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Sample records for prospective audit comparing

  1. Forensic Accounting and Auditing: Compared and Contrasted to Traditional Accounting and Auditing

    ERIC Educational Resources Information Center

    Gray, Dahli

    2008-01-01

    Forensic versus traditional accounting and auditing are compared and contrasted. Evidence gathering is detailed. Forensic science and fraud symptoms are explained. Criminalists, expert testimony and corporate governance are presented.

  2. Prospective memory: A comparative perspective

    PubMed Central

    Crystal, Jonathon D.; Wilson, A. George

    2014-01-01

    Prospective memory consists of forming a representation of a future action, temporarily storing that representation in memory, and retrieving it at a future time point. Here we review the recent development of animal models of prospective memory. We review experiments using rats that focus on the development of time-based and event-based prospective memory. Next, we review a number of prospective-memory approaches that have been used with a variety of non-human primates. Finally, we review selected approaches from the human literature on prospective memory to identify targets for development of animal models of prospective memory. PMID:25101562

  3. Study protocol: first nationwide comparative audit of acute lower gastrointestinal bleeding in the UK

    PubMed Central

    Oakland, Kathryn; Guy, Richard; Uberoi, Raman; Seeney, Frances; Collins, Gary; Grant-Casey, John; Mortensen, Neil; Murphy, Mike; Jairath, Vipul

    2016-01-01

    Introduction Acute lower gastrointestinal bleeding (LGIB) is a common indication for emergency hospitalisation worldwide. In contrast to upper GIB, patient characteristics, modes of investigation, transfusion, treatment and outcomes are poorly described. There are minimal clinical guidelines to inform care pathways and the use of endoscopy, including (diagnostic and therapeutic yields), interventional radiology and surgery are poorly defined. As a result, there is potential for wide variation in practice and clinical outcomes. Methods and analysis The UK Lower Gastrointestinal Bleeding Audit is a large nationwide audit of adult patients acutely admitted with LGIB or those who develop LGIB while hospitalised for another reason. Consecutive, unselected presentations with LGIB will be enrolled prospectively over a 2-month period at the end of 2015 and detailed data will be collected on patient characteristics, comorbidities, use of anticoagulants, transfusion, timing and modalities of diagnostic and therapeutic procedures, clinical outcome, length of stay and mortality. These will be audited against predefined minimum standards of care for LGIB. It is anticipated that over 80% of all acute hospitals in England and some hospitals in Scotland, Wales and Northern Ireland will participate. Data will be collected on the availability and organisation of care, provision of diagnostic and therapeutic GI endoscopy, interventional radiology, surgery and transfusion protocols. Ethics and dissemination This audit will be conducted as part of the national comparative audit programme of blood transfusion through collaboration with specialists in gastroenterology, surgery and interventional radiology. Individual reports will be provided to each participant site as well as an overall report and disseminated through specialist societies. Results will also be published in peer-reviewed journals. The study has been funded by National Health Services (NHS) Blood and Transplant and the

  4. A Prospective Multi-Center Audit of Nutrition Support Parameters Following Burn Injury.

    PubMed

    Kurmis, Rochelle; Heath, Kathryn; Ooi, Selena; Munn, Zachary; Forbes, Sharon; Young, Vicki; Rigby, Paul; Wood, Kate; Phillips, Frances; Greenwood, John

    2015-01-01

    The importance of nutrition support delivery to the severe burn-injured patient is well recognized, however, nutrition provision to the patient may be sub optimal in practice. The aim of this study was to conduct a prospective multi-center audit across Australia and New Zealand using the Joanna Briggs Institute Burns Node Nutrition audit criteria. Thirty-four patients with severe burn injury (≥20% TBSA in adults and ≥10% TBSA in children) were identified on admission or on referral to the Dietitian at the eight participating Burn Units between February 1, 2012 and April 30, 2012 for inclusion in the study. De-identified patient data was analyzed using the Joanna Briggs Institute, Practical Application of Clinical Evidence System. Compliance with individual audit criterion ranged from 33 to 100%. Provision of prescribed enteral feed volumes and weekly weighing of patients were highlighted as key areas for clinical improvement. Clinical audit is a valuable tool for evaluating current practice against best evidence to ensure that quality patient care is delivered. The use of the Joanna Briggs Institute Burns Node audit criteria has allowed for a standardized multi-center audit to be conducted. Improving nutrition support delivery in burn patients was identified as a key area requiring ongoing clinical improvement across Australia and New Zealand. Clinician feedback on use of the audit criteria will allow for future refinement of individual criterion, and presentation of results of this audit has resulted in a review of the Bi-National Burns Registry nutrition quality indicators. PMID:25094004

  5. Automated comparative auditing of NCIT genomic roles using NCBI.

    PubMed

    Cohen, Barry; Oren, Marc; Min, Hua; Perl, Yehoshua; Halper, Michael

    2008-12-01

    Biomedical research has identified many human genes and various knowledge about them. The National Cancer Institute Thesaurus (NCIT) represents such knowledge as concepts and roles (relationships). Due to the rapid advances in this field, it is to be expected that the NCIT's Gene hierarchy will contain role errors. A comparative methodology to audit the Gene hierarchy with the use of the National Center for Biotechnology Information's (NCBI's) Entrez Gene database is presented. The two knowledge sources are accessed via a pair of Web crawlers to ensure up-to-date data. Our algorithms then compare the knowledge gathered from each, identify discrepancies that represent probable errors, and suggest corrective actions. The primary focus is on two kinds of gene-roles: (1) the chromosomal locations of genes, and (2) the biological processes in which genes play a role. Regarding chromosomal locations, the discrepancies revealed are striking and systematic, suggesting a structurally common origin. In regard to the biological processes, difficulties arise because genes frequently play roles in multiple processes, and processes may have many designations (such as synonymous terms). Our algorithms make use of the roles defined in the NCIT Biological Process hierarchy to uncover many probable gene-role errors in the NCIT. These results show that automated comparative auditing is a promising technique that can identify a large number of probable errors and corrections for them in a terminological genomic knowledge repository, thus facilitating its overall maintenance. PMID:18486558

  6. Automated Comparative Auditing of NCIT Genomic Roles Using NCBI

    PubMed Central

    Cohen, Barry; Oren, Marc; Min, Hua; Perl, Yehoshua; Halper, Michael

    2008-01-01

    Biomedical research has identified many human genes and various knowledge about them. The National Cancer Institute Thesaurus (NCIT) represents such knowledge as concepts and roles (relationships). Due to the rapid advances in this field, it is to be expected that the NCIT’s Gene hierarchy will contain role errors. A comparative methodology to audit the Gene hierarchy with the use of the National Center for Biotechnology Information’s (NCBI’s) Entrez Gene database is presented. The two knowledge sources are accessed via a pair of Web crawlers to ensure up-to-date data. Our algorithms then compare the knowledge gathered from each, identify discrepancies that represent probable errors, and suggest corrective actions. The primary focus is on two kinds of gene-roles: (1) the chromosomal locations of genes, and (2) the biological processes in which genes plays a role. Regarding chromosomal locations, the discrepancies revealed are striking and systematic, suggesting a structurally common origin. In regard to the biological processes, difficulties arise because genes frequently play roles in multiple processes, and processes may have many designations (such as synonymous terms). Our algorithms make use of the roles defined in the NCIT Biological Process hierarchy to uncover many probable gene-role errors in the NCIT. These results show that automated comparative auditing is a promising technique that can identify a large number of probable errors and corrections for them in a terminological genomic knowledge repository, thus facilitating its overall maintenance. PMID:18486558

  7. Prospective audit and feedback on antibiotic prescription in an adult hematology-oncology unit in Singapore.

    PubMed

    Yeo, C-L; Chan, D S-G; Earnest, A; Wu, T-S; Yeoh, S-F; Lim, R; Jureen, R; Fisher, D; Hsu, L-Y

    2012-04-01

    We evaluated the impact of a prospective audit and feedback antimicrobial stewardship program (ASP) on antibiotic prescription and resistance trends in a hematology-oncology unit in a university hospital (National University Cancer Institute, Singapore [NCIS]). A prospective interrupted time-series study comprising 11-month pre-intervention (PIP) and intervention evaluation phases (IEP) flanking a one-month implementation phase was carried out. Outcome measures included defined daily dose per 100 (DDD/100) inpatient-days of ASP-audited and all antibiotics (encompassing audited and non-audited antibiotics), and the incidence-density of antibiotic-resistant microorganisms at the NCIS. Internal and external controls were DDD/100 inpatient-days of paracetamol at the NCIS and DDD/100 inpatient-days of antibiotics prescribed in the rest of the hospital. There were 580 ASP recommendations from 1,276 audits, with a mean monthly compliance of 86.9%. Significant reversal of prescription trends towards reduced prescription of audited (coefficient = -2.621; 95% confidence interval [CI]: -4.923, -0.319; p = 0.026) and all evaluated antibiotics (coefficient = -4.069; 95% CI: -8.075, -0.063; p = 0.046) was observed. No changes were seen for both internal and external controls, except for the reversal of prescription trends for cephalosporins hospital-wide. Antimicrobial resistance did not change over the time period of the study. Adverse outcomes-the majority unavoidable-occurred following 5.5% of accepted ASP recommendations. Safe and effective ASPs can be implemented in the complex setting of hematology-oncology inpatients. PMID:21845470

  8. Comparing short versions of the AUDIT in a community-based survey of young people

    PubMed Central

    2013-01-01

    Background The 10-item Alcohol Use Disorders Identification Test (AUDIT-10) is commonly used to monitor harmful alcohol consumption among high-risk groups, including young people. However, time and space constraints have generated interest for shortened versions. Commonly used variations are the AUDIT-C (three questions) and the Fast Alcohol Screening Test (FAST) (four questions), but their utility in screening young people in non-clinical settings has received little attention. Methods We examined the performance of established and novel shortened versions of the AUDIT in relation to the full AUDIT-10 in a community-based survey of young people (16–29 years) attending a music festival in Melbourne, Australia (January 2010). Among those reporting drinking alcohol in the previous 12 months, the following statistics were systematically assessed for all possible combinations of three or four AUDIT items and established AUDIT variations: Cronbach’s alpha (internal consistency), variance explained (R2) and Pearson’s correlation coefficient (concurrent validity). For our purposes, novel shortened AUDIT versions considered were required to represent all three AUDIT domains and include item 9 on alcohol-related injury. Results We recruited 640 participants (68% female) reporting drinking in the previous 12 months. Median AUDIT-10 score was 10 in males and 9 in females, and 127 (20%) were classified as having at least high-level alcohol problems according to WHO classification. The FAST scored consistently high across statistical measures; it explained 85.6% of variance in AUDIT-10, correlation with AUDIT-10 was 0.92, and Cronbach’s alpha was 0.66. A number of novel four-item AUDIT variations scored similarly high. Comparatively, the AUDIT-C scored substantially lower on all measures except internal consistency. Conclusions Numerous abbreviated variations of the AUDIT may be a suitable alternative to the AUDIT-10 for classifying high-level alcohol problems in a

  9. Prospective audit to evaluate the potential of the coronial system to increase solid organ donation

    PubMed Central

    Twamley, Huw; Haigh, Andrew; Williment, Claire; Hudson, Cara; Whitney, Julie; Neuberger, James

    2016-01-01

    Objectives Anecdotal evidence suggests that organ donation from deceased donors referred to the Coroner/Procurator Fiscal (PF) could be increased if all followed best practice. The aim of this prospective audit was to establish how referrals affected organ donation and to develop evidence-based guidelines to ensure that organ donation can be facilitated safely without interfering in the Coroner/PF's investigative process. Design Prospective audit. Setting All acute National Health Service Hospitals in the UK where deceased organ donation was considered. Participants 1437 deceased patients who met the eligibility criteria for organ donation and were referred to Coroner/PF. Main outcome measures Number of cases where permission for transplantation was given, number of organs where permission was refused and number of organs which might have been transplanted if all had followed best practice. Results Full permission for organ retrieval was given in 87% cases and partial permission in 9%. However, if full permission had been given where no autopsy was performed or restrictions seemed unjustified, up to 77 organs (22 lungs, 22 kidneys, 9 pancreases, 9 livers, 8 hearts and 7 small bowels) could have been available for transplant. Conclusions Coroners/PFs and their officers show strong support for transplantation but improvement in practice could result in a small but significant increase in life-saving and life-enhancing transplants. PMID:27401356

  10. When Antimicrobial Stewardship Isn't Watching: The Educational Impact of Critical Care Prospective Audit and Feedback.

    PubMed

    Fleming, Dimitra; Ali, Karim F; Matelski, John; D'Sa, Ryan; Powis, Jeff

    2016-09-01

    Prospective audit and feedback (PAF) is an effective strategy to optimize antimicrobial use in the critical care setting, yet whether skills gained during PAF influence future antimicrobial prescribing is uncertain. This multisite study demonstrates that knowledge learned during PAF is translated and incorporated into the practice of critical care physicians even when not supported by an antimicrobial stewardship program. PMID:27382599

  11. When Antimicrobial Stewardship Isn′t Watching: The Educational Impact of Critical Care Prospective Audit and Feedback

    PubMed Central

    Fleming, Dimitra; Ali, Karim F.; Matelski, John; D'Sa, Ryan; Powis, Jeff

    2016-01-01

    Prospective audit and feedback (PAF) is an effective strategy to optimize antimicrobial use in the critical care setting, yet whether skills gained during PAF influence future antimicrobial prescribing is uncertain. This multisite study demonstrates that knowledge learned during PAF is translated and incorporated into the practice of critical care physicians even when not supported by an antimicrobial stewardship program.

  12. Auditing Orthopaedic Audit

    PubMed Central

    Guryel, E; Acton, K; Patel, S

    2008-01-01

    INTRODUCTION Clinical audit plays an important role in the drive to improve the quality of patient care and thus forms a cornerstone of clinical governance. Assurance that the quality of patient care has improved requires completion of the audit cycle. A considerable sum of money and time has been spent establishing audit activity in the UK. Failure to close the loop undermines the effectiveness of the audit process and wastes resources. PATIENTS AND METHODS We analysed the effectiveness of audit in trauma and orthopaedics at a local hospital by comparing audit projects completed over a 6-year period to criteria set out in the NHS National Audit and Governance report. RESULTS Of the 25 audits performed since 1999, half were presented to the relevant parties and only 20% completed the audit cycle. Only two of these were audits against national standards and 28% were not based on any standards at all. Only a third of the audits led by junior doctors resulted in implementation of their action plan compared to 75% implementation for consultant-led and 67% for nurse-led audits. CONCLUSIONS A remarkably large proportion of audits included in this analysis failed to meet accepted criteria for effective audit. Audits completed by junior doctors were found to be the least likely to complete the cycle. This may relate to the lack of continuity in modern medical training and little incentive to complete the cycle. Supervision by permanent medical staff, principally consultants, and involvement of the audit department may play the biggest role in improving implementation of change. PMID:18828963

  13. Supracostal percutaneous nephrolithotomy: A prospective comparative study

    PubMed Central

    Sinha, Maneesh; Krishnappa, Pramod; Subudhi, Santosh Kumar; Krishnamoorthy, Venkatesh

    2016-01-01

    Introduction: A widely prevalent fear of thoracic complications with the supracostal approach has led to its underutilization in percutaneous nephrolithotomy (PCNL). We frequently use the supracostal approach and compared the efficacy and thoracic complications of infracostal, supra 12th, and supra 11th punctures. Materials and Methods: This was a prospective study of patients who underwent PCNL between January 2005 and December 2012. The patients were divided into three groups based on the access: infracostal, supra 12th (between the 11th and 12th ribs) and supra 11th (between the 10th and 11th ribs). Clearance rates, fall in hemoglobin levels, transfusion rates, perioperative analgesic requirements, hospital stay and thoracic complications were compared. Results: Seven hundred patients were included for analysis. There were 179 (25.5%) patients in the supra 11th group, 187 (26.7%) patients in the supra 12th group and 334 (47.8%) patients in the infracostal group. The overall clearance rate was 78% with no difference in the three groups. The postoperative analgesic requirements were significantly higher in the supracostal groups and showed a graded increase from infracostal to supra 12th to supra 11th. During the study period, only 2 patients required angioembolization (0.3%) and none required open exploration. The number of patients requiring intercostal chest drain insertion was extremely low, at 1.6% and 2.2% in the supra 12th and supra 11th groups, respectively. Conclusions: Our results confirm the feasibility of the supracostal approach including punctures above the 11th rib, albeit at the cost of an increase in thoracic complications. Staying in the line of the calyx has helped us to minimize the most dreaded complication of bleeding requiring angioembolization. PMID:26941494

  14. Comparative dosimetry study of three UK centres implementing total skin electron treatment through external audit

    PubMed Central

    Gonzalez, R; McGovern, M; Greener, A

    2015-01-01

    Objective: This article describes the external audit measurements conducted in two UK centres implementing total skin electron beam therapy (TSEBT) and the results obtained. Methods: Measurements of output, energy, beam flatness and symmetry at a standard distance (95 or 100 cm SSD) were performed using a parallel plate chamber in solid water. Similarly, output and energy measurements were also performed at the treatment plane for single and dual fields. Clinical simulations were carried out using thermoluminescent dosemeters (TLDs) and Gafchromic® film (International Specialty Products, Wayne, NJ) on an anthropomorphic phantom. Results: Extended distance measurements confirmed that local values for the beam dosimetry at Centres A and B were within 2% for outputs and 1-mm agreement of the expected depth at which the dose is 50% of the maximum for the depth–dose curve in water (R50,D) value. Clinical simulation using TLDs) showed an agreement of −1.6% and −6.7% compared with the expected mean trunk dose for each centre, respectively, and a variation within 10% (±1 standard deviation) across the trunk. The film results confirmed that the delivery of the treatment technique at each audited centre complies with the European Organisation for Research and Treatment of Cancer recommendations. Conclusion: This audit methodology has proven to be a successful way to confirm the agreement of dosimetric parameters for TSEBT treatments at both audited centres and could serve as the basis for an audit template to be used by other audit groups. Advances in knowledge: TSEBT audits are not established in the UK owing to a limited number of centres carrying out the treatment technique. This article describes the audits performed at two UK centres prior to their clinical implementation. PMID:25761213

  15. Removal of glucose from the cardiopulmonary bypass prime: a prospective clinical audit.

    PubMed

    Newland, R F; Baker, R A; Mazzone, A L; Ottens, J; Sanderson, A J; Moubarak, J R

    2004-09-01

    To quantify our decision for the removal of glucose and the use of mannitol as a substitute osmotic agent in the cardiopulmonary bypass prime, we conducted a prospective clinical audit to evaluate the effects of this change on patient outcomes. Data were prospectively collected for 172 consecutive routine cardiac surgery patients. The first 85 patients (Surgeon A, 42 patients [Group 1], Surgeon B, 43 patients [Group 2]) received 1000 mL Plasmalyte 148 + 5% glucose as per institutional protocol. The remaining priming volume for each group consisted of 500 mL hemaccel or 4% albumin, 50 mL 8.4% sodium bicarbonate, 100 mL Hartmann's solution. The change to a glucose-free prime was then initiated, substituting Plasmalyte 148 (without 5% glucose) for the Plasmalyte 148 + 5% glucose, in addition 12.5 g mannitol was administered following delivery of cardioplegia to the patients operated on by Surgeon B. Surgeon A would not include mannitol at this time. Forty-one patients operated by Surgeon A (Group 3) subsequently received Plasmalyte 148, and 46 patients operated on by Surgeon B (Group 4) received Plasmalyte 148 plus mannitol. Analysis was performed stratified by surgeon to quantify the effects of removing glucose from the prime. Comparisons were made between groups 1 and 3, and 2 and 4. Net fluid changes were recorded from pre-CPB, up to 24-h postoperatively. Intraoperative data collection included serum glucose, hematocrit, osmolality, return to rhythm, arrhythmias, and blood transfusions. Post-operative variables, including cardiac enzymes, arrhythmias, intubation time, length of stay, and mortality were also collected. Removal of glucose from the CPB prime resulted in a lower serum glucose concentration (mmol/L) during CPB (Gp 1 [13.6] vs. Gp 3 [5.4]; Gp 2 [14.7] vs. Gp 4 [5.4], p < .05). The addition of 12.5 g of mannitol to the CPB prime resulted in a significantly lower net fluid gain (mL) 24 h postoperatively (Gp 2[2792] vs. Gp 4 [1970], p < .05) and greater CPB

  16. A prospective audit of pacemaker function, implant lifetime, and cause of death in the patient.

    PubMed Central

    Suvarna, S K; Start, R D; Tayler, D I

    1999-01-01

    AIM: To audit prospectively the reasons for pacemaker implantation, the duration of the pacemaker use, the cause of death, and pacemaker function after removal from the patient. METHODS: Pacemakers were removed at necropsy, or from the bodies of patients awaiting cremation, in three hospitals over a three year period. The cause of death was taken from the results of the necropsy or from the certified cause of death. Demographic data, including the time of implant and reasons for implantation, were checked. The pacemakers were analysed in terms of battery status, program, and output under a standard 470 ohm load. RESULTS: 69 patients were studied. Average age at death was 78 and 80 years for men and women, respectively. The average duration since pacemaker implantation was 46 months. Eleven patients had necropsies, showing that three died from ischaemic heart disease, six from cardiomyopathy, one from an aortic aneurysm, and one from disseminated neoplasia. From the necropsy results and death certificates, the distribution of causes of death in the group as a whole were ischaemic heart disease (21), cardiomyopathy (8), cerebrovascular disease (11), neoplasia (11), chest infection/chronic obstructive airways disease (8), and other causes (10). In all cases the pacemaker box function was within normal limits. CONCLUSIONS: Neither primary nor secondary pacemaker dysfunction was found. The study highlights the impact of arrhythmias in cardiomyopathy, and raises questions about the true role of ischaemic heart disease in these pacemaker requiring patients. The relatively short gap between pacemaker implantation and death requires further study. Images PMID:10655989

  17. HSE auditing

    SciTech Connect

    Herwaarden, A.J.F. van; Sykes, R.M.

    1996-12-31

    Shell International Exploration and Production (SIEP) commenced a programme of Health Safety and Environmental (HSE) auditing in its Operating Companies (Opcos) in the late 1970s. Audits in the initial years focused on safety aspects with environmental and occupational aspects being introduced as the process matured. Part of the audit programme is performed by SIEP auditors, external to the Opcos. The level of SIEP-led audit activity increased linearly until the late 1980s, since when a level of around 40 Audits per year has been maintained in roughly as many companies. For the last 15 years each annual programme has included structured audits of all facets of EP operations. The frequency and duration of these audits have the principle objective of auditing all HSE critical processes of each Opco`s activity, within each five-year cycle. Durations vary from 8-10 days with a 4 person team to 18-20 days with a 6-8 person team. Each audit returns a satisfactory or unsatisfactory rating based on analysis of the effectiveness of the so-called eleven principles of Enhanced Safety Management (ESM) required to be applied throughout the Group. Independence is maintained by the SIEP audit leader, who carries ultimate responsibility for the content and wording of each report, where necessary backed-up by senior management in SIEP. These SIEP-led audits have been successful in the following areas: (1) Provision of early warning in areas where facilities integrity or HSE management was likely to be compromised. (2) Aiding the establishment of an internal HSE auditing process in many Opcos. (3) Training, through participation in audits, not only auditors, but also prospective line managers in the effective management of HSE. With the recent introduction of HSE Management Systems (HSE-MS) in many Opcos, auditing is now in the process of controlled evolution from ESM to HSE-MS based.

  18. Prospective Audit of Avoidable Factors in Institutional Stillbirths and Early Neonatal Deaths at Tikur Anbessa Hospital in Addis Ababa, Ethiopia.

    PubMed

    Demise, Asrat; Gebrehiwot, Yirgu; Worku, Bogale; Spector, Jonathan M

    2015-12-01

    Mortality audits are being used with increasing frequency to improve health outcomes by pinpointing precisely where deficiencies in clinical care exist. We conducted a prospective audit of stillbirths and early neonatal deaths at Tikur Anbessa Hospital in Addis Ababa, Ethiopia, as part of a broader initiative to reduce perinatal mortality in the labor room and neonatal intensive care unit. Out of 1,225 deliveries that took place during the six-month study period, there were 30 stillbirths and 31 early neonatal deaths (PMR 50/1,000). A multi-disciplinary Audit Team was established and convened monthly to review standardized data collection forms that were completed for each death. It was determined that avoidable factors were present in 70% of perinatal deaths. Health worker-related factors were the most common avoidable factors identified (accounting for 84% of avoidable factors identified), followed by patient-related factors (11%) and administrative-related factors (5%). Based on the study findings, quality improvement programs that target gaps in care are being implemented on the hospital's labor room and in the neonatal intensive care unit. PMID:27337856

  19. Safety Auditing and Assessments

    NASA Technical Reports Server (NTRS)

    Goodin, James Ronald (Ronnie)

    2005-01-01

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

  20. Antimicrobial stewardship for carbapenem use at a Japanese tertiary care center: An interrupted time series analysis on the impact of infectious disease consultation, prospective audit, and feedback.

    PubMed

    Tagashira, Yasuaki; Horiuchi, Mikihiro; Tokuda, Yasuharu; Heist, Brian S; Higuchi, Masanori; Honda, Hitoshi

    2016-06-01

    Given the concerns surrounding the overuse of carbapenem antibiotics in Japan, we evaluated the impact of infectious disease consultation and a prospective carbapenem audit at a tertiary care center in Tokyo, Japan. Overall, carbapenem use was safely and effectively reduced after implementation of these interventions. The leadership of the infectious diseases physicians also proved critically important to implementing effective stewardship. PMID:26831278

  1. PROSPECTIVE RANDOMIZED STUDY COMPARING TWO ANESTHETIC METHODS FOR SHOULDER SURGERY

    PubMed Central

    Ikemoto, Roberto Yukio; Murachovsky, Joel; Prata Nascimento, Luis Gustavo; Bueno, Rogerio Serpone; Oliveira Almeida, Luiz Henrique; Strose, Eric; de Mello, Sérgio Cabral; Saletti, Deise

    2015-01-01

    Objective: To evaluate the efficacy of suprascapular nerve block in combination with infusion of anesthetic into the subacromial space, compared with interscalene block. Methods: Forty-five patients with small or medium-sized isolated supraspinatus tendon lesions who underwent arthroscopic repair were prospectively and comparatively evaluated through random assignation to three groups of 15, each with a different combination of anesthetic methods. The efficacy of postoperative analgesia was measured using the visual analogue scale for pain and the analgesic, anti-inflammatory and opioid drug consumption. Inhalation anesthetic consumption during surgery was also compared between the groups. Results: The statistical analysis did not find any statistically significant differences among the groups regarding anesthetic consumption during surgery or postoperative analgesic efficacy during the first 48 hours. Conclusion: Suprascapular nerve block with infusion of anesthetic into the subacromial space is an excellent alternative to interscalene block, particularly in hospitals in which an electrical nerve stimulating device is unavailable. PMID:27022569

  2. A Comparative Analysis of Internal Communication and Public Relations Audits. State of the Art.

    ERIC Educational Resources Information Center

    Dozier, David M.; Hellweg, Susan A.

    A review of current literature regarding the state of the art in the conduct of internal communication and public relations audits by public relations practitioners reveals that these two related measurement activities are of considerable importance to the practice of public relations. Public relations audits are concerned with exploratory…

  3. A computerized prospective audit of cardiopulmonary resuscitation in the accident and emergency department.

    PubMed Central

    Wardrope, J; Crosby, A C; Ferguson, D G; Edbrooke, D L

    1986-01-01

    A prospective survey of cardiopulmonary resuscitation is in progress in the Accident and Emergency Department of the Royal Hallamshire Hospital. During the 12 months from January 1985 to January 1986, 123 cardiac arrests were treated in the accident department. Ninety of these arrests occurred outside the hospital; nine of these patients survived to leave hospital. Of the 33 people arresting in the department, 10 survived to leave hospital. The causes of death are presented. PMID:3768122

  4. Misuse of antibiotics reserved for hospital settings in outpatients: a prospective clinical audit in a university hospital in Southern France.

    PubMed

    Roche, Manon; Bornet, Charléric; Monges, Philippe; Stein, Andreas; Gensollen, Sophie; Seng, Piseth

    2016-07-01

    Some antibiotics are reserved essentially for hospital settings owing to cost effectiveness and in order to fight the emerging antibiotic resistance crisis. In some cases, antibiotics reserved exclusively for use in hospitals may be prescribed in outpatients for serious infections or in the absence of a therapeutic alternative. A 30-day prospective audit of outpatient prescriptions of antibiotics reserved exclusively for use in hospitals was performed. The objective of this study was to evaluate the relevance of outpatient antibiotic prescriptions by measuring appropriateness according to guidelines. During the study period, 53 prescriptions were included, only 40% of which were appropriate. Among the 32 inappropriate prescriptions, 4 cases lacked microbial arguments, 1 case was not adequate for the infection type, 1 case involved an incorrect antibiotic dosage, 1 case involved an incorrect interval of dose administration, 3 cases had a therapeutic alternative and 22 cases were not recommended. Of the 53 prescriptions, 66% were started in hospital and 34% in outpatients. Only 25% of cases were prescribed with infectious diseases specialist (IDS) advice, 64% were based on microbiological documentation and 13% had a negative bacterial culture. Inappropriate prescriptions were usually observed in antibiotic lock therapy, skin infections, Clostridium difficile colitis, intra-abdominal infections and intravascular catheter-related infections. Outpatient prescriptions of antimicrobial drugs reserved exclusively for use in hospitals are frequently inappropriate. We recommend a real-time analysis algorithm with the involvement of an IDS for monitoring prescriptions to improve the quality of these prescriptions and possibly to prevent antibiotic resistance. PMID:27234677

  5. Hospital audit committees: a comparative analysis of structural and functional characteristics.

    PubMed

    Urbancic, F R; Hauser, R C

    1991-01-01

    In an effort to counteract rising costs and financial problems, many hospitals have adopted certain management practices that are followed by commercial corporations. In particular, the boards of directors for many hospitals have created audit committees to enhance organizational governance in the areas of internal control, accounting, auditing, and financial reporting. The formative stages in which most hospital audit committees currently exist creates a need for shared information. Such information can serve as a potential source of guidance for the further development of existing hospital audit committees, as well as for boards that are near the point of establishing an audit committee for the first time. The purpose of this study is to present an analysis of the structure, responsibilities, and activities of hospital audit committees. Data for the analysis was obtained through a questionnaire survey of 400 hospitals. The analysis of structural and functional differences affords a basis for suggesting several specific ways in which hospitals can improve their organizational governance through a more effective audit committee. PMID:10112575

  6. Prospective audit of adverse reactions occurring in 459 primary antibody-deficient patients receiving intravenous immunoglobulin

    PubMed Central

    BRENNAN, V M; SALOMÉ-BENTLEY, N J; CHAPEL, H M

    2003-01-01

    Intravenous immunoglobulin (IVIG) is used as the standard replacement therapy for patients with primary antibody deficiencies. A previous study of adverse reactions in patients self-infusing at home over 1 year showed an overall reaction rate of 0·7%. A larger prospective study is reported here, involving a greater number of immunology centres and including children and adults who received infusions from medical or nursing staff as well as those self-infusing. Four hundred and fifty-nine patients were entered into this study and 13 508 infusions were given. The study showed that no severe reactions occurred and the reaction rate was low at 0·8%. This figure could have been lower, 0·5%, if predisposing factors responsible for some reactions had been considered before infusion. In conclusion, the study shows the importance of ongoing training for patients and staff to recognize the predisposing factors to prevent avoidable reactions. Because none of these reactions were graded as severe, the present guidance to prescribe self-injectable adrenaline for patients infusing outside hospital should be reviewed. PMID:12869031

  7. Pain assessment of the intratympanic injections: a prospective comparative study.

    PubMed

    Belhassen, Sarah; Saliba, Issam

    2012-12-01

    The objective of the study is to compare the pain level of three methods of intratympanic (IT) injections using prospective, randomized clinical study in a tertiary care center. 39 patients with Ménière's disease and 30 patients with sudden sensorineural hearing loss are included. Excluded were patients treated for a chronic pain or those who took any pain killer for the last 24 h. Each patient received one IT injection a week, for three consecutive weeks. Three methods of IT injections were compared, with the application of EMLA cream on the tympanic membrane filling the external auditory canal 60 min before the procedure, with subcutaneous injection of lidocaine 1% with 1:100,000 epinephrine in the external auditory canal, and finally with an IT injection without any previous anesthesia. The pain intensity was immediately measured at 5 min, and then 45 min after the procedure, each time using four pain rating scales (visual analogue scale, numerical rating scale, verbal rating scale and categorical rating scale). No difference in pain intensity between the three methods of IT injections was detected by the visual analogue scale and numerical rating scale (p > 0.05). 45.8% of patients preferred the IT injection without previous anesthesia. However, methylprednisolone has been associated with pain intensity greater than that of gentamicin 45 min after the injection (p < 0.05). The IT injection performed without any previous anesthesia is an interesting option since it has not been shown to be more painful than the other methods of injections, and spares the patient from disadvantages associated with the anesthesia. PMID:22203120

  8. Endoscopic versus transcranial procurement of allograft tympano-ossicular systems: a prospective double-blind randomized controlled audit.

    PubMed

    Caremans, Jeroen; Hamans, Evert; Muylle, Ludo; Van de Heyning, Paul; Van Rompaey, Vincent

    2016-06-01

    Allograft tympano-ossicular systems (ATOS) have proven their use over many decades in tympanoplasty and reconstruction after resection of cholesteatoma. The transcranial bone plug technique has been used in the past 50 years to procure en bloc ATOS (tympanic membrane with malleus, incus and stapes attached). Recently, our group reported the feasibility of the endoscopic procurement technique. The aim of this study was to assess whether clinical outcome is equivalent in ATOS acquired by using the endoscopic procurement technique compared to ATOS acquired by using the transcranial technique. A double-blind randomized controlled audit was performed in a tertiary referral center in patients that underwent allograft tympanoplasty because of chronic otitis media with and without cholesteatoma. Allograft epithelialisation was evaluated at the short-term postoperative visit by microscopic examination. Failures were reported if reperforation was observed. Fifty patients underwent allograft tympanoplasty: 34 received endoscopically procured ATOS and 16 received transcranially procured ATOS. One failed case was observed, in the endoscopic procurement group. We did not observe a statistically significant difference between the two groups in failure rate. This study demonstrates equivalence of the clinical outcome of allograft tympanoplasty using either endoscopic or transcranial procured ATOS and therefore indicates that the endoscopic technique can be considered the new standard procurement technique. Especially because the endoscopic procurement technique has several advantages compared to the former transcranial procurement technique: it avoids risk of prion transmission and it is faster while lacking any noticeable incision. PMID:26342932

  9. A Comparative Study of Problematic Internet Use and Loneliness among Turkish and Korean Prospective Teachers

    ERIC Educational Resources Information Center

    Tutgun, Aylin; Deniz, Levent; Moon, Man-Ki

    2011-01-01

    The main aim of this study is to compare the problematic internet use and its relation to loneliness among two nations' prospective teachers, Turkey and South Korea. Five hundred and ninety five prospective teachers from three universities, two from Turkey and one from South Korea participated in the study. Generalized Problematic Internet Use…

  10. Incidence of ventilator-associated pneumonia in Australasian intensive care units: use of a consensus-developed clinical surveillance checklist in a multisite prospective audit

    PubMed Central

    Elliott, Doug; Elliott, Rosalind; Burrell, Anthony; Harrigan, Peter; Murgo, Margherita; Rolls, Kaye; Sibbritt, David

    2015-01-01

    Objectives With disagreements on diagnostic criteria for ventilator-associated pneumonia (VAP) hampering efforts to monitor incidence and implement preventative strategies, the study objectives were to develop a checklist for clinical surveillance of VAP, and conduct an audit in Australian/New Zealand intensive care units (ICUs) using the checklist. Setting Online survey software was used for checklist development. The prospective audit using the checklist was conducted in 10 ICUs in Australia and New Zealand. Participants Checklist development was conducted with members of a bi-national professional society for critical care physicians using a modified Delphi technique and survey. A 30-day audit of adult patients mechanically ventilated for >72 h. Primary and secondary outcome measures Presence of items on the screening checklist; physician diagnosis of VAP, clinical characteristics, investigations, treatments and patient outcome. Results A VAP checklist was developed with five items: decreasing gas exchange, sputum changes, chest X-ray infiltrates, inflammatory response, microbial growth. Of the 169 participants, 17% (n=29) demonstrated characteristics of VAP using the checklist. A similar proportion had an independent physician diagnosis (n=30), but in a different patient subset (only 17% of cases were identified by both methods). The VAP rate per 1000 mechanical ventilator days for the checklist and clinician diagnosis was 25.9 and 26.7, respectively. The item ‘inflammatory response’ was most associated with the first episode of physician-diagnosed VAP. Conclusions VAP rates using the checklist and physician diagnosis were similar to ranges reported internationally and in Australia. Of note, different patients were identified with VAP by the checklist and physicians. While the checklist items may assist in identifying patients at risk of developing VAP, and demonstrates synergy with the recently developed Centers for Disease Control (CDC) guidelines

  11. Religious Confession and Symptom Severity: A Prospective Comparative Study.

    PubMed

    Rana, Madiha; Rana, Majeed; Herzberg, Philipp Y; Krause, Christin

    2015-12-01

    Little research has been done on comparing confessions regarding mental health. In the present study, 320 people (78 Buddhists, 77 Catholics, 89 Protestants and 79 Muslims) were compared in terms of their symptom severity. Buddhists and Protestants had lower scores than Catholics and Muslims for obsessive-compulsive behavior and hostility. Muslim group had the highest comparative scores for psychoticism. Buddhists and Protestants had comparatively low scores for paranoid ideation and overall symptom severity, with Catholics and Muslims having high ones. Results reveal that confession should be taken in account in psychological research and diagnosis, since it is explicitly associated with psychological well-being. PMID:25204789

  12. Impact of a Prospective Audit and Feedback Antimicrobial Stewardship Program at a Veterans Affairs Medical Center: A Six-Point Assessment

    PubMed Central

    Morrill, Haley J.; Caffrey, Aisling R.; Gaitanis, Melissa M.; LaPlante, Kerry L.

    2016-01-01

    Background Prospective audit and feedback is a core antimicrobial stewardship program (ASP) strategy; however its impact is difficult to measure. Methods Our quasi-experimental study measured the effect of an ASP on clinical outcomes, antimicrobial use, resistance, costs, patient safety (adverse drug events [ADE] and Clostridium difficile infection [CDI]), and process metrics pre- (9/10–10/11) and post-ASP (9/12–10/13) using propensity adjusted and matched Cox proportional-hazards regression models and interrupted time series (ITS) methods. Results Among our 2,696 patients, median length of stay was 1 day shorter post-ASP (5, interquartile range [IQR] 3–8 vs. 4, IQR 2–7 days, p<0.001). Mortality was similar in both periods. Mean broad-spectrum (-11.3%), fluoroquinolone (-27.0%), and anti-pseudomonal (-15.6%) use decreased significantly (p<0.05). ITS analyses demonstrated a significant increase in monthly carbapenem use post-ASP (trend: +1.5 days of therapy/1,000 patient days [1000PD] per month; 95% CI 0.1–3.0). Total antimicrobial costs decreased 14%. Resistance rates did not change in the one-year post-ASP period. Mean CDI rates/10,000PD were low pre- and post-ASP (14.2 ± 10.4 vs. 13.8 ± 10.0, p = 0.94). Fewer patients experienced ADEs post-ASP (6.0% vs. 4.4%, p = 0.06). Conclusions Prospective audit and feedback has the potential to improve antimicrobial use and outcomes, and contain bacterial resistance. Our program demonstrated a trend towards decreased length of stay, broad-spectrum antimicrobial use, antimicrobial costs, and adverse events. PMID:26978263

  13. A Comparative Study of Financial Data Sources for Critical Access Hospitals: Audited Financial Statements, the Medicare Cost Report, and the Internal Revenue Service Form 990

    ERIC Educational Resources Information Center

    Ozmeral, Alisha Bhadelia; Reiter, Kristin L.; Holmes, George M.; Pink, George H.

    2012-01-01

    Purpose: Medicare Cost Reports (MCR), Internal Revenue Service Form 990s (IRS 990), and Audited Financial Statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across…

  14. A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service

    PubMed Central

    Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M.

    2015-01-01

    Objective The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. Methods An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the ‘Guidelines on prevention & management of foot problems in Type 2 Diabetes’ by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. Results An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. Discussion During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines. PMID:26048860

  15. What are incident reports telling us? A comparative study at two Australian hospitals of medication errors identified at audit, detected by staff and reported to an incident system

    PubMed Central

    Westbrook, Johanna I.; Li, Ling; Lehnbom, Elin C.; Baysari, Melissa T.; Braithwaite, Jeffrey; Burke, Rosemary; Conn, Chris; Day, Richard O.

    2015-01-01

    Objectives To (i) compare medication errors identified at audit and observation with medication incident reports; (ii) identify differences between two hospitals in incident report frequency and medication error rates; (iii) identify prescribing error detection rates by staff. Design Audit of 3291patient records at two hospitals to identify prescribing errors and evidence of their detection by staff. Medication administration errors were identified from a direct observational study of 180 nurses administering 7451 medications. Severity of errors was classified. Those likely to lead to patient harm were categorized as ‘clinically important’. Setting Two major academic teaching hospitals in Sydney, Australia. Main Outcome Measures Rates of medication errors identified from audit and from direct observation were compared with reported medication incident reports. Results A total of 12 567 prescribing errors were identified at audit. Of these 1.2/1000 errors (95% CI: 0.6–1.8) had incident reports. Clinically important prescribing errors (n = 539) were detected by staff at a rate of 218.9/1000 (95% CI: 184.0–253.8), but only 13.0/1000 (95% CI: 3.4–22.5) were reported. 78.1% (n = 421) of clinically important prescribing errors were not detected. A total of 2043 drug administrations (27.4%; 95% CI: 26.4–28.4%) contained ≥1 errors; none had an incident report. Hospital A had a higher frequency of incident reports than Hospital B, but a lower rate of errors at audit. Conclusions Prescribing errors with the potential to cause harm frequently go undetected. Reported incidents do not reflect the profile of medication errors which occur in hospitals or the underlying rates. This demonstrates the inaccuracy of using incident frequency to compare patient risk or quality performance within or across hospitals. New approaches including data mining of electronic clinical information systems are required to support more effective medication error detection and

  16. Secondary analysis of outcomes after 11,085 hip fracture operations from the prospective UK Anaesthesia Sprint Audit of Practice (ASAP-2).

    PubMed

    White, S M; Moppett, I K; Griffiths, R; Johansen, A; Wakeman, R; Boulton, C; Plant, F; Williams, A; Pappenheim, K; Majeed, A; Currie, C T; Grocott, M P W

    2016-05-01

    We re-analysed prospective data collected by anaesthetists in the Anaesthesia Sprint Audit of Practice (ASAP-1) to describe associations with linked outcome data. Mortality was 165/11,085 (1.5%) 5 days and 563/11,085 (5.1%) 30 days after surgery and was not associated with anaesthetic technique (general vs. spinal, with or without peripheral nerve blockade). The risk of death increased as blood pressure fell: the odds ratio (95% CI) for mortality within five days after surgery was 0.983 (0.973-0.994) for each 5 mmHg intra-operative increment in systolic blood pressure, p = 0.0016, and 0.980 (0.967-0.993) for each mmHg increment in mean pressure, p = 0.0039. The equivalent odds ratios (95% CI) for 30-day mortality were 0.968 (0.951-0.985), p = 0.0003 and 0.976 (0.964-0.988), p = 0.0001, respectively. The lowest systolic blood pressure after intrathecal local anaesthetic relative to before induction was weakly correlated with a higher volume of subarachnoid bupivacaine: r(2) -0.10 and -0.16 for hyperbaric and isobaric bupivacaine, respectively. A mean 20% relative fall in systolic blood pressure correlated with an administered volume of 1.44 ml hyperbaric bupivacaine. Future research should focus on refining standardised anaesthesia towards administering lower doses of spinal (and general) anaesthesia and maintaining normotension. PMID:26940645

  17. A comparative audit of anticardiolipin antibodies in oligoclonal band negative and positive multiple sclerosis.

    PubMed

    Vilisaar, Janek; Wilson, Martin; Niepel, Graham; Blumhardt, Lance D; Constantinescu, Cris S

    2005-08-01

    It has been suggested that multiple sclerosis (MS) patients with positive anticardiolipin antibodies (ACLA) have some atypical features, including absent oligoclonal bands (OCB) in the cerebrospinal fluid (CSF). Our aim was to compare the frequencies of ACLA and related laboratory and clinical features in OCB negative (OCB-) and positive (OCB+) MS patients. We compared 41 OCB- patients attending a MS Clinic in a tertiary referral center, with 206 OCB+ patients. ACLA, anti-beta2-glycoprotein and other autoantibodies, lupus anticoagulant and coagulation markers were measured. We found a higher frequency of ACLA in OCB- patients, 18/41 versus 33/206 in OCB+ patients (P<0.0001). OCB- patients had more progressive MS than OCB+ subjects. There were no differences in age, sex, Expanded Disability Status Scale (EDSS) score, antiphospholipid syndrome symptoms between the groups. ACLA+ MS patients were more frequently in the OCB- group. Although this may suggest that they represent a special subgroup of MS, no other clinical or laboratory findings distinguish the groups. Although OCB- MS patients may be thought to be less active immunologically, this study shows they have more frequently ACLA than OCB+ patients. OCB- MS patients in our cohort do not appear to have a more benign form of MS, as has previously been suggested. PMID:16042217

  18. Comparing the AUDIT and 3 Drinking Indices as Predictors of Personal and Social Drinking Problems in Freshman First Offenders

    ERIC Educational Resources Information Center

    O'Hare, Thomas

    2005-01-01

    The current study of 376 college freshman adjudicated the first time for breaking university drinking rules tested the predictive power of four alcohol consumption and problem drinking indices--recent changes in drinking (the Alcohol Change Index: ACI), heavy drinking, binge drinking index, and the Alcohol Use Disorders Identification Test (AUDIT)…

  19. Comparing Prospective Twice-Exceptional Students with High-Performing Peers on High-Stakes Tests of Achievement

    ERIC Educational Resources Information Center

    Bell, Sherry Mee; Taylor, Emily P.; McCallum, R. Steve; Coles, Jeremy T.; Hays, Elizabeth

    2015-01-01

    From a sample of 1,242 third graders, prospective twice-exceptional students were selected using reading and math curriculum-based measures (CBMs), routinely used in Response to Intervention (RtI). These prospective twice-exceptional students were compared with non-twice-exceptional peers with similar strengths in either math or reading on CBMs…

  20. Resting heart rate variability after yogic training and swimming: A prospective randomized comparative trial

    PubMed Central

    Sawane, Manish Vinayak; Gupta, Shilpa Sharad

    2015-01-01

    Context: Resting heart rate variability (HRV) is a measure of the modulation of autonomic nervous system (ANS) at rest. Increased HRV achieved by the exercise is good for the cardiovascular health. However, prospective studies with comparison of the effects of yogic exercises and those of other endurance exercises like walking, running, and swimming on resting HRV are conspicuous by their absence. Aims: Study was designed to assess and compare the effects of yogic training and swimming on resting HRV in normal healthy young volunteers. Settings and Design: Study was conducted in Department of Physiology in a medical college. Study design was prospective randomized comparative trial. Subjects and Methods: One hundred sedentary volunteers were randomly ascribed to either yoga or swimming group. Baseline recordings of digital electrocardiogram were done for all the subjects in cohorts of 10. After yoga training and swimming for 12 weeks, evaluation for resting HRV was done again. Statistical Analysis Used: Percentage change for each parameter with yoga and swimming was compared using unpaired t-test for data with normal distribution and using Mann-Whitney U test for data without normal distribution. Results: Most of the HRV parameters improved statistically significantly by both modalities of exercise. However, some of the HRV parameters showed statistically better improvement with yoga as compared to swimming. Conclusion: Practicing yoga seems to be the mode of exercise with better improvement in autonomic functions as suggested by resting HRV. PMID:26170587

  1. Prospective individual matching: covariate balance and power in a comparative study.

    PubMed

    Makuch, R W; Zhang, Z; Charpentier, P A; Inouye, S K

    1998-07-15

    In phase II to phase IV studies, randomization has gained widespread acceptance as a methodologic tool for the allocation of patients to treatment. However, randomization is not always feasible. At times, the treatment intervention occurs universally throughout one or more units (for example, a hospital unit), while the control therapy is the only intervention provided in other units. Patients may arrive randomly at a unit, based solely on availability of the unit to accept new subjects. Thus, the treatment assignment process is out of the investigator's control and not subject to selection bias. We describe a prospective individual matching procedure through which one can achieve balanced allocation of subjects to treatment groups in this comparative study setting. In this paper, we compare balance of baseline covariates and power for this design, in which the subject is selected at random and assigned to a treatment group, and the traditional randomized block design, in which the treatment is chosen at random and assigned to a subject. We show that the prospective individual matching procedure compares favourably to the traditional randomized blocked design with respect to both baseline covariate comparability and statistical power. PMID:9695196

  2. Energy Auditing.

    ERIC Educational Resources Information Center

    Association of Energy Engineers, Atlanta, GA.

