual layer of the kind of a virtual health record (VHR) over the EHR whose contents need to be integrated and used in the CDSS, associating them with structural and terminology-based semantics. Subsequently, the archetypes are mapped to the EHR by means of an expressive mapping language and specific-purpose tools. We also describe a case study where the tools and methodology have been employed in a CDSS to support

  12. Using the Electronic Medical Record to Reduce Unnecessary Ordering of Coagulation Studies for Patients with Chest Pain

    Directory of Open Access Journals (Sweden)

    Jeremiah S. Hinson

    2017-02-01

    Full Text Available Introduction: Our goal was to reduce ordering of coagulation studies in the emergency department (ED that have no added value for patients presenting with chest pain. We hypothesized this could be achieved via implementation of a stopgap measure in the electronic medical record (EMR. Methods: We used a pre and post quasi-experimental study design to evaluate the impact of an EMRbased intervention on coagulation study ordering for patients with chest pain. A simple interactive prompt was incorporated into the EMR of our ED that required clinicians to indicate whether patients were on anticoagulation therapy prior to completion of orders for coagulation studies. Coagulation order frequency was measured via detailed review of randomly sampled encounters during two-month periods before and after intervention. We classified existing orders as clinically indicated or non-value added. Order frequencies were calculated as percentages, and we assessed differences between groups by chi-square analysis. Results: Pre-intervention, 73.8% (76/103 of patients with chest pain had coagulation studies ordered, of which 67.1% (51/76 were non-value added. Post-intervention, 38.5% (40/104 of patients with chest pain had coagulation studies ordered, of which 60% (24/40 were non-value added. There was an absolute reduction of 35.3% (95% confidence interval [CI]: 22.7%, 48.0% in the total ordering of coagulation studies and 26.4% (95% CI: 13.8%, 39.0% in non-value added order placement. Conclusion: Simple EMR-based interactive prompts can serve as effective deterrents to indiscriminate ordering of diagnostic studies. [West J Emerg Med. 2017;18(2267-269.

  13. Antidepressant medication use for primary care patients with and without medical comorbidities: a national electronic health record (EHR) network study.

    Science.gov (United States)

    Gill, James M; Klinkman, Michael S; Chen, Ying Xia

    2010-01-01

    Because comorbid depression can complicate medical conditions (eg, diabetes), physicians may treat depression more aggressively in patients who have these conditions. This study examined whether primary care physicians prescribe antidepressant medications more often and in higher doses for persons with medical comorbidities. This secondary data analysis of electronic health record data was conducted in the Centricity Health Care User Research Network (CHURN), a national network of ambulatory practices that use a common outpatient electronic health record. Participants included 209 family medicine and general internal medicine providers in 40 primary care CHURN offices in 17 US states. Patients included adults with a new episode of depression that had been diagnosed during the period October 2006 through July 2007 (n = 1513). Prescription of antidepressant medication and doses of antidepressant medication were compared for patients with and without 6 comorbid conditions: diabetes, coronary heart disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, and cancer. 20.7% of patients had at least one medical comorbidity whereas 5.8% had multiple comorbidities. Overall, 77% of depressed patients were prescribed antidepressant medication. After controlling for age and sex, patients with multiple comorbidities were less likely to be prescribed medication (adjusted odds ratio, 0.58; 95% CI, 0.35-0.96), but there was no significant difference by individual comorbidities. Patients with cerebrovascular disease were less likely to be prescribed a full dose of medication (adjusted odds ratio, 0.26; 95% CI, 0.08-0.88), but there were no differences for other comorbidities or for multiple comorbidities, and there was no difference for any comorbidities in the prescription of minimally effective doses. Patients with new episodes of depression who present to a primary care practice are not treated more aggressively if they have medical

  14. Reliability of radiographic observations recorded on a proforma measured using inter- and intra-observer variation: a preliminary study.

    Science.gov (United States)

    Saunders, M B; Gulabivala, K; Holt, R; Kahan, R S

    2000-05-01

    The aim of this preliminary study was to test the reliability of radiographic evaluation of features of endodontic interest using a newly devised data collection system. Twelve endodontic MSc postgraduate students and one specialist endodontist examined sample radiographs derived from a random selection of 42 patients seen previously on an Endodontic New Patient Clinic (EDI). Each student examined a random selection of 8-9 roots on periapical radiographs of single- and multirooted teeth, with and without previous root canal therapy and 3-4 dental panoramic tomograms (DPTs). A total of 100 roots were examined. A proforma was used to record observations on 67 radiographic features using predefined criteria. Intra-observer agreement was tested by asking the students to re-examine the radiographs. The principle investigator and the specialist endodontist examined the same radiographs and devised a Gold Standard using the same criteria. This was compared with the student assessments to determine inter-observer variation. The postgraduates then attended a revision session on the use of the form. Each student subsequently examined 8-9 different roots from the pool of radiographs. A further assessment of inter-observer variation was made by comparing these observations with the Gold Standard. Of the 67 radiographic features, only 25 had sufficient response to allow statistical analysis. Kappa values for intra- and inter-observer variation were estimated. These varied depending on the particular radiographic feature being assessed. Fifteen out of 25 intra-observer recordings showed 'good' or 'very good' Kappa agreement, but only three out of 25 inter-observer observations achieved 'good' or 'very good' values. Inter-observer variation was improved following the revision session with 16 out of 25 observations achieving 'good' or 'very good' Kappa agreement. Modification to the proforma, the criteria used, and training for radiographic assessment were considered necessary to

  15. Reusability of coded data in the primary care electronic medical record: A dynamic cohort study concerning cancer diagnoses.

    Science.gov (United States)

    Sollie, Annet; Sijmons, Rolf H; Helsper, Charles; Numans, Mattijs E

    2017-03-01

    To assess quality and reusability of coded cancer diagnoses in routine primary care data. To identify factors that influence data quality and areas for improvement. A dynamic cohort study in a Dutch network database containing 250,000 anonymized electronic medical records (EMRs) from 52 general practices was performed. Coded data from 2000 to 2011 for the three most common cancer types (breast, colon and prostate cancer) was compared to the Netherlands Cancer Registry. Data quality is expressed in Standard Incidence Ratios (SIRs): the ratio between the number of coded cases observed in the primary care network database and the expected number of cases based on the Netherlands Cancer Registry. Ratios were multiplied by 100% for readability. The overall SIR was 91.5% (95%CI 88.5-94.5) and showed improvement over the years. SIRs differ between cancer types: from 71.5% for colon cancer in males to 103.9% for breast cancer. There are differences in data quality (SIRs 76.2% - 99.7%) depending on the EMR system used, with SIRs up to 232.9% for breast cancer. Frequently observed errors in routine healthcare data can be classified as: lack of integrity checks, inaccurate use and/or lack of codes, and lack of EMR system functionality. Re-users of coded routine primary care Electronic Medical Record data should be aware that 30% of cancer cases can be missed. Up to 130% of cancer cases found in the EMR data can be false-positive. The type of EMR system and the type of cancer influence the quality of coded diagnosis registry. While data quality can be improved (e.g. through improving system design and by training EMR system users), re-use should only be taken care of by appropriately trained experts. Copyright © 2016. Published by Elsevier B.V.

  16. Reliability of Alberta Infant Motor Scale Using Recorded Video Observations Among the Preterm Infants in India: A Reliability Study

    Directory of Open Access Journals (Sweden)

    Veena Kirthika S

    2017-10-01

    Full Text Available Background: Assessment of motor function is a vital characteristic of infant development. Alberta Infant Motor scale (AIMS is considered to be one of the tool available for screening the developmental delays, but this scale was formulated by using western samples. Every country has its own ethnic and cultural background and various differences are observed in the culture and ethnicity. Therefore, there is a need to obtain reliability for the use of AIMS in south Indian population. Purpose: To find the intra-rater and inter-rater reliability of Alberta Infant Motor Scale (AIMS on pre-term infants using the recorded video observations in Indian population. Method: 30 preterm infants in three age groups, 0-3 months (10 infants, 4-7 months (10 infants, 8-18 months (10 infants were recruited for this reliability study. The AIMS was administered to the preterm infants and the performance was videotaped. The performance was then rescored by the same therapist, immediately from the video and on another two consecutive months to estimate intra-rater reliability using ICC (3,1, two-way mixed effects model. For reporting inter-rater reliability, AIMS was scored by three different raters, using ICC (2,k two-way random effects model and by two other therapists to examine the inter and intra-rater reliability. Results: The two-way mixed effects model for intra-rater reliability of AIMS, ICC (3,1 = 0.99 and for reporting inter-rater reliability of AIMS by two-way random effects model, ICC (2,k = 0.96. Conclusion: AIMS has excellent intra and inter-rater reliability using recorded video observations among the preterm infants in India

  17. Vinyl Record

    DEFF Research Database (Denmark)

    Bartmanski, Dominik; Woodward, Ian

    2018-01-01

    . This relational process means that both the material affordances and entanglements of vinyl allow us to feel, handle, experience, project, and share its iconicity. The materially mediated meanings of vinyl enabled it to retain currency in independent and collector’s markets and thus resist the planned......In this paper, we use the case of the vinyl record to show that iconic objects become meaningful via a dual process. First, they offer immersive engagements which structure user interpretations through various material experiences of handling, use, and extension. Second, they always work via...

  18. Oak Ridge Institute for Science and Education: A guide to record series supporting epidemiologic studies conducted for the Department of Energy

    International Nuclear Information System (INIS)

    1995-01-01

    This guide describes record series that pertain to epidemiologic and health-related studies at the Center for Epidemiologic Research (CER) of the Oak Ridge Institute for Science and Education (ORISE). These records document the health and safety monitoring of employees and contract employees of the Department of Energy (DOE) and its predecessor organizations, the Manhattan Engineer District (MED), the Atomic Energy Commission (AEC), and the Energy Research and Development Administration (ERDA). History Associates Incorporated (HAI) prepared this guide as part of DOE's Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project, HAI's role in the project, the history of the DOE and its epidemiologic research program, and the history of the Oak Ridge Reservation and the Oak Ridge Institute for Science and Education. It also furnishes information on the procedures that HAI sued to select, inventory, and describe pertinent records; the methodology used to produce the guide; the arrangement of the record series descriptions; the location of the records; and procedures for accessing records repositories

  19. Oak Ridge Institute for Science and Education: A guide to record series supporting epidemiologic studies conducted for the Department of Energy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-17

    This guide describes record series that pertain to epidemiologic and health-related studies at the Center for Epidemiologic Research (CER) of the Oak Ridge Institute for Science and Education (ORISE). These records document the health and safety monitoring of employees and contract employees of the Department of Energy (DOE) and its predecessor organizations, the Manhattan Engineer District (MED), the Atomic Energy Commission (AEC), and the Energy Research and Development Administration (ERDA). History Associates Incorporated (HAI) prepared this guide as part of DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project, HAI`s role in the project, the history of the DOE and its epidemiologic research program, and the history of the Oak Ridge Reservation and the Oak Ridge Institute for Science and Education. It also furnishes information on the procedures that HAI sued to select, inventory, and describe pertinent records; the methodology used to produce the guide; the arrangement of the record series descriptions; the location of the records; and procedures for accessing records repositories.

  20. Attitudes of pregnant women towards personally controlled electronic, hospital-held, and patient-held medical record systems: a survey study.

    Science.gov (United States)

    Quinlivan, Julie A; Lyons, Sarah; Petersen, Rodney W

    2014-09-01

    On July 1, 2012 the Australian Government launched the personally controlled electronic health record (PCEHR). This article surveys obstetric patients about their medical record preferences and identifies barriers to adoption of the PCEHR. A survey study was conducted of antenatal patients attending a large Australian metropolitan hospital. Consecutive patients completed questionnaires during the launch phase of the PCEHR system. Quantitative and qualitative data were collected on demographics, computer access and familiarity, preference for medical record system, and perceived benefits and concerns. Of 528 women eligible to participate, 474 completed the survey (89.8%). Respondents had high levels of home access to a computer (90.5%) and the Internet (87.1%) and were familiar with using computers in daily life (median Likert scale of 9 out of 10). Despite this, respondents preferred hospital-held paper records, and only one-third preferred a PCEHR; the remainder preferred patient-held records. Compared with hospital-held paper records, respondents felt a PCEHR would reduce the risk of lost records (padvantages and disadvantages with the PCEHR, although the majority still prefer existing record systems. To increase uptake, confidentiality, privacy, and control concerns need to be addressed.

  1. A comparative evaluation of static and functional methods for recording centric relation and condylar guidance: a clinical study.

    Science.gov (United States)

    Thakur, Mridul; Jain, Veena; Parkash, Hari; Kumar, Pravesh

    2012-09-01

    To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal wax and extra oral Gothic arch methods and subjective evaluation of dentures thus fabricated. Centric relation and horizontal condylar guidance was recorded by using interocclusal wax and gothic arch tracing in 28 completely edentulous patients. These records were transferred to the articulator and difference in both values was recorded. After that patients were divided in two groups according to the centric relation and horizontal condylar guidance recording method used to achieve balanced occlusion. Response of the dentures was subjectively evaluated using "Woelfel subjective evaluation criteria". Centric relation recorded by both the methods did coincide in 7.14 % of patients. Centric relation recorded by interocclusal wax was posterior to Gothic centric relation in 21.43 % of patients, and anterior to Gothic centric relation in 71.42 % patients. Gothic arch tracings gave higher mean guidance values on both the sides as compared to protrusive wax record in all the subjects, although the difference was statistically insignificant (P > 0.05). Subjective evaluation showed statistical insignificance for all the parameters in both groups. Gothic arch method records the centric relation at a more posterior position than the Static method, but it does not make any difference in clinical performance of the complete denture. Horizontal condylar guidance angle was approximately similar by both the methods.