    Presented is a discussion of various aspects of policy and implementation of energy auditing at various levels of government. Included are 11 chapters dealing with: (1) a national energy plan, (2) state certification for energy auditors, (3) survey instrumentation, (4) energy management economics, (5) Maine school energy auditing, (6) energy…

  3. Prospective clinical trial comparing outcome measures between Furlow and von Langenbeck Palatoplasties for UCLP.

    PubMed

    Williams, William N; Seagle, M Brent; Pegoraro-Krook, Maria Ines; Souza, Telma V; Garla, Luis; Silva, Marcos L; Machado Neto, José S; Dutka, Jeniffer C R; Nackashi, John; Boggs, Steve; Shuster, Jonathan; Moorhead, Jacquelyn; Wharton, William; Graciano, Maria I G; Pimentel, Maria C; Feniman, Mariza; Piazentin-Penna, Silvia H A; Kemker, Joseph; Zimmermann, Maria C; Bento-Gonçalvez, Cristina; Borgo, Hilton; Marques, Ilza L; Martinelli, Angela P M C; Jorge, José C; Antonelli, Patrick; Neves, Josiane F A; Whitaker, Melina E

    2011-02-01

    The goal of this prospective randomized clinical trial was to compare 2 cohorts of standardized cleft patients with regard to functional speech outcome and the presence or absence of palatal fistulae. The 2 cohorts are randomized to undergo either a conventional von Langenbeck repair with intravelar velarplasty or the double-opposing Z-plasty Furlow procedure. A prospective 2 × 2 × 2 factorial clinical trial was used in which each subject was randomly assigned to 1 of 8 different groups: 1 of 2 different lip repairs (Spina vs. Millard), 1 of 2 different palatal repair (von Langenbeck vs. Furlow), and 1 of 2 different ages at time of palatal surgery (9-12 months vs. 15-18 months). All surgeries were performed by the same 4 surgeons. A cul-de-sac test of hypernasality and a mirror test of nasal air emission were selected as primary outcome measures for velopharyngeal function. Both a surgeon and speech pathologist examined patients for the presence of palatal fistulae. In this study, the Furlow double-opposing Z-palatoplasty resulted in significantly better velopharyngeal function for speech than the von Langenbeck procedure as determined by the perceptual cul-de-sac test of hypernasality. Fistula occurrence was significantly higher for the Furlow procedure than for the von Langenbeck. Fistulas were more likely to occur in patients with wider clefts and when relaxing incisions were not used. PMID:21042188

  4. Stereotactically-navigated percutaneous Irreversible Electroporation (IRE) compared to conventional IRE: a prospective trial

    PubMed Central

    Pregler, Benedikt; Nießen, Christoph; Schicho, Andreas; Haimerl, Michael; Jung, Ernst Michael; Stroszczynski, Christian; Wiggermann, Philipp

    2016-01-01

    Purpose. The purpose of this study was to compare CT-navigated stereotactic IRE (SIRE) needle placement to non-navigated conventional IRE (CIRE) for percutaneous ablation of liver malignancies. Materials and Methods. A prospective trial including a total of 20 patients was conducted with 10 patients in each arm of the study. IRE procedures were guided using either CT fluoroscopy (CIRE) or a stereotactic planning and navigation system (SIRE). Primary endpoint was procedure time. Secondary endpoints were accuracy of needle placement, technical success rate, complication rate and dose-length product (DLP). Results. A total of 20 IRE procedures were performed to ablate hepatic malignancies (16 HCC, 4 liver metastases), 10 procedures in each arm. Mean time for placement of IRE electrodes in SIRE was significantly shorter with 27 ± 8 min compared to 87 ± 30 min for CIRE (p < 0.001). Accuracy of needle placement for SIRE was higher than CIRE (2.2 mm vs. 3.3 mm mean deviation, p < 0.001). The total DLP and the fluoroscopy DLP were significantly lower in SIRE compared to CIRE. Technical success rate and complication rates were equal in both arms. Conclusion. SIRE demonstrated a significant reduction of procedure length and higher accuracy compared to CIRE. Stereotactic navigation has the potential to reduce radiation dose for the patient and the radiologist without increasing the risk of complications or impaired technical success compared to CIRE. PMID:27602266

  5. Stereotactically-navigated percutaneous Irreversible Electroporation (IRE) compared to conventional IRE: a prospective trial.

    PubMed

    Beyer, Lukas P; Pregler, Benedikt; Nießen, Christoph; Schicho, Andreas; Haimerl, Michael; Jung, Ernst Michael; Stroszczynski, Christian; Wiggermann, Philipp

    2016-01-01

    Purpose. The purpose of this study was to compare CT-navigated stereotactic IRE (SIRE) needle placement to non-navigated conventional IRE (CIRE) for percutaneous ablation of liver malignancies. Materials and Methods. A prospective trial including a total of 20 patients was conducted with 10 patients in each arm of the study. IRE procedures were guided using either CT fluoroscopy (CIRE) or a stereotactic planning and navigation system (SIRE). Primary endpoint was procedure time. Secondary endpoints were accuracy of needle placement, technical success rate, complication rate and dose-length product (DLP). Results. A total of 20 IRE procedures were performed to ablate hepatic malignancies (16 HCC, 4 liver metastases), 10 procedures in each arm. Mean time for placement of IRE electrodes in SIRE was significantly shorter with 27 ± 8 min compared to 87 ± 30 min for CIRE (p < 0.001). Accuracy of needle placement for SIRE was higher than CIRE (2.2 mm vs. 3.3 mm mean deviation, p < 0.001). The total DLP and the fluoroscopy DLP were significantly lower in SIRE compared to CIRE. Technical success rate and complication rates were equal in both arms. Conclusion. SIRE demonstrated a significant reduction of procedure length and higher accuracy compared to CIRE. Stereotactic navigation has the potential to reduce radiation dose for the patient and the radiologist without increasing the risk of complications or impaired technical success compared to CIRE. PMID:27602266

  6. A Critical Evaluation of Academic Internal Audit

    ERIC Educational Resources Information Center

    Blackmore, Jacqueline Ann

    2004-01-01

    This account of internal audit is set within the context of higher education in the UK and a fictitiously named Riverbank University. The study evaluates the recent introduction of "Internal Academic Audit" to the University and compares the process with that of the internationally recognized ISO 19011 Guidelines for Auditing Quality Management…

  7. 25 CFR 571.12 - Audit standards.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Audit standards. 571.12 Section 571.12 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR COMPLIANCE AND ENFORCEMENT PROVISIONS MONITORING AND INVESTIGATIONS Audits § 571.12 Audit standards. (a) Each tribe shall prepare comparative financial...

  8. NCQA implements new outcomes audit standards.

    PubMed

    1997-06-01

    Faulty data gathering and auditing techniques have put in question the comparability of HEDIS outcomes standards. The National Center for Quality Assurance has moved to shore up its data's credibility with new auditing standards. A new class of certified auditors must be trained. Until then, the Health Care Financing Administration will have Medicare managed care organizations audited by independent firms. PMID:10168410

  9. Lumbar myelography with iohexol and metrizamide: a comparative multicenter prospective study

    SciTech Connect

    Kieffer, S.A.; Binet, E.F.; Davis, D.O.; Gabrielsen, T.O.; Kido, D.K.; Latchaw, R.E.; Turski, P.A.; Shaw, D.D.

    1984-06-01

    Diagnostic quality of radiographs and adverse reactions associated with the use of metrizamide and iohexol as contrast agents in lumbar myelography were compared in a prospective randomized double blind study in 350 patients at seven centers. Overall quality of radiographic visualization was graded good or excellent in 95% of 175 metrizamide studies and in 98% of 175 iohexol studies. Ninety-three patients examined using metrizamide (53%) and 130 patients examined using iohexol (74%) experienced no discomfort during or after myelography. Postmyelographic headache was associated with 38% of metrizamide examinations and 21% of iohexol examinations. Nausea and vomiting were also more common with metrizamide. Five patients examined using metrizamide (3%) experienced transient confusion and disorientation following lumbar myelography. No such reactions were observed following iohexol myelography.

  10. A Report of the Senate Committee on Post Audit and Oversight Relative to Massachusetts' Financial Commitment to Public Education in the Eighties: A Multi-State Comparative Study. Senate No. 2080.

    ERIC Educational Resources Information Center

    Massachusetts State Legislature, Boston. Senate Committee on Post Audit and Oversight.

    During the 1980s, Massachusetts' public commitment to increase educational funding was not carried through. To determine state educational funding for the decade, the Senate Committee on Post Audit and Oversight compared Massachusetts with nine other comparable states in expenditures per pupil, expenditures per capita, and expenditures per $1,000…

  11. Superior border versus inferior border fixation in displaced mandibular angle fractures: prospective randomized comparative study.

    PubMed

    Singh, V; Khatana, S; Bhagol, A

    2014-07-01

    A prospective randomized comparative study was conducted to compare open reduction and internal fixation of displaced fractures (>2mm) via intraoral approach with application of a single monocortical miniplate according to Champy's ideal line of osteosynthesis (group A) versus an extraoral approach with application of an inferior border plate with at least two holes (bicortical screws) on either side of the fracture line (group B). Clinical and radiographic assessment was done preoperatively, immediately postoperative, and at 1, 4, and 12 weeks of follow-up. Parametric and non-parametric data were evaluated by independent samples t-test and χ(2) analysis, respectively; P<0.05 was considered statistically significant. There was no significant difference between the two groups with regard to complication rates, although functional outcomes including pain (visual analogue scale score) at the 1-week follow-up and inter-incisal mouth opening at the 12-week follow-up were found to be better in group B. On radiographic assessment, the inferior border was better aligned in group B than in group A, with no superior border distraction in group B. The duration of surgery was shorter in group B, and this was considered to be the easier approach for fixation of the device as assessed by the surgeons. PMID:24636170

  12. Scholastic Audits. Research Brief

    ERIC Educational Resources Information Center

    Walker, Karen

    2009-01-01

    What is a scholastic audit? The purpose of the audit is to assist individual schools and districts improve. The focus is on gathering data and preparing recommendations that can be used to guide school improvement initiatives. Scholastic audits use a multi-step approach and include: (1) Preparing for the Audit; (2) Audit process; (3) Audit report;…

  13. Breast Cancer–Related Lymphedema: Comparing Direct Costs of a Prospective Surveillance Model and a Traditional Model of Care

    PubMed Central

    Pfalzer, Lucinda A.; Springer, Barbara; Levy, Ellen; McGarvey, Charles L.; Danoff, Jerome V.; Gerber, Lynn H.; Soballe, Peter W.

    2012-01-01

    Secondary prevention involves monitoring and screening to prevent negative sequelae from chronic diseases such as cancer. Breast cancer treatment sequelae, such as lymphedema, may occur early or late and often negatively affect function. Secondary prevention through prospective physical therapy surveillance aids in early identification and treatment of breast cancer–related lymphedema (BCRL). Early intervention may reduce the need for intensive rehabilitation and may be cost saving. This perspective article compares a prospective surveillance model with a traditional model of impairment-based care and examines direct treatment costs associated with each program. Intervention and supply costs were estimated based on the Medicare 2009 physician fee schedule for 2 groups: (1) a prospective surveillance model group (PSM group) and (2) a traditional model group (TM group). The PSM group comprised all women with breast cancer who were receiving interval prospective surveillance, assuming that one third would develop early-stage BCRL. The prospective surveillance model includes the cost of screening all women plus the cost of intervention for early-stage BCRL. The TM group comprised women referred for BCRL treatment using a traditional model of referral based on late-stage lymphedema. The traditional model cost includes the direct cost of treating patients with advanced-stage lymphedema. The cost to manage early-stage BCRL per patient per year using a prospective surveillance model is $636.19. The cost to manage late-stage BCRL per patient per year using a traditional model is $3,124.92. The prospective surveillance model is emerging as the standard of care in breast cancer treatment and is a potential cost-saving mechanism for BCRL treatment. Further analysis of indirect costs and utility is necessary to assess cost-effectiveness. A shift in the paradigm of physical therapy toward a prospective surveillance model is warranted. PMID:21921254

  14. RANDOMIZED PROSPECTIVE STUDY COMPARING TRANSVERSE AND EXTRACORTICAL FIXATION IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

    PubMed Central

    da Silva Guarilha, Eduardo; de Andrade Fígaro Caldeira, Paulo Roberto; de Almeida Lira Neto, Ozorio; Navarro, Marcelo Schmidt; Milani, Antonio; Filho, Mario Carneiro

    2015-01-01

    Objective: This study had the objective of prospectively comparing transverse fixation (Cross-Pin™) with extracortical fixation (EZLoc™) for the femur, in surgical reconstruction of the anterior cruciate ligament, from a clinical, biomechanical and functional point of view. Methods: Between April 2007 and November 2009, 50 patients with acute or chronic anterior cruciate ligament injuries underwent arthroscopic reconstruction using the homologous flexor tendons (gracilis and semitendinosus). Randomization of the femoral fixation method was done by means of a draw at the time of the procedure. Patients were excluded if they presented multiple ligament lesions, fractures, previous surgery, autoimmune disease and impairment of the contralateral knee. The Lysholm scale, SF36 quality-of-life questionnaire and KT1000™ arthrometer were used. Results: After a mean follow-up of 18.1 months, there were no statistically significant differences between the groups regarding the Lysholm scale and KT1000™ measurements. However, the SF36 questionnaire showed a statistical difference such that transverse fixation was superior regarding pain and vitality. Conclusion: Both techniques were shown to be efficient for transfemoral fixation, but with almost no statistically significant difference between them. We believe that new studies will be necessary for better understanding of these differences. PMID:27042646

  15. Is the peripapillary retinal perfusion related to myopia in healthy eyes? A prospective comparative study

    PubMed Central

    Wang, Xiaolei; Kong, Xiangmei; Jiang, Chunhui; Li, Mengwei; Yu, Jian; Sun, Xinghuai

    2016-01-01

    Objectives The aim of this study was to evaluate the peripapillary and parafoveal perfusion of young, healthy myopic subjects with spectral domain optical coherence tomography (OCT) angiography. Design A prospective comparative study was conducted from December 2014 to January 2015. Setting Participants recruited from a population-based study performed by the Eye, Ear, Nose and Throat Hospital of Fudan University in Shanghai. Participants A total of 78 Chinese normal subjects (78 eyes) with different refraction were included. Myopia was divided into 4 groups on the basis of the refractive status: 20 eyes with emmetropia (mean spherical equivalent (MSE) 0.50D to −0.50D), 20 eyes with mild myopia (MSE −0.75D to −2.75D), 20 eyes with moderate myopia (MSE −3.00D to −5.75D), and 18 eyes with high myopia (MSE≤−6.00D). Main outcome measures Peripapillary and parafoveal retinal and choroidal perfusion parameters and their relationships with axial length (AL) and retinal nerve fibre layer (RNFL) thickness were analysed. Results Significant differences were found for the retinal flow index and vessel density in the peripapillary area among the 4 groups, but not in the parafoveal area. The high myopia group had the lowest peripapillary retinal flow index and vessel density. In addition, there was a negative correlation (β=−0.002, p=0.047) between the AL and peripapillary retinal flow index and a positive correlation between RNFL thickness and the peripapillary retinal perfusion parameters (flow index: β=0.001, p=0.006; vessel density: β=0.350, p=0.002) even after adjustment for other variables. Conclusions Highly myopic eyes have a decreased peripapillary retinal perfusion compared with emmetropic eyes. Such vascular features might increase the susceptibility to vascular-related eye diseases. PMID:26969645

  16. Outcome in primary cemented total knee arthroplasty with or without drain: A prospective comparative study

    PubMed Central

    Kęska, Rafał; Paradowski, T Przemysław; Witoński, Dariusz

    2014-01-01

    Background: Suction drain insertion is a common practice in orthopedic surgery, especially after joint arthroplasty to prevent the formation of a hematoma. Theoretically the use of a drain should diminish the volume of hematoma; however the literature has conflicting data. Some authors state that drainage evacuates fluid from a limited area only and can be a cause of infection due to retrograde migration of bacteria. It can also impair the early postoperative rehabilitation. The aim of this study was to evaluate the clinical outcome (especially postoperative pain) and intake of analgesics in patients who had undergone primary cemented total knee arthroplasty (TKA) with or without a postoperative drain. Materials and Methods: A prospective comparative study of 108 consecutive patients (121 knees) was conducted. They were divided into two groups: A study group, with no drainage and a control group with drain inserted at the end of surgery. A total of 121 patients were recruited into two groups. A study group consisted of 59 knees, in which we did not use drainage after TKA and a control group with 62 knees, in which drain was inserted post surgery. Both groups were comparable in terms of preoperative characteristics. The indication for TKA was osteoarthritis (n = 105) and rheumatoid arthritis (n = 16). Results: In patients without drainage we observed lower need for opioids, higher blood loss on the 1st postoperative day and a lower need for change of dressings. There were no statistically significant differences in terms of total blood loss, hidden blood loss, transfusion rate, range of motion, length of hospital stay or incidence of complications between the two groups. In 1 year observation there were no differences in clinical outcome between the two groups. Conclusions: The present study conclude that there is no rationale for the use of drain after primary TKA. There are benefits in terms of lower opioid intake, lower blood loss on the first postoperative day

  17. Prospective, comparative effectiveness trial of cow's milk elimination and swallowed fluticasone for pediatric eosinophilic esophagitis.

    PubMed

    Kruszewski, P G; Russo, J M; Franciosi, J P; Varni, J W; Platts-Mills, T A E; Erwin, E A

    2016-05-01

    Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease in which food antigens play a key role. Current therapeutic options are limited to long-term steroid medication and dietary elimination of multiple foods, each of which is challenging. Our objective was to compare single food elimination of cow's milk to swallowed fluticasone in pediatric EoE patients. This is a prospective, comparative effectiveness trial of newly diagnosed EoE patients (ages 2-18 years) treated with swallowed fluticasone (n = 24) or elimination of cow's milk (n = 20). The dual outcome measures of repeat esophageal biopsy (6-8 weeks) and change in Pediatric Quality of Life Inventor (PedsQL) EoE Module and Symptoms Scales were used to assess response to treatment. After 6-8 weeks of treatment, peak esophageal eosinophil counts decreased to below the threshold of 15 eosinophils/high-power field in 64% of patients treated with cow's milk elimination and 80% of patients treated with swallowed fluticasone (P = 0.4). Mean PedsQL EoE Module total scores (69 vs. 82; P < 0.005) and Total Symptoms scores (58 vs. 75; P = 0.001) showed significant improvement with cow's milk elimination. Among children treated with swallowed fluticasone, mean PedsQL EoE Module total scores (64 vs. 75; P < 0.05) and Total Symptoms scores (58 vs. 69; P < 0.01) were also significantly improved after 6-8 weeks of therapy. Removal of cow's milk from the diet is an effective single food elimination treatment for pediatric patients with EoE as assessed by statistically significant histologic and symptomatic improvement. Cow's milk elimination may be more desirable for EoE patients who do not want to take chronic, long-term steroid medications. PMID:25721813

  18. A Comparative Analysis of Graduate Employment Prospects in European Labour Markets: A Study of Graduate Recruitment in Four Countries

    ERIC Educational Resources Information Center

    Branine, Mohamed; Avramenko, Alex

    2015-01-01

    The aim of this paper is to provide a comparative analysis of higher education and the graduate labour markets in selected European countries (France, Germany, Spain and United Kingdom) in the context of the expectations of graduates and prospective employers, and respective recruitment and selection practices. Expectations of graduating students…

  19. The Prospective Oral Mucositis Audit: relationship of severe oral mucositis with clinical and medical resource use outcomes in patients receiving high-dose melphalan or BEAM-conditioning chemotherapy and autologous SCT.

    PubMed

    McCann, S; Schwenkglenks, M; Bacon, P; Einsele, H; D'Addio, A; Maertens, J; Niederwieser, D; Rabitsch, W; Roosaar, A; Ruutu, T; Schouten, H; Stone, R; Vorkurka, S; Quinn, B; Blijlevens, N

    2009-01-01

    The Prospective Oral Mucositis Audit was an observational study in 197 patients with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL) undergoing, respectively, high-dose melphalan or BEAM chemotherapy and autologous SCT at 25 European centres. We evaluated the relationship between severe oral mucositis (SOM; WHO Oral Toxicity Scale grade 3-4) and local and systemic clinical sequelae and medical resource use. SOM occurred in 44% of patients. The duration of SOM (mean 5.3 days) correlated with time to neutrophil engraftment. The following parameters increased gradiently with maximum grade of oral mucositis: duration of pain score >or=4, opioid use, dysphagia score >or=4, total parenteral nutrition (TPN) use, incidence and/or duration of fever and infection, and duration of antibiotic use. SOM increased the duration of TPN use by 2.7 days (P<0.001), opioids by 4.6 days (P<0.001), and antibiotics by 2.4 days (P=0.045). SOM prolonged hospital stay by 2.3 days (P=0.013) in MM patients, but not in NHL patients (who tended to have a longer hospital stay). In conclusion, this analysis of prospectively collected observational data provides important insight into the scope and impact of SOM in the European transplant setting. PMID:18776926

  20. A prospective randomized trial comparing stapler and laser techniques for interlobar fissure completion during pulmonary lobectomy.

    PubMed

    Marulli, Giuseppe; Droghetti, Andrea; Di Chiara, Francesco; Calabrese, Francesca; Rebusso, Alessandro; Perissinotto, Egle; Muriana, Giovanni; Rea, Federico

    2013-02-01

    Alveolar air leaks, often resulting from lung tissue traumatization during dissection of fissures, still remain a challenging problem in lung surgery. Several tools and techniques have been used to reduce air leakage, but none was judged ideal. This prospective, randomized trial was designed to evaluate the feasibility, safety, and effectiveness of completion of fissures during pulmonary lobectomy by using a laser system. A standard stapler technique was used for comparison; the primary goal was to reach at least a comparable result. Forty-four patients were enrolled, 22 were treated with standard technique by using staplers (S) and 22 underwent laser (L) dissection. Randomization to one of the two groups was intraoperative after evaluating the presence of incomplete fissure (grade 3-4 following Craig's classification). A Thulium laser 2010 nm (Cyber TM, Quanta System, Italy) was used at power of 40 W. Outcome primary measures were the evaluation and duration of intra- and postoperative air leaks, the rate of complications, and the hospital stay. Air leaks (2.1 ± 4.2 vs 3.6 ± 7.2 days; p = 0.98) and chest tube duration (6.4 ± 4.2 vs 7.5 ± 6.3 days, p = 0.44) were lower in L compared with S group even if these were not statistically significant. Complications (36.4 vs 77.3 %; p = 0.006), hospital stay (6.9 ± 3.8 vs 9.9 ± 6.9 days; p = 0.03), hospitalization costs (5,650 vs 8,147 euros; p = 0.01), and procedure costs (77 % of difference; p < 0.0001) were significantly lower for L group, while operative time was longer (197 ± 34 vs 158 ± 41 min; p = 0.004). The use of laser dissection to prevent postoperative air leaks is effective and comparable with stapler technique. Aero-haemostatic laser properties (by sealing of small blood vessels and checking air leaks) allow a safe application during pulmonary lobectomy in interlobar fissure completion avoiding stapler use. PMID:22526973

  1. A prospective study comparing the efficacy and safety of two sublingual birch allergen preparations

    PubMed Central

    2014-01-01

    Background SUBLIVAC FIX Birch (SUB-B) is a liquid oral preparation of Betula verrucosa pollen extract for the treatment of allergic rhinitis/rhinoconjuctivitis induced by birch pollen. The major allergen content of SUB-B and Staloral Birch (Stal-B) have been shown to be comparable. In order to compare the clinical efficacy and safety of both products, the present study was designed to investigate efficacy of treatment with SUB-B compared to Stal-B by means of reduction in allergy symptoms assessed by a titrated nasal provocation test (TNPT) in subjects suffering from IgE mediated allergy complaints triggered by birch pollen. Methods A prospective, randomized, open, blinded endpoint (PROBE), controlled, single-centre study in 74 birch allergic adults was performed. Treatment consisted of either SUB-B (10,000 AUN/ml) or Stal-B (initial phase 10 I.R./ml and maintenance phase 300 I.R./ml) for 16–20 weeks at maintenance dose. The primary efficacy outcome was defined by the difference in change of the TNPT-threshold dose between the two treatment groups at baseline and after completion of treatment. Secondary outcomes included determination of birch pollen specific IgE and IgG levels, safety lab and ECG. During the first 30 days of treatment, subjects were requested to fill out a diary concerning compliance with study medication, occurrence of AEs and the use of concomitant medication. Results Analysis of the primary efficacy parameter showed that the percentage of subjects showing a beneficial treatment effect was similar in both treatment groups, 33.3% for SUB-B vs. 31.4% for Stal-B in the intention to treat population. Evaluation of the immunologic response, showed that treatment with SUB-B and Stal-B induced similar increases (approximately 2 times) in IgE, IgG and IgG4 specific for Bet v 1. In total, 143 related adverse events (AEs) were reported. The majority of the AEs was of mild intensity. The same pattern of AEs was observed for both products. No clinically

  2. Comparing Utility Scores in Common Spinal Radiculopathies: Results of a Prospective Valuation Study

    PubMed Central

    Nayak, Nikhil R.; Stephen, James H.; Abdullah, Kalil G.; Stein, Sherman C.; Malhotra, Neil R.

    2015-01-01

    Study Design Prospective observational study. Objective To determine whether preference-based health utility scores for common spinal radiculopathies vary by specific spinal level. Methods We employed a standard gamble study using the general public to calculate individual preference-based quality of life for four common radiculopathies: C6, C7, L5, and S1. We compared utility scores obtained for each level of radiculopathy with analysis of variance and t test. Multivariable regression was used to test the effects of the covariates age, sex, and years of education. We also reviewed the literature for publications reporting EuroQol-5 Dimensions (EQ-5D) scores for patients with radiculopathy. Results Two hundred participants were included in the study. Average utility for the four spinal levels fell within a narrow range (0.748 to 0.796). There were no statistically significant differences between lumbar and cervical radiculopathies, nor were there significant differences among the different spinal levels (F = 0.0850, p = 0.086). Age and sex had no significant effect on utility scores. There was a significant correlation between years of education and utility values for S1 radiculopathy (p = 0.037). On review of the literature, no study separated utility values by specific spinal level. EQ-5D utilities for both cervical and lumbar radiculopathy were considerably lower than the results of our study. Conclusions Utility values associated with the most common levels of cervical and lumbar radiculopathy do not significantly differ from each other, validating the current practice of grouping utility by spinal segment rather than by specific root levels. The discrepancy in average utility values between our study and the EQ-5D highlights the need to be mindful of the underlying instruments used when assessing outcomes studies from different sources. PMID:27099818

  3. Comparing Utility Scores in Common Spinal Radiculopathies: Results of a Prospective Valuation Study.

    PubMed

    Nayak, Nikhil R; Stephen, James H; Abdullah, Kalil G; Stein, Sherman C; Malhotra, Neil R

    2016-05-01

    Study Design Prospective observational study. Objective To determine whether preference-based health utility scores for common spinal radiculopathies vary by specific spinal level. Methods We employed a standard gamble study using the general public to calculate individual preference-based quality of life for four common radiculopathies: C6, C7, L5, and S1. We compared utility scores obtained for each level of radiculopathy with analysis of variance and t test. Multivariable regression was used to test the effects of the covariates age, sex, and years of education. We also reviewed the literature for publications reporting EuroQol-5 Dimensions (EQ-5D) scores for patients with radiculopathy. Results Two hundred participants were included in the study. Average utility for the four spinal levels fell within a narrow range (0.748 to 0.796). There were no statistically significant differences between lumbar and cervical radiculopathies, nor were there significant differences among the different spinal levels (F = 0.0850, p = 0.086). Age and sex had no significant effect on utility scores. There was a significant correlation between years of education and utility values for S1 radiculopathy (p = 0.037). On review of the literature, no study separated utility values by specific spinal level. EQ-5D utilities for both cervical and lumbar radiculopathy were considerably lower than the results of our study. Conclusions Utility values associated with the most common levels of cervical and lumbar radiculopathy do not significantly differ from each other, validating the current practice of grouping utility by spinal segment rather than by specific root levels. The discrepancy in average utility values between our study and the EQ-5D highlights the need to be mindful of the underlying instruments used when assessing outcomes studies from different sources. PMID:27099818

  4. Prospective Randomized Trial Comparing Hepatic Venous Outflow and Renal Function after Conventional versus Piggyback Liver Transplantation

    PubMed Central

    Brescia, Marília D’Elboux Guimarães; Massarollo, Paulo Celso Bosco; Imakuma, Ernesto Sasaki; Mies, Sérgio

    2015-01-01

    Background This randomized prospective clinical trial compared the hepatic venous outflow drainage and renal function after conventional with venovenous bypass (n = 15) or piggyback (n = 17) liver transplantation. Methods Free hepatic vein pressure (FHVP) and central venous pressure (CVP) measurements were performed after graft reperfusion. Postoperative serum creatinine (Cr) was measured daily on the first week and on the 14th, 21st and 28th postoperative days (PO). The prevalence of acute renal failure (ARF) up to the 28th PO was analyzed by RIFLE-AKIN criteria. A Generalized Estimating Equation (GEE) approach was used for comparison of longitudinal measurements of renal function. Results FHVP-CVP gradient > 3 mm Hg was observed in 26.7% (4/15) of the patients in the conventional group and in 17.6% (3/17) in the piggyback group (p = 0.68). Median FHVP-CVP gradient was 2 mm Hg (0–8 mmHg) vs. 3 mm Hg (0–7 mm Hg) in conventional and piggyback groups, respectively (p = 0.73). There is no statistically significant difference between the conventional (1/15) and the piggyback (2/17) groups regarding massive ascites development (p = 1.00). GEE estimated marginal mean for Cr was significantly higher in conventional than in piggyback group (2.14 ± 0.26 vs. 1.47 ± 0.15 mg/dL; p = 0.02). The conventional method presented a higher prevalence of severe ARF during the first 28 PO days (OR = 3.207; 95% CI, 1.010 to 10.179; p = 0.048). Conclusion Patients submitted to liver transplantation using conventional or piggyback methods present similar results regarding venous outflow drainage of the graft. Conventional with venovenous bypass technique significantly increases the harm of postoperative renal dysfunction. Trial Registration ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT01707810 PMID:26115520

  5. Sedation in gastrointestinal endoscopy: a prospective study comparing nonanesthesiologist-administered propofol and monitored anesthesia care

    PubMed Central

    de Paulo, Gustavo Andrade; Martins, Fernanda P.B.; Macedo, Erika P.; Gonçalves, Manoel Ernesto P.; Mourão, Carlos Alberto; Ferrari, Angelo P.

    2015-01-01

    Introduction: Adequate sedation is one of the cornerstones of good quality gastrointestinal endoscopy (GIE). Propofol sedation has increased significantly but there has been much debate over whether it can be administered by endoscopists. The aim of this prospective trial was to compare nonanesthesiologist-administered propofol (NAAP) and monitored anesthesia care (MAC). Methods: A total of 2000 outpatients undergoing GIE at Hospital Albert Einstein (São Paulo, Brazil), a tertiary-care private hospital, were divided into two matched groups: NAAP (n = 1000) and MAC (n = 1000). In NAAP, propofol doses were determined by the endoscopist. A second physician stayed in the room during the entire procedure, according to local regulations. In MAC, the anesthesiologist administered propofol. Results: In total, 1427 patients (71.3 %) were ASA (American Society of Anesthesiologists) class I and 573 were ASA class II. In NAAP, patients received more propofol + fentanyl (61.1 % vs. 50.5 %; P < 0.05) and there were fewer cases of deep sedation (44.7 % vs. 66.1 %; P < 0.05). Hypoxemia rates were similar (12.8 % for NAAP and 11.2 % for MAC; P = 0.3) but these reverted more rapidly in MAC (4.22 seconds vs. 7.26 seconds; P < 0.05). Agitation was more frequent in MAC (14.0 % vs. 5.6 %; P < 0.05). No later complications were observed. Patient satisfaction was very high and similar in both groups. Conclusion: In this setting, NAAP was as safe and effective as MAC for healthy patients undergoing GIE. Clinical trial ref. no.: U1111-1134-4430 PMID:26134777

  6. Transverse vs torsional ultrasound: prospective randomized contralaterally controlled study comparing two phacoemulsification-system handpieces

    PubMed Central

    Assil, Kerry K; Harris, Lindsay; Cecka, Jeannie

    2015-01-01

    Purpose To compare surgical efficiency and multiple early clinical outcome variables in eyes undergoing phacoemulsification using either transversal or torsional ultrasound systems. Setting Assil Eye Institute, Beverly Hills, CA, USA. Design Prospective, randomized, clinician-masked, contralaterally controlled single-center evaluation. Patients and methods Patients seeking cataract removal in both eyes with implantation of multifocal intraocular lenses were randomly assigned to one of two treatment rooms for phacoemulsification with either a transverse ultrasound system or torsional handpiece system. The contralateral eye was treated at a later date with the alternate device. A total of 54 eyes of 27 patients having similar degrees of cataract, astigmatism, and visual potential were included. All operative data were collected for analysis, and patients were followed for 3 months after surgery. Results Similar visual acuity was reported at all postoperative visits between the two groups. Mean phacoemulsification time and total power required were both significantly lower with the transverse system than with the torsional technique (P<0.05 for both). Similarly, mean total balanced salt solution used was significantly less with the transverse system vs torsional (P<0.05). Postoperative safety demonstrated significantly lower endothelial cell loss at 1 day and 1 month (P<0.05) with transverse vs torsional. Macular swelling was less at 1 week, 1 month, and 3 months with transverse vs torsional, although the difference did not achieve significance (P=0.1) at any single time point. Clinically detectable corneal edema was reported less frequently at all postoperative time points with the transverse system. Conclusion The transverse ultrasound system was found to be possibly associated with less balanced salt-solution use, less phacoemulsification time, and less power required than the torsional phaco system. Postoperative data suggested that improved phaco efficiency may

  7. Is faecal calprotectin equally useful in all Crohn's disease locations? A prospective, comparative study

    PubMed Central

    Eder, Piotr; Lykowska-Szuber, Liliana; Krela-Kazmierczak, Iwona; Klimczak, Katarzyna; Szymczak, Aleksandra; Szachta, Patrycja; Katulska, Katarzyna; Linke, Krzysztof

    2015-01-01

    Introduction There are data suggesting that the diagnostic usefulness of faecal calprotectin (FC) may vary depending on the Crohn's disease (CD) location. The aim of the study was to compare the diagnostic usefulness of FC in CD patients with different disease locations. Material and methods We prospectively enrolled 120 CD patients in the study. Disease activity was assessed by using Crohn's Disease Activity Index (CDAI), biochemical markers, and endoscopic and radiographic methods. Faecal calprotectin concentration was assessed in single stool samples by using the ELISA method. Results Among all patients, 54 (45%) had ileocolonic CD location, 44 (36.5%) had isolated small bowel location, and 22 (18.5%) had colonic CD location. FC correlated significantly with C-reactive protein concentration and endoscopic and radiographic activity among patients with isolated small bowel CD (p = 0.03, r = 0.32; p < 0.0001, r = 0.78; p = 0.03, r = 0.35; respectively) and with C-reactive protein and endoscopic activity in isolated colonic CD (p = 0.0009, r = 0.7; p = 0.0002, r = 0.78; respectively). CDAI and inflammatory biochemical markers did not correlate with endoscopic and radiographic assessment in small bowel CD. In patients with ileocolonic CD, FC correlated significantly with endoscopy (p = 0.006, r = 0.5), radiographic assessment (p = 0.04, r = 0.3), CDAI (p = 0.0006, r = 0.5) and the majority of biochemical markers. Conclusions Faecal calprotectin is a useful diagnostic marker in all CD patients. Although its usefulness in small bowel CD seems to be the lowest, it should be utilized particularly in this disease location because of the lack of other reliable, non-invasive diagnostic methods. PMID:25995752

  8. PROSPECTIVE AND COMPARATIVE STUDY ON FUNCTIONAL OUTCOMES AFTER OPEN AND ARTHROSCOPIC REPAIR OF ROTATOR CUFF TEARS

    PubMed Central

    de Castro Veado, Marco Antônio; Castilho, Rodrigo Simões; Maia, Philipe Eduardo Carvalho; Rodrigues, Alessandro Ulhôa

    2015-01-01

    Objective: To prospectively assess the surgical results from patients undergoing repairs to rotator cuff injuries via open and arthroscopic procedures, with regard to functional and clinical features, and by means of ultrasound examinations, and to compare occurrences of renewed tearing. Methods: Sixty patients underwent operations performed by the same surgeon (29 via open surgery and 31 via arthroscopy), to repair complete rotator cuff tears. The procedures were performed at Hospital Governor Israel Pinheiro (HGIP) and Mater Dei Hospital in Belo Horizonte, Minas Gerais, between August 2007 and February 2009. The patients were assessed functionally by means of the UCLA score before and after the operation, and magnetic resonance imaging was done before the operation. All the patients were reassessed at least 12 months after the operation, and an ultrasound examination was also performed at this time. Results: Out of the 29 patients who underwent open surgery, 27 (93.1%) presented good or excellent results, with a mean UCLA score of 32 after the operation. Their mean follow-up was 14 months. Three patients presented renewed tearing on ultrasound, of whom one remained asymptomatic. Out of the 31 patients who underwent arthroscopic procedures, 29 (93.5%) presented good or excellent results, with a mean UCLA score of 33 after the operation. Their mean follow-up was 19 months. Two patients presented renewed tearing, of whom one remained asymptomatic and one evolved with loosening of an anchor, with an unsatisfactory result. Conclusion: The repairs on rotator cuff injuries presented good results by means of both open surgery and arthroscopy, with similar functional results in the two groups and similar rates of renewed tearing. PMID:27027052

  9. Scene disposition and mode of transport following rural trauma: a prospective cohort study comparing patient costs.

    PubMed

    Cummings, G; O'Keefe, G

    2000-04-01

    This prospective cohort study was performed from 1994 to 1996 to compare the impact of scene disposition on prehospital and hospital costs incurred by rural trauma patients transported to a trauma center by helicopter or ground ambulance. The study included all rural adult injury victims who arrived at the tertiary trauma center by ambulance within 24 h of injury. Inclusion criteria consisted of inpatient admission or death in the emergency department, and any traumatic injury except burns. Data collected included mortality, mode of transport, Injury Severity Score (ISS), and costs from impact to discharge or death. Of 105 study patients, 52 initially went to a rural hospital, while 53 went directly to the trauma center. There was no significant difference in survival in the two groups. The ISS was significantly higher for patients taken directly to the trauma center from the scene. The ISS of trauma patients transported from the rural hospital was highest for patients sent by ground transport. The prehospital transport costs were significantly more for patients transported to a rural hospital first. The costs incurred at the trauma center were highest for those patients transported directly from the scene. Many severely injured patients were initially transported to a rural hospital rather than directly to the trauma center. At both the scene and rural hospital, consistent use of triage criteria appeared to be lacking in determining the severity of injury, appropriate destination, and mode of transport for trauma patients. Since no significant difference in prehospital helicopter and ground transport costs was demonstrated, the decision on mode of transport should be in the best interest of patient care. PMID:10729675

  10. The Training Audit.

    ERIC Educational Resources Information Center

    Buckley, Roger; Caple, Jim

    1984-01-01

    This article discusses the role of the auditor and describes a seven-stage training audit model currently being employed by a multinational United Kingdom bank. Stages include familiarization, auditing the client, auditing the program, auditing the program organizer, auditing the consumer, presenting the report, and tasking action agencies. (CT)

  11. Prospective randomized study comparing clinical, functional, and aesthetic results of minipterional and classic pterional craniotomies.

    PubMed

    Welling, Leonardo C; Figueiredo, Eberval G; Wen, Hung T; Gomes, Marcos Q T; Bor-Seng-Shu, Edson; Casarolli, Cesar; Guirado, Vinicius M P; Teixeira, Manoel Jacobsen

    2015-05-01

    OBJECT The object of this study was to compare the clinical, functional, and aesthetic results of 2 surgical techniques, pterional (PT) and minipterional (MPT) craniotomies, for microsurgical clipping of anterior circulation aneurysms. METHODS Fifty-eight patients with ruptured and unruptured anterior circulation aneurysms were enrolled into a prospective randomized study. The first group included 28 patients who underwent the MPT technique, and the second group comprised 30 patients who underwent the classic PT craniotomy. To evaluate the aesthetic effects, patients were asked to grade on a rule from 0 to 100 the best and the worst aesthetic result. Photographs were also taken, assessed by 2 independent observers, and classified as showing excellent, good, regular, or poor aesthetic results. Furthermore, quantitative radiological assessment (percentage reduction in thickness and volumetric analysis) of the temporal muscle, subcutaneous tissue, and skin was performed. Functional outcomes were compared using the modified Rankin Scale (mRS). Frontal facial palsy, postoperative hemorrhage, cerebrospinal fistula, hydrocephalus, and mortality were also analyzed. RESULTS Demographic and preoperative characteristics were similar in both groups. Satisfaction in terms of aesthetic result was observed in 19 patients (79%) in the MPT group and 13 (52%) in the PT group (p = 0.07). The mean score on the aesthetic rule was 27 in the MPT group and 45.8 in the PT group (p = 0.03). Two independent observers analyzed the patient photos, and the kappa coefficient for the aesthetic results was 0.73. According to these observers, excellent and good results were seen in 21 patients (87%) in the MPT and 12 (48%) in the PT groups. The degree of temporal muscle, subcutaneous tissue, and skin atrophy was 14.9% in the MPT group and 24.3% in the PT group (p = 0.01). Measurements of the temporal muscle revealed 12.7% atrophy in the MPT group and 22% atrophy in the PT group (p = 0.005). The

  12. Northern Territory Heart Failure Initiative–Clinical Audit (NTHFI–CA)–a prospective database on the quality of care and outcomes for acute decompensated heart failure admission in the Northern Territory: study design and rationale

    PubMed Central

    Iyngkaran, Pupalan; Tinsley, Jeff; Smith, David; Haste, Mark; Nadarajan, Kangaharan; Ilton, Marcus; Battersby, Malcolm; Stewart, Simon; Brown, Alex

    2014-01-01

    Introduction Congestive heart failure is a significant cause of morbidity and mortality in Australia. Accurate data for the Northern Territory and Indigenous Australians are not presently available. The economic burden of this chronic cardiovascular disease is felt by all funding bodies and it still remains unclear what impact current measures have on preventing the ongoing disease burden and how much of this filters down to more remote areas. Clear differentials also exist in rural areas including a larger Indigenous community, greater disease burden, differing aetiologies for heart failure as well as service and infrastructure discrepancies. It is becoming increasingly clear that urban solutions will not affect regional outcomes. To understand regional issues relevant to heart failure management, an understanding of the key performance indicators in that setting is critical. Methods and analysis The Northern Territory Heart Failure Initiative—Clinical Audit (NTHFI-CA) is a prospective registry of acute heart failure admissions over a 12-month period across the two main Northern Territory tertiary hospitals. The study collects information across six domains and five dimensions of healthcare. The study aims to set in place an evidenced and reproducible audit system for heart failure and inform the developing heart failure disease management programme. The findings, is believed, will assist the development of solutions to narrow the outcomes divide between remote and urban Australia and between Indigenous and Non-Indigenous Australians, in case they exist. A combination of descriptive statistics and mixed effects modelling will be used to analyse the data. Ethics and dissemination This study has been approved by respective ethics committees of both the admitting institutions. All participants will be provided a written informed consent which will be completed prior to enrolment in the study. The study results will be disseminated through local and international

  13. Comparing Science Process Skills of Prospective Science Teachers: A Cross-Sectional Study

    ERIC Educational Resources Information Center

    Farsakoglu, Omer Faruk; Sahin, Cigdem; Karsli, Fethiye

    2012-01-01

    This study was conducted with the purpose of examining how Prospective Science Teachers' (PST) Science Process Skills (SPS) develop according to different grades. In this study, a cross-sectional research approach in the form of a case study was used. The sample group consisted of a total number of 102 undergraduate students who were selected from…

  14. A prospective comparative clinical study of peripheral blood counts and indices in patients with primary brain tumors

    PubMed Central

    Subeikshanan, V; Dutt, A; Basu, D; Tejus, MN; Maurya, VP; Madhugiri, VS

    2016-01-01

    Background: Elevation of the neutrophil to lymphocyte ratio (NLR) has been shown to be an indicator of poor prognosis in many malignancies including recurrent glioblastoma multiforme. Objectives: This study was aimed at assessing if the NLR and other leukocyte counts and indices were deranged in treatment-naïve patients with primary brain tumors when compared with an age-matched healthy control group. Materials and Methods: This was a prospective comparative clinical observational study by design. A healthy control population was compared with treatment-naïve patients diagnosed with intra- and extraaxial brain tumors. Leukocyte counts (neutrophil, lymphocyte, monocyte, eosinophil, and basophil counts) as well as leukocyte ratios such as the NLR and the monocyte to lymphocyte ratio (MLR) were calculated. We also evaluated if the counts and indices were related to the tumor volume. Results: In all patients with tumors, the platelet and neutrophil counts were elevated when compared to the controls. In contrast, monocyte counts and the MLR were found to be decreased in patients with tumors when compared to the controls. The subset of patients with glioblastoma showed a significant increase in NLR when compared to the controls. Conclusions: Significant changes in the neutrophil, monocyte, and platelet counts as well as NLR and MLR were observed. Prospective longitudinal studies are required to determine the prognostic and therapeutic implications of these findings. PMID:27089106

  15. Prospects of pulse phase thermography for finding disbonds in CFRP-sandwich parts with aluminum honeycomb cores compared to ultrasonic

    NASA Astrophysics Data System (ADS)

    Gruber, J.; Stotter, B.; Mayr, G.; Hendorfer, G.