  2. The necessity of repeated assessment of imaging studies contained in medical records in medico-legal opinions

    Directory of Open Access Journals (Sweden)

    Aleksandra Borowska-Solonynko

    2014-12-01

    Full Text Available The paper presents two case reports of living victims, in which imaging studies of the chest conducted at a medical facility were an essential part of the medico-legal opinion. The first case was that of a young male hospitalized due to CT evidence of bilateral rib fractions, who claimed to have been assaulted by police officers. The other case was that of a six week old baby hospitalized due to chest X-ray evidence of right hand side rib fractions. The chest X-ray was performed due to one bruise found on the baby’s forehead and two small bruises on the back, which gave rise to suspicions of child abuse. In both cases, expert witnesses in radiology definitively excluded the presence of any fractures. These cases indicate that a new assessment of imaging studies contained in medical records is needed. Expert opinions based solely on the description of imaging studies may result in grave consequences.

  3. Record Club

    CERN Multimedia

    Record Club

    2011-01-01

    http://cern.ch/Record.Club November  Selections Just in time for the holiday season, we have added a number of new CDs and DVDs into the Club. You will find the full lists at http://cern.ch/record.club; select the "Discs of the Month" button on the left side on the left panel of the web page and then Nov 2011. New films include the all 5 episodes of Fast and Furious, many of the most famous films starring Jean-Paul Belmondo and those of Louis de Funes and some more recent films such as The Lincoln Lawyer and, according to some critics, Woody Allen’s best film for years – Midnight in Paris. For the younger generation there is Cars 2 and Kung Fu Panda 2. New CDs include the latest releases by Adele, Coldplay and the Red Hot Chili Peppers. We have also added the new Duets II CD featuring Tony Bennett singing with some of today’s pop stars including Lady Gaga, Amy Winehouse and Willy Nelson. The Club is now open every Monday, Wednesday and Friday ...

  4. Record Club

    CERN Multimedia

    Record Club

    2011-01-01

    http://cern.ch/Record.Club June Selections We have put a significant number of new CDs and DVDs into the Club You will find the full lists at http://cern.ch/record.club and select the «Discs of the Month» button on the left side on the left panel of the web page and then June 2011. New films include the latest Action, Suspense and Science Fiction film hits, general drama movies including the Oscar-winning The King’s Speech, comedies including both chapter of Bridget Jones’s Diary, seven films for children and a musical. Other highlights include the latest Harry Potter release and some movies from the past you may have missed including the first in the Terminator series. New CDs include the latest releases by Michel Sardou, Mylene Farmer, Jennifer Lopez, Zucchero and Britney Spears. There is also a hits collection from NRJ. Don’t forget that the Club is now open every Monday, Wednesday and Friday lunchtimes from 12h30 to 13h00 in Restaurant 2, Building 504. (C...

  5. Record club

    CERN Document Server

    Record club

    2010-01-01

      Bonjour a tous, Voici les 24 nouveaux DVD de Juillet disponibles depuis quelques jours, sans oublier les 5 CD Pop musique. Découvrez la saga du terroriste Carlos, la vie de Gainsbourg et les aventures de Lucky Luke; angoissez avec Paranormal Activity et évadez vous sur Pandora dans la peau d’Avatar. Toutes les nouveautés sont à découvrir directement au club. Pour en connaître la liste complète ainsi que le reste de la collection du Record Club, nous vous invitons sur notre site web: http://cern.ch/crc. Toutes les dernières nouveautés sont dans la rubrique « Discs of the Month ». Rappel : le club est ouvert les Lundis, Mercredis, Vendredis de 12h30 à 13h00 au restaurant n°2, bâtiment 504. A bientôt chers Record Clubbers.  

  6. Record Club

    CERN Multimedia

    Record Club

    2011-01-01

    http://cern.ch/Record.Club Nouveautés été 2011 Le club de location de CDs et de DVDs vient d’ajouter un grand nombre de disques pour l’été 2011. Parmi eux, Le Discours d’un Roi, oscar 2011 du meilleur film et Harry Potter les reliques de la mort (1re partie). Ce n’est pas moins de 48 DVDs et 10 CDs nouveaux qui vous sont proposés à la location. Il y en a pour tous les genres. Alors n’hésitez pas à consulter notre site http://cern.ch/record.club, voir Disc Catalogue, Discs of the month pour avoir la liste complète. Le club est ouvert tous les Lundi, Mercredi, Vendredi de 12h30 à 13h dans le bâtiment du restaurent N°2 (Cf. URL: http://www.cern.ch/map/building?bno=504) A très bientôt.  

  7. Benefits of applying a proxy eligibility period when using electronic health records for outcomes research: a simulation study.

    Science.gov (United States)

    Yu, Tzy-Chyi; Zhou, Huanxue

    2015-06-09

    Electronic health records (EHRs) can provide valuable data for outcomes research. However, unlike administrative claims databases, EHRs lack eligibility tables or a standard way to define the benefit coverage period, which could lead to underreporting of healthcare utilization or outcomes, and could result in surveillance bias. We tested the effect of using a proxy eligibility period (eligibility proxy) when estimating a range of health resource utilization and outcomes parameters under varying degrees of missing encounter data. We applied an eligibility proxy to create a benchmark cohort of chronic obstructive pulmonary disease (COPD) patients with 12 months of follow-up, with the assumption of no missing encounter data. The benchmark cohort provided parameter estimates for comparison with 9,000 simulated datasets representing 10-90% of COPD patients (by 10th percentiles) with between 1 and 11 months of continuous missing data. Two analyses, one for datasets using an eligibility proxy and one for those without an eligibility proxy, were performed on the 9,000 datasets to assess estimator performance under increasing levels of missing data. Estimates for each study variable were compared with those from the benchmark dataset, and performance was evaluated using bias, percentage change, and root-mean-square error. The benchmark dataset contained 6,717 COPD patients, whereas the simulated datasets where the eligibility proxy was applied had between 671 and 6,045 patients depending on the percentage of missing data. Parameter estimates had better performance when an eligibility proxy based on the first and last month of observed activity was applied. This finding was consistent across a range of variables representing patient comorbidities, symptoms, outcomes, health resource utilization, and medications, regardless of the measures of performance used. Without the eligibility proxy, all evaluated parameters were consistently underestimated. In a large COPD patient

  8. Linking a research register to clinical records in older adults' mental health services: a mixed-methods study.

    Science.gov (United States)

    Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

    2015-01-01

    Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities. This was a two-stage cross-sectional observational study. In phase one, focus groups with service users, carers and clinicians informed a framework for clinicians to explain C4C to those on their caseload. In phase two, clinicians explained C4C to 26 service users (and carers where applicable). These conversations were recorded, and their content was analysed. Service users and carers were then interviewed to provide further feedback on their conversations with clinicians. A total of 31 service users, 24 carers and 13 clinical staff took part across the two phases. In phase one, service users and carers sought assurance of the right to refuse participation in further studies (after joining C4C). Clinicians expressed concerns over legal and practical implications of ascertaining mental capacity and best interest. In phase two, clinicians' explanations were less thorough than similar explanations given to younger adults with psychosis. Clinicians omitted details of service users' right to stipulate contact arrangements, which was significantly associated with whether service users/carers agreed to join. Common reasons for joining C4C included altruism and the chance to speak to new people. Few participants refused to join, but reasons included avoidance of stress (potentially alleviated through the presence of a carer). Implementing C4C in older adults' services requires clinicians to deliver concise, simple explanations to individuals and their carers where applicable. Older adults can be suspicious of unsolicited contact; thus

  9. Cardiovascular safety of liraglutide assessed in a patient-level pooled analysis of phase 2: 3 liraglutide clinical development studies.

    Science.gov (United States)

    Marso, Steven P; Lindsey, Jason B; Stolker, Joshua M; House, John A; Martinez Ravn, Gabriela; Kennedy, Kevin F; Jensen, Troels M; Buse, John B

    2011-07-01

    We assessed the cardiovascular safety of liraglutide, a glucagon-like peptide-1 receptor agonist, using existing clinical data. Patient-level results from all completed phase 2 and 3 studies from the liraglutide clinical development programme were pooled to determine rates of major adverse cardiovascular events (MACE): cardiovascular death, myocardial infarction, stroke. MACE were identified by querying the study database using Medical Dictionary for Regulatory Activities (MedDRA) terms combined with serious adverse events recorded by study investigators. Broad, narrow, and custom groups of MedDRA queries were used. Candidate events from each query were independently adjudicated post hoc. In 15 studies (6638 patients; 4257 liraglutide treated), there were 114 patients with MACE identified using the broad MedDRA query. Of these, 44 were classified as serious adverse events and 39 were adjudicated as MACE. The incidence ratio for adjudicated broad/serious MACE associated with liraglutide was 0.73 (95% CI 0.38-1.41) versus all comparator drugs (metformin, glimepiride, rosiglitazone, insulin glargine, placebo), within cardiovascular safety limits defined by the United States Food & Drug Administration for diabetes therapies under current investigation.

  10. Study on the performance of eosin-doped poly(vinyl alcohol)/acrylamide photopolymer films for holographic recording using 488-nm wavelength

    Science.gov (United States)

    Rajesh, Chelakkal Sukumaran; Sreeroop, Sasidharan Savithrydevi; Pramitha, Vayalamkuzhi; Joseph, Rani; Sreekumar, Krishnapillai; Kartha, Cheranellore Sudha

    2011-12-01

    This article reports a study done on eosin-doped poly(vinyl alcohol)/acrylamide films for holographic recording using 488 nm Ar+ laser. Films were fabricated using gravity settling method at room temperature and were stored under normal laboratory conditions. Ar+ laser (488 nm) was used for fringe recording. Characterization was done by real time transmittance measurement, optical absorption studies, and diffraction efficiency measurements. Various holographic parameters such as exposure energy, recording power, spatial frequency, etc., were optimized so as to ensure maximum performance. More than 85% diffraction efficiency was obtained at an exposure energy of 50 mJ/cm2 in the optimized film. Efforts were taken to study the environmental stability of this self-developing polymeric material by looking at its shelf life and storage life. Compatibility for recording transmission hologram was also checked.

  11. Validating self-report of diabetes use by participants in the 45 and up study: a record linkage study

    Science.gov (United States)

    2013-01-01

    Background Prevalence studies usually depend on self-report of disease status in survey data or administrative data collections and may over- or under-estimate disease prevalence. The establishment of a linked data collection provided an opportunity to explore the accuracy and completeness of capture of information about diabetes in survey and administrative data collections. Methods Baseline questionnaire data at recruitment to the 45 and Up Study was obtained for 266,848 adults aged 45 years and over sampled from New South Wales, Australia in 2006–2009, and linked to administrative data about hospitalisation from the Admitted Patient Data Collection (APDC) for 2000–2009, claims for medical services (MBS) and pharmaceuticals (PBS) from Medicare Australia data for 2004–2009. Diabetes status was determined from response to a question ‘Has a doctor EVER told you that you have diabetes’ (n = 23,981) and augmented by examination of free text fields about diagnosis (n = 119) or use of insulin (n = 58). These data were used to identify the sub-group with type 1 diabetes. We explored the agreement between self-report of diabetes, identification of diabetes diagnostic codes in APDC data, claims for glycosylated haemoglobin (HbA1c) in MBS data, and claims for dispensed medication (oral hyperglycaemic agents and insulin) in PBS data. Results Most participants with diabetes were identified in APDC data if admitted to hospital (79.3%), in MBS data with at least one claim for HbA1c testing (84.7%; 73.4% if 2 tests claimed) or in PBS data through claim for diabetes medication (71.4%). Using these alternate data collections as an imperfect ‘gold standard’ we calculated sensitivities of 83.7% for APDC, 63.9% (80.5% for two tests) for MBS, and 96.6% for PBS data and specificities of 97.7%, 98.4% and 97.1% respectively. The lower sensitivity for HbA1c may reflect the use of this test to screen for diabetes suggesting that it is less useful in identifying

  12. Pattern of presenting complaints recorded as near-drowning events in emergency departments: a national surveillance study from Pakistan.

    Science.gov (United States)

    He, Siran; Lunnen, Jeffrey C; Zia, Nukhba; Khan, Uzma; Shamim, Khusro; Hyder, Adnan A

    2015-01-01

    Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation. There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning

  13. Associations of supermarket characteristics with weight status and body fat: a multilevel analysis of individuals within supermarkets (RECORD study.

    Directory of Open Access Journals (Sweden)

    Basile Chaix

    Full Text Available Previous research on the influence of the food environment on weight status has often used impersonal measures of the food environment defined for residential neighborhoods, which ignore whether people actually use the food outlets near their residence. To assess whether supermarkets are relevant contexts for interventions, the present study explored between-residential neighborhood and between-supermarket variations in body mass index (BMI and waist circumference (WC, and investigated associations between brands and characteristics of supermarkets and BMI or WC, after adjustment for individual and residential neighborhood characteristics.Participants in the RECORD Cohort Study (Paris Region, France, 2007-2008 were surveyed on the supermarket (brand and exact location where they conducted their food shopping. Overall, 7 131 participants shopped in 1 097 different supermarkets. Cross-classified multilevel linear models were estimated for BMI and WC.Just 11.4% of participants shopped for food primarily within their residential neighborhood. After accounting for participants' residential neighborhood, people shopping in the same supermarket had a more comparable BMI and WC than participants shopping in different supermarkets. After adjustment for individual and residential neighborhood characteristics, participants shopping in specific supermarket brands, in hard discount supermarkets (especially if they had a low education, and in supermarkets whose catchment area comprised low educated residents had a higher BMI/WC.A public health strategy to reduce excess weight may be to intervene on specific supermarkets to change food purchasing behavior, as supermarkets are where dietary preferences are materialized into definite purchased foods.