    2013-01-01

    This work shows the prospects of pulse phase thermography (PPT) compared to ultrasonic testing when applied to carbon fiber reinforced polymer (CFRP) sandwich parts with aluminum honeycomb cores. Measurements were carried out on full-scale components with flaws like disbonds, septum disbonds, staggers and displaced cores, where the last two are not literally flaws, but nevertheless regions of interest. The effect of the measurement time and the feasibility of extrapolating temperature decays were evaluated. Phase images, gathered with PPT, are compared with ultrasonic Cscan images to show the capability of PPT for quality assurance purposes. Finally, the saving on inspection time when using pulse phase thermography instead of ultrasonic testing is considered.

  16. AUDIT OF BLOOD REQUISITION.

    PubMed

    Deb, P; Swarup, D; Singh, M M

    2001-01-01

    A total of 2793 requisition forms received by the blood banks of a Service zonal hospital, between June 1995 and December 1999, were analysed. 1697 (60.71%) forms were demand for single unit blood. Blood was collected against only 1099 forms (39.34%) out of which 713 (64.88%) were single unit issue. Urgency of requirement and blood group of patients was omitted in 56% cases. 104 forms were received without mention of the indications for transfusion. History of previous transfusion and pregnancy/HDN were omitted in 25.1% and 37.38% cases respectively. At an average 14.61% of the total collection was discarded. Of the 292 units discarded, 242 units were due to non utilisation. A transfusion committee should be established in all hospitals with a licensed blood bank. It should constitute definite objectives and conduct regular audits (prospective audit, concurrent review or retrospective review), in order to achieve utmost efficiency and numerous benefits, in terms of workload, cost, errors, risks of transfusion and ultimately increased customer satisfaction. It should strive to abolish single unit and inappropriate transfusion, and advocate autologous transfusion. PMID:27365575

  17. Comparing health inequality in men and women: prospective study of mortality 1986-96

    PubMed Central

    Sacker, Amanda; Firth, David; Fitzpatrick, Ray; Lynch, Kevin; Bartley, Mel

    2000-01-01

    Objectives To study prospectively the differences in health inequality in men and women from 1986-96 using the Office for National Statistics' longitudinal study and new socioeconomic classification. To assess the relative importance of social class (based on employment characteristics) and social position according to the general social advantage of the household to mortality risk in men and women. Design Prospective study. Setting England and Wales. Subjects Men and women of working age at the time of the 1981 census, with a recorded occupation. Main outcome measures Mortality. Results In men, social class based on employment relations, measured according to the Office for National Statistics' socioeconomic classification, was the most important influence on mortality. In women, social class based on individual employment relations and conditions showed only a weak gradient. Large differences in risk of mortality in women were found, however, when social position was measured according to the general social advantage in the household. Conclusions Comparisons of the extent of health inequality in men and women are affected by the measures of social inequality used. For women, even those in paid work, classifications based on characteristics of the employment situation may give a considerable underestimate. The Office for National Statistics' new measure of socioeconomic position is useful for assessing health inequality in men, but in women a more important predictor of mortality is inequality in general social advantage of the household. PMID:10807620

  18. Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries

    PubMed Central

    Burnett, Susan; Renz, Anna; Wiig, Siri; Fernandes, Alexandra; Weggelaar, Anne Marie; Calltorp, Johan; Anderson, Janet E.; Robert, Glenn; Vincent, Charles; Fulop, Naomi

    2013-01-01

    Purpose Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway). Main Challenges Identified The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country. Conclusion Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries. PMID:23292003

  19. The use of a prospective audit proforma to improve door-to-mask times for acute exacerbations chronic obstructive pulmonary disease (COPD) requiring non-invasive ventilation (NIV).

    PubMed

    Mandal, S; Howes, T Q; Parker, M; Roberts, C M

    2014-12-01

    Non-invasive ventilation (NIV) is an evidence based management of acidotic, hypercapnic exacerbations of COPD. Previous national and international audits of clinical practice have shown variation against guideline standards with significant delays in initiating NIV. We aimed to map the clinical pathway to better understand delays and reduce the door-to-NIV time to less than 3 hours for all patients with acidotic, hypercapnic exacerbations of COPD requiring this intervention, by mandating the use of a guideline based educational management proforma.The proforma was introduced at 7 acute hospitals in North London and Essex and initiated at admission of the patient. It was used to record the clinical pathway and patient outcomes until the point of discharge or death. Data for 138 patients were collected. 48% of patients commenced NIV within 3 hours with no reduction in door-to-mask time during the study period. Delays in starting NIV were due to: time taken for review by the medical team (101 minutes) and time taken for NIV to be started once a decision had been made (49 minutes). There were significant differences in door-to-NIV decision and mask times between differing respiratory on-call systems, p < 0.05). The introduction of the proforma had no effect on door-to-mask times over the study period. Main reasons for delay were related to timely access to medical staff and to NIV equipment; however, a marked variation in practice within these hospitals was been noted, with a 9-5 respiratory on-call system associated with shorter NIV initiation times. PMID:24945887

  20. Hassle-free audit trails: Automated audits

    SciTech Connect

    Manatt, D.R.

    1989-04-01

    The origin and history of data in databases are often as important as the data itself. A full audit trail of database operations is the best record of a database's history. INGRES provides an audit facility to format journal file entries into audit records. This facility is cumbersome and difficult to use. I describe two INGRES Report Writer reports that take all the effort out of maintaining a complete audit trail. To maintain an audit trail of changes to INGRES tables it is necessary to run AUDITDB individually on each table and store a record of the AUDITDB output. The INGRES manuals suggest how the audit records can be copied into INGRES tables for storage. Thus the maintenance of an audit trail consists of: creating tables to receive audit records, running AUDITDB, and storing the audit records into the tables. All this must be done for each table to be audited. My approach to this drudgery is to give it all to the INGRES system. Therefore, I present reports that generate command files to create the tables and run the audits. The only job left for a human is to submit the generated command files to the batch queue.

  1. The Comparative Imperative for the Social Foundations of Education of Prospective Teachers

    ERIC Educational Resources Information Center

    McDowell, David W.

    1977-01-01

    A comparative and global perspective is necessary within the introductory social foundations component of teacher education. Reasons include students' minimal knowledge about the role of education in society and their high interest in social foundations when a comparative and global dimension is added. Journal available from College of Education,…

  2. Synthetic porous ceramic compared with autograft in scoliosis surgery. A prospective, randomized study of 341 patients.

    PubMed

    Ransford, A O; Morley, T; Edgar, M A; Webb, P; Passuti, N; Chopin, D; Morin, C; Michel, F; Garin, C; Pries, D

    1998-01-01

    We have evaluated the use of a synthetic porous ceramic (Triosite) as a substitute for bone graft in posterior spinal fusion for idiopathic scoliosis. In a prospective, randomised study 341 patients at five hospitals in the UK and France were randomly allocated either to autograft from the iliac crest or rib segments (171) or to receive Triosite blocks (170). All patients were assessed after operation and at 3, 6, 12 and 18 months. The two groups were similar with regard to all demographic and baseline variables, but the 184 treated in France (54%) had Cotrel-Dubouset instrumentation and the 157 treated in the UK usually had Harrington-Luque implants. In the Triosite group the average Cobb angle of the upper curve was 56 degrees, corrected to 24 degrees (57%). At 18 months, the average was 26 degrees (3% loss). In the autograft group the average preoperative upper curve of 53 degrees was corrected to 21 degrees (60%). At 18 months the mean curve was 25 degrees (8% loss). Pain levels after operation were similar in the two groups, being mild in most cases. In the Triosite group only three patients had problems of wound healing, but in the autograft group, 14 patients had delayed healing, infection or haematoma in the spinal wound. In addition, 15 autograft patients had pain at the donor site at three months. Seven had infections, two had haematoma and four had delayed healing. The haematological and serum biochemistry results showed no abnormal trends and no significant differences between the groups. There were no adverse events related to the graft material and no evidence of allergenicity. Our results suggest that Triosite synthetic porous ceramic is a safe and effective substitute for autograft in these patients. Histological findings on biopsy indicate that Triosite provides a favourable scaffolding for the formation of new bone and is gradually incorporated into the fusion mass. PMID:9460945

  3. Hospital Based Prospective Observational Study to Audit the Prescription Practices and Outcomes of Paediatric Patients (6 months to 5 years age group) Presenting with Acute Diarrhea

    PubMed Central

    Kondekar, Santosh; Rathi, Surbhi

    2016-01-01

    Introduction Diarrhea is a leading killer of children, accounting for 9% of all deaths among under-five children worldwide. WHO protocol deviation in management of diarrheas in children is likely due to various reasons. Aim To study the prescription practices, regarding adherence to WHO protocol and deviations, in the management of acute diarrhea in children presenting at a tertiary care hospital and its impact on the outcome. Materials and Methods This was a prospective observational hospital based study at a tertiary care carried out over a 12-month period including all cases of acute diarrhea (defined as 3 or more loose stools in last 24 hours) in children belonging to the age group of 6 months to 5 years. Patients were followed up on day 3,7,14 and 28 from the day of presentation. Software SPSS Version 17.0 was used for analysis. Correlation regression analysis was used to study predictiveness of different variables affecting outcome. Results In this study, 447 children aged between 6 months and 5 years were enrolled, of which 45 cases were lost in follow-up and excluded. The median age was 14 months. Some deviation from WHO protocol was noted in 78.4% of the cases. Most common deviations from WHO protocol were addition of probiotics (78.1% of cases) and addition of race cadotril (15.9% of cases). Inadvertent use of antibiotics in diarrhea was noted in 12.2% of cases. Presence of fever was strong predictor for use of antibiotics. Cases of early recovery within 3 days of presentation were higher in WHO protocol deviation group. Use of probiotics had statistically significant association with early recovery. Conclusion In diarrhea management, WHO protocol deviation is common. Probiotics are likely to help in early recovery. PMID:27437317

  4. Blood loss associated with radical cystectomy: A prospective, randomized study comparing impact LigaSure vs. stapling device☆

    PubMed Central

    Thompson, Ian M.; Kappa, Stephen F.; Morgan, Todd M.; Barocas, Daniel A.; Bischoff, Carl J.; Keegan, Kirk A.; Stratton, Kelly L.; Clark, Peter E.; Resnick, Matthew J.; Smith, Joseph A.; Cookson, Michael S.; Chang, Sam S.

    2014-01-01

    Objectives Radical cystectomy (RC) is associated with significant blood loss and transfusion requirement. We performed a prospective, randomized trial to compare blood loss, operative time, and cost using 2 different and commonly employed approaches to tissue ligation and division during RC: mechanical (stapler device) and electrosurgical (heat-sealing device). Methods and materials Eighty patients undergoing RC for urothelial bladder carcinoma were randomized to use of either an Endo GIA Stapler or Impact LigaSure device for tissue ligation and division. Primary outcomes were blood loss, operative time, and device costs. Data were analyzed with Wilcoxon rank sum test and Welch 2-sample t test. Results There were no significant demographic or preoperative differences between the cohorts. Mean estimated blood loss was similar between the electrosurgical (687 ml) and stapler (708 ml) arms (P = 0.850). There were no significant differences between cohorts when comparing operative times or transfusion requirement. There was a significant increase in the mean number of adjunctive suture ligatures used in the stapling device arm (3.0 vs. 1.5, P = 0.047). Total device costs were significantly lower with the LigaSure compared with the GIA Stapler ($625.00 vs. $1490.10, P < 0.001). There were no complications attributable to either device. Conclusions This prospective, randomized study demonstrates no significant difference in blood loss, transfusion requirement, or safety between mechanical vs. electrosurgical control of the vascular pedicles. The LigaSure device, however, is significantly less costly than the GIA Stapler and required fewer additional measures for hemostasis. PMID:24054870

  5. Comparing the Open University Systems of China and India: Origins, Developments and Prospects

    ERIC Educational Resources Information Center

    Perris, Kirk

    2015-01-01

    The national open universities of China and India are unique adaptations of the open university model that emanated from the UK. These institutions have expanded to become the largest universities in the world as measured by current enrollment of approximately four million each. This article comparatively analyzes how these open universities have…

  6. The Environmental Knowledge and Attitudes of Prospective Teachers in Lebanon: A Comparative Study

    ERIC Educational Resources Information Center

    Vlaardingerbroek, Barend; Taylor, T. G. Neil

    2007-01-01

    This paper presents data arising from a study of final-year primary and secondary teaching students in Lebanon using an equivalent Australian sample as a comparative reference group. It was found that the Lebanese students lagged behind their Australian counterparts with respect to their knowledge of global environmental issues, and displayed a…

  7. Do audition electives impact match success?

    PubMed Central

    Higgins, Elizabeth; Newman, Linnie; Halligan, Katherine; Miller, Margaret; Schwab, Sally; Kosowicz, Lynn

    2016-01-01

    Purpose The authors sought to determine the value of the audition elective to the overall success of medical students in the match. Method The authors surveyed 1,335 fourth-year medical students at 10 medical schools in 2013. The study took place over a 2-month period immediately following the match. Medical students were emailed a 14-question survey and asked about audition electives, rank order, and cost of ‘away’ rotations. Results One hundred percent of students wishing to match in otolaryngology, neurosurgery, plastic surgery, radiation oncology, and urology took the audition electives. The difference by specialty in the proportion of students who took an audition was statistically significant (p<0.001). Of the students who auditioned, 71% matched at one of their top three choices compared with 84% of non-auditioners who matched to one of their top three choices (p<0.01). Conclusions Students performed a large number of ‘away’ rotations as ‘auditions’ in order to improve their chances in the match. For certain competitive specialties, virtually all students auditioned. Overall, students who did not audition were just as successful as or more successful than students who did audition. PMID:27301380

  8. Computerizing Audit Studies

    PubMed Central

    Lahey, Joanna N.; Beasley, Ryan A.

    2014-01-01

    This paper briefly discusses the history, benefits, and shortcomings of traditional audit field experiments to study market discrimination. Specifically it identifies template bias and experimenter bias as major concerns in the traditional audit method, and demonstrates through an empirical example that computerization of a resume or correspondence audit can efficiently increase sample size and greatly mitigate these concerns. Finally, it presents a useful meta-tool that future researchers can use to create their own resume audits. PMID:24904189

  9. Overcoming barriers to residential conservation: do energy audits help

    SciTech Connect

    Hoffman, W.L.

    1982-12-01

    A study on the effects of energy audits on the pace and choice of household investment in energy-saving improvements in the home is reported. An evaluation based on the household's assessment of the usefulness of the audit which was provided for their home was performed. The number and types of recent conservation actions among audited and unaudited samples of households are compared. The audit's effect on household knowledge about the economically attractive options for their home and on the choice of recent improvements is assessed. Possible reasons are suggested for the weak effect of audits in stimulating activity and reorienting investment choices. (LEW)

  10. A re-audit of the management of gonorrhoea.

    PubMed

    Ekanayaka, Ratna; Challenor, Rachel

    2016-08-01

    A re-audit of the management of gonorrhoea was undertaken in 2014. Six out of nine auditable outcomes were met in the second audit (2014) compared with three out of eight in the first audit (2012). The new measures that were introduced following the original audit may have helped to improve outcomes. However, electronic patient records were introduced in December 2012. Documentation was much improved with the use of patient record templates and this has contributed considerably to the improved outcomes. PMID:26738518

  11. A prospective study to compare serum human placental lactogen and menstrual dates for determining gestational age.

    PubMed

    Whittaker, P G; Lind, T; Lawson, J Y

    1987-01-01

    In a group of 575 healthy pregnant women with certain menstrual dates the estimation of the length of gestation from maternal serum human placental lactogen concentrations has been compared with gestational age calculated from the last menstrual period and ultrasonic measurements of the fetal biparietal diameter. In 412 of these patients labor started spontaneously, and the estimated dates of delivery determined by these three methods were also compared. In the range of 9 to 17 weeks of pregnancy, gestational age can be determined by human placental lactogen measurement to within 7 days (+/- 1 SD) which compares favorably with other methods. Regarding the prediction of the expected date of delivery, 88% were delivered within 2 weeks of the date predicted by last menstrual period, 82% within 2 weeks of the sonar date, and 80% by the date determined by human placental lactogen assessment. Prediction of delivery in a further group of 139 women with uncertain dates gave 73% within 2 weeks by sonar date and 69% within 2 weeks by human placental lactogen determination. We suggest human placental lactogen measurements should become part of routine antenatal care complementing rather than replacing the role of ultrasonic scanning. For those doctors and patients who wish to avoid more exposure to ultrasonic scanning than absolutely necessary, human placental lactogen estimates offer an alternative method for assessing the length of gestation. PMID:3541617

  12. Early indicators of autism spectrum disorders at 12 and 24 months of age: a prospective, longitudinal comparative study.

    PubMed

    Veness, Carly; Prior, Margot; Bavin, Edith; Eadie, Patricia; Cini, Eileen; Reilly, Sheena

    2012-03-01

    Prospective questionnaire data from a longitudinal population sample on children with autism spectrum disorders (ASD), developmental delay, specific language impairment, or typical development (TD), were collected at ages eight, 12 and 24 months, via the Communication and Symbolic Behavior Scale Developmental Profile (CSBS) - Infant Toddler Checklist, and the Actions and Gesture section of the MacArthur-Bates Communicative Development Inventory (CDI):Words and Gestures. The four groups were compared at four years of age to identify whether any early behaviours differentiated the groups. While children with ASD differed from TD children on most social communicative measures by 12 months of age, the only social communication characteristic which could differentiate the children with ASD from the other groups were gesture scores on the CDI at 12 months and the CSBS at 24 months. Significant markers of ASD were identifiable in this community sample at an early age, although discrimination between clinical groups was rarely evident. PMID:21733958

  13. Prospective randomized trial comparing alumina ceramic-on-ceramic with ceramic-on-conventional polyethylene bearings in total hip arthroplasty.

    PubMed

    Lewis, Peter M; Al-Belooshi, Ali; Olsen, Michael; Schemitch, Emil H; Waddell, James P

    2010-04-01

    This prospective randomized study aims to compare the outcome between an alumina ceramic-on-ceramic (CC) articulation with a ceramic on ultra-high-molecular-weight polyethylene articulation (CP). Fifty-six hips in 55 patients with mean age 42.2 (range, 19-56) each received uncemented components, a 28-mm alumina head with randomization of acetabular liner. Mean St Michael's outcome score for each group with up to 10 years follow-up (median, 8 years; range, 1-10) was 22.8 and 22.9, respectively (P = .819). Wear was identified in all but 1 CP replacement, but only 12 of the 23 CC. Mean wear in the CP group was 0.11 mm/y and 0.02 mm/yr in the CC group (P < .001). Other than significantly greater wear in the polyethylene group, there was no significant difference in midterm outcome between the 2 groups. PMID:19195824

  14. Intraoperative monitoring of stroke volume variation versus central venous pressure in laparoscopic liver surgery: a randomized prospective comparative trial☆

    PubMed Central

    Ratti, Francesca; Cipriani, Federica; Reineke, Raffaella; Catena, Marco; Paganelli, Michele; Comotti, Laura; Beretta, Luigi; Aldrighetti, Luca

    2015-01-01

    Background Central venous pressure (CVP) is used as a marker of cardiac preload to control intraoperative blood loss in open hepatectomies, while its reliability in laparoscopy is less certain. The aim of this randomized prospective trial was to evaluate the outcome of laparoscopic resections performed with stroke volume variation (SVV) or CVP monitoring. Methods All candidates for laparoscopic liver resection were assigned randomly to SVV or to CVP groups. Outcome was evaluated included conversion rate, cause of conversion, intraoperative blood loss, need for transfusions, length of surgery and postoperative results. Results Ninety consecutive patients were enrolled: both SVV and CVP groups included 45 patients each and were comparable in terms of patient and disease characteristics. A reduced rate of conversion was recorded in the SVV compared to the CVP group (6.7% and 17.8% respectively, p = 0.02). Blood loss was lower in the SVV group (150 mL), compared to the CVP group (300 mL, p = 0.04). Morbidity, mortality, length of stay and functional recovery were comparable. On multivariate analysis, lesion location, extent of hepatectomy and type of cardiac preload monitoring were associated significantly to risk of conversion. Conclusion SVV monitoring in laparoscopic liver surgery improves intraoperative outcome, thus enhancing the benefits of the minimally-invasive approach and fast-track protocols. PMID:26902132

  15. Contracting for Audit Services.

    ERIC Educational Resources Information Center

    Heifetz, Harry S.

    1987-01-01

    The Single Audit Act of 1984 requires most school districts receiving over $25,000 in federal funds to undergo financial audits. This article highlights requirements for selecting certified public accountants to perform the audit and suggests factors to be considered before drafting a contract or letter of engagement. A sample letter is included.…

  16. Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice

    PubMed Central

    van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

    2016-01-01

    Objective Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. Setting The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Primary and secondary outcome measures Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Results Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Conclusions Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated

  17. Comparative effectiveness research in cancer genomics and precision medicine: current landscape and future prospects.

    PubMed

    Simonds, Naoko I; Khoury, Muin J; Schully, Sheri D; Armstrong, Katrina; Cohn, Wendy F; Fenstermacher, David A; Ginsburg, Geoffrey S; Goddard, Katrina A B; Knaus, William A; Lyman, Gary H; Ramsey, Scott D; Xu, Jianfeng; Freedman, Andrew N

    2013-07-01

    A major promise of genomic research is information that can transform health care and public health through earlier diagnosis, more effective prevention and treatment of disease, and avoidance of drug side effects. Although there is interest in the early adoption of emerging genomic applications in cancer prevention and treatment, there are substantial evidence gaps that are further compounded by the difficulties of designing adequately powered studies to generate this evidence, thus limiting the uptake of these tools into clinical practice. Comparative effectiveness research (CER) is intended to generate evidence on the "real-world" effectiveness compared with existing standards of care so informed decisions can be made to improve health care. Capitalizing on funding opportunities from the American Recovery and Reinvestment Act of 2009, the National Cancer Institute funded seven research teams to conduct CER in genomic and precision medicine and sponsored a workshop on CER on May 30, 2012, in Bethesda, Maryland. This report highlights research findings from those research teams, challenges to conducting CER, the barriers to implementation in clinical practice, and research priorities and opportunities in CER in genomic and precision medicine. Workshop participants strongly emphasized the need for conducting CER for promising molecularly targeted therapies, developing and supporting an integrated clinical network for open-access resources, supporting bioinformatics and computer science research, providing training and education programs in CER, and conducting research in economic and decision modeling. PMID:23661804

  18. A prospective, randomized study on hepatotoxicity of anastrozole compared with tamoxifen in women with breast cancer

    PubMed Central

    Lin, Ying; Liu, Jianlun; Zhang, Xiaohua; Li, Li; Hu, Rui; Liu, Jian; Deng, Yongchuan; Chen, Dedian; Zhao, Yangbing; Sun, Shengrong; Ma, Rong; Zhao, Ying; Liu, Jinping; Zhang, Yang; Wang, Xijing; Li, Yafen; He, Pingqing; Li, Enxiao; Xu, Zheli; Wu, Yaqun; Tong, Zhongsheng; Wang, Xiaojia; Huang, Tao; Liang, Zhongxiao; Wang, Shui; Su, Fengxi; Lu, Yunfei; Zhang, Helong; Feng, Guosheng; Wang, Shenming

    2014-01-01

    Tamoxifen and anastrozole are widely used as adjuvant treatment for early stage breast cancer, but their hepatotoxicity is not fully defined. We aimed to compare hepatotoxicity of anastrozole with tamoxifen in the adjuvant setting in postmenopausal breast cancer patients. Three hundred and fifty-three Chinese postmenopausal women with hormone receptor-positive early breast cancer were randomized to anastrozole or tamoxifen after optimal primary therapy. The primary end-point was fatty liver disease, defined as a liver–spleen ratio <0.9 as determined using a computed tomography scan. The secondary end-points included abnormal liver function and treatment failure during the 3-year follow up. The cumulative incidence of fatty liver disease after 3 years was lower in the anastrozole arm than that of tamoxifen (14.6% vs 41.1%, P < 0.0001; relative risk, 0.30; 95% CI, 0.21–0.45). However, there was no difference in the cumulative incidence of abnormal liver function (24.6% vs 24.7%, P = 0.61). Interestingly, a higher treatment failure rate was observed in the tamoxifen arm compared with anastrozole and median times to treatment failure were 15.1 months and 37.1 months, respectively (P < 0.0001; HR, 0.27; 95% CI, 0.20–0.37). The most commonly reported adverse events were ‘reproductive system disorders’ in the tamoxifen group (17.1%), and ‘musculoskeletal disorders’ in the anastrozole group (14.6%). Postmenopausal women with hormone receptor-positive breast cancer receiving adjuvant anastrozole displayed less fatty liver disease, suggesting that this drug had a more favorable hepatic safety profile than tamoxifen and may be preferred for patients with potential hepatic dysfunction. PMID:24975596

  19. Tamsulosin versus Alfuzosin in the Treatment of Patients with Distal Ureteral Stones: Prospective, Randomized, Comparative Study

    PubMed Central

    Al-sayed, Abul-yazid Saad

    2010-01-01

    Purpose We evaluated and compared the efficacy of tamsulosin and alfuzosin in the medical treatment of symptomatic, uncomplicated distal ureteral stones. Materials and Methods A total of 87 patients with distal ureteral stones of ≤10 mm were randomly divided into 3 groups. Group I patients (n=29) received 0.4 mg tamsulosin daily, group II patients (n=30) received 10 mg alfuzosin daily, and group III patients (n=28) were not given tamsulosin or alfuzosin. Patients in all groups received Diclofenac sodium regularly for 1 week and then on demand. Follow-up was done on a weekly basis for 30 days. Results The mean stone size was comparable in the 3 groups (4.97±2.24, 5.47±2.13, and 5.39±1.81 mm, respectively). The stone expulsion rate was 86.2%, 76.6%, and 50% in groups I, II, and III, respectively. The difference in groups I and II with respect to group III was significant (p=0.0028 and 0.035). The mean expulsion time for groups I to III was 7.52±7.06, 8.26±7.34, and 13.90±6.99 days, respectively. The expulsion time was significantly shorter in groups I and II than in group III (p=0.0097 and 0.026). Patients taking tamsulosin and alfuzosin had fewer pain attacks than did group III patients (1.24±0.57 vs. 1.43±0.67 vs. 1.75±1.17). Only 3 cases of drug side effects, 2 in group I and 1 in group II, were recorded. Conclusions The use of tamsulosin or alfuzosin for the medical treatment of lower ureteric stones proved to be safe and effective. Moreover, tamsulosin did not have any significant benefits over alfuzosin. PMID:20414396

  20. Comparison of outpatient versus inpatient transurethral prostate resection for benign prostatic hyperplasia: Comparative, prospective bi-centre study

    PubMed Central

    Kim, Jae Heon; Park, Jae Young; Shim, Ji Sung; Lee, Jeong Gu; Moon, Du Geon; Yoo, Jeong woo; Choi, Hoon; Bae, Jae Hyun

    2014-01-01

    Introduction: We compare the symptomatic relief with urodynamic parameter change and operative safety of the outpatient transurethral resection in saline (TURIS-V) technique with inpatient transurethral resection of the prostate (TURP) for the management of benign prostatic hyperplasia (BPH). Methods: This prospective cohort comparison study enrolled patients who needed BPH surgery. Between January 2010 and June 2011, outpatient TURIS-V was performed at 1 centre and the results of the treatment were compared with inpatient TURP performed at a separate hospital. Preoperative characteristics, including prostate volume, were similar in both groups. Perioperative data and any treatment complications were recorded. The analysis compared postoperative outcomes, including a 6-month postoperative International Prostate Symptom Score (IPSS), a quality of life (QoL) evaluation and a record of any changes in uroflowmetry findings, between the 2 groups. Results: In the TURIS-V patient group, 75 patients agreed to be in the study. Of these, 69 ultimately complete the study. In the TURP group, 76 patients agreed and 71 of these completed the study. Both study groups were well-matched for age, IPSS, QoL and uroflowmetry findings. The TURIS-V group experienced both shorter operation times (54.6 vs. 74.8 minutes) and shorter catheterization times (2.2 vs. 4.2 days) when compared to the TURP group. There were comparable improvements in the 6-month postoperative IPSS, QoL, and uroflowmetry findings between the 2 groups. There were also equally low incidence rates of procedural complications. Conclusions: Both TURIS-V and TURP relieve lower urinary tract symptoms in a similar way, with great efficacy and safety. Overall, TURIS-V had shorter operative and catheterization times compared to TURP. Notwithstanding the paper’s limitations (non- randomized cohort comparison with possible selection or surgeon bias and small heterogeneous sample size), TURIS-V can be performed safely even in

  1. PROSPECTIVE COMPARATIVE STUDY BETWEEN PROXIMAL TRANSVERSE INCISION AND THE CONVENTIONAL LONGITUDINAL INCISIONS FOR CARPAL TUNNEL RELEASE

    PubMed Central

    Teixeira Alves, Marcelo de Pinho

    2015-01-01

    Carpal tunnel syndrome (CTS) is a pathological condition frequently seen in orthopedic consultation offices. It is most common compressive neuropathy and also the one most often treated surgically. CTS is usually diagnosed clinically, through the clinical history, physical examination (Tinel, Phalen and Durkan tests) and complementary examinations, and more specifically, nerve conduction studies. Ultrasound scans and magnetic resonance imaging may also be used. Conservative treatment is reserved for patients presenting with mild symptoms, with little incapacitation, who show good response to non-steroidal or steroidal anti-inflammatory drugs, physiotherapy and lifestyle changes. Surgical treatment is more frequent, and a variety of techniques are used. The goal of the surgery is to decompress the carpal tunnel and, by sectioning the transverse carpal ligament, release the median nerve. The aim of this paper was to compare surgical treatment of CTS by means of a transverse mini-incision made proximally to the carpal canal, with the classic longitudinal incision over the carpal canal. The mini-incision technique was shown to be less invasive and equally effective for treating CTS, with less morbidity than with the classic longitudinal incision. PMID:27022592

  2. Bacteremia in narcotic addicts at the Detroit Medical Center. II. Infectious endocarditis: a prospective comparative study.

    PubMed

    Levine, D P; Crane, L R; Zervos, M J

    1986-01-01

    For one year all narcotic addicts admitted to the Detroit Medical Center with infectious endocarditis (74 cases) were compared with a control group of bacteremic addicts who had other infections (106 cases). Endocarditis was caused by Staphylococcus aureus (60.8% of cases), streptococci (16.2%), Pseudomonas aeruginosa (13.5%), mixed bacteria (8.1%), and Corynebacterium JK (1.4%). S. aureus endocarditis most frequently involved the tricuspid valve; streptococci infected left-sided valves significantly more often than other organisms (P = .001). Biventricular and multiple-valve infections were commonest in patients with pseudomonas endocarditis (P = .05). Two-dimensional echocardiography, when combined with an abnormal chest roentgenogram, was highly predictive of endocarditis. Bacteremia in the absence of endocarditis was associated with primary skin and soft tissue infection, mycotic aneurysm at the site of narcotic injection, septic arthritis, septic thrombophlebitis, pneumonia, osteomyelitis, mediastinal abscess, and unclassified infection. Polymicrobial bacteremia in the nonendocarditis group was associated with markedly increased morbidity. Mild hyponatremia occurred in 41% of all patients and was also associated with significantly increased morbidity. Analysis of the two groups disclosed similarities and differences with implications for the pathophysiology and treatment of addicts with bacteremic infection. PMID:3755255

  3. Computerized tomographic simulation compared with clinical mark-up in palliative radiotherapy: A prospective study

    SciTech Connect

    Haddad, Peiman; Cheung, Fred; Pond, Gregory; Easton, Debbie; Cops, Frederick; Bezjak, Andrea; McLean, Michael; Levin, Wilfred; Billingsley, Susan; Williams, Diane; Wong, Rebecca . E-mail: Rebecca.Wong@rmp.uhn.on.ca

    2006-07-01

    Purpose To evaluate the impact of computed tomographic (CT) planning in comparison to clinical mark-up (CM) for palliative radiation of chest wall metastases. Methods and Materials In patients treated with CM for chest wall bone metastases (without conventional simulation/fluoroscopy), two consecutive planning CT scans were acquired with and without an external marker to delineate the CM treatment field. The two sets of scans were fused for evaluation of clinical tumor volume (CTV) coverage by the CM technique. Under-coverage was defined as the proportion of CTV not covered by the CM 80% isodose. Results Twenty-one treatments (ribs 17, sternum 2, and scapula 2) formed the basis of our study. Due to technical reasons, comparable data between CM and CT plans were available for 19 treatments only. CM resulted in a mean CTV under-coverage of 36%. Eleven sites (58%) had an under-coverage of >20%. Mean volume of normal tissues receiving {>=}80% of the dose was 5.4% in CM and 9.3% in CT plans (p = 0.017). Based on dose-volume histogram comparisons, CT planning resulted in a change of treatment technique from direct apposition to a tangential pair in 7 of 19 cases. Conclusions CT planning demonstrated a 36% under-coverage of CTV with CM of ribs and chest wall metastases.

  4. Magnetic Resonance Imaging–Guided versus Surrogate-Based Motion Tracking in Liver Radiation Therapy: A Prospective Comparative Study

    SciTech Connect

    Paganelli, Chiara; Seregni, Matteo; Fattori, Giovanni; Summers, Paul; Bellomi, Massimo; Baroni, Guido; Riboldi, Marco

    2015-03-15

    Purpose: This study applied automatic feature detection on cine–magnetic resonance imaging (MRI) liver images in order to provide a prospective comparison between MRI-guided and surrogate-based tracking methods for motion-compensated liver radiation therapy. Methods and Materials: In a population of 30 subjects (5 volunteers plus 25 patients), 2 oblique sagittal slices were acquired across the liver at high temporal resolution. An algorithm based on scale invariant feature transform (SIFT) was used to extract and track multiple features throughout the image sequence. The position of abdominal markers was also measured directly from the image series, and the internal motion of each feature was quantified through multiparametric analysis. Surrogate-based tumor tracking with a state-of-the-art external/internal correlation model was simulated. The geometrical tracking error was measured, and its correlation with external motion parameters was also investigated. Finally, the potential gain in tracking accuracy relying on MRI guidance was quantified as a function of the maximum allowed tracking error. Results: An average of 45 features was extracted for each subject across the whole liver. The multi-parametric motion analysis reported relevant inter- and intrasubject variability, highlighting the value of patient-specific and spatially-distributed measurements. Surrogate-based tracking errors (relative to the motion amplitude) were were in the range 7% to 23% (1.02-3.57mm) and were significantly influenced by external motion parameters. The gain of MRI guidance compared to surrogate-based motion tracking was larger than 30% in 50% of the subjects when considering a 1.5-mm tracking error tolerance. Conclusions: Automatic feature detection applied to cine-MRI allows detailed liver motion description to be obtained. Such information was used to quantify the performance of surrogate-based tracking methods and to provide a prospective comparison with respect to MRI

  5. Comparison of K-loop Molar Distalization with that of Pendulum Appliance - A Prospective Comparative Study

    PubMed Central

    Shashidhar, Nagam Reddy; Reddy, S.Rama Koteswara

    2016-01-01

    Introduction Molar distalization is the non extraction method of managing Class II malocclusions. Aim The purpose of this study was to evaluate the skeletal and dentoalveolar effects of maxillary molar distalization with K-loop appliance, and to compare these effects with that of pendulum group. Materials and Methods Class I and dental Class II malocclusions were divided into two groups of 15 each: In Group 1 (nine females and six males; mean age, 16.0±2.6 years) patients were treated with K-Loop molar distalization supported palatally by Nance button, while in Group 2 (seven females and eight males; mean age, 15.4±4.7 years), the patients were treated with conventional pendulum appliance. Standardized lateral cephalograms were taken at the beginning of treatment (T0) and at the end of molar distalization (T1) and the changes were statistically analyzed with paired t-test. Results The results showed no statistically significant difference in the amount of molar distalization in either of the appliance groups: the mean amount of molar distal movement of 5.1±0.8 mm and 4.93±1.68 mm was observed in the Group 1 and 2 respectively. The incisors moved mesially by 1.3±0.63 mm in Group 1 and 1.57±0.58 mm in Group 2. Conclusion K-Loop molar distalizing appliance has similar skeletal and dentoalveolar effects as that of pendulum appliance, with the advantages of simple yet efficient to control the moment-force ratio to produce all types of tooth movements and also requires minimal patient co-operation. PMID:27504403

  6. Audits Made Simple

    SciTech Connect

    Belangia, David Warren

    2015-04-09

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

  7. Comparative Evaluation of Efficacy of Physics Forceps versus Conventional Forceps in Orthodontic Extractions: A Prospective Randomized Split Mouth Study

    PubMed Central

    Managutti, Anil M; Menat, Shailesh; Agarwal, Arvind; Shah, Dishan; Patel, Jigar

    2016-01-01

    Introduction Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic procedure often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. Recently developed physics forceps is one of the instruments which is claimed to perform atraumatic extractions. Aim The aim of the present study was to compare the efficacy of physics forceps with conventional forceps in terms of operating time, prevention of marginal bone loss & soft tissue loss, postoperative pain and postoperative complications following bilateral premolar extractions for orthodontic purpose. Materials and Methods In this prospective split-mouth study, outcomes of the 2 groups (n = 42 premolars) requiring extraction of premolars for orthodontic treatment purpose using Physics forceps and Conventional forceps were compared. Clinical outcomes in form of time taken, loss of buccal soft tissue and buccal cortical plate based on extraction defect classification system, postoperative pain and other complication associated with extraction were recorded and compared. Results Statistically significant reduction in the operating time was noted in physics forceps group. Marginal bone loss and soft tissue loss was also significantly lesser in physics forceps group when compared to conventional forceps group. However, there was no statistically significant difference in severity of postoperative pain between both groups. Conclusion The results of the present study suggest that physics forceps was more efficient in reducing operating time and prevention of marginal bone loss & soft tissue loss when compared to conventional forceps in orthodontically indicated premolar extractions.

  8. Analytical laboratory quality audits

    SciTech Connect

    Kelley, William D.

    2001-06-11

    Analytical Laboratory Quality Audits are designed to improve laboratory performance. The success of the audit, as for many activities, is based on adequate preparation, precise performance, well documented and insightful reporting, and productive follow-up. Adequate preparation starts with definition of the purpose, scope, and authority for the audit and the primary standards against which the laboratory quality program will be tested. The scope and technical processes involved lead to determining the needed audit team resources. Contact is made with the auditee and a formal audit plan is developed, approved and sent to the auditee laboratory management. Review of the auditee's quality manual, key procedures and historical information during preparation leads to better checklist development and more efficient and effective use of the limited time for data gathering during the audit itself. The audit begins with the opening meeting that sets the stage for the interactions between the audit team and the laboratory staff. Arrangements are worked out for the necessary interviews and examination of processes and records. The information developed during the audit is recorded on the checklists. Laboratory management is kept informed of issues during the audit so there are no surprises at the closing meeting. The audit report documents whether the management control systems are effective. In addition to findings of nonconformance, positive reinforcement of exemplary practices provides balance and fairness. Audit closure begins with receipt and evaluation of proposed corrective actions from the nonconformances identified in the audit report. After corrective actions are accepted, their implementation is verified. Upon closure of the corrective actions, the audit is officially closed.

  9. Calcifying tendinitis of the shoulder: arthroscopic needling versus complete calcium removal and rotator cuff repair. A prospective comparative study

    PubMed Central

    CASTAGNA, ALESSANDRO; DE GIORGI, SILVANA; GAROFALO, RAFFAELE; CONTI, MARCO; TAFURI, SILVIO; MORETTI, BIAGIO

    2015-01-01

    Purpose the aim of the present study was to verify the differences in the clinical outcomes of two arthroscopic techniques used to treat calcifying tendinitis of the shoulder: needling versus complete removal of the calcium deposit and tendon repair. Methods from September 2010 to September 2012, 40 patients with calcifying tendinitis of the rotator cuff were arthroscopically treated by the same surgeon using one of the two following techniques: needling (Group 1) and complete removal of the calcium deposit and tendon repair with suture anchors (Group 2). Both groups followed the same rehabilitation program. The two groups were compared at 6 and 12 months of follow-up for the presence of residual calcifications and for the following clinical outcomes: Constant score, American Shoulder and Elbow Surgeons Evaluation Form (ASES) shoulder score, University of California Los Angeles (UCLA) shoulder rating scale, Simple Shoulder Test (SST) and Visual Analogue Scale (VAS). Results all the clinical scores (Constant, ASES, UCLA, SST and VAS scores) improved significantly between baseline and postoperative follow-up, both at 6 and at 12 months. No differences at final follow-up were found between the two groups. Conclusions both the techniques were effective in solving the symptoms of calcifying tendinitis of the shoulder. Clinical scores improved in both groups. Residual calcifications were found in only a few cases and were always less than 10 mm. Level of evidence Level II, prospective comparative study. PMID:26904521

  10. A prospective, randomised study to compare two palliative radiotherapy schedules for non-small-cell lung cancer (NSCLC)

    PubMed Central

    Senkus-Konefka, E; Dziadziuszko, R; Bednaruk-Młyński, E; Pliszka, A; Kubrak, J; Lewandowska, A; Małachowski, K; Wierzchowski, M; Matecka-Nowak, M; Jassem, J

    2005-01-01

    A prospective randomised study compared two palliative radiotherapy schedules for inoperable symptomatic non-small-cell lung cancer (NSCLC). After stratification, 100 patients were randomly assigned to 20 Gy/5 fractions (fr)/5 days (arm A) or 16 Gy/2 fr/day 1 and 8 (arm B). There were 90 men and 10 women aged 47–81 years (mean 66), performance status 1–4 (median 2). The major clinical characteristics and incidence and degree of initial disease-related symptoms were similar in both groups. Treatment effects were assessed using patient's chart, doctor's scoring of symptomatic change and chest X-ray. Study end points included degree and duration of symptomatic relief, treatment side effects, objective response rates and overall survival. A total of 55 patients were assigned to arm A and 45 to arm B. In all, 98 patients received assigned treatment, whereas two patients died before its termination. Treatment tolerance was good and did not differ between study arms. No significant differences between study arms were observed in the degree of relief of all analysed symptoms. Overall survival time differed significantly in favour of arm B (median 8.0 vs 5.3 months; P=0.016). Both irradiation schedules provided comparable, effective palliation of tumour-related symptoms. The improved overall survival and treatment convenience of 2-fraction schedule suggest its usefulness in the routine management of symptomatic inoperable NSCLC. PMID:15770205

  11. Do partial thickness, bursal side cuff tears affect outcome following arthroscopic subacromial decompression? A prospective comparative cohort study

    PubMed Central

    Al-Maiyah, Mohammed; Goodchild, Lorna; Fourie, J M Brendan; Finn, Paul; Rangan, Amar

    2014-01-01

    Background: The present study aimed to compare medium-term clinical outcomes of patients following arthroscopic subacromial decompression (ASAD): those with intact rotator cuff with two groups of increasing size of partial thickness bursal-side tears. Methods: Patients undergoing shoulder arthroscopy by a single surgeon had pre- and postoperative Constant scores prospectively recorded. Arthroscopic surgery included the assessment of any supraspinatus tears using the Ellman criteria, as well as ASAD and cuff debridement. Groups were created based on the status of rotator cuff and size of bursal tear. Outcome in these patient groups was then compared and analyzed Results: Seventy-four patients were suitable for inclusion in the study: 32 patients without a cuff tear; 21 patients with a cuff tear of 9 mm or less in length; and 21 patients with a cuff tear of 10 mm or more in length. Baseline characteristics of the three groups were similar. All three groups showed a significant improvement in their Constant scores following surgery. There was, however, no significant difference in Constant scores between the three groups. Conclusions: The results of the present study show that patients with varying sizes of bursal-side tears respond to ASAD as well as those with no rotator cuff tear.

  12. Sutureless and Glue-free Versus Sutures for Limbal Conjunctival Autografting in Primary Pterygium Surgery: A Prospective Comparative Study

    PubMed Central

    Raj, Hans; Gupta, Aditi; Raina, Amit Vikram

    2015-01-01

    Introduction Sutureless and glue-free conjunctival autograft as a treatment modality for primary pterygium is recently gaining popularity but conventional technique of suturing conjunctival autograft is still practised widely. Aim To compare the outcome of sutureless and glue-free technique with sutures for limbal conjunctival autografting in management of primary pterygium. Materials and Methods A prospective interventional study was carried out in 50 consecutive eyes with primary nasal pterygium requiring surgical excision. Simple excision under local anaesthesia was performed followed by closure of the bare sclera by sutureless and glue-free conjunctival autograft in 25 eyes of 25 patients (group 1) and by the conventional method of suturing conjunctival autograft using interrupted 10-0 nylon sutures in 25 eyes of 25 patients (group 2), followed by bandaging for 24 hours in both the groups. Surgical time was recorded for both the techniques. Postoperative discomfort was assessed using preformed questionnaires. The patients were followed up for 6 months. During follow up, graft related complications and recurrence if any were noted. Results Mean surgical time for group 1 (23.20±1.55 minutes) was significantly less as compared to group 2 (37.76±1.89 minutes); (p=0.001). Postoperative symptoms were seen in less number of patients (20%) and were of shorter duration (2 weeks) in group 1 as compared to group 2 with 20 (80%) patients having symptoms lasting for 4 weeks; (p<0.001). Recurrence rate and conjunctival granuloma formation rate for group 1 (0%) and for group 2 (4%) were statistically insignificant. Conclusion Sutureless and glue-free conjunctival autograft technique is simple, easy, safe, effective and less time consuming than sutured limbal autograft technique with less postoperative discomfort and adverse events encountered with the use of suture material. Postoperative results of both techniques are comparable. Hence sutureless and glue-free conjunctival

  13. Comparative study between computed tomography guided superior hypogastric plexus block and the classic posterior approach: A prospective randomized study

    PubMed Central

    Ghoneim, Ayman A.; Mansour, Sahar M.

    2014-01-01

    Context: The classic posterior approach to superior hypogastric plexus block (SHPB) is sometimes hindered by the iliac crest or a prominent transverse process of L5. The computed tomography (CT) – guided anterior approach might overcome these difficulties. Aims: This prospective, comparative, randomized study was aimed to compare the CT guided anterior approach versus the classic posterior approach. Settings and Design: Controlled randomized study. Materials and Methods: A total of 30 patients with chronic pelvic cancer pain were randomized into either classic or CT groups where classic posterior approach or CT guided anterior approach were done, respectively. Visual analog score, daily analgesic morphine consumed and patient satisfaction were assessed just before the procedure, then, after 24 h, 1 week and monthly for 2 months after the procedure. Duration of the procedure was also recorded. Adverse effects associated with the procedure were closely observed and recorded. Statistical Analysis Used: Student's t-test was used for comparison between groups. Results: Visual analog scale and morphine consumption decreased significantly in both groups at the measured times after the block compared with the baseline in the same group with no significant difference between both groups. The procedure was carried out in significantly shorter duration in the CT group than that in the classic group. The mean patient satisfaction scale increased significantly in both groups at the measured times after the block compared with the baseline in the same group. The patients in the CT groups were significantly more satisfied than those in classic group from day one after the procedure until the end of the study. Conclusions: The CT guided approach for SHPB is easier, faster, safer and more effective, with less side-effects than the classic approach. PMID:25191191

  14. A Comparative Analysis of the English-Language Accent Preferences of Prospective and Practicing Businesspersons from around the World

    ERIC Educational Resources Information Center

    Scott, James C.; Green, Diana J.; Blaszczynski, Carol; Rosewarne, David D.

    2007-01-01

    Problem: The studies of the English-language accent preferences of prospective and practicing businesspersons from around the world have not been integrated. Research Questions: What are the English-language accent preferences of prospective and practicing businesspersons from around the world, and how are those preferences influenced by the…

  15. 46 CFR Sec. 12 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  16. Anesthetic efficacy of 4% articaine versus 2% lignocaine during the surgical removal of the third molar: A comparative prospective study

    PubMed Central

    Jain, Nikil Kumar; John, Reena Rachel

    2016-01-01

    Aim: The study aimed at evaluating the clinical efficacy of articaine over lidocaine in the surgical removal of impacted mandibular third molars. Objective: The objectives were to compare the onset of anesthesia, pain during injection, during the procedure and after the procedure, compare the duration of anesthesia, and need for re-anesthesia. Materials and Methods: A prospective study was conducted on 70 subjects planned for surgical removal of mandibular third molars. Subjects were randomly administered one of two local anesthetics. The anesthetic agent used was unknown for the patient and the observer who performed the measurements. Results: The differences in latency with 4% articaine (56.57 ± 9.8 s) and with 2% lignocaine (88.26 ± 12.87 s), pain during procedure for articaine 1.31 ± 0.87 and for lignocaine 2.60 ± 1.06, pain after procedure was 0.89 ± 0.58 for articaine and 1.31 ± 1.05 for lignocaine, and mean duration of anesthetic effect for articaine was 231 ± 57.15 min and 174.80 ± 37.02 min for lignocaine, which was statistically significant. For re-anesthesia, 6 out of 35 patients needed re-anesthesia at the frequency of 8.57% for articaine and 13 out of 35 patients needed re-anesthesia at a frequency of 18.57% for lignocaine. Conclusion: The results proved that articaine had a significant faster onset of action and longer duration of action when compared to lignocaine. Hence, the pain experienced by the patients during and after the surgical procedure was significantly less. The study was concluded that articaine is a safe alternative to lignocaine, which is potent and effective in minor surgical procedures such as removal of mandibular third molars. PMID:27212774

  17. Comparative efficacy of tadalafil versus tamsulosin as the medical expulsive therapy in lower ureteric stone: a prospective randomized trial

    PubMed Central

    Mylarappa, Prasad; Aggarwal, Kuldeep; Patil, Avinash; Joshi, Prarthan; Desigowda, Ramesh

    2016-01-01

    Introduction In recent years, medical expulsive therapy has been used in the management of distal ureteric stones as a supplement to conservative treatment. Therefore, we conducted a prospective randomized study to evaluate the possible role of tadalafil individually in comparison with proven tamsulosin therapy in ureteric stone expulsion. The aim of this study is to compare the safety and efficacy of a phosphodiesterase-5 inhibitor (tadalafil) and an α-1 blocker (tamsulosin) as medical expulsive therapy for distal ureteric calculi. Material and methods Between August 2014 and October 2015, 207 patients who presented with distal ureteric stones of size 5–10 mm were randomly divided into two groups: tadalafil (Group A) and tamsulosin (Group B). Therapy was given for a maximum of 4 weeks. Stone expulsion rate, time to stone expulsion, analgesic use, number of hospital visits for pain, follow-up, endoscopic treatment and adverse effects of drugs were noted. Both groups were compared for normally distributed data by percentage, analysis of variance, and T-test. All the classified and categorical data were analyzed for both groups using the chi-square test. Results A statistically significant expulsion rate of 84.0% in Group A compared with 68.0% in Group B (P value = 0.0130), and shorter stone expulsion time in Group A (14.7±3.8) in comparison to Group B (16.8 ±4.5) was observed. Statistically significant differences were noted in renal colic episodes and analgesic requirement in Group A than Group B. No serious adverse effects were noted. Conclusions Tadalafil is safe, efficacious, and well tolerated as medical expulsive therapy for distal ureteric stones. This study showed that tadalafil increases ureteric stone expulsion quite significantly along with better control of pain and significantly lower analgesic requirement. PMID:27551555

  18. Comparative Outcomes of the Two Types of Sacral Extradural Spinal Meningeal Cysts Using Different Operation Methods: A Prospective Clinical Study

    PubMed Central

    Sun, Jian-jun; Wang, Zhen-yu; Teo, Mario; Li, Zhen-dong; Wu, Hai-bo; Yen, Ru-yu; Zheng, Mei; Chang, Qing; Yisha Liu, Isabelle

    2013-01-01

    This prospective study compares different clinical characteristics and outcomes of patients with two types of sacral extradural spinal meningeal cysts (SESMC) undergoing different means of surgical excision. Using the relationship between the cysts and spinal nerve roots fibers (SNRF) as seen under microscope, SESMCs were divided into two types: cysts with SNRF known as Tarlov cysts and cysts without. The surgical methods were tailored to the different types of SESMCs. The improved Japanese Orthopedic Association (IJOA) scoring system was used to evaluate preoperative and postoperative neurological function of the patients. Preoperative IJOA scores were 18.5±1.73, and postoperative IJOA scores were 19.6±0.78. The difference between preoperative and postoperative IJOA scores was statistically significant (t = -4.52, p = 0.0001), with a significant improvement in neurological function after surgery. Among the improvements in neurological functions, the most significant was sensation (z=-2.74, p=0.006), followed by bowel/bladder function (z=-2.50, p=0.01). There was a statistically significant association between the types of SESMC and the number (F=12.57, p=0.001) and maximum diameter (F=8.08, p=0.006) of the cysts. SESMC with SNRF are often multiple and small, while cysts without SNRF tend to be solitary and large. We advocate early surgical intervention for symptomatic SESMCs in view of significant clinical improvement postoperatively. PMID:24386317

  19. Comparative Effectivenesses of Pulsed Radiofrequency and Transforaminal Steroid Injection for Radicular Pain due to Disc Herniation: a Prospective Randomized Trial

    PubMed Central

    2016-01-01

    Transforaminal Epidural steroid injections (TFESI) have been widely adopted to alleviate and control radicular pain in accord with current guidelines. However, sometimes repeated steroid injections have adverse effects, and thus, this prospective randomized trial was undertaken to compare the effectivenesses of pulsed radiofrequency (PRF) administered to a targeted dorsal root ganglion (DRG) and TFESI for the treatment of radicular pain due to disc herniation. Subjects were recruited when first proved unsuccessful (defined as a score of > 4 on a visual analogue scale (VAS; 0-10 mm) and of > 30% according to the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI)). Forty-four patients that met the inclusion criteria were enrolled. The 38 subjects were randomly assigned to receive either PRF (PRF group; n = 19) or additional TFESI (TFESI group; n = 19) and were then followed for 2, 4, 8, and 12 weeks. To evaluate pain intensity were assessed by VAS. ODI and NDI were applied to evaluate functional disability. Mean VAS scores for cervical and lumbar radicular pain were significantly lower 12 weeks after treatment in both study groups. NDI and ODI scores also declined after treatment. However, no statistically significant difference was observed between the PRF and TFESI groups in terms of VAS, ODI, or NDI scores at any time during follow-up. PRF administered to a DRG might be as effective as TFESI in terms of attenuating radicular pain caused by disc herniation, and its use would avoid the adverse effects of steroid. PMID:27478346

  20. Comparative Effectivenesses of Pulsed Radiofrequency and Transforaminal Steroid Injection for Radicular Pain due to Disc Herniation: a Prospective Randomized Trial.

    PubMed

    Lee, Dong Gyu; Ahn, Sang-Ho; Lee, Jungwon

    2016-08-01

    Transforaminal Epidural steroid injections (TFESI) have been widely adopted to alleviate and control radicular pain in accord with current guidelines. However, sometimes repeated steroid injections have adverse effects, and thus, this prospective randomized trial was undertaken to compare the effectivenesses of pulsed radiofrequency (PRF) administered to a targeted dorsal root ganglion (DRG) and TFESI for the treatment of radicular pain due to disc herniation. Subjects were recruited when first proved unsuccessful (defined as a score of > 4 on a visual analogue scale (VAS; 0-10 mm) and of > 30% according to the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI)). Forty-four patients that met the inclusion criteria were enrolled. The 38 subjects were randomly assigned to receive either PRF (PRF group; n = 19) or additional TFESI (TFESI group; n = 19) and were then followed for 2, 4, 8, and 12 weeks. To evaluate pain intensity were assessed by VAS. ODI and NDI were applied to evaluate functional disability. Mean VAS scores for cervical and lumbar radicular pain were significantly lower 12 weeks after treatment in both study groups. NDI and ODI scores also declined after treatment. However, no statistically significant difference was observed between the PRF and TFESI groups in terms of VAS, ODI, or NDI scores at any time during follow-up. PRF administered to a DRG might be as effective as TFESI in terms of attenuating radicular pain caused by disc herniation, and its use would avoid the adverse effects of steroid. PMID:27478346

  1. Auditing radiation sterilization facilities

    NASA Astrophysics Data System (ADS)

    Beck, Jeffrey A.

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

  2. A prospective, open, comparative study of 5% potassium hydroxide solution versus cryotherapy in the treatment of genital warts in men*

    PubMed Central

    Camargo, Caio Lamunier de Abreu; Belda, Walter; Fagundes, Luiz Jorge; Romiti, Ricardo

    2014-01-01

    BACKGROUND Genital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts. OBJECTIVE A prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men. METHODS Over a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy. RESULT In our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile. CONCLUSION Topical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts. PMID:24770498

  3. Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography

    SciTech Connect

    Gibson, R.S.; Watson, D.D.; Craddock, G.B.; Crampton, R.S.; Kaiser, D.L.; Denny, M.J.; Beller, G.A.

    1983-08-01

    The ability of predischarge quantitative exercise thallium-201 (/sup 201/T1) scintigraphy to predict future cardiac events was evaluated prospectively in 140 consecutive patients with uncomplicated acute myocardial infarction; the results were compared with those of submaximal exercise treadmill testing and coronary angiography. High risk was assigned if scintigraphy detected /sup 201/T1 defects in more than one discrete vascular region, redistribution, or increased lung uptake, if exercise testing caused ST segment depression greater than or equal to 1 mm or angina or if angiography revealed multivessel disease. Low risk was designated if scintigraphy detected a single-region defect, no redistribution, or no increase in lung uptake, if exercise testing caused no ST segment depression or angina, or if angiography revealed single-vessel disease or no disease. By 15 +/- 12 months, 50 patients had experienced a cardiac event; seven died (five suddenly), nine suffered recurrent myocardial infarction, and 34 developed severe class III or IV angina pectoris. Compared with that of patients at low risk, the cumulative probability of a cardiac event was greater in high-risk patients identified by scintigraphy, exercise testing, or angiography. Scintigraphy predicted low-risk status better than exercise testing or angiography. Each predicted mortality with equal accuracy. These results indicate that (1) submaximal exercise /sup 201/T1 scintigraphy can distinguish high- and low-risk groups after uncomplicated acute myocardial infarction before hospital discharge; (2) /sup 201/T1 defects in more than one discrete vascular region, presence of delayed redistribution, or increased lung thallium uptake are more sensitive predictors of subsequent cardiac events than ST segment depression, angina, or extent of angiographic disease; and (3) low-risk patients are best identified by a single-region /sup 201/T1 defect without redistribution and no increased lung uptake.

  4. Is sclerosant injection mandatory after an epinephrine injection for arrest of peptic ulcer haemorrhage? A prospective, randomised, comparative study.

    PubMed Central

    Lin, H J; Perng, C L; Lee, S D

    1993-01-01

    A prospective, randomised, comparative study was performed to assess the need for a pure alcohol injection after an epinephrine injection in the arrest of active peptic ulcer bleeding. Sixty four patients with active ulcer bleeding were enrolled in the study. The two groups (epinephrine and epinephrine plus pure alcohol) were matched for sex, age, site of bleed, endoscopic findings, shock, haemoglobin, and concomitant illness at randomisation. The volume of injected epinephrine in the epinephrine and the epinephrine plus pure alcohol groups mean (SD) was 6.0 (3.0) ml and 5.5 (3.0) ml respectively (p > 0.05). The volume of injected pure alcohol in the epinephrine plus pure alcohol group was 1.9 (1.1) ml. Bleeding was initially controlled in 31 (97%) of the epinephrine group and all of the epinephrine plus pure alcohol group. Rebleeding occurred in 11 (36%) of the epinephrine group and in five (16%) of the epinephrine plus pure alcohol group (p > 0.05). Rebleeding was successfully controlled in some patients with treatment by a second injection. Other patients had heat probe thermocoagulation or surgery. Ultimate haemostatic rates were 69% (22/32) and 88% (28/32) for the epinephrine and the epinephrine plus pure alcohol groups respectively (p > 0.05). The epinephrine plus pure alcohol group achieved a better haemostatic effect for spurting haemorrhage (9/10 v 5/11, p < 0.05). The need for emergency operations and blood transfusions were comparable in both groups. The stay in hospital were less in the epinephrine plus pure alcohol group (mean 4.3 v 7.1, p < 0.05). It is concluded that pure alcohol injection after an epinephrine injection can improve the haemostatic rate in patients with spurting haemorrhage and shorten the hospital stay for patients with active bleeding. PMID:8406150

  5. Prospective Molecular Profiling of Canine Cancers Provides a Clinically Relevant Comparative Model for Evaluating Personalized Medicine (PMed) Trials

    PubMed Central

    Mazcko, Christina; Cherba, David; Hendricks, William; Lana, Susan; Ehrhart, E. J.; Charles, Brad; Fehling, Heather; Kumar, Leena; Vail, David; Henson, Michael; Childress, Michael; Kitchell, Barbara; Kingsley, Christopher; Kim, Seungchan; Neff, Mark; Davis, Barbara

    2014-01-01

    Background Molecularly-guided trials (i.e. PMed) now seek to aid clinical decision-making by matching cancer targets with therapeutic options. Progress has been hampered by the lack of cancer models that account for individual-to-individual heterogeneity within and across cancer types. Naturally occurring cancers in pet animals are heterogeneous and thus provide an opportunity to answer questions about these PMed strategies and optimize translation to human patients. In order to realize this opportunity, it is now necessary to demonstrate the feasibility of conducting molecularly-guided analysis of tumors from dogs with naturally occurring cancer in a clinically relevant setting. Methodology A proof-of-concept study was conducted by the Comparative Oncology Trials Consortium (COTC) to determine if tumor collection, prospective molecular profiling, and PMed report generation within 1 week was feasible in dogs. Thirty-one dogs with cancers of varying histologies were enrolled. Twenty-four of 31 samples (77%) successfully met all predefined QA/QC criteria and were analyzed via Affymetrix gene expression profiling. A subsequent bioinformatics workflow transformed genomic data into a personalized drug report. Average turnaround from biopsy to report generation was 116 hours (4.8 days). Unsupervised clustering of canine tumor expression data clustered by cancer type, but supervised clustering of tumors based on the personalized drug report clustered by drug class rather than cancer type. Conclusions Collection and turnaround of high quality canine tumor samples, centralized pathology, analyte generation, array hybridization, and bioinformatic analyses matching gene expression to therapeutic options is achievable in a practical clinical window (<1 week). Clustering data show robust signatures by cancer type but also showed patient-to-patient heterogeneity in drug predictions. This lends further support to the inclusion of a heterogeneous population of dogs with cancer

  6. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community dwelling seniors age 65 and older

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Purpose: To compare the extent to which 7 available definitions of sarcopenia and 2 related definitions predict the prospective rate of falling. Methods: We studied a cohort of 445 seniors (mean age 71 years, 45% men) living in the community who were followed with a detailed fall assessment for 3 ...

  7. Comparing Discourse in Face-to-Face and Synchronous Online Mathematics Teacher Education: Effects on Prospective Teachers' Development of Knowledge for Teaching Statistics with Technology

    ERIC Educational Resources Information Center

    Starling, Tina T.

    2011-01-01

    This comparative study examined discourse and opportunities for interaction in two mathematics education methods classes, one face-to-face and one synchronous, online. Due to the content taught in the course, this study also sought to determine prospective mathematics teachers' understanding of variability and the role of discourse in each…

  8. Stakeholder Views on the Roles, Challenges, and Future Prospects of Korean and Chinese Heritage Language-Community Language Schools in Phoenix: A Comparative Study

    ERIC Educational Resources Information Center

    You, Byeong-keun; Liu, Na

    2011-01-01

    This study examines stakeholders' perspectives on Korean and Chinese heritage language and community language (HL-CL) schools and education in the Phoenix Metropolitan Area, Arizona. It investigates and compares the roles, major challenges, and future prospects of Korean and Chinese HL-CL schools as viewed by principals, teachers, and parents. To…

  9. Prospective Randomized Study Comparing Robotic-Assisted Surgery with Traditional Laparotomy for Rectal Cancer-Indian Study.

    PubMed

    Somashekhar, S P; Ashwin, K R; Rajashekhar, Jaka; Zaveri, Shabber

    2015-12-01

    Rectal cancer is one of the common cancers in India. Surgical management is the mainstay of initial treatment for majority of patients. Minimally invasive surgery has gained acceptance for the surgical treatment of rectal cancer because, compared with laparotomy, it is associated with fewer complications, shorter hospitalization, and faster recovery. The aim of this study is to evaluate the safety, feasibility, technique, and outcomes (postoperative, oncological, and functional) of robotic-assisted rectal surgery in comparison with open surgery in the Indian population. A prospective randomized study was undertaken from August 2011 to December 2012. Fifty patients who presented with rectal carcinoma were randomized to either robotic arm (RA) or open arm (OA) group. Both groups were matched for clinical stage and operation type. Technique and feasibility of robotic-assisted surgery in terms of operating time, estimated blood loss, margins status, total number of lymph nodes retrieved, hospital stay, conversion to open procedure, complications, and functional outcomes were analyzed. The mean operative time was significantly longer in the RA than in the OA group (310 vs 246 min, P < 0.001) but was significantly reduced in the latter part of the robotic-assisted patients compared with the initial patients. The mean estimated blood loss was significantly less in the RA compared with the OA group (165.14 vs 406.04 ml, P < 0.001). None of the patients had margin positivity. The mean distal resection margin was significantly longer in the RA than in the OA group (3.6 vs 2.4 cm, P < 0.001). A total of 100 % of patients in the RA group had complete mesorectal excision while two patients in the OA group had incomplete mesorectal excision. The average number of retrieved lymph nodes was adequate for accurate staging. The number of lymph nodes removed by robotic method is slightly higher than the open method (16.88 vs 15.20) but with no statistical significance

  10. Outcome of Burns Treated With Autologous Cultured Proliferating Epidermal Cells: A Prospective Randomized Multicenter Intrapatient Comparative Trial.

    PubMed

    Gardien, Kim L M; Marck, Roos E; Bloemen, Monica C T; Waaijman, Taco; Gibbs, Sue; Ulrich, Magda M W; Middelkoop, Esther

    2016-01-01

    Standard treatment for large burns is transplantation with meshed split skin autografts (SSGs). A disadvantage of this treatment is that healing is accompanied by scar formation. Application of autologous epidermal cells (keratinocytes and melanocytes) may be a suitable therapeutic alternative, since this may enhance wound closure and improve scar quality. A prospective, multicenter randomized clinical trial was performed in 40 adult patients with acute full thickness burns. On two comparable wound areas, conventional treatment with SSGs was compared to an experimental treatment consisting of SSGs in combination with cultured autologous epidermal cells (ECs) seeded in a collagen carrier. The primary outcome measure was wound closure after 5-7 days. Secondary outcomes were safety aspects and scar quality measured by graft take, scar score (POSAS), skin colorimeter (DermaSpectrometer) and elasticity (Cutometer). Wound epithelialization after 5-7 days was significantly better for the experimental treatment (71%) compared to the standard treatment (67%) (p = 0.034, Wilcoxon), whereas the take rates of the grafts were similar. No related adverse events were recorded. Scar quality was evaluated at 3 (n = 33) and 12 (n = 28) months. The POSAS of the observer after 3 and 12 months and of the patient after 12 months were significantly better for the experimental area. Improvements between 12% and 23% (p ≤ 0.010, Wilcoxon) were detected for redness, pigmentation, thickness, relief, and pliability. Melanin index at 3 and 12 months and erythema index at 12 months were closer to normal skin for the experimental treatment than for conventional treatment (p ≤ 0.025 paired samples t-test). Skin elasticity showed significantly higher elasticity (p = 0.030) in the experimental area at 3 months follow-up. We showed a safe application and significant improvements of wound healing and scar quality in burn patients after treatment with ECs versus SSGs only

  11. A prospective randomised comparative parallel study of amniotic membrane wound graft in the management of diabetic foot ulcers

    PubMed Central

    Zelen, Charles M; Serena, Thomas E; Denoziere, Guilhem; Fetterolf, Donald E

    2013-01-01

    Our purpose was to compare healing characteristics of diabetic foot ulcers treated with dehydrated human amniotic membrane allografts (EpiFix®, MiMedx, Kennesaw, GA) versus standard of care. An IRB-approved, prospective, randomised, single-centre clinical trial was performed. Included were patients with a diabetic foot ulcer of at least 4-week duration without infection having adequate arterial perfusion. Patients were randomised to receive standard care alone or standard care with the addition of EpiFix. Wound size reduction and rates of complete healing after 4 and 6 weeks were evaluated. In the standard care group (n = 12) and the EpiFix group (n = 13) wounds reduced in size by a mean of 32·0% ± 47·3% versus 97·1% ± 7·0% (P < 0·001) after 4 weeks, whereas at 6 weeks wounds were reduced by −1·8% ± 70·3% versus 98·4% ± 5·8% (P < 0·001), standard care versus EpiFix, respectively. After 4 and 6 weeks of treatment the overall healing rate with application of EpiFix was shown to be 77% and 92%, respectively, whereas standard care healed 0% and 8% of the wounds (P < 0·001), respectively. Patients treated with EpiFix achieved superior healing rates over standard treatment alone. These results show that using EpiFix in addition to standard care is efficacious for wound healing. PMID:23742102

  12. A comparative in-vivo evaluation of the alignment efficiency of 5 ligation methods: A prospective randomized clinical trial

    PubMed Central

    Reddy, Vijaya Bhaskara; Kumar, Talapaneni Ashok; Prasad, Mandava; Nuvvula, Sivakumar; Patil, Rajedra Goud; Reddy, Praveen Kumar

    2014-01-01

    Objectives: To conduct a prospective randomized study comparing the efficiency of 5 different ligation systems (ELL; elastomeric ligature, SSL; stainless steel ligature, LL; leone slide ligature, PSL; passive self-ligation and ASL; active self-ligation) over the duration of mandibular crowding alleviation. Materials and Methods: Fifty consecutive patients (54.2% male, 45.8% female; mean age: 16.69 years) satisfying the inclusion criteria were randomly allocated to 5 ligation groups with an equal sample size of 10 per group. The 5 groups received treatment with 0.022-inch MBT pre-adjusted edge-wise technique (ELL: Gemini 3M Unitek, SSL: Gemini 3M Unitek, LL: Gemini 3M Unitek, PSL: SmartClip 3M Unitek and ASL: In-Ovation R Euro GAC International). The models and cephalograms were evaluated for anterior arch alignment, extraction space closure, and lower incisal inclinations at pre-treatment T1 and at the end of initial alignment T2. Analysis of variance (ANOVA) and Post-hoc tests were used for data analysis. Results: Forty-eight participants completed the study, and SL systems showed a significant difference over CL groups in time to alignment, passive space closure, and incisal inclination. Multiple regression showed a reduction of 5.28 days in time to alignment by changing the ligation group in the order of ELL to ASL group and 1 mm increase in initial irregularity index increases time to alignment by 11.68 days. Conclusion: Self-ligation brackets were more efficient than conventional ligation brackets during initial leveling and alignment. PMID:24966742

  13. Dosimetric audit in brachytherapy

    PubMed Central

    Bradley, D A; Nisbet, A

    2014-01-01

    Dosimetric audit is required for the improvement of patient safety in radiotherapy and to aid optimization of treatment. The reassurance that treatment is being delivered in line with accepted standards, that delivered doses are as prescribed and that quality improvement is enabled is as essential for brachytherapy as it is for the more commonly audited external beam radiotherapy. Dose measurement in brachytherapy is challenging owing to steep dose gradients and small scales, especially in the context of an audit. Several different approaches have been taken for audit measurement to date: thimble and well-type ionization chambers, thermoluminescent detectors, optically stimulated luminescence detectors, radiochromic film and alanine. In this work, we review all of the dosimetric brachytherapy audits that have been conducted in recent years, look at current audits in progress and propose required directions for brachytherapy dosimetric audit in the future. The concern over accurate source strength measurement may be essentially resolved with modern equipment and calibration methods, but brachytherapy is a rapidly developing field and dosimetric audit must keep pace. PMID:24807068

  14. School Safety Audit Protocol.

    ERIC Educational Resources Information Center

    DeMary, Jo Lynne; Owens, Marsha; Ramnarain, A. K. Vijay

    The 1997 Virginia General Assembly passed legislation directing school boards to require all schools to conduct safety audits. This audit is designed to assess the safety conditions in each public school to: (1) identify and, if necessary, develop solutions for physical safety concerns, including building security issues; and (2) identify and…

  15. Auditing Schools for Safety.

    ERIC Educational Resources Information Center

    Butterfield, Eric,

    2000-01-01

    Explores the issues involved in conducting effective safety audits for educational facilities. Areas covered include auditing for site characteristics, access control, lighting, building exterior, door types and locking mechanisms, key control, alarm system controls, security monitors, and vision panels in the doors. (GR)

  16. Comparative Evaluation of Stroke Triage Algorithms for Emergency Medical Dispatchers (MeDS): Prospective Cohort Study Protocol

    PubMed Central

    2011-01-01

    Background Stroke is a major cause of death and leading cause of disability in the United States. To maximize a stroke patient's chances of receiving thrombolytic treatment for acute ischemic stroke, it is important to improve prehospital recognition of stroke. However, it is known from published reports that emergency medical dispatchers (EMDs) using Card 28 of the Medical Priority Dispatch System protocols recognize stroke poorly. Therefore, to improve EMD's recognition of stroke, the National Association of Emergency Medical Dispatchers recently designed a new diagnostic stroke tool (Cincinnati Stroke Scale -CSS) to be used with Card 28. The objective of this study is to determine whether the addition of CSS improves diagnostic accuracy of stroke triage. Methods/Design This prospective experimental study will be conducted during a one-year period in the 911 call center of Santa Clara County, CA. We will include callers aged ≥ 18 years with a chief complaint suggestive of stroke and second party callers (by-stander or family who are in close proximity to the patient and can administer the tool) ≥ 18 years of age. Life threatening calls will be excluded from the study. Card 28 questions will be administered to subjects who meet study criteria. After completion of Card 28, CSS tool will be administered to all calls. EMDs will record their initial assessment of a cerebro-vascular accident (stroke) after completion of Card 28 and their final assessment after completion of CSS. These assessments will be compared with the hospital discharge diagnosis (ICD-9 codes) recorded in the Office of Statewide Health Planning and Development (OSHPD) database after linking the EMD database and OSHPD database using probabilistic linkage. The primary analysis will compare the sensitivity of the two stroke protocols using logistic regression and generalizing estimating equations to account for clustering by EMDs. To detect a 15% difference in sensitivity between the two groups

  17. Evaluation of high-pitch flash scan for pulmonary venous CTA on a 128-slice dual source CT: compared with prospective ECG-triggered sequence scan.

    PubMed

    Cao, Li Xiu; Zhang, Huan; Liu, Bo; Yang, Wen Jie; Zhang, Yan Yan; Pan, Zi Lai; Yan, Fu Hua; Chen, Ke Min

    2013-10-01

    To compare the image quality (IQ) and radiation dose of high-pitch scan and prospective ECG-triggered sequence scan on a 128-slice DSCT system for patients with atrial fibrillation (AF). Pulmonary venous (PV) CTA was performed with two protocols, including high-pitch scan and prospective ECG-triggered sequence scan. For each protocol, 20 sex, age and body-mass-index (mean 24.2 kg/m(2)) matched patients were identified. Two experienced radiologists, who were blinded to the scan protocols, independently graded the CT images of the two groups by a 5-point scale for subjective IQ assessment. Measured CT attenuation (Hounsfield units ± standard deviation), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) at various anatomic locations were also recorded for objective IQ evaluation. Radiation exposure parameters [dose length product (DLP) and effective radiation dose (ERD)] were compared. Twenty-three patients (57.5 %) showed an ECG pattern of AF in total. Subjective IQ was rated excellent in 100 % for the high-pitch scan group, while minor step artifacts were observed in two patients (10 %) with arrhythmia for the prospective ECG-triggered sequence group. There was no significant difference on IQ, neither by subjective, nor by objective measures (SNR, CNR) between the two groups. The ERD of high-pitch flash scan and prospective ECG-triggered sequence scan were 0.9 (± 0.25) and 2.9 (± 0.69) mSv, respectively. Significantly lower radiation was achieved by using high-pitch flash scan (P < 0.05). High-pitch flash scan can provide similar subjective and objective IQ compared with prospective ECG-triggered sequence scan for PV CTA, while radiation exposure was significantly reduced. PMID:23645131

  18. New state legislation for auditing privilege

    SciTech Connect

    Washington, W.

    1995-12-31

    The California Manufacturers Association (CMA) is the sponsor of AB 1729. The bill would establish a safety and health audit privilege for employers who engage in voluntary workplace audits in order to prevent workplace injury and illnesses or to evaluate the effectiveness of their management systems. The voluntary audit is in addition to any other required audit, inspection, review, etc. required under the appropriate authority. In a recent national occupational safety and health survey, California was rated number one overall. Much of the credit has to do with the heightened awareness of California based employers of the importance of workplace safety, the high workers` compensation cost associated with injuries and illnesses and the nation`s only mandatory injury and illness prevention program. Moreover, many employers have made the prevention of injury and illness in the workplace a top priority. Voluntary internal safety and health audits are the most thorough and efficient means of achieving that goal. Compared to all other available procedures, audits are the most proactive, and they provide an outstanding tool to assist employers in actively identifying and eliminating potential hazards that could result in an injury or illness before it happens.

  19. Surgical audit: a review. Proceedings of an audit symposium.

    PubMed

    1989-11-01

    card can be designed to make entry into a computer system easy for a secretary.It is alos much easier to take records to a weekly meeting than 30 sets of patients' notes. In broad terms the audit systems discussed fell into 2 groups: those which used computers and those which did not. There is no doubt that the use of a computer helps in marshalling the information collected. Although a card system was very cheap and easy to use,it was very much difficult to retrieve information rapidly from it than from a computer based system.It seems that the use of computer entails the consumption of more time for entry and validation of data than a card based system, and there may be a temptation not to spend so much time on the educational aspects of audit. This problem can be overcome by holding regular meetings at which only results presented, perhaps firm by firm, in a hospital, so that discussions on policies relating to thromboembolic prophylaxis, the use of prophylactic antibiotics and similar topics can be discussed. Indeed if this kind of meeting does not take place, then it would seem that one of the principal objectives of audit is lost. For this meetings to take place a computer based system is almost certainly going to be essential. In setting up a clinical audit there is clearly a requirement for financial investment. This means first buy in a computer based system and several options are open to the prospective auditor. A simple desk top computer with a modified database system can be used but Messrs. Baird and Horrocks found it required a great deal of programming using a database programme that was already commercially available to obtain a workable system.Two or three commercial systems are now available using personal computers and it seems likely that in many hospitals this will be a popular choice. When introduced in Colchester General Hospital by Mr. Motson where such a facility had not existed in the past, computerisation has been well received and has

  20. Internal Auditing for School Districts.

    ERIC Educational Resources Information Center

    Cuzzetto, Charles

    This book provides guidelines for conducting internal audits of school districts. The first five chapters provide an overview of internal auditing and describe techniques that can be used to improve or implement internal audits in school districts. They offer information on the definition and benefits of internal auditing, the role of internal…

  1. Early Indicators of Autism Spectrum Disorders at 12 and 24 Months of Age: A Prospective, Longitudinal Comparative Study

    ERIC Educational Resources Information Center

    Veness, Carly; Prior, Margot; Bavin, Edith; Eadie, Patricia; Cini, Eileen; Reilly, Sheena

    2012-01-01

    Prospective questionnaire data from a longitudinal population sample on children with autism spectrum disorders (ASD), developmental delay, specific language impairment, or typical development (TD), were collected at ages eight, 12 and 24 months, via the Communication and Symbolic Behavior Scale Developmental Profile (CSBS)--Infant Toddler…

  2. A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up.

    PubMed

    Parry, Ingrid; Painting, Lynda; Bagley, Anita; Kawada, Jason; Molitor, Fred; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2015-01-01

    Commercially available, interactive videogames that use body movements for interaction are used clinically in burn rehabilitation and have been shown to facilitate functional range of motion (ROM) but their efficacy with burn patients has not yet been proven. The purpose of this pilot randomized control study was to prospectively compare planar and functional ROM, compliance, pain, enjoyment, and exertion in pediatric burn patients receiving two types of rehabilitation therapy. Seventeen school-aged children with 31 affected limbs who demonstrated limited shoulder ROM from burn injury were randomized to receive exercises using either standard therapy ROM activities (ST) or interactive videogame therapy (VGT). Patients received 3 weeks of the designated therapy intervention twice daily. They were then given a corresponding home program of the same type of therapy to perform regularly for 6 months. Standard goniometry and three-dimensional motion analysis during functional tasks were used to assess ROM. Measures were taken at baseline, 3 weeks, 3 months, and 6 months. Pain was measured before and after each treatment session during the 3-week intervention. There was no difference in compliance, enjoyment, or exertion between the groups. Patients in both the ST and VGT groups showed significant improvement in shoulder flexion (P < .001), shoulder abduction (P <.001), shoulder external rotation (P = .01), and elbow flexion (P = .004) ROM from baseline to 6 months as measured with goniometry. Subjects also showed significant gains in elbow flexion (P = .04) during hand to head and shoulder flexion (P = .04) during high reach. There was no difference in ROM gains between the groups. Within group comparison showed that the VGT group had significantly more recovery of ROM during the first 3 weeks than any other timeframe in the study, whereas ST had most gains at 3 months. There was a significant difference between the groups in the subjects' pain response. ST subjects

  3. Audits of radiopharmaceutical formulations.

    PubMed

    Castronovo, F P

    1992-03-01

    A procedure for auditing radiopharmaceutical formulations is described. To meet FDA guidelines regarding the quality of radiopharmaceuticals, institutional radioactive drug research committees perform audits when such drugs are formulated away from an institutional pharmacy. All principal investigators who formulate drugs outside institutional pharmacies must pass these audits before they can obtain a radiopharmaceutical investigation permit. The audit team meets with the individual who performs the formulation at the site of drug preparation to verify that drug formulations meet identity, strength, quality, and purity standards; are uniform and reproducible; and are sterile and pyrogen free. This team must contain an expert knowledgeable in the preparation of radioactive drugs; a radiopharmacist is the most qualified person for this role. Problems that have been identified by audits include lack of sterility and apyrogenicity testing, formulations that are open to the laboratory environment, failure to use pharmaceutical-grade chemicals, inadequate quality control methods or records, inadequate training of the person preparing the drug, and improper unit dose preparation. Investigational radiopharmaceutical formulations, including nonradiolabeled drugs, must be audited before they are administered to humans. A properly trained pharmacist should be a member of the audit team. PMID:1598931

  4. Improving energy audit process and report outcomes through planning initiatives

    NASA Astrophysics Data System (ADS)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  5. Communication of Audit Risk to Students.

    ERIC Educational Resources Information Center

    Alderman, C. Wayne; Thompson, James H.

    1986-01-01

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

  6. 7 CFR 1773.8 - Audit date.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.8 Audit date. (a) The annual... change the as of audit date is obtained, in writing, from RUS. (1) A borrower may request a change in...

  7. PERFORMANCE AUDIT PROCEDURES FOR OPACITY MONITORS

    EPA Science Inventory

    The manual contains monitor-specific performance audit procedures and data forms for use in conducting audits of installed opacity continuous emission monitoring systems (CEMS). General auditing procedures and acceptance limits for various audit criteria are discussed. Practical ...

  8. Auditing the auditors.

    PubMed

    Pallarito, K

    1998-09-21

    An independent auditor's opinion is supposed to be the gold standard in healthcare accounting. Such audits provide reasonable assurance that financial statements are accurate, which is particularly important in not-for-profit healthcare because most organizations don't have shareholder oversight. But the recent firing of a Big Five accounting firm by a major healthcare system in bankruptcy reorganization raises questions about the credibility of external audits. PMID:10185568

  9. Oneida Tribe Energy Audits

    SciTech Connect

    Olson, Ray; Schubert, Eugene

    2014-08-15

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

  10. Energy audits at 48 hospitals

    NASA Astrophysics Data System (ADS)

    Hirst, E.

    1981-11-01

    Staff at the Oak Ridge Associated Universities (ORAU) conducted energy audits at 48 hospitals in four states (New York, Pennsylvania, Virginia, Tennessee) between 1978 and 1980. Staff at the Oak Ridge National Laboratory (ORNL) and ORAU developed and organized a computerized data base containing information from these audits. This paper describes the ORAU audit process; summarizes the data collected from these audits on hospital characteristics annual energy use, and the audit recommendations; and analyzes the audit data in terms of cost effectiveness, type of recommendations, and the relationship between potential energy saving and characteristics of the individual hospital.

  11. 29 CFR 96.42 - Audit standards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Audit standards. 96.42 Section 96.42 Labor Office of the... Standards and Relation of Organization-wide Audits to Other Audit Requirements § 96.42 Audit standards. Surveys, audits, and examinations will conform to the Government auditing standards, issued by...

  12. Acid Rain Program CEM audit program

    SciTech Connect

    Nguyen, K.O.T.; Alexander, T.H.; Dupree, J.C.

    1997-12-31

    This presentation will give an overview of the Acid Rain Program CEM Audit Program: electronic and field audits. The presentation will include the reasons for audits, field audit types and levels the steps used in develop in the audit program and the audit procedures.

  13. 7 CFR 1773.7 - Audit standards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Audit standards. 1773.7 Section 1773.7 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.7 Audit standards. (a) The audit must be performed in accordance with GAGAS and this part. The audit must be performed in...

  14. 29 CFR 96.42 - Audit standards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit standards. 96.42 Section 96.42 Labor Office of the Secretary of Labor AUDIT REQUIREMENTS FOR GRANTS, CONTRACTS, AND OTHER AGREEMENTS Access to Records, Audit Standards and Relation of Organization-wide Audits to Other Audit Requirements § 96.42 Audit...

  15. 7 CFR 1773.7 - Audit standards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Audit standards. 1773.7 Section 1773.7 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.7 Audit standards. (a) The audit must be performed in accordance with GAGAS and this part. The audit must be performed in...

  16. 7 CFR 1773.7 - Audit standards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Audit standards. 1773.7 Section 1773.7 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.7 Audit standards. (a) The audit must be performed in accordance with GAGAS and this part. The audit must be performed in...

  17. 7 CFR 1773.7 - Audit standards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false Audit standards. 1773.7 Section 1773.7 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.7 Audit standards. (a) The audit must be performed in accordance with GAGAS and this part. The audit must be performed in...

  18. 7 CFR 1773.7 - Audit standards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false Audit standards. 1773.7 Section 1773.7 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.7 Audit standards. (a) The audit must be performed in accordance with GAGAS and this part. The audit must be performed in...

  19. The audit process: Part I. Pre-audit preparation.

    PubMed

    Bialachowski, Anne; Clinker, Karen; LeBlanc, Mary; McDonald, Shirley

    2010-01-01

    Infection prevention and control audits are an important element in the achievement of a health care setting's patient safety goals. The successful audit can result in enhanced partnerships between infection control professionals and other departments and services in the organization, implement change and lead to continuing improvement in outcomes for patients/residents and staff. In this first part of the audit process, the preparation leading up to the actual administration of the audit is described. PMID:20469658

  20. Auditing chronic disease care: Does it make a difference?

    PubMed Central

    van Vuuren, Unita; De Sa, Angela; Govender, Srini; Murie, Katie; Schlemmer, Arina; Gunst, Colette; Namane, Mosedi; Boulle, Andrew; de Vries, Elma

    2015-01-01

    Background An integrated audit tool was developed for five chronic diseases, namely diabetes, hypertension, asthma, chronic obstructive pulmonary disease and epilepsy. Annual audits have been done in the Western Cape Metro district since 2009. The year 2012 was the first year that all six districts in South Africa's Western Cape Province participated in the audit process. Aim To determine whether clinical audits improve chronic disease care in health districts over time. Setting Western Cape Province, South Africa. Methods Internal audits were conducted of primary healthcare facility processes and equipment availability as well as a folder review of 10 folders per chronic condition per facility. Random systematic sampling was used to select the 10 folders for the folder review. Combined data for all facilities gave a provincial overview and allowed for comparison between districts. Analysis was done comparing districts that have been participating in the audit process from 2009 to 2010 (‘2012 old’) to districts that started auditing recently (‘2012 new’). Results The number of facilities audited has steadily increased from 29 in 2009 to 129 in 2012. Improvements between different years have been modest, and the overall provincial average seemed worse in 2012 compared to 2011. However, there was an improvement in the ‘2012 old’ districts compared to the ‘2012 new’ districts for both the facility audit and the folder review, including for eight clinical indicators, with ‘2012 new’ districts being less likely to record clinical processes (OR 0.25, 95% CI 0.21–0.31). Conclusion These findings are an indication of the value of audits to improve care processes over the long term. It is hoped that this improvement will lead to improved patient outcomes. PMID:26245615

  1. Limited femoral navigation versus conventional intramedullary femoral jig based instrumentation for achieving optimal restoration of mechanical axis post total knee arthroplasty: a prospective comparative study of 200 knees.

    PubMed

    Shah, Nilen A; Patil, Hitendra G; Dhawale, Amol S; Khedkar, Bipin M

    2015-04-01

    A prospective comparative study was conducted to compare the mechanical axis post total knee arthroplasty (TKA) between two groups: In the first group of 100 knees (ASM group) Articular Surface Mounted navigation system was used to guide the distal femoral cut. In the second group of 100 knees (JIG group) conventional intramedullary femoral jig was used. The postoperative mechanical axis of the leg was within 3° of neutral alignment in 90% of the TKA in the ASM group (mean 178.12°) as compared to 74% in the JIG group (mean 177.02°). This difference was statistically significant (P<0.05). The data presented show that the use of limited femoral navigation leads to more accurate restoration of mechanical axis alignment when compared to conventional intramedullary femoral jigs. PMID:25466168

  2. Decentralization Calls for Internal Audits.

    ERIC Educational Resources Information Center

    DiCello, Jim

    1995-01-01

    Outlines internal-auditing strategies necessitated by decentralization. Describes the following areas of concern: the student activities account, student attendance, and funding delegated to the site level. Guidelines for conducting an internal audit are also included. (LMI)

  3. Comparing two theories of health behavior: a prospective study of noncompletion of treatment following cervical cancer screening.

    PubMed

    Orbell, Sheina; Hagger, Martin; Brown, Val; Tidy, John

    2006-09-01

    Some women receiving abnormal cervical screening tests do not complete recommended treatment. A prospective study (N = 660) investigated the value of conceptualizing attendance at colposcopy for treatment as either (a) an active problem-solving response to a health threat, motivated by attitudes toward an abnormal result, as implied by self-regulation theory (H. Leventhal, D. Meyer, & D. Nerenz, 1980); or (b) as a behavior motivated by attitudes toward clinic attendance, as implied by the theory of planned behavior (TPB; I. Ajzen, 1985). Responses to questionnaires containing variables specified by these models were used to predict women's subsequent attendance or nonattendance for treatment over the following 15 months. Although the TPB offered superior prediction of intentions and completion of treatment, discriminant function analyses showed that consideration of both models was important in distinguishing between those who attended all their appointments as scheduled, attended after being prompted, or ceased attending. Implications for measurement and theory in health protection are discussed. PMID:17014278

  4. Audits that Make a Difference

    SciTech Connect

    Malsbury, Judith

    1999-02-01

    This paper presents guidance on how to perform internal audits that get management's attention and result in effective corrective action. It assumes that the reader is already familiar with the basic constructs of auditing and knows how to perform them. Instead, it focuses on additional techniques that have proven to be effective in our internal auditing program. Examples using a theoretical audit of a calibration program are included.

  5. Internal Audit in Higher Education.

    ERIC Educational Resources Information Center

    Holmes, Alison, Ed.; Brown, Sally, Ed.

    This book describes a range of examples of internal audit in higher education as part of a process of the exchange of good practice. The book recognizes well-established links with audit theory from other contexts and makes use of theoretical perspectives explored in the financial sector. The chapters are: (1) "Quality Audit Issues" (Sally Brown…

  6. Preparing for the Annual Audit.

    ERIC Educational Resources Information Center

    Nuehring, Bert

    2002-01-01

    Proposes several key questions that school district business officials should answer to prepare for an annual financial audit involving auditor information and resource needs, district and auditor monitoring and reporting on the audit progress, and reporting the results of the audit to the board of education. (PKP)

  7. Developmental Audits with Challenging Youth

    ERIC Educational Resources Information Center

    Brendtro, Larry K.; du Toit, Lesley; Bath, Howard; Van Bockern, Steve

    2006-01-01

    The Developmental Audit[R] is a new strength-based assessment model for youth who are in conflict in home, school, or community. Developmental Audits involve collaboration with young persons who are seen as experts on themselves. Discussing challenging life events provides a window to the young person's private logic and goals. The audit scans…

  8. Auditing audits: use and development of the Oxfordshire Medical Audit Advisory Group rating system.

    PubMed Central

    Lawrence, M.; Griew, K.; Derry, J.; Anderson, J.; Humphreys, J.