  14. A Study of Personal Health Record User's Behavioral Model Based on the PMT and UTAUT Integrative Perspective.

    Science.gov (United States)

    Hsieh, Hui-Lung; Kuo, Yu-Ming; Wang, Shiang-Ru; Chuang, Bi-Kun; Tsai, Chung-Hung

    2016-12-23

    The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management.

  15. A Study of Personal Health Record User’s Behavioral Model Based on the PMT and UTAUT Integrative Perspective

    Directory of Open Access Journals (Sweden)

    Hui-Lung Hsieh

    2016-12-01

    Full Text Available The personal health record (PHR is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT and Unified Theory of Acceptance and Use of Technology (UTAUT model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1 The PMT and UTAUT were effective at predicting PHR usage behaviors; (2 Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3 Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management.

  16. Private primary care physicians' perspectives on factors affecting the adoption of electronic medical records: a qualitative pre-implementation study.

    Science.gov (United States)

    Or, Calvin; Wong, Katie; Tong, Ellen; Sek, Antonio

    2014-01-01

    Use of electronic medical records (EMR) has the potential to offer quality and safety benefits, but without the adoption of the technology, the benefits will not be realized. This study aimed to identify the factors perceived as relevant by private physicians when considering EMR adoption. A qualitative pre-implementation study was conducted using semi-structured, face to face interviews to explore the perspectives of physicians (n=16) operating in private clinics on the factors affecting their adoption of EMR. A multilevel, work system approach and the immersion/crystallization data analysis technique guided the researchers in examining the data, identifying patterns and key themes, and extracting representative quotes to illustrate these themes. The major factors associated with EMR adoption, which relate to the five categories of a work system, were system usefulness; user interface design; technical support; cost; system reliability; the privacy, confidentiality, and security of patient information; physical space in the clinic; data migration process; adverse work-related factors; and the computer and systems skills of physicians. Pre-implementation identification of factors important to adoption can allow system developers to focus proactively on these factors when developing the system and its implementation strategies, to maximize the likelihood of successful introduction.

  17. Making a web based ulcer record work by aligning architecture, legislation and users - a formative evaluation study.

    Science.gov (United States)

    Ekeland, Anne G; Skipenes, Eva; Nyheim, Beate; Christiansen, Ellen K

    2011-01-01

    The University Hospital of North Norway selected a web-based ulcer record used in Denmark, available from mobile phones. Data was stored in a common database and easily accessible. According to Norwegian legislation, only employees of the organization that owns an IT system can access the system, and use of mobile units requires strong security solutions. The system had to be changed. The paper addresses interactions in order to make the system legal, and assesses regulations that followed. By addressing conflicting scripts and the contingent nature of knowledge, we conducted a formative evaluation aiming at improving the object being studied. Participatory observation in a one year process, minutes from meetings and information from participants, constitute the data material. In the technological domain, one database was replaced by four. In the health care delivery domain, easy access was replaced by a more complicated log on procedure, and in the domain of law and security, a clarification of risk levels was obtained, thereby allowing for access by mobile phones with today's authentication mechanisms. Flexibility concerning predefined scripts was important in all domains. Changes were made that improved the platform for further development of legitimate communication of patient data via mobile units. The study also shows the value of formative evaluations in innovations.

  18. Associations of supermarket characteristics with weight status and body fat: a multilevel analysis of individuals within supermarkets (RECORD study).

    Science.gov (United States)

    Chaix, Basile; Bean, Kathy; Daniel, Mark; Zenk, Shannon N; Kestens, Yan; Charreire, Hélène; Leal, Cinira; Thomas, Frédérique; Karusisi, Noëlla; Weber, Christiane; Oppert, Jean-Michel; Simon, Chantal; Merlo, Juan; Pannier, Bruno

    2012-01-01

    Previous research on the influence of the food environment on weight status has often used impersonal measures of the food environment defined for residential neighborhoods, which ignore whether people actually use the food outlets near their residence. To assess whether supermarkets are relevant contexts for interventions, the present study explored between-residential neighborhood and between-supermarket variations in body mass index (BMI) and waist circumference (WC), and investigated associations between brands and characteristics of supermarkets and BMI or WC, after adjustment for individual and residential neighborhood characteristics. Participants in the RECORD Cohort Study (Paris Region, France, 2007-2008) were surveyed on the supermarket (brand and exact location) where they conducted their food shopping. Overall, 7 131 participants shopped in 1 097 different supermarkets. Cross-classified multilevel linear models were estimated for BMI and WC. Just 11.4% of participants shopped for food primarily within their residential neighborhood. After accounting for participants' residential neighborhood, people shopping in the same supermarket had a more comparable BMI and WC than participants shopping in different supermarkets. After adjustment for individual and residential neighborhood characteristics, participants shopping in specific supermarket brands, in hard discount supermarkets (especially if they had a low education), and in supermarkets whose catchment area comprised low educated residents had a higher BMI/WC. A public health strategy to reduce excess weight may be to intervene on specific supermarkets to change food purchasing behavior, as supermarkets are where dietary preferences are materialized into definite purchased foods.

  19. A Study of Personal Health Record User’s Behavioral Model Based on the PMT and UTAUT Integrative Perspective

    Science.gov (United States)

    Hsieh, Hui-Lung; Kuo, Yu-Ming; Wang, Shiang-Ru; Chuang, Bi-Kun; Tsai, Chung-Hung

    2016-01-01

    The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management. PMID:28025557

  20. An unexplored sedimentary record for the study of environmental change in mediterranean coastal environments: Posidonia oceanica (L.) Delile peats

    International Nuclear Information System (INIS)

    Mateo, M.-A.; Renom, P.; Romero, J.; Julia, R.; Michener, R.

    2002-01-01

    Information on seagrass paleo-ecology is very scarce because detailed seagrass paleorecords are virtually lacking. The endemic Mediterranean seagrass Posidonia oceanica conjugates two unusual features that allow the reconstruction of the past history of the plant at two different time scales. On the one hand, the study of the leaf sheaths that remain attached to the rhizomes after leaf abcision (lepidochronology), allows to differentiate up to 30 yearly cycles. On the other hand, radiocarbon dating of peat-like deposits derived from Posidonia oceanica rhizomes and roots ('mattes'), reveals a chronological organic record of the plant spanning several thousands of years. Changes in the isotopic signature (δ 13 C) of the sheaths along Posidonia rhizomes from a meadow off Medes Islands (NW Mediterranean, Spain), were highly correlated with changes in annual leave production and with water transparency. These relationships and the isotopic analysis of sheath debris from several Posidonia peats along the Spanish Mediterranean coast are used to make some preliminary inferences about long-term meadow history. Several phenomena potentially making difficult the interpretation of the information contained in Posidonia peats are critically discussed. It is concluded that a detailed study of P. oceanica peats will open new vistas in Mediterranean paleo-ecological and paleo-environmental research (author)

  1. RECORD CLUB

    CERN Multimedia

    Record Club

    2010-01-01

    DVD James Bond – Series Complete To all Record Club Members, to start the new year, we have taken advantage of a special offer to add copies of all the James Bond movies to date, from the very first - Dr. No - to the latest - Quantum of Solace. No matter which of the successive 007s you prefer (Sean Connery, George Lazenby, Roger Moore, Timothy Dalton, Pierce Brosnan or Daniel Craig), they are all there. Or perhaps you have a favourite Bond Girl, or even perhaps a favourite villain. Take your pick. You can find the full selection listed on the club web site http://cern.ch/crc; use the panel on the left of the page “Discs of the Month” and select Jan 2010. We remind you that we are open on Mondays, Wednesdays and Fridays from 12:30 to 13:00 in Restaurant 2 (Bldg 504).

  2. Record dynamics

    DEFF Research Database (Denmark)

    Robe, Dominic M.; Boettcher, Stefan; Sibani, Paolo

    2016-01-01

    When quenched rapidly beyond their glass transition, colloidal suspensions fall out of equilibrium. The pace of their dynamics then slows down with the system age, i.e., with the time elapsed after the quench. This breaking of time translational invariance is associated with dynamical observables...... which depend on two time-arguments. The phenomenology is shared by a broad class of aging systems and calls for an equally broad theoretical description. The key idea is that, independent of microscopic details, aging systems progress through rare intermittent structural relaxations that are de......-facto irreversible and become increasingly harder to achieve. Thus, a progression of record-sized dynamical barriers are traversed in the approach to equilibration. Accordingly, the statistics of the events is closely described by a log-Poisson process. Originally developed for relaxation in spin glasses...

  3. Record breakers

    CERN Multimedia

    Antonella Del Rosso

    2012-01-01

    In the sixties, CERN’s Fellows were but a handful of about 50 young experimentalists present on site to complete their training. Today, their number has increased to a record-breaking 500. They come from many different fields and are spread across CERN’s different activity areas.   “Diversifying the Fellowship programme has been the key theme in recent years,” comments James Purvis, Head of the Recruitment, Programmes and Monitoring group in the HR Department. “In particular, the 2005 five-yearly review introduced the notion of ‘senior’ and ‘junior’ Fellowships, broadening the target audience to include those with Bachelor-level qualifications.” Diversification made CERN’s Fellowship programme attractive to a wider audience but the number of Fellows on site could not have increased so much without the support of EU-funded projects, which were instrumental in the growth of the programme. ...

  4. Effects of implementing electronic medical records on primary care billings and payments: a before-after study.

    Science.gov (United States)

    Jaakkimainen, R Liisa; Shultz, Susan E; Tu, Karen

    2013-09-01

    Several barriers to the adoption of electronic medical records (EMRs) by family physicians have been discussed, including the costs of implementation, impact on work flow and loss of productivity. We examined billings and payments received before and after implementation of EMRs among primary care physicians in the province of Ontario. We also examined billings and payments before and after switching from a fee-for-service to a capitation payment model, because EMR implementation coincided with primary care reform in the province. We used information from the Electronic Medical Record Administrative Data Linked Database (EMRALD) to conduct a retrospective before-after study. The EMRALD database includes EMR data extracted from 183 community-based family physicians in Ontario. We included EMRALD physicians who were eligible to bill the Ontario Health Insurance Plan at least 18 months before and after the date they started using EMRs and had completed a full 18-month period before Mar. 31, 2011, when the study stopped. The main outcome measures were physicians' monthly billings and payments for office visits and total annual payments received from all government sources. Two index dates were examined: the date physicians started using EMRs and were in a stable payment model (n = 64) and the date physicians switched from a fee-for-service to a capitation payment model (n = 42). Monthly billings and payments for office visits did not decrease after the implementation of EMRs. The overall weighted mean annual payment from all government sources increased by 27.7% after the start of EMRs among EMRALD physicians; an increase was also observed among all other primary care physicians in Ontario, but it was not as great (14.4%). There was a decline in monthly billings and payments for office visits after physicians changed payment models, but an increase in their overall annual government payments. Implementation of EMRs by primary care physicians did not result in decreased

  5. Effects of implementing electronic medical records on primary care billings and payments: a before–after study

    Science.gov (United States)

    Shultz, Susan E.; Tu, Karen

    2013-01-01

    Background Several barriers to the adoption of electronic medical records (EMRs) by family physicians have been discussed, including the costs of implementation, impact on work flow and loss of productivity. We examined billings and payments received before and after implementation of EMRs among primary care physicians in the province of Ontario. We also examined billings and payments before and after switching from a fee-for-service to a capitation payment model, because EMR implementation coincided with primary care reform in the province. Methods We used information from the Electronic Medical Record Administrative Data Linked Database (EMRALD) to conduct a retrospective before–after study. The EMRALD database includes EMR data extracted from 183 community-based family physicians in Ontario. We included EMRALD physicians who were eligible to bill the Ontario Health Insurance Plan at least 18 months before and after the date they started using EMRs and had completed a full 18-month period before Mar. 31, 2011, when the study stopped. The main outcome measures were physicians’ monthly billings and payments for office visits and total annual payments received from all government sources. Two index dates were examined: the date physicians started using EMRs and were in a stable payment model (n = 64) and the date physicians switched from a fee-for-service to a capitation payment model (n = 42). Results Monthly billings and payments for office visits did not decrease after the implementation of EMRs. The overall weighted mean annual payment from all government sources increased by 27.7% after the start of EMRs among EMRALD physicians; an increase was also observed among all other primary care physicians in Ontario, but it was not as great (14.4%). There was a decline in monthly billings and payments for office visits after physicians changed payment models, but an increase in their overall annual government payments. Interpretation Implementation of EMRs by

  6. Subject and authorship of records related to the Organization for Tropical Studies (OTS) in BINABITROP, a comprehensive database about Costa Rican biology.

    Science.gov (United States)

    Monge-Nájera, Julián; Nielsen-Muñoz, Vanessa; Azofeifa-Mora, Ana Beatriz

    2013-06-01

    BINABITROP is a bibliographical database of more than 38000 records about the ecosystems and organisms of Costa Rica. In contrast with commercial databases, such as Web of Knowledge and Scopus, which exclude most of the scientific journals published in tropical countries, BINABITROP is a comprehensive record of knowledge on the tropical ecosystems and organisms of Costa Rica. We analyzed its contents in three sites (La Selva, Palo Verde and Las Cruces) and recorded scientific field, taxonomic group and authorship. We found that most records dealt with ecology and systematics, and that most authors published only one article in the study period (1963-2011). Most research was published in four journals: Biotropica, Revista de Biología Tropical/ International Journal of Tropical Biology and Conservation, Zootaxa and Brenesia. This may be the first study of a such a comprehensive database for any case of tropical biology literature.