    1994-01-01

    OBJECTIVES--To assess the value of the Oxfordshire Medical Audit Advisory Group rating system in monitoring and stimulating audit activity, and to implement a development of the system. DESIGN--Use of the rating system for assessment of practice audits on three annual visits in Oxfordshire; development and use of an "audit grid" as a refinement of the system; questionnaire to all medical audit advisory groups in England and Wales. SETTING--All 85 general practices in Oxfordshire; all 95 medical audit advisory groups in England and Wales. MAIN OUTCOME MEASURES--Level of practices' audit activity as measured by rating scale and grid. Use of scale nationally together with perceptions of strengths and weaknesses as perceived by chairs of medical audit advisory groups. RESULTS--After one year Oxfordshire practices more than attained the target standards set in 1991, with 72% doing audit involving setting target standards or implementing change; by 1993 this had risen to 78%. Most audits were confined to chronic disease management, preventive care, and appointments. 38 of 92 medical audit advisory groups used the Oxfordshire group's rating scale. Its main weaknesses were insensitivity in assessing the quality of audits and failure to measure team involvement. CONCLUSIONS--The rating system is effective educationally in helping practices improve and summatively for providing feedback to family health service authorities. The grid showed up weakness in the breadth of audit topics studied. IMPLICATIONS AND ACTION--Oxfordshire practices achieved targets set for 1991-2 but need to broaden the scope of their audits and the topics studied. The advisory group's targets for 1994-5 are for 50% of practices to achieve an audit in each of the areas of clinical care, access, communication, and professional values and for 80% of audits to include setting targets or implementing change. PMID:8086911

  9. National Energy Audit

    Energy Science and Technology Software Center (ESTSC)

    2001-12-30

    A user-friendly, advanced computer energy audit, the National Energy Audit (NEAT) has been developed by the Existing Buildings Research Program at Oak Ridge National Laboratory''s (ORNL''s) Building Technology Center for the U.S. Department of Energy''s (DOE''s) Weatherization Assistance and Existing Buildings Program. The computer program is designed for use by State agencies and utilities to determine the most cost-effective retrofit measures for single-family homes to increase the energy efficiency and comfort level. NEAT7.1.3 contains minormore » changes and improvements in NEAT7.1.« less

  10. Walkability Audit Tool.

    PubMed

    Smith, Letha

    2015-09-01

    Walking is one of the simplest lifestyle changes workers can make to improve their health. Research shows a wealth of health benefits. Often, occupational and environmental health nurses are in charge of implementing walking programs. A tool is needed to continuously improve a company's walking program whether in the beginning stages or to an already established program. The Centers for Disease Control and Prevention (CDC) Walkability Audit Tool for a healthier worksite is an easy seven-step audit tool that occupational and environmental health nurses can easily implement. PMID:26215975

  11. Prospective study comparing skin impedance with EEG parameters during the induction of anaesthesia with fentanyl and etomidate

    PubMed Central

    2010-01-01

    Objective Sympathetic stimulation leads to a change in electrical skin impedance. So far it is unclear whether this effect can be used to measure the effects of anaesthetics during general anaesthesia. The aim of this prospective study is to determine the electrical skin impedance during induction of anaesthesia for coronary artery bypass surgery with fentanyl and etomidate. Methods The electrical skin impedance was measured with the help of an electro-sympathicograph (ESG). In 47 patients scheduled for elective cardiac surgery, anaesthesia was induced with intravenous fentanyl 10 μg/kg and etomidate 0.3 mg/kg. During induction, the ESG (Electrosympathicograph), BIS (Bispectral IndeX), BP (arterial blood pressure) and HR (heart rate) values of each patient were recorded every 20 seconds. The observation period from administration of fentanyl to intubation for surgery lasted 4 min. Results The ESG recorded significant changes in the electrical skin impedance after administration of fentanyl and etomidate(p < 0.05). During induction of anaesthesia, significant changes of BIS, HR and blood pressure were observed as well (p < 0.05). Conclusions The electrical skin impedance measurement may be used to monitor the effects of anesthetics during general anaesthesia. PMID:20452883

  12. Composition of the inflammatory infiltrate in pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans): a prospective, comparative immunophenotyping study.

    PubMed

    Hinchliffe, S A; Ciftci, A O; Khine, M M; Rickwood, A M; Ashwood, J; McGill, F; Clapham, E M; van Velzen, D

    1994-01-01

    Dermatopathological evaluation of pediatric preputial inflammatory disease rarely allows for specific diagnosis other than pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans, LSA/BXO). A prospective immunopathological study was performed on 20 consecutive, unselected, clinically and histopathologically confirmed LSA/BXO cases to determine the relative presence of T and B lymphocytes. There were seven cases with early stages of disease, eight with florid disease, and five with later stages of disease. Two ritual circumcision specimens and 12 specimens with non-LSA/BXO balanitis, collected during the same period, were used as controls. The infiltrate in LSA/BXO patients was wholly composed of T cells (positive with UCLH-1 antibody) in all cases. B cells (positive with L-26 antibody) were found only focally in small, discreet, easily recognizable (follicular or early follicle-like) aggregates, positioned slightly deeper than the band-like infiltrate of T cells. T cells were inconspicuous in 9 of the 12 control specimens. In the three other controls, T cells were much more obvious and these patients showed clinical features possibly suggestive of LSA/BXO in early, prediagnosable phases of development. We conclude that limited immunophenotyping may be a useful adjunct to diagnosis in pediatric cases in which only limited tissue is available or the disease may be more difficult to classify with confidence. PMID:8008686

  13. Does surgery for instability of the shoulder truly stabilize the glenohumeral joint?: A prospective comparative cohort study.

    PubMed

    Lädermann, Alexandre; Denard, Patrick J; Tirefort, Jérôme; Kolo, Frank C; Chagué, Sylvain; Cunningham, Grégory; Charbonnier, Caecilia

    2016-08-01

    Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects glenohumeral translation. The purpose of this prospective clinical study was to analyze the effect of surgical stabilization on glenohumeral translation.Glenohumeral translation was assessed in 11 patients preoperatively and 1 year postoperatively following surgical stabilization for anterior shoulder instability. Translation was measured using optical motion capture and computed tomography.Preoperatively, anterior translation of the affected shoulder was bigger in comparison to the normal contralateral side. Differences were significant for flexion and abduction movements (P < 0.001). Postoperatively, no patients demonstrated apprehension and all functional scores were improved. Despite absence of apprehension, postoperative anterior translation for the surgically stabilized shoulders was not significantly different from the preoperative values.While surgical treatment for anterior instability limits the chance of dislocation, it does not seem to restore glenohumeral translation during functional range of motion. Such persistent microinstability may explain residual pain, apprehension, inability to return to activity and even emergence of dislocation arthropathy that is seen in some patients. Further research is necessary to better understand the causes, effects, and treatment of residual microinstability following surgical stabilization of the shoulder. PMID:27495043

  14. A prototype Distributed Audit System

    SciTech Connect

    Banning, D.L.

    1993-08-01

    Security auditing systems are used to detect and assess unauthorized or abusive system usage. Historically, security audits were confined to a single computer system. Recent work examines ways of extending auditing to include heterogeneous groups of computers (distributed system). This paper describes the design and prototype development of a Distributed Audit System (DAS) which was developed with funding received from Lawrence Livermore Laboratory and through the Master`s thesis effort performed by the author at California State University, Long Beach. The DAS is intended to provide collection, transfer, and control of audit data on distributed, heterogeneous hosts.

  15. The Brazilian Audit Tribunal's role in improving the federal environmental licensing process

    SciTech Connect

    Lima, Luiz Henrique; Magrini, Alessandra

    2010-02-15

    This article describes the role played by the Brazilian Audit Tribunal (Tribunal de Contas da Uniao - TCU) in the external auditing of environmental management in Brazil, highlighting the findings of an operational audit conducted in 2007 of the federal environmental licensing process. Initially, it records the constitutional and legal framework of Brazilian environmental licensing, describing the powers and duties granted to federal, state and municipal institutions. In addition, it presents the responsibilities of the TCU in the environmental area, comparing these with those of other Supreme Audit Institutions (SAI) that are members of the International Organization of Supreme Audit Institutions (INTOSAI). It also describes the work carried out in the operational audit of the Brazilian environmental licensing process and its main conclusions and recommendations. Finally, it draws a parallel between the findings and recommendations made in Brazil with those of academic studies and audits conducted in other countries.

  16. [Nurses' practice in health audit].

    PubMed

    Pinto, Karina Araújo; de Melo, Cristina Maria Meira

    2010-09-01

    The objective of this investigation was to identify nurses' practice in heath audit. The hermeneutic-dialectic method was used for the analysis. The study was performed in three loci: the internal audit service of a hospital; the external audit service of a private health service buyer, and the state audit service of the public health system (SUS, acronym in Portuguese for Sistema Unico de Saúde-Unique Health System), in Bahia. Nine audit nurses were interviewed. In the SUS audit, the nurses report being fulfilled with their practice and with the valorization of their professional role. In the private audit--both inside and outside of health organizations--the nurses' activities are focused on meeting the interests of their contractors, and do not get much involved with the care delivered by the nursing team and with the needs of service users. PMID:20964043

  17. Neurological outcome in preterm small for gestational age infants compared to appropriate for gestational age preterm at the age of 18 months: a prospective study.

    PubMed

    Karagianni, Paraskevi; Kyriakidou, Maria; Mitsiakos, Georgios; Chatzioanidis, Helias; Koumbaras, Emmanouel; Evangeliou, Athanasios; Nikolaides, Nikolaos

    2010-02-01

    The aim of this study was to investigate the neurological outcome of premature small for gestational age infants at the corrected age of 18 months by the Hammersmith Infant Neurological Examination. A prospective trial was conducted comparing 41 preterm infants being small for gestational age with 41 appropriate for gestational age infants. Birth weight was significantly lower in small for gestational age infants compared with appropriate for gestational age infants (1724.6 +/- 433 versus 1221 +/- 328 g). There were no significant differences regarding the median gestational age and Apgar scores. Median global scores differ significantly between both groups: 75 (47-78) versus 76 (72-78) for the small for gestational age and appropriate for gestational age infants, respectively. Both groups had optimal scores. In conclusion, although the small for gestational age group scored lower in the Hammersmith Infant Neurological Examination, median global score in both groups was within optimal range. PMID:19372094

  18. Microemboli in our Bypass Circuits: A Contemporary Audit

    PubMed Central

    Willcox, Timothy W.; Mitchell, Simon J.

    2009-01-01

    Abstract: Cardiopulmonary bypass (CPB) may introduce micro-emboli into the patient’s arterial circulation. These may arise from the CPB circuit. Most relevant studies have been performed in vitro; there are relatively few clinical studies. We used the Emboli Detection and Classification quantifier (EDAC) (Luna Innovations, Roanoke, VA) in a prospective clinical audit of emboli in a contemporary CPB circuit. Following ethics approval, standard clinical CPB circuits in patients undergoing CPB were instrumented with three EDAC system probes placed on the venous line, outlet of the hard-shell venous reservoir (HSVR), and distal to the arterial line filter. This was synchronized with the perfusion data management system and emboli number and volume were recorded at 30-second intervals. Recorded observations and combined data from both the EDAC and data management system were analyzed. We report data from the first 12 patients (24.5 hours of CPB) of a larger series currently being performed. The mean total emboli count per minute was significantly greater downstream of the HSVR than in the venous line and significantly less downstream of the arterial line filter than either of the above. The total count downstream of both the HSVR and the arterial line filter was greater when the vent pump was on vs. off. Despite the significant increase in emboli count downstream of the reservoir during vent operation there was a significant reduction in the total volume of emboli in this position compared with the venous line. This was further reduced by the arterial line filter. Nevertheless, the total embolic volume was greater downstream of the HSVR and the arterial filter with the vent on vs. off. The two overwhelming sources of emboli emanating from our CPB circuit were the use of the left ventricular vent and air entrained from the venous line. Such audit enables refinement of CPB management and potential component redesign which may make CPB safer and improve patient outcome

  19. Going beyond Audit

    ERIC Educational Resources Information Center

    Thomas, Mike; Liss, Anne; Milner, Alastair

    2011-01-01

    This article describes the work undertaken by a cluster of Resource Teachers: Learning and Behaviour (RTLB) to ensure that annual effectiveness reviews were more than a compliance exercise but a genuine attempt to improve their service to schools, hence the title of this article of "Going Beyond Audit". Historically, the cluster had met the…

  20. Energy Audit . . . Here's How.

    ERIC Educational Resources Information Center

    American School and University, 1983

    1983-01-01

    After establishing building use patterns and complaints, a consulting engineer's walkthrough energy audit begins with the exterior. Then heating/cooling system efficiency is checked with a flue gases kit. Efficient use of water heaters, lighting, teacher lounges, and food preparation and eating areas saves energy. Most effective conservation…

  1. Conducting a Technology Audit

    ERIC Educational Resources Information Center

    Flaherty, William

    2011-01-01

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

  2. Towards an Educational Audit.

    ERIC Educational Resources Information Center

    Further Education Unit, London (England).

    Written in response to pressure for British colleges and local education authorities (LEAs) to be more businesslike, this document consists almost entirely of a working manual or guide (the Educational Audit Reference Inventory) and instructions for how managers can use it to carry out effective performance evaluation of any element of their…

  3. Enhancing compliance at Department of Defense facilities: comparison of three environmental audit tools.

    PubMed

    Hepler, Jeff A; Neumann, Cathy

    2003-04-01

    To enhance environmental compliance, the U.S. Department of Defense (DOD) recently developed and implemented a standardized environmental audit tool called The Environmental Assessment and Management (TEAM) Guide. Utilization of a common audit tool (TEAM Guide) throughout DOD agencies could be an effective agent of positive change. If, however, the audit tool is inappropriate, environmental compliance at DOD facilities could worsen. Furthermore, existing audit systems such as the U.S. Environmental Protection Agency's (U.S. EPA's) Generic Protocol for Conducting Environmental Audits of Federal Facilities and the International Organization for Standardization's (ISO's) Standard 14001, "Environmental Management System Audits," may be abandoned even if they offer significant advantages over TEAM Guide audit tool. Widespread use of TEAM Guide should not take place until thorough and independent evaluation has been performed. The purpose of this paper is to compare DOD's TEAM Guide audit tool with U.S. EPA's Generic Protocol for Conducting Environmental Audits of Federal Facilities and ISO 14001, in order to assess which is most appropriate and effective for DOD facilities, and in particular those operated by the U.S. Army Corps of Engineers (USACE). USACE was selected as a result of one author's recent experience as a district environmental compliance coordinator responsible for the audit mission at this agency. Specific recommendations for enhancing the quality of environmental audits at all DOD facilities also are given. PMID:12690821

  4. Prospective randomized study comparing concomitant chemoradiotherapy using weekly cisplatin & paclitaxel versus weekly cisplatin in locally advanced carcinoma cervix

    PubMed Central

    Seam, Rajeev; Gupta, Manoj; Gupta, Manish

    2016-01-01

    Background To evaluate the benefit with the addition of paclitaxel to cisplatin-based concurrent chemoradiotherapy (C-CRT) for the treatment of locally advanced carcinoma of the uterine cervix in terms of local control, disease free survival (DFS) and overall survival (OS). Methods From 1/7/2011 to 31/5/2012, 81 women (median age of 50 years) with newly diagnosed, histopathologically proven carcinoma cervix with FIGO stages IIA to IIIB were randomized to two arms—cisplatin 40 mg/m2/week for 5 weeks was given in single agent cisplatin (control arm), while cisplatin 30 mg/m2/week and paclitaxel 50 mg/m2/week for 5 weeks were given in cisplatin and paclitaxel (study arm). External beam radiotherapy (EBRT) was delivered to a total dose of 50 Gray (Gy) in 25 fractions (#) followed by intracavitary (I/C) brachytherapy or supplement EBRT at 20 Gy/10# with 2 cycles of respective chemotherapy. This prospective trial was registered with clinicaltrials.gov (NCT01593306). Results Patients (n=81) had a maximum follow up of 36 months with a median follow up of 29 months. At first follow up study arm showed complete response in 84% vs. 75.6% in control arm (P=0.4095). An increase in toxicities was observed in the study arm in comparison to the control arm in terms of haematological grade II (35% vs. 12.2%), gastrointestinal (GI) grade III (20% vs. 7.4%) and GI grade IV (12.5% vs. 2.4%) toxicities. At median follow-up, the study arm demonstrated enhanced outcomes over the control arm in terms of DFS (79.5% vs. 64.3%; P=0.07) and OS (87.2% vs. 78.6%; P=0.27). Conclusions Despite the expected increase in manageable toxicities, these early results reveal promise with the inclusion of paclitaxel into the standard cisplatin based chemoradiation regime. Larger multi-institutional studies are justified to confirm a potential for the enhancement of response rates and survival. PMID:26904570

  5. The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study: Comparative Effectiveness of a Time-varying Treatment with Competing Risks

    PubMed Central

    Holcomb, John B.; del Junco, Deborah J.; Fox, Erin E.; Wade, Charles E.; Cohen, Mitchell J.; Schreiber, Martin A.; Alarcon, Louis H.; Bai, Yu; Brasel, Karen J.; Bulger, Eileen M.; Cotton, Bryan A.; Matijevic, Nena; Muskat, Peter; Myers, John G.; Phelan, Herb A.; White, Christopher E.; Zhang, Jiajie; Rahbar, Mohammad H.

    2013-01-01

    Context Hemorrhagic shock is the leading potentially preventable cause of death after injury. Transfusion of early and increased ratios of plasma and platelets to red blood cells (RBCs) has been associated with decreased mortality; however conflicting reports and the time-varying nature of transfusions and hemorrhagic death raise concern for the validity of the clinical conclusions drawn from the retrospective data. Objective To relate in-hospital mortality to: 1) early transfusion of plasma and/or platelets and 2) time-varying plasma:RBC and platelet:RBC ratios. Design Prospective cohort study documenting the timing of transfusions during active resuscitation and patient outcomes. Data were analyzed using time-dependent proportional hazards models. Setting Ten US Level 1 trauma centers. Patients Adult trauma patients surviving for 30 minutes after admission, transfused at least 1 unit RBC within 6 hours of admission (n=1245, the original study group) and at least 3 total units (of RBC, plasma or platelets) within 24 hours (n=905, the analysis group). Main outcome measure In-hospital mortality Results Plasma:RBC and platelet:RBC ratios were not constant over the first 24 hours (p<.001 for both). In a multivariable time-dependent Cox model, increased ratios of plasma:RBC (adjusted hazard ratio, HR=0.31, 95% CI=0.16–0.58) and platelets:RBC (adjusted HR=0.55, 95% CI=0.31–0.98) were independently associated with decreased 6-hour mortality, when hemorrhagic death predominated. In the first 6 hours, patients with ratios < 1:2 were 3–4 times more likely to die than patients with ratios ≥1:1. After 24 hours, plasma and platelet ratios were unassociated with mortality, when competing risks from non-hemorrhagic causes prevailed. Conclusions Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients transfused at least three units of blood products during the first 24 hours after admission. Among survivors at 24 hours

  6. 12 CFR 1274.2 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Audit requirements. 1274.2 Section 1274.2 Banks... § 1274.2 Audit requirements. (a) Each Bank, the OF, and the FICO shall obtain annually an independent external audit of and an audit report on its individual financial statement. (b) The OF audit...

  7. 38 CFR 41.200 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit requirements. 41.200 Section 41.200 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.200 Audit requirements. (a) Audit required. Non-Federal entities...

  8. 7 CFR 3052.200 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit requirements. 3052.200 Section 3052.200..., DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.200 Audit requirements. (a) Audit required. Non-Federal entities that expend $500,000 or more in a year...

  9. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Annual audit. 1773.3 Section 1773.3 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.3 Annual audit. (a) Each borrower... RUS as set forth in § 1773.4. (b) Each borrower must establish an annual as of audit date...

  10. 30 CFR 735.22 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  11. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false Annual audit. 1773.3 Section 1773.3 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.3 Annual audit. (a) Each borrower... RUS as set forth in § 1773.4. (b) Each borrower must establish an annual as of audit date...

  12. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  13. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false Annual audit. 1773.3 Section 1773.3 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.3 Annual audit. (a) Each borrower... RUS as set forth in § 1773.4. (b) Each borrower must establish an annual as of audit date...

  14. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  15. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Annual audit. 1773.3 Section 1773.3 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.3 Annual audit. (a) Each borrower... RUS as set forth in § 1773.4. (b) Each borrower must establish an annual as of audit date...

  16. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Annual audit. 1773.3 Section 1773.3 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.3 Annual audit. (a) Each borrower... RUS as set forth in § 1773.4. (b) Each borrower must establish an annual as of audit date...

  17. 12 CFR 704.15 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... summary of the audit report to the membership at the next annual meeting. (b) Internal audit. A corporate... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Audit requirements. 704.15 Section 704.15 Banks... UNIONS § 704.15 Audit requirements. (a) External audit. The corporate credit union supervisory...

  18. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  19. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  20. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 1 2012-07-01 2012-07-01 false Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  1. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  2. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  3. 2 CFR 200.516 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Audit findings. 200.516 Section 200.516... MANAGEMENT AND BUDGET GUIDANCE Reserved UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS Audit Requirements Auditors § 200.516 Audit findings. (a) Audit...

  4. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Audit findings. 3052.510 Section 3052.510 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in...

  5. 20 CFR 632.33 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AND TRAINING PROGRAMS Administrative Standards and Procedures § 632.33 Audits. (a) General. The audit provisions of 41 CFR part 29-70 shall apply to Native American grantees. Until unified or single audit... tribal governments. (b) Audit reports. Upon receipt of a final audit report the Inspector General...

  6. 13 CFR 120.490 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Audits. 120.490 Section 120.490... Companies (sblc) § 120.490 Audits. Every SBLC is subject to periodic audits by SBA's Office of Inspector General, Auditing Division, and the cost of such audits will be assessed against the SBLC, except for...

  7. 7 CFR 1290.10 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Audit requirements. 1290.10 Section 1290.10... PROGRAM § 1290.10 Audit requirements. The State is accountable for conducting a financial audit of the... audit, a copy of the audit results....

  8. 20 CFR 655.1312 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 655.1312 Section 655.1312 Employees... United States (H-2A Workers) § 655.1312 Audits. (a) Discretion. The Department will conduct audits of... selected for audit will be chosen within the sole discretion of the Department. (b) Audit letter. Where...

  9. Medical audit data: counting is not enough.

    PubMed Central

    Lyons, C; Gumpert, R

    1990-01-01

    OBJECTIVE--To assess the meaningfulness of a year's worth of audit data relating to all the inpatients of one consultant general surgeon and to question the usefulness of certain outcome measures. DESIGN--Analysis of records entered on to audit computer (Dunnfile) and relating to inpatient episodes for one consultant general surgeon over one year. Data obtained were compared with ward records and the patient administration system to check their accuracy. SETTING--The three hospitals and 12 wards in Brighton health district where the surgeon admitted patients. SUBJECTS--859 Records relating to inpatient episodes from 1 January to 31 December 1988. These covered 655 main procedures and 79 secondary procedures performed at the same time. MAIN OUTCOME MEASURES--Procedures were analysed by complexity of operation (BUPA code) and grade of surgeon; complications were counted and rates constructed by surgeon and by BUPA code: returns to theatre were analysed. RESULTS--Simple counts revealed some data, such as the fact that one registrar performed more major operations (32) than the senior registrars (22 and 14), and an analysis of complications showed that he had a lower complication rate (11.4% v 20.0% and 19.4%). But the simple complication rate disclosed nothing about whether the complication was avoidable. Likewise, the number of returns to theatre needed further qualification. Analysis of data collection for February to April 1988 showed a 30% deficit of information on the audit system compared with ward records and prompted a re-examination of everyone's role in collecting data. After the year's audit there was still a 17% shortfall compared with the district's patient administration system, though some of this was accounted for by a backlog of work. CONCLUSIONS--It is difficult to ensure adequate data collection and entails everyone in an unfamiliar discipline. Connecting the audit system to the patient administration system would help. Despite the limitations of

  10. Analgesic effect of ceruletide compared with pentazocine in biliary and renal colic: a prospective, controlled, double-blind study.

    PubMed

    Lishner, M; Lang, R; Jutrin, I; De-Paolis, C; Ravid, M

    1985-06-01

    The analgesic effect of ceruletide in biliary and renal colic was evaluated by a randomized, double-blind study in 82 patients. Ceruletide was compared with pentazocine, a well-established analgetic agent. Rapid and effective analgesia was obtained by intramuscular injection of ceruletide 0.5 micrograms/kg in 56 patients with biliary colic. The analgesic effect of ceruletide compared well with pentazocine 0.5 mg/kg im, and was associated with remarkably fewer side effects. In 26 patients with renal colic, ceruletide was significantly inferior to pentazocine. These data support the recommendation of ceruletide as a first-choice analgetic agent for biliary colic. PMID:3891284

  11. European COPD Audit: design, organisation of work and methodology.

    PubMed

    López-Campos, Jose Luis; Hartl, Sylvia; Pozo-Rodriguez, Francisco; Roberts, C Michael

    2013-02-01

    Clinical audit has an important role as an indicator of the clinical practice in a given community. The European Respiratory Society (ERS) chronic obstructive pulmonary disease (COPD) audit was designed as a pilot study to evaluate clinical practice variability as well as clinical and organisational factors related to outcomes for COPD hospital admissions across Europe. The study was designed as a prospective observational noninterventional cohort trial, in which 422 hospitals from 13 European countries participated. There were two databases: one for hospital's resources and organisation and one for clinical information. The study was comprised of an initial 8-week phase during which all consecutive cases admitted to hospital due to an exacerbation of COPD were identified and information on clinical practice was gathered. During the 90-day second phase, mortality and readmissions were recorded. Patient data were anonymised and encrypted through a multi-lingual web-tool. As there is no pan-European Ethics Committee for audits, all partners accepted the general ethical rules of the ERS and ensured compliance with their own national ethical requirements. This paper describes the methodological issues encountered in organising and delivering a multi-national European audit, highlighting goals, barriers and achievements, and provides valuable information for those interested in developing clinical audits. PMID:22599361

  12. Digital versus traditional air leak evaluation after elective pulmonary resection: a prospective and comparative mono-institutional study

    PubMed Central

    Nigra, Victor Auguste; Lanza, Giovanni; Costardi, Lorena; Bora, Giulia; Solidoro, Paolo; Cristofori, Riccardo Carlo; Molinatti, Massimo; Lausi, Paolo Olivo; Ruffini, Enrico; Oliaro, Alberto; Guerrera, Francesco

    2015-01-01

    Background The increased demand to reduce costs and hospitalization in general pushed several institution worldwide to develop fast-tracking protocols after pulmonary resections. One of the commonest causes of protracted hospital stay remains prolonged air leaks (ALs). We reviewed our clinical practice with the aim to compare traditional vs. digital chest drainages in order to evaluate which is the more effective to correctly manage the chest tube after pulmonary resection. Methods All patients submitted to elective pulmonary resection for lung malignancies, between April to December, 2014 in our General Thoracic Surgery Department were included in the study. The primary outcome was the chest tube duration, the secondary the postoperative overall hospitalization. Significant differences between traditional and digital groups were investigated with logistic regression models. Numerical variables between the groups were compared by means of the unpaired Wilcoxon-Mann-Whitney test. Results Both series of patients were comparable for clinical, surgical and pathological characteristics. Chest tube duration showed to be significantly shorter in the digital group (3 vs. 5 days, P=0.0009), while the hospitalization was longer in traditional one [8 vs. 7 days in digital drainage (DD); P=0.0385]. No chest drainage replacement was required at 30-day, in both groups. Conclusions We were able to demonstrate that patients managed with a digital system experienced a shorter chest tube duration as well as a lower overall hospital length of stay, compared to those who received the traditional drainage (TD). PMID:26623093

  13. Intercultural Communication Skills among Prospective Turkish Teachers of German in the Context of the Comparative Country Knowledge Course

    ERIC Educational Resources Information Center

    Basbagi, R. Ragip

    2012-01-01

    This study develops and provides a sample implementation of a seminar for the "Comparative Country Knowledge" course taught in the German Language Teaching departments of Turkish universities. The study was conducted with the participation of forty-seven 1st year students attending a German Language Teaching department. As part of the study,…

  14. A Clinical Audit of the Management of Acute Asthmatic Attacks in Adults and Children Presenting to an Emergency Department

    PubMed Central

    Dasgupta, S; Williams, EW; Walters, C; Eldemire-Shearer, D; Williams-Johnson, J

    2014-01-01

    Objective: To compare the guidelines in the University Hospital of the West Indies (UHWI) acute asthma management protocol with actual practice in the Accident and Emergency Department. Methods: A prospective docket audit was done of all consecutive medical records of patients, presenting with a diagnosed acute asthmatic attack between June 1 and September 30, 2010, to the emergency department of the UHWI. A convenient sample was used. The audit tool used was created from the UHWI protocol for the emergency management of asthma in adults and children, as well as the British Adult Asthma Audit Tool. The audit tool assessed three main sections: initial assessment, initial management, and discharge considerations. Data were coded and entered in Microsoft Excel 2007 and statistical analyses conducted using Stata version 10. Management patterns were compared to the actual protocol and then discussed. Results: A total of 15 864 patients were seen during the study period. Of these, a total of 293 patients were seen for a presentation of acute asthma. More females (57.3%) than males were seen, with the mean age of 33.53 years. Only 31% of patients were given a severity assessment of mild, moderate, or severe. Peak expiratory flow rate (PEFR) was attempted and recorded in 62%, but only 18.1% of patients had both pre and post PEFR done. Only 4.4% of patients were administered nebulizations within the suggested time frame. Positively, 94.2% of patients were given a prescription for inhaled corticosteroids and bronchodilators to continue post-discharge. Conclusion: Acute asthma management still remains an area of medical practice that continues to have long-standing difficulties. Failure to assess and document the severity of asthma attacks along with the under-utilization of PEFR was noted. PMID:25314279

  15. Comparison of a minimally invasive posterior approach and the standard posterior approach for total hip arthroplasty A prospective and comparative study

    PubMed Central

    2010-01-01

    Background It is not clear whether total hip arthroplasty performed via a minimally invasive approach leads to less muscle trauma compared to the standard approach. Materials and methods To investigate whether a minimally invasive posterior approach for total hip arthroplasty results in lower levels of muscle-derived enzymes and better post-operative clinical results than those obtained with the standard posterolateral approach fifty patients in both groups were compared in a prospective and comparative study. The following parameters were examined: muscle-derived enzymes CPK, CK-MM and myoglobin pre-operatively, 24 and 48 hours post-operatively, CRP and hemoglobin on the third postoperative day, loss of blood, daily pain levels, the rate of recovery (time taken to attain predefined functional parameters), the Oxford Hip Score, the SF-36 score and the WOMAC score pre-operatively and six weeks post-surgery, the position of the implant and the cement coating by post-operative X-ray examination. Results and Conclusions The minimally invasive operated patients exhibited a significantly lower loss of blood, significantly less pain at rest and a faster rate of recovery but the clinical chemistry values and the other clinical parameters were comparable. PMID:20663200

  16. 40 CFR 68.79 - Compliance audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... are being followed. (b) The compliance audit shall be conducted by at least one person knowledgeable... compliance audit, and document that deficiencies have been corrected. (e) The owner or operator shall retain the two (2) most recent compliance audit reports....

  17. Auditing the Records of Student-Athletes.

    ERIC Educational Resources Information Center

    Riggs, Robert O.; Hedden, Carole R.

    1985-01-01

    A 1985 survey showed that NCAA members favored mandating annual audits of athletics budgets by institutional or independent auditors. Development of Tennessee's internal audit system is described, and its internal audit procedures is outlined. (MLW)

  18. 11 CFR 9007.4 - Additional audits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... EXAMINATIONS AND AUDITS; REPAYMENTS § 9007.4 Additional audits. In accordance with 11 CFR 104.16(c), the Commission, pursuant to 11 CFR 111.10, may upon affirmative vote of four members conduct an audit and...

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

    ERIC Educational Resources Information Center

    Goldhaber, Gerald M.; Krivonos, Paul D.

    1977-01-01

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

  20. Environmental audits: A literature review.

    PubMed

    Tomlinson, P; Atkinson, S F

    1987-05-01

    This paper presents a literature review focused on predictive technique audits, one of the types of audit considered to have the greatest potential role in improving environmental impact assessment practice. The literature review is limited to US literature with the exception of a few UK audits, one undertaken by Tomlinson at the University of Aberdeen. The authors are, however, aware that literature from other countries exists on this subject, for example from Canada and South Africa.In the review, predictive technique audits performed for or by the US Bureau of Land Management, the Electric Power Research Institute, the US Nuclear Regulatory Commission, the US Corps of Engineers, together with the Wisconsin Power Plant Impact Study are described. In addition, articles describing the auditing of models designed to predict environmental change are reviewed, before details of auditing activity in the UK are presented. PMID:24253996

  1. A prospective randomized study to compare pelvic floor rehabilitation and dapoxetine for treatment of lifelong premature ejaculation.

    PubMed

    Pastore, A L; Palleschi, G; Leto, A; Pacini, L; Iori, F; Leonardo, C; Carbone, A

    2012-08-01

    Premature ejaculation (PE) is the most common male sexual disorder. We compared pelvic floor muscle rehabilitation to on-demand treatment with the selective serotonin reuptake inhibitor dapoxetine in 40 men with lifelong PE (baseline intra-vaginal ejaculatory latency time (IELT) ≤1 min). Subjects were randomized into the following two treatment groups: (1) PFM rehabilitation or (2) 30 or 60 mg of on-demand dapoxetine. Total treatment time for both groups was 12 weeks, at the end of which, IELT mean values were calculated to compare the effectiveness of the two different therapeutic approaches. At the end of treatment, 11 of the 19 patients (57%) treated with rehabilitation were able to control the ejaculation reflex, with a mean IELT of 126.6 sec (range: 123.6-152.4 sec). In the dapoxetine group, after 12 weeks of therapy, 5 of 8 (62.5%) patients in the 30 mg subgroup and five of seven (72%) in the 60 mg subgroup had an IELT >180 sec (mean: 178.2 and 202.8 sec, respectively). The results obtained in the group treated with pelvic floor rehabilitation are promising, and this treatment represents an important cost reduction if compared to dapoxetine on-demand treatment. The present study confirms the data that are previously available in the literature on the efficacy and safety of the new inhibitor of serotonin reuptake, dapoxetine, as well as proposes and evaluates a new type of physical treatment that may be a viable therapeutic option for treatment of PE. PMID:22320846

  2. Narrow-Band Ultraviolet B versus Oral Minocycline in Treatment of Unstable Vitiligo: A Prospective Comparative Trial

    PubMed Central

    Siadat, Amir Hossein; Zeinali, Naser; Iraji, Fariba; Abtahi-Naeini, Bahareh; Nilforoushzadeh, Mohammad Ali; Jamshidi, Kioumars; Khosravani, Parastoo

    2014-01-01

    Background. We have compared NB-UVB and oral minocycline in stabilizing vitiligo for the first time. Subjects and Methods. 42 patients were divided equally into two groups: the NB-UVB and minocycline groups. Phototherapy was administered twice a week on nonconsecutive days. In the minocycline group, patients were advised to take minocycline 100 mg once daily. The treatment period was 3 months. Vitiligo disease activity (VIDA) score was noted every 4 weeks for 12 months. Digital photographs were taken at baseline and monthly intervals. Results. Before the therapy, disease activity was present in 100% of the patients, which was reduced to 23.8% and 66.1% by the end of therapy in the NB-UVB and minocycline groups retrospectively (P < 0.05). 16 of the 21 (76/1%) patients with unstable disease in the NB-UVB group achieved stability, whereas this was the case for only 7 of the 21 (33.3%) in the minocycline group (P < 0.001). The diameter changes were statistically significant at the end of treatment in the NB-UVB group compared to the minocycline group (P = 0.031). Side effects in both groups were mild. Conclusion. NB-UVB was statistically more advantageous than oral minocycline in unstable vitiligo in terms of efficacy and the resulting stability. PMID:25221600

  3. Criteria for internal auditing.

    PubMed

    Holder, W W; Clay, R J

    1979-01-01

    An effective, inclusive internal auditing endeavor should help assure hospital managements that (1) an adequate system of internal control exists to assure the safeguarding of assets and the reliability of data produced by the financial information system, (2) uneconomic operating practices are detected promptly so they can be remedied, and (3) program results and effectiveness levels are of sufficiently high quality to demonstrate managerial competence. PMID:102583

  4. Epigenetic: A missing paradigm in cellular and molecular pathways of sulfur mustard lung: a prospective and comparative study

    PubMed Central

    Imani, Saber; Panahi, Yunes; Salimian, Jafar; Fu, Junjiang; Ghanei, Mostafa

    2015-01-01

    Sulfur mustard (SM, bis- (2-chloroethyl) sulphide) is a chemical warfare agent that causes DNA alkylation, protein modification and membrane damage. SM can trigger several molecular pathways involved in inflammation and oxidative stress, which cause cell necrosis and apoptosis, and loss of cells integrity and function. Epigenetic regulation of gene expression is a growing research topic and is addressed by DNA methylation, histone modification, chromatin remodeling, and noncoding RNAs expression. It seems SM can induce the epigenetic modifications that are translated into change in gene expression. Classification of epigenetic modifications long after exposure to SM would clarify its mechanism and paves a better strategy for the treatment of SM-affected patients. In this study, we review the key aberrant epigenetic modifications that have important roles in chronic obstructive pulmonary disease (COPD) and compared with mustard lung. PMID:26557960

  5. The efficacy of minimally invasive discectomy compared with open discectomy: a meta-analysis of prospective randomized controlled trials

    PubMed Central

    Dasenbrock, Hormuzdiyar H.; Juraschek, Stephen P.; Schultz, Lonni R.; Witham, Timothy F.; Sciubba, Daniel M.; Wolinsky, Jean-Paul; Gokaslan, Ziya L.; Bydon, Ali

    2013-01-01

    Object Advocates of minimally invasive discectomy (MID) have promoted this operation as an alternative to open discectomy (OD), arguing that there may be less injury to the paraspinal muscles, decreased postoperative pain, and a faster recovery time. However, a recently published large randomized controlled trial (RCT) comparing these approaches reported inferior relief of leg pain in patients undergoing MID. The authors conducted a meta-analysis to evaluate complications and improvement in leg pain in patients with radiculopathy enrolled in RCTs comparing OD to MID. Methods The authors performed a literature search using Medline and EMBASE of studies indexed between January 1990 and January 2011. Predetermined RCT eligibility included the usage of tubular retractors during MID, a minimum follow-up duration of 1 year, and quantification of pain with the visual analog scale (VAS). Trials that only evaluated patients with recurrent disc herniation were excluded. Data on operative parameters, complications, and VAS scores of leg pain were extracted by 2 investigators. A meta-analysis was performed assuming random effects to determine the difference in mean change for continuous outcomes and the risk ratio for binary outcomes. Results Six trials comprising 837 patients (of whom 388 were randomized to MID and 449 were randomized to OD) were included. The mean operative time was 49 minutes during MID and 44 minutes during OD; this difference was not statistically significant. Incidental durotomies occurred significantly more frequently during MID (5.67% compared with 2.90% for OD; RR 2.05, 95% CI 1.05–3.98). Intraoperative complications (incidental durotomies and nerve root injuries) were also significantly more common in patients undergoing MID (RR 2.01, 95% CI 1.07–3.77). The mean preoperative VAS score for leg pain was 6.9 in patients randomized to MID and 7.2 in those randomized to OD. With long-term follow-up (1–2 years postoperatively), the mean VAS score

  6. Epigenetic: A missing paradigm in cellular and molecular pathways of sulfur mustard lung: a prospective and comparative study.

    PubMed

    Imani, Saber; Panahi, Yunes; Salimian, Jafar; Fu, Junjiang; Ghanei, Mostafa

    2015-08-01

    Sulfur mustard (SM, bis- (2-chloroethyl) sulphide) is a chemical warfare agent that causes DNA alkylation, protein modification and membrane damage. SM can trigger several molecular pathways involved in inflammation and oxidative stress, which cause cell necrosis and apoptosis, and loss of cells integrity and function. Epigenetic regulation of gene expression is a growing research topic and is addressed by DNA methylation, histone modification, chromatin remodeling, and noncoding RNAs expression. It seems SM can induce the epigenetic modifications that are translated into change in gene expression. Classification of epigenetic modifications long after exposure to SM would clarify its mechanism and paves a better strategy for the treatment of SM-affected patients. In this study, we review the key aberrant epigenetic modifications that have important roles in chronic obstructive pulmonary disease (COPD) and compared with mustard lung. PMID:26557960

  7. Ultrasound-guided Central Line Insertion and Standard Peripherally Inserted Catheter Placement in Preterm Infants: Comparing Results from Prospective Study in a Single-center

    PubMed Central

    Al Hamod, Dany Antanios; Zeidan, Smart; Al Bizri, Ayah; Baaklini, Georges; Nassif, Yolla

    2016-01-01

    Background: Among preterm infants, the peripherally inserted central catheter (PICC) is the standard line for central venous access; however, its placement exposes them to hypothermia and pain. Ultrasound (US)-guided central line insertion may be less morbid than standard PICC line. Aims: To determine the ease, success rate, and morbidity associated with US-guided central line insertion in the internal jugular vein (IJV) by comparing it to the standard PICC line placement. Materials and Methods: This is a single-center nonrandomized prospective study evaluating preterm infants between October 2013 and June 2014. Patients were allocated into two groups: The standard group (control group) who underwent blind PICC line insertion and the intervention group who underwent a percutaneous US-guided central line insertion in the IJV. The epicutaneo-cava-catheter was used in both groups. Results: Fifty neonates were enrolled on study. A statistically difference in favor of US-IJV insertion was noted concerning the rate of successful first attempt (P < 0.001), insertion (P = 0.001), and procedure duration (P < 0.001) and number of trials (P < 0.001) compared to PICC. No difference in complications (P = 1.000) was noted. Conclusion: US guided catheterization of the IJV technique is faster than PICC line insertion with higher rates of successful first attempt and insertion, less procedure duration and fewer number of trials compared to PICC line insertion. There were no differences in complications. PMID:27298814

  8. Evaluation of Low Blood Lead Levels and Its Association with Oxidative Stress in Pregnant Anemic Women: A Comparative Prospective Study.

    PubMed

    Tiwari, Amit Kumar Mani; Mahdi, Abbas Ali; Zahra, Fatima; Sharma, Sudarshna; Negi, Mahendra Pal Singh

    2012-07-01

    To correlate blood lead levels (BLLs) and oxidative stress parameters in pregnant anemic women. A total of 175 pregnant women were found suitable and included for this study. Following WHO criteria, 50 each were identified as non-anemic, mild anemic and moderate anemic and 25 were severe anemic. The age of all study subjects ranged from 24-41 years. At admission, BLLs and oxidative stress parameters were estimated as per standard protocols and subjected with ANOVA, Pearson correlation analysis and cluster analysis. Results showed significantly (p < 0.01) high BLLs, zinc protoporphyrin (ZPP), oxidized glutathione (GSSG), lipid peroxide (LPO) levels while low delta aminolevulinic acid dehydratase (δ-ALAD), iron (Fe), selenium (Se), zinc (Zn), haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), red blood cell (RBC) count, reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and total antioxidant capacity (TAC) in all groups of anemic pregnant women as compared with non anemic pregnant women. In all groups of pregnant women, BLLs showed significant (p < 0.01) and direct association with ZPP, GSSG and LPO while inverse relation with δ-ALAD, Fe, Se, Zn, Hb, Hct, MCV, MCH, MCHC, RBC, GSH, SOD, CAT and TAC. Study concluded that low BLLs perturb oxidant-antioxidant balance and negatively affected hematological parameters which may eventually Pb to Fe deficiency anemia during pregnancy. PMID:26405382

  9. Off to a good start: A comparative study of changes in men's first job prospects in East Asia

    PubMed Central

    Yu, Wei-hsin; Chiu, Chi-Tsun

    2015-01-01

    Research on young adults’ transition to the labor market rarely investigates how nation-level institutional arrangements shape changes over time. In particular, a systematic comparison of shifts in young adults’ job opportunities in East Asia is virtually absent. Using comparable data from Japan, Korea, and Taiwan, we examine cohort differences in the timing, quality, and stability of men's first jobs. The results indicate overall declines in first occupational attainment for men in all three countries, but the main driving force for the decrease in Japan differs from that in Korea and Taiwan. Whereas macroeconomic pressure fully explains the decline in Japanese men's first occupational attainment, educational expansion accounts for a considerable part of the declines for men in Korea and Taiwan. Moreover, educational expansion has eroded better-educated men's advantages in speedily transitioning from school to work in Taiwan, but it has not had a similar effect on Japanese men. We argue that Japan's employment system, coupled with a fair amount of institutional ties between schools and firms, has shielded young men from the pressure of educational expansion, making the trends about their early-career outcomes different from those of their counterparts in Korea and Taiwan. The different degrees to which firm internal labor markets have been adopted in Japan, Korea, and Taiwan also explain how increasing macroeconomic pressure has different impacts on men's first job stability in East Asia. PMID:25999637

  10. Relevance of psychosocial factors to quality of life in oral cancer and oral lichen planus: a prospective comparative study.

    PubMed

    Rana, Madiha; Kanatas, Anastasios; Herzberg, Philipp Y; Gellrich, Nils-Claudius; Rana, Majeed

    2015-09-01

    We can improve our understanding of how patients cope with oral squamous cell carcinoma (SCC) by making a comparison with their processes of coping and those used in other conditions. We have therefore compared quality of life (QoL), severity of symptoms, coping strategies, and factors that influence coping between patients with oral SCC and those with oral lichen planus. We asked 104 patients with oral SCC and 51 with oral lichen planus to complete questionnaires about their coping strategies, social support, locus of control, spirituality, QoL, and severity of symptoms. The outcome was that patients with oral SCC were far more likely to resort to coping strategies such as depressive coping, distraction, and self-motivation. The groups also differed regarding QoL and severity of symptoms. Patients with oral SCC had a poorer QoL and higher depression scores, whereas patients with oral lichen planus had better scores in the social support and spirituality categories. Patients with oral SCC generally had more distress than those with oral lichen planus. Not only did the former resort to depressive coping strategies, but they also had poorer QoL and higher values for depression. For the patients with oral lichen planus, social support and spirituality were protective, whereas they were associated with distress by patients with oral SCC. PMID:26004933

  11. Teachers' and prospective teachers' explanations of liquid-state phenomena: A comparative study involving three European countries

    NASA Astrophysics Data System (ADS)

    Leite, Laurinda; Mendoza, José; Borsese, Aldo

    2007-02-01

    As contact with liquids occurs from an early stage in individuals' lives, children construct explanations for liquids and liquid-state phenomena. These may differ from the accepted scientific explanations, interfere with formal teaching, and even persist until entry into higher education. The objective of this investigation is to compare student-teachers' and in-service science teachers' explanations for liquid-state phenomena, in three European countries. Data were collected by means of a questionnaire applied to 195 Italian, Portuguese, and Spanish in-service science teachers. Data analysis revealed poor performance among participants, showing low percentages of correct answers. In addition, no systematic differences were found between participants from the three countries, and teaching experience seems to minimize some of the conceptual difficulties showed by in-service teachers. Globally, science education seems to have had a limited effect on student-teachers' and in-service science teachers' conceptions. We conclude that more attention should be paid to the liquid state in both initial and continuing teacher education programs so that teachers can understand more clearly liquid-state phenomena and succeed in explaining them to their students.

  12. A prospective multi-centre clinical trial to compare buprenorphine and butorphanol for postoperative analgesia in cats.

    PubMed

    Taylor, Polly M; Kirby, Jonathan J; Robinson, Clare; Watkins, Elizabeth A; Clarke, David D; Ford, Marion A; Church, Karen E

    2010-04-01

    One hundred and fifty-three cats undergoing surgery in seven veterinary practices in Great Britain were studied. They were randomly allocated to receive either 10-20 microg/kg buprenorphine or 0.4 mg/kg butorphanol with acepromazine before anaesthesia with propofol, Saffan or thiopentone and isoflurane or halothane. Routine monitoring was undertaken. Pain and sedation were assessed blind using a four point (0-3) simple descriptive scale (SDS) at 1, 2, 4, 8 and 24h. Pain and sedation data were compared using non-parametric statistical tests and continuous data using t tests or analysis of variance (ANOVA). Anaesthesia and surgery were uneventful, and cardiorespiratory data were within normal limits. After surgery, overall, more cats had pain score 0 after buprenorphine and more had pain score 3 after butorphanol (P=0.0465). At individual time points, more cats had lower pain scores after buprenorphine at 2 (P=0.040) and 24 (P=0.036)h. At 24h 83% after buprenorphine and 63% after butorphanol had pain score 0 (P<0.04). Buprenorphine provided better and longer lasting postoperative analgesia than butorphanol. PMID:19836984

  13. Real-Time Elastography and Contrast-Enhanced Ultrasonography in the Evaluation of Testicular Masses: A Comparative Prospective Study.

    PubMed

    Schröder, Claudia; Lock, Guntram; Schmidt, Christa; Löning, Thomas; Dieckmann, Klaus-Peter

    2016-08-01

    This study investigates the usefulness of contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for the characterization of testicular masses by comparing pre-operative ultrasound findings with post-operative histology. Sixty-seven patients with 68 sonographically detected testicular masses underwent B-mode, color-coded Doppler sonography (CCDS), CEUS and RTE according to defined criteria. For RTE, elasticity score (ES), difference of elasticity score (D-ES), strain ratio (SR) and size quotient (Qsize) were evaluated. Histopathologically, 54/68 testicular lesions were neoplastic (47 malignant, 7 benign). Descriptive statistics revealed the following results (neoplastic vs. non-neoplastic) for sensitivity, specificity, positive predictive value, negative predictive value and accuracy, respectively: B-mode, 100%, 43%, 87%, 100%, 88%; CCDS 81%, 86%, 96%, 55%, 82%; CEUS 93%, 85%, 96%, 73%, 91%; ES 98%, 25%, 85%, 75%, 85%; D-ES 98%, 50%, 90%, 83%, 89%; SR 90%, 45%, 86%, 56%, 81%; and Qsize 57%, 83%, 94%, 28%, 61%. B-mode with CCDS remains the standard for assessing testicular masses. In characterization of testicular lesions, CEUS clearly outperformed all other modalities. Our study does not support the routine use of RTE in testicular ultrasonography because of its low specificity. PMID:27181687

  14. Is Nephrolithiasis an Unrecognized Extra-Articular Manifestation in Ankylosing Spondylitis? A Prospective Population-Based Swedish National Cohort Study with Matched General Population Comparator Subjects

    PubMed Central

    Jakobsen, Ane Krag; Jacobsson, Lennart T. H.; Patschan, Oliver; Askling, Johan; Kristensen, Lars Erik

    2014-01-01

    Background Ankylosing spondylitis (AS) is associated with several extra-articular manifestations. Nephrolithiasis (NL) has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors of NL in Swedish patients with AS compared to the general population. Methods and Findings We performed a prospective population-based nationwide cohort study based on linkage of data from Swedish registries. 8,572 AS patients were followed for 49,258 person-years (py) and 39,639 matched general population comparators were followed for 223,985 py. Patients were followed prospectively together with comparator subjects from January 2001 through December 2009. The first occurrence of NL during follow-up was the primary outcome. Hazard Ratios (HR) were used to compare these rates adjusting for comorbidities and treatment, and to assess predictors for NL. Mean age at study entry was 46 years (inter quartile range 36–56 years), 65% were males. Based on 250 vs. 466 NL events, the adjusted HR of NL in AS patients was 2.1 (95%CI 1.8 to 2.4). Predictors of NL within the AS group included prior diagnosis of inflammatory bowel disease (IBD) (HR 2.3; 95%CI 1.7 to 3.3), prior diagnosis of NL (HR 16.4; 95%CI 11.5 to 23.4), and patients receiving anti-TNF treatment (HR 1.6; 95%CI 1.2 to 2.1). Male sex was a risk factor for NL both in AS patients and in the general population. Limitations The risk for residual confounding and inability to study the chemical nature of NL were considered the main limitations of the study. Conclusions Patients with AS are at increased risk of NL, which may be considered a novel extra-articular manifestation. Previous history of NL, IBD, AS disease severity and male sex were identified as predictors of NL in AS. PMID:25423471

  15. Prospective randomized trial comparing shock wave lithotripsy and flexible ureterorenoscopy for lower pole stones smaller than 1 cm.

    PubMed

    Sener, Nevzat Can; Imamoglu, M Abdurrahim; Bas, Okan; Ozturk, Ufuk; Goktug, H N Goksel; Tuygun, Can; Bakirtas, Hasan

    2014-04-01

    In this study, we aimed to compare the success and complications of flexible ureterorenoscopy (F-URS) with its advanced technology and the accomplished method of shock wave lithotripsy (SWL) in the treatment of lower pole stones smaller than 1 cm. One hundred and forty patients were randomized as 70 undergoing SWL (Group 1) and 70 undergoing F-URS (Group 2). Patients were evaluated by plain X-ray and urinary ultrasound 1 week and after 3 months following SWL. The same procedure was done for F-URS patients 1 week after surgery and after 3 months. Success rates were established the day following the procedure and after 3 months. Fragmentation less than 3 mm was considered success. Mean operative time was 44 ± 7.4 min for Group 2 and mean fluoroscopy duration was 51 ± 12 s. In F-URS group, all the patients were stone free after 3 months (100 %). Group 1 had 2.7 ± 0.4 sessions of SWL. Sixty-four patients were stone free in that group after 3 months (91.5 %). The procedure yielded significant success in FURS group, even though patients underwent SWL for 2.7 ± 0.4 sessions and F-URS for 1 session (p < 0.05). With higher success and similar complication rates, fewer sessions per treatment, and advances in technology and experience, we believe F-URS has a potential to be the first treatment option over SWL in the future. PMID:24220692

  16. Articular ganglia of the volar aspect of the wrist: arthroscopic resection compared with open excision. A prospective randomised study.

    PubMed

    Rocchi, Lorenzo; Canal, Alessandra; Fanfani, Francesco; Catalano, Francesco

    2008-01-01

    Our aim was to compare two methods of treatment of ganglia on the volar aspect of the wrist (the open excision done through a longitudinal volar skin incision and the arthroscopic resection through two or three dorsal ports), to see if arthroscopy could reduce the risks of operating in this area and the time to healing. Twenty radiocarpal and five midcarpal volar ganglia were operated on by open approach and an equivalent group was treated by arthroscopy. Fifteen radiocarpal and five midcarpal ganglia were treated with good results in the open group and 18 radiocarpal and one midcarpal ganglia in the arthroscopic group (no visible or palpable ganglion, a full range of active wrist movement, grip strength equal to preoperatively, no pain, and a cosmetically acceptable scar). In the open group there were four injuries to a branch of the radial artery, two cases of partial stiffness of the wrist associated with a painful scar, one case of neuropraxia, and one recurrence (all of which were among the 20 radiocarpal ganglia). In the arthroscopic group there was one case of neuropraxia, one injury to a branch of the radial artery, and three recurrences (three of the complications were among the five midcarpal ganglia). The mean functional recovery time was equal to 15 (6) days in the open group and 6 (2) days in the arthroscopic group. The mean time lost from work was equal to 23 (11) days in the open group and 10 (5) days in the arthroscopic group. Our results suggest that arthroscopic resection is a reasonable alternative to open excision in treating radiocarpal volar ganglia because it has less postoperative morbidity and a better cosmetic result. Midcarpal volar ganglia, however, should still be treated by open operation. PMID:18791910

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

    EPA Science Inventory

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

  18. Comparative Effectiveness of Targeted Prostate Biopsy Using MRI-US Fusion Software and Visual Targeting: a Prospective Study

    PubMed Central

    Lee, Daniel J.; Recabal, Pedro; Sjoberg, Daniel D.; Thong, Alan; Lee, Justin K.; Eastham, James A.; Scardino, Peter T.; Vargas, Hebert Alberto; Coleman, Jonathan; Ehdaie, Behfar

    2016-01-01

    Purpose To compare diagnostic outcomes between 2 different techniques for targeting regions-of-interest on prostate multiparametric Magnetic resonance imaging (mpMRI); MRI-ultrasound fusion (MR-F) and visually targeted (VT) biopsy. Materials and Methods Patients presenting for prostate biopsy with regions-of-interest on mpMRI underwent MRI-targeted biopsy. For each region-of-interest two VT cores were obtained, followed by 2 cores using an MR-F device. Our primary endpoint was the difference in the detection of high-grade (Gleason ≥7) and any-grade cancer between VT and MR-F, investigated using McNemar’s method. Secondary endpoints were the difference in detection rate by biopsy location using a logistic regression model, and difference in median cancer length using Wilcoxon sign-rank test. Results We identified 396 regions-of-interest in 286 men. The difference in high-grade cancer detection between MR-F biopsy and VT biopsy was −1.4% (95% CI −6.4% to 3.6%; p=0.6); for any-grade cancer the difference was 3.5% (95% CI −1.9% to 8.9%; p=0.2). Median cancer length detected by MR-F and VT were 5.5mm vs. 5.8mm, respectively (p=0.8). MR-F biopsy detected 15% more cancers in the transition zone (p=0.046), and VT biopsy detected 11% more high-grade cancer at the prostate base (p=0.005). Only 52% of all high-grade cancers were detected by both techniques. Conclusions We found no evidence of a significant difference in the detection of high-grade or any-grade cancer between VT and MR-F biopsy. However, the performance of each technique varied in specific biopsy locations, and the outcomes of both techniques were complementary. Combining VT biopsy and MR-F biopsy may optimize prostate cancer detection. PMID:27038768

  19. Temporary external pedicular fixation versus definitive bony fusion: a prospective comparative study on pain relief and function.

    PubMed

    Axelsson, Paul; Johnsson, Ragnar; Strömqvist, Björn; Andréasson, Håkan

    2003-02-01

    Temporary external pedicular fixation is used as a prognostic instrument when treating degenerative conditions with spinal fusion. We studied the validity of the method and whether a functional test could improve the prognostic value of such fixation. Twenty-six patients with long-standing lumbar pain had an external temporary fixation. Pain levels were registered before fixation on a visual analogue scale at rest, as a mean for the previous week, and at seven different standardized activities. Walking capacity and walking speed for a standardized distance were also measured. Identical evaluations were then repeated during the external fixation and 1 year after definitive fusion. Based on the outcome of the temporary fixation, 20 patients were recommended for definitive surgical fusion. In six cases, the option of fusion surgery was rejected due to an unfavourable pain response or insufficient pain relief during the test fixation period, and this group was not further followed within the study. One year after surgery, 14 of 20 patients reported a good outcome. Solid bony fusion assessed by conventional radiography was seen in 19 patients. One patient with a poor clinical outcome had a pseudarthrosis. The mean values for pain level at rest, during last week and at the seven different activities in the functional test tended to decrease after fusion compared to the situation with temporary external fixation. In no activity did the external fixator overestimate the mean positive pain-relieving effect after definitive fusion. The walking capacity significantly increased, while the walking speed did not alter at the three different measurements. We conclude that with a good outcome ratio of 14 patients out of 19 having a solid fusion, the external frame improved patient selection and can be used as a valid prognostic instrument. The pain relief and function after definitive fusion can not be quantified by the external fixation, probably due to the fact that the

  20. Environmental auditing: Theory and applications

    NASA Astrophysics Data System (ADS)

    Thompson, Dixon; Wilson, Melvin J.

    1994-07-01

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

  1. EPA clarifies its environmental auditing policy

    SciTech Connect

    Bergeson, L.L.

    1994-10-01

    EPA's audit policy is entitled ''Environmental Auditing Policy Statement.'' EPA's current policy is intended to encourage regulated entities to develop, implement and periodically upgrade environmental auditing programs. The policy outlines the elements EPA believes must be included in an audit program if it is to be effective. These include: Explicit top management support for environmental auditing and commitment to follow up on audit findings; An environmental auditing function independent of auditing activities; Adequate team staffing and auditor training; Explicit audit program objectives, scope, resources and frequency; A process that collects, analyzes, interprets and documents information sufficient to achieve audit objectives. A process that includes specific procedure to prepare promptly candid, clear and appropriate written reports on audit findings, corrective actions and schedules for implementation; and A process that includes quality assurance procedures.

  2. Final Results of a Prospective Study Comparing the Local Control of Short-Course and Long-Course Radiotherapy for Metastatic Spinal Cord Compression

    SciTech Connect

    Rades, Dirk; Lange, Marisa; Veninga, Theo; Stalpers, Lukas J.A.; Bajrovic, Amira; Adamietz, Irenaeus A.; Rudat, Volker; Schild, Steven E.

    2011-02-01

    Purpose: Many patients with metastatic spinal cord compression (MSCC) live long enough to develop a recurrence in the irradiated spinal area. This is the first prospective study that has compared local control of different radiotherapy schedules for MSCC. Methods and Materials: A total of 265 patients treated with radiotherapy alone were included in this prospective nonrandomized study. The primary goal was to compare local control from short-course (1 x 8 Gy/5 x 4 Gy, n = 131) and long-course radiotherapy (10 x 3 Gy/15 x 2.5 Gy/20 x 2 Gy, n = 134). Secondary end points were motor function and survival. The analysis of local control (no MSCC recurrence in the irradiated spinal area) included the 224 patients with improvement or no change of motor deficits during radiotherapy. Eleven additional factors were evaluated for outcomes. Results: One-year local control was 61% after short-course and 81% after long-course radiotherapy (p = 0.005). On multivariate analysis (MVA), improved local control was associated with long-course radiotherapy (p = 0.018). Motor function improved in 37% after short-course and 39% after long-course radiotherapy (p = 0.95). Improved motor function was associated with better performance status (p = 0.015), favorable tumor type (p = 0.034), and slower development of motor deficits (p < 0.001). One-year survival rates were 23% after short-course and 30% after long-course radiotherapy (p = 0.28). On MVA, improved survival was associated with better performance status (p < 0.001), no visceral metastases (p < 0.001), involvement of only one to three vertebrae (p = 0.040), ambulatory status (p = 0.038), and bisphosphonate administration after radiotherapy (p < 0.001). Conclusions: Long-course radiotherapy was associated with better local control, similar functional outcome, and similar survival compared to short-course radiotherapy. Patients with a relatively favorable expected survival should receive long-course radiotherapy.

  3. The impact of a GP clinical audit on the provision of smoking cessation advice

    PubMed Central

    McKay-Brown, Lisa; Bishop, Nicole; Balmford, James; Borland, Ron; Kirby, Catherine; Piterman, Leon

    2008-01-01

    Aim To investigate whether participation in a clinical audit and education session would improve GP management of patients who smoke. Methods GPs who participated in an associated smoking cessation research program were invited to complete a three-stage clinical audit. This process included a retrospective self-audit of smoking cessation management practices over the 6 months prior to commencing the study, attending a 2.5 hour education session about GP management of smoking cessation, and completion of a second retrospective self-audit 6 months later. Twenty-eight GPs completed the full audit and education process, providing information about their smoking cessation management with 1114 patients. The main outcome measure was changes in GP management of smoking cessation with patients across the audit period, as measured by the clinical audit tool. Results The majority of GPs (57%) indicated that as a result of the audit process they had altered their approach to the management of patients who smoke. Quantitative analyses confirmed significant increases in various forms of evidence-based smoking cessation management practices to assist patients to quit, or maintain quitting across the audit period. However comparative analyses of patient data challenged these findings, suggesting that the clinical audit process had less impact on GP practice than suggested in GP's self-reported audit data. Conclusion This study provides some support for the combined use of self-auditing, feedback and education to improve GP management of smoking cessation. However further research is warranted to examine GP- and patient-based reports of outcomes from clinical audit and other educational interventions. PMID:18973708

  4. Audit: an exploration of two models from outside the health care environment.

    PubMed

    Earl-Slater, A; Wilcox, V

    1997-11-01

    Whilst there has been exponential growth in auditing health care services and a proliferation of the instruments involved, there seems to have been less cross-fertilization of audit systems and instruments between health care environments and other environments. This paper identifies and explores two audit systems and instruments outside the health care environment. The objective is to seek to improve the level of common understanding, communication and collaboration amongst those who are interested or involved in audit in any sector of the economy. This exercise offers an opportunity and incentive for cross-fertilization of ideas with respect to audit concepts, systems, instruments, results and experiences. Yet there is a more fundamental question to be considered: why bother with audit? This paper identifies core reasons for performing audit which, although they have been mentioned elsewhere, are worth recalling once again. The two non-health care audit systems and instruments are then identified and explored. On the one hand it is seen that the two audit systems and instruments outside health care have common features with audits in health care. On the other hand, it is also suggested that there are some significant differences in the two audit systems and instruments when compared to health care audits. This paper identifies and discusses similarities and differences. Finally, if we fail to learn from the mixture of experiences and insights of various audit exercises, not only will be doing our professions and our customers a disservice but we will lower the chances of continuous improvement in knowledge and understanding. PMID:9456426

  5. Icodextrin does not impact infectious and culture-negative peritonitis rates in peritoneal dialysis patients: a 2-year multicentre, comparative, prospective cohort study

    PubMed Central

    Vychytil, Andreas; Remón, César; Michel, Catherine; Williams, Paul; Rodríguez-Carmona, Ana; Marrón, Belén; Vonesh, Ed; van der Heyden, Synke; Filho, Jose C. Divino

    2008-01-01

    Background. Icodextrin is a glucose polymer derived by hydrolysis of cornstarch. The different biocompatibility profile of icodextrin-containing peritoneal dialysis (PD) solutions may have a positive influence on peritoneal host defence. Furthermore, cases of sterile peritonitis potentially associated with icodextrin have been reported. Methods. The primary objective of this multicentre, longitudinal, observational, non-interventional, prospective cohort study, which included 722 PD patients, was to evaluate the incidence of overall peritonitis in patients treated with icodextrin-containing PD solutions (Extraneal™) used during one long-dwell exchange/day compared with those treated with non-icodextrin-containing PD solutions. The secondary objective was to determine if culture-negative peritonitis rates differed between patients treated with icodextrin from two independent manufacturers. All peritonitis episodes were assessed by a Steering Committee in a blind manner. Results. There was no significant difference between icodextrin-treated and control patients in the adjusted overall, culture-positive or culture-negative peritonitis rates. When stratified by the icodextrin supplier, there was no significant difference in the adjusted rate of culture-negative peritonitis episodes between groups. Conclusion. Subjects receiving icodextrin as part of their PD regimen experienced neither a higher rate of culture-negative peritonitis nor a lower rate of infectious peritonitis compared with non-icodextrin users. There was no significant influence of the icodextrin raw material supplier on peritonitis rates. PMID:18556747

  6. Outcome of short proximal femoral nail antirotation and dynamic hip screw for fixation of unstable trochanteric fractures. A randomised prospective comparative trial.

    PubMed

    Garg, Bhavuk; Marimuthu, Kanniraj; Kumar, Vijay; Malhotra, Rajesh; Kotwal, Prakash P

    2011-01-01

    A prospective, randomised, controlled trial was performed to compare the outcome of treatment of unstable trochanteric fractures with either a short proximal femoral nail antirotation (PFNA) or dynamic hip screw (DHS). Eighty one patients with unstable fracture of the proximal part of the femur were randomised, at the time of admission, for fixation with either a short PFNA (n=42) or DHS (n= 39). The primary outcome measure was reoperation within the first postoperative year and mortality at the end of one year. Operative time, fluoroscopy time, blood loss, and any intra-operative complication were recorded for each patient. Clinical and radiological follow-up was undertaken for a minimum of 36 months. Any changes in the position of the implant or fixation failure were recorded. Hip range of motion, pain in the hip or thigh and return to work were used to compare the outcomes. There was no significant difference between 1 year mortality rates for the two groups. The mean operative time was significantly less in PFNA group (25 min) than in the DHS group (38 min). Patients treated with a PFNA experienced a shorter fluoroscopy time and less blood loss. Six patients in DHS group had implant failure while none experienced this in PFNA group. The PFNA group had a better functional outcome than the DHS group. PMID:21948030

  7. Preoperative Quantitative MR Tractography Compared with Visual Tract Evaluation in Patients with Neuropathologically Confirmed Gliomas Grades II and III: A Prospective Cohort Study

    PubMed Central

    Delgado, Anna F.; Nilsson, Markus; Latini, Francesco; Mårtensson, Johanna; Zetterling, Maria; Berntsson, Shala G.; Alafuzoff, Irina; Lätt, Jimmy; Larsson, Elna-Marie

    2016-01-01

    Background and Purpose. Low-grade gliomas show infiltrative growth in white matter tracts. Diffusion tensor tractography can noninvasively assess white matter tracts. The aim was to preoperatively assess tumor growth in white matter tracts using quantitative MR tractography (3T). The hypothesis was that suspected infiltrated tracts would have altered diffusional properties in infiltrated tract segments compared to noninfiltrated tracts. Materials and Methods. Forty-eight patients with suspected low-grade glioma were included after written informed consent and underwent preoperative diffusion tensor imaging in this prospective review-board approved study. Major white matter tracts in both hemispheres were tracked, segmented, and visually assessed for tumor involvement in thirty-four patients with gliomas grade II or III (astrocytomas or oligodendrogliomas) on postoperative neuropathological evaluation. Relative fractional anisotropy (rFA) and mean diffusivity (rMD) in tract segments were calculated and compared with visual evaluation and neuropathological diagnosis. Results. Tract segment infiltration on visual evaluation was associated with a lower rFA and high rMD in a majority of evaluated tract segments (89% and 78%, resp.). Grade II and grade III gliomas had similar infiltrating behavior. Conclusion. Quantitative MR tractography corresponds to visual evaluation of suspected tract infiltration. It may be useful for an objective preoperative evaluation of tract segment involvement. PMID:27190647

  8. Women's Campus Safety Audit Guide.

    ERIC Educational Resources Information Center

    Council of Ontario Universities, Toronto.

    This booklet is designed for those who want to make the college campus a safer environment for women. Specifically, it provides information to help make public and semi-public places safer and more comfortable for women, focusing on preventing sexual harassment and assault. The booklet introduces the safety audit and explains what the audit is…

  9. The Audit Committee. Board Basics

    ERIC Educational Resources Information Center

    Ostrom, John S.

    2004-01-01

    The Effective Committees set of booklets comprises publications on the following committees: investment, buildings and grounds, academic affairs, student affairs, finance, development, trustees, audit, compensation, and executive. It is part of the AGB Board Basics Series. This report describes the primary role of an audit committee. The primary…

  10. Safety Audit/Inspection Manual.

    ERIC Educational Resources Information Center

    American Chemical Society, Washington, DC.

    This guide provides guidelines and procedures for safety audits and inspections in work environments. Contents include: (1) Administrative Concepts, (2) Physical Concepts, (3) Protecting Your Audits, (4) Safety Inspections, and (5) Safety Inspection Checklist. The appendix features federal laws and regulations affecting laboratories. (YDS)

  11. Your Audit and Financial Controls.

    ERIC Educational Resources Information Center

    Hatch, Mary B.; And Others

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

  12. Elderly Peritoneal Dialysis Compared with Elderly Hemodialysis Patients and Younger Peritoneal Dialysis Patients: Competing Risk Analysis of a Korean Prospective Cohort Study

    PubMed Central

    Kim, Hyunsuk; An, Jung Nam; Kim, Dong Ki; Kim, Myoung-Hee; Kim, Ho; Kim, Yong-Lim; Park, Ki Soo; Oh, Yun Kyu; Lim, Chun Soo; Kim, Yon Su; Lee, Jung Pyo

    2015-01-01

    The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck’s Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50~64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001). However, the technical survival rate was similar (P = 0.097). Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients. PMID:26121574

  13. Elderly Peritoneal Dialysis Compared with Elderly Hemodialysis Patients and Younger Peritoneal Dialysis Patients: Competing Risk Analysis of a Korean Prospective Cohort Study.

    PubMed

    Kim, Hyunsuk; An, Jung Nam; Kim, Dong Ki; Kim, Myoung-Hee; Kim, Ho; Kim, Yong-Lim; Park, Ki Soo; Oh, Yun Kyu; Lim, Chun Soo; Kim, Yon Su; Lee, Jung Pyo

    2015-01-01

    The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50~64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001). However, the technical survival rate was similar (P = 0.097). Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients. PMID:26121574

  14. Operative blood transfusion quality improvement audit

    PubMed Central

    Al Sohaibani, Mazen; Al Malki, Assaf; Pogaku, Venumadhav; Al Dossary, Saad; Al Bernawi, Hanan

    2014-01-01

    Context: To determine how current anesthesia team handless the identification of surgical anaesthetized patient (right patient). And the check of blood unit before collecting and immediately before blood administration (right blood) in operating rooms where nurses have minimal duties and responsibility to handle blood for transfusion in anaesthetized patients. Aims: To elicit the degree of anesthesia staff compliance with new policies and procedures for anaesthetized surgical patient the blood transfusion administration. Settings and Design: Setting: A large tertiary care reference and teaching hospital. Design: A prospective quality improvement. Elaboration on steps for administration of transfusion from policies and procedures to anaesthetized patients; and analysis of the audit forms for conducted transfusions. Subjects and Methods: An audit form was used to get key performance indicators (KPIs) observed in all procedures involve blood transfusion and was ticked as item was met, partially met, not met or not applicable. Statistical Analysis Used: Descriptive statistics as number and percentage Microsoft excel 2003. Central quality improvement committee presented the results in number percentage and graphs. Results: The degree of compliance in performing the phases of blood transfusion by anesthesia staff reached high percentage which let us feel certain that the quality is assured that the internal policy and procedures (IPP) are followed in the great majority of all types of red cells and other blood products transfusion from the start of requesting the blood or blood product to the prescript of checking the patient in the immediate post-transfusion period. Conclusions: Specific problem area of giving blood transfusion to anaesthetized patient was checking KPI concerning the phases of blood transfusion was audited and assured the investigators of high quality performance in procedures of transfusion. PMID:25886107

  15. Introducing students to clinical audit.

    PubMed

    Parkes, Jacqueline; O'Dell, Cindy

    2015-11-01

    It is more than a decade since the UK Central Council for Nursing Midwifery and Health Visiting said that engaging with clinical audit is 'the business of every registered practitioner', yet there appears to be little evidence that nursing has embraced the process. To address this issue, Northampton General Hospital and the University of Northampton implemented a pilot project in which two third-year adult nursing students worked on a 'real life' audit. Supported by the hospital's audit department, and supervised by academic tutors with the relevant experience, the students worked on a pressure-ulcer care audit for their final year dissertation. This article describes the process undertaken by the hospital audit team and the university academic team to develop the pilot project and support the students. Based on the positive evaluations, the university has extended the project to a second phase, incorporating two new partner organisations. PMID:26508069

  16. Designing Academic Audit: Lessons Learned in Europe and Asia.

    ERIC Educational Resources Information Center

    Dill, David D.

    2000-01-01

    Reviews lessons learned from early experiments with academic audits in the United Kingdom, Sweden, New Zealand, and Hong Kong in areas such as: focus of audits, selection and training of audit teams, nature of audit self-studies, conduct of audit visits, audit reports, and audit follow-up and enhancement activities. Suggests guidelines for design…

  17. 29 CFR 99.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Relation to other audit requirements. 99.215 Section 99.215... Audits § 99.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  18. 7 CFR 3052.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Relation to other audit requirements. 3052.215... ORGANIZATIONS Audits § 3052.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  19. 29 CFR 99.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Relation to other audit requirements. 99.215 Section 99.215... Audits § 99.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  20. 29 CFR 99.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Relation to other audit requirements. 99.215 Section 99.215... Audits § 99.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  1. 7 CFR 3052.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Relation to other audit requirements. 3052.215... ORGANIZATIONS Audits § 3052.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  2. 7 CFR 3052.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Relation to other audit requirements. 3052.215... ORGANIZATIONS Audits § 3052.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  3. 7 CFR 3052.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Relation to other audit requirements. 3052.215... ORGANIZATIONS Audits § 3052.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  4. 29 CFR 99.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 1 2012-07-01 2012-07-01 false Relation to other audit requirements. 99.215 Section 99.215... Audits § 99.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  5. 29 CFR 99.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Relation to other audit requirements. 99.215 Section 99.215... Audits § 99.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  6. 7 CFR 3052.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Relation to other audit requirements. 3052.215... ORGANIZATIONS Audits § 3052.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required...

  7. Auditing urinary catheter care.

    PubMed

    Dailly, Sue

    Urinary catheters are the main cause of hospital-acquired urinary tract infections among inpatients. Healthcare staff can reduce the risk of patients developing an infection by ensuring they give evidence-based care and by removing the catheter as soon as it is no longer necessary. An audit conducted in a Hampshire hospital demonstrated there was poor documented evidence that best practice was being carried out. Therefore a urinary catheter assessment and monitoring tool was designed to promote best practice and produce clear evidence that care had been provided. PMID:22375340

  8. 32 CFR 34.16 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... awards shall have an audit made for that year by an independent auditor, in accordance with paragraph (b) of this section. The audit generally should be made a part of the regularly scheduled, annual audit... independent audit is intended to ascertain the adequacy of the recipient's internal financial...

  9. 21 CFR 820.22 - Quality audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... QUALITY SYSTEM REGULATION Quality System Requirements § 820.22 Quality audit. Each manufacturer shall establish procedures for quality audits and conduct such audits to assure that the quality system is in... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Quality audit. 820.22 Section 820.22 Food...

  10. 29 CFR 96.12 - Audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... (b) The audit requirements contained in 29 CFR part 99 shall be followed for audits of all fiscal... of 29 CFR 99.320, which provides for submission of audit data collection forms and reporting packages... 29 Labor 1 2014-07-01 2013-07-01 true Audit requirements. 96.12 Section 96.12 Labor Office of...

  11. 29 CFR 96.12 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... (b) The audit requirements contained in 29 CFR part 99 shall be followed for audits of all fiscal... of 29 CFR 99.320, which provides for submission of audit data collection forms and reporting packages... 29 Labor 1 2011-07-01 2011-07-01 false Audit requirements. 96.12 Section 96.12 Labor Office of...

  12. 12 CFR 363.5 - Audit committees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Audit committees. 363.5 Section 363.5 Banks and... INDEPENDENT AUDITS AND REPORTING REQUIREMENTS § 363.5 Audit committees. (a) Composition and duties. Each insured depository institution shall establish an audit committee of its board of directors,...

  13. 7 CFR 226.8 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... disregard may be made once per each management evaluation, review, or audit per Program within a fiscal year.... State agencies must establish audit policy for for-profit institutions. However, the audit policy... funds provided to an institution for an organization-wide audit must be determined in accordance...

  14. 7 CFR 250.18 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... Fiscal matters shall continue to be reviewed in audits under the Single Audit Act (31 U.S.C. 7501-07) and the Department's Uniform Federal Assistance Regulations (7 CFR part 3015). (b) Independent CPA audits... auditing provisions set forth under the Uniform Federal Assistance Regulations (7 CFR part 3015, subpart...

  15. 7 CFR 285.4 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... such audit shall be reported to FNS no later than 120 days from the end of each fiscal year in which the audit is made. (b) Within 120 days of the end of each fiscal year, the Commonwealth of Puerto Rico... PUERTO RICO § 285.4 Audits. (a) The Commonwealth of Puerto Rico shall provide an audit of expenditures...

  16. 7 CFR 285.4 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... such audit shall be reported to FNS no later than 120 days from the end of each fiscal year in which the audit is made. (b) Within 120 days of the end of each fiscal year, the Commonwealth of Puerto Rico... PUERTO RICO § 285.4 Audits. (a) The Commonwealth of Puerto Rico shall provide an audit of expenditures...

  17. 7 CFR 250.18 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... Fiscal matters shall continue to be reviewed in audits under the Single Audit Act (31 U.S.C. 7501-07) and the Department's Uniform Federal Assistance Regulations (7 CFR part 3015). (b) Independent CPA audits... auditing provisions set forth under the Uniform Federal Assistance Regulations (7 CFR part 3015, subpart...

  18. 29 CFR 96.12 - Audit requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... (b) The audit requirements contained in 29 CFR part 99 shall be followed for audits of all fiscal... of 29 CFR 99.320, which provides for submission of audit data collection forms and reporting packages... 29 Labor 1 2012-07-01 2012-07-01 false Audit requirements. 96.12 Section 96.12 Labor Office of...

  19. 7 CFR 226.8 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... disregard may be made once per each management evaluation, review, or audit per Program within a fiscal year.... State agencies must establish audit policy for for-profit institutions. However, the audit policy... funds provided to an institution for an organization-wide audit must be determined in accordance...

  20. 12 CFR 363.5 - Audit committees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Audit committees. 363.5 Section 363.5 Banks and... INDEPENDENT AUDITS AND REPORTING REQUIREMENTS § 363.5 Audit committees. (a) Composition and duties. Each insured depository institution shall establish an audit committee of its board of directors,...

  1. 7 CFR 226.8 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... disregard may be made once per each management evaluation, review, or audit per Program within a fiscal year.... State agencies must establish audit policy for for-profit institutions. However, the audit policy... funds provided to an institution for an organization-wide audit must be determined in accordance...

  2. 7 CFR 226.8 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... made once per each management evaluation, review, or audit per Program within a fiscal year. However.... State agencies must establish audit policy for for-profit institutions. However, the audit policy... funds provided to an institution for an organization-wide audit must be determined in accordance...

  3. 12 CFR 363.5 - Audit committees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Audit committees. 363.5 Section 363.5 Banks and... INDEPENDENT AUDITS AND REPORTING REQUIREMENTS § 363.5 Audit committees. (a) Composition and duties. Each insured depository institution shall establish an audit committee of its board of directors,...

  4. 7 CFR 250.18 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... Fiscal matters shall continue to be reviewed in audits under the Single Audit Act (31 U.S.C. 7501-07) and the Department's Uniform Federal Assistance Regulations (7 CFR part 3015). (b) Independent CPA audits... auditing provisions set forth under the Uniform Federal Assistance Regulations (7 CFR part 3015, subpart...

  5. 12 CFR 363.5 - Audit committees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Audit committees. 363.5 Section 363.5 Banks and... INDEPENDENT AUDITS AND REPORTING REQUIREMENTS § 363.5 Audit committees. (a) Composition and duties. Each insured depository institution shall establish an audit committee of its board of directors,...

  6. 29 CFR 96.12 - Audit requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... (b) The audit requirements contained in 29 CFR part 99 shall be followed for audits of all fiscal... of 29 CFR 99.320, which provides for submission of audit data collection forms and reporting packages... 29 Labor 1 2013-07-01 2013-07-01 false Audit requirements. 96.12 Section 96.12 Labor Office of...

  7. 7 CFR 250.18 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... Fiscal matters shall continue to be reviewed in audits under the Single Audit Act (31 U.S.C. 7501-07) and the Department's Uniform Federal Assistance Regulations (7 CFR part 3015). (b) Independent CPA audits... auditing provisions set forth under the Uniform Federal Assistance Regulations (7 CFR part 3015, subpart...

  8. 29 CFR 96.12 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... (b) The audit requirements contained in 29 CFR part 99 shall be followed for audits of all fiscal... of 29 CFR 99.320, which provides for submission of audit data collection forms and reporting packages... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirements. 96.12 Section 96.12 Labor Office of...

  9. 12 CFR 561.6 - Audit period.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Audit period. 561.6 Section 561.6 Banks and... SAVINGS ASSOCIATIONS § 561.6 Audit period. The audit period of a savings association means the twelve month period (or other period in the case of a change in audit period) covered by the annual...

  10. 20 CFR 601.9 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., Advances and Audits § 601.9 Audits. The Department of Labor's audit regulations at 29 CFR Part 96 and 29 CFR Part 99 shall apply with respect to employment service and unemployment compensation programs. ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Audits. 601.9 Section 601.9...

  11. 30 CFR 217.250 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Audits. 217.250 Section 217.250 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT AUDITS AND INSPECTIONS Other Solid Minerals § 217.250 Audits. An audit of the lessee's accounts and books may be...

  12. 49 CFR 663.9 - Audit limitations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Audit limitations. (a) An audit under this part is limited to verifying compliance with (1) Applicable... 49 Transportation 7 2010-10-01 2010-10-01 false Audit limitations. 663.9 Section 663.9... audit under this part includes, where appropriate, a copy of a manufacturer's self...

  13. 7 CFR 3052.230 - Audit costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... principles circulars, the Federal Acquisition Regulation (FAR) (48 CFR parts 30 and 31), or other applicable... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit costs. 3052.230 Section 3052.230 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.230 Audit...

  14. 30 CFR 725.19 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  15. 29 CFR 99.505 - Audit reporting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit reporting. 99.505 Section 99.505 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.505 Audit... the audit was conducted in accordance with this part and include the following: (a) An opinion...

  16. Internal Audits: A Must for Governing Boards.

    ERIC Educational Resources Information Center

    Allcorn, Seth

    1983-01-01

    Internal auditing, which can help governing boards exercise their control responsibilities, is discussed, including financial, compliance, and operations auditing. Governing boards should be prepared to handle reports on operation audits, financial and compliance audits, and reviews of management information systems. (MLW)

  17. Community College Internal Auditors: Internal Audit Guidebook.

    ERIC Educational Resources Information Center

    Jones, Ronna; And Others

    This guidebook includes information compiled by the "Audit Manual" committee of Community College Internal Auditors (CCIA) from several California community college districts regarding their internal auditing practices. The first section of the guidebook discusses the purpose of internal audits, indicating that audits assist members of the…

  18. 12 CFR 363.5 - Audit committees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INDEPENDENT AUDITS AND REPORTING REQUIREMENTS § 363.5 Audit committees. (a) Composition and duties. Each insured depository institution shall establish an audit committee of its board of directors, the... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Audit committees. 363.5 Section 363.5 Banks...

  19. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  20. 10 CFR 600.316 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... (a) Any recipient that expends $500,000 or more in a year under Federal awards must have an audit... recipient is currently performing under a Federal award that requires an audit by its Federal cognizant agency, that auditor must perform the independent audit. The audit generally should be made a part of...

  1. 10 CFR 600.316 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... (a) Any recipient that expends $500,000 or more in a year under Federal awards must have an audit... recipient is currently performing under a Federal award that requires an audit by its Federal cognizant agency, that auditor must perform the independent audit. The audit generally should be made a part of...

  2. 12 CFR 620.30 - Audit committees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Audit committees. 620.30 Section 620.30 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DISCLOSURE TO SHAREHOLDERS Bank and Association Audit and Compensation Committees § 620.30 Audit committees. Each Farm Credit bank and association must establish and maintain an audit...

  3. 10 CFR 600.316 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... (a) Any recipient that expends $500,000 or more in a year under Federal awards must have an audit... recipient is currently performing under a Federal award that requires an audit by its Federal cognizant agency, that auditor must perform the independent audit. The audit generally should be made a part of...

  4. 10 CFR 600.316 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... (a) Any recipient that expends $500,000 or more in a year under Federal awards must have an audit... recipient is currently performing under a Federal award that requires an audit by its Federal cognizant agency, that auditor must perform the independent audit. The audit generally should be made a part of...

  5. 2 CFR 200.515 - Audit reporting.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... whether significant deficiencies or material weaknesses in internal control were disclosed by the audit of... defined in § 200.516 Audit findings, paragraph (a). (i) Audit findings (e.g., internal control findings... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Audit reporting. 200.515 Section...

  6. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  7. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  8. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Audit findings. 41.510... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule...

  9. 20 CFR 627.481 - Audit resolution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PROGRAMS UNDER TITLES I, II, AND III OF THE ACT Administrative Standards § 627.481 Audit resolution. (a) Federal audit resolution. When the OIG issues an audit report to the Employment and Training... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit resolution. 627.481 Section...

  10. 28 CFR 33.51 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Audit. 33.51 Section 33.51 Judicial... Additional Requirements § 33.51 Audit. Pursuant to Office of Management and Budget Circular A-128 “Audits of State and Local Governments,” all grantees and subgrantees must provide for an independent audit...

  11. 7 CFR 226.8 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... State agencies must establish audit policy for for-profit institutions. However, the audit policy... funds provided to an institution for an organization-wide audit must be determined in accordance with... remaining after all required program-specific audits have been performed to conduct administrative...

  12. 20 CFR 416.1027 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Board. The rules for hearings and appeals are provided in 45 CFR part 16. (b) Audits performed by the... Determinations of Disability Administrative Responsibilities and Requirements § 416.1027 Audits. (a) Audits... disability program under the Act, will be performed by the States in accordance with the Single Audit Act...

  13. 12 CFR 620.30 - Audit committees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... administrative expenses. A two-thirds majority vote of the full board of directors is required to deny an audit... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Audit committees. 620.30 Section 620.30 Banks... Association Audit and Compensation Committees § 620.30 Audit committees. Each Farm Credit bank and...

  14. 20 CFR 638.809 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.809 Audit. (a) The Secretary of Labor... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit. 638.809 Section 638.809 Employees... reasonable frequency, survey, audit, or examine, or arrange for the survey, audit, or examination of...

  15. 23 CFR 172.7 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Audits. 172.7 Section 172.7 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES ADMINISTRATION OF ENGINEERING AND DESIGN RELATED SERVICE CONTRACTS § 172.7 Audits. (a) Performance of audits. When State procedures call for audits of contracts or subcontracts...

  16. 29 CFR 96.32 - Audit requirement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirement. 96.32 Section 96.32 Labor Office of the Secretary of Labor AUDIT REQUIREMENTS FOR GRANTS, CONTRACTS, AND OTHER AGREEMENTS Audits of Entities Not Covered by Subpart A § 96.32 Audit requirement. The Secretary of Labor is responsible for the...

  17. 30 CFR 220.033 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operations shall be subject to audit by DOI or its appointed agent. Where possible, the auditor for DOI shall coordinate audit efforts with other nonoperators, if any. DOI shall have the right to initiate an audit any... notified. DOI may elect to send an auditor with the audit team specified by the nonoperators in lieu...

  18. 7 CFR 3052.230 - Audit costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... principles circulars, the Federal Acquisition Regulation (FAR) (48 CFR parts 30 and 31), or other applicable... 7 Agriculture 15 2014-01-01 2014-01-01 false Audit costs. 3052.230 Section 3052.230 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.230 Audit...

  19. 7 CFR 3052.230 - Audit costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... principles circulars, the Federal Acquisition Regulation (FAR) (48 CFR parts 30 and 31), or other applicable... 7 Agriculture 15 2011-01-01 2011-01-01 false Audit costs. 3052.230 Section 3052.230 Agriculture... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.230 Audit...

  20. 21 CFR 820.22 - Quality audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality audit. 820.22 Section 820.22 Food and... QUALITY SYSTEM REGULATION Quality System Requirements § 820.22 Quality audit. Each manufacturer shall establish procedures for quality audits and conduct such audits to assure that the quality system is...

  1. 50 CFR 81.15 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Audits. 81.15 Section 81.15 Wildlife and..., WILDLIFE, AND PLANTS-COOPERATION WITH THE STATES § 81.15 Audits. The State is required to conduct an audit.... Failure to conduct audits as required may result in withholding of grant payments or such other...

  2. 31 CFR 50.60 - Audit authority.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Audit authority. 50.60 Section 50.60... Audit and Investigative Procedures § 50.60 Audit authority. The Secretary of the Treasury, or an... pursuant to subpart H of this part, for the purpose of investigation, confirmation, audit and examination....

  3. 42 CFR 457.236 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 457.236 Section 457.236 Public Health...-Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments § 457.236 Audits. The CHIP agency must assure appropriate audit of records...

  4. 24 CFR 236.901 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... accordance with HUD audit requirements at 24 CFR part 44. ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Audit. 236.901 Section 236.901... AND INTEREST REDUCTION PAYMENT FOR RENTAL PROJECTS Audits § 236.901 Audit. Where a State or...

  5. 20 CFR 655.24 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 655.24 Section 655.24 Employees...) § 655.24 Audits. (a) Discretion. OFLC will conduct audits of H-2B temporary labor certification applications. The applications selected for audit will be chosen within the sole discretion of OFLC. (b)...

  6. 30 CFR 208.15 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Audits. 208.15 Section 208.15 Mineral Resources... OIL General Provisions § 208.15 Audits. Audits of the accounts and books of lessees, operators, payors... directed by MMS. Such audits will be for the purpose of determining compliance with applicable...