  7. Subject and authorship of records related to the Organization for Tropical Studies (OTS in BINABITROP, a comprehensive database about Costa Rican biology

    Directory of Open Access Journals (Sweden)

    Julián Monge-Nájera

    2013-06-01

    Full Text Available BINABITROP is a bibliographical database of more than 38 000 records about the ecosystems and organisms of Costa Rica. In contrast with commercial databases, such as Web of Knowledge and Scopus, which exclude most of the scientific journals published in tropical countries, BINABITROP is a comprehensive record of knowledge on the tropical ecosystems and organisms of Costa Rica. We analyzed its contents in three sites (La Selva, Palo Verde and Las Cruces and recorded scientific field, taxonomic group and authorship. We found that most records dealt with ecology and systematics, and that most authors published only one article in the study period (1963-2011. Most research was published in four journals: Biotropica, Revista de Biología Tropical/ International Journal of Tropical Biology and Conservation, Zootaxa and Brenesia. This may be the first study of a such a comprehensive database for any case of tropical biology literature.

  8. A mobile app for securely capturing and transferring clinical images to the electronic health record: description and preliminary usability study.

    Science.gov (United States)

    Landman, Adam; Emani, Srinivas; Carlile, Narath; Rosenthal, David I; Semakov, Simon; Pallin, Daniel J; Poon, Eric G

    2015-01-02

    Photographs are important tools to record, track, and communicate clinical findings. Mobile devices with high-resolution cameras are now ubiquitous, giving clinicians the opportunity to capture and share images from the bedside. However, secure and efficient ways to manage and share digital images are lacking. The aim of this study is to describe the implementation of a secure application for capturing and storing clinical images in the electronic health record (EHR), and to describe initial user experiences. We developed CliniCam, a secure Apple iOS (iPhone, iPad) application that allows for user authentication, patient selection, image capture, image annotation, and storage of images as a Portable Document Format (PDF) file in the EHR. We leveraged our organization's enterprise service-oriented architecture to transmit the image file from CliniCam to our enterprise clinical data repository. There is no permanent storage of protected health information on the mobile device. CliniCam also required connection to our organization's secure WiFi network. Resident physicians from emergency medicine, internal medicine, and dermatology used CliniCam in clinical practice for one month. They were then asked to complete a survey on their experience. We analyzed the survey results using descriptive statistics. Twenty-eight physicians participated and 19/28 (68%) completed the survey. Of the respondents who used CliniCam, 89% found it useful or very useful for clinical practice and easy to use, and wanted to continue using the app. Respondents provided constructive feedback on location of the photos in the EHR, preferring to have photos embedded in (or linked to) clinical notes instead of storing them as separate PDFs within the EHR. Some users experienced difficulty with WiFi connectivity which was addressed by enhancing CliniCam to check for connectivity on launch. CliniCam was implemented successfully and found to be easy to use and useful for clinical practice. CliniCam is

  9. Effects of maltreatment and parental schizophrenia spectrum disorders on early childhood social-emotional functioning: a population record linkage study.

    Science.gov (United States)

    Matheson, S L; Kariuki, M; Green, M J; Dean, K; Harris, F; Tzoumakis, S; Tarren-Sweeney, M; Brinkman, S; Chilvers, M; Sprague, T; Carr, V J; Laurens, K R

    2017-12-01

    Childhood maltreatment and a family history of a schizophrenia spectrum disorder (SSD) are each associated with social-emotional dysfunction in childhood. Both are also strong risk factors for adult SSDs, and social-emotional dysfunction in childhood may be an antecedent of these disorders. We used data from a large Australian population cohort to determine the independent and moderating effects of maltreatment and parental SSDs on early childhood social-emotional functioning. The New South Wales Child Development Study combines intergenerational multi-agency data using record linkage methods. Multiple measures of social-emotional functioning (social competency, prosocial/helping behaviour, anxious/fearful behaviour; aggressive behaviour, and hyperactivity/inattention) on 69 116 kindergarten children (age ~5 years) were linked with government records of child maltreatment and parental presentations to health services for SSD. Multivariable analyses investigated the association between maltreatment and social-emotional functioning, adjusting for demographic variables and parental SSD history, in the population sample and in sub-cohorts exposed and not exposed to parental SSD history. We also examined the association of parental SSD history and social-emotional functioning, adjusting for demographic variables and maltreatment. Medium-sized associations were identified between maltreatment and poor social competency, aggressive behaviour and hyperactivity/inattention; small associations were revealed between maltreatment and poor prosocial/helping and anxious/fearful behaviours. These associations did not differ greatly when adjusted for parental SSD, and were greater in magnitude among children with no history of parental SSD. Small associations between parental SSD and poor social-emotional functioning remained after adjusting for demographic variables and maltreatment. Childhood maltreatment and history of parental SSD are associated independently with poor early

  10. Bridging the digital divide in HIV care: a pilot study of an iPod personal health record.

    Science.gov (United States)

    Luque, Amneris E; Corales, Roberto; Fowler, Richard J; DiMarco, Jamie; van Keken, Adjuah; Winters, Paul; Keefer, Michael C; Fiscella, Kevin

    2013-01-01

    Persons living with HIV (PLWH) need practical tools to self-manage their condition. We conducted a proof-of-concept study among PLWH to assess whether patients could learn to use a personal health record (PHR) on a hand-held device (iPod Touch) to manage their condition. We began individual trainings and later adapted this to group training. We assessed usability, acceptability and also effects on self-efficacy for treatment adherence using the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES). Nine PLWH participated in the individual training and 29 participated in the group sessions. The participants were largely middle aged, low-income and of racial/ethnic minorities. The sessions were well attended and participants fully engaged in tasks and shared learning. Most participants stated they intended to use the PHR and reported improved self-efficacy in treatment adherence (P = .05) particularly on the integration of treatment adherence into one's routine (P < .02). Training PLWH in use of a handheld PHR shows promise.

  11. What information is provided in transcripts and Medical Student Performance Records from Canadian Medical Schools? A retrospective cohort study.

    Science.gov (United States)

    Robins, Jason A; McInnes, Matthew D F; Esmail, Kaisra

    2014-01-01

    Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates' documentation, the heterogeneity therein, as well as its objective data. Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison.

  12. Focused Ethnography as Research Method: A Case Study of Techno Music Producers in Home-Recording Studios

    Directory of Open Access Journals (Sweden)

    Jan Michael Kühn

    2013-05-01

    Full Text Available Translator's Introduction: Jan-Michael Kühn's essay introduces the reader to Hubert Knoblauch's focused ethnography [fokussierte Ethnographie] as an ethnographic fieldwork method. More than a decade after Knoblauch's first publications on this method, there are precious few guides to focused ethnography in the English language, save one (Knoblauch 2005. At any rate, there are certainly no introductions to this methodology that also use EDM scenes as a case study. Kühn's article was originally published in German in Soziologie Magazin, a student-run journal published from Martin Luther University in Halle (Saale but operated by an editorial network that spans Germany. As a result, Kühn orients his writing towards an audience of junior researchers, post-docs and graduate students, highlighting the ways in which focused ethnography suits the circumstances of early research careers, where one may have difficulty securing long-term research stays for fieldwork of broader scope. In particular, he notes that Knoblauch's methods require a very narrow scope for the project (i.e., a "field sector" rather than the whole field, a reliance on the researcher's previous knowledge of the field, and short bursts of intense ethnographic activity in order to create work that is tightly focused but still rigorous and generative of fresh knowledge and new concepts.KEYWORDS: qualitative methods; cultural production; music production; home-recording; technoculture

  13. A study of 2014 record drought in India with CFSv2 model: role of water vapor transport

    KAUST Repository

    Ramakrishna, S. S. V. S.; Brahmananda Rao, V.; Srinivasa Rao, B. R.; Hari Prasad, D.; Nanaji Rao, N.; Panda, Roshmitha

    2016-01-01

    The Indian summer monsoon season of 2014 was erratic and ended up with a seasonal rainfall deficit of 12 % and a record drought in June. In this study we analyze the moisture transport characteristics for the monsoon season of 2014 using both NCEP FNL reanalysis (FNL) and CFSv2 (CFS) model data. In FNL, in June 2014 there was a large area of divergence of moisture flux. In other months also there was lesser flux. This probably is the cause of 2014 drought. The CFS model overestimated the drought and it reproduces poorly the observed rainfall over central India (65E–95E; 5N–35N). The correlation coefficient (CC) between the IMD observed rainfall and CFS model rainfall is only 0.1 while the CC between rainfall and moisture flux convergence in CFS model is only 0.20 and with FNL data −0.78. This clearly shows that the CFS model has serious difficulty in reproducing the moisture flux convergence and rainfall. We found that the rainfall variations are strongly related to the moisture convergence or divergence. The hypothesis of Krishnamurti et al. (J Atmos Sci 67:3423–3441, 2010) namely the intrusion of west African desert air and the associated low convective available potential energy inhibiting convection and rainfall shows some promise to explain dry spells in Indian summer monsoon. However, the rainfall or lack of it is mainly explained by convergence or divergence of moisture flux. © 2016 Springer-Verlag Berlin Heidelberg

  14. Electronic medical record in central polyclinic of isfahan oil industry: a case study based on technology acceptance model.

    Science.gov (United States)

    Tavakoli, Nahid; Jahanbakhsh, Maryam; Shahin, Arash; Mokhtari, Habibollah; Rafiei, Maryam

    2013-03-01

    Today, health information technologies are base of health services and Electronic Medical Record is one of them. The purpose of this paper is to investigate the Technology Acceptance Model (TAM) on EMR at Central Polyclinic Oil Industry that is a pioneer in implementation of EMR in Isfahan. This study was an applied and analytical survey that it was done at the Central Polyclinic Oil Industry. Because statistical population were limited, sampling bas been done by conducting the census and the sample was according to the population. The data was collected by a researcher-made questionnaire that it was validated by experts and its reliability was confirmed by test retest. The questionnaire was developed in 5 scopes including external factors (data quality and user interface), perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use. The Results analyzed by SPSS. There was a significant relationship between data quality with PU(r=/295, p/005). The survey of the scopes in the polyclinic showed that there is relationship among user interface, perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use, but data quality has no relationship with attitude. It seems the system designers didn't consider to data quality characteristics. It is proposed that they consult with health information management professionals for improvement the existing system.

  15. Parameters recorded by software of non-invasive ventilators predict COPD exacerbation: a proof-of-concept study.

    Science.gov (United States)

    Borel, Jean-Christian; Pelletier, Julie; Taleux, Nellie; Briault, Amandine; Arnol, Nathalie; Pison, Christophe; Tamisier, Renaud; Timsit, Jean-François; Pepin, Jean-Louis

    2015-03-01

    To assess whether daily variations in three parameters recorded by non-invasive ventilation (NIV) software (respiratory rate (RR), percentage of respiratory cycles triggered by the patient (%Trigg) and NIV daily use) predict the risk of exacerbation in patients with chronic obstructive pulmonary disease (COPD) treated by home NIV. Patients completed the EXACT-Pro questionnaire daily to detect exacerbations. The 25th and 75th percentiles of each 24 h NIV parameter were calculated and updated daily. For a given day, when the value of any parameter was >75th or 75th, 'low value' <25th). Stratified conditional logistic regressions estimated the risk of exacerbation when ≥2 days (for RR and %Trigg) or ≥3 days (for NIV use) out of five had an 'abnormal value'. Sixty-four patients were included. Twenty-one exacerbations were detected and medically confirmed. The risk of exacerbation was increased when RR (OR 5.6, 95% CI 1.4 to 22.4) and %Trigg (OR 4.0, 95% CI 1.1 to 14.5) were considered as 'high value' on ≥2 days out of five. This proof-of-concept study shows that daily variations in RR and %Trigg are predictors of an exacerbation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Exploring the Association Between Electronic Health Record Use and Burnout Among Psychiatry Residents and Faculty: a Pilot Survey Study.

    Science.gov (United States)

    Domaney, Nicholas M; Torous, John; Greenberg, William E

    2018-05-21

    Burnout is a phenomenon with profound negative effects on the US healthcare system. Little is known about the relationship between time spent working on electronic health record (EHR) and burnout among psychiatry residents. The purpose of this study is to generate preliminary data on EHR use and burnout among psychiatry residents and faculty. In August 2017, psychiatry residents and faculty at an academic medical center were given the Maslach Burnout Inventory (MBI), a standardized measurement tool for burnout, and a survey of factors related to EHR use and potential risk factors for burnout. MBI data along with selected burnout risk and protective factors were analyzed with R Studio software. Responses were obtained from 40 psychiatry residents (73%) and 12 clinical faculty members (40%). Residents reported 22 h per week using EHR on average. Mean score of residents surveyed in postgraduate year (PGY)-1-4 met criteria for high emotional exhaustion associated with burnout. The magnitude of correlation between EHR use and emotional exhaustion was stronger than for other burnout factors including sleep, exercise, and clinical service. Psychiatry residents show signs of high emotional exhaustion, which is associated with burnout. Results demonstrate a strong positive correlation between EHR use and resident burnout. Time spent on EHR use may be an area of importance for psychiatry program directors and other psychiatric educators to consider when seeking to minimize burnout and promote wellness.

  17. What information is provided in transcripts and Medical Student Performance Records from Canadian Medical Schools? A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Jason A. Robins

    2014-09-01

    Full Text Available Background: Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates’ documentation, the heterogeneity therein, as well as its objective data. Methods: Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Results: Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Conclusions: Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison.

  18. Attending Physician Remote Access of the Electronic Health Record and Implications for Resident Supervision: A Mixed Methods Study.

    Science.gov (United States)

    Martin, Shannon K; Tulla, Kiara; Meltzer, David O; Arora, Vineet M; Farnan, Jeanne M

    2017-12-01

    Advances in information technology have increased remote access to the electronic health record (EHR). Concurrently, standards defining appropriate resident supervision have evolved. How often and under what circumstances inpatient attending physicians remotely access the EHR for resident supervision is unknown. We described a model of attending remote EHR use for resident supervision, and quantified the frequency and magnitude of use. Using a mixed methods approach, general medicine inpatient attendings were surveyed and interviewed about their remote EHR use. Frequency of use and supervisory actions were quantitatively examined via survey. Transcripts from semistructured interviews were analyzed using grounded theory to identify codes and themes. A total of 83% (59 of 71) of attendings participated. Fifty-seven (97%) reported using the EHR remotely, with 54 (92%) reporting they discovered new clinical information not relayed by residents via remote EHR use. A majority (93%, 55 of 59) reported that this resulted in management changes, and 54% (32 of 59) reported making immediate changes by contacting cross-covering teams. Six major factors around remote EHR use emerged: resident, clinical, educational, personal, technical, and administrative. Attendings described resident and clinical factors as facilitating "backstage" supervision via remote EHR use. In our study to assess attending remote EHR use for resident supervision, attendings reported frequent remote use with resulting supervisory actions, describing a previously uncharacterized form of "backstage" oversight supervision. Future work should explore best practices in remote EHR use to provide effective supervision and ultimately improve patient safety.

  19. A study of 2014 record drought in India with CFSv2 model: role of water vapor transport

    KAUST Repository

    Ramakrishna, S. S. V. S.

    2016-09-16

    The Indian summer monsoon season of 2014 was erratic and ended up with a seasonal rainfall deficit of 12 % and a record drought in June. In this study we analyze the moisture transport characteristics for the monsoon season of 2014 using both NCEP FNL reanalysis (FNL) and CFSv2 (CFS) model data. In FNL, in June 2014 there was a large area of divergence of moisture flux. In other months also there was lesser flux. This probably is the cause of 2014 drought. The CFS model overestimated the drought and it reproduces poorly the observed rainfall over central India (65E–95E; 5N–35N). The correlation coefficient (CC) between the IMD observed rainfall and CFS model rainfall is only 0.1 while the CC between rainfall and moisture flux convergence in CFS model is only 0.20 and with FNL data −0.78. This clearly shows that the CFS model has serious difficulty in reproducing the moisture flux convergence and rainfall. We found that the rainfall variations are strongly related to the moisture convergence or divergence. The hypothesis of Krishnamurti et al. (J Atmos Sci 67:3423–3441, 2010) namely the intrusion of west African desert air and the associated low convective available potential energy inhibiting convection and rainfall shows some promise to explain dry spells in Indian summer monsoon. However, the rainfall or lack of it is mainly explained by convergence or divergence of moisture flux. © 2016 Springer-Verlag Berlin Heidelberg

  20. [Study on the Effects and Compensation Effect of Recording Parameters Error on Imaging Performance of Holographic Grating in On-Line Spectral Diagnose].

    Science.gov (United States)

    Jiang, Yan-xiu; Bayanheshig; Yang, Shuo; Zhao, Xu-long; Wu, Na; Li, Wen-hao

    2016-03-01

    To making the high resolution grating, a numerical calculation was used to analyze the effect of recording parameters on groove density, focal curve and imaging performance of the grating and their compensation. Based on Fermat' s principle, light path function and aberration, the effect on imaging performance of the grating was analyzed. In the case of fixed using parameters, the error of the recording angle has a greater influence on imaging performance, therefore the gain of the weight of recording angle can improve the accuracy of the recording angle values in the optimization; recording distance has little influence on imaging performance; the relative errors of recording parameters cause the change of imaging performance of the grating; the results indicate that recording parameter errors can be compensated by adjusting its corresponding parameter. The study can give theoretical guidance to the fabrication for high resolution varied-line-space plane holographic grating in on-line spectral diagnostic and reduce the alignment difficulty by analyze the main error effect the imaging performance and propose the compensation method.

  1. An exploratory study of the personal health records adoption model in the older adult with chronic illness

    Directory of Open Access Journals (Sweden)

    Melanie D Logue

    2013-05-01

    Full Text Available Background Despite international efforts moving toward integrated care using health information technologies and the potential of electronic PHRs to help us better coordinate patient-centered care, PHR adoption in the United States remains low among patients who have been offered free access to them from private-sector companies. If older adult stand to benefit from the use of PHRs for its usefulness in self-managing chronic illness, why have they not been more readily adopted? Since the chronically ill older adult has unique circumstances that impact their decision to participate in self-directed care, a theoretical framework to help understand factors that influence the adoption of PHRs is important. Here we describe the results of an exploratory study that provided an initial test of such a framework.Methods The study used a descriptive survey methodology with 38 older adults. The survey questionnaire asked about the personal barriers and facilitators associated with personal health record adoption and included items measuring each of the PHRAM’s four interacting factors (environmental factors, personal factors, technology factors, and self-management, and the resulting behavioural outcome.Results Younger seniors had a more positive attitude toward computers, knew what health resources were available on the internet, agreed that they had the resources in place to use PHRs, and would be more influenced by a family member than a healthcare provider to use them. Conversely, older seniors reported less confidence in their ability to use Internet-based PHRs and did not perceive that they had the resources in place to use them.Conclusions The results of this study indicated that personal, environmental, technology, chronic illness, and behavioral factors operated concurrently as personal barriers and/or facilitators to the adoption of PHRs among the older adult with chronic illness. These factors cannot be isolated because the person commonly

  2. The environmental correlates of overall and neighborhood based recreational walking (a cross-sectional analysis of the RECORD Study).

    Science.gov (United States)

    Chaix, Basile; Simon, Chantal; Charreire, Hélène; Thomas, Frédérique; Kestens, Yan; Karusisi, Noëlla; Vallée, Julie; Oppert, Jean-Michel; Weber, Christiane; Pannier, Bruno

    2014-02-21

    Preliminary evidence suggests that recreational walking has different environmental determinants than utilitarian walking. However, previous studies are limited in their assessment of environmental exposures and recreational walking and in the applied modeling strategies. Accounting for individual sociodemographic profiles and weather over the walking assessment period, the study examined whether numerous street network-based neighborhood characteristics related to the sociodemographic, physical, service, social-interactional, and symbolic environments were associated with overall recreational walking and recreational walking in one's residential neighborhood and could explain their spatial distribution. Based on the RECORD Cohort Study (Paris region, France, n=7105, 2007-2008 data), multilevel-spatial regression analyses were conducted to investigate environmental factors associated with recreational walking (evaluated by questionnaire at baseline). A risk score approach was applied to quantify the overall disparities in recreational walking that were predicted by the environmental determinants. Sixty-nine percent of the participants reported recreational walking over the past 7 days. Their mean reported recreational walking time was 3h 31mn. After individual-level adjustment, a higher neighborhood education, a higher density of destinations, green and open spaces of quality, and the absence of exposure to air traffic were associated with higher odds of recreational walking and/or a higher recreational walking time in one's residential neighborhood. As the overall disparities that were predicted by these environmental factors, the odds of reporting recreational walking and the odds of a higher recreational walking time in one's neighborhood were, respectively, 1.59 [95% confidence interval (CI): 1.56, 1.62] times and 1.81 (95% CI: 1.73, 1.87) times higher in the most vs. the least supportive environments (based on the quartiles). Providing green/open spaces of

  3. A feasibility study of multi-site,intracellular recordings from mammalian neurons by extracellular gold mushroom-shaped microelectrodes.

    Science.gov (United States)

    Ojovan, Silviya M; Rabieh, Noha; Shmoel, Nava; Erez, Hadas; Maydan, Eilon; Cohen, Ariel; Spira, Micha E

    2015-09-14

    The development of multi-electrode array platforms for large scale recording of neurons is at the forefront of neuro-engineering research efforts. Recently we demonstrated, at the proof-of-concept level, a breakthrough neuron-microelectrode interface in which cultured Aplysia neurons tightly engulf gold mushroom-shaped microelectrodes (gMμEs). While maintaining their extracellular position, the gMμEs record synaptic- and action-potentials with characteristic features of intracellular recordings. Here we examined the feasibility of using gMμEs for intracellular recordings from mammalian neurons. To that end we experimentally examined the innate size limits of cultured rat hippocampal neurons to engulf gMμEs and measured the width of the "extracellular" cleft formed between the neurons and the gold surface. Using the experimental results we next analyzed the expected range of gMμEs-neuron electrical coupling coefficients. We estimated that sufficient electrical coupling levels to record attenuated synaptic- and action-potentials can be reached using the gMμE-neuron configuration. The definition of the engulfment limits of the gMμEs caps diameter at ≤2-2.5 μm and the estimated electrical coupling coefficients from the simulations pave the way for rational development and application of the gMμE based concept for in-cell recordings from mammalian neurons.

  4. Record Club

    CERN Document Server

    Record Club

    2012-01-01

      March  Selections By the time this appears, we will have added a number of new CDs and DVDs into the Club. You will find the full lists at http://cern.ch/record.club; select the "Discs of the Month" button on the left panel of the web page and then Mar 2012. New films include recent releases such as Johnny English 2, Bad Teacher, Cowboys vs Aliens, and Super 8. We are also starting to acquire some of the classic films we missed when we initiated the DVD section of the club, such as appeared in a recent Best 100 Films published by a leading UK magazine; this month we have added Spielberg’s Jaws and Scorsese’s Goodfellas. If you have your own ideas on what we are missing, let us know. For children we have no less than 8 Tin-Tin DVDs. And if you like fast moving pop music, try the Beyonce concert DVD. New CDs include the latest releases from Paul McCartney, Rihanna and Amy Winehouse. There is a best of Mylene Farmer, a compilation from the NRJ 201...

  5. Environmental conditions around itineraries to destinations as correlates of walking for transportation among adults: the RECORD cohort study.

    Directory of Open Access Journals (Sweden)

    Noëlla Karusisi

    Full Text Available INTRODUCTION: Assessing the contextual factors that influence walking for transportation is important to develop more walkable environments and promote physical activity. To advance previous research focused on residential environments and overall walking for transportation, the present study investigates objective environmental factors assessed around the residence, the workplace, the home--work itinerary, and the home--supermarket itinerary, and considered overall walking for transportation but also walking to work and to shops. METHODS: Data from the RECORD Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Multilevel ordinal regression analyses were conducted to investigate environmental characteristics associated with self-reported overall walking for transportation, walking to work, and walking to shops. RESULTS: High individual education was associated with overall walking for transportation, with walking to work, and walking to shops. Among workers, a high residential neighborhood education was associated with increased overall walking for transportation, while a high workplace neighborhood education was related to an increased time spent walking to work. The residential density of destinations was positively associated with overall walking for transportation, with walking to work, and with walking to shops, while the workplace density of destinations was positively associated with overall walking for transportation among workers. Environmental factors assessed around the itineraries were not associated with walking to work or to the shops. CONCLUSION: This research improves our understanding of the role of the environments on walking for transportation by accounting for some of the environments visited beyond the residential neighborhood. It shows that workers' walking habits are more influenced by the density of destinations around the workplace than

  6. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

    Directory of Open Access Journals (Sweden)

    Mia Tyrstrup

    2016-11-01

    Full Text Available Abstract Background Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines. Methods A descriptive study of Sweden’s largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS, for the years 2008, 2010 and 2013. Results Although the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032. The antibiotic prescribing rate for respiratory tract infections (RTIs decreased from 40.5% in 2008 to 24.9% in 2013 while those for urinary tract infections and skin and soft tissue infections were unchanged. For most RTI diagnoses there was a decrease in prescription rate from 2008 to 2013, particularly for the age group 0–6 years. Phenoxymethylpenicillin (PcV was the antibiotic most often prescribed, followed by tetracycline. Tonsillitis and acute otitis media were the two RTI diagnoses with the highest number of prescriptions per 1000 patient years (PY. For these diagnoses an increase in adherence to national guidelines was seen, with regards to treatment frequency, choice of antibiotics and use of rapid antigen detection test. The frequency in antibiotic prescribing varied greatly between different Primary Healthcare Centres (PHCCs. Conclusion Falling numbers of consultations and decreased antibiotic prescription rates for RTIs have reduced the antibiotic use in Swedish primary care substantially. Overprescribing of antibiotics could still be suspected due to large variability

  7. Using a data entry clerk to improve data quality in primary care electronic medical records: a pilot study.

    Science.gov (United States)

    Greiver, Michelle; Barnsley, Jan; Aliarzadeh, Babak; Krueger, Paul; Moineddin, Rahim; Butt, Debra A; Dolabchian, Edita; Jaakkimainen, Liisa; Keshavjee, Karim; White, David; Kaplan, David

    2011-01-01

    The quality of electronic medical record (EMR) data is known to be problematic; research on improving these data is needed. The primary objective was to explore the impact of using a data entry clerk to improve data quality in primary care EMRs. The secondary objective was to evaluate the feasibility of implementing this intervention. We used a before and after design for this pilot study. The participants were 13 community based family physicians and four allied health professionals in Toronto, Canada. Using queries programmed by a data manager, a data clerk was tasked with re-entering EMR information as coded or structured data for chronic obstructive pulmonary disease (COPD), smoking, specialist designations and interprofessional encounter headers. We measured data quality before and three to six months after the intervention. We evaluated feasibility by measuring acceptability to clinicians and workload for the clerk. After the intervention, coded COPD entries increased by 38% (P = 0.0001, 95% CI 23 to 51%); identifiable data on smoking categories increased by 27% (P = 0.0001, 95% CI 26 to 29%); referrals with specialist designations increased by 20% (P = 0.0001, 95% CI 16 to 22%); and identifiable interprofessional headers increased by 10% (P = 0.45, 95 CI -3 to 23%). Overall, the intervention was rated as being at least moderately useful and moderately usable. The data entry clerk spent 127 hours restructuring data for 11 729 patients. Utilising a data manager for queries and a data clerk to re-enter data led to improvements in EMR data quality. Clinicians found this approach to be acceptable.

  8. Costs and Outcomes of Increasing Access to Bariatric Surgery: Cohort Study and Cost-Effectiveness Analysis Using Electronic Health Records.

    Science.gov (United States)

    Gulliford, Martin C; Charlton, Judith; Prevost, Toby; Booth, Helen; Fildes, Alison; Ashworth, Mark; Littlejohns, Peter; Reddy, Marcus; Khan, Omar; Rudisill, Caroline

    2017-01-01

    To estimate costs and outcomes of increasing access to bariatric surgery in obese adults and in population subgroups of age, sex, deprivation, comorbidity, and obesity category. A cohort study was conducted using primary care electronic health records, with linked hospital utilization data, for 3,045 participants who underwent bariatric surgery and 247,537 participants who did not undergo bariatric surgery. Epidemiological analyses informed a probabilistic Markov model to compare bariatric surgery, including equal proportions with adjustable gastric banding, gastric bypass, and sleeve gastrectomy, with standard nonsurgical management of obesity. Outcomes were quality-adjusted life-years (QALYs) and net monetary benefits at a threshold of £30,000 per QALY. In a UK population of 250,000 adults, there may be 7,163 people with morbid obesity including 1,406 with diabetes. The immediate cost of 1,000 bariatric surgical procedures is £9.16 million, with incremental discounted lifetime health care costs of £15.26 million (95% confidence interval £15.18-£15.36 million). Patient-years with diabetes mellitus will decrease by 8,320 (range 8,123-8,502). Incremental QALYs will increase by 2,142 (range 2,032-2,256). The estimated cost per QALY gained is £7,129 (range £6,775-£7,506). Net monetary benefits will be £49.02 million (range £45.72-£52.41 million). Estimates are similar for subgroups of age, sex, and deprivation. Bariatric surgery remains cost-effective if the procedure is twice as costly, or if intervention effect declines over time. Diverse obese individuals may benefit from bariatric surgery at acceptable cost. Bariatric surgery is not cost-saving, but increased health care costs are exceeded by health benefits to obese individuals. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Using aggregated, de-identified electronic health record data for multivariate pharmacosurveillance: a case study of azathioprine.

    Science.gov (United States)

    Patel, Vishal N; Kaelber, David C

    2014-12-01

    To demonstrate the use of aggregated and de-identified electronic health record (EHR) data for multivariate post-marketing pharmacosurveillance in a case study of azathioprine (AZA). Using aggregated, standardized, normalized, and de-identified, population-level data from the Explore platform (Explorys, Inc.) we searched over 10 million individuals, of which 14,580 were prescribed AZA based on RxNorm drug orders. Based on logical observation identifiers names and codes (LOINC) and vital sign data, we examined the following side effects: anemia, cell lysis, fever, hepatotoxicity, hypertension, nephrotoxicity, neutropenia, and neutrophilia. Patients prescribed AZA were compared to patients prescribed one of 11 other anti-rheumatologic drugs to determine the relative risk of side effect pairs. Compared to AZA case report trends, hepatotoxicity (marked by elevated transaminases or elevated bilirubin) did not occur as an isolated event more frequently in patients prescribed AZA than other anti-rheumatic agents. While neutropenia occurred in 24% of patients (RR 1.15, 95% CI 1.07-1.23), neutrophilia was also frequent (45%) and increased in patients prescribed AZA (RR 1.28, 95% CI 1.22-1.34). After constructing a pairwise side effect network, neutropenia had no dependencies. A reduced risk of neutropenia was found in patients with co-existing elevations in total bilirubin or liver transaminases, supporting classic clinical knowledge that agranulocytosis is a largely unpredictable phenomenon. Rounding errors propagated in the statistically de-identified datasets for cohorts as small as 40 patients only contributed marginally to the calculated risk. Our work demonstrates that aggregated, standardized, normalized and de-identified population level EHR data can provide both sufficient insight and statistical power to detect potential patterns of medication side effect associations, serving as a multivariate and generalizable approach to post-marketing drug surveillance

  10. Young adults on the perceived benefits and expected use of personal health records: a qualitative descriptive study.

    Science.gov (United States)

    Nguyen, Quynh; Bartlett, Gillian; Rodriguez, Charo; Tellier, Pierre-Paul

    2016-04-18

    Personal health records (PHRs) are tools that allow individuals to access, share and manage their health information online. Despite apparent interest, adoption rates remain low. There is a gap in our understanding as to what different populations of users, in particular young adults, might want from such a tool. To describe and interpret the views and expectations of young healthy adults about using an online PHR. A qualitative descriptive study was carried out. Four focus groups were conducted with a total of 29 participants (18-34 years old) from a community setting in Montreal, Canada. Interviews were transcribed and analyzed with inductivethematic analysis. With respect to how young adults viewed PHRs, three broad themes were identified: perceived advantages to using a PHR, future PHR users and concerns about PHRs. Three other overarching themes emerged from data analysis in terms of what participants expected from using a PHR: the use of the PHR for preventative health, PHR support to take more control over their health and strategies to make the PHR worthwhile. A conceptual framework of factors influencing expectations of PHR use in this population is proposed. While young adults view the PHR as beneficial, this is not enough for them to be motivated to actually use a PHR. To foster use, the PHRs need to be perceived as a health prevention tool that helps users to increase control over theirhealth status. More research is needed to understand the expectations and anticipated use of different populations in designing a person-centered tool;the proposedframework provides theoretical basis in this regard.

  11. Exposure of children with developmental delay to social determinants of poor health: cross-sectional case record review study.

    Science.gov (United States)

    Emerson, E; Brigham, P

    2015-03-01

    Research on child development in general has highlighted the importance that the family environment plays in mediating the pathway between exposure to low socio-economic position (SEP) and child well-being. While child developmental models in intellectual disability have highlighted the interplay between social context, family environment and child development, little empirical work has attempted to formally evaluate the evidence in support of specific mediating pathways between low SEP and child outcomes. Secondary analysis of cross-sectional confidentialized needs analysis data collected in three Primary Care Trusts in England covering a total population of 1.25 million people. Case record reviews were undertaken for 46 023 households, 2236 (4.9%) of which contained a child in the target age range with developmental delay. Children with developmental delay, when compared with their non-disabled peers, were at significantly increased risk of poorer health outcomes and of being exposed to a wide range of social determinants of poor health. Controlling for between-group differences in exposure to social determinants of poor health reduced the risk of developmental delay being associated with poorer health outcomes by 45% for behaviour problems and 89% for risk of significant harm. For children with developmental delay, parenting difficulties appears to play a particularly significant role in partially mediating the effects of low SEP. The findings of the present study point to the potential effectiveness of family-focused early intervention to prevent the emergence and escalation of behavioural difficulties and health problems in children with developmental delay. © 2014 John Wiley & Sons Ltd.

  12. Reducing Misses and Near Misses Related to Multitasking on the Electronic Health Record: Observational Study and Qualitative Analysis.

    Science.gov (United States)

    Ratanawongsa, Neda; Matta, George Y; Bohsali, Fuad B; Chisolm, Margaret S

    2018-02-06

    Clinicians' use of electronic health record (EHR) systems while multitasking may increase the risk of making errors, but silent EHR system use may lower patient satisfaction. Delaying EHR system use until after patient visits may increase clinicians' EHR workload, stress, and burnout. We aimed to describe the perspectives of clinicians, educators, administrators, and researchers about misses and near misses that they felt were related to clinician multitasking while using EHR systems. This observational study was a thematic analysis of perspectives elicited from 63 continuing medical education (CME) participants during 2 workshops and 1 interactive lecture about challenges and strategies for relationship-centered communication during clinician EHR system use. The workshop elicited reflection about memorable times when multitasking EHR use was associated with "misses" (errors that were not caught at the time) or "near misses" (mistakes that were caught before leading to errors). We conducted qualitative analysis using an editing analysis style to identify codes and then select representative themes and quotes. All workshop participants shared stories of misses or near misses in EHR system ordering and documentation or patient-clinician communication, wondering about "misses we don't even know about." Risk factors included the computer's position, EHR system usability, note content and style, information overload, problematic workflows, systems issues, and provider and patient communication behaviors and expectations. Strategies to reduce multitasking EHR system misses included clinician transparency when needing silent EHR system use (eg, for prescribing), narrating EHR system use, patient activation during EHR system use, adapting visit organization and workflow, improving EHR system design, and improving team support and systems. CME participants shared numerous stories of errors and near misses in EHR tasks and communication that they felt related to EHR

  13. Teamwork and Electronic Health Record Implementation: A Case Study of Preserving Effective Communication and Mutual Trust in a Changing Environment.

    Science.gov (United States)

    Gross, Anne H; Leib, Ryan K; Tonachel, Anne; Tonachel, Richard; Bowers, Danielle M; Burnard, Rachel A; Rhinehart, Catherine A; Valentim, Rahila; Bunnell, Craig A

    2016-11-01

    This article describes how trust among team members and in the technology supporting them was eroded during implementation of an electronic health record (EHR) in an adult outpatient oncology practice at a comprehensive cancer center. Delays in care of a 38-year-old woman with high-risk breast cancer occurred because of ineffective team communication and are illustrated in a case study. The case explores how the patient's trust and mutual trust between team members were disrupted because of inaccurate assumptions about the functionality of the EHR's communication tool, resultant miscommunications between team members and the patient, and the eventual recognition that care was not being effectively coordinated, as it had been previously. Despite a well-established, team-based culture and significant preparation for the EHR implementation, the challenges that occurred point to underlying human and system failures from which other organizations going through a similar process may learn. Through an analysis and evaluation of events that transpired before and during the EHR rollout, suggested interventions for preventing this experience are offered, which include: a thorough crosswalk between old and new communication mechanisms before implementation; understanding and mitigation of gaps in the communication tool's functionality; more robust training for staff, clinicians, and patients; greater consideration given to the pace of change expected of individuals; and development of models of collaboration between EHR users and vendors in developing products that support high-quality, team-based care in the oncology setting. These interventions are transferable to any organizational or system change that threatens mutual trust and effective communication.

  14. Intra-rater and inter-rater reliability of a medical record abstraction study on transition of care after childhood cancer.

    Directory of Open Access Journals (Sweden)

    Micòl E Gianinazzi

    Full Text Available The abstraction of data from medical records is a widespread practice in epidemiological research. However, studies using this means of data collection rarely report reliability. Within the Transition after Childhood Cancer Study (TaCC which is based on a medical record abstraction, we conducted a second independent abstraction of data with the aim to assess a intra-rater reliability of one rater at two time points; b the possible learning effects between these two time points compared to a gold-standard; and c inter-rater reliability.Within the TaCC study we conducted a systematic medical record abstraction in the 9 Swiss clinics with pediatric oncology wards. In a second phase we selected a subsample of medical records in 3 clinics to conduct a second independent abstraction. We then assessed intra-rater reliability at two time points, the learning effect over time (comparing each rater at two time-points with a gold-standard and the inter-rater reliability of a selected number of variables. We calculated percentage agreement and Cohen's kappa.For the assessment of the intra-rater reliability we included 154 records (80 for rater 1; 74 for rater 2. For the inter-rater reliability we could include 70 records. Intra-rater reliability was substantial to excellent (Cohen's kappa 0-6-0.8 with an observed percentage agreement of 75%-95%. In all variables learning effects were observed. Inter-rater reliability was substantial to excellent (Cohen's kappa 0.70-0.83 with high agreement ranging from 86% to 100%.Our study showed that data abstracted from medical records are reliable. Investigating intra-rater and inter-rater reliability can give confidence to draw conclusions from the abstracted data and increase data quality by minimizing systematic errors.

  15. Effect of recent climate change on Arctic Pb pollution: A comparative study of historical records in lake and peat sediments

    International Nuclear Information System (INIS)

    Liu Xiaodong; Jiang Shan; Zhang Pengfei; Xu Liqiang

    2012-01-01

    Historical changes of anthropogenic Pb pollution were reconstructed based on Pb concentrations and isotope ratios in lake and peat sediment profiles from Ny-Ålesund of Arctic. The calculated excess Pb isotope ratios showed that Pb pollution largely came from west Europe and Russia. The peat profile clearly reflected the historical changes of atmospheric deposition of anthropogenic Pb into Ny-Ålesund, and the result showed that anthropogenic Pb peaked at 1960s–1970s, and thereafter a significant recovery was observed by a rapid increase of 206 Pb/ 207 Pb ratios and a remarkable decrease in anthropogenic Pb contents. In contrast to the peat record, the longer lake record showed relatively high anthropogenic Pb contents and a persistent decrease of 206 Pb/ 207 Pb ratios within the uppermost samples, suggesting that climate-sensitive processes such as catchment erosion and meltwater runoff might have influenced the recent change of Pb pollution record in the High Arctic lake sediments. - Highlights: ► Historical changes of anthropogenic Pb pollution in Ny-Ålesund were reconstructed. ► Anthropogenic Pb in Ny-Ålesund was largely originated from W. European and Russia. ► Anthropogenic Pb recorded in peat sediments peaked at 1960–1970s and then declined. ► High anthropogenic fluxes were found in recent change of Pb record from lake sediments. ► Climate-sensitive processes might have influenced recent Pb accumulation rate in lakes. - This manuscript reports the effects of climate-sensitive processes on historical records of Pb pollution in sediments of Arctic lakes.

  16. Incidence of Traumatic Brain Injury Across the Full Disease Spectrum: A Population-Based Medical Record Review Study

    Science.gov (United States)

    Leibson, Cynthia L.; Brown, Allen W.; Ransom, Jeanine E.; Diehl, Nancy N.; Perkins, Patricia K.; Mandrekar, Jay; Malec, James F.

    2012-01-01

    Background Extremely few objective estimates of traumatic brain injury incidence include all ages, both sexes, all injury mechanisms, and the full spectrum from very mild to fatal events. Methods We used unique Rochester Epidemiology Project medical records-linkage resources, including highly sensitive and specific diagnostic coding, to identify all Olmsted County, MN, residents with diagnoses suggestive of traumatic brain injury regardless of age, setting, insurance, or injury mechanism. Provider-linked medical records for a 16% random sample were reviewed for confirmation as definite, probable, possible (symptomatic), or no traumatic brain injury. We estimated incidence per 100,000 person-years for 1987–2000 and compared these record-review rates with rates obtained using Centers for Disease Control and Prevention (CDC) data-systems approach. For the latter, we identified all Olmsted County residents with any CDC-specified diagnosis codes recorded on hospital/emergency department administrative claims or death certificates 1987–2000. Results Of sampled individuals, 1257 met record-review criteria for incident traumatic brain injury; 56% were ages 16–64 years, 56% were male, 53% were symptomatic. Mechanism, sex, and diagnostic certainty differed by age. The incidence rate per 100,000 person-years was 558 (95% confidence interval = 528–590) versus 341 (331–350) using the CDC data system approach. The CDC approach captured only 40% of record-review cases. Seventy-four percent of missing cases presented to hospital/emergency department; none had CDC-specified codes assigned on hospital/emergency department administrative claims or death certificates; 66% were symptomatic. Conclusions Capture of symptomatic traumatic brain injuries requires a wider range of diagnosis codes, plus sampling strategies to avoid high rates of false-positive events. PMID:21968774

  17. Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England.

    Science.gov (United States)

    Takian, Amirhossein; Sheikh, Aziz; Barber, Nicholas

    2014-09-01

    To explore the role of organizational learning in enabling implementation and supporting adoption of electronic health record systems into two English hospitals. In the course of conducting our prospective and sociotechnical evaluation of the implementation and adoption of electronic health record into 12 "early adopter" hospitals across England, we identified two hospitals implementing virtually identical versions of the same "off-the-shelf" software (Millennium) within a comparable timeframe. We undertook a longitudinal qualitative case study-based analysis of these two hospitals (referred to hereafter as Alpha and Omega) and their implementation experiences. Data included the following: 63 in-depth interviews with various groups of internal and external stakeholders; 41-h on-site observation; and content analysis of 218 documents of various types. Analysis was both inductive and deductive, the latter being informed by the "sociotechnical changing" theoretical perspective. Although Alpha and Omega shared a number of contextual similarities, our evaluation revealed fundamental differences in visions of electronic health record and the implementation strategy between the hospitals, which resulted in distinct local consequences of electronic health record implementation and impacted adoption. Both hospitals did not, during our evaluation, see the hoped-for benefits to the organization as a result of the introduction of electronic health record, such as speeding-up tasks. Nonetheless, the Millennium software worked out to be easier to use at Omega. Interorganizational learning was at the heart of this difference. Despite the turbulent overall national "roll out" of electronic health record systems into the English hospitals, considerable opportunities for organizational learning were offered by sequential delivery of the electronic health record software into "early adopter" hospitals. We argue that understanding the process of organizational learning and its

  18. Provincial prenatal record revision: a multiple case study of evidence-based decision-making at the population-policy level

    Directory of Open Access Journals (Sweden)

    Olson Joanne

    2008-12-01

    Full Text Available Abstract Background There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Methods Guided by Dobrow et al.'s (2004 conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review

  19. Probabilistic record linkage.

    Science.gov (United States)

    Sayers, Adrian; Ben-Shlomo, Yoav; Blom, Ashley W; Steele, Fiona

    2016-06-01

    Studies involving the use of probabilistic record linkage are becoming increasingly common. However, the methods underpinning probabilistic record linkage are not widely taught or understood, and therefore these studies can appear to be a 'black box' research tool. In this article, we aim to describe the process of probabilistic record linkage through a simple exemplar. We first introduce the concept of deterministic linkage and contrast this with probabilistic linkage. We illustrate each step of the process using a simple exemplar and describe the data structure required to perform a probabilistic linkage. We describe the process of calculating and interpreting matched weights and how to convert matched weights into posterior probabilities of a match using Bayes theorem. We conclude this article with a brief discussion of some of the computational demands of record linkage, how you might assess the quality of your linkage algorithm, and how epidemiologists can maximize the value of their record-linked research using robust record linkage methods. © The Author 2015; Published by Oxford University Press on behalf of the International Epidemiological Association.

  20. Characteristics and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in Western Tanzania : a retrospective medical record study

    NARCIS (Netherlands)

    Mooij, Rob; Lugumila, Joseph; Mwashambwa, Masumbuko Y.; Mwampagatwa, Ipyana H.; van Dillen, Jeroen; Stekelenburg, Jelle

    2015-01-01

    Background: Eclampsia and pre-eclampsia are well-recognized causes of maternal and neonatal mortality in low income countries, but are never studied in a district hospital. In order to get reliable data to facilitate the hospital's obstetric audit a retrospective medical record study was performed

  1. An electronic health records cohort study on heart failure following myocardial infarction in England : Incidence and predictors

    NARCIS (Netherlands)

    Gho, Johannes M.I.H.; Schmidt, Amand F.; Pasea, Laura; Koudstaal, Stefan; Pujades-Rodriguez, Mar; Denaxas, Spiros; Shah, Anoop D.; Patel, Riyaz S.; Gale, Chris P.; Hoes, Arno W.; Cleland, John G.; Hemingway, Harry; Asselbergs, Folkert W.

    2018-01-01

    Objectives: To investigate the incidence and determinants of heart failure (HF) following a myocardial infarction (MI) in a contemporary cohort of patients with MI using routinely collected primary and hospital care electronic health records (EHRs). Methods: Data were used from the CALIBER

  2. A Study of the Intent to Fully Utilize Electronic Personal Health Records in the Context of Privacy and Trust

    Science.gov (United States)

    Richards, Rhonda J.

    2012-01-01

    Government initiatives called for electronic health records for each individual healthcare consumer by 2014. The purpose of the initiatives is to provide for the common exchange of clinical information between healthcare consumers, healthcare providers, third-party payers and public healthcare officials. This exchange of healthcare information…

  3. Prediction of cardiac death : an epidemiological study on the prognostic significance of 24-hour ECG-recording

    NARCIS (Netherlands)

    J.P. Velema (Johan)

    1982-01-01

    textabstractSince the introduction of the string galvanometer by Einthoven (1901), various instruments have been developed (a technical review is given by Dunn & Rahm, 1950) to record the so-called electrocardiogram (ECG). Physical activity, changes in position and certain bodily functions such as

  4. Using Digital Acoustic Recording Tags to Detect Marine Mammals on Navy Ranges and Study their Responses to Naval Sonar

    Science.gov (United States)

    2011-02-01

    densirostris) off the coast of El Hierro in the Canary Islands. A tag was deployed with relative ease on an adult beaked whale which proceeded to carry it for...located off-shore of El Hierro by chance. On examination, we found that water ingress had again caused failure of the recording circuit early in the

  5. Short-term association between personal exposure to noise and heart rate variability: The RECORD MultiSensor Study.

    Science.gov (United States)

    El Aarbaoui, Tarik; Méline, Julie; Brondeel, Ruben; Chaix, Basile

    2017-12-01

    Studies revealed long-term associations between noise exposure and cardiovascular health, but the underlying short-term mechanisms remain uncertain. To explore the concomitant and lagged short-term associations between personal exposure to noise and heart rate variability (HRV) in a real life setting in the Île-de-France region. The RECORD MultiSensor Study collected between July 2014 and June 2015 noise and heart rate data for 75 participants, aged 34-74 years, in their living environments for 7 days using a personal dosimeter and electrocardiography (ECG) sensor on the chest. HRV parameters and noise levels were calculated for 5-min windows. Short-term relationships between noise level and log-transformed HRV parameters were assessed using mixed effects models with a random intercept for participants and a temporal autocorrelation structure, adjusted for heart rate, physical activity (accelerometry), and short-term trends. An increase by one dB(A) of A-weighted equivalent sound pressure level (Leq) was associated with a 0.97% concomitant increase of the Standard deviation of normal to normal intervals (SDNN) (95% CI: 0.92, 1.02), of 2.08% of the Low frequency band power (LF) (95% CI: 1.97, 2.18), of 1.30% of the High frequency band power (HF) (95% CI: 1.17, 1.43), and of 1.16% of the LF/HF ratio (95% CI: 1.10, 1.23). The analysis of lagged exposures to noise adjusted for the concomitant exposure illustrates the dynamic of recovery of the autonomic nervous system. Non-linear associations were documented with all HRV parameters with the exception of HF. Piecewise regression revealed that the association was almost 6 times stronger below than above 65 Leq dB(A) for the SDNN and LF/HF ratio. Personal noise exposure was found to be related to a concomitant increase of the overall HRV, with evidence of imbalance of the autonomic nervous system towards sympathetic activity, a pathway to increased cardiovascular morbidity and mortality. Copyright © 2017 Elsevier Ltd

  6. Use of electronic personal health record systems to encourage HIV screening: an exploratory study of patient and provider perspectives

    Directory of Open Access Journals (Sweden)

    McInnes D Keith

    2011-08-01

    Full Text Available Abstract Background When detected, HIV can be effectively treated with antiretroviral therapy. Nevertheless in the U.S. approximately 25% of those who are HIV-infected do not know it. Much remains unknown about how to increase HIV testing rates. New Internet outreach methods have the potential to increase disease awareness and screening among patients, especially as electronic personal health records (PHRs become more widely available. In the US Department of Veterans' Affairs medical care system, 900,000 veterans have indicated an interest in receiving electronic health-related communications through the PHR. Therefore we sought to evaluate the optimal circumstances and conditions for outreach about HIV screening. In an exploratory, qualitative research study we examined patient and provider perceptions of Internet-based outreach to increase HIV screening among veterans who use the Veterans Health Administration (VHA health care system. Findings We conducted two rounds of focus groups with veterans and healthcare providers at VHA medical centers. The study's first phase elicited general perceptions of an electronic outreach program to increase screening for HIV, diabetes, and high cholesterol. Using phase 1 results, outreach message texts were drafted and then presented to participants in the second phase. Analysis followed modified grounded theory. Patients and providers indicated that electronic outreach through a PHR would provide useful information and would motivate patients to be screened for HIV. Patients believed that electronic information would be more convenient and understandable than information provided verbally. Patients saw little difference between messages about HIV versus about diabetes and cholesterol. Providers, however, felt patients would disapprove of HIV-related messages due to stigma. Providers expected increased workload from the electronic outreach, and thus suggested adding primary care resources and devising

  7. Birth weight and risk of paediatric Hodgkin lymphoma: Findings from a population-based record linkage study in California.

    Science.gov (United States)

    Triebwasser, Corey; Wang, Rong; DeWan, Andrew T; Metayer, Catherine; Morimoto, Libby; Wiemels, Joseph L; Kadan-Lottick, Nina; Ma, Xiaomei

    2016-12-01

    To evaluate the relationship between birth weight (along with a variety of pre and perinatal characteristics) and the risk of paediatric Hodgkin lymphoma (HL) diagnosed at age birth records from 1978-2009 and cancer diagnosis data from 1988-2011 to conduct a population-based case-control study with 1216 cases and 4485 controls (matched on birth month and year, sex, and race/ethnicity). Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) of paediatric HL overall and by age of diagnosis, controlling for other perinatal factors. Compared to children with a normal birth weight (2500-3999 g), those who had a high birth weight (≥4000 g) had an increased risk of paediatric HL overall (OR = 1.23, 95% CI: 1.02-1.48) after adjusting for birth order, maternal age at the time of delivery, and paternal age at the time of delivery. The magnitude of association appeared larger for subgroups of children whose age of diagnosis was 0-10 years (OR = 1.56, 95% CI: 1.04-2.24) or 15-19 years (OR = 1.43, 95% CI: 1.11-1.83), while no association was observed in 11-14 year olds. Compared with firstborn children, those who were third or higher in birth order had a reduced risk of paediatric HL overall (OR = 0.80, 95% CI: 0.67-0.95), and this association also varied by age of diagnosis. In this study with the largest number of paediatric HL cases, high birth weight was associated with an increased disease risk for most but not all ages of diagnosis. The different findings by age of diagnosis regarding both birth weight and birth order underscore the importance to stratify paediatric HL by age at diagnosis in future etiological investigations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Feasibility of studying brain morphology in major depressive disorder with structural magnetic resonance imaging and clinical data from the electronic medical record: A pilot study

    Science.gov (United States)

    Hoogenboom, Wouter S.; Perlis, Roy H.; Smoller, Jordan W.; Zeng-Treitler, Qing; Gainer, Vivian S.; Murphy, Shawn N.; Churchill, Susanne E.; Kohane, Isaac S.; Shenton, Martha E.; Iosifescu, Dan V.

    2012-01-01

    For certain research questions related to long-term outcomes or to rare disorders, designing prospective studies is impractical or prohibitively expensive. Such studies could instead utilize clinical and magnetic resonance imaging data (MRI) collected as part of routine clinical care, stored in the electronic medical record (EMR). Using major depressive disorder (MDD) as a disease model, we examined the feasibility of studying brain morphology and associations with remission using clinical and MRI data exclusively drawn from the EMR. Advanced automated tools were used to select MDD patients and controls from the EMR who had brain MRI data, but no diagnosed brain pathology. MDD patients were further assessed for remission status by review of clinical charts. Twenty MDD patients (eight full-remitters, six partial-remitters, and six non-remitters), and fifteen healthy control subjects met all study criteria for advanced morphometric analyses. Compared to controls, MDD patients had significantly smaller right rostral-anterior cingulate volume, and level of non-remission was associated with smaller left hippocampus and left rostral-middle frontal gyrus volume. The use of EMR data for psychiatric research may provide a timely and cost-effective approach with the potential to generate large study samples reflective of the real population with the illness studied. PMID:23149041

  9. Antimicrobial consumption on Austrian dairy farms: an observational study of udder disease treatments based on veterinary medication records.

    Science.gov (United States)

    Firth, Clair L; Käsbohrer, Annemarie; Schleicher, Corina; Fuchs, Klemens; Egger-Danner, Christa; Mayerhofer, Martin; Schobesberger, Hermann; Köfer, Josef; Obritzhauser, Walter

    2017-01-01

    Antimicrobial use in livestock production is an important contemporary issue, which is of public interest worldwide. Antimicrobials are not freely available to Austrian farmers and can only be administered to livestock by veterinarians, or by farmers who are trained members of the Animal Health Service. Since 2015, veterinarians have been required by law to report antimicrobials dispensed to farmers for use in food-producing animals. The study presented here went further than the statutory framework, and collected data on antimicrobials dispensed to farmers and those administered by veterinarians. Seventeen veterinary practices were enrolled in the study via convenience sampling. These veterinarians were asked to contact interested dairy farmers regarding participation in the study (respondent-driven sampling). Data were collected from veterinary practice software between 1st October 2015 and 30th September 2016. Electronic data (89.4%) were transferred via an online interface and paper records (10.6%) were entered by the authors. Antimicrobial treatments with respect to udder disease were analysed by number of defined daily doses per cow and year (nDDD vet /cow/year), based on the European Medicines Agency technical unit, Defined Daily Dose for animals (DDD vet ). Descriptive statistics and the Wilcoxon rank sum test were used to analyse the results. Antimicrobial use data from a total of 248 dairy farms were collected during the study, 232 of these farms treated cows with antibiotics; dry cow therapy was excluded from the current analysis. The mean number of DDD vet /cow/year for the antimicrobial treatment of all udder disease was 1.33 DDD vet /cow/year. Of these treatments, 0.73 DDD vet /cow/year were classed as highest priority critically important antimicrobials (HPCIAs), according to the World Health Organization (WHO) definition. The Wilcoxon rank sum test determined a statistically significant difference between the median number of DDD vet /cow/year for

  10. Antimicrobial consumption on Austrian dairy farms: an observational study of udder disease treatments based on veterinary medication records

    Directory of Open Access Journals (Sweden)

    Clair L. Firth

    2017-11-01

    Full Text Available Background Antimicrobial use in livestock production is an important contemporary issue, which is of public interest worldwide. Antimicrobials are not freely available to Austrian farmers and can only be administered to livestock by veterinarians, or by farmers who are trained members of the Animal Health Service. Since 2015, veterinarians have been required by law to report antimicrobials dispensed to farmers for use in food-producing animals. The study presented here went further than the statutory framework, and collected data on antimicrobials dispensed to farmers and those administered by veterinarians. Methods Seventeen veterinary practices were enrolled in the study via convenience sampling. These veterinarians were asked to contact interested dairy farmers regarding participation in the study (respondent-driven sampling. Data were collected from veterinary practice software between 1st October 2015 and 30th September 2016. Electronic data (89.4% were transferred via an online interface and paper records (10.6% were entered by the authors. Antimicrobial treatments with respect to udder disease were analysed by number of defined daily doses per cow and year (nDDDvet/cow/year, based on the European Medicines Agency technical unit, Defined Daily Dose for animals (DDDvet. Descriptive statistics and the Wilcoxon rank sum test were used to analyse the results. Results Antimicrobial use data from a total of 248 dairy farms were collected during the study, 232 of these farms treated cows with antibiotics; dry cow therapy was excluded from the current analysis. The mean number of DDDvet/cow/year for the antimicrobial treatment of all udder disease was 1.33 DDDvet/cow/year. Of these treatments, 0.73 DDDvet/cow/year were classed as highest priority critically important antimicrobials (HPCIAs, according to the World Health Organization (WHO definition. The Wilcoxon rank sum test determined a statistically significant difference between the median

  11. Taxation records as a source of information for the study of historical floods in South Moravia, Czech Republic

    Science.gov (United States)

    Brázdil, R.; Chromá, K.; Řezníčková, L.; Valášek, H.; Dolák, L.; Stachoň, Z.; Soukalová, E.; Dobrovolný, P.

    2014-07-01

    Since the second half of the 17th century, tax relief has been available to farmers and landowners to offset flood damage to property (buildings) and land (fields, meadows, pastures, gardens) in South Moravia, Czech Republic. Historically, the written applications for this were supported by a relatively efficient bureaucratic process that left a clear data trail of documentation, preserved at several levels: in the communities affected, in regional offices, and in the Moravian Land Office, all of which are to be found in estate and family collections in the Moravian Land Archives in the city of Brno, the provincial capital. As well as detailed information about damage done and administrative responses to it, data is often preserved as to the flood event itself, the time of its occurrence and its impacts, sometimes together with causes and stages. The final flood database based on taxation records is used here to describe the temporal and spatial density of both flood events and the records themselves. The information derived is used to help create long-term flood chronologies for the Rivers Dyje, Jihlava, Svratka and Morava, combining floods interpreted from taxation records with other documentary data and floods derived from later systematic hydrological measurements (water levels, discharges). Common periods of higher flood frequency appear largely in 1821-1850 and 1921-1950, although this shifts to several other decades for individual rivers. Certain uncertainties are inseparable from flood data taxation records: their spatial and temporal incompleteness; the inevitable limitation to larger-scale damage and to the summer half-year; and the different characters of rivers, including land-use changes and channel modifications. Taxation data has great potential for extending our knowledge of past floods for the rest of the Czech Republic as well, not to mention other European countries in which records have survived.

  12. Head-disk Interface Study for Heat Assisted Magnetic Recording (HAMR) and Plasmonic Nanolithography for Patterned Media

    Science.gov (United States)

    Xiong, Shaomin

    The magnetic storage areal density keeps increasing every year, and magnetic recording-based hard disk drives provide a very cheap and effective solution to the ever increasing demand for data storage. Heat assisted magnetic recording (HAMR) and bit patterned media have been proposed to increase the magnetic storage density beyond 1 Tb/in2. In HAMR systems, high magnetic anisotropy materials are recommended to break the superparamagnetic limit for further scaling down the size of magnetic bits. However, the current magnetic transducers are not able to generate strong enough field to switch the magnetic orientations of the high magnetic anisotropy material so the data writing is not able to be achieved. So thermal heating has to be applied to reduce the coercivity for the magnetic writing. To provide the heating, a laser is focused using a near field transducer (NFT) to locally heat a ~(25 nm)2 spot on the magnetic disk to the Curie temperature, which is ~ 400 C-600°C, to assist in the data writing process. But this high temperature working condition is a great challenge for the traditional head-disk interface (HDI). The disk lubricant can be depleted by evaporation or decomposition. The protective carbon overcoat can be graphitized or oxidized. The surface quality, such as its roughness, can be changed as well. The NFT structure is also vulnerable to degradation under the large number of thermal load cycles. The changes of the HDI under the thermal conditions could significantly reduce the robustness and reliability of the HAMR products. In bit patterned media systems, instead of using the continuous magnetic granular material, physically isolated magnetic islands are used to store data. The size of the magnetic islands should be about or less than 25 nm in order to achieve the storage areal density beyond 1 Tb/in2. However, the manufacture of the patterned media disks is a great challenge for the current optical lithography technology. Alternative lithography

  13. The Influence of Resettlement of the Capital of Probolinggo Regency Toward Service Quality of Police Record (SKCK (Study in Probolinggo Resort Police

    Directory of Open Access Journals (Sweden)

    Erlinda Puspitasari

    2014-02-01

    Full Text Available This study examined the influence of resettlement of the capital of Probolinggo Regency toward service quality of Police Record (SKCK in Probolinggo Resort Police. Probolinggo Resort Police (Polres is one government agencies that experiencing resettlement of the location from Probolinggo City to Kraksaan district. It is expected that by this resettlement, public service processes would become ‘better and in high quality’. The study used quantitative research method with explanatory approach to test the hypothesis that has been set. Dependent variable in this study are resettlement of the capital of regency (X with the variables: affordability, recoverability and replicability. While the dependent variable in this study are the service quality of Police Record (SKCK (Y with the indicators: tangibles, reliability, responsiveness, assurance and empathy. The study used multiple linear regression method of analysis. The study revealed that the resettlement of the capital of regency variable (X which consist of three variables such as affordability (X1, recoverability (X2 and replicability variable (X3 influence significantly toward service quality of the Police Record (SKCK in Probolinggo Resort Police (Polres. Keywords: The Resettlement, The Capital of Regency, Service Quality, Police Record (SKCK, Probolinggo Resort Police.

  14. 1993 Department of Energy Records Management Conference

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    This document consists of viewgraphs from the presentations at the conference. Topics included are: DOE records management overview, NIRMA and ARMA resources, NARA records management training, potential quality assurance records, filing systems, organizing and indexing technical records, DOE-HQ initiatives, IRM reviews, status of epidemiologic inventory, disposition of records and personal papers, inactive records storage, establishing administrative records, managing records at Hanford, electronic mail -- legal and records issues, NARA-GAO reports status, consultive selling, automated indexing, decentralized approach to scheduling at a DOE office, developing specific records management programs, storage and retrieval at Savannah River Plant, an optical disk case study, and special interest group reports.

  15. Effect of recent climate change on Arctic Pb pollution: a comparative study of historical records in lake and peat sediments.

    Science.gov (United States)

    Liu, Xiaodong; Jiang, Shan; Zhang, Pengfei; Xu, Liqiang

    2012-01-01

    Historical changes of anthropogenic Pb pollution were reconstructed based on Pb concentrations and isotope ratios in lake and peat sediment profiles from Ny-Ålesund of Arctic. The calculated excess Pb isotope ratios showed that Pb pollution largely came from west Europe and Russia. The peat profile clearly reflected the historical changes of atmospheric deposition of anthropogenic Pb into Ny-Ålesund, and the result showed that anthropogenic Pb peaked at 1960s-1970s, and thereafter a significant recovery was observed by a rapid increase of (206)Pb/(207)Pb ratios and a remarkable decrease in anthropogenic Pb contents. In contrast to the peat record, the longer lake record showed relatively high anthropogenic Pb contents and a persistent decrease of (206)Pb/(207)Pb ratios within the uppermost samples, suggesting that climate-sensitive processes such as catchment erosion and meltwater runoff might have influenced the recent change of Pb pollution record in the High Arctic lake sediments. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Simplifying the audit of risk factor recording and control: A report from an international study in 11 countries.

    Science.gov (United States)

    Zhao, Min; Cooney, Marie Therese; Klipstein-Grobusch, Kerstin; Vaartjes, Ilonca; De Bacquer, Dirk; De Sutter, Johan; Reiner, Željko; Prescott, Eva; Faggiano, Pompilio; Vanuzzo, Diego; AlFaleh, Hussam; Menown, Ian Ba; Gait, Dan; Posogova, Nana; Sheu, Wayne H-H; Zhao, Dong; Zuo, Huijuan; Grobbee, Diederick E; Graham, Ian M

    2016-07-01

    To simplify the assessment of the recording and control of coronary heart disease risk factors in different countries and regions. The SUrvey of Risk Factors (SURF) is an international clinical audit. Data on consecutive patients with established coronary heart disease from countries in Europe, Asia and the Middle East were collected on a one-page collection sheet or electronically during routine clinic visits. Information on demographics, diagnostic category, risk factors, physical and laboratory measurements, and medications were included and key variables summarized in a Cardiovascular Health Index Score. Coronary heart disease patients (N = 10,186; 29% women) were enrolled from 79 centres in 11 countries. Recording of risk factors varied considerably: smoking was recorded in over 98% of subjects, while about 20% lacked data on laboratory measurements relevant to cardiovascular disease risk. Sixteen per cent of participants reported smoking, 29% were obese, and 46% had abdominal obesity. Sixty per cent of participants had blood pressure control of risk factors with substantial variation between countries, calling for development and implementation of clinical standards of secondary prevention of coronary heart disease. © The European Society of Cardiology 2016.

  17. Oral tactile sensibility recorded in overdenture wearers with implants or natural roots: a comparative study. Part 2.

    Science.gov (United States)

    Mericske-Stern, R

    1994-01-01

    The capacity of dentate subjects to discriminate the thickness of objects placed between the teeth seems to depend on receptors in the periodontal ligament and muscles. The compensatory mechanism of ankylotic implants for the function of missing periodontal ligaments is not yet known. To investigate this question in overdenture wearers, 26 patients with ITI implants and 20 patients with natural roots were selected. According to the experimental protocol, the discriminatory ability was recorded with 10 steel foils (thickness ranging from 10 to 100 microns) placed between the premolars. Each thickness was tested 10 times and the test subjects were required to distinguish whether foil was positioned between the teeth. A maximum of 100 correct or 100 incorrect answers was possible. The average number of inco