  7. Newly diagnosed immune thrombocytopenia in children and adults: a comparative prospective observational registry of the Intercontinental Cooperative Immune Thrombocytopenia Study Group

    PubMed Central

    Kühne, Thomas; Berchtold, Willi; Michaels, Lisa A.; Wu, Runhui; Donato, Hugo; Espina, Bibiana; Tamary, Hannah; Rodeghiero, Francesco; Chitlur, Meera; Rischewski, Johannes; Imbach, Paul

    2011-01-01

    Background Primary immune thrombocytopenia is a bleeding diathesis with an unknown etiology in predisposed individuals with immune disturbances. Although it is claimed that children and adults differ in clinical and laboratory aspects, few data exist to corroborate this observation. Our objective was to assess comparative data from children and adults with newly diagnosed immune thrombocytopenia. Design and Methods Clinical and laboratory data of 1,784 children and 340 adults were extracted from the Pediatric and Adult Registry on Chronic Immune Thrombocytopenia. The registry represents a prospective cohort of children and adults with newly diagnosed immune thrombocytopenia. Participating investigators registered their patients immediately after the diagnosis using a web based data transfer. Children aged under 16 years were compared with adults aged 16 years and over with descriptive statistical analyses. Results The presenting mean platelet count of children and adults was 18.1 and 25.4×109/L. Signs of bleeding were reported in 24% of children and in 23% of adults, and intracranial hemorrhage in 10 of 1,784 children and in 6 of 340 adults. Co-morbidity was observed in 3.9% of children and in 30% of adults. Bone marrow aspiration and laboratory tests (antinuclear antibodies, human immunodeficiency and hepatitis C virus) were performed more frequently in adults. Children and adults were followed with a ‘watch and wait’ strategy in 20% and in 29%, respectively. Immunoglobulins were used more frequently in children and corticosteroids in adults. Conclusions Comparative data of children and adults with newly diagnosed immune thrombocytopenia revealed similarities in presenting platelet counts and in bleeding, whereas differences occurred in co-morbidity, diagnostic procedures and therapy. PMID:21880634

  8. A prospective randomized study comparing alfuzosin and tamsulosin in the management of patients suffering from acute urinary retention caused by benign prostatic hyperplasia

    PubMed Central

    Agrawal, Madhu S.; Yadav, Abhishek; Yadav, Himanshu; Singh, Amit K.; Lavania, Prashant; Jaiman, Richa

    2009-01-01

    Objective: Prospective randomized study to compare the efficacy and safety of alfuzosin and tamsulosin in patients suffering from acute urinary retention caused by benign prostatic hyperplasia (BPH). Methods: Patients with acute urinary retention (AUR) due to BPH (total 150) were catheterized and randomized into three groups: Group A: alfuzosin 10 mg (50 patients), Group B: tamsulosin 0.4 mg (50 patients), Group C: placebo (50 patients). After three days, catheter was removed, and patients were put on trial without catheter (TWOC). Patients with successful TWOC were followed up for three months, taking into account the prostate symptom score (AUA Score), post-void residual urine volume (PVRV), and peak flow rate (PFR). ANOVA was used for statistical analysis. Results: Both group A (alfuzosin) and group B (tamsulosin) had similar results of TWOC (group A – 66%, group B – 70%), which were significantly superior than group C (placebo) – 36%. In follow up, three (9.1%) patients in group A, three (8.6%) patients in group B and eight (44.4%) patients in group C had retention of urine, requiring recatheterization. These patients were withdrawn from the study. After three months, alfuzosin- or tamsulosin-treated patients showed a significant decrease in AUA score and PVRV; and a significant increase in PFR as compared to placebo. Conclusions: TWOC was more successful in men treated with either alfuzosin or tamsulosin and the subsequent need for recatheterization was also reduced. Tamsulosin was comparable to alfuzosin in all respects, except a small but significant side effect of retrograde ejaculation. PMID:19955671

  9. Dose Escalation to the Dominant Intraprostatic Lesion Defined by Sextant Biopsy in a Permanent Prostate I-125 Implant: A Prospective Comparative Toxicity Analysis

    SciTech Connect

    Gaudet, Marc; Vigneault, Eric; Aubin, Sylviane; Varfalvy, Nicolas; Harel, Francois; Beaulieu, L.; Martin, Andre-Guy

    2010-05-01

    Purpose: Using real-time intraoperative inverse-planned permanent seed prostate implant (RTIOP/PSI), multiple core biopsy maps, and three-dimensional ultrasound guidance, we planned a boost volume (BV) within the prostate to which hyperdosage was delivered selectively. The aim of this study was to investigate the potential negative effects of such a procedure. Methods and Materials: Patients treated with RTIOP/PSI for localized prostate cancer with topographic biopsy results received an intraprostatic boost (boost group [BG]). They were compared with patients treated with a standard plan (reference group [RG]). Plans were generated using a simulated annealing inverse planning algorithm. Prospectively recorded urinary, rectal, and sexual toxicities and dosimetric parameters were compared between groups. Results: The study included 120 patients treated with boost technique who were compared with 70 patients treated with a standard plan. Boost technique did not significantly change the number of seeds (55.1/RG vs. 53.6/BG). The intraoperative prostate V150 was slightly higher in BG (75.2/RG vs. 77.2/BG, p = 0.039). Urethra V100, urethra D90, and rectal D50 were significantly lower in the BG. No significant differences were seen in acute or late urinary, rectal, or sexual toxicities. Conclusions: Because there were no differences between the groups in acute and late toxicities, we believe that BV can be planned and delivered to the dominant intraprostatic lesion without increasing toxicity. It is too soon to say whether a boost technique will ultimately increase local control.

  10. Prospective Randomized Study Comparing Combined Phaco-ExPress and Phacotrabeculectomy in Open Angle Glaucoma Treatment: 12-Month Follow-Up

    PubMed Central

    Konopińska, Joanna; Deniziak, Marta; Saeed, Emil; Bartczak, Agnieszka; Zalewska, Renata; Mariak, Zofia; Rękas, Marek

    2015-01-01

    Purpose of the Study. To compare the efficacy and safety of phacotrabeculectomy (P-Trab) and phacoemulsification with the ExPress (P-ExPress) mini glaucoma shunt implantation. Study Plan. Prospective randomized study. Material and Methods. 85 eyes with cataract and unregulated open angle glaucoma. There were 46 eyes in the P-ExPress and 39 the P-Trab group. Intraocular pressure (IOP), the number of antiglaucoma medications, qualified and complete surgical success (defined as IOP ≤ 18.0 mmHg), visual acuity (CDVA), the number of endothelial cells, and postoperative complications and additional procedures were assessed. Results. After 12 months of observation, the average IOP in the P-Express group went from 26.4 ± 9.3 down to 17.1 ± 5 mmHg (P < 0.05) and from 27.9 ± 12.9 down to 15.9 ± 2.7 mmHg in the P-Trab group (P < 0.05). No significant differences in the amount of medications used after surgery and CDVA were discovered between the groups. In the P-ExPress group, greater loss of endothelial cells was noted (CDloss%), compared to the P-Trab group. Conclusions. Both P-ExPress and P-Trab have comparable efficacy and similar early postoperative complication profile. The presence of additional implant (as is the case of the ExPress mini glaucoma shunt implantation) may cause progressive loss of endothelial cells. PMID:26137318

  11. Prevention of medication errors: detection and audit.

    PubMed

    Montesi, Germana; Lechi, Alessandro

    2009-06-01

    1. Medication errors have important implications for patient safety, and their identification is a main target in improving clinical practice errors, in order to prevent adverse events. 2. Error detection is the first crucial step. Approaches to this are likely to be different in research and routine care, and the most suitable must be chosen according to the setting. 3. The major methods for detecting medication errors and associated adverse drug-related events are chart review, computerized monitoring, administrative databases, and claims data, using direct observation, incident reporting, and patient monitoring. All of these methods have both advantages and limitations. 4. Reporting discloses medication errors, can trigger warnings, and encourages the diffusion of a culture of safe practice. Combining and comparing data from various and encourages the diffusion of a culture of safe practice sources increases the reliability of the system. 5. Error prevention can be planned by means of retroactive and proactive tools, such as audit and Failure Mode, Effect, and Criticality Analysis (FMECA). Audit is also an educational activity, which promotes high-quality care; it should be carried out regularly. In an audit cycle we can compare what is actually done against reference standards and put in place corrective actions to improve the performances of individuals and systems. 6. Patient safety must be the first aim in every setting, in order to build safer systems, learning from errors and reducing the human and fiscal costs. PMID:19594533

  12. Assessment of ambient gamma dose rate around a prospective uranium mining area of South India - A comparative study of dose by direct methods and soil radioactivity measurements

    NASA Astrophysics Data System (ADS)

    Karunakara, N.; Yashodhara, I.; Sudeep Kumara, K.; Tripathi, R. M.; Menon, S. N.; Kadam, S.; Chougaonkar, M. P.

    Indoor and outdoor gamma dose rates were evaluated around a prospective uranium mining region - Gogi, South India through (i) direct measurements using a GM based gamma dose survey meter, (ii) integrated measurement days using CaSO4:Dy based thermo luminescent dosimeters (TLDs), and (iii) analyses of 273 soil samples for 226Ra, 232Th, and 40K activity concentration using HPGe gamma spectrometry. The geometric mean values of indoor and outdoor gamma dose rates were 104 nGy h-1 and 97 nGy h-1, respectively with an indoor to outdoor dose ratio of 1.09. The gamma dose rates and activity concentrations of 226Ra, 232Th, and 40K varied significantly within a small area due to the highly localized mineralization of the elements. Correlation study showed that the dose estimated from the soil radioactivity is better correlated with that measured directly using the portable survey meter, when compared to that obtained from TLDs. This study showed that in a region having localized mineralization in situ measurements using dose survey meter provide better representative values of gamma dose rates.

  13. Nutritional support of bone marrow transplant recipients: a prospective, randomized clinical trial comparing total parental nutrition to an enteral feeding program

    SciTech Connect

    Szeluga, D.J.

    1985-01-01

    Allogeneic and autologous bone marrow transplantation (BMT) have been associated with nutritionally-depleting side effects. Total parental nutrition (TPN) has become the standard, but it has not been demonstrated that TPN is the appropriate method of nutritional support. Therefore, in a prospective, randomized clinical trial TPN and enteral feeding were compared for their effectiveness in maintaining the nutritional status of patients through the first 29 post-transplant days. Nutritional assessment included measurement of serum proteins, body weight, anthropometry and isotope dilution analysis of body composition. Total body water (TBW) and extracellular fluid (ECF) were quantified by standard radioisotope dilution techniques using tritiated water and /sup 169/ytterbium-diethylenetriaminepentaacetate, respectively as the tracers. Consenting patients 10-58 years of age were stratified by type of BMT (autologous or allogeneic) and randomized to either TPN plus ad libitum oral feeding or the individualized enteral feeding program (EFP), which included one-on-one counseling, meal-by-meal menu selection, special snacks and tube feeding. There were no differences in the rate of hematologic recovery, incidence of graft-versus-host disease, organ toxicity, length of hospitalization or survival. Therefore, the observed changes in body composition were not clinically significant. Even allowing for increased dietary service, the EFP was only half as expensive as TPN. It was concluded that TPN is not superior to the EFP and therefore, TPN should be reserved for patients who demonstrate intolerance to enteral feeding.

  14. Current situation and prospects of newborn screening and treatment for Phenylketonuria in China — compared with the current situation in the United States, UK and Japan

    PubMed Central

    Mei, Lin; Song, Peipei; Kokudo, Norihiro; Xu, Lingzhong; Tang, Wei

    2013-01-01

    Summary Phenylketonuria (PKU) is a treat-able and prevent-able inborn error of metabolism which leads to severe mental retardation and neurobehavioral abnormalities. A screening program, especially for early detection, combined with a Phe-restricted therapeutic diet can help to control the process of PKU of most patients. The China government has put more emphasis on newborn screening and treatment against PKU, yet by comparing the situation of newborn screening and treatment against PKU in China and the relatively developed countries — United States, United Kingdom and Japan, the newborn screening and treatment against PKU in China is relatively weak and many deficiencies are found. More studies concerning multi-stage target blood Phe concentration criteria, a policy that requires newborn screening has to be taken, better financial support for newborn screening, publicity for newborn screening, and national guidelines for treatment of PKU may be prospects in China and may provide some support for better development of newborn screening and treatment against PKU in China. PMID:25343113

  15. [Clinical value of new rapid nuclear magnetic resonance tomography in preoperative assessment of hypernephroma. A prospective comparative study of CT and MR].

    PubMed

    Vorreuther, R; Krestin, G P; Franzen, W; Engelking, R; Friedmann, G

    1990-01-01

    The new technique of rapid magnetic resonance imaging (MRI) with a paramagnetic contrast agent provides excellent imaging of the kidneys and their lesions. MR imaging of this anatomical region at short breath holding intervals matches the well-known quality of computed tomography (CT) for the first time. MR and CT studies were performed on 36 patients with proven renal cell carcinoma. Different investigators evaluated the staging of the tumor by means of both techniques in a prospective study. In all patients a radical nephrectomy was performed. Surgical and pathological findings were compared. Though little difference was found in diagnostic value between the two systems, MRI results concerning the T-stage were better. Venous invasion was clearly shown by MRI without the use of contrast medium. Furthermore, sagittal and transaxial images provided a more direct assessment of the extent of the tumor and its demarcation to healthy parenchyma. Thus, MRI is helpful in planning of the surgical approach when organ-sparing excision of renal tumors is to be performed. PMID:2316079

  16. [Medical audit: a modern undervalued management tool].

    PubMed

    Osorio, Guido; Sayes, Nilda; Fernández, Lautaro; Araya, Ester; Poblete, Dennis

    2002-02-01

    Medical audit is defined as the critical and periodical assessment of the quality of medical care, through the revision on medical records and hospital statistics. This review defines the work of the medical auditor and shows the fields of action of medical audit, emphasizing its importance and usefulness as a management tool. The authors propose that every hospital should create an audit system, should provide the necessary tools to carry out medical audits and should form an audit committee. PMID:11974537

  17. Is the intraosseous access route fast and efficacious compared to conventional central venous catheterization in adult patients under resuscitation in the emergency department? A prospective observational pilot study

    PubMed Central

    Leidel, Bernd A; Kirchhoff, Chlodwig; Bogner, Viktoria; Stegmaier, Julia; Mutschler, Wolf; Kanz, Karl-Georg; Braunstein, Volker

    2009-01-01

    Background For patients' safety reasons, current American Heart Association and European Resuscitation Council guidelines recommend intraosseous (IO) vascular access as an alternative in cases of emergency, if prompt venous catheterization is impossible. The purpose of this study was to compare the IO access as a bridging procedure versus central venous catheterization (CVC) for in-hospital adult emergency patients under resuscitation with impossible peripheral intravenous (IV) access. We hypothesised, that CVC is faster and more efficacious compared to IO access. Methods A prospective observational study comparing success rates and procedure times of IO access (EZ-IO, Vidacare Corporation) versus CVC in adult (≥18 years of age) patients under trauma and medical resuscitation admitted to our emergency department with impossible peripheral IV catheterization was conducted. Procedure time was defined from preparation and insertion of vascular access type until first drug or infusion solution administration. Success rate on first attempt and procedure time for each access route was evaluated and statistically tested. Results Ten consecutive adult patients under resuscitation, each receiving IO access and CVC, were analyzed. IO access was performed with 10 tibial or humeral insertions, CVC in 10 internal jugular or subclavian veins. The success rate on first attempt was 90% for IO insertion versus 60% for CVC. Mean procedure time was significantly lower for IO cannulation (2.3 min ± 0.8) compared to CVC (9.9 min ± 3.7) (p < 0.001). As for complications, failure of IO access was observed in one patient, while two or more attempts of CVC were necessary in four patients. No other relevant complications, like infection, bleeding or pneumothorax were observed. Conclusion Preliminary data demonstrate that IO access is a reliable bridging method to gain vascular access for in-hospital adult emergency patients under trauma or medical resuscitation with impossible

  18. A Guide to Energy Audits

    SciTech Connect

    Baechler, Michael C.

    2011-09-01

    Energy audits are a powerful tool for uncovering operational and equipment improvements that will save energy, reduce energy costs, and lead to higher performance. Energy audits can be done as a stand-alone effort or as part of a larger analysis across a group of facilities, or across an owner's portfolio. The purpose of an energy audit (sometimes called an 'energy assessment' or 'energy study') is to determine where, when, why and how energy is used in a facility, and to identify opportunities to improve efficiency. Energy auditing services are offered by energy services companies (ESCOs), energy consultants and engineering firms. The energy auditor leads the audit process but works closely with building owners, staff and other key participants throughout to ensure accuracy of data collection and appropriateness of energy efficiency recommendation. The audit typically begins with a review of historical and current utility data and benchmarking of your building's energy use against similar buildings. This sets the stage for an onsite inspection of the physical building. The main outcome of an energy audit is a list of recommended energy efficiency measures (EEMs), their associated energy savings potential, and an assessment of whether EEM installation costs are a good financial investment.

  19. Obstetric audit: the Bradford way

    PubMed Central

    Lomas, Karen; Jaworskyj, Suzanne; Thomson, Heidi

    2014-01-01

    Ultrasound is widely used as a screening tool in obstetrics with the aim of reducing maternal and foetal morbidity. However, to be effective it is recommended that scanning services follow standard protocols based on national guidelines and that scanning practice is audited to ensure consistency. Bradford has a multi-ethnic population with one of the highest rates of birth defects in the UK and it requires an effective foetal anomaly screening service. We implemented a rolling programme of audits of dating scans, foetal anomaly scans and growth scans carried out by sonographers in Bradford. All three categories of scan were audited using measurable parameters based on national guidelines. Following feedback and re-training to address issues identified, re-audits of dating and foetal anomaly scans were carried out. In both cases, sonographers being re-audited had a marked improvement in their practice. Analysis of foetal abnormality detection rates showed that as a department, we were reaching the nationally agreed detection rates for the Fetal Anomaly Screening Programme auditable conditions. Audit has been shown to be a useful and essential process in achieving consistent scanning practices and high quality images and measurements.

  20. Nutritional support of bone marrow transplant recipients: a prospective, randomized clinical trial comparing total parenteral nutrition to an enteral feeding program.

    PubMed

    Szeluga, D J; Stuart, R K; Brookmeyer, R; Utermohlen, V; Santos, G W

    1987-06-15

    Although standard supportive care for bone marrow transplant (BMT) recipients includes total parenteral nutrition (TPN), it has not been shown that this is the most appropriate method of nutritional support. To determine whether current BMT recipients require TPN during the early recovery period, we conducted a prospective, randomized clinical trial comparing TPN and an individualized enteral feeding program (counseling, high protein snacks and/or tube feeding). Nutritional assessment included measurement of serum proteins, anthropometry, and body composition analysis. For the latter, total body water and extracellular fluid were measured by standard radioisotope dilution techniques and used to quantitate body cell mass and body fat plus extracellular solids (FAT + ECS). In 27 TPN patients, body composition 28 days after BMT, expressed as a percentage of baseline, was body cell mass, 100%, extracellular fluid, 108%, FAT + ECS, 108%, and in 30 enteral feeding program patients, was body cell mass, 93%, extracellular fluid, 104%, and FAT + ECS, 94%. Only the difference in FAT + ECS was statistically significant (p less than 0.01). Compared to the enteral feeding program, TPN was associated with more days of diuretic use, more frequent hyperglycemia, and more frequent catheter removal (prompted by catheter-related complications), but less frequent hypomagnesemia. There were no significant differences in the rate of hematopoietic recovery, length of hospitalization, or survival, but nutrition-related costs were 2.3 times greater in the TPN group. We conclude that TPN is not clearly superior to individualized enteral feeding and recommend that TPN be reserved for BMT patients who demonstrate intolerance to enteral feeding. PMID:3107808

  1. A prospective study comparing the predictions of doctors versus models for treatment outcome of lung cancer patients: a step towards individualized care and shared decision making

    PubMed Central

    Oberije, Cary; Nalbantov, Georgi; Dekker, Andre; Boersma, Liesbeth; Borger, Jacques; Reymen, Bart; van Baardwijk, Angela; Wanders, Rinus; De Ruysscher, Dirk; Steyerberg, Ewout; Dingemans, Anne-Marie; Lambin, Philippe

    2015-01-01

    Background Decision Support Systems, based on statistical prediction models, have the potential to change the way medicine is being practiced, but their application is currently hampered by the astonishing lack of impact studies. Showing the theoretical benefit of using these models could stimulate conductance of such studies. In addition, it would pave the way for developing more advanced models, based on genomics, proteomics and imaging information, to further improve the performance of the models. Purpose In this prospective single-center study, previously developed and validated statistical models were used to predict the two-year survival (2yrS), dyspnea (DPN), and dysphagia (DPH) outcomes for lung cancer patients treated with chemo radiation. These predictions were compared to probabilities provided by doctors and guideline-based recommendations currently used. We hypothesized that model predictions would significantly outperform predictions from doctors. Materials and Methods Experienced radiation oncologists (ROs) predicted all outcomes at two timepoints: 1) after the first consultation of the patient, and 2) after the radiation treatment plan was made. Differences in the performances of doctors and models were assessed using Area under the Curve (AUC) analysis. Results A total number of 155 patients were included. At timepoint #1 the differences in AUCs between the ROs and the models were 0.15, 0.17, and 0.20 (for 2yrS, DPN, and DPH respectively), with p-values of 0.02, 0.07, and 0.03. Comparable differences at timepoint #2 were not statistically significant due to the limited number of patients. Comparison to guideline-based recommendations also favored the models. Conclusions The models substantially outperformed ROs’ predictions and guideline-based recommendations currently used in clinical practice. Identification of risk groups on the basis of the models facilitates individualized treatment, and should be further investigated in clinical impact

  2. Palonosetron has superior prophylactic antiemetic efficacy compared with ondansetron or ramosetron in high-risk patients undergoing laparoscopic surgery: a prospective, randomized, double-blinded study

    PubMed Central

    Kim, Sung-Hoon; Hong, Jeong-Yeon; Kim, Won Oak; Karm, Myong-Hwan; Hwang, Jai-Hyun

    2013-01-01

    Background Postoperative nausea and vomiting (PONV) continues to be a major problem, because PONV is associated with delayed recovery and prolonged hospital stay. Although the PONV guidelines recommended the use of 5-hydroxy-tryptamine (5-HT3) receptor antagonists as the first-line prophylactic agents in patients categorized as high-risk, there are few studies comparing the efficacies of ondansetron, ramosetron, and palonosetron. The aim of present study was to compare the prophylactic antiemetic efficacies of three 5HT3 receptor antagonists in high-risk patients after laparoscopic surgery. Methods In this prospective, randomized, double-blinded trial, 109 female nonsmokers scheduled for elective laparoscopic surgery were randomized to receive intravenous 4 mg ondansetron (n = 35), 0.3 mg ramosetron (n = 38), or 75 µg palonosetron (n = 36) before anesthesia. Fentanyl-based intravenous patient-controlled analgesia was administered for 48 h after surgery. Primary antiemetic efficacy variables were the incidence and severity of nausea, the frequency of emetic episodes during the first 48 h after surgery, and the need to use a rescue antiemetic medication. Results The overall incidence of nausea/retching/vomiting was lower in the palonosetron (22.2%/11.1%/5.6%) than in the ondansetron (77.1%/48.6%/28.6%) and ramosetron (60.5%/28.9%/18.4%) groups. The rescue antiemetic therapy was required less frequently in the palonosetron group than the other groups (P < 0.001). Kaplan-Meier analysis showed that the order of prophylactic efficacy in delaying the interval to use of a rescue emetic was palonosetron, ramosetron, and ondansetron. Conclusions Single-dose palonosetron is the prophylactic antiemetics of choice in high-risk patients undergoing laparoscopic surgery. PMID:23814652

  3. Comparative electrocardiographic effects of intravenous ondansetron and granisetron in patients undergoing surgery for carcinoma breast: A prospective single-blind randomised trial

    PubMed Central

    Ganjare, Ashish; Kulkarni, Atul P

    2013-01-01

    Background: Postoperative nausea and vomiting (PONV) are common and distressing symptoms after surgery performed under general anaesthesia. 5-hydroxytryptamine3 antagonists are routinely used for prevention and treatment of PONV. The aim of our study was to compare the incidence of QTc prolongation and quantify the amount of QTc prolongation with ondansetron and granisetron. Methods: This prospective, randomised, single-blind study was carried out in the OT and Recovery Room (RR) of a tertiary referral cancer centre. After obtaining Institutional Review Board approval and written informed consent from the patients, 70 patients undergoing elective surgery for carcinoma breast were included. In the RR, patients randomly received 8 mg of ondansetron or 1 mg of granisetron intravenously. Serial ECGs were recorded at various intervals, Non-invasive blood pressure and SpO2 were also recorded. Chi-square test and Mann-Whiteny test were used for statistical analysis. Results: The demographics were similar in both groups. The incidence of significant QTc prolongation was significantly higher in the ondansetron group (22 of 37 (59.4%) vs. 11 of 33 patients (33.33%) (P<0.05)). There was an increase in the QTc interval in both the groups as compared to the baseline. The median prolongation in QTc interval from baseline was much more in the ondansetron group; this was statistically significant only at 5 and 15 min. Conclusion: Granisetron may be a safer option than ondanasetron for prevention and treatment of PONV due to lesser prolongation QTc interval. (ClinicalTrials.gov ID: NCT01352130) PMID:23716765

  4. Academicians' and Practitioners' Views on the Importance of the Topical Content in the First Auditing Course

    ERIC Educational Resources Information Center

    Armitage, Jack; Poyzer, Jillian K.

    2010-01-01

    The research question addressed in this study is to compare and identify differences between academics teaching auditing classes and practicing accountants regarding the importance of topics covered in the first university auditing course. This is accomplished by surveying academics and practitioners regarding their perceptions of the importance…

  5. Influences on Career Choice among Music Education Audition Candidates: A Pilot Study

    ERIC Educational Resources Information Center

    Rickels, David A.; Councill, Kimberly H.; Fredrickson, William E.; Hairston, Michelle J.; Porter, Ann M.; Schmidt, Margaret

    2010-01-01

    The purpose of this pilot study was to survey prospective undergraduate music education majors to learn what motivated them to aspire to a career in music education. Respondents were candidates auditioning, but not yet accepted, for music teacher preparation programs at four institutions (N = 228). Findings corroborate prior research that suggests…

  6. Dual-stream accounts bridge the gap between monkey audition and human language processing. Comment on "Towards a Computational Comparative Neuroprimatology: Framing the language-ready brain" by Michael Arbib

    NASA Astrophysics Data System (ADS)

    Garrod, Simon; Pickering, Martin J.

    2016-03-01

    Over the last few years there has been a resurgence of interest in dual-stream dorsal-ventral accounts of language processing [4]. This has led to recent attempts to bridge the gap between the neurobiology of primate audition and human language processing with the dorsal auditory stream assumed to underlie time-dependent (and syntactic) processing and the ventral to underlie some form of time-independent (and semantic) analysis of the auditory input [3,10]. Michael Arbib [1] considers these developments in relation to his earlier Mirror System Hypothesis about the origins of human language processing [11].

  7. The audit checklist: Your key to audit success

    SciTech Connect

    Maday, J.H. Jr.

    1992-02-01

    As the old saying goes, ``If you have no objective, any road will take your there.`` So it is with the audit checklist. The checklist is the primary tool for providing order to Quality Assurance audit activities. With a well-planned and well-defined checklist, success is achievable. Without a checklist, the auditor has a disjointed, disorganized activity and no place to document his or her failed efforts. A number of formal quality programs which include audits as one of their program elements require the audit to be performed using a checklist or procedures to document what the auditor reviewed and what he or she found. It is the intent of this paper to provide the reader with the some insight as to the value of the checklist; the varieties of checklists that can be constructed; the pitfalls of improper application; and the success that can be achieved when the checklist has been properly researched, developed, and deployed.

  8. The audit checklist: Your key to audit success

    SciTech Connect

    Maday, J.H. Jr.

    1992-02-01

    As the old saying goes, If you have no objective, any road will take your there.'' So it is with the audit checklist. The checklist is the primary tool for providing order to Quality Assurance audit activities. With a well-planned and well-defined checklist, success is achievable. Without a checklist, the auditor has a disjointed, disorganized activity and no place to document his or her failed efforts. A number of formal quality programs which include audits as one of their program elements require the audit to be performed using a checklist or procedures to document what the auditor reviewed and what he or she found. It is the intent of this paper to provide the reader with the some insight as to the value of the checklist; the varieties of checklists that can be constructed; the pitfalls of improper application; and the success that can be achieved when the checklist has been properly researched, developed, and deployed.

  9. Realization rates of the National Energy Audit

    SciTech Connect

    Berry, L.G.; Gettings, M.B.

    1998-11-01

    Engineering estimates of savings resulting from installation of energy conservation measures in homes are often greater than the savings actually realized. A brief review of prior studies of realization rates prefaces this study of rates from an engineering audit tool, NEAT, (developed for the Department of Energy`s Low-Income Weatherization Assistance Program) used in a New York state utility`s low-income program. Estimates of metered and predicted savings are compared for 49 homes taken from a data base of homes that participated in the first year of the utility`s program. Average realization rates ranging from 57% to 69% result, depending on the data quality. Detailed examinations of two houses using an alternate engineering method, the DOE-2 computer program (considered an industry standard), seem to indicate that the low realization rates mainly result from factors other than inaccuracies in the audit`s internal algorithms. Causes of the low realization rates are examined, showing that the strongest single factor linked to the low rates in this study is the use of secondary heating fuels that supplement the primary heating fuel. This study, like the other similar studies, concludes that engineering estimates are valuable tools in determining ranked lists of cost-effective weatherization measures, but may not be accurate substitutes for measured results in evaluating program performance.

  10. Reliability of Japanese clinical trials estimated from GCP audit findings.

    PubMed

    Saito, K; Kodama, Y; Ono, S; Maida, C; Fujimura, A; Miyamoto, E

    2008-08-01

    To describe the reliability of Japanese clinical trials, we compared the results of a Good Clinical Practice (GCP) audit conducted between April 1997 and March 2000 (fiscal year (FY) 1997 - 1999) with those from April 2004 - March 2005 (FY2004). The number and proportion of various types of deficiencies described in GCP audit reports were compared between the 2 periods. The audit findings in the former period were based on official audits that covered 331 hospitals and 775 trials. The audits in the latter period targeted 114 hospitals and 189 trials. The inspection of former period was undertaken by the Organization for Pharmaceuticals Safety and Research (OPSR). On the other hand, the latter period was undertaken by the Pharmaceuticals and Medical Devices Agency (PMDA). The total number of deficiencies detected in GCP audits was 1,529 in the former 3-year period (FY1997 - 1999) and 819 in the latter period (FY2004). The total number of deficiencies detected and reported was more than 1.5-fold on an annual basis in the latter period. By category of deficiencies, the proportion of protocol deviations increased from 14.7 (225/1,529) to 45.7% (374/819), while the proportion of errors in case report forms (CRFs) decreased from 43.6 (666/ 1,529) to 27.1% (222/819). There were two remarkable changes in audit findings between FY1997 - 1999 and FY2004; the increase in the proportion of protocol deviations and the decrease in the proportion of CRF-related deficiencies. We think that in Japan the improvement of research environments is needed to provide reliable clinical data responsible for the regulatory standard of GCP. PMID:18793583

  11. Followup audit of the cask development program

    SciTech Connect

    Not Available

    1994-03-15

    The Department of Energy is responsible for developing a system for the transportation and storage of spent nuclear fuel generated by utility companies. To carry out this responsibility, the Department of Energy established the Office of Civilian Radioactive Waste Management (Waste Management Office). The Waste Management office began development of a series of new shipping casks to transport the spent fuel. The purpose of this audit was to review the current development status of the cask designs; compare the original milestone dates to current milestone dates; and review the program funds that have been used to date on the development of these casks. The Office of Inspector General audited the cask development program in 1987. The audit report (DOE/IG-0244), recommended that program management establish minimum criteria that each cask must meet to qualify for further development funding. Our followup audit found that this recommendation had not been adequately implemented. As a result, the Waste Management office will spend an estimated $143 million on the cask development program and receive only two cask designs that were originally scheduled to cost $26 million. Moreover, it is not certain, at this time, whether those two cask designs will eventually receive the Nuclear Regulatory Commission certification. Historically, the program has experienced slippage in milestone dates and steady increases in total cost. Management generally agreed with our current recommendations to establish formal contingency plans to counter further delays, develop current baselines and schedules in sufficient detail to adequately control cask development schedules and costs, and reevaluate the current status of the casks under development for the purpose of justifying further development. Management has proposed actions to correct the milestone date slippages and continued growth in the total cost of the program.

  12. Local, state governments get serious about energy audits

    SciTech Connect

    2009-08-15

    In June, the city of Austin, Texas, joined San Francisco and Berkeley, Calif., in requiring an energy audit before an owner can sell an existing home. The Austin ordinance, costing some $200-300 on average, applies to any single-family home older than 10 years and requires an audit of its air conditioning and heating system, insulation and air-tightness, among other things. The seller is obliged to provide the findings to potential buyers but is not obliged to necessarily fix any identified deficiencies. In contrast, the California cities, which pioneered a similar requirement in the 1980s, require sellers to fix recommended upgrades prior to selling the unit to a prospective buyer. Many cities around the country are looking into similar ordinances as an effective means of fixing leaking ducts, poorly installed and operating heating and cooling systems, and inadequate insulation that are prevalent in older homes.

  13. Audit Today, Revocation Tomorrow?

    PubMed

    Miserez, Kevin R

    2015-01-01

    Federal regulations grant the Centers for Medicare & Medicaid Services (CMS) the authority to revoke a healthcare provider's Medicare billing privileges for submitting claims for services that could not have been provided on the purported date of service, such as billing for deceased beneficiaries. A Final Rule became effective in 2015 extending the authority of CMS to revoke a provider's billing privileges if CMS determines that the provider has a pattern or practice of billing for services that do not meet Medicare requirements. Violations under the Final Rule include situations in which a provider regularly and repeatedly submits claims for medically unnecessary services. While historically a provider's noncompliance exposed the provider to overpayment refund demands resulting from CMS audit activity, this new revocation authority emphasizes an even greater need for providers to ensure their billing and documentation practices are in compliance with Medicare reimbursement requirements. PMID:26665474

  14. A 4-year prospective evaluation of protocols to improve clinical outcomes for patients with lymphangioleiomyomatosis in a national clinical centre.

    PubMed

    Bee, Janet; Bhatt, Rupesh; McCafferty, Ian; Johnson, Simon R

    2015-12-01

    Lymphangioleiomyomatosis (LAM) is a rare multisystem disease. Progressive airflow limitation, pneumothorax and angiomyolipoma-related bleeding are major morbidities. As treatments are available for these complications, we prospectively audited loss of FEV1 (ΔFEV1), pneumothorax and angiomyolipoma bleeding against clinical standards over 4 years at the UK Clinical Centre. ΔFEV1 for these patients is lower than previously reported and rates of pneumothorax and angiomyolipoma haemorrhage are low. This suggests that real-time analysis of clinical data with targeted interventions can reduce morbidity in LAM. These measures could be applied as quality standards to compare the emerging LAM clinical networks worldwide. PMID:26123659

  15. The health care market audit.

    PubMed

    Macstravic, R E

    1978-10-01

    With marketing increasingly being accepted as a mechanism by which hospitals can more effectively meet community needs, a hospital can begin a marketing program by auditing its markets. This involves identifying, collecting, and evaluating information. PMID:689659

  16. A prospective, randomised comparative study of weekly versus biweekly application of dehydrated human amnion/chorion membrane allograft in the management of diabetic foot ulcers

    PubMed Central

    Zelen, Charles M; Serena, Thomas E; Snyder, Robert J

    2014-01-01

    The aim of this study is to determine if weekly application of dehydrated human amnion/chorion membrane allograft reduce time to heal more effectively than biweekly application for treatment of diabetic foot ulcers. This was an institutional review board-approved, registered, prospective, randomised, comparative, non-blinded, single-centre clinical trial. Patients with non-infected ulcers of ≥ 4 weeks duration were included for the study. They were randomised to receive weekly or biweekly application of allograft in addition to a non-adherent, moist dressing with compressive wrapping. All wounds were offloaded. The primary study outcome was mean time to healing. Overall, during the 12-week study period, 92·5% (37/40) ulcers completely healed. Mean time to complete healing was 4·1 ± 2·9 versus 2·4 ± 1·8 weeks (P = 0·039) in the biweekly versus weekly groups, respectively. Complete healing occurred in 50% versus 90% by 4 weeks in the biweekly and weekly groups, respectively (P = 0·014). Number of grafts applied to healed wounds was similar at 2·4 ± 1·5 and 2·3 ± 1·8 for biweekly versus weekly groups, respectively (P = 0·841). These results validate previous studies showing that the allograft is an effective treatment for diabetic ulcers and show that wounds treated with weekly application heal more rapidly than with biweekly application. More rapid healing may decrease clinical operational costs and prevent long-term medical complications. PMID:24618401

  17. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG

    PubMed Central

    Fudge, Jessie; Harmon, Kimberly G; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Asif, Irfan M; Haruta, Alison; Pelto, Hank; Rao, Ashwin L; Toresdahl, Brett G; Drezner, Jonathan A

    2015-01-01

    Background This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. Methods Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). Results From September 2010 to July 2011, 1339 participants underwent screening: age 13–24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/ 916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. Conclusions A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA. PMID:24948082

  18. A prospective, randomised comparative study of weekly versus biweekly application of dehydrated human amnion/chorion membrane allograft in the management of diabetic foot ulcers.

    PubMed

    Zelen, Charles M; Serena, Thomas E; Snyder, Robert J

    2014-04-01

    The aim of this study is to determine if weekly application of dehydrated human amnion/chorion membrane allograft reduce time to heal more effectively than biweekly application for treatment of diabetic foot ulcers. This was an institutional review board-approved, registered, prospective, randomised, comparative, non-blinded, single-centre clinical trial. Patients with non-infected ulcers of ≥ 4 weeks duration were included for the study. They were randomised to receive weekly or biweekly application of allograft in addition to a non-adherent, moist dressing with compressive wrapping. All wounds were offloaded. The primary study outcome was mean time to healing. Overall, during the 12-week study period, 92·5% (37/40) ulcers completely healed. Mean time to complete healing was 4·1 ± 2·9 versus 2·4 ± 1·8 weeks (P = 0·039) in the biweekly versus weekly groups, respectively. Complete healing occurred in 50% versus 90% by 4 weeks in the biweekly and weekly groups, respectively (P = 0·014). Number of grafts applied to healed wounds was similar at 2·4 ± 1·5 and 2·3 ± 1·8 for biweekly versus weekly groups, respectively (P = 0·841). These results validate previous studies showing that the allograft is an effective treatment for diabetic ulcers and show that wounds treated with weekly application heal more rapidly than with biweekly application. More rapid healing may decrease clinical operational costs and prevent long-term medical complications. PMID:24618401

  19. Embolization of the Gastroduodenal Artery Before Selective Internal Radiotherapy: A Prospectively Randomized Trial Comparing Standard Pushable Coils with Fibered Interlock Detachable Coils

    SciTech Connect

    Dudeck, Oliver Bulla, Karsten; Wieners, Gero; Ruehl, Ricarda; Ulrich, Gerd; Amthauer, Holger; Ricke, Jens; Pech, Maciej

    2011-02-15

    The purpose of this study was compare embolization of the gastroduodenal artery (GDA) using standard pushable coils with the Interlock detachable coil (IDC), a novel fibered mechanically detachable long microcoil, in patients scheduled for selective internal radiotherapy (SIRT). Fifty patients (31 male and 19 female; median age 66.6 {+-} 8.1 years) were prospectively randomized for embolization using either standard coils or IDCs. Procedure time, radiation dose, number of embolization devices, complications, and durability of vessel occlusion at follow-up angiography were recorded. The procedures differed significantly in time (14:32 {+-} 5:56 min for standard coils vs. 2:13 {+-} 1:04 min for IDCs; p < 0.001); radiation dose for coil deployment (2479 {+-} 1237 cGycm Superscript-Two for standard coils vs. 275 {+-} 268 cGycm Superscript-Two for IDCs; p < 0.001); and vessel occlusion (17:18 {+-} 6:39 min for standard coils vs. 11:19 {+-} 7:54 min for IDCs; p = 0.002). A mean of 6.2 {+-} 1.8 coils (n = 27) were used in the standard coil group, and 1.3 {+-} 0.9 coils (p < 0.0001) were used in the IDC group (n = 23) because additional pushable coils were required to achieve GDA occlusion in 4 patients. In 2 patients, the IDC could not be deployed through a Soft-VU catheter. One standard coil dislodged in the hepatic artery and was retrieved. Vessel reperfusion was noted in only 1 patient in the standard coil group. Controlled embolization of the GDA with fibered IDCs was achieved more rapidly than with pushable coils. However, vessel occlusion may not be obtained using a single device only, and the use of sharply angled guiding catheters hampered coil pushability.

  20. Research audit and publication.

    PubMed

    Pollard, Brian J

    2006-12-01

    The ethics of research, audit and publication have developed mainly within the last fifty years. The Declaration of Helsinki is the universally accepted code of conduct for researchers worldwide. All research has to be approved by an ethics committee, all of which are governed by a centralised structure which is the Central Office for Research Ethics Committees (COREC) in the UK. This standardised system has been developed to oversee all research activity across the whole of Europe and every European county will have an equivalent organisation. The committees concern themselves with research but the differences between audit and research are difficult to discern in many places. If there is any doubt then the advice of the local research ethics committee should be sought. Only the individual him/herself can give consent. This may produce difficulties in cases of certain groups especially unconscious patients and children. The outcome of every study should be published whatever the results and the ongoing development of centralised (national) research trial databases will promote this philosophy. Publication of results thought to be of lesser importance may prove difficult, however, and so there is a temptation to falsify or modify data to make it more attractive. This, together with other activities such as the fabrication of data, plagiarism, dual publication, salami publication, conflicts of interest and irregularities in authorship, have given Editors of journals a number of problems. Many of these issues around publication ethics may prove difficult to detect but the fear of sanctions from employers and professional organisations is a useful deterrent. PMID:17219948

  1. Software Assists in Extensive Environmental Auditing

    NASA Technical Reports Server (NTRS)

    Callac, Christopher; Matherne, Charlie

    2003-01-01

    The Base Environmental Management System (BEMS) is a Web-based application program for managing and tracking audits by the Environmental Office of Stennis Space Center in conformity with standard 14001 of the International Organization for Standardization (ISO 14001). (This standard specifies requirements for an environmental-management system.) BEMS saves time by partly automating what were previously manual processes for creating audit checklists; recording and tracking audit results; issuing, tracking, and implementing corrective-action requests (CARs); tracking continuous improvements (CIs); and tracking audit results and statistics. BEMS consists of an administration module and an auditor module. As its name suggests, the administration module is used to administer the audit. It helps administrators to edit the list of audit questions; edit the list of audit locations; assign mandatory questions to locations; track, approve, and edit CARs; and edit completed audits. The auditor module is used by auditors to perform audits and record audit results: it helps the auditors to create audit checklists, complete audits, view completed audits, create CARs, record and acknowledge CIs, and generate reports from audit results.

  2. Software Assists in Extensive Environmental Auditing

    NASA Technical Reports Server (NTRS)

    Callac, Christopher; Matherne, Charlie

    2002-01-01

    The Base Enivronmental Management System (BEMS) is a Web-based application program for managing and tracking audits by the Environmental Office of Stennis Space Center in conformity with standard 14001 of the International Organization for Standardization (ISO 14001). (This standard specifies requirements for an environmental-management system.) BEMS saves time by partly automating what were previously manual processes for creating audit checklists; recording and tracking audit results; issuing, tracking, and implementing corrective-action requests (CARs); tracking continuous improvements (CIs); and tracking audit results and statistics. BEMS consists on an administration module and an auditor module. As its name suggests, the administration module is used to administer the audit. It helps administrators to edit the list of audit questions; edit the list of audit locations; assign manditory questions to locations; track, approve, and edit CARs; and edit completed audits. The auditor module is used by auditors to perform audits and record audit results: It helps the auditors to create audit checklists, complete audits, view completed audits, create CARs, record and acknowledge CIs, and generate reports from audit results.

  3. Software Assists in Extensive Environmental Auditing

    NASA Technical Reports Server (NTRS)

    Callac, Christopher; Matherne, Charlie; Selinsky, T.

    2002-01-01

    The Base Environmental Management System (BEMS) is a Web-based application program for managing and tracking audits by the Environmental Office of Stennis Space Center in conformity with standard 14001 of the International Organization for Standardization (ISO 14001). (This standard specifies requirements for an environmental-management system.) BEMS saves time by partly automating what were previously manual processes for creating audit checklists; recording and tracking audit results; issuing, tracking, and implementing corrective-action requests (CARs); tracking continuous improvements (CIs); and tracking audit results and statistics. BEMS consists of an administration module and an auditor module. As its name suggests, the administration module is used to administer the audit. It helps administrators to edit the list of audit questions; edit the list of audit locations; assign mandatory questions to locations; track, approve, and edit CARs; and edit completed audits. The auditor module is used by auditors to perform audits and record audit results: it helps the auditors to create audit checklists, complete audits, view completed audits, create CARs, record and acknowledge CIs, and generate reports from audit results.

  4. TECHNICAL ASSISTANCE DOCUMENT, PERFORMANCE AUDIT PROCEDURES FOR OPACITY MONITORS

    EPA Science Inventory

    This manual contains monitor-specific performance audIt procedures and data forms for use in conducting audits of installed continuous opacity monitoring systems (COMSs). eneral auditing procedure and acceptance criteria for various audit criteria are delineated. Practical consid...

  5. Are RCS energy audits valid

    SciTech Connect

    Hirst, E.; Goeltz, R.

    1984-07-01

    The major goal of the federal Residential Conservation Service (RCS) is to improve the energy efficiency of existing homes (US Department of Energy, 1982). Its main feature is an on-site home energy audit (Oak Ridge National Laboratory, 1983). Information collected during the audit is combined with engineering calculations to develop recommendations to the household on conservation practices and measures to reduce home energy use. A major premise of the RCS (and of other similar home energy audit programs) is that provision of accurate site-specific information concerning energy conservation potentials and their costs will motivate households to adopt at least some of the suggested actions. Unfortunately, little information is available concerning the accuracy of these energy audits or the energy savings actually achieved by households after adoption of practices and measures. Data collected during a recent evaluation of the Minnesota RCS program (Hirst et al., 1983) are sufficient to allow examination and analysis of actual energy savings and of the relationship between actual savings and audit predictions of savings. The program, operated by Northern States Power in the southern half of the state, is part of Minnesota's version of the federal Residential Conservation Service. NSP conducted almost 12,000 RCS audits between April 1981 (when the program began) and the end of 1982. The Minnesota effort is evaluated to estimate energy savings of the program and evaluate the cost-effectiveness of Residential Conservation Service.

  6. Embolization of the Gastroduodenal Artery Before Selective Internal Radiotherapy: A Prospectively Randomized Trial Comparing Platinum-Fibered Microcoils with the Amplatzer Vascular Plug II

    SciTech Connect

    Pech, Maciej Kraetsch, Annett; Wieners, Gero; Redlich, Ulf; Gaffke, Gunnar; Ricke, Jens; Dudeck, Oliver

    2009-05-15

    The Amplatzer Vascular Plug II (AVP II) is a novel device for transcatheter vessel occlusion, for which only limited comparative data exist. Embolotherapy of the gastroduodenal artery (GDA) is essential before internal radiotherapy (SIRT) in order to prevent radiation-induced peptic ulcerations due to migration of yttrium-90 microspheres. The purpose of this study was to compare the vascular anatomical limitations, procedure time, effectiveness, and safety of embolization of the GDA with coils versus the AVP II. Fifty patients stratified for SIRT were prospectively randomized for embolization of the GDA with either coils or the AVP II. The angle between the aorta and the celiac trunk, diameter of the GDA, fluoroscopy time and total time for embolization, number of embolization devices, complications, and durability of vessel occlusion at follow-up angiography for SIRT were recorded. A t-test was used for statistical analysis. Embolizations with either coils or the AVP II were technically feasible in all but two patients scheduled for embolization of the GDA with the AVP II. In both cases the plug could not be positioned due to the small celiac trunk outlet angles of 17{sup o} and 21{sup o}. The mean diameter of the GDA was 3.7 mm (range, 2.2-4.8 mm) for both groups. The procedures differed significantly in fluoroscopy time (7.8 min for coils vs. 2.6 min for the AVP II; P < 0.001) and embolization time (23.1 min for coils vs. 8.8 min for the AVP II; P < 0.001). A mean of 6.0 {+-} 3.2 coils were used for GDA embolization, while no more than one AVP II was needed for successful vessel occlusion (P < 0.001). One coil migration occurred during coil embolization, whereas no procedural complication was encountered with the use of the AVP II. Vessel reperfusion was noted in only one patient, in whom coil embolization was performed. In conclusion, embolization of the GDA with the AVP II is safe, easy, rapid, and highly effective; only an extremely sharp-angled celiac trunk

  7. A prospective, randomized, controlled trial comparing the effects of noncontact, low-frequency ultrasound to standard care in healing venous leg ulcers.

    PubMed

    Gibbons, Gary W; Orgill, Dennis P; Serena, Thomas E; Novoung, Aksone; O'Connell, Jessica B; Li, William W; Driver, Vickie R

    2015-01-01

    Current scientific evidence suggests venous leg ulcers (VLUs) that do not respond to guideline-defined care may have a wound microenvironment that is out of physiological balance. A prospective, randomized, controlled, multicenter trial was conducted to compare percent wound size reduction, proportions healed, pain, and quality-of-life (QOL) outcomes in patients randomized to standard care (SC) alone or SC and 40 kHz noncontact, low-frequency ultrasound (NLFU) treatments 3 times per week for 4 weeks. One hundred, twelve (112) eligible participants with documented venous stasis, a VLU >30 days' duration, measuring 4 cm2 to 50 cm2, and demonstrated arterial flow were enrolled. Of these, 81 reduced <30% in size during the 2-week run-in study phase and were randomized (SC, n = 40; NLFU+SC, n = 41). Median age of participants was 59 years; 83% had multiple complex comorbidities. Index ulcers were 56% recurrent, with a median duration of 10.3 months (range 1 month to 204.5 months) and median ulcer area of 11.0 cm2 (range 3.7 cm2-41.3 cm2). All participants received protocol-defined SC compression (30-40 mm Hg), dressings to promote a moist wound environment, and sharp debridement at the bedside for a minimum of 1 time per week. Ulcer measurements were obtained weekly using digital planimetry. Pain and QOL scores were assessed at baseline and after 4 weeks of treatment using the Visual Analog Scale and the Short Form-36 Health Survey. After 4 weeks of treatment, average wound size reduction was 61.6% ± 28.9 in the NLFU+SC compared to 45% ± 32.5 in the SC group (P = 0.02). Reductions in median (65.7% versus 44.4%, P = 0.02) and absolute wound area (9.0 cm2 versus 4.1 cm2, P = 0.003) as well as pain scores (from 3.0 to 0.6 versus 3.0 to 2.4, P = 0.01) were also significant. NLFU therapy with guideline-defined standard VLU care should be considered for healing VLUs not responding to SC alone. The results of this study warrant further research on barriers to healing and the

  8. Comparative Prospective Study of Load Distribution Projection Among Patients with Vertebral Fractures Treated with Percutaneous Vertebroplasty and a Control Group of Healthy Volunteers

    SciTech Connect

    Kelekis, Alexios Filippiadis, Dimitrios K. Vergadis, Chrysovalantis Tsitskari, Maria Nasis, Nikolaos Malagari, Aikaterini Kelekis, Nikolaos

    2013-04-12

    PurposeThrough a prospective comparison of patients with vertebral fractures and normal population, we illustrate effect of percutaneous vertebroplasty (PV) upon projection of load distribution changes.MethodsVertebroplasty group (36 symptomatic patients with osteoporotic vertebral fractures) was evaluated on an electronic baropodometer registering projection of weight bearing areas on feet. Load distribution between right and left foot (including rear-front of the same foot) during standing and walking was recorded and compared before (group V1) and the day after (group V2) PV. Control group (30 healthy asymptomatic volunteers-no surgery record) were evaluated on the same baropodometer.ResultsMean value of load distribution difference between rear-front of the same foot was 9.45 ± 6.79 % (54.72–45.28 %) upon standing and 14.76 ± 7.09 % (57.38–42.62 %) upon walking in the control group. Respective load distribution values before PV were 16.52 ± 11.23 and 30.91 ± 19.26 % and after PV were 10.08 ± 6.26 and 14.25 ± 7.68 % upon standing and walking respectively. Mean value of load distribution variation between the two feet was 6.36 and 14.6 % before and 4.62 and 10.4 % after PV upon standing and walking respectively. Comparison of load distribution variation (group V1–V2, group V1-control group) is statistically significant. Comparison of load distribution variation (group V2-control group) is not statistically significant. Comparison of load distribution variation among the two feet is statistically significant during walking but not statistically significant during standing.ConclusionsThere is a statistically significant difference when comparing load distribution variation prior vertebroplasty and that of normal population. After vertebroplasty, this difference normalizes in a statistically significant way. PV is efficient on equilibrium-load distribution improvement as well.

  9. 12 CFR 1710.18 - Change of audit partner.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Change of audit partner. 1710.18 Section 1710... audit partner. An Enterprise may not accept audit services from an external auditing firm if the lead or coordinating audit partner who has primary responsibility for the external audit of the Enterprise, or...

  10. 12 CFR 1710.18 - Change of audit partner.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Change of audit partner. 1710.18 Section 1710... audit partner. An Enterprise may not accept audit services from an external auditing firm if the lead or coordinating audit partner who has primary responsibility for the external audit of the Enterprise, or...

  11. 38 CFR 41.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Relation to other audit... other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required under individual Federal awards. To...

  12. 38 CFR 41.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Relation to other audit... other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required under individual Federal awards. To...

  13. 12 CFR 1710.18 - Change of audit partner.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Change of audit partner. 1710.18 Section 1710... audit partner. An Enterprise may not accept audit services from an external auditing firm if the lead or coordinating audit partner who has primary responsibility for the external audit of the Enterprise, or...

  14. 38 CFR 41.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Relation to other audit... other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required under individual Federal awards. To...

  15. 12 CFR 1710.18 - Change of audit partner.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Change of audit partner. 1710.18 Section 1710... audit partner. An Enterprise may not accept audit services from an external auditing firm if the lead or coordinating audit partner who has primary responsibility for the external audit of the Enterprise, or...

  16. 2 CFR 200.503 - Relation to other audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Relation to other audit requirements. 200... PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS Audit Requirements Audits § 200.503 Relation to other audit requirements. (a) An audit conducted in accordance with this part must be in lieu of any...

  17. 38 CFR 41.215 - Relation to other audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Relation to other audit... other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance with this part shall be in lieu of any financial audit required under individual Federal awards. To...

  18. 45 CFR 201.12 - Public assistance audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... representatives of the Audit Agency of the Department. Such audits are made to determine whether the State agency...) Reports of these audits are released by the Audit Agency simultaneously to program officials of the Department, and to the cognizant State officials. These audit reports relate the opinion of the Audit...

  19. 2 CFR 200.507 - Program-specific audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... MANAGEMENT AND BUDGET GUIDANCE Reserved UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS Audit Requirements Audits § 200.507 Program-specific audits. (a) Program-specific audit guide available. In many cases, a program-specific audit guide will be available to...

  20. 47 CFR 53.213 - Audit analysis and evaluation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... auditor shall submit a draft of the audit report to the Federal/State joint audit team. (1) The Federal/State joint audit team shall have 45 days to review the audit findings and audit workpapers, and offer... auditor. Exceptions of the Federal/State joint audit team to the finding and conclusions of...

  1. Treatment of chronic diabetic lower extremity ulcers with advanced therapies: a prospective, randomised, controlled, multi-centre comparative study examining clinical efficacy and cost.

    PubMed

    Zelen, Charles M; Serena, Thomas E; Gould, Lisa; Le, Lam; Carter, Marissa J; Keller, Jennifer; Li, William W

    2016-04-01

    Advanced therapies such as bioengineered skin substitutes (BSS) and dehydrated human amnion/chorion membrane (dHACM) have been shown to promote healing of chronic diabetic ulcers. An interim analysis of data from 60 patients enrolled in a prospective, randomised, controlled, parallel group, multi-centre clinical trial showed that dHACM (EpiFix®, MiMedx Group Inc., Marietta, GA) is superior to standard wound care (SWC) and BSS (Apligraf®, Organogenesis, Inc., Canton, MA) in achieving complete wound closure within 4-6 weeks. Rates and time to closure at a longer time interval and factors influencing outcomes remained unassessed; therefore, the study was continued in order to achieve at least 100 patients. With the larger cohort, we compare clinical outcomes at 12 weeks in 100 patients with chronic lower extremity diabetic ulcers treated with weekly applications of Apligraf (n = 33), EpiFix (n = 32) or SWC (n = 35) with collagen-alginate dressing as controls. A Cox regression was performed to analyse the time to heal within 12 weeks, adjusting for all significant covariates. A Kaplan-Meier analysis was conducted to compare time-to-heal within 12 weeks for the three treatment groups. Clinical characteristics were well matched across study groups. The proportion of wounds achieving complete closure within the 12-week study period were 73% (24/33), 97% (31/32), and 51% (18/35) for Apligraf, EpiFix and SWC, respectively (adjusted P = 0·00019). Subjects treated with EpiFix had a very significant higher probability of their wounds healing [hazard ratio (HR: 5·66; adjusted P: 1·3 x 10(-7) ] compared to SWC alone. No difference in probability of healing was observed for the Apligraf and SWC groups. Patients treated with Apligraf were less likely to heal than those treated with EpiFix [HR: 0·30; 95% confidence interval (CI): 0·17-0·54; unadjusted P: 5·8 x 10(-5) ]. Increased wound size and presence of hypertension were significant factors that influenced healing. Mean

  2. Improvement in fresh frozen plasma transfusion practice: results of an outcome audit.

    PubMed

    Kakkar, N; Kaur, R; Dhanoa, J

    2004-06-01

    Blood components have been in use in clinical practice for many decades now. In spite of fairly clear guidelines regarding their use, inappropriate prescriptions for components are still rampant. We undertook this work to assess the appropriateness of fresh frozen plasma (FFP) transfusions in our hospital. A prospective audit of 504 transfusion orders for 1761 FFP units was conducted over a 6-month period which was followed by a re-audit of 294 FFP prescriptions for 961 units. In the initial audit, we identified 304 (60.3%) prescriptions which were inappropriate according to the British Committee for Standardization in Hematology (BCSH) guidelines. The re-audit performed after an educational campaign among clinicians showed a reduction in inappropriate requests by 26.6%. The specific areas of misuse were FFP transfusions in patients with hypoproteinaemic states (40.5%), anaemia (36.5%), bleeding without coagulation factor deficiency (10.2%) and volume depletion (9.2%). A significant 50.3% of requests in the initial audit and 38.4% in the re-audit were for single- or two-unit transfusions, which were subtherapeutic. FFP transfusions carry the same risks to the patients as any other blood component. Prescribers of these transfusions need to be aware of the clinical setting where their use is appropriate. Local hospital transfusion committees can play a vital role in overseeing transfusion practices to ensure optimal use of blood/component therapy. PMID:15180815

  3. Assessing Understanding of the Concept of Function: A Study Comparing Prospective Secondary Mathematics Teachers' Responses to Multiple-Choice and Constructed-Response Items

    ERIC Educational Resources Information Center

    Feeley, Susan Jane

    2013-01-01

    The purpose of this study was to determine whether multiple-choice and constructed-response items assessed prospective secondary mathematics teachers' understanding of the concept of function. The conceptual framework for the study was the Dreyfus and Eisenberg (1982) Function Block. The theoretical framework was Sierpinska's (1992, 1994)…

  4. Low-Cost Audit Resource: Student Audits Are a Win-Win Proposition.

    ERIC Educational Resources Information Center

    Lightle, Susan S.; Timm, Teresa

    1997-01-01

    Discusses the use of undergraduate accounting students to assist the one-person internal audit department at Wright State University in Dayton, Ohio, in conducting a low-cost audit of the school. The audit, conducted as part of the accounting department's Auditing II course, helped students develop interviewing and documentation skills and…

  5. 34 CFR 668.23 - Compliance audits and audited financial statements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... purpose financial statements. (3) Third-party servicers. Except as provided under this part or 34 CFR part... 34 Education 3 2012-07-01 2012-07-01 false Compliance audits and audited financial statements. 668... Standards for Participation in Title IV, HEA Programs § 668.23 Compliance audits and audited...

  6. 34 CFR 668.23 - Compliance audits and audited financial statements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... purpose financial statements. (3) Third-party servicers. Except as provided under this part or 34 CFR part... 34 Education 3 2011-07-01 2011-07-01 false Compliance audits and audited financial statements. 668... Standards for Participation in Title IV, HEA Programs § 668.23 Compliance audits and audited...

  7. 34 CFR 668.23 - Compliance audits and audited financial statements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... purpose financial statements. (3) Third-party servicers. Except as provided under this part or 34 CFR part... 34 Education 3 2013-07-01 2013-07-01 false Compliance audits and audited financial statements. 668... Standards for Participation in Title IV, HEA Programs § 668.23 Compliance audits and audited...

  8. Comparative Long-Term Effectiveness of a Monotherapy with Five Antiepileptic Drugs for Focal Epilepsy in Adult Patients: A Prospective Cohort Study

    PubMed Central

    Zhu, Pan; He, Ru-Qian; Bao, Yi-Xin; Zheng, Rong-Yuan; Xu, Hui-Qin

    2015-01-01

    Objective To evaluate and compare long-term effectiveness of five antiepileptic drugs (AEDs) for monotherapy of adult patients with focal epilepsy in routine clinical practice. Methods Adult patients with focal epilepsy, who were prescribed with carbamazepine (CBZ), valproate (VPA), lamotrigine (LTG), topiramate (TPM), or oxcarbazepine (OXC) as monotherapy, during the period from January 2004 to June 2012 registered in Wenzhou Epilepsy Follow Up Registry Database (WEFURD), were included in the study. Prospective long-term follow-up was conducted until June 2013. The endpoints were time to treatment failure, time to seizure remission, and time to first seizure. Results This study included 654 patients: CBZ (n=125), VPA (n=151), LTG (n=135), TPM (n=76), and OXC (n=167). The retention rates of CBZ, VPA, LTG, TPM, and OXC at the third year were 36.1%, 32.4%, 57.6%, 37.9%, and 41.8%, respectively. For time to treatment failure, LTG was significantly better than CBZ and VPA (LTG vs. CBZ, hazard ratio, [HR] 0.80 [95% confidence interval: 0.67-0.96], LTG vs. VPA, 0.53 [0.37-0.74]); TPM was worse than LTG (TPM vs. LTG, 1.77 [1.15-2.74]), and OXC was better than VPA (0.86 [0.78-0.96]). After initial target doses, the seizure remission rates of CBZ, VPA, LTG, TPM, and OXC were 63.0%, 77.0%, 83.6%, 67.9%, and 75.3%, respectively. LTG was significantly better than CBZ (1.44 [1.15-1.82]) and OXC (LTG vs. OXC, 0.76 [0.63-0.93]); OXC was less effective than LTG in preventing the first seizure (1.20 [1.02-1.40]). Conclusion LTG was the best, OXC was better than VPA only, while VPA was the worst. The others were equivalent for comparisons between five AEDs regarding the long-term treatment outcomes of monotherapy for adult patients with focal epilepsy in a clinical practice. For selecting AEDs for these patients among the first-line drugs, LTG is an appropriate first choice; others are reservation in the first-line but VPA is not. PMID:26147937

  9. Continuous epidural block versus continuous popliteal nerve block for postoperative pain relief after major podiatric surgery in children: a prospective, comparative randomized study.

    PubMed

    Dadure, Christophe; Bringuier, Sophie; Nicolas, Florence; Bromilow, Luke; Raux, Olivier; Rochette, Alain; Capdevila, Xavier

    2006-03-01

    Foot and ankle surgery in children is very painful postoperatively. Adverse effects from opioids and continuous epidural block (CEB) limit their use in children. Continuous popliteal nerve blocks (CPNB) have not been studied for this indication in children. In this prospective, randomized study we evaluated the effectiveness and adverse events of CPNB or CEB in children after podiatric surgery. Fifty-two children scheduled for foot surgery were separated into four groups by age and analgesia technique. After general anesthesia, 0.5 to 1 mL/kg of an equal-volume mixture of 0.25% bupivacaine and 1% lidocaine with 1:200000 epinephrine was injected via epidural or popliteal catheters. In the postoperative period, 0.1 mL x kg(-1) x h(-1) (group CPNB) or 0.2 mL x kg(-1) x h(-1) (group CEB) of 0.2% ropivacaine was administered for 48 h. Niflumic acid was routinely used. Adverse events were noted in each treatment group. Postoperative pain during motion was evaluated at 1, 6, 12, 18, 24, 36, and 48 h. Requirement for rescue analgesia (first-line propacetamol 30 mg/kg 4 times daily or second-line 0.2 mg/kg IV nalbuphine), and motor blockade were recorded. Parental satisfaction was noted at 48 h. Twenty-seven patients were included in the CEB groups and 25 in CPNB groups. There were 32 children 1 to 6 yr of age (CPNB = 15; CEB = 17) and 20 children 7 to 12 yr of age (CPNB = 10; CEB = 10). The demographic data were comparable among groups. Postoperative analgesia was excellent for the two continuous block techniques and in the two age groups. Motor block intensity was equal between techniques. Adverse events (postoperative nausea or vomiting, urinary retention, and premature discontinuation of local anesthetic infusion in the 1- to 6-yr-old group) were significantly more frequent in the CEB group (P < 0.05). Eighty-six percent of the parents in the CEB groups and 100% in the CPNB groups were satisfied. We conclude that although both CEB and CPNB resulted in excellent

  10. An example of medical audit under political pressure.

    PubMed

    West, R R; Willis, J D

    1983-12-01

    Management of medical services necessitates decisions regarding the possibly ineffective treatment programmes, hospitals and (even) individual practitioners. Although rigorous evaluations of effectiveness can only be achieved by randomized trials there has been, in recent years, much increase in audit (or peer review) activity. Ideally medical audit is undertaken as a collaborative exercise, and follows preplanned methods of data collection and evaluation of outcome. However, real management situations frequently do not conform to the ideal, as when the medico-political finger of accusation points at one particular hospital and asks for an immediate enquiry. This audit analyses the mortality and morbidity after coronary artery bypass graft surgery in the 'suspect' hospital and in control hospitals. The paper describes the difficulties of obtaining comparable records post hoc and the interpretations of small differences, mostly non-significant statistically yet possibly 'real', both in the characteristics of patients operated on and in the outcomes of operations. PMID:6606630

  11. Your District Deserves an Audit Committee

    ERIC Educational Resources Information Center

    Schaupp, Frederick W.; Maust, Robert S.

    1974-01-01

    A school district audit committee has the capacity to unearth pertinent information about the operating efficiency and effectiveness of a school district, as well as providing a more professional audit. (Author/WM)

  12. 50 CFR 401.23 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A ANADROMOUS FISHERIES CONSERVATION, DEVELOPMENT AND ENHANCEMENT § 401.23 Audits. The State is required to conduct an audit at least every two years in...

  13. Links between clinical audit and contracting systems.

    PubMed

    Lord, J; Littlejohns, P

    1995-01-01

    In 1989, a programme of clinical audit was introduced throughout the UK National Health Service (NHS), in an attempt to improve care through the application of quality methodology to clinical issues. However, the role of clinical audit in the new NHS "internal market" is unclear. Reviews evidence on the development of audit and concludes that it has operated largely in isolation, under professional control. Central policy is now advocating greater purchaser and provider management involvement in audit, enabling feedback from and to service provision and management decisions. Where there are constructive local relationships the opening up of audit should be beneficial, but these do not always exist. Discusses a range of models for the interaction of clinical audit with wider NHS management systems. Recommends a split system of professionally controlled background audit and collaborative shared audits to balance conflicting goals. PMID:10143993

  14. 20 CFR 637.310 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TRAINING PARTNERSHIP ACT Additional Title V Administrative Standards and Procedures § 637.310 Audits. The Governor shall ensure that the State complies with the audit provisions at § 629.480 of this chapter....

  15. 11 CFR 9008.13 - Additional audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Convention Committees § 9008.13 Additional audits. In accordance with 11 CFR 104.16(c), the Commission, pursuant to 11 CFR 111.10, may upon affirmative vote of four members conduct an audit and...

  16. 11 CFR 9007.4 - Additional audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... FINANCING EXAMINATIONS AND AUDITS; REPAYMENTS § 9007.4 Additional audits. In accordance with 11 CFR 104.16(c), the Commission, pursuant to 11 CFR 111.10, may upon affirmative vote of four members conduct an...

  17. 11 CFR 9007.4 - Additional audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... FINANCING EXAMINATIONS AND AUDITS; REPAYMENTS § 9007.4 Additional audits. In accordance with 11 CFR 104.16(c), the Commission, pursuant to 11 CFR 111.10, may upon affirmative vote of four members conduct an...

  18. 11 CFR 9008.13 - Additional audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Convention Committees § 9008.13 Additional audits. In accordance with 11 CFR 104.16(c), the Commission, pursuant to 11 CFR 111.10, may upon affirmative vote of four members conduct an audit and...

  19. 11 CFR 9008.13 - Additional audits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Convention Committees § 9008.13 Additional audits. In accordance with 11 CFR 104.16(c), the Commission, pursuant to 11 CFR 111.10, may upon affirmative vote of four members conduct an audit and...

  20. 28 CFR 901.4 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to the provisions of part 901 and the FBI's CJIS Security Policy. (b) Authorized agencies shall cause... specified by the Compact Council. (d) In addition to the audits as stated above, the FBI CJIS Audit...

  1. 28 CFR 901.4 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... to the provisions of part 901 and the FBI's CJIS Security Policy. (b) Authorized agencies shall cause... specified by the Compact Council. (d) In addition to the audits as stated above, the FBI CJIS Audit...

  2. 28 CFR 901.4 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to the provisions of part 901 and the FBI's CJIS Security Policy. (b) Authorized agencies shall cause... specified by the Compact Council. (d) In addition to the audits as stated above, the FBI CJIS Audit...

  3. 28 CFR 901.4 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to the provisions of part 901 and the FBI's CJIS Security Policy. (b) Authorized agencies shall cause... specified by the Compact Council. (d) In addition to the audits as stated above, the FBI CJIS Audit...

  4. 28 CFR 901.4 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... to the provisions of part 901 and the FBI's CJIS Security Policy. (b) Authorized agencies shall cause... specified by the Compact Council. (d) In addition to the audits as stated above, the FBI CJIS Audit...

  5. Identifying best practices for audit committees.

    PubMed

    Burke, J V; Luecke, R W; Meeting, D

    1996-06-01

    Most healthcare organizations have an audit committee of the governing board, or a finance committee, that fulfills the audit oversight function. Financial managers play a key role in shaping the content, agency, and operation of the audit committee. The findings of a recent research study conducted by Arthur Anderson & Co., SC, into the best practices of audit committees have implications for healthcare organizations. PMID:10158244

  6. Overview of Auditing for the Busy Rheumatologist.

    PubMed

    Huffstutter, Jessica G; Huffstutter, J Eugene

    2016-06-01

    Medical audits have become commonplace in the United States. A variety of companies service government and private payers to document accuracy of medical services provided as reflected in the medical record. When audited, the physician may not understand the nature of the inquiry, jurisdictions, methods, or purpose. This article gives practicing rheumatologists a reference to learn the types of audits and suggests responses that should minimize the impact of the audit to the practice. PMID:27219307

  7. Basic Sequence Analysis Techniques for Use with Audit Trail Data

    ERIC Educational Resources Information Center

    Judd, Terry; Kennedy, Gregor

    2008-01-01

    Audit trail analysis can provide valuable insights to researchers and evaluators interested in comparing and contrasting designers' expectations of use and students' actual patterns of use of educational technology environments (ETEs). Sequence analysis techniques are particularly effective but have been neglected to some extent because of real…

  8. Auditing the management of hypertension in British general practice: a critical literature review.

    PubMed Central

    Cranney, M; Barton, S; Walley, T

    1998-01-01

    Hypertension is a common condition almost exclusively managed by general practitioners (GPs), making it an ideal subject for practice-based audit. However, the conduct and interpretation of such audits is complex. Even minor variations in methodology can produce dramatic differences in results obtained. We used a focus group of seven GPs with a special interest in audit to establish a standardized method for the planning and reporting of audits for the management of hypertension. In order to enhance the reliability and comparability of hypertension audits, 13 key areas of audit methodology were produced by the focus group. Eleven audits were identified in a literature search using pre-determined selection criteria. These were then assessed to compare their methodology with the criteria produced by the focus group. None of the recently published audits in this subject covered all of the key areas (range: 27-65% of the areas covered). One key area, that of digit preference, was not mentioned by any. Other problematic key areas included the selection of patient records without bias, the determination of the prevalence of hypertension, the number of recordings used to determine the diagnosis of hypertension and its subsequent control, the time period examined by the audit, and the approach taken to notes containing an inadequate number of blood pressure recordings. Significant variability in the methods used by different authors in these key areas calls into question the reliability of their results and makes comparisons between them very difficult. We propose a standardized method for hypertension audits comprising 13 key areas, which will enhance the reliability of results and facilitate such comparisons. PMID:9800405

  9. 12 CFR 1273.9 - Audit Committee.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Audit Committee. 1273.9 Section 1273.9 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS OFFICE OF FINANCE § 1273.9 Audit Committee. (a) Composition. The Independent Directors shall serve as the Audit Committee. The...

  10. 24 CFR 574.650 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... must provide for audits in accordance with 24 CFR part 44. A nonprofit organization that is a grantee or a project sponsor is subject to the audit requirements set forth in 24 CFR part 45. ... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Audit. 574.650 Section...

  11. 24 CFR 590.27 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., excerpts, and transcripts. (b) Audit. The LUHA's financial management system shall provide for audits in accordance with 24 CFR part 44. ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Audit. 590.27 Section...

  12. 7 CFR 735.403 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... authorized under §§ 735.401 and 735.402 must submit to FSA an annual audit level financial statement and an electronic data processing audit that meets the minimum requirements as provided in the applicable provider agreement. The electronic data processing audit will be used by DACO to evaluate current computer...

  13. 11 CFR 9038.1 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... audit and examination conducted under 11 CFR 9038.1(a) (1) and (2) may be used by the Commission as the... determination made by the Commission pursuant to 11 CFR 9038.2(c)(1). (2) The audit report may contain issues....C. 437g and 11 CFR part 111. (3) Addenda to the audit report may be approved and issued by...

  14. 24 CFR 574.650 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... must provide for audits in accordance with 24 CFR part 44. A nonprofit organization that is a grantee or a project sponsor is subject to the audit requirements set forth in 24 CFR part 45. ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Audit. 574.650 Section...

  15. 7 CFR 735.403 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... authorized under §§ 735.401 and 735.402 must submit to FSA an annual audit level financial statement and an electronic data processing audit that meets the minimum requirements as provided in the applicable provider agreement. The electronic data processing audit will be used by DACO to evaluate current computer...

  16. 12 CFR 917.7 - Audit committees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Audit committees. 917.7 Section 917.7 Banks and... RESPONSIBILITIES OF BANK BOARDS OF DIRECTORS AND SENIOR MANAGEMENT § 917.7 Audit committees. (a) Establishment. The board of directors of each Bank shall establish an audit committee, consistent with the requirements...

  17. 12 CFR 917.7 - Audit committees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Audit committees. 917.7 Section 917.7 Banks and... RESPONSIBILITIES OF BANK BOARDS OF DIRECTORS AND SENIOR MANAGEMENT § 917.7 Audit committees. (a) Establishment. The board of directors of each Bank shall establish an audit committee, consistent with the requirements...

  18. 45 CFR 96.31 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... the Single Audit Act Amendments of 1996 (31 U.S.C. 7501-7507) and revised OMB Circular A-133, “Audits... Single Audit Act Amendments of 1996, that provide Federal awards to a subgrantee, expending $300,000 or more (or other amount as specified by OMB) in Federal awards in a fiscal year, shall: (1)...

  19. 25 CFR 571.12 - Audit standards.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...,000,000 during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is... during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is satisfied... 25 Indians 2 2014-04-01 2014-04-01 false Audit standards. 571.12 Section 571.12 Indians...

  20. 29 CFR 99.200 - Audit requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Audit requirements. 99.200 Section 99.200 Labor Office of....200 Audit requirements. (a) Audit required. Non-Federal entities that expend $300,000 or more in a year in Federal awards (or $500,000 for fiscal years ending after December 31, 2003) shall have...

  1. 29 CFR 99.200 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirements. 99.200 Section 99.200 Labor Office of....200 Audit requirements. (a) Audit required. Non-Federal entities that expend $300,000 or more in a year in Federal awards (or $500,000 for fiscal years ending after December 31, 2003) shall have...

  2. 29 CFR 99.230 - Audit costs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... principles circulars, the Federal Acquisition Regulation (FAR)(48 CFR parts 30 and 31), or other applicable... 29 Labor 1 2013-07-01 2013-07-01 false Audit costs. 99.230 Section 99.230 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230...

  3. 29 CFR 99.200 - Audit requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Audit requirements. 99.200 Section 99.200 Labor Office of....200 Audit requirements. (a) Audit required. Non-Federal entities that expend $300,000 or more in a year in Federal awards (or $500,000 for fiscal years ending after December 31, 2003) shall have...

  4. 29 CFR 99.230 - Audit costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... principles circulars, the Federal Acquisition Regulation (FAR)(48 CFR parts 30 and 31), or other applicable... 29 Labor 1 2011-07-01 2011-07-01 false Audit costs. 99.230 Section 99.230 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230...

  5. 25 CFR 571.12 - Audit standards.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...,000,000 during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is... during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is satisfied... 25 Indians 2 2013-04-01 2013-04-01 false Audit standards. 571.12 Section 571.12 Indians...

  6. 29 CFR 99.230 - Audit costs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... principles circulars, the Federal Acquisition Regulation (FAR)(48 CFR parts 30 and 31), or other applicable... 29 Labor 1 2014-07-01 2013-07-01 true Audit costs. 99.230 Section 99.230 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230...

  7. 29 CFR 99.200 - Audit requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Audit requirements. 99.200 Section 99.200 Labor Office of....200 Audit requirements. (a) Audit required. Non-Federal entities that expend $300,000 or more in a year in Federal awards (or $500,000 for fiscal years ending after December 31, 2003) shall have...

  8. 29 CFR 99.230 - Audit costs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... principles circulars, the Federal Acquisition Regulation (FAR)(48 CFR parts 30 and 31), or other applicable... 29 Labor 1 2012-07-01 2012-07-01 false Audit costs. 99.230 Section 99.230 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230...

  9. 25 CFR 571.12 - Audit standards.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...,000,000 during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is... during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is satisfied... 25 Indians 2 2011-04-01 2011-04-01 false Audit standards. 571.12 Section 571.12 Indians...

  10. 25 CFR 571.12 - Audit standards.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...,000,000 during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is... during the prior fiscal year, the annual audit requirement of paragraph (b) of this section is satisfied... 25 Indians 2 2012-04-01 2012-04-01 false Audit standards. 571.12 Section 571.12 Indians...

  11. 29 CFR 99.200 - Audit requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 1 2012-07-01 2012-07-01 false Audit requirements. 99.200 Section 99.200 Labor Office of....200 Audit requirements. (a) Audit required. Non-Federal entities that expend $300,000 or more in a year in Federal awards (or $500,000 for fiscal years ending after December 31, 2003) shall have...

  12. 45 CFR 96.31 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the Single Audit Act Amendments of 1996 (31 U.S.C. 7501-7507) and revised OMB Circular A-133, “Audits... Single Audit Act Amendments of 1996, that provide Federal awards to a subgrantee, expending $300,000 or more (or other amount as specified by OMB) in Federal awards in a fiscal year, shall: (1)...

  13. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Auditing. 995.14 Section 995.14 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC... HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  14. 47 CFR 54.516 - Auditing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Auditing. 54.516 Section 54.516... SERVICE Universal Service Support for Schools and Libraries § 54.516 Auditing. (a) Recordkeeping... is set forth as follows: § 54.516 Auditing and inspections. (a) Recordkeeping...

  15. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Auditing. 995.14 Section 995.14 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC... HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  16. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Auditing. 995.14 Section 995.14 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC... HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  17. 15 CFR 995.14 - Auditing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Auditing. 995.14 Section 995.14 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC... HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED...

  18. 11 CFR 9007.4 - Additional audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... FINANCING EXAMINATIONS AND AUDITS; REPAYMENTS § 9007.4 Additional audits. In accordance with 11 CFR 104.16(c), the Commission, pursuant to 11 CFR 111.10, may upon affirmative vote of four members conduct an audit and field investigation of any committee in any case in which the Commission finds reason to...

  19. 38 CFR 41.505 - Audit reporting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit reporting. 41.505... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.505 Audit reporting. The... differently from the manner presented in this section. The auditor's report(s) shall state that the audit...

  20. 7 CFR 3052.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... for the purpose of reporting an audit finding is in relation to a type of compliance requirement for a major program or an audit objective identified in the compliance supplement. The auditor shall identify... type of compliance requirement for a major program or an audit objective identified in the...

  1. 10 CFR 603.1295 - Periodic audit.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Periodic audit. 603.1295 Section 603.1295 Energy... Used in this Part § 603.1295 Periodic audit. An audit of a participant, performed at an agreed-upon... Federal awards in compliance with the terms of those awards. Appendix A to this part describes what...

  2. 7 CFR 3052.505 - Audit reporting.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... § 3052.510(a). (i) Audit findings (e.g., internal control findings, compliance findings, questioned costs... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit reporting. 3052.505 Section 3052.505....505 Audit reporting. The auditor's report(s) may be in the form of either combined or separate...

  3. 38 CFR 41.230 - Audit costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., the Federal Acquisition Regulation (FAR) (48 CFR parts 30 and 31), or other applicable cost principles... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit costs. 41.230... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.230 Audit costs. (a)...

  4. 30 CFR 217.200 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... copies of audit reports that express opinions on such compliance to the Associate Director for Minerals... INSPECTIONS Coal § 217.200 Audits. An audit of the accounts and books of operators/lessees for the purpose of determining compliance with Federal lease terms relating to Federal royalties may be required annually or...

  5. 40 CFR 68.58 - Compliance audits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... are being followed. (b) The compliance audit shall be conducted by at least one person knowledgeable... the compliance audit and document that deficiencies have been corrected. (e) The owner or operator shall retain the two (2) most recent compliance audit reports. This requirement does not apply to...

  6. 38 CFR 41.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... purpose of reporting an audit finding is in relation to a type of compliance requirement for a major program or an audit objective identified in the compliance supplement. The auditor shall identify... type of compliance requirement for a major program or an audit objective identified in the...

  7. 47 CFR 53.209 - Biennial audit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... necessary to ensure compliance with the audit requirements listed in paragraph (b) of this section. If the... independent auditor to take any actions necessary to ensure compliance with the audit requirements in... 47 Telecommunication 3 2010-10-01 2010-10-01 false Biennial audit. 53.209 Section...

  8. 7 CFR 1948.96 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 13 2010-01-01 2009-01-01 true Audit requirements. 1948.96 Section 1948.96... Program § 1948.96 Audit requirements. (a) Audit requirements for Site Development and Acquisition Grants... funds have been used in compliance with the proposal, any applicable laws and regulations, and the...

  9. 29 CFR 99.230 - Audit costs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... principles circulars, the Federal Acquisition Regulation (FAR)(48 CFR parts 30 and 31), or other applicable... 29 Labor 1 2010-07-01 2010-07-01 true Audit costs. 99.230 Section 99.230 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230...

  10. The Single Audit for School Districts.

    ERIC Educational Resources Information Center

    Robinson, Edward A.; Lilja, John B.

    1983-01-01

    Discusses the Office of Management and Budget's recent requirement that all state and local governments receiving federal grants undergo a single audit (a comprehensive financial and compliance audit conducted by one audit firm or organization) at least once every two years in conjunction with an appropriate federal or state agency. (JBM)

  11. 7 CFR 285.4 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PUERTO RICO § 285.4 Audits. (a) The Commonwealth of Puerto Rico shall provide an audit of expenditures in compliance with the requirements in part 3015 of this title at least once every two years. The findings of such audit shall be reported to FNS no later than 120 days from the end of each fiscal year in...

  12. 32 CFR 37.1325 - Periodic audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Periodic audit. 37.1325 Section 37.1325 National... TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1325 Periodic audit. An audit of... whether the participant as a whole is managing its Federal awards in compliance with the terms of...

  13. 29 CFR 99.510 - Audit findings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... for the purpose of reporting an audit finding is in relation to a type of compliance requirement for a major program or an audit objective identified in the compliance supplement. The auditor shall identify... type of compliance requirement for a major program or an audit objective identified in the...

  14. 28 CFR 33.51 - Audit.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Audit. 33.51 Section 33.51 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Additional Requirements § 33.51 Audit. Pursuant to Office of Management and Budget Circular A-128 “Audits...

  15. 24 CFR 511.74 - Audit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATION GRANT PROGRAM Grant Administration § 511.74 Audit. The... audits in accordance with 24 CFR part 44. ... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Audit. 511.74 Section 511.74...

  16. 24 CFR 511.74 - Audit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATON GRANT PROGRAM Grant Administration § 511.74 Audit. The... audits in accordance with 24 CFR part 44. ... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Audit. 511.74 Section 511.74...

  17. 24 CFR 511.74 - Audit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATION GRANT PROGRAM Grant Administration § 511.74 Audit. The... audits in accordance with 24 CFR part 44. ... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Audit. 511.74 Section...

  18. 24 CFR 511.74 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATON GRANT PROGRAM Grant Administration § 511.74 Audit. The... audits in accordance with 24 CFR part 44. ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Audit. 511.74 Section...

  19. 24 CFR 511.74 - Audit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATION GRANT PROGRAM Grant Administration § 511.74 Audit. The... audits in accordance with 24 CFR part 44. ... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Audit. 511.74 Section...

  20. 12 CFR 917.7 - Audit committees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... internal auditor and that the internal auditor may be removed only with the approval of the audit committee; (ii) Provide that the internal auditor shall report directly to the audit committee on substantive matters and that the internal auditor is ultimately accountable to the audit committee and board...

  1. 10 CFR 835.102 - Internal audits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of...

  2. 12 CFR 620.30 - Audit committees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of this chapter. (3) Internal controls. Each audit committee must oversee the institution's system of... institution's compliance with applicable laws and regulations. Any internal audit functions of the institution... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Audit committees. 620.30 Section 620.30...

  3. 10 CFR 835.102 - Internal audits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of...

  4. 12 CFR 1273.9 - Audit Committee.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... internal audit activities, including the selection, evaluation, compensation and, where appropriate, replacement of the internal auditor. The internal auditor shall report directly to the Audit Committee and... board of directors and the internal and external auditors. (12) The Audit Committee shall conduct...

  5. 7 CFR 3052.505 - Audit reporting.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... § 3052.510(a). (i) Audit findings (e.g., internal control findings, compliance findings, questioned...

  6. 12 CFR 917.7 - Audit committees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... internal auditor and that the internal auditor may be removed only with the approval of the audit committee; (ii) Provide that the internal auditor shall report directly to the audit committee on substantive matters and that the internal auditor is ultimately accountable to the audit committee and board...

  7. 29 CFR 99.505 - Audit reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... 29 Labor 1 2014-07-01 2013-07-01 true Audit reporting. 99.505 Section 99.505 Labor Office of...

  8. 32 CFR 34.16 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... independent audit is intended to ascertain the adequacy of the recipient's internal financial management... awards shall have an audit made for that year by an independent auditor, in accordance with paragraph (b) of this section. The audit generally should be made a part of the regularly scheduled, annual...

  9. 10 CFR 835.102 - Internal audits.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of...

  10. 32 CFR 34.16 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... independent audit is intended to ascertain the adequacy of the recipient's internal financial management... awards shall have an audit made for that year by an independent auditor, in accordance with paragraph (b) of this section. The audit generally should be made a part of the regularly scheduled, annual...

  11. 29 CFR 99.505 - Audit reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... 29 Labor 1 2013-07-01 2013-07-01 false Audit reporting. 99.505 Section 99.505 Labor Office of...

  12. 38 CFR 41.505 - Audit reporting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... internal control were disclosed by the audit of the financial statements and whether any such conditions... reportable conditions in internal control over major programs were disclosed by the audit and whether any... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Audit reporting....

  13. 12 CFR 620.30 - Audit committees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of this chapter. (3) Internal controls. Each audit committee must oversee the institution's system of... institution's compliance with applicable laws and regulations. Any internal audit functions of the institution... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Audit committees. 620.30 Section 620.30...

  14. 38 CFR 41.505 - Audit reporting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... internal control were disclosed by the audit of the financial statements and whether any such conditions... reportable conditions in internal control over major programs were disclosed by the audit and whether any... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Audit reporting....

  15. 7 CFR 3052.505 - Audit reporting.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... § 3052.510(a). (i) Audit findings (e.g., internal control findings, compliance findings, questioned...

  16. 7 CFR 3052.505 - Audit reporting.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... § 3052.510(a). (i) Audit findings (e.g., internal control findings, compliance findings, questioned...

  17. 10 CFR 835.102 - Internal audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of...

  18. 29 CFR 99.505 - Audit reporting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... 29 Labor 1 2011-07-01 2011-07-01 false Audit reporting. 99.505 Section 99.505 Labor Office of...

  19. 38 CFR 41.505 - Audit reporting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... internal control were disclosed by the audit of the financial statements and whether any such conditions... reportable conditions in internal control over major programs were disclosed by the audit and whether any... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Audit reporting....

  20. 38 CFR 41.505 - Audit reporting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... internal control were disclosed by the audit of the financial statements and whether any such conditions... reportable conditions in internal control over major programs were disclosed by the audit and whether any... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Audit reporting....

  1. 29 CFR 99.505 - Audit reporting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... 29 Labor 1 2012-07-01 2012-07-01 false Audit reporting. 99.505 Section 99.505 Labor Office of...

  2. 7 CFR 3052.505 - Audit reporting.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... reportable conditions in internal control were disclosed by the audit of the financial statements and whether... that reportable conditions in internal control over major programs were disclosed by the audit and... § 3052.510(a). (i) Audit findings (e.g., internal control findings, compliance findings, questioned...

  3. 32 CFR 34.16 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... independent audit is intended to ascertain the adequacy of the recipient's internal financial management... awards shall have an audit made for that year by an independent auditor, in accordance with paragraph (b) of this section. The audit generally should be made a part of the regularly scheduled, annual...

  4. 49 CFR 237.151 - Audits; general.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Audits; general. 237.151 Section 237.151 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Documentation, Records, and Audits of Bridge Management Programs § 237.151 Audits; general....

  5. 49 CFR 237.151 - Audits; general.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Audits; general. 237.151 Section 237.151 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Documentation, Records, and Audits of Bridge Management Programs § 237.151 Audits; general....

  6. 10 CFR 835.102 - Internal audits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of...

  7. 20 CFR 416.2220 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in the Federal Procurement Regulations (41 CFR parts 1-20). (b) Audit basis. Auditing will be based... unless the State VR agency appeals that decision in writing in accordance with 45 CFR part 16 to the... Payments for Vocational Rehabilitation Services Administrative Provisions § 416.2220 Audits. (a)...

  8. 20 CFR 656.20 - Audit procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit procedures. 656.20 Section 656.20... FOR PERMANENT EMPLOYMENT OF ALIENS IN THE UNITED STATES Labor Certification Process § 656.20 Audit procedures. (a) Review of the labor certification application may lead to an audit of the...

  9. 20 CFR 601.9 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROCEDURE Grants, Advances and Audits § 601.9 Audits. The Department of Labor's audit regulations at 29 CFR Part 96 and 29 CFR Part 99 shall apply with respect to employment service and unemployment compensation programs....

  10. 7 CFR 277.17 - Audit requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Audit requirements. 277.17 Section 277.17 Agriculture... FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PAYMENTS OF CERTAIN ADMINISTRATIVE COSTS OF STATE AGENCIES § 277.17 Audit requirements. (a) General. This section sets forth the audit requirements for...

  11. 20 CFR 404.2120 - Audits.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in the Federal Procurement Regulations (41 CFR parts 1-20). (b) Audit basis. Auditing will be based... unless the State VR agency appeals that decision in writing in accordance with 45 CFR part 16 to the...- ) Payments for Vocational Rehabilitation Services Administrative Provisions § 404.2120 Audits. (a)...

  12. 28 CFR 31.201 - Audit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Audit. 31.201 Section 31.201 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Formula Grants General Requirements § 31.201 Audit. The State must assure that it adheres to the audit requirements enumerated in the “Financial...

  13. 43 CFR 3597.2 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... INTERIOR MINERALS MANAGEMENT (3000) SOLID MINERALS (OTHER THAN COAL) EXPLORATION AND MINING OPERATIONS Production Records § 3597.2 Audits. (a) An audit of the operator's/lessee's accounts and books may be made or... Federal Regulations. (b) An audit of the operator's/lessee's accounts and production records by...

  14. 10 CFR 71.137 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Audits. 71.137 Section 71.137 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Quality Assurance § 71.137 Audits... the area audited. Followup action, including reaudit of deficient areas, must be taken where indicated....

  15. 10 CFR 71.137 - Audits.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Audits. 71.137 Section 71.137 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Quality Assurance § 71.137 Audits... the area audited. Followup action, including reaudit of deficient areas, must be taken where indicated....

  16. 10 CFR 71.137 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Audits. 71.137 Section 71.137 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Quality Assurance § 71.137 Audits... the area audited. Followup action, including reaudit of deficient areas, must be taken where indicated....

  17. 42 CFR 457.236 - Audits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Audits. 457.236 Section 457.236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE... Federal Medical Payments § 457.236 Audits. The CHIP agency must assure appropriate audit of records...

  18. 42 CFR 457.236 - Audits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Audits. 457.236 Section 457.236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE... Federal Medical Payments § 457.236 Audits. The CHIP agency must assure appropriate audit of records...

  19. 42 CFR 457.236 - Audits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Audits. 457.236 Section 457.236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE... Federal Medical Payments § 457.236 Audits. The CHIP agency must assure appropriate audit of records...

  20. 38 CFR 41.230 - Audit costs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., the Federal Acquisition Regulation (FAR) (48 CFR parts 30 and 31), or other applicable cost principles... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Audit costs. 41.230... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.230 Audit costs. (a)